Fire Hydrant of Freedom
Politics, Religion, Science, Culture and Humanities => Science, Culture, & Humanities => Topic started by: Crafty_Dog on November 01, 2006, 05:37:18 AM
-
How depressing, how utterly unjust, to be the one in your social circle who is aging least gracefully.
Jim Wilson/The New York Times
Mike Linksvayer, 36, on a low-calorie diet for six years, is 6 feet and 135 pounds, and his blood pressure is 112 over 63.
In a laboratory at the Wisconsin National Primate Research Center, Matthias is learning about time?s caprice the hard way. At 28, getting on for a rhesus monkey, Matthias is losing his hair, lugging a paunch and getting a face full of wrinkles.
Yet in the cage next to his, gleefully hooting at strangers, one of Matthias?s lab mates, Rudy, is the picture of monkey vitality, although he is slightly older. Thin and feisty, Rudy stops grooming his smooth coat just long enough to pirouette toward a proffered piece of fruit.
Tempted with the same treat, Matthias rises wearily and extends a frail hand. ?You can really see the difference,? said Dr. Ricki Colman, an associate scientist at the center who cares for the animals.
What a visitor cannot see may be even more interesting. As a result of a simple lifestyle intervention, Rudy and primates like him seem poised to live very long, very vital lives.
This approach, called calorie restriction, involves eating about 30 percent fewer calories than normal while still getting adequate amounts of vitamins, minerals and other nutrients. Aside from direct genetic manipulation, calorie restriction is the only strategy known to extend life consistently in a variety of animal species.
How this drastic diet affects the body has been the subject of intense research. Recently, the effort has begun to bear fruit, producing a steady stream of studies indicating that the rate of aging is plastic, not fixed, and that it can be manipulated.
In the last year, calorie-restricted diets have been shown in various animals to affect molecular pathways likely to be involved in the progression of Alzheimer?s disease, diabetes, heart disease, Parkinson?s disease and cancer. Earlier this year, researchers studying dietary effects on humans went so far as to claim that calorie restriction may be more effective than exercise at preventing age-related diseases.
Monkeys like Rudy seem to be proving the thesis. Recent tests show that the animals on restricted diets, including Canto and Eeyore, two other rhesus monkeys at the primate research center, are in indisputably better health as they near old age than Matthias and other normally fed lab mates like Owen and Johann. The average lifespan for laboratory monkeys is 27.
The findings cast doubt on long-held scientific and cultural beliefs regarding the inevitability of the body?s decline. They also suggest that other interventions, which include new drugs, may retard aging even if the diet itself should prove ineffective in humans. One leading candidate, a newly synthesized form of resveratrol ? an antioxidant present in large amounts in red wine ? is already being tested in patients. It may eventually be the first of a new class of anti-aging drugs. Extrapolating from recent animal findings, Dr. Richard A. Miller, a pathologist at the University of Michigan, estimated that a pill mimicking the effects of calorie restriction might increase human life span to about 112 healthy years, with the occasional senior living until 140, though some experts view that projection as overly optimistic.
According to a report by the Rand Corporation, such a drug would be among the most cost-effective breakthroughs possible in medicine, providing Americans more healthy years at less expense (an estimated $8,800 a year) than new cancer vaccines or stroke treatments.
?The effects are global, so calorie restriction has the potential to help us identify anti-aging mechanisms throughout the body,? said Richard Weindruch, a gerontologist at the University of Wisconsin who directs research on the monkeys.
Many scientists regard the study of life extension, once just a reliable plotline in science fiction, as a national priority. The number of Americans 65 and older will double in the next 25 years to about 72 million, according to government census data. By then, seniors will account for nearly 20 percent of the population, up from just 12 percent in 2003.
Earlier this year, four prominent gerontologists, among them Dr. Miller, published a paper calling for the government to spend $3 billion annually in pursuit of a modest goal: delaying the onset of age-related diseases by seven years.
Doing so, the authors asserted, would lay the foundation for a healthier and wealthier country, a so-called longevity dividend.
?The demographic wave entering their 60s is enormous, and that is likely to greatly increase the prevalence of diseases like diabetes and heart disease,? said Dr. S. Jay Olshansky, an epidemiologist at the University of Illinois at Chicago, and one of the paper?s authors. ?The simplest way to positively affect them all is to slow down aging.?
Science, of course, is still a long way from doing anything of the sort. Aging is a complicated phenomenon, the intersection of an array of biological processes set in motion by genetics, lifestyle, even evolution itself.
Still, in laboratories around the world, scientists are becoming adept at breeding animal Methuselahs, extraordinarily long lived and healthy worms, fish, mice and flies.
In 1935, Dr. Clive McCay, a nutritionist at Cornell University, discovered that mice that were fed 30 percent fewer calories lived about 40 percent longer than their free-grazing laboratory mates. The dieting mice were also more physically active and far less prone to the diseases of advanced age.
Dr. McCay?s experiment has been successfully duplicated in a variety of species. In almost every instance, the subjects on low-calorie diets have proven to be not just longer lived, but also more resistant to age-related ailments.
?In mice, calorie restriction doesn?t just extend life span,? said Leonard P. Guarente, professor of biology at the Massachusetts Institute of Technology. ?It mitigates many diseases of aging: cancer, cardiovascular disease, neurodegenerative disease. The gain is just enormous.?
Page 2 of 3)
For years, scientists financed by the National Institute on Aging have closely monitored rhesus monkeys on restricted and normal-calorie diets. At the University of Wisconsin, where 50 animals survive from the original group of 76, the differences are just now becoming apparent in the older animals.
Those on normal diets, like Matthias, are beginning to show signs of advancing age similar to those seen in humans. Three of them, for instance, have developed diabetes, and a fourth has died of the disease. Five have died of cancer.
But Rudy and his colleagues on low-calorie meal plans are faring better. None have diabetes, and only three have died of cancer. It is too early to know if they will outlive their lab mates, but the dieters here and at the other labs also have lower blood pressure and lower blood levels of certain dangerous fats, glucose and insulin.
?The preliminary indicators are that we?re looking at a robust life extension in the restricted animals,? Dr. Weindruch said.
Despite widespread scientific enthusiasm, the evidence that calorie restriction works in humans is indirect at best. The practice was popularized in diet books by Dr. Roy Walford, a legendary pathologist at the University of California, Los Angeles, who spent much of the last 30 years of his life following a calorie-restricted regimen. He died of Lou Gehrig?s disease in 2004 at 79.
Largely as a result of his advocacy, several thousand people are now on calorie-restricted diets in the United States, says Brian M. Delaney, president of the Calorie Restriction Society.
Mike Linksvayer, a 36-year-old chief technology officer at a San Francisco nonprofit group, embarked on just such a diet six years ago. On an average day, he eats an apple or some cereal for breakfast, followed by a small vegan dish at lunch. Dinner is whatever his wife has cooked, excluding bread, rice, sugar and whatever else Mr. Linksvayer deems unhealthy (this often includes the entr?e). On weekends, he occasionally fasts.
Mr. Linksvayer, 6 feet tall and 135 pounds, estimated that he gets by on about 2,000 to 2,100 calories a day, a low number for men of his age and activity level, and his blood pressure is a remarkably low 112 over 63. He said he has never been in better health.
?I don?t really get sick,? he said. ?Mostly I do the diet to be healthier, but if it helps me live longer, hey, I?ll take that, too.?
Researchers at Washington University in St. Louis have been tracking the health of small groups of calorie-restricted dieters. Earlier this year, they reported that the dieters had better-functioning hearts and fewer signs of inflammation, which is a precursor to clogged arteries, than similar subjects on regular diets.
In previous studies, people in calorie-restricted groups were shown to have lower levels of LDL, the so-called bad cholesterol, and triglycerides. They also showed higher levels of HDL, the so-called good cholesterol, virtually no arterial blockage and, like Mr. Linksvayer, remarkably low blood pressure.
?Calorie restriction has a powerful, protective effect against diseases associated with aging,? said Dr. John O. Holloszy, a Washington University professor of medicine. ?We don?t know how long each individual will end up living, but they certainly have a longer life expectancy than average.?
Researchers at Louisiana State University reported in April in The Journal of the American Medical Association that patients on an experimental low-calorie diet had lower insulin levels and body temperatures, both possible markers of longevity, and fewer signs of the chromosomal damage typically associated with aging.
These studies and others have led many scientists to believe they have stumbled onto a central determinant of natural life span. Animals on restricted diets seem particularly resistant to environmental stresses like oxidation and heat, perhaps even radiation. ?It is a very deep, very important function,? Dr. Miller said. Experts theorize that limited access to energy alarms the body, so to speak, activating a cascade of biochemical signals that tell each cell to direct energy away from reproductive functions, toward repair and maintenance. The calorie-restricted organism is stronger, according to this hypothesis, because individual cells are more efficiently repairing mutations, using energy, defending themselves and mopping up harmful byproducts like free radicals.
?The stressed cell is really pulling out all the stops? to preserve itself, said Dr. Cynthia Kenyon, a molecular biologist at the University of California, San Francisco. ?This system could have evolved as a way of letting animals take a timeout from reproduction when times are harsh.?
But many experts are unsettled by the prospect, however unlikely, of Americans adopting a draconian diet in hopes of living longer. Even the current epidemiological data, they note, do not consistently show that those who are thinnest live longest. After analyzing decades of national mortality statistics, federal researchers reported last year that exceptional thinness, a logical consequence of calorie restriction, was associated with an increased risk of death. This controversial study did not attempt to assess the number of calories the subjects had been consuming, or the quality of their diets, which may have had an effect on mortality rates.
Page 2 of 3)
For years, scientists financed by the National Institute on Aging have closely monitored rhesus monkeys on restricted and normal-calorie diets. At the University of Wisconsin, where 50 animals survive from the original group of 76, the differences are just now becoming apparent in the older animals.
Skip to next paragraph
Southern Illinois University School of Medicine
In a longevity study at Southern Illinois University the top mouse was fed a calorie-restricted diet, and the one below a normal diet. Both are 28 months old.
Multimedia
Graphic
Calorie Restriction vs. Normal Diet
Readers? Opinions
Forum: Fitness and Nutrition
Those on normal diets, like Matthias, are beginning to show signs of advancing age similar to those seen in humans. Three of them, for instance, have developed diabetes, and a fourth has died of the disease. Five have died of cancer.
But Rudy and his colleagues on low-calorie meal plans are faring better. None have diabetes, and only three have died of cancer. It is too early to know if they will outlive their lab mates, but the dieters here and at the other labs also have lower blood pressure and lower blood levels of certain dangerous fats, glucose and insulin.
?The preliminary indicators are that we?re looking at a robust life extension in the restricted animals,? Dr. Weindruch said.
Despite widespread scientific enthusiasm, the evidence that calorie restriction works in humans is indirect at best. The practice was popularized in diet books by Dr. Roy Walford, a legendary pathologist at the University of California, Los Angeles, who spent much of the last 30 years of his life following a calorie-restricted regimen. He died of Lou Gehrig?s disease in 2004 at 79.
Largely as a result of his advocacy, several thousand people are now on calorie-restricted diets in the United States, says Brian M. Delaney, president of the Calorie Restriction Society.
Mike Linksvayer, a 36-year-old chief technology officer at a San Francisco nonprofit group, embarked on just such a diet six years ago. On an average day, he eats an apple or some cereal for breakfast, followed by a small vegan dish at lunch. Dinner is whatever his wife has cooked, excluding bread, rice, sugar and whatever else Mr. Linksvayer deems unhealthy (this often includes the entr?e). On weekends, he occasionally fasts.
Mr. Linksvayer, 6 feet tall and 135 pounds, estimated that he gets by on about 2,000 to 2,100 calories a day, a low number for men of his age and activity level, and his blood pressure is a remarkably low 112 over 63. He said he has never been in better health.
?I don?t really get sick,? he said. ?Mostly I do the diet to be healthier, but if it helps me live longer, hey, I?ll take that, too.?
Researchers at Washington University in St. Louis have been tracking the health of small groups of calorie-restricted dieters. Earlier this year, they reported that the dieters had better-functioning hearts and fewer signs of inflammation, which is a precursor to clogged arteries, than similar subjects on regular diets.
In previous studies, people in calorie-restricted groups were shown to have lower levels of LDL, the so-called bad cholesterol, and triglycerides. They also showed higher levels of HDL, the so-called good cholesterol, virtually no arterial blockage and, like Mr. Linksvayer, remarkably low blood pressure.
?Calorie restriction has a powerful, protective effect against diseases associated with aging,? said Dr. John O. Holloszy, a Washington University professor of medicine. ?We don?t know how long each individual will end up living, but they certainly have a longer life expectancy than average.?
Researchers at Louisiana State University reported in April in The Journal of the American Medical Association that patients on an experimental low-calorie diet had lower insulin levels and body temperatures, both possible markers of longevity, and fewer signs of the chromosomal damage typically associated with aging.
These studies and others have led many scientists to believe they have stumbled onto a central determinant of natural life span. Animals on restricted diets seem particularly resistant to environmental stresses like oxidation and heat, perhaps even radiation. ?It is a very deep, very important function,? Dr. Miller said. Experts theorize that limited access to energy alarms the body, so to speak, activating a cascade of biochemical signals that tell each cell to direct energy away from reproductive functions, toward repair and maintenance. The calorie-restricted organism is stronger, according to this hypothesis, because individual cells are more efficiently repairing mutations, using energy, defending themselves and mopping up harmful byproducts like free radicals.
?The stressed cell is really pulling out all the stops? to preserve itself, said Dr. Cynthia Kenyon, a molecular biologist at the University of California, San Francisco. ?This system could have evolved as a way of letting animals take a timeout from reproduction when times are harsh.?
But many experts are unsettled by the prospect, however unlikely, of Americans adopting a draconian diet in hopes of living longer. Even the current epidemiological data, they note, do not consistently show that those who are thinnest live longest. After analyzing decades of national mortality statistics, federal researchers reported last year that exceptional thinness, a logical consequence of calorie restriction, was associated with an increased risk of death. This controversial study did not attempt to assess the number of calories the subjects had been consuming, or the quality of their diets, which may have had an effect on mortality rates.
-
Marc,
page 3 is missing, page 2 double.
"Even the current epidemiological data, they note, do not consistently show that those who are thinnest live longest. After analyzing decades of national mortality statistics, federal researchers reported last year that exceptional thinness, a logical consequence of calorie restriction, was associated with an increased risk of death."
I would like to the point that the thinnest might have no muscles, low basal metabolic rate, no exercise. So - why should they live longer? Low calories? - What is low?
I think that low body fat should be the goal - sometimes calories are necessary to keep your muscles well and alive. "On weekends, he occasionally fasts" - which will make him loose muscle mass, as he has no body fat. Even if he had, muscle energy gets lost first.
Calorie restriction alone will not do it. You have to know when and where.
-
http://www.latimes.com/features/health/la-he-cholesterol6nov06,1,4868473,full.story?coll=la-headlines-health
A better number?
We obsess over bad cholesterol levels, but when it comes to heart disease risk, good cholesterol may be more important. Next up: New treatments.
By Shari Roan
Times Staff Writer
November 6, 2006
FOR the last two decades, a fear of bad cholesterol has gripped Americans. We've measured it, compared it, worried about it and doused it with statins, now among the bestselling drugs of all time.
But hovering on the sidelines has been another type of cholesterol ? HDL, the good kind, also known as high-density lipoprotein. HDL cholesterol doesn't get anywhere near the attention of its bad LDL twin (low-density lipoprotein). But now it may be poised to receive the respect it deserves.
Recent research suggests that HDL may actually be the more important player of the two in raising or lowering heart disease risk. And as the 20th anniversary of the first cholesterol-lowering statin draws close, a new heart disease deterrent is ready to leap onto the stage: the first drug to substantially raise good cholesterol.
If approved, it could usher in a radically new era in the battle against the No. 1 killer of Americans, responsible for 37% of adult deaths in the United States every year.
In fact, by simultaneously tinkering with good and bad ? giving medications in tandem to alter both HDL and LDL ? doctors may finally have the potent one-two punch against heart disease they have long been searching for.
"We've taken LDL management as far as we can go," says Dr. Prediman K. Shah, director of the division of cardiology and the Atherosclerosis Research Center at Cedars-Sinai Medical Center. "Everyone is on the bandwagon that HDL is the next frontier for atherosclerosis management."
Interest in raising HDL cholesterol has been growing in recent years for several reasons. Chiefly, researchers have discovered that HDL prevents or reduces the build-up of plaque in artery walls and appears to be a significant cardiovascular risk factor independent of whether LDL is high or low.
But doctors have long known that LDL cannot be the whole story. Statins, for example, lower LDL cholesterol 30% to 40% and reduce heart attack and stroke rates by about the same amount ? but most doctors can remember patients who dutifully lowered their LDL and still suffered heart attacks or strokes.
"Even with 30% to 40% reduction, we have not eliminated cardiovascular disease," says Dr. William Averill, a cardiologist and past president of the Los Angeles division of the American Heart Assn.
Doctors also know people who have too-high LDL but never succumb to cardiac trouble ? perhaps, in some cases, because their high HDL is protecting them.
The interest in HDL cholesterol is also, to some extent, market-driven. Many drug companies have blockbuster statin drugs with patents that are expiring, and they're searching for ways to reignite the market for treating cardiovascular disease.
In this case, however, market forces and the quest for better heart health may happily align.
When arteries clog
Cholesterol is a type of fat known as a lipid that helps many types of body cells function. The liver manufactures most of what the body needs; the rest is obtained through diet.
The lipid uses a two-way street to travel through the bloodstream: LDL particles are carried from the liver to body cells; HDL particles move in reverse, returning extra cholesterol to the liver for disposal.
When too much LDL is in the blood, it can accumulate along the artery walls, forming the hard plaque deposits that lead to heart attacks. Statins help fight this traffic pileup.
Until the last decade or so, the role of HDL cholesterol in this process was largely overlooked.
"We've had a blind spot about HDL," says Dr. William Tierney, Chancellor's Professor of Medicine at Indiana University School of Medicine and author of a recent study highlighting the importance of HDL levels. "I think that's because we're used to focusing on the bad risk factors. As physicians we think, what can we fix? We fix something that is broken."
But evidence for HDL's benefits has been accumulating in recent years and can no longer be ignored. Animal studies and lab research on cells show that HDL has properties that reduce tissue inflammation and blood clotting and improve blood vessel function.
Additional research has found that the risk of heart disease is lower in people with higher levels of HDL and that tinkering with HDL may give patients more bang for their buck. Studies suggest that reducing LDL by 1 milligram per deciliter cuts cardiovascular risk by 1% ? but raising HDL by 1 mg/dl reduces risk by 2% to 3%.
Tierney's study, published in March in the American Heart Journal, examined 7,000 individuals who had two or more cholesterol measurements between 1985 and 1997. The scientists found that for every 10 mg/dl increase in the HDL level, there was an 11% decrease in heart attacks and other so-called acute coronary events.
In contrast, changes in the subjects' blood LDL levels, or in levels of lipids known as triglycerides (also heart disease risk factors) did not decrease the risk of heart attack or stroke.
"If you believe our research, HDL turns out to be the more important of the two," Tierney says.
Based on the science so far, the National Cholesterol Education Program (a federally funded group that issues guidelines) categorizes people as being at high risk for heart disease if their HDL is less than 40 mg/dl in men and less than 50 mg/dl in women. A level of 60 or higher is considered protective.
About 30% of American adults who have heart disease have sub-optimal HDL as their "dominant abnormality," says Shah ? in other words, low HDL is their most glaring risk factor for heart trouble.
Low HDL is more common in non-hispanic white and Mexican American men than in women or other ethnic groups. But as obesity rates and the incidence of diabetes have risen, HDL levels appear to be declining throughout the population.
Renewed interest in niacin
There are a number of measures that people or doctors can take to ramp up HDL levels. Lifestyle changes, such as a healthful diet and exercise, can boost HDL slightly ? and even small changes can lower heart disease risk (see sidebar). So can statins and drugs called fibrates.
Niacin, also known as vitamin B3, can raise HDL substantially. But there has been a significant problem with this remedy: It can cause intense itching and facial and upper-body flushing.
"Niacin is the most effective HDL drug available. But the problem is that only about 70% of people can take it because of the major side effects," Shah says.
Now, however, Merck & Co. is in the late stages of testing a pill that combines extended-release niacin with a drug called a prostaglandin D2 blocker that prevents flushing. Early studies suggest the drug may raise HDL 20% to 30%, says Dr. Yale Mitchel, executive director for clinical research at Merck.
The company plans to seek permission from the Food and Drug Administration to market the pill, called MK-0524A, next year, Mitchel says.
"I think if [Merck's] strategy proves to be true and effective that would revive interest in niacin," Shah says.
The company is also testing the niacin and prostaglandin D2 blocker in combination with a statin. And it is conducting an international study of 20,000 people to see if MK-0524A reduces cardiovascular events in high-risk people who have already lowered their LDL cholesterol with a statin. This study may be the first to show if raising HDL can truly reduce heart attacks, strokes and deaths even after LDL has been controlled.
"We think this study is critical," Mitchel says. That's because so far, the belief that raising HDL can slash heart disease risk is based on observational studies, ones in which populations of people have simply been observed.
To truly test the idea, a clinical trial is needed in which HDL is raised with drugs (after LDL has already been lowered) and the effect on heart disease is carefully monitored.
That gold-standard clinical trial hasn't been possible before now, Mitchel says, for one principal reason. "We haven't had drugs to raise HDL and test the hypothesis."
Other researchers are focusing on new drugs to improve levels of HDL. One approach evolved after a discovery about 15 years ago of a group of people in Japan who have a genetic mutation that causes high levels of HDL. The people, who have a low incidence of heart disease, lack an enzyme called CETP (cholesteryl ester transfer protein) that is responsible for transferring cholesterol from HDL particles to LDL particles.
Several drug companies are working on oral drugs that block CETP and would thus raise HDL in patients. Torcetrapib, under development at Pfizer Inc., is furthest along. In a small 2004 study of 19 patients with low HDL, torcetrapib raised HDL levels by 46%. It boosted them higher, by 61%, in people receiving torcetrapib plus the statin atorvastatin (Lipitor).
Questions remain about the drug. It may, for one thing, increase blood pressure, Shah says, undermining its benefit to the heart. And even if it raises HDL, that doesn't necessarily mean it will reduce heart disease for certain.
"It may lead to a form of HDL that is dysfunctional. You may get a lot of HDL but it doesn't do anything. That is a concern that has been raised," Shah says.
Heart disease experts are anticipating the results of the company's Phase 3 clinical trials, expected early next year. These will gauge the medicine's effects on heart disease, measuring whether atherosclerotic plaque is reduced.
If the findings are promising, Pfizer could seek approval to sell torcetrapib in combination with Lipitor, its bestselling statin drug, next year or in 2008.
The company recently bowed to public pressure and announced it would also sell torcetrapib alone so that people who don't need a statin (or use statins other than Pfizer's) could benefit from the medication.
Another novel approach to raise HDL ? this one advanced by Shah's studies in animals ? uses high doses of a synthetic type of HDL to diminish plaque buildup. Again, the research stems from observing unusual human beings.
In the 1980s, doctors discovered a small group of people in a picturesque Italian village near Milan who had extraordinarily low levels of HDL but no heart disease. The scientists determined that these people carried a genetic mutation, named ApoA-1 Milano, that gave them a kind of super-charged HDL that is more protective than regular HDL. The gene variant prevents the accumulation of plaque in spite of low HDL levels.
Shah showed that this special HDL could shrink plaque in the arteries of lab animals. That finding was followed by a landmark study published in the Journal of the American Medical Assn. in 2003 that found that five weekly infusions of synthetic ApoA-1 Milano produced a 4.2% decrease in atherosclerotic plaque in people with heart disease.
Several drug companies are working on products based on ApoA-1 Milano. But because it has to be infused into the blood, such a treatment would probably be reserved for people with acute heart disease. "It's not ideally suited for repeat therapy over many years," Shah says.
The discovery of ApoA-1 Milano raises an intriguing question about HDL cholesterol, however. It could be that the quality of HDL is just as important as the quantity, affected by genes or environmental factors that subtly alter its structure and properties. It could be that scientists have just begun to explore the complexities of the good fat that flows through our bloodstreams.
"There is a lot of work going on," Shah says ? work that may uncover new exceptions to any simple test that just measures HDL levels. But for most of us for now, Shah adds, one thing about HDL seems clear: "The more you have, the better off you are."
--------------------------------------------------------------------------------
shari.roan@latimes.com
BOOST YOUR LEVELS
It's more difficult to raise HDL cholesterol than it is to lower LDL. After all, statin drugs alone routinely lower LDL by 30% to 40%. But there are still ways to improve your HDL.
Exercise: Aerobic exercise for 30 minutes several times a week can raise HDL by 3% to 9% in sedentary, healthy people. But you'll have to get your heart rate up. There is little evidence that walking increases HDL.
Quitting smoking: Average increase of 4 milligrams per deciliter.
Weight control: Every 1 kilogram (2.2 pounds) of weight lost raises HDL by average of 0.35 mg/dl.
Alcohol consumption: Mild to moderate drinking (one to two drinks a day) can raise HDL by an average of 4 mg/dl.
Diet: A diet low in trans fatty acids and high in monounsaturated and polyunsaturated fatty acids can raise HDL. Choose oils such as olive, flaxseed and canola; nuts; cold-water fish; and shellfish. Limit high glycemic load foods such as pasta and bread made with refined flour, which can lower HDL.
Niacin therapy: Increases of 20% to 35%.
Fibrate therapy: Increases of 10% to 25%.
Statins: Increases of 2% to 15%.
? Shari Roan
Sources: American Heart Assn.; Dr. William Averill; New England Journal of Medicine
--------------------------------------------------------------------------------
WHO HAS TOO-LOW HDL?
Here are the numbers, as described by the American Heart Assn. (Defined as less than 40 milligrams per deciliter.)
--------------------------------------------------------------------------------
NON-HISPANIC WHITES
Men: 34.5%
Women: 12.4%
NON-HISPANIC BLACKS
Men: 22.7%
Women: 11.3%
MEXICAN-AMERICANS
Men: 34.4%
Women: 15.4%
-
From the weekly Gilder Tech letter:
================================
The Week / Human Health in the Telecosm
Dr. Arthur Robinson, Founder, Oregon Institute of Science and Medicine, speaking at Gilder/Forbes Telecosm 2006 last month in Lake Tahoe (transcribed excerpt):
Something needs to be done in medicine and the entrepreneurs and technologists of the telecosm are the exact people to do it. It involves moving diagnostic medicine into the hands of the consumers?taking the diagnostic and technological tools of medicine and making computer peripherals out of them, as well as making on-person monitors and turning the Internet into an interpretive tool, so that the consumers of medicine can evaluate the product that they receive and medicine itself could be turned into a therapeutic industry competing on the basis of quality and price.
My youngest son Matthew has a dog named Rusty. When Matthew takes Rusty to the veterinarian, the vet can take a blood sample from Rusty, put it in a computer peripheral beside his PC, which costs $1,000, get the analysis in a few minutes, diagnose Rusty, and go on about his business. It measures the same couple of dozen things that would be measured if you went to a physician. Some veterinarians, in fact, send their samples to the local hospital and put them through the same medical devices used for humans.
In any case, the veterinarian can do this for Rusty, but he can?t do this for Matthew. If he measured Matthew?s sample, that would be unlawful. And, if a physician had this device in his office, he also couldn?t use it. That also would be unlawful. The only people allowed to use these devices are working in approved commercial clinical laboratories, and most of those laboratories would not measure a sample if Matthew asked them to do it. But, there is an out. Matthew can measure his own sample. If he does it himself, it is lawful.
Medicine is an odd industry. It is a monopoly that controls not only the product it produces but also the evaluation of its own product. This is a historical result. Initially medicine had very little technology. What was known about medicine resided in the minds of the physicians.
As technology developed for medicine, especially diagnostic technology, this technology involved very expensive machinery and evolved in a time when computers were very expensive. It was just not possible for the people being helped by medicine to handle their own diagnostic work. The industry grew up measuring samples commercially. (It is now about a $100 billion industry.) But, as the monopoly matured, these commercial laboratories disappeared behind the gatekeepers of medicine, so that the individual cannot use high technology or evaluate the product that he is using. Moreover, the technology advances at a slow rate?
The thing that holds back medicine is the quantitative measurement of health. It is necessary to be able to measure quantitatively to make an advance. And yet it is very difficult to do.
Why would you want to do this?
Suppose you could measure the percentage of life remaining to you or at least your physiological age, quantitatively. Things would change. Someone may tell you you?ll live longer if you eat more Vitamin E or exercise or eat your veggies. You can do those things and have the opportunity to go back and re-measure to see if these life style changes have changed your rate of aging either positively or negatively.
The second reason for measuring health quantitatively is the probability of illness. And the third is, if you do get sick, you need to be able to measure your sickness quantitatively.
If you develop cancer and your physician suggests three or four options. What do you do? You pick the one that looks the best and close your eyes and see if you die. It shouldn?t be that way. You should be able to pick a method, watch the rate of growth of the cancer as a function of time, see if it?s improved or made worse by what you are doing, and then modulate and adjust your method of battling the illness?
The greatest amount of information is held in the metabolites, the small molecules found in urine, blood, and saliva that are produced and consumed in the normal course of metabolism. They are where the action is and they are all interlocked in different bio-chemical pathways. You don?t have to measure any specific one. There may be 5,000 of them in there, but if you take a sample of 200, those 200 are carrying information about the other 4,800. For example, 30 percent of the substances in your urine are correlated with your physiological age.
You can obtain tremendous amounts of information by profiling these molecules it is not being done?
Find out how human suffering could be decreased and the human lifespan increased using the technologies of the telecosm. Listen to Dr. Robinson?s complete Telecosm 2006 talk by downloading the MP3 audio file available on: http://www.gildertech.com/public/Telecosm2006/Agenda.htm#health
-
The free audio download will take about 28 minutes to hear. The mp3 file is larger than that because the next presentation is on the same mp3. While you are at the site, if you haven't already, be sure to listen to Carver Mead's keynote address (at the end of the agenda).
-
For those among us with wives/daughters...
The Family Un-Planner
The Bush administration's crazy new HHS appointment.
By Amanda Schaffer (www.salon.com)
Posted Tuesday, Nov. 21, 2006, at 4:50 PM ET
On Monday, the federal office that oversees the nation's family-planning program got a new boss who doesn't believe in birth control. Eric Keroack is a Massachusetts obstetrician-gynecologist who argues that abstinence until marriage is the only healthy choice for women. Until recently, he served as medical director of a pregnancy-counseling organization that runs down contraception and gives out scientifically false health information?for instance, that condoms "offer virtually no protection" against herpes or HPV. Keroack also promotes a wacky piece of pseudoscience: the claim that premarital sex disrupts brain chemistry so as to create a physiological barrier to happy marriage.
Keroack's appointment, as deputy assistant secretary of population affairs within the Department of Health and Human Services, did not require congressional approval. The Bush administration picked him on its own. And women's health advocates, editorial pages, and bloggers, along with Democratic members of Congress, are right to think he's a crazy choice for this job.
The Title X family-planning program, which Keroack will now oversee, has a federal mandate (http://opa.osophs.dhhs.gov/titlex/ofp.html) to provide information and access to birth control, as well as pregnancy tests and counseling. (Patients may receive referrals for abortion, but Title X funds may not be used to pay for the procedure.) The program also offers information and treatment for sexually transmitted diseases and screening for breast and cervical cancer. Title X has been financially squeezed in recent years, but it still funds approximately 4,500 clinics that serve about 5 million patients across the country.
Keroack's professional history suggests a mismatch, to put it mildly, with Title X's goal of educating women about contraception and helping them get it. He has lectured widely (http://kansascity.abstinence.net/details.php) for groups like the National Abstinence Clearinghouse, which disparages the use of birth control and disseminates medical misinformation. The policy statement of the pregnancy-counseling organization he served as medical director for, A Woman's Concern (http://awomansconcern.com/), says:
A Woman's Concern does not distribute, or encourage the use of, contraceptive drugs and devices. ? A Woman's Concern is persuaded that the crass commercialization and distribution of birth control is demeaning to women, degrading of human sexuality, and adverse to human health and happiness.
The statement further claims that widespread availability of birth control, especially for young people, "actually increases (rather than decreases) out-of-wedlock pregnancy and abortion"?a view that flies in the face of persuasive evidence (see www.guttmacher.org/in-the-know/index.html (http://www.guttmacher.org/in-the-know/index.html), www.guttmacher.org/pubs/fb_contr_use.html (http://www.guttmacher.org/pubs/fb_contr_use.html), and www.guttmacher.org/pubs/2006/11/16/or33.pdf (http://www.guttmacher.org/pubs/2006/11/16/or33.pdf)).
Misleading or factually false information about sexual health abounds in the group's educational materials and on its Web site. To disparage the notion of "safe sex" and make the case that abstinence is the only healthy choice, A Woman's Concern teaches (http://awomansconcern.com/rel_safesex.htm) that condoms "only protect against HIV/AIDS 85% of the time, which means you have a 15% chance of contracting it while using a condom." And, lest a patient consider having an abortion, it claims that teens who undergo the procedure "may face an eight times greater risk of contracting breast cancer by age 45."
These claims have been resoundingly discredited. Recent studies show that condom use can substantially reduce the transmission of HPV, herpes, and numerous other STDs. Condoms also dramatically reduce the risk of HIV infection. The research on condoms and HIV transmission that Keroack's group seems to allude to is a report by the National Institutes of Health that found (http://www.hhs.gov/news/press/2001pres/20010720.html) "an 85 percent decrease in risk of HIV transmission" for condom users compared with nonusers (my italics). The twisted version of this statistic touted by A Woman's Concern implies that if 100 kids have sex while using condoms, 15 will become infected with HIV?an absurd suggestion.
As for the purported link between abortion and breast cancer, that old favorite of the pro-life movement was refuted by research published in the New England Journal of Medicine (http://content.nejm.org/cgi/content/short/336/2/81)in 1997. After pro-lifers snuck an ambiguous statement on the topic onto a government Web site in 2002, a scientific panel appointed by the director of the National Cancer Institute knocked it down in 2003. That panel examined all of the available population-based, clinical, and animal data and found no link (http://www.cancer.gov/cancerinfo/ere-workshop-report) between induced abortion and breast cancer. Nor is there a plausible, biological mechanism that would connect abortion to breast cancer. As medical director, Keroack should have known better than to promote this information. That he didn't suggests a willingness to manipulate science to interfere with patients' ability to make informed choices?a willingness to breach the ethics of his profession.
In Keroack's own lectures and writing, he also makes claims designed to scare the bejesus out of kids to convince them to remain abstinent. One pet theory involves the neuropeptide oxytocin, which plays a role in mother-child bonding and social affiliation. Keroack claims that that people who engage in premarital sex experience chronic emotional pain, which lowers their oxytocin levels. This in turn impairs their ability to form healthy relationships down the road. "People who have misused their sexual faculty and become bonded to multiple persons will diminish the power of oxytocin to maintain a permanent bond with an individual," he writes.
Keroack's cites research on oxytocin levels in animals like prairie voles. There are obvious problems in extrapolating from voles to humans, whose brains are much more complex. A handful of human studies show a role for oxytocin in promoting sociability. But there are inconsistencies. One study found that lactating women who had higher plasma levels of oxytocin reported being more sociable. But two others found that women with higher oxytocin levels reported higher relationship distress?precisely the opposite of Keroack's claim. More crucially, there are no data to suggest a causal link between oxytocin levels and marital happiness?or between any of this and premarital sex. Keroack's claim is simply "not borne out by the current evidence," says Jennifer Bartz of Mount Sinai School of Medicine, author of an excellent review article. To be less polite, this is a guy who takes a neuropeptide and a prairie vole and spins from them science fiction.
In his new role, Keroack will have extensive power to shape the kinds of information disseminated to millions of women. He will be able to develop new guidelines for clinics, set priorities, and determine how scarce dollars get spent, says Marilyn Keefe of the National Family Planning and Reproductive Health Association. "We've seen that people in these political slots have a tremendous influence over how programs get implemented," she said. A spokeswoman for the Department of Health and Human Services defended the appointment in an e-mail, stating that "Dr. Keroack is highly qualified and a well-respected physician."
But at a moment when the need for subsidized birth control is rising, and clinics are struggling to pay for basic services?not to mention advances in screening and prevention like the HPV vaccine?a new hire hostile to family planning and accurate medical information is the last thing women need. Keroack has also won props from the Christian right for using ultrasounds in pregnancy counseling. He argues that the images dissuade women from having abortions and that at A Woman's Concern, the number of patients choosing abortions dropped dramatically when the ultrasounds were introduced. So, stay tuned. This innovation, too, may be coming to a publicly funded clinic near you.
-
CAFTA and Dietary Supplements
by Rep. Ron Paul, MD
The House of Representatives is scheduled to vote on the Central
American Free Trade Agreement in the next two weeks, and one
little-known provision of the agreement desperately needs to be
exposed to public view. CAFTA, like the World Trade Organization, may
serve as a forum for restricting or even banning dietary supplements
in the U.S.
The Codex Alimentarius Commission, organized by the United Nations in
the 1960s, is charged with "harmonizing" food and supplement rules
between all nations of the world. Under Codex rules, even basic
vitamins and minerals require a doctor's prescription. The European
Union already has adopted Codex-type regulations, regulations that
will be in effect across Europe later this year. This raises concerns
that the Europeans will challenge our relatively open market for
health supplements in a WTO forum. This is hardly far-fetched, as
Congress already has cravenly changed our tax laws to comply with a
WTO order.
Like WTO, CAFTA increases the possibility that Codex regulations will
be imposed on the American public. Section 6 of CAFTA discusses Codex
as a regulatory standard for nations that join the agreement. If CAFTA
has nothing to do with dietary supplements, as CAFTA supporters claim,
why in the world does it specifically mention Codex?
Unquestionably there has been a slow but sustained effort to regulate
dietary supplements on an international level. WTO and CAFTA are part
of this effort. Passage of CAFTA does not mean your supplements will
be outlawed immediately, but it will mean that another international
trade body will have a say over whether American supplement
regulations meet international standards. And make no mistake about
it, those international standards are moving steadily toward the Codex
regime and its draconian restrictions on health freedom. So the
question is this: Does CAFTA, with its link to Codex, make it more
likely or less likely that someday you will need a doctor's
prescription to buy even simple supplements like Vitamin C? The answer
is clear. CAFTA means less freedom for you, and more control for
bureaucrats who do not answer to American voters.
Pharmaceutical companies have spent billions of dollars trying to get
Washington to regulate your dietary supplements like European
governments do. So far, that effort has failed in America, in part
because of a 1994 law called the Dietary Supplement Health and
Education Act. Big Pharma and the medical establishment hate this Act,
because it allows consumers some measure of freedom to buy the
supplements they want. Americans like this freedom, however ?
especially the health conscious Baby Boomers.
This is why the drug companies support WTO and CAFTA. They see
international trade agreements as a way to do an end run around
American law and restrict supplements through international
regulations.
The largely government-run health care establishment, including the
nominally private pharmaceutical companies, want government to control
the dietary supplement industry ? so that only they can manufacture
and distribute supplements. If that happens, as it already is
happening in Europe, the supplements you now take will be available
only by prescription and at a much higher cost ? if they are available
at all. This alone is sufficient reason for Congress to oppose the
unconstitutional, sovereignty-destroying CAFTA bill.
July 19, 2005
-
Some friends comments:
=======================
Thanks for your input. You may want to check out this page: http://www.healthfreedomusa.org/aboutcodex/propaganda.shtml.
Here is a link to a British documentary on Codex and its implications: http://herballure.com/Special/WeBecomeSilent/QuickTime.html
Also, on its own website, the Codex Alimentarius Commission/FAO states:
================================
Objective 6:
Promoting Maximum Application of Codex Standards
18. As the pre-eminent international standards setting body for food, the CAC has a clear and strategic interest in promoting the maximum use of its standards both for domestic regulation and international trade. (Emphasis mine.)
If you want to read more, here?s a very comprehensive article with dozens of embedded links:
CODEX: WHAT IS IT AND HOW DOES IT AFFECT YOU AND YOUR HEALTH?
http://www4.dr-rath-foundation.org/THE_FOUNDATION/Events/codex-whatisit.html
Best,
Shannara Johnson
Senior Editor
Casey Research
-----Original Message-----
From:
Sent: Tuesday, November 28, 2006 10:55 PM
This article did not make sense to me from a legal perspective (on what authority could Codex take over our laws??), so I did a quick google search. As this is the first I've heard of it, I don't know all the implications or have any informed opinion, but it does seem as though the article you found is in conflict with what's on the fda site, and it seems like a rather large gap of misunderstanding somewhere. http://www.cfsan.fda.gov/~dms/dscodex.html -
We hope the responses below help you understand why the Codex Guidelines for Vitamin and Mineral Food Supplements will not restrict U.S. consumers' access to vitamin and mineral supplements or impose any restrictions that go beyond those established by U.S. law. We also hope the responses help explain why the U.S. participates in the Codex process and how you can keep abreast of Codex activities.
? What is Codex?
? What work has Codex undertaken on vitamin and mineral supplements?
? What is the scope and content of these Guidelines?
? What has been the U.S. position on these Guidelines?
? Why won't these Guidelines restrict U.S. consumers' access to vitamin and mineral supplements?
? The Guidelines also include packaging and labeling provisions for vitamin and mineral food supplement products. Would vitamin and mineral supplements sold in the U.S. be required to comply with these?
? If the U.S. is not trying to harmonize its regulatory framework for dietary supplements with Codex, what are the benefits of our country participating in the process of developing these Codex Guidelines?
? How can I keep abreast of the work of Codex?
What has been the U.S. position on these Guidelines?
The U.S. supports consumer choice and access to dietary supplements that are safe and labeled in a truthful and non-misleading manner. The Dietary Supplement Health and Education Act of 1994 (DSHEA) ensures that a broad array of dietary supplements are available to U.S. consumers. The Codex Guidelines for Vitamin and Mineral Food Supplements do not, in any way, affect the availability of supplement products to U.S. consumers. On the contrary, the absence of science-based Codex guidelines could adversely affect the ability of U.S. manufacturers to compete in the international marketplace.
Why won't these Guidelines restrict U.S. consumers' access to vitamin and mineral supplements?
Some consumers mistakenly believe that with the adoption of the Guidelines on Vitamin and Mineral Food Supplements, the U.S. is required to automatically change its laws and regulations to comply with the international standard. Some have expressed concerns that the World Trade Organization (WTO) and its trade dispute settlement panels may place pressure on the U.S. to change its laws because of international trade agreements such as the Agreement on the Application of Sanitary and Phytosanitary Measures (SPS Agreement), which references Codex as the international organization for food safety standards.
We see no basis for these concerns. First, the DSHEA covers a much broader range of dietary supplements than the vitamin and mineral supplements that are the subject of the Codex Guidelines. Moreover, for supplements covered by these Guidelines, we note the following:
? The SPS Agreement does not require a country to adopt any international standard. Rather, the SPS Agreement provides that members may base their Sanitary and Phytosanitary measures either on international standards, guidelines or recommendations, where they exist, or may establish measures that result in a higher level of protection if there is a scientific justification, or if a country determines it to be appropriate in accord with provisions of the SPS Agreement (SPS Agreement, Article 3(1) and (3)).
? WTO and WTO dispute panels do not have the power to change U.S. law. If a WTO decision in response to a dispute settlement panel is adverse to the U.S., only Congress and the Administration can decide whether to implement the panel recommendation, and, if so, how to implement it.
? For dietary supplements, it is unlikely that another country will accuse the U.S. of imposing a trade barrier for the importation of supplement products into the U.S. marketplace because the U.S. laws and regulations are generally broader in scope and less restrictive than the international standard.
? However, other countries with more restrictive laws and regulations for dietary supplement products than the U.S. may create trade barriers to the importation of products manufactured by the U.S. dietary supplement industry. Thus, the U.S. government's involvement in the setting of international standards can help minimize the potential of trade barriers to U.S products in international trade.
Further, there is no basis for the concern that the Codex Guidelines on Vitamin and Mineral Food Supplements would require dietary supplements be sold as prescription drugs in the United States. First, there is nothing in the Guidelines that suggests that supplements be sold as drugs requiring a prescription. Second, U.S. regulatory agencies are bound by the laws established by Congress, not by Codex standards. Third, because of our generally less restrictive standards, it is unlikely that the trade dispute would be brought against the U.S.
In summary, U.S. consumers' access to a broad array of dietary supplements under DSHEA would not be changed in any way by Codex's adoption of guidelines on vitamin and mineral food supplements.
The Guidelines also include packaging and labeling provisions for vitamin and mineral food supplement products. Would vitamin and mineral supplements sold in the U.S. be required to comply with these?
All Codex standards and related texts are voluntary, and vitamin and mineral food supplement products sold in the U.S. would not be required to comply with provisions that are more restrictive than U.S. law (i.e., DSHEA).
=================
On 11/28/06, > wrote:
I find this essay, from Doug Casey's bi-weekly, WHAT WE NOW KNOW, to be absolutely fascinating. I knew none of this; now, however, I am on alert. I ingest, among other mentioned items, CO-Q 10.
What say those of you who know this matter??
==============================================
A Nutricidal Codex
By Shannara Johnson
Ever heard of the Codex Alimentarius? If not, don't be surprised. It's one of the best-kept "open secrets" of the U.S. government. It's scheduled to take effect on December 21, 2009 , and it may present the greatest disaster for our food supply?and thus for our health?this country has ever seen.
What is the Codex Alimentarius, and how did it come to pass?
In the Austro-Hungarian Empire between 1897 and 1911, a collection of standards and regulations for a wide variety of foods was developed, called the Codex Alimentarius Austriacus . It wasn't legally binding but served as a useful reference for the courts to determine standards for specific foods.
The post-World War II rebirth of the Codex Alimentarius (or short, Codex), however, is much more dubious. To understand the full implications, we need to go back to the history of one huge conglomerate: The Interessengemeinschaft Farben, or IG Farben?a powerful cartel that consisted of German chemical and pharmaceutical companies such as BASF, Bayer, and Hoechst.
IG Farben was, you could say, the corporate arm of the Third Reich. Having lucrative contracts with Hitler's regime, IG Farben produced everything from ammunition to Zyklon B, the nerve gas that was used to kill prisoners in the concentration camps. IG Farben was the single largest donor to Hitler's election campaign? and later the single largest profiteer of World War II.
"Whenever the German Wehrmacht conquered another country, IG Farben followed, systematically taking over the industries of those countries," states the website of the Dr. Rath Health Foundation, a non-profit promoter of natural health. "The U.S. government investigation of the factors that led to the Second World War in 1946 came to the conclusion that without IG Farben the Second World War would simply not have been possible."
Auschwitz, the largest and most infamous German concentration camp, also benefited IG Farben. New, unsafe pharmaceutical drugs and vaccines were liberally tested on Auschwitz prisoners?many of which died during the tests.
Not surprising, the Nuremberg War Crime Tribunal prosecuted 24 IG Farben board members and executives for mass murder, slavery and other crimes against humanity. One of those convicted was Fritz ter Meer, the highest-ranking scientist on the executive board of IG Farben, who was sentenced to seven years in prison (of which he only served four). When asked during trial whether he thought those human experiments had been justified, he answered that "concentration camp prisoners were not subjected to exceptional suffering, because they would have been killed anyway."
In 1955, ter Meer was reinstated as a member of the supervisory board at Bayer and one year later became its chairman. In 1962, together with other executives of BASF, Bayer and Hoechst, he was one of the main architects of the Codex Alimentarius.
"When he got out of jail, he went to his UN buddies," said Dr. Rima Laibow, MD, in a passionate speech at the 2005 conference of the National Association of Nutrition Professionals (NANP). "And he said, '[?] If we take over food worldwide, we have power worldwide.'"
The result was the creation of a trade commission called the Codex Alimentarius Commission, now funded and run by the UN's World Health Organization (WHO) and the Food and Agricultural Organization (FAO).
At its foundation in 1994, the World Trade Organization (WTO) accepted the standards of the Codex?and by the end of 2009, all member countries of the WTO will be required to implement the Codex, "to harmonize the standards" for the global trade of foods.
In the U.S. meanwhile, Congress passed the Dietary Supplements Health and Education Act (DSHEA) in 1994, which defined vitamins, minerals and herbs as foods, therefore not to be regulated by pharmaceutical standards. The Codex Alimentarius would reverse all that. It would treat those dietary supplements not as foods, but as toxins.
"How do you protect somebody from a poison?" asks Laibow. "You use toxicology. You use a science called 'risk assessment.'"
Risk assessment, she explains, works as follows. You take the toxin in question, feed it to lab animals and "determine the dose that kills 50% of them. That's called the LD 50. And you extrapolate what the LD 50 for a human being might be. Then you go down to the other end of the dosage range and you start feeding [little] bits of it to test animals, and you come up with the largest possible dose?the maximum permissible upper limit?that can be fed to an animal before a discernible impact is shown. [?] Then you divide that by 100. [?] And now you've got a safety margin, so you got 1/100 of the largest dose that can be given with no discernible impact."
In other words, classified as toxins, vitamins, minerals and herbs would only be allowed to be marketed in doses that have no discernible impact on anyone. Then why bother taking them?
And that's not all. Where our grocery and health food store shelves are now brimming with supplements, only 18 of them would be on the Codex whitelist. Everything not on the list, such as CoQ10, glucosamine, etc. would be illegal?not as in "prescription-only" illegal, but as in "take it and you go to jail" illegal.
But the mandatory requirements of the Codex will not only concern vitamins and minerals, but all foods. Under Codex rules, nearly all foods must be irradiated. And levels of radiation can be much higher than previously permitted.
While irradiated U.S. foods are currently treated with 1 ? 7.5 kiloGray of radiation, the Codex would lift its already high limit of 10kiloGray?the equivalent of ca. 330 million chest X-rays?"when necessary to achieve a legitimate technological purpose," whatever that may be. Granted, the text says, that the dose of radiation "should not compromise consumer safety or wholesomeness of the food." Note, however, that it says "should," not "shall" (an important legal difference, since "should" is not compulsory).
You buy rBST-free milk? Not much longer, because under the Codex all dairy cows will have to be treated with Monsanto's recombinant bovine growth hormone. All animals used for human consumption will have to be fed antibiotics. Organic standards will be relaxed to include such measures. And did we mention that under the Codex, genetically modified (GM) produce will no longer have to be labeled?
Say good-bye to true organic food, and maybe even food that retains any resemblance of nutritional value.
Moreover, in 2001, twelve hazardous, cancer-causing organic chemicals called POPs (Persistent Organic Pollutants) were unanimously banned by 176 countries, including the United States. Codex Alimentarius will bring back seven of these forbidden substances?such as hexachlorobenzene, dieldrin, and aldrin?to be freely used again. Permitted levels of various chemicals in foods will be upped as well.
What, are they trying to kill us?
Rima Laibow has done the math, she claims, using figures coming directly from the WHO and FAO. And according to those epidemiological projections, she believes that just the Vitamin and Mineral Guideline alone will result in about 3 billion deaths. "1 billion through simple starvation," she says. "But the next 2 billion, they will die from the preventable diseases of under-nutrition."
She calls the new Codex standards "food regulations that are in fact the legalization of mandated toxicity and under-nutrition."
Even if you're thinking of emigrating to Thailand or Guatemala to escape this nutritional holocaust, forget it. Once implemented, the Codex Alimentarius will set food safety standards, rules and regulations for over 160 countries, or 97% of the world's population.
The only way is to fight it before it gets implemented, says Laibow, who is working on just that with a team of lawyers. If you want to help, send an email to your Congressman and/or sign the citizens petition on Laibow's website, www.HealthFreedomUSA.org.
-
Weird shoes for Plantar Fascitis
http://www.zcoil.com:80/ztechnology.cfm
-
Link to :
http://www.functionalmedicine.org/about/whatis.asp
an excerpt…What is Functional Medicine?
Functional medicine is a science-based field of health care that is grounded in the following principles:
Biochemical individuality describes the importance of individual variations in metabolic function that derive from genetic and environmental differences among individuals.
Patient-centered medicine emphasizes "patient care" rather than "disease care," following Sir William Osler’s admonition that "It is more important to know what patient has the disease than to know what disease the patient has."
Dynamic balance of internal and external factors.
Web-like interconnections of physiological factors – an abundance of research now supports the view that the human body functions as an orchestrated network of interconnected systems, rather than individual systems functioning autonomously and without effect on each other. For example, we now know that immunological dysfunctions can promote cardiovascular disease, that dietary imbalances can cause hormonal disturbances, and that environmental exposures can precipitate neurologic syndromes such as Parkinson’s disease.
Health as a positive vitality – not merely the absence of disease.
Promotion of organ reserve as the means to enhance health span.
Functional medicine is anchored by an examination of the core clinical imbalances that underlie various disease conditions. Those imbalances arise as environmental inputs such as diet, nutrients (including air and water), exercise, and trauma are processed by one’s body, mind, and spirit through a unique set of genetic predispositions, attitudes, and beliefs. The fundamental physiological processes include communication, both outside and inside the cell; bioenergetics, or the transformation of food into energy; replication, repair, and maintenance of structural integrity, from the cellular to the whole body level; elimination of waste; protection and defense; and transport and circulation. The core clinical imbalances that arise from malfunctions within this complex system include:
Hormonal and neurotransmitter imbalances
Oxidation-reduction imbalances and mitochondropathy
Detoxification and biotransformational imbalances
Immune imbalances
Inflammatory imbalances
Digestive, absorptive, and microbiological imbalances
Structural imbalances from cellular membrane function to the musculoskeletal system
Imbalances such as these are the precursors to the signs and symptoms by which we detect and label (diagnose) organ system disease. Improving balance – in the patient’s environmental inputs and in the body’s fundamental physiological processes – is the precursor to restoring health and it involves much more than treating the symptoms. Functional medicine is dedicated to improving the management of complex, chronic disease by intervening at multiple levels to address these core clinical imbalances and to restore each patient’s functionality and health. Functional medicine is not a unique and separate body of knowledge. It is grounded in scientific principles and information widely available in medicine today, combining research from various disciplines into highly detailed yet clinically relevant models of disease pathogenesis and effective clinical management.
Functional medicine emphasizes a definable and teachable process of integrating multiple knowledge bases within a pragmatic intellectual matrix that focuses on functionality at many levels, rather than a single treatment for a single diagnosis. Functional medicine uses the patient’s story as a key tool for integrating diagnosis, signs and symptoms, and evidence of clinical imbalances into a comprehensive approach to improve both the patient’s environmental inputs and his or her physiological function. It is a clinician’s discipline, and it directly addresses the need to transform the practice of primary care.
"What is Functional Medicine?" Click here to download a printer-friendly summary.
-
Published: December 7, 2006
NY Times
HE had not expected to spend his 60th birthday in a hospital cardiac unit. R. J. Turner, a commercial real estate broker from Frederick County, Va., had planned a robust celebration. “I was going to finish my 10th marathon,” Mr. Turner said, “which isn’t bad for a guy my age.”
Skip to next paragraph
Heather Bancroft/George Washington University
With him is Dr. Frederick C. Lough, director of cardiac surgery at George Washington University Hospital and himself a runner.
But near the start of the Marine Corps Marathon on Oct. 29, Mr. Turner raised an arm to wave at bystanders, and “everything went black.” Collapsing violently, he gashed his head, chipped a tooth and bit a deep hole in his bottom lip.
Mr. Turner, who had passed a stress test a year before, had just had a heart attack.
This has been an unusual season for the cardiac health of marathoners. After years in which almost no deaths were attributed to heart attacks at this country’s major marathons, at least six runners have died in 2006.
Two police officers, one 53, the other 60, died of heart attacks at the Los Angeles Marathon in March. The hearts of three runners in their early 40s gave out during marathons in Chicago in October, San Francisco in July and the Twin Cities in October. And at the same marathon where Mr. Turner was felled, another man, 56, crumpled near the 17th mile, never to recover.
This year’s toll has sobered race directors and medical directors of marathons. But, as Rick Nealis, the director of the Marine Corps Marathon, said, “Statistically, maybe, it was inevitable.”
Race fields have grown. In 2005, 382,000 people completed a marathon in the United States, an increase of more than 80,000 since 2000, according to marathonguide.com. Meanwhile, the risk of dying from a heart attack during a marathon is about 1 in 50,000 runners, said Dr. Arthur Siegel, the director of internal medicine at McLean Hospital in Belmont, Mass., and an assistant professor of medicine at Harvard.
But some physicians, including Dr. Siegel, an author of more than two dozen studies of racers at the Boston Marathon, wonder if there is more to the deaths than mathematical inevitability: Does racing 26.2 miles put a heart at risk?
A new study by Dr. Siegel and colleagues at Massachusetts General Hospital and other institutions is at least suggestive. Sixty entrants from the 2004 and 2005 Boston Marathon were tested before and after the race. Each was given an echocardiogram to find abnormalities in heart rhythm and was checked for blood markers of cardiac problems — in particular for troponin, a protein found in cardiac muscle cells. If the heart is traumatized, troponin can show up in the blood. Its presence can determine whether there has been damage from a heart attack.
The runners (41 men, 19 women) had normal cardiac function before the marathon, with no signs of troponin in their blood. Twenty minutes after finishing, 60 percent of the group had elevated troponin levels, and 40 percent had levels high enough to indicate the destruction of heart muscle cells. Most also had noticeable changes in heart rhythms. Those who had run less than 35 miles a week leading up to the race had the highest troponin levels and the most pronounced changes in heart rhythm.
The findings, published in the Nov. 28 issue of Circulation, a journal of the American Heart Association, were a surprise, and not least to the runners. None had reported chest pains or shortness of breath at the finish. All had felt fine, Dr. Siegel said (to the extent one can feel fine after pounding through 26.2 miles).
Within days, the abnormalities disappeared. But something seemed to have happened in the race. “Their hearts appeared to have been stunned,” Dr. Siegel said.
“Although the evidence is not conclusive, it does look like the Boston study is showing some effect on cardiac muscle,” said Dr. Paul D. Thompson, 59, the director of cardiology at Hartford Hospital in Connecticut, and an author of an editorial that accompanied the study. “It’s far too early to draw any conclusions,” he added. “We’d be seeing lots more bodies piling up if there were real lingering long-term cardiac damage” caused by running marathons.
“Over all, the evidence is strongly in favor of the idea that endurance exercise is helpful in terms of cardiac health,” said Dr. Thompson, who has run more than 30 marathons.
But questions do remain. Another new study, this one out of the University of Duisburg-Essen in Germany, showed completely unexpected results in a group of experienced middle-aged male marathoners. In the study, which was presented in November at a meeting of the American Heart Association, the subjects, each of whom had completed at least five marathons, underwent an advanced type of heart screening called a spiral CT scan. Unlike echocardiograms or stress tests, spiral CTs show the level of calcium plaque buildup or atherosclerosis in the arteries.
=========
Is Marathoning Too Much of a Good Thing for Your Heart?
E-Mail
Print
Single Page
Reprints
Save
Published: December 7, 2006
(Page 2 of 2)
More than a third of the runners had significant calcium deposits, suggesting they were at relatively high risk for a heart attack. Only 22 percent of a control group of nonrunners had a comparable buildup.
The researchers scrupulously avoided suggesting that marathoning had caused the men to develop heart disease. (After all, running may have kept them alive when they would otherwise have keeled over years earlier.) But neither did the authors rule out the possibility that in some baffling way distance running had contributed to the men’s arterial gunk.
What worries Dr. Siegel and some of his colleagues is that marathons present an opportunity for silent symptomless heart disease to introduce itself abruptly. The pulsing excitement, the adrenaline, the unpleasant process of “hitting the wall” may trigger physiological changes that loosen arterial plaques, precipitating a heart attack, Dr. Siegel said.
His advice to runners with any history of heart trouble is “train for the race, getting the cardiac benefits of endurance exercise,” then watch the event on television.
The risk of going into cardiac arrest as a spectator, he said, is only about one in a million. (The applicable studies of spectators involved Super Bowl fans.)
Anyone considering joining the ranks of marathoners should undergo a full medical screening, with a visit to a cardiologist for those over 40, Dr. Siegel said. Spiral CT scans are desirable (the cost can range from $250 to $850) and are covered by insurance if recommended by a physician.
Those with a family history of cardiac problems should be especially cautious. “You can’t outrun your genes,” Dr. Siegel said, a reality that marathon medical experts call the Jim Fixx effect, after the author of “The Complete Book of Running,” who died of a heart attack in 1984 at 52. His father had also died young.
Still, the majority of cardiologists remain avid fans of marathons. “It is an extraordinary event,” said Dr. Frederick C. Lough, the director of cardiac surgery at George Washington University Hospital in Washington. “But you have to respect that distance. It’s not something everyone necessarily should attempt.”
Dr. Lough, 57, was less than a block behind Mr. Turner when the older man collapsed. He interrupted his own race to help revive Mr. Turner and accompany him to the hospital, before completing the marathon. “It was a vivid reminder that running does not make anyone immune to heart disease,” Dr. Lough said.
Experts familiar with the new cardiac studies of marathoners urge caution and perspective. The numbers of people studied were small, the findings unexplained, and results have not yet been replicated.
Don’t use the studies, in other words, to justify parking yourself smugly on the couch. “There’s not yet in my opinion cause for alarm,” Dr. Thompson said. “I would still tell people, run.”
His words doubtless will cheer Mr. Turner. “You know the worst thing about almost dying?” he said. “That I didn’t finish.” After having had a stent installed in his heart to open an artery that was about 98 percent blocked, he’s now walking a mile a day and planning his comeback. “I want to get that 10th marathon in,” he said.
But not before he gets a full medical screening, including a spiral CT scan.
-
Here is a Holiday tip.
Oil-- Olive oil that is-- Not just 8 days a week; but 365 days a year!
New Year's Resolution No. 1: Prevent Cancer, Use Olive Oil
If you want to avoid developing cancer, then you might want to add eating more olive oil to your list of New Year's resolutions. In a study to be published in the January 2007 issue of The FASEB Journal, scientists from five European countries describe how the anti-cancer effects of olive oil may account for the significant difference in cancer rates among Northern and Southern Europeans.
The authors drew this conclusion based on the outcomes of volunteers from Denmark, Finland, Germany, Italy, and Spain, who consumed 25 milliliters (a little less than a quarter cup) of olive oil every day for three weeks. During this time, the researchers examined urine samples of the subjects for specific compounds known to be waste by-products of oxidative damage to cells, a precursor to cancer. At the beginning of the trial, the presence of these waste by-products was much higher in Northern European subjects than their Southern European counterparts. By the end of three weeks, however, the presence of this compound in Northern European subjects was substantially reduced.
"Determining the health benefits of any particular food is challenging because of it involves relatively large numbers of people over significant periods of time," said lead investigator Henrik E. Poulsen, M.D. of Rigshospitalet, Denmark. "In our study, we overcame these challenges by measuring how olive oil affected the oxidation of our genes, which is closely linked to development of disease. This approach allows us to determine if olive oil or any other food makes a difference. Our findings must be confirmed, but every piece of evidence so far points to olive oil being a healthy food. By the way, it also tastes great."
Another interesting finding in the study suggests that researchers are just beginning to unlock the mysteries of this ancient "health food." Specifically, the researchers found evidence that the phenols in olive oil are not the only compounds that reduced oxidative damage. Phenols are known antioxidant compounds that are present in a wide range of everyday foods, such as dark chocolate, red wine, tea, fruits, and vegetables. Despite reducing the level of phenols in the olive oil, the study's subjects still showed that they were receiving the same level of health benefits.
"Every New Year people make resolutions that involve eating less fat to improve their health," said Gerald Weissmann, MD, Editor-in-Chief of The FASEB Journal. "This academically sound, practically useful study shows that what you eat is just as important as how much you eat. No wonder Plato taught wisdom in an olive grove called Academe."
The FASEB Journal (http://www.fasebj.org) is published by the Federation of American Societies for Experimental Biology (FASEB) and is consistently ranked among the top three biology journals worldwide by the Institute for Scientific Information. FASEB comprises 21 nonprofit societies with more than 80,000 members, making it the largest coalition of biomedical research associations in the United States. FASEB's mission is to enhance the ability of biomedical and life scientists to improve -- through their research -- the health, well-being, and productivity of all people. FASEB serves the interests of these scientists in those areas related to public policy, facilitates coalition activities among member societies, and disseminates information on biological research through scientific conferences and publications.
-
http://ezraklein.typepad.com/blog/2006/12/the_healthy_ame.html
The Healthy Americans Act
It's been some time since I've run across a genuinely new health care proposal, but the comprehensive reform legislation Ron Wyden's unveiled today is just such a beast. Wyden, a gangly goofball of a Senator who last turned heads for his tax reform ideas, must have decided fully restructuring the tax code was thinking too small, so this morning, he took over the Senate Finance Committee's hearing room, brought in an array of union leaders, CEOs, and health wonks, and argued to totally scrap the employer-based health system.
Here's how it would work: The Healthy Americans Act of 2007 would begin by dissolving all employer-based insurance. Instead, it would mandate that every employer who had covered his employees in 2006 convert the total they spent on insurance into salary increases creating, in one day, the single largest pay raise America has ever seen. Now, why would employers go along with that? Well, legislatively they'd have to, but, as Len Nichols explained to me, they'll also want to: Health costs are accelerating, every year costs 10 or so percent more than they ear before. By freezing the total at what employers paid in 2006, Wyden's plan would exempt them from 2007's increase.
Meanwhile, an individual mandate would be implemented, forcing every American to purchase one of the options offered by their state's newly formed Health Help Agency (HHA). The HHA's will have a menu of private insurance plans, all of which must provide coverage equal to or better than the Blue Cross Blue Shield Standard Plan used by Congress. All plans will be community rated by the state, meaning an end to adverse selection and preexisting condition problems. The only acceptable variables for price will be geography, family size, and smoking status. Subsidies will be offered up to 400 percent of the poverty line, will full coverage provided to those below 100 percent. Employers will contribute through a set equation related to business size and yearly profits. There's quite a bit more, but that's the basic outline.
I have to spend some more time with the legislation ("c'mon baby, open up to me, tell me your secrets..."), but my snap reaction is heavily favorable. It isn't everything I'd want, but imposing the combination of community rating and an insurance floor will be a huge step forward. The cost stability offered to employers seems very, very savvy, as does the forced conversion of 2006 health costs into salary increases. The Lewin Group, the gold standard in health care actuarial data (I can't believe I just wrote that sentence), has evaluated the plan. Their conclusion? The plan would cover more than 99 percent of Americans, we'd save $4.8 billion in the first year and $1.48 trillion over the next decade. How's that sound? To me, it sounds like precisely the sort of big thinking Democrats need to be doing now that they're back in the majority.
For those want to dive in, there are more materials at Wyden HQ.
-
Second post of the day on this thread:
DIABETES BREAKTHROUGH; TORONTO SCIENTISTS CURE DISEASE IN MICE: In a discovery that has stunned even those behind it, scientists at a Toronto hospital say they have proof the body's nervous system helps trigger diabetes, opening the door to a potential near-cure of the disease that affects millions of Canadians. Diabetic mice became healthy virtually overnight after researchers injected a substance to counteract the effect of malfunctioning pain neurons in the pancreas."I couldn't believe it," said Dr. Michael Salter, a pain expert at the Hospital for Sick Children and one of the scientists. "Mice with diabetes suddenly didn't have diabetes any more."
LB News
-
Anyone have the other side on this?
E. Coli's Enablers
December 18, 2006; Page A16
WSJ
The recent E. coli outbreaks are playing as a familiar morality tale of too little regulation. The real story is a much bigger scandal: How special interests have blocked approval of a technology that could sanitize fruits and vegetables and reduce food poisoning in America.
The technology is known as food "irradiation," a process that propels gamma rays into meat, poultry and produce in order to kill most insects and bacteria. It is similar to milk pasteurization, and it's a shame some food marketer didn't call it that from the beginning because its safety and health benefits are well established. The American Medical Association, the Centers for Disease Control (CDC), the Food and Drug Administration and the World Health Organization have all certified that a big reduction in disease could result from irradiating foods.
Says Michael Osterholm, director of the Center for Infectious Disease Research at the University of Minnesota: "If even 50% of meat and poultry consumed in the United States were irradiated, the potential impact on foodborne disease would be a reduction in 900,000 cases, and 350 deaths." A 2005 CDC assessment agrees: "Food irradiation is a logical next step to reducing the burden of food borne diseases in the United States."
We asked several leading health scientists whether food irradiation could have prevented the E. coli outbreak at Taco Bell restaurants. "Almost certainly, yes," says Dennis Olson, who runs a research programs on food irradiation at Iowa State University. A recent study by the USDA's Agriculture Research Service confirms that "most of the fresh-cut (minimally processed) fruits and vegetables can tolerate a radiation of 1.0 kGy, a dose that potentially inactivates 99.999% of E. coli."
So what's stopping irradiation? The answer is a combination of political pressure, media scare tactics and bureaucratic and industry timidity. And it starts with organic food groups and such left-wing pressure groups as Public Citizen that have engaged in a fright campaign to persuade Americans that irradiation causes cancer and disease. Something called the Stop Food Irradiation Project tells consumers to tell grocers not to carry irradiated foods.
The liberal-leaning Consumer Reports gave credence to these claims in a 2003 article suggesting that the chemicals formed in meat as a result of irradiation may cause cancer. Public Citizen President Joan Claybrook has served on the Consumer Reports board. Eric Schlosser, author of the best-selling "Fast Food Nation," also disparages irradiation as an "exotic technology" developed "while conducting research for the Star Wars antimissile program." Scary.
None of these mythologies has ever been substantiated by science. The Centers for Disease Control concluded its investigation by noting: "An overwhelming body of scientific evidence demonstrates that irradiation does not harm the nutritional value of food, nor does it make the food unsafe to eat." According to Paisan Loaharanu, a former director at the Food and Agriculture Organization of the United Nations, "The safety of irradiated foods is well established through many toxicological studies. . . . No other food technology has gone through more safety tests than food irradiation."
The Food and Drug Administration bears some of the blame for bending to political pressure and slowing the spread of food irradiation. The food processing industry requested permission to apply irradiation to enhance the safety of produce in 1999, but seven years later the agency still hasn't approved this "food additive." The FDA does allow irradiation for meat, but it requires warning labels that send a message to consumers that eating such beef or chicken is risky. Elizabeth Whelan of the American Council on Science and Health points out that the FDA would be wiser to require that meats and produce that aren't irradiated have a safety warning label. Those are the potentially unsafe foods.
Somehow this side of the story never seems to make it into the mainstream media. Instead, the press replays the familiar yarn that the E. coli outbreaks are caused by budget cuts and government collusion with industry. In fact, FDA spending on food safety has increased to $535 million in 2006 from $354 million in 2001, a 51% increase. (See nearby chart.) In any case, such inspections and more regulations can never hope to prevent E. coli as well as irradiation does. The government couldn't possibly hire enough inspectors to track the many sources of fresh produce in the U.S.
Over the past 50 years, the U.S. has reduced by roughly half the death and illness from foodborne disease. Yet 325,000 Americans are still hospitalized and 5,000 die each year from contaminated food. Today only about 1% of our meat and produce is irradiated, though the technology was invented here. Such nations as India, Mexico and Thailand are starting to irradiate most of the food they export to the U.S., which means that produce from abroad could be safer than that grown here. The real scandal of these E. coli outbreaks is that public safety has taken a back seat to political correctness and bureaucratic delay at the FDA.
-
Hormones and Cancer: Assessing the Risks
a..
By GINA KOLATA
Published: December 26, 2006
When researchers reported recently that a precipitous drop in breast cancer
rates might be explained by a corresponding decrease in the use of hormones
for menopause, women reacted with shock, anger and, in some cases, profound
relief that they had never taken the drugs.
Research Leader Dr. V. Craig Jordan studies the effects of estrogen-blocking
drugs on breast cancer.
Related
Complete Coverage: Hormones
But many also had questions. How certain were scientists that the hormones
were responsible? How could stopping hormones have such an immediate and
pronounced effect? And how much did scientists really know about the biology
of breast cancer and hormones?
The data seemed clear enough. In 2003, after climbing for almost seven
decades, the breast cancer rate fell for the first time in the United
States, and it fell sharply. Over all, the incidence of newly diagnosed
breast cancer dropped 7 percent, and it dropped 15 percent among women with
cancers whose growth is fueled by estrogen.
There also was no question that at the same time, women had begun to abandon
hormones as a treatment for menopause. In July 2002, a large study, the
Women's Health Initiative, concluded that a popular hormone therapy for
menopause, Prempro, made by Wyeth, slightly increased the risk of breast
cancer. Within the next six months, prescriptions for Prempro dropped by
half.
A connection between hormone use and breast cancer rates did not surprise
scientists like Dr. V. Craig Jordan, vice president and scientific director
for the medical science division at Fox Chase Cancer Center in Philadelphia.
Dr. Jordan is a leader in studying the effects of estrogen-blocking drugs on
breast cancer. Among his many awards is this year's American Cancer Society
Award from the American Society for Clinical Oncology for his work on
estrogen and the prevention and treatment of breast cancer.
Dr. Jordan's wife, Dr. Monica Morrow, a breast cancer surgeon, is chairwoman
of the surgical oncology department at Fox Chase. Their offices, he says,
are across the hall from each other, "so we are together 24 hours a day."
Q. Prempro, the combination drug that many women took for menopause
symptoms, contains both estrogen and progestins. And the findings from the
Women's Health Initiative study suggested that estrogen alone has only a
tiny effect, if any, on breast cancer risk. So which is the bad actor,
progestins or estrogen? Or is it both hormones combined?
A. We've known for 30 years that estrogen can directly cause the growth of
breast cells and of endometrial cells. Estrogen is fuel for the fire. But
progesterone seems to do different things in different places in a woman's
body. In the uterus, it stops the growth of the endometrium and makes it
ready for implanting a fertilized egg. In breast cancer, estrogen causes a
doubling of cancer cells every 36 hours. Soon, the growing tumor ball needs
to increase its blood supply because cells in the middle are not getting
enough food and oxygen. Progesterone seems to cause other cells, stromal
cells, to gather around the ball of cancer cells and play a supporting role.
Stromal cells are the woman's own cells that researchers now think may be
specifically selected to build an architecture and send out signals for more
blood supply, more fuel.
Q. That seems to be an unusual arrangement. Why would progesterone act on
stromal cells in the breast?
A. When a woman is pregnant, her breasts are much larger and her estrogen
and progesterone levels are huge. Progesterone is sending out signals that
provide a skeleton to build the breasts.
Q. Was it a surprise to learn that estrogen and progestins can cause breast
cancer?
A. We've known there is a cause and effect with hormones and breast cancer
since 1896. If a woman is premenopausal and she has breast cancer and you
take out her ovaries, the tumors decrease in size. Not all the tumors - if
you took 100 women who were premenopausal and took their ovaries out, 35
percent would have a response. And you could get a dramatic response. A
tumor that was the size of a walnut could shrink in six months to the size
of a pinhead. It turned out that the tumors that responded contained
estrogen receptors. This became cause and effect - the estrogen receptor was
the mechanism that estrogen used to stimulate tumors to grow. If there was
no estrogen receptor, taking away estrogen didn't do anything at all.
Q. Did taking away estrogen ever make a breast cancer go away completely?
A. This is the basic difficulty. We were dealing with advanced breast
cancer, and what we saw was that we could get complete remissions in 4 or 5
percent of the women. In the majority of women, the remission would last for
one to two years. Taking away estrogen slowed things down, it reversed the
process, but it did not cure.
Q. Do you agree with the latest analysis indicating that breast cancer is
declining because so many women stopped taking Prempro and other menopausal
hormones?
A. Throughout the 1990s, physicians were recommending that menopausal women
take hormone replacement therapy. What happens is that you increased the
rate of breast cancer in the whole country. And it shifted the epidemiology.
We have seen an increase in the percentage of estrogen-receptor-positive
tumors in the 1990s and in the beginning of the 2000s, so that now 70
percent of tumors are estrogen-receptor positive.
This was, if you like, consistent. Everything was ticking in. The Women's
Health Initiative and the Million Women Study in Britain really said: "Here's
a controlled series of studies comparing taking nothing with taking hormone
replacement therapy. How many cancers were there at the end of the day?"
====================
Page 2 of 2)
The Women's Health Initiative found a 23 percent increase in breast cancer;
the Million Women Study found a 100 percent increase. Those studies were
highly publicized and women stopped taking hormones. Now the breast cancer
rates are going down. Now tumors you would have detected are not being
detected. There is no proof the tumors will ever go away, but you can't
detect them. And it is possible that many subclinical cancer cells may never
grow inside a woman's breast if she has no estrogen around to fuel that
fire.
Skip to next paragraph
Related
Complete Coverage: Hormones
Q. If a woman has a tumor that is undetectable because she did not take
menopausal hormones, will it eventually grow anyway and turn into a cancer
that can be seen on a mammogram?
A. We don't know. What we have learned from the tamoxifen clinical trial is
that tamoxifen, which blocks estrogen, did a fantastic job. The cancer rate
in the group taking tamoxifen dropped by 50 percent. Tamoxifen prevented the
development of breast cancers that were early stage, and it also stopped
cells from progressing to breast cancer.
Q. Some people suggest that the real problem was that the hormones women
were taking were artificial or were given in artificial ways. Prempro, for
example, gets its estrogen from pregnant mares. Some say other hormone
preparations, for example, so-called bioidentical hormones, would be safe.
Do you agree?
A. We've been talking about women's ovaries producing estrogen and
progesterone. When a woman enters menopause, hormone levels drop
dramatically. The longer you bathe a woman's breasts in these hormones, the
more likely she will have cancer. If you start menstruating early, if you
have two extra years of estrogen in your body, bathing your breasts in that
fuel is a risk factor for breast cancer. If you start menopause late, if
your periods go on for an extra four or five years, that is a risk. The
longer you have menstrual cycles, the higher your probability of breast
cancer. And that is with natural hormones, the ones in your body.
Q. What about birth control pills? Do they increase the risk of breast
cancer?
A. We have had testing of birth control pills in huge groups of women since
the 1950s, and there really is no evidence of a significant rise in breast
cancer risk. What we do know is that oral contraceptives reproduce the
messages in the brain to stop a woman from ovulating. You are bathing a
woman's body with artificial hormones, but normally she would be bathing her
own body with estrogen and progesterone. You don't have women getting
endometrial cancer, and oral contraceptives reduce the risk of getting
ovarian cancer by 50 percent. It is one of the few things we know of that
reduces the risk of ovarian cancer.
Q. What about chemicals in the environment, like DDT or chemicals in
plastics, that can mimic estrogen. Could they be causing breast cancer?
A. There are a group of compounds like DDT that are byproducts of industry
and are in our environment. They can affect cells in the laboratory and can
affect the reproduction of animals, but in really huge doses. There is an
effect, but does it cause an increase in cancer? I personally don't believe
that is the case. I don't think there is enough around to do that. A pinch
of estrogen in the environment is very small compared to the gallons in a
woman's body.
Q. What should women do now? Should they ever take menopausal hormones?
A. The value of hormone therapy for women with extremely severe menopausal
symptoms is well established, and women, in consultation with their doctors,
should consider using it for only a few months to alleviate severe symptoms.
The main concern is using the drugs for many years to prevent osteoporosis.
They can reduce the risk of hip fractures, but there are now many different
alternatives for women to maintain bone density, such as bisphosphonates or
raloxifene. Hormone replacement therapy should only be considered after all
other options have failed.
-
A Red Flag for Jet Lag
In Study, Simulated Flights Result in Deaths of Older Mice
By Del Quentin Wilber
Washington Post Staff Writer
Tuesday, December 26, 2006; D01
It's the caged-mouse syndrome of air travel -- you feel crammed into your
seat on a long-distance flight with little to munch on except a bag of
pretzels.
But you better hope you beat jet lag better than a mouse.
A study at the University of Virginia released during the height of
Thanksgiving and Christmas travel seasons showed that a majority of elderly
mice died while being subjected to the equivalent of a Washington-to-Paris
flight once a week for eight weeks. More intense forms of jet lag sped up
the death rate in the elderly rodents, the study found.
For decades, flyers have stoically battled the modern-age problem of jet
lag, viewing its accompanying grogginess, burning eyes, headaches, insomnia
and fatigue as more of a nuisance than a potential health issue.
The study has focused new attention on the problem and raised questions
about whether severe jet lag can be harmful to health. It also has drawn
attention to work by other researchers looking into ways to help vacationing
families and business travelers avoid jet lag. The study is one of the first
hard scientific looks into the health effects of jet lag, experts said.
The condition has become such a common scourge of the jet age that an entire
industry has emerged on the Internet, offering such solutions as acupressure
kits, homeopathic pills and light-enhancing visors. Many travelers have
invented their own treatments: slurping down gallons of coffee, dunking
heads in ice-cold water, taking naps, jogging and popping sleeping pills and
homeopathic remedies. But researchers say few of those remedies are backed
by science.
In the study, younger mice seemed to rebound more quickly and were not
immediately harmed by the jet lag. Simulated jet lag conditions were created
by advancing and delaying the rodent's exposure to light.
Researchers aren't sure what conclusions to draw from the results.
Gene Block, the report's co-author, said older mice might be more
susceptible to sudden light changes than younger mice. Or, he said, jet lag
might be a health problem that builds up in younger subjects, causing future
maladies.
To further explore the issue, his researchers have launched another set of
tests to determine whether jet lag causes long-term health consequences in
younger and middle-age rodents, Block said minutes before boarding a 14-hour
flight to Japan from Washington.
"I feel like a subject in the experiment," said the 58-year-old, who
recently returned from a conference in Italy. "Like many people, I am
finding it more difficult to cope with jet lag as I get older. . . . I would
like to know whether it's a phenomenon of old age or whether it is something
I really have to worry about."
Block's study also hinted at what flyers have been saying for years: It is
more difficult to adjust to time zone changes when flying east. The
researchers found that 53 percent of elderly mice died when they were
subjected to a simulated weekly flight from Washington to Paris over the
eight-week study. The death rate dropped to 32 percent of elderly mice on a
simulated Paris-to-Washington route, according to the study, which was
published last month in the journal Current Biology. Seventeen percent of
the mice in a control group died in the eight-week study.
Research has identified links between night-shift work and chronic health
problems. And doctors and aviation experts have worked hard to help pilots
and flight attendants mitigate the effects of jet lag to ensure they can
function properly in the air.
Jet lag is caused when people fly across time zones. Many factors, including
daylight, sleep cycles, hormones and other natural rhythms, play a role in
how humans' complicated internal clocks handle it.
Researchers say the only way to truly avoid jet lag is for travelers to
gradually prepare before leaving on their trips.
Charmane I. Eastman, a professor and director of the Biological Rhythms
Research Lab at Rush University Medical Center in Chicago, believes that
flyers can more easily cope with jet lag by adjusting their sleep schedules
before traveling.
If headed east from the Washington area, for example, travelers should go to
bed an hour earlier each night and wake up an hour earlier each morning for
several days before leaving town.
When travelers wake up, they should get sunlight or use a "light box" to
help trigger changes in their biological clocks. Travelers should also
consider taking small amounts of melatonin, a hormone, five hours before
going to sleep to help them adjust to their future time zone, Eastman said.
The only other way to avoid jet lag on overseas trips: "Take a boat," she
said.
There are also ways to mitigate jet lag once you land. If heading to Europe
from Washington, most people should wear dark sunglasses after landing until
about 11 a.m. Exposure to too much light too early can delay adjustment to
new time zones, Eastman said.
After 11 a.m., travelers should try to get as much sunlight as possible to
help kick-start the body's clock, she said.
Several veteran travelers said they would have a difficult time switching
schedules under Eastman's plan and said booking a cruise was an inefficient
option.
They have found their own ways to cope.
Steve Solomon, 30, a consultant who lives in Gaithersburg, sets his watch to
his destination's time zone before he takes off "to get your mind into the
right mind-set." He also avoids alcohol and drinks a lot of water.
"I view it as more of a hassle than anything else," he said. "You have to
run with the punches."
Carol Lane, a 42-year-old free-lance advertising and marketing writer, says
she relies on homeopathic pills she buys at a health food store.
Even with the pills, though, she said she hadn't been able to adjust to jet
lag as well as she did a few years ago.
"When you are in a particularly bad bout, you are just so walloped," she
said. "I'm an old mouse, I guess."
-
THE VACCINE TO PREVENT EVERY STRAIN OF FLU: British scientists are on the verge of producing a revolutionary flu vaccine that works against all major types of the disease. Described as the 'holy grail' of flu vaccines, it would protect against all strains of influenza A - the virus behind both bird flu and the nastiest outbreaks of winter flu. Just a couple of injections could give long-lasting immunity - unlike the current vaccine which has to be given every year. The brainchild of scientists at Cambridge biotech firm Acambis, working with Belgian researchers, the vaccine will be tested on humans for the first time in the next few months.
Levine Breaking News
-
Table of Contents:
AFPA Fitness
The Health-Harming Confusion About Saturated
Fats
Too Much Exercise is Just as Bad as Not Enough
10 Steps to Being Happier and Healthier
More Evidence Ginkgo Biloba Works Just as Well
as Dementia Drugs
Do Not Drink Airplane Water
After-Dinner Snacks Can Aid in Weight Loss
Eating Artifical Sweeteners Triggers Appetite
Red Grapefruit Lowers LDL Cholesterol
Another Reason to Eat Your Vegetables: Lowering
the Risk of Diabetes
_________________________________________
_________________________________________
The Health-Harming Confusion About Saturated
Fats
DiabetesWhile studies have shown that consuming
saturated fat can slightly increase insulin levels,
which can be a risk factor for type-2 diabetes, the
studies did not reflect real-world diets, and did not
reflect the fatty acid profiles consumed in normal
diets. In addition, recommendations to avoid
saturated fats generally result in people consuming
more trans fats, which are definitely dangerous.
Trans fats have a detrimental effect on the
incidence and treatment of type-2 diabetes, while
saturated fats have been shown to have no effect
when appropriate comparisons are made.
Trans fats interfere with insulin receptors, while
saturated fats do not. Type-2 diabetes did not exist
100 years ago, when the human diet was very rich
in saturated fats; it appeared when trans fats came
into the diet.
As people eat more and more foods containing
trans fats, it has become an epidemic.
Green Clippings December 2, 2006
http://www.greenclippings.co.za/gc_main/article.php
?story=20061202160334259
_________________________________________
Too Much Exercise is Just as Bad as Not Enough
After a number of years in which almost no deaths
were caused by heart attacks during marathons, at
least six runners have died in 2006. Some
physicians, including Dr. Arthur Siegel, author of
numerous studies of Boston Marathon racers,
believe that the extended races put the heart at
risk.
A new study by Dr. Siegel and colleagues examined
60 Boston Marathon entrants. The runners showed
normal cardiac function before the marathon.
But 20 minutes after finishing, 60 percent of the
group had elevated levels of troponin (a protein that
shows up in the blood when the heart is
traumatized), and 40 percent had levels high
enough to indicate the destruction of heart muscle
cells. Many also showed noticeable changes in
heart rhythms.
Another study, from Germany, showed that as many
as one-third of middle-aged male marathoners may
have higher than expected calcium plaque deposits
in their arteries, putting them at a greater risk for
heart attack.
Just over 20 percent of a control group of non-
runners had comparable calcium plaque buildup.
Circulation November 28, 2006; 114(22): 2325-2333
New York Times December 7, 2006
The (Lakeland, FL) Ledger December 7, 2006
_________________________________________
10 Steps to Being Happier and Healthier
Researchers at the National Institute on Aging have
determined that well-being is strongly influenced by
individual characteristics. Their 10-year study
showed people with a happy disposition in 1973
were still happy in 1983, even if their job, location, or
marital status had changed.
If you want to create positive emotions, but don't
know where to begin, the links below will bring
happiness into your life. Here's a sampling:
1. Stop trying to be perfect. Don’t expect perfection
from yourself or from anybody. You don’t need to
impress people around you and you don’t have to
get everything done perfectly.
2. Be happy and satisfied with what you have.
Stop comparing with others at every stage, this will
infact add to your misery. Be happy and content with
your life. Remove the feelings of jealousy
and enemity.
3. Schedule some time for yourself. Give yourself
one hour each day when you can truly relax and
enjoy yourself. Do some exercise, work on a
hobby, go for a walk, or read a book.
Pamper youself with some massages or
beauty therapies. Meditate or pray to God. This will
renew your energy and concentration.
4. If you are too stressed at work, take a break and
refresh your energy. Go for a holiday with your
family and friends. Explore new places. Taking
breaks helps your body recover the lost energy. You
may take short or long breaks, depending on your
work and stress levels. When you get back to work
after a break, your concentration and focus
improves a great deal and you are more motivated.
5. Don’t be alone all the time. Go out with
your friends and talk to them on the phone regularly.
Watch a movie, go shopping or do things that you
always loved but did not get the time because
of your busy schedules. Call your friends home and
watch a funny movie together.
6. If you are a working parent, take a break from
work and spend time with your kids. Or play with
your pets. Visit your relatives and throw
a party for them. Dance and sing with them.
7. Be grateful to people around you. Be thankful for
even small favours and blessings.
8. Help Others. It has been observed that helping
others gives you immense satisfaction and
happiness. Make someone’s life more beautiful by
contributing in your own small way.
9. Re-assess your priorties. Spend time with your
family and pray to God. Stay in the present. Do not
waste time regretting your past or worrying about
the future.
10. Laugh out loud atleast once in a day and keep
smiling. Focus on things that keep you happy
instead of those that keep you down. Forget your
worries and pains, everybody in this world, has
some problems. But it all depends on the way you
deal with it.
Alternative Therapies and Health News November
27, 2006 Psychology Today
_________________________________________
More Evidence Ginkgo Biloba Works Just as Well
as Dementia Drugs
An Italian study has determined that ginkgo biloba
works just as well as Aricept (donepezil) in treating
mild or moderate Alzheimer's-related dementia.
For the study, 76 mild-to-moderate dementia
patients received either a placebo, ginkgo or Aricept
for six months, followed by a four-week course of a
placebo to exclude those reactions.
During the study period, more ginkgo patients
dropped out of the test, but not for the same
reasons as the four Aricept dropouts, who left due to
adverse drug reactions.
Based on test scores to determine the severity of
dementia afterward, scientists agreed both ginkgo
biloba and Aricept work just as effectively to slow
down the damage.
European Journal of Neurology September 2006;
13(9): 981-985
_________________________________________
Do Not Drink Airplane Water
According the the Environmental Protection Agency
tap water on more than 17 percent of flights recently
tested contained disease-causing bacteria,
including E.coli. Bring your own bottled water.
_________________________________________
After-Dinner Snacks Can Aid in Weight Loss
Recent research has found that a lower calorie,
higher fiber snack about 90 minutes after dinner
[such as an apple or pear] can reduce the cravings
for higher calorie late night snacks that lead to
weight gain in many over-weight individuals].
_________________________________________
Eating Artifical Sweeteners Triggers Appetite
Researchers have found that eating artifical
sweeteners encourages your body to increase its
calorie intake. A better alternative to either artifical
sweeteners or sugar is Stevia, a natural zero-calorie
alternative that is sold as an herbal supplement.
Trulie Ankerberg-Nobis, RD, clinical research
coordinator and staff dietitian, Physicans Committee
for Responsible Medicine, Washington, DC.
_________________________________________
Red Grapefruit Lowers LDL Cholesterol
Recent research has found that even in individuals
who do not responde to statin drugs have a
favorable cholesterol lowering response to eating
red grapefruit. Eating one red grapefruit daily for
four weeks demonstrated a 20 percent reduction in
LDL cholesterol.
Gorinstein S, Caspi, et. al.Red Grapefruit Positively
Influences Serum Triglyceride Level in Patients
Suffering from Coronary Atherosclerosis:
Studies in Vitro and in Humans. J Agric Food Chem.
2006 Mar 8;54(5):1887-1892.
_________________________________________
Another Reason to Eat Your Vegetables: Lowering
the Risk of Diabetes
Researchers continue to substantiate the need to
eat vegetables daily. The risk of developing diabetes
is 38 percent lower in those individuals who eat
vegetables daily. High blood levels of carotenoids;
powerful anti-oxidants found in yellow-orange
vegetables [carrots, sweet potatoes and squash, as
well as dark green leafy vegetables are sited as the
best sources.
Am J Epidemiol 2006;163:929-937
_________________________________________
-
Terminatorcare
Gov. Schwarzenegger writes a prescription for disaster.
BY DAVID R. HENDERSON
Wednesday, January 10, 2007 12:01 a.m. EST
WSJ
MONTEREY, Calif.--On Monday, Arnold Schwarzenegger presented his proposal for reducing the number of Californians who lack health insurance. His proposal is almost indistinguishable--except in details--from that of the Democrats who dominate the California Assembly and Senate.
The Democrats tend to favor solutions involving regulations, government spending and taxes, and Senate President Pro Tem Don Perata's proposal--the main contending Democrat plan--hits the trifecta. It would require employers to provide health insurance; give them the option of paying a tax instead of providing health insurance; and increase spending by expanding both the Medi-Cal and Healthy Families programs, which provide care to low-income children--including children of illegal immigrants and the disabled.
Mr. Schwarzenegger's solution hits the trifecta also. He would require employers with 10 or more workers to provide health insurance or pay a 4% tax on all wages covered by Social Security: Look for employers with 10 to 12 employees to get creative about outsourcing. And look as well, as Harvard economist Jonathan Gruber has documented, for wages to fall in firms that offer health insurance because of the mandate. Gov. Schwarzenegger would throw in a 2% tax on doctors and a 4% tax on hospitals to help fund Medi-Cal, California's name for Medicaid. And he would expand Medi-Cal to adults earning as much as 100% above the poverty line and to children, even those here illegally, in poor and middle-income families. He hopes, by doing this, to shift $5 billion of Medi-Cal's annual cost to the federal government.
There are two problems with such solutions. First, they infringe on economic freedom, preventing, in Robert Nozick's phrase, "capitalist acts between consenting adults." Second, government solutions rarely work.
Why doesn't increased government power tend to solve the problem of the uninsured? There are two main reasons. First, when government provides health insurance, many people who take advantage of it drop their own privately provided health insurance. In a 1996 article in the Quarterly Journal of Economics, Harvard economists David M. Cutler and Jonathan Gruber found a 50% "crowding-out effect." As the federal Medicaid program expanded, for every two people who gained insurance through Medicaid, one dropped private health insurance. Although this is a net addition of one, the costs to taxpayers are much higher than expected because now half of the newly covered, instead of paying their own way as they previously did, become wards of the state.
Second, of the 46 million or so people without health insurance at any given time, about 45% will have health insurance within four months. This is one of the main findings of a 2003 study by the Congressional Budget Office, "How Many People Lack Health Insurance and for How Long?" That shouldn't be surprising in a country where most private health insurance is employer-provided and most unemployment spells last 11 weeks or less. Solutions that involve government mandates on employers or employees will, therefore, miss connecting with about half of the people who are uninsured at a given point in time.
But what if the governor could solve some of the problem by making health insurance cheaper? He can--not by regulating more, but by deregulating.
Let me explain. In the last few decades, state governments, the main regulators of health insurance in the individual and small-group markets, have mandated coverages for many kinds of health care. According to the Council for Affordable Health Insurance (CAHI), a pro-market association of insurance carriers, there were 1,843 state mandates in 2006. Among the most common, and most expensive, mandates are chiropractic care, treatment for alcoholism and drug abuse, and mental health benefits. California's government mandates coverage for all of the above, as well as for many other benefits, including, for example, infertility treatment--a very expensive benefit.
Abolishing these mandates would allow people who don't want to be covered for these things to buy cheaper insurance, while still allowing those who want them to buy and pay for them. Would such an approach work? That's like asking whether, if the government currently required new cars to have CD players, eliminating that requirement would lower the price of a car. Of course it would work.
It is important, though, not to overstate its benefits. The gain to Californians from abolishing these mandates would not be huge. CAHI compiled data from America's Health Insurance plan and eHealthInsurance for the individual market and from the federal government for the small-group market and found that in 2003, although California had more mandated coverages than all but six other states, it had among the lowest insurance rates for individual health insurance policies ($1,885 versus a top rate of $6,048 for New Jersey.)
The reason, explains CAHI, is that in other ways California is much less regulatory than many other states. It does not, for example, require guaranteed issue on individual policies--which drives up premiums by forcing insurance companies to supply policies to all comers, regardless of health status. Yet the governor's proposal would reverse this somewhat and prevent insurance companies from saying no because of age and health.
California should not, contra Gov. Schwarzenegger, do new regulatory harm; rather it should repeal existing regulations that cause harm--so as to make health insurance even more affordable.
There is one other way to deregulate: The California government could allow any Californian to buy health insurance from any willing insurer in any state and be subject to the regulations of that state. That way, people could shop for the degree of paternalism they want. If they want insurance from a state that requires many coverages, they could do so and pay the high premiums that result. If they want bare-bones coverage, they could do so also. The result would surely be that some of the current uninsured would buy insurance. Were I in the market for individual insurance and given the choice, I would not bother paying for coverage for alcohol or drug abuse.
If a version of Gov. Schwarzenegger's plan passes, the only thing certain is that there will be more regulation, more government spending and more taxes. A better path would be to deregulate, and thus achieve some increase in the number of insured--without new spending or taxes or regulation.
Mr. Henderson, a research fellow at Stanford's Hoover Institution, was the senior economist for health policy with President Reagan's Council of Economics Advisers (1982-84). He is co-author of "Making Great Decisions in Business and Life" (Chicago Park Press, 2006).
-
15 December 2006 09:09
Another C -- circumcision -- looks set to be added to the “Abstain, Be Faithful and Condomise” HIV prevention campaigns after conclusive evidence emerged this week that removing a man’s foreskin can halve his chances of catching HIV.
Two clinical trials, in Uganda and Kenya, have confirmed previous South African research into the protective power of circumcision.
The news has been hailed as one of the most significant breakthroughs in the fight against HIV for years, with the potential to prevent millions of new infections.
Circumcision as a prevention measure is not a part of the South African government’s draft strategic plan on HIV/Aids, although Aids experts expect this now to change rapidly.
The way is open for governments and funders to roll out mass circumcision campaigns and several of the biggest donor organisations are said to be looking at providing funding.
No African country has yet adopted mass circumcision as a policy, although several countries have been discussing the measure. And some, such as Kenya, have created task teams to tackle implementation.
Swaziland has “circumcision Sundays” to encourage men to undergo the operation.
The Kenyan and Ugandan clinical trials were terminated early, after preliminary research found that circumcision was so safe and effective that it would be unethical not to offer the operation to the uncircumcised control group.
In 2005 a similar trial in South Africa’s Orange Farm was also halted on ethical grounds after it found at least a two-thirds reduction in new HIV infections among circumcised men. Research into whether circumcision also protects female sexual partners from HIV infection is ongoing, although there is indirect evidence suggesting it will.
Male circumcision as a public health measure has been controversial, with some arguing that it is mutilation. There is also concern that circumcised men may practise riskier sex out of over-confidence, and that circumcision may be culturally inappropriate.
However, studies in Africa indicate most men would have the operation as protection against HIV, even if circumcision is not part of their culture.
Anthony Fauci, the director of the National Institute of Allergic and Infectious Diseases, which oversaw the latest research, said there did not seem to be a significant rise in risky sex among circumcised men, although this would continue to be monitored. As circumcision confers only partial protection, men and their partners are still urged to practise safer sex, especially condom usage.
“This data is going to put some people on the spot,” said Harvard researcher Daniel Halperin, who has advocated expanding circumcision for several years. “The response of the international agencies and donors will be crucial. Many people were basically putting aside the Orange Farm data and saying lets see what Uganda and Kenya show. It’s now shown to be at least 50% to 60% effective. Considering how many people are dying from this disease, that is a rather powerful result. Circumcision services need to be made available, safe and affordable.
“The ideal scenario now would be an increase in male circumcision and a decrease in concurrent sexual partners, probably the two strongest things impacting on the spread of HIV, along with consistent condom use.”
In the Kenyan trial, involving 2 784 men, circumcision reduces participants’ risk of catching HIV by 53%. In the Ugandan research there was 48% reduction among the 4 996 participants.
The protective effect is the result of the removal of the mucosal inner lining of the foreskin, which is far more vulnerable to HIV infection than vaginal mucus membranes. An uncircumcised penis also provides a comfortable environment for other sexually transmitted diseases, in turn providing a portal into the body for HIV.
The challenge will now be to be to spread the news among men and their partners, and to implement safe mass circumcision campaigns. One danger is that men may use unregulated and risky circumcision providers, such as “initiation” schools.
In South Africa, the most common method is to use forceps and scissors to slice off the unwanted piece of skin. The wound is cauterised and stitched with dissolvable thread, and healing takes, at most, six weeks.
The procedure is often carried out under local anaesthetic injected into the base of the penis.
But there is growing research into other techniques, including “bloodless” procedures where the foreskin is held tightly in a clamp for several days until the blood-starved skin dies and drops off. Involuntary erections can, however, interfere with the procedure, while the different kinds of clamp need to be sized to fit each individual man.
Other options being examined are surgical glue rather than stitching, because it is fast and potentially less vulnerable to infection. However, the highly adhesive glue could lead to serious -- and potentially permanent -- problems if applied accidentally to the wrong areas.
-
Issue of 2007-01-29
Posted 2007-01-22
WHAT’S THE TROUBLE?
by JEROME GROOPMAN
How doctors think
On a spring afternoon several years ago, Evan McKinley was hiking in the woods near Halifax, Nova Scotia, when he felt a sharp pain in his chest. McKinley (a pseudonym) was a forest ranger in his early forties, trim and extremely fit. He had felt discomfort in his chest for several days, but this was more severe: it hurt each time he took a breath. McKinley slowly made his way through the woods to a shed that housed his office, where he sat and waited for the pain to pass. He frequently carried heavy packs on his back and was used to muscle aches, but this pain felt different. He decided to see a doctor.
Pat Croskerry was the physician in charge in the emergency room at Dartmouth General Hospital, near Halifax, that day. He listened intently as McKinley described his symptoms. He noted that McKinley was a muscular man; that his face was ruddy, as would be expected of someone who spent most of his day outdoors; and that he was not sweating. (Perspiration can be a sign of cardiac distress.) McKinley told him that the pain was in the center of his chest, and that it had not spread into his arms, neck, or back. He told Croskerry that he had never smoked or been overweight; had no family history of heart attack, stroke, or diabetes; and was under no particular stress. His family life was fine, McKinley said, and he loved his job.
Croskerry checked McKinley’s blood pressure, which was normal, and his pulse, which was sixty and regular—typical for an athletic man. Croskerry listened to McKinley’s lungs and heart, but detected no abnormalities. When he pressed on the spot between McKinley’s ribs and breastbone, McKinley felt no pain. There was no swelling or tenderness in his calves or thighs. Finally, the doctor ordered an electrocardiogram, a chest X-ray, and blood tests to measure McKinley’s cardiac enzymes. (Abnormal levels of cardiac enzymes indicate damage to the heart.) As Croskerry expected, the results of all the tests were normal. “I’m not at all worried about your chest pain,” Croskerry told McKinley, before sending him home. “You probably overexerted yourself in the field and strained a muscle. My suspicion that this is coming from your heart is about zero.”
Early the next evening, when Croskerry arrived at the emergency room to begin his shift, a colleague greeted him. “Very interesting case, that man you saw yesterday,” the doctor said. “He came in this morning with an acute myocardial infarction.” Croskerry was shocked. The colleague tried to console him. “If I had seen this guy, I wouldn’t have gone as far as you did in ordering all those tests,” he said. But Croskerry knew that he had made an error that could have cost the ranger his life. (McKinley survived.) “Clearly, I missed it,” Croskerry told me, referring to McKinley’s heart attack. “And why did I miss it? I didn’t miss it because of any egregious behavior, or negligence. I missed it because my thinking was overly influenced by how healthy this man looked, and the absence of risk factors.”
Croskerry, who is sixty-four years old, began his career as an experimental psychologist, studying rats’ brains in the laboratory. In 1979, he decided to become a doctor, and, as a medical student, he was surprised at how little attention was paid to what he calls the “cognitive dimension” of clinical decision-making—the process by which doctors interpret their patients’ symptoms and weigh test results in order to arrive at a diagnosis and a plan of treatment. Students spent the first two years of medical school memorizing facts about physiology, pharmacology, and pathology; they spent the last two learning practical applications for this knowledge, such as how to decipher an EKG and how to determine the appropriate dose of insulin for a diabetic. Croskerry’s instructors rarely bothered to describe the mental logic they relied on to make a correct diagnosis and avoid mistakes.
In 1990, Croskerry became the head of the emergency department at Dartmouth General Hospital, and was struck by the number of errors made by doctors under his supervision. He kept lists of the errors, trying to group them into categories, and, in the mid-nineties, he began to publish articles in medical journals, borrowing insights from cognitive psychology to explain how doctors make clinical decisions—especially flawed ones—under the stressful conditions of the emergency room. “Emergency physicians are required to make an unusually high number of decisions in the course of their work,” he wrote in “Achieving Quality in Clinical Decision Making: Cognitive Strategies and Detection of Bias,” an article published in Academic Emergency Medicine, in 2002. These doctors’ decisions necessarily entail a great deal of uncertainty, Croskerry wrote, since, “for the most part, patients are not known and their illnesses are seen through only small windows of focus and time.” By calling physicians’ attention to common mistakes in medical judgment, he has helped to promote an emerging field in medicine: the study of how doctors think.
There are limited data about the frequency of misdiagnoses. Research from the nineteen-eighties and nineties suggests that they occur in about fifteen per cent of cases, but Croskerry suspects that the rate is significantly higher. He believes that many misdiagnoses are the result of readily identifiable—and often preventable—errors in thinking.
Doctors typically begin to diagnose patients the moment they meet them. Even before they conduct an examination, they are interpreting a patient’s appearance: his complexion, the tilt of his head, the movements of his eyes and mouth, the way he sits or stands up, the sound of his breathing. Doctors’ theories about what is wrong continue to evolve as they listen to the patient’s heart, or press on his liver. But research shows that most physicians already have in mind two or three possible diagnoses within minutes of meeting a patient, and that they tend to develop their hunches from very incomplete information. To make diagnoses, most doctors rely on shortcuts and rules of thumb—known in psychology as “heuristics.”
Heuristics are indispensable in medicine; physicians, particularly in emergency rooms, must often make quick judgments about how to treat a patient, on the basis of a few, potentially serious symptoms. A doctor is trained to assume, for example, that a patient suffering from a high fever and sharp pain in the lower right side of the abdomen could be suffering from appendicitis; he immediately sends the patient for X-rays and contacts the surgeon on call. But, just as heuristics can help doctors save lives, they can also lead them to make grave errors. In retrospect, Croskerry realized that when he saw McKinley in the emergency room the ranger had been experiencing unstable angina—a surge of chest pain that is caused by coronary-artery disease and that may precede a heart attack. “The unstable angina didn’t show on the EKG, because fifty per cent of such cases don’t,” Croskerry said. “His unstable angina didn’t show up on the cardiac-enzymes test, because there had been no damage to his heart muscle yet. And it didn’t show up on the chest X-ray, because the heart had not yet begun to fail, so there was no fluid backed up in the lungs.”
The mistake that Croskerry made is called a “representativeness” error. Doctors make such errors when their thinking is overly influenced by what is typically true; they fail to consider possibilities that contradict their mental templates of a disease, and thus attribute symptoms to the wrong cause. Croskerry told me that he had immediately noticed the ranger’s trim frame: most fit men in their forties are unlikely to be suffering from heart disease. Moreover, McKinley’s pain was not typical of coronary-artery disease, and the results of the physical examination and the blood tests did not suggest a heart problem. But, Croskerry emphasized, this was precisely the point: “You have to be prepared in your mind for the atypical and not be too quick to reassure yourself, and your patient, that everything is O.K.” (Croskerry could have kept McKinley under observation and done a second cardiac-enzyme test or had him take a cardiac stress test, which might have revealed the source of his chest pain.) When Croskerry teaches students and interns about representativeness errors, he cites Evan McKinley as an example.
Doctors can also make mistakes when their judgments about a patient are unconsciously influenced by the symptoms and illnesses of patients they have just seen. Many common infections tend to occur in epidemics, afflicting large numbers of people in a single community at the same time; after a doctor sees six patients with, say, the flu, it is common to assume that the seventh patient who complains of similar symptoms is suffering from the same disease. Harrison Alter, an emergency-room physician, recently confronted this problem. At the time, Alter was working in the emergency room of a hospital in Tuba City, Arizona, which is situated on a Navajo reservation. In a three-week period, dozens of people had come to his hospital suffering from viral pneumonia. One day, Blanche Begaye (a pseudonym), a Navajo woman in her sixties, arrived at the emergency room complaining that she was having trouble breathing. Begaye was a compact woman with long gray hair that she wore in a bun. She told Alter that she had begun to feel unwell a few days earlier. At first, she said, she had thought that she had a bad head cold, so she had drunk orange juice and tea, and taken a few aspirin. But her symptoms had got worse. Alter noted that she had a fever of 100.2 degrees, and that she was breathing rapidly—at almost twice the normal rate. He listened to her lungs but heard none of the harsh sounds, called rhonchi, that suggest an accumulation of mucus. A chest X-ray showed that Begaye’s lungs did not have the white streaks typical of viral pneumonia, and her white-blood-cell count was not elevated, as would be expected if she had the illness.
However, a blood test to measure her electrolytes revealed that her blood had become slightly acidic, which can occur in the case of a major infection. Alter told Begaye that he thought she had “subclinical pneumonia.” She was in the early stages of the infection, he said; the virus had not yet affected her lungs in a way that would show up on a chest X-ray. He ordered her to be admitted to the hospital and given intravenous fluids and medicine to bring her fever down. Viral pneumonia can tax an older person’s heart and sometimes cause it to fail, he told her, so it was prudent that she remain under observation by doctors. Alter referred Begaye to the care of an internist on duty and began to examine another patient.
A few minutes later, the internist approached Alter and took him aside. “That’s not a case of viral pneumonia,” the doctor said. “She has aspirin toxicity.”
Immediately, Alter knew that the internist was right. Aspirin toxicity occurs when patients overdose on the drug, causing hyperventilation and the accumulation of lactic acid and other acids in the blood. “Aspirin poisoning—bread-and-butter toxicology,” Alter told me. “This was something that was drilled into me throughout my training. She was an absolutely classic case—the rapid breathing, the shift in her blood electrolytes—and I missed it. I got cavalier.”
Alter’s misdiagnosis resulted from the use of a heuristic called “availability,” which refers to the tendency to judge the likelihood of an event by the ease with which relevant examples come to mind. This tendency was first described in 1973, in a paper by Amos Tversky and Daniel Kahneman, psychologists at the Hebrew University of Jerusalem. For example, a businessman may estimate the likelihood that a given venture could fail by recalling difficulties that his associates had encountered in the marketplace, rather than by relying on all the data available to him about the venture; the experiences most familiar to him can bias his assessment of the chances for success. (Kahneman won the Nobel Prize in Economics in 2002, for his research on decision-making under conditions of uncertainty.) The diagnosis of subclinical pneumonia was readily available to Alter, because he had recently seen so many cases of the infection. Rather than try to integrate all the information he had about Begaye’s illness, he had focussed on the symptoms that she shared with other patients he had seen: her fever, her rapid breathing, and the acidity of her blood. He dismissed the data that contradicted his diagnosis—the absence of rhonchi and of white streaks on the chest X-ray, and the normal white-blood-cell count—as evidence that the infection was at an early stage. In fact, this information should have made him doubt his hypothesis. (Psychologists call this kind of cognitive cherry-picking “confirmation bias”: confirming what you expect to find by selectively accepting or ignoring information.)
-
After the internist made the correct diagnosis, Alter recalled his conversation with Begaye. When he had asked whether she had taken any medication, including over-the-counter drugs, she had replied, “A few aspirin.” As Alter told me, “I didn’t define with her what ‘a few’ meant.” It turned out to be several dozen.
Representativeness and availability errors are intellectual mistakes, but the errors that doctors make because of their feelings for a patient can be just as significant. We all want to believe that our physician likes us and is moved by our plight. Doctors, in turn, are encouraged to develop positive feelings for their patients; caring is generally held to be the cornerstone of humanistic medicine. Sometimes, however, a doctor’s impulse to protect a patient he likes or admires can adversely affect his judgment.
In 1979, I treated Brad Miller (a pseudonym), a young literature instructor who was suffering from bone cancer. I was living in Los Angeles at the time, completing a fellowship in hematology and oncology at the U.C.L.A. Medical Center. “You look familiar,” Brad said to me when I introduced myself to him in his hospital room as the doctor who would be overseeing his care. “I see you running with two or three friends around the university,” he said. “I’m a runner, too—or, at least, was.”
I told Brad that I hoped he would be able to run again soon, though I warned him that his chemotherapy treatment would be difficult.
About six weeks earlier, Brad had noticed an ache in his left knee. He had been training to run in a marathon, and at first he thought that the ache was caused by a sore muscle. He saw a specialist in sports medicine, who examined the leg and recommended that he wear a knee brace when he ran. Brad followed this advice, but the ache got worse. The physician ordered an X-ray, which showed an osteosarcoma, a cancerous growth, around the end of the femur, just above the knee.
Several years earlier, the surgical-oncology department at U.C.L.A. had devised an experimental treatment for this kind of sarcoma, involving a new chemotherapy drug called Adriamycin. Oncologists had nicknamed Adriamycin “the red death,” because of its cranberry color and its toxicity. Not only did it cause severe nausea, vomiting, mouth blisters, and reduced blood counts; repeated doses could injure cardiac muscle and lead to heart failure. Patients had to be monitored closely, since once the heart is damaged there is no good way to restore its pumping capacity. Still, doctors at U.C.L.A. had found that giving patients multiple doses of Adriamycin often shrank tumors, allowing them to surgically remove the cancer without amputating the affected limb—the standard approach in the past.
I began administering the treatment that afternoon. Despite taking Compazine to stave off vomiting, Brad was acutely nauseated. After several doses of chemotherapy, his white-blood-cell count dropped precipitately. Because his immune system was weakened, he was at great risk of contracting an infection. I required visitors to Brad’s room to wear a mask, a gown, and gloves, and instructed the nurses not to give him raw food, in order to limit his exposure to bacteria.
“Not to your taste,” I said at the end of the first week of treatment, seeing an untouched meal on his tray.
“My mouth hurts,” Brad whispered. “And, even if I could chew, it looks pretty tasteless.”
I agreed that the food looked dismal.
“What is to your taste?” I asked. “Fried kidney?”
I had told Brad when we met that I had studied “Ulysses” in college, in a freshman seminar. The professor had explained the relevant Irish history, the subtle references to Catholic liturgy, and a number of other allusions that most of us in the class would otherwise not have grasped. I had enjoyed Joyce’s descriptions of Leopold Bloom eating fried kidneys.
Brad was my favorite patient on the ward. Each morning when I made rounds with the residents and the medical students, I would take an inventory of his symptoms and review his laboratory results. I would often linger a few moments in his room, trying to distract him from the misery of his therapy by talking about literature.
The treatment called for a CAT scan after the third cycle of Adriamycin. If the cancer had shrunk sufficiently, the surgery would proceed. If it hadn’t, or if the cancer had grown despite the chemotherapy, then there was little to be done short of amputation. Even after amputation, patients with osteosarcomas are at risk of a recurrence.
One morning, Brad developed a low-grade fever. During rounds, the residents told me that they had taken blood and urine cultures and that Brad’s physical examination was “nonfocal”—they had found no obvious reason for the fever. Patients often get low fevers during chemotherapy after their white-blood-cell count falls; if the fever has no identifiable cause, the doctor must decide whether and when to administer a course of antibiotics.
“So you feel even more wiped out?” I asked Brad.
He nodded. I asked him about various symptoms that could help me determine what was causing the fever. Did he have a headache? Difficulty seeing? Pressure in his sinuses? A sore throat? Problems breathing? Pain in his abdomen? Diarrhea? Burning on urination? He shook his head.
Two residents helped prop Brad up in bed so that I could examine him; I had a routine that I followed with each immune-deficient patient, beginning at the crown of the head and working down to the tips of the toes. Brad’s hair was matted with sweat, and his face was ashen. I peered into his eyes, ears, nose, and throat, and found only some small ulcers on his inner cheeks and under his tongue—side effects of his treatment. His lungs were clear, and his heart sounds were strong. His abdomen was soft, and there was no tenderness over his bladder.
“Enough for today,” I said. Brad looked exhausted; it seemed wise to let him rest.
Later that day, I was in the hematology lab, looking at blood cells from a patient with leukemia, when my beeper went off. “Brad Miller has no blood pressure,” the resident told me when I returned the call. “His temperature is up to a hundred and four, and we’re moving him to the I.C.U.”
Brad was in septic shock. When bacteria spread through the bloodstream, they can damage the circulation. Septic shock can be fatal even in people who are otherwise healthy; patients with impaired immunity, like Brad, whose white-blood-cell count had fallen because of chemotherapy, are at particular risk of dying.
“Do we have a source of infection?” I asked.
“He has what looks like an abscess on his left buttock,” the resident said.
Patients who lack enough white blood cells to fight bacteria are prone to infections at sites that are routinely soiled, like the area between the buttocks. The abscess must have been there when I examined Brad. But I had failed to ask him to roll over so that I could inspect his buttocks and rectal area.
The resident told me that he had repeated Brad’s cultures and started him on broad-spectrum antibiotics, and that the I.C.U. team was about to take over.
I was furious with myself. Because I liked Brad, I hadn’t wanted to add to his discomfort and had cut the examination short. Perhaps I hoped unconsciously that the cause of his fever was trivial and that I would not find evidence of an infection on his body. This tendency to make decisions based on what we wish were true is what Croskerry calls an “affective error.” In medicine, this type of error can have potentially fatal consequences. In the case of Evan McKinley, for example, Pat Croskerry chose to rely on the ranger’s initial test results—the normal EKG, chest X-ray, and blood tests—all of which suggested a benign diagnosis. He didn’t arrange for follow-up testing that might have revealed the source of the ranger’s chest pain. Croskerry, who had been an Olympic rower in his thirties, told me that McKinley had reminded him of himself as an athlete; he believed that this association contributed to his misdiagnosis.
As soon as I finished my work in the lab, I rushed to the I.C.U. to check on Brad. He was on a respirator and opened his eyes wide to signal hello. Through an intravenous line attached to one arm, he was receiving pressors, drugs that cause the heart to pump more effectively and increase the tone of the vessels to help maintain blood pressure. Brad’s heart was holding up, despite all the Adriamycin he had taken. His platelet count had fallen, as often happens with septic shock, and he was receiving platelet transfusions. The senior doctor in the I.C.U. had told Brad’s parents, who lived nearby, that he was extremely ill. I saw his parents sitting in a room next to the I.C.U., their heads bowed. They had not seen me, and I was tempted to avoid them. But I forced myself to speak to them and offered a few words of encouragement. They thanked me for my care of their son, which only made me feel worse.
The next morning, I arrived before the residents to review my patients’ charts. Rounds lasted an hour longer than usual, as I insisted on double-checking each bit of information that the residents offered about the patients in our care.
Brad Miller survived. Slowly, his white-blood-cell count increased, and the infection was resolved. After he left the I.C.U., I told him that I should have examined him more thoroughly that morning, but I did not explain why I had not. A CAT scan showed that his sarcoma had shrunk enough for him to undergo surgery without amputation, but a large portion of his thigh muscle had to be removed along with the tumor. After he recovered, he was no longer able to run, but occasionally I saw him riding his bicycle on campus.
Medical education has not changed substantially since Pat Croskerry and I were trained. Students are still expected to assimilate large amounts of basic science and apply that knowledge as they are taught practical aspects of patient care. And young physicians still learn largely by observing more senior members of their field. (“See one, do one, teach one” remains a guiding maxim at medical schools.) This approach produces confident and able physicians. Yet the ideal it implies, of the doctor as a dispassionate and rational actor, is misguided. As Tversky and Kahneman and other cognitive psychologists have shown, when people are confronted with uncertainty—the situation of every doctor attempting to diagnose a patient—they are susceptible to unconscious emotions and personal biases, and are more likely to make cognitive errors. Croskerry believes that the first step toward incorporating an awareness of heuristics and their liabilities into medical practice is to recognize that how doctors think can affect their success as much as how much they know, or how much experience they have. “Currently, in medical training, we fail to recognize the importance of critical thinking and critical reasoning,” Croskerry told me. “The implicit assumption in medicine is that we know how to think. But we don’t.”
-
Ex-Players Dealing With Not-So-Glamorous Health Issues
By CLIFTON BROWN
NY Times
Published: February 1, 2007
MIAMI, Jan. 31 - Bob Brudzinski turned 52 on Jan. 1, and he considers
himself lucky for a man who played 13 seasons as a linebacker with the Los
Angeles Rams and the Miami Dolphins. Sometimes, his memory fails him. But he
sees former teammates the same age in far worse shape.
Skip to next paragraph
Bob Galbraith/Associated Press
Reggie White, a Hall of Fame defensive lineman, died at 43 after having
cardiac arrhythmia.
"I see guys that I've played with that are depressed; as a matter of fact,
guys from college also," said Brudzinski, sitting in a doctor's office about
20 miles from Dolphin Stadium, site of Super Bowl XLI. "It's sad. I don't
think they had information back then. If they did, I think they wanted to
keep it away from us.
"I can't say the owners and coaches didn't care. They wanted to see how
tough you are. Anybody can play not injured. They wanted to see if you can
play injured. There were a lot of injections and stuff like that.
"And the other thing is, you didn't want to sit out a game, because there's
always somebody behind you who can take your spot. I never thought about
concussions, never thought about blowing my knee out. The one thing I really
wish is that I could remember more. We used our head too much, in the wrong
way."
As concern grows among former N.F.L. players about the impact of football on
health, the medical community is working to gather more information. The
Living Heart Foundation, the National Football League Players Association
and the Baptist Hospital of Miami are sponsoring the third annual Super Bowl
Health Screening Program, to examine current and retired players for
cardiovascular disease and obstructive sleep apnea. Dozens of former N.F.L.
players filed through the office of Dr. Arthur Agatston on Wednesday, being
checked for sleep apnea, diabetes, high cholesterol, high blood pressure and
other ailments.
Retired players have reason to be concerned about their long-term health. A
neuropathologist recently determined that Andre Waters, a former Eagles
safety who committed suicide in November at age 44, sustained brain damage
from playing football that led to his depression and death. Last month, a
United States Court of Appeals upheld a 2005 trial court ruling that the
Hall of Fame center Mike Webster sustained brain damage from playing
professional football, mostly for the Steelers.
According to a 2003 study published in The New England Journal of Medicine,
14 percent of N.F.L. players had obstructive sleep apnea, a disease that
impairs breathing and is known to affect large, muscular individuals like
football linemen more often than people of average size. Reggie White, a
Hall of Fame defensive lineman, died at 43 in 2004 after having cardiac
arrhythmia, but he also had sleep apnea, which may have contributed to his
death.
With more football linemen weighing much more than 300 pounds, doctors said
they expected sleep apnea to become more prevalent .
"The primary treatment for sleep apnea is to lose weight, and they can't,"
said Dr. Allan Levy, an associate team physician with the Giants, who is
assisting with this week's screening. "There's no such thing as a 225-pound
offensive lineman. We try to make certain that they understand that they've
got to come down in weight when they retire. All of my offensive lineman
from the Giants' two Super Bowl wins have all lost at least 50 pounds. They're
all in excellent health. You see some of the other guys, and they're just
huge. They've got all kinds of problems.
"The problem with sleep apnea is in the neck. A 17½-inch neck is usually
where the problem begins. When they sleep, the muscles relax in the body.
Now the weight of their neck clasps down on their airway. They stop
breathing. They momentarily wake up, then the cycle starts over again, and
they never get into deep sleep. They develop heart disease and hypertension.
Sleep apnea is a killer. One of the kids that played for us, we did a sleep
study on, had 440 awakenings during the night."
The most common treatment for sleep apnea involves wearing a mask that
supplies a stream of air through the nose during sleep. But some retired
players have ailments that are far more debilitating. Tom Nowatzke, the
president of the N.F.L. Alumni Detroit chapter, said more should be done by
the league and the players union to help retired players with disabilities
related to football.
"I get $843 a month, but some guys are only getting $300, $400 a month
because of when they played," said Nowatzke, a 64-year-old former running
back who scored a touchdown for the Baltimore Colts in Super Bowl V.
"Four hundred dollars a month won't pay for a car payment these days, not to
mention doctor bills and medicine, and stuff that's not covered. I'm very
fortunate to be as healthy as I am at my age. I'm going to see people this
weekend who have trouble walking, and they're eight or nine years younger
than I am."
Nowatzke said he hoped that more players would stop to think how they may
feel when they turn 60 and consider the health of players who have come
before them.
"Not many do," Nowatzke said. "Guys who played in the '30s, '40s, '50s
probably died before they turned 70. Now guys are living to be 75 or 80. So
it becomes a bigger problem."
-
Top 10 Foods for a Good Night's Sleep
Posted Tue, Jan 23, 2007, 6:32 pm PST
POST A COMMENT »
What is the secret to getting a solid 7 to 8 hours of sleep? Head for the kitchen and enjoy one or two of these 10 foods. They relax tense muscles, quiet buzzing minds, and/or get calming, sleep-inducing hormones - serotonin and melatonin - flowing. Yawning yet?
Bananas. They're practically a sleeping pill in a peel. In addition to a bit of soothing melatonin and serotonin, bananas contain magnesium, a muscle relaxant.
Chamomile tea. The reason chamomile is such a staple of bedtime tea blends is its mild sedating effect - it's the perfect natural antidote for restless minds/bodies.
Warm milk. It's not a myth. Milk has some tryptophan - an amino acid that has a sedative - like effect - and calcium, which helps the brain use tryptophan. Plus there's the psychological throw-back to infancy, when a warm bottle meant "relax, everything's fine."
Honey. Drizzle a little in your warm milk or herb tea. Lots of sugar is stimulating, but a little glucose tells your brain to turn off orexin, a recently discovered neurotransmitter that's linked to alertness.
Potatoes. A small baked spud won't overwhelm your GI tract, and it clears away acids that can interfere with yawn-inducing tryptophan. To up the soothing effects, mash it with warm milk.
Oatmeal. Oats are a rich source of sleep - inviting melatonin, and a small bowl of warm cereal with a splash of maple syrup is cozy - plus if you've got the munchies, it's filling too.
Almonds. A handful of these heart-healthy nuts can be snooze-inducing, as they contain both tryptophan and a nice dose of muscle-relaxing magnesium.
Flaxseeds. When life goes awry and feeling down is keeping you up, try sprinkling 2 tablespoons of these healthy little seeds on your bedtime oatmeal. They're rich in omega-3 fatty acids, a natural mood lifter.
Whole-wheat bread. A slice of toast with your tea and honey will release insulin, which helps tryptophan get to your brain, where it's converted to serotonin and quietly murmurs "time to sleep."
Turkey. It's the most famous source of tryptophan, credited with all those Thanksgiving naps. But that's actually modern folklore. Tryptophan works when your stomach's basically empty, not overstuffed, and when there are some carbs around, not tons of protein. But put a lean slice or two on some whole-wheat bread mid-evening, and you've got one of the best sleep inducers in your kitchen.
What if none of these foods help you get your zzz's? Check out your sleep habits with this quick RealAge test to find out what?s keeping you up at night. http://www.realage.com/health_guides/RLS/intro.aspx
-
AFPA [American Fitness Professionals &
Associates] March 2007 Health & Fitness
Newsletter Online vol. 12 no. 3
"There are no great people in this world, only
great challenges which ordinary people rise to
meet".
William "Bull" Halsey, Admiral 1882-1595
Table of Contents:
AFPA Fitness Conferences for Spring 2007
AFPA announces Pilates Fitness Instructor
Level II Certification
Depression Promotes Heart Problems
Why Doctors Miss Colon Cancer
Why Exercising as You Age Becomes More
Important and Challenging
Fruits and Vegetables Improve Male Fertility
Take advantage of AFPA's Resources
Use Folic Acid to Cut Heart Disease, Say
Experts
Depression Promotes Heart Problems
Depression appears to increase the
development of blood vessel plaques, known
as atherosclerosis, a condition that can lead to
heart attack, stroke, and a host of other
cardiovascular problems, according to a report
in the Archives of General Psychiatry.
Patients' psychological status influence quality
of life, and may also have a "significant impact"
on their physical status, including cardiovascular
health, Dr. Jesse C. Stewart, from Indiana
University-Purdue University Indianapolis, told
Reuters Health.
Stewart and colleagues evaluated the contribution of
depression, anxiety, and anger to atherosclerosis
among 324 men and women between 50 and 70
years old.
Symptom scoring tests evaluated the presence
of depression, anxiety and anger, while the
extent of atherosclerosis was accessed using
an imaging test, which measured the thickness
of the walls of the carotid arteries, major blood
vessels in the neck that carry oxygen to the
brain.
Why Doctors Miss Colon Cancer
An interesting study underscored one more
reason, among a seemingly, never-ending
number of them, why patients may die from the
errors their doctors make: Your physician may be
missing signs of colon cancer right in front of
him.
Among more than 12,000 colon cancer
patients, 430 patients had a new or missed
tumor that was diagnosed anywhere from six
months to three years after having a
colonoscopy. What's more, family physicians
and internists who did their own colonoscopies
were generally far more prone to miss colon
cancer, with women (85 percent) edging men
(77 percent).
The other troublesome variable, Canadian
researchers discovered, was where a
colonoscopy was performed. An office setting
tripled the risk of new or missed cancers
among men and doubled it among women.
Fortunately, there are many natural measures
you can take -- none of which have anything to
do with a drug, doctor or procedure -- to
prevent or fight colon cancer. A few to get you
started:
Have your C-reactive protein levels checked
and reduce them, if necessary.
Get the right amount of exercise.
Rebalance the ratio of omega-3 fats you
consume by taking a high quality fish oil or krill
oil.
Eat plenty of vegetables, ideally based on your
body's unique metabolic type.
Gastroenterology, Vol. 132, No. 1, January
2007: 96-102
Yahoo News February 23, 2007
Why Exercising as You Age Becomes More
Important and Challenging
A biological process called AMP-activated
protein kinase (AMPK), which boosts muscles,
begins to fail with advancing age. This leads to
a need for increased effort to achieve the
same effects from exercise, and could help
explain the link between aging and type 2
diabetes.
AMPK stimulates the body to burn off fat by
producing mitochondria, the power sources of
cells. The skeletal muscles of athletes have
been found to contain a much higher number
of mitochondria, which is likely linked to AMPK
activity.
When scientists compared the skeletal muscle
of 3-month-old rats and 2-year-olds, they found
that AMPK was significantly slowed down in
older animals. In addition, the muscle of young
rats who did more exercise had double the
normal AMPK activity, but this effect was not
nearly as strong in older rats.
Older people have more fat in their muscles
and livers than younger people do. These fat
cells have been linked to insulin resistance and
type 2 diabetes.
Cell Metabolism February 7, 2007; 5(2): 151-
156
BBC News February 10, 2007
Science Daily February 7, 2007
Fruits and Vegetables Improve Male Fertility
A new study shows that eating fruits and
vegetables can improve fertility in men.
Researchers from the University of Rochester
compared the dietary intake of antioxidants of
10 fertile and 48 infertile men and correlated
the findings with sperm motility. Infertile men
were twice as likely to have a low intake of
fruits and vegetables (fewer than five servings
per day) compared with fertile men. Also, men
with the lowest overall intake of dietary
antioxidants had lower sperm motility than men
with higher intakes.
Lewis V, Kochman L, Herko R, Brewer K,
Andolina E, Song G. Dietary antioxidants and
sperm quality in infertile men.Paper presented
at: Annual Scientific Meeting of the American
Society for Reproductive Medicine; October
2006; New Orleans.
Please make sure you take advantage of our
monthly online newsletter at:
http://www.afpafitness.com/newsletter.htm
Also please note that AFPA has archived
newsletters:
http://www.afpafitness.com/archived.htm
As well as articles:
http://www.afpafitness.com/articlesa_h.htm
http://www.afpafitness.com/articlesi_z.htm
Site Search for Information:
http://www.afpafitness.com/search.htm
Use Folic Acid to Cut Heart Disease, Say
Experts
The scientific evidence is strong enough to
justify using folic acid as a cheap and simple
way of reducing heart disease and strokes.
Debate continues over whether raised
homocysteine levels in the blood (an amino
acid implicated in the development of arterial
disease) causes heart disease and stroke, and
whether folic acid, which lowers homocysteine,
will help reduce the risk of these disorders.
So heart expert, Dr David Wald and colleagues
set out to clarify the issue. They examined all
the evidence from different studies to see
whether raised homocysteine is a cause of
cardiovascular disease.
Some studies looked at homocysteine and the
occurrence of heart attacks and strokes in
large numbers of people (cohort studies),
some focused on people with a common
genetic variant which increases homocysteine
levels to a small extent (genetic studies), while
others tested the effects of lowering
homocysteine levels (randomised controlled
trials).
The conclusion that homocysteine is a cause
of cardiovascular disease explains the
observations from all the different types of
study, even if the results from one type of
study are, on their own, insufficient to reach
that conclusion, say the authors.
Since folic acid reduces homocysteine
concentrations, it follows that increasing folic
acid consumption will reduce the risk of heart
attack and stroke.
They therefore take the view that the evidence
is now sufficient to justify action on lowering
homocysteine concentrations, although the
position should be reviewed as evidence from
ongoing clinical trials emerges.
BMJ Volume 333 pp 1114-7 Click here to view
paper:
http://press.psprings.co.uk/bmj/november/ac11
14.pdf
Source: Diabetes In Control
-
Today's NY Times
THE video was dark and grainy, the camera operator anonymous. But the clip, which appeared to show a customer at a popular downtown restaurant extracting a disposable glove from a plate of food, caused a small stir on Monday when a link to it was posted at eater.com, a blog that chronicles the New York dining scene.
IS THE SOLUTION A PROBLEM? Employees at a deli wear gloves as they handle ready-to-eat foods. But latex gloves can cause allergic reactions and vinyl gloves contain a chemical that has been called a carcinogen.
After a series of restaurant closings by the city’s health department, the amateur video raised new concerns about sanitation practices in restaurant kitchens. The very object that is supposed to keep diners safe from germs appeared to be a menace.
The unusual episode hinted at a larger problem. Twenty years after disposable gloves became common in restaurant kitchens, it is not clear that they prevent the transmission of illness. There are some who argue that the gloves themselves are dangerous to health.
“The typical hand contains millions of bacteria, including harmful ones like staph and strep,” said Elaine Larson, associate dean in the Columbia University School of Nursing and an expert on hand hygiene. “Gloves can prevent most of those bacteria from being transmitted to food.”
But only if the gloves are clean. “The problem is that a worker may never change the gloves or clean them, thinking that the gloves themselves are sufficient protection,” Dr. Larson said. “The trick is to make sure that workers are properly trained.”
That is easier said than done. Thousands of United States restaurant workers were surveyed for a study published in the International Journal of Hygiene and Environmental Health in 2005. More than a third said they did not always change their gloves between touching raw meat or poultry and ready-to-eat food.
Moreover, most gloves are made of latex, a component of natural rubber. Particles of latex can cause allergic reactions not only among people wearing the gloves but also among customers eating food prepared by them. As a result, three states have banned latex gloves in restaurants. In New York a bill has been introduced in the Legislature requiring warning signs in restaurants that use latex gloves.
Many restaurants have switched to gloves made of vinyl, but vinyl contains Di(2-ethylhexyl) phthalate, or DEHP, a chemical that some scientists believe can cause testicular damage in infants and young men. It is also classified as a carcinogen in California. In 2001 Japan banned vinyl gloves from food establishments after large quantities of DEHP were found in food prepared by workers wearing them.
But in the United States, because of latex allergy concerns, vinyl gloves are becoming ever more popular.
Andy Igrejas, the environmental health campaign director at the National Environmental Trust, a nonprofit organization in Washington, characterized the switch as “out of the frying pan and into the fire.”
But Michael Herndon, a spokesman for the Food and Drug Administration, said the government is “not now planning any regulatory action.” In 2002 his agency cautioned that “developing males” should avoid exposure to the DEHP in vinyl used in medical devices.
When it comes to food preparation, Mr. Herndon wrote in an e-mail message, DEHP dissolves in oil, “but is not easily soluble in water,” so it should be used in gloves “that are intended to contact foods of high water content only.” He did not elaborate on how restaurants were to follow that advice.
Allen Blakey, a spokesman for the Vinyl Institute, a trade group based in Arlington, Va., said: “We have seen no evidence that vinyl gloves are unsafe. The Consumer Product Safety Commission has reviewed the safety of vinyl toys, and the F.D.A. has reviewed the safety of vinyl medical devices, and both agencies have found little to no concern with the vast majority of vinyl products they’ve reviewed. I think that probably says a lot about the safety of vinyl gloves.”
The practice of using gloves in restaurants was intended to cut down on food-borne illnesses, which sicken tens of millions of Americans a year, according to the Centers for Disease Control and Prevention. Some of those illnesses are transmitted by workers’ hands. Under New York State law, food workers must use gloves, utensils or paper when touching ready-to-eat foods. Most states have similar guidelines.
Rhode Island was the first state to ban latex gloves from restaurants, in 1999; Arizona followed in 2001, Oregon in 2003. The states acted as a result of increases in consumer complaints and in workers’ compensation claims stemming from latex-related allergies. About a dozen states are considering or have considered such legislation.
“I’d be thrilled to see fewer gloves, more washing,” said Sue Lockwood, the executive director of the American Latex Allergy Association in Slinger, Wis., who said latex allergies affect about one percent of Americans. Some sufferers try to avoid restaurants where latex is used, she said, but it is often difficult for them to get accurate information from restaurant employees. One way to be sure, she said, “is to ask to have a manager read the box” the gloves come in.
=========
(Page 2 of 2)
Adam T. Bradley, who represents parts of Westchester in the New York State Assembly, introduced a bill in January that would require restaurants to post warning signs if they use latex gloves. Mr. Bradley said a constituent told him about his grandson, who has a severe latex allergy. “The first step is to warn people who may be in danger,” Mr. Bradley said.
Such regulations are opposed by the Malaysian Rubber Glove Manufacturers’ Association. (Malaysian companies make most of the gloves used in this country.) Its representatives in Washington say the anti-latex claims are exaggerated. In 2003 it began what it called a public relations offensive that included pointing out that allergic reactions to latex are rare and claiming that vinyl gloves posed other problems.
Bare-hand contact with ready-to-eat food can be safe, said Dr. Donna M. Garren, the vice president for health and safety regulatory affairs for the National Restaurant Association, which represents restaurant owners and opposes mandatory glove rules. But it is safe only if employee hand-washing is carefully monitored. Some health experts agreed that regular washing would be more effective than glove use.
“The reason that workers wear gloves is that they don’t wash their hands as much as they should,” said Denise Korniewicz, a professor at the University of Miami School of Nursing and Health Studies who has studied the efficacy of rubber gloves for more than 20 years. “If you walk into any fast-food restaurant and observe people, they use the cash register, they wipe their nose and then they make your sandwich.”
Some restaurant owners are not sure the gloves make anybody safer.
“When your hands are bare you can tell if you get something on them, and you immediately wash,” said Debra Silva, who owns Clem & Ursie’s, a seafood restaurant in Provincetown, Mass. “But if you’re wearing gloves, you might have no idea that you’ve touched something dirty.”
Ms. Silva said she spends thousands of dollars a year on gloves. “I go through a case or two a week,” she said. Each case contains 100 gloves.
Many sushi chefs prepare raw fish with their bare fingers despite the rules requiring them to use gloves, tongs or paper. On a recent night the chefs at a Greenwich Village sushi bar scoffed at the idea of using gloves. One, who did not want to give his name for fear of getting the restaurant in trouble, said gloves would make it difficult to tell, by feel, if the fish was fresh. In that way, he said, gloves could make customers less safe. “You can’t make real sushi with gloves on,” he said.
It was the same story at a sushi restaurant in Midtown. “We’ve been doing it this way for 250 years,” one chef said. “People who make the regulations just don’t understand.”
-
AFPA April 2007 Health & Fitness Online Newsletter
vol. 12 no. 4
When you wish to instruct, be brief; that men's minds take in quickly what you say, learn its lesson, and retain it faithfully. Every word that is unnecessary only pours over the side of a brimming mind. - Cicero (106 BC - 43 BC)
--------------------------------------------------------------------------------
Table of Contents:
AFPA Re-launches all New Website
AFPA Fitness Conferences for Spring 2007
God Does Answer Your Prayers
Cancer Rates Continue to Worsen
Are You Eating Enough Fruits and Vegetables?
Calcium Supplements Fail to Improve Children's Bone Health
--------------------------------------------------------------------------------
AFPA Re-launches all New Website
AFPA Re-launches our award winning website with more information, articles, members area, and more.
www.afpafitness.com
--------------------------------------------------------------------------------
AFPA Fitness Conferences for Spring 2007
April 27-29 Beach Jam XIII Fitness, Trainer, Sports & Mind Body Conference, Ocean City, MD.
May 10-12 Myrtle Beach Fitness, Trainer, Sports & Mind Body Conference, Kingston Plantation, Myrtle Beach, SC.
http://www.afpafitness.com
--------------------------------------------------------------------------------
God Does Answer Your Prayers
According to a new, comprehensive analysis of 17 major studies on the effects of intercessory prayer -- prayer that is offered for the benefit of another person -- there is a positive effect for people with both medical and psychological problems.
Some individual studies have found positive results, while others have shown no effect. A meta-analysis of all studies allowed researchers to take into account the entire body of research.
When the effects of prayer were averaged across all 17 studies, controlling for differences in sample sizes, there was a net positive effect on the group being prayed for.
Research on Social Work Practice, Vol. 17, No. 2, March 2007: 174-187
Science Blog March 14, 2007
--------------------------------------------------------------------------------
Cancer Rates Continue to Worsen
America's aging population will increase the number of cancer patients 55 percent by 2020, and doctors may not be able to cope with the additional burden.
Today, 11.7 million people, or one in 26, have been diagnosed with the illness.
Analyses predict that the number of Americans who are diagnosed with cancer will grow to 18.2 million by 2020, about one in 19 Americans. There may not be enough doctors to care for so many sick people; if current trends continue, the country could face a shortage of up to 4,000 cancer specialists.
Increases in cancer have paralleled the increase in the number of Americans over 65. The country can also expect to see increases in heart disease, diabetes and Alzheimer's disease as the population ages.
Journal of Oncology Practice, Vol. 3, No. 2, March 2007: 79-86
USA Today March 14, 2007
The following are some excellent recommendations:
Control your insulin levels: Make certain that you limit your intake of processed foods and sugars as much as possible.
Get appropriate amounts of animal-based omega-3 fats and make sure you use cod liver oil if you don't have regular access to sun exposure.
Get appropriate exercise. One of the primary reasons exercise works is that it drives your insulin levels down. Controlling insulin levels is one of the most powerful ways to reduce your cancer risks.
Normalize your vitamin D levels with safe amounts of sun exposure (addressed in my video). This works primarily by optimizing your vitamin D level. If you have regular access to sun exposure then you should use fish oil, not cod liver oil, as your primary source of omega-3 fats. Ideally, it would be best to monitor your vitamin D levels.
Have a tool to permanently erase the neurological short-circuiting that can activate cancer genes. Even the CDC states that 85 percent of disease is caused by emotions. It is likely that this factor may be more important than all the other physical ones listed here, so make sure this is addressed. Energy psychology seems to be one of the best approaches and my particular favorite tool, as you may know, is the Emotional Freedom Technique.
Only 25 percent of people eat enough vegetables, so by all means eat as many vegetables as you are comfortable with. Ideally, they should be fresh and organic. However, please understand that, frequently, fresh conventionally grown vegetables are healthier than organic ones that are older and wilted in the grocery store. They are certainly better than no vegetables at all, so don't use that as an excuse.
Make sure you are not in the two-thirds of the population who are overweight and maintain an ideal body weight.
Get enough high-quality sleep.
Reduce your exposure to environmental toxins like pesticides, household chemical cleaners, synthetic air fresheners and air pollution.
Boil, poach or steam your foods, rather than frying or charbroiling them.
--------------------------------------------------------------------------------
Are You Eating Enough Fruits and Vegetables?
According to the U.S. Centers for Disease Control and Prevention, fewer than a third of American adults eat the amount of fruits and vegetables recommended by the government.
This trend has remained steady for more than a decade, and is well below the benchmark for the national goal of getting the majority of Americans to eat two servings of fruits and three servings of vegetables each day by 2010.
The information comes from a massive diet survey of more than 300,000 adults in 2005. It showed that only 27 percent of adults ate vegetables three times a day, and only about 33 percent ate fruit twice a day.
Senior citizens were more likely to eat more fruits and vegetables. Adults aged 18 to 24 ate the fewest vegetables, and those aged 35 to 44 ate the least fruit.
Morbidity and Mortality Weekly Report, Vol. 56, No. 10, March 16, 2007: 213-217 Free Full-Text Report
San Francisco Chronicle March 15, 2007
--------------------------------------------------------------------------------
Calcium Supplements Fail to Improve Children's Bone Health
A new analysis shows little benefit to using calcium supplements to improve bone health in children. Nineteen randomized controlled trials were reviewed to determine the effectiveness of calcium supplementation for improving bone mineral density in children. Supplementation had no effect on the bone mineral density in the neck or spine and caused only a small increase in the density of the upper limb, equivalent to a 1.7 percentage increase in the supplemented group compared with the control. No lasting effect of supplementation was seen in the one study that reported total body density after supplementation stopped.
Winzenberg T, Shaw K, Fryer J, Jones G. Effects of calcium supplementation on bone density in healthy children: meta-analysis of randomized controlled trials. BMJ. 2006;333:775
-
A MD friend recommends this article: "An unusually thoughtful and competent recent medical NYT article"
-------------------------------------------------------------------------------
April 8, 2007
By GINA KOLATA
Keith Orr thought he would surprise his doctor when he came for a checkup.
His doctor had told him to have a weight-loss operation to reduce the amount
of food his stomach could hold, worried because Mr. Orr, at 6 feet 2 inches,
weighed 278 pounds. He also had a blood sugar level so high he was on the
verge of diabetes and a strong family history of early death from heart
attacks. And Mr. Orr, who is 44, had already had a heart attack in 1998 when
he was 35.
But Mr. Orr had a secret plan. He had been quietly dieting and exercising
for four months and lost 45 pounds. He envisioned himself proudly telling
his doctor what he had done, sure his tests would show a huge drop in his
blood sugar and cholesterol levels. He planned to confess that he had also
stopped taking all of his prescription drugs for heart disease.
After all, he reasoned, with his improved diet and exercise, he no longer
needed the drugs. And, anyway, he had never taken his medications regularly,
so stopping altogether would not make much difference, he decided.
But the surprise was not what Mr. Orr had anticipated. On Feb. 6, one week
before the appointment with his doctor, Mr. Orr was working out at a gym
near his home in Boston when he felt a tightness in his chest. It was the
start of a massive heart attack, with the sort of blockage in an artery that
doctors call the widow-maker.
He survived, miraculously, with little or no damage to his heart. But his
story illustrates the reasons that heart disease still kills more Americans
than any other disease, as it has for nearly a century.
Medical research has revealed enough about the causes and prevention of
heart attacks that they could be nearly eliminated. Yet nearly 16 million
Americans are living with coronary heart disease, and nearly half a million
die from it each year.
It's not that prevention doesn't work, and it's not that once someone has a
heart attack there is little to be done. In fact, said Dr. Elizabeth Nabel,
director of the National Heart, Lung and Blood Institute at the National
Institutes of Health, age-adjusted death rates for heart disease dropped
precipitously in the past few decades, and prevention and better treatment
are major reasons why.
But the concern, Dr. Nabel and others say, is that much more could be done.
In many ways, scientists' hard-won and increasingly detailed understanding
of what causes heart disease and what to do for it often goes unknown or
ignored.
Studies reveal, for example, that people have only about an hour to get
their arteries open during a heart attack if they are to avoid permanent
heart damage. Yet, recent surveys find, fewer than 10 percent get to a
hospital that fast, sometimes because they are reluctant to acknowledge what
is happening. And most who reach the hospital quickly do not receive the
optimal treatment - many American hospitals are not fully equipped to
provide it but are reluctant to give up heart patients because they are so
profitable.
And new studies reveal that even though drugs can protect people who already
had a heart attack from having another, many patients get the wrong doses
and most, Mr. Orr included, stop taking the drugs in a matter of months.
They should take the drugs for the rest of their lives.
"We've done pretty well," Dr. Nabel said. "But we could be doing much
better. I've heard some people refer to it as the rule of halves. Half the
people who need to be treated are treated and half who are treated are
adequately treated."
The result, heart researchers say, is a huge disconnect between what is
possible and what is actually happening.
Crucial Miscalculations
Keith Orr's story has themes that resonate with every cardiologist. He did
many things right, but also made some crucial miscalculations that were so
common that nearly every patient makes them, cardiologists say. But not
everyone comes out as well.
Mr. Orr anticipated a pleasant day on Feb. 6, starting with a workout at his
gym, then lunch with a friend before he went to work at Smith & Wollensky, a
steakhouse where he is a manager.
He arrived at the gym around noon and lifted weights, concentrating on the
pectoral muscles of his chest. Then he moved on to an elliptical
cross-trainer for cardiovascular exercise.
After half an hour on the elliptical, Mr. Orr felt a tightness in his chest.
"I attributed it to the weight training," he said, but stopped exercising,
showered, dressed and walked to his car.
"I felt really bad, out of sorts," he said. The pressure in his chest would
ease off and then intensify, and now he was sweating profusely and was
nauseated. When he arrived at the restaurant, he told his friend Darrin
Friedman that he would have to beg off from lunch. "I feel like hell," he
told Mr. Friedman.
He went home and lay on his bed.
"I knew at that point that it was not a pulled muscle," Mr. Orr said. "It's
a completely different feeling of pressure and discomfort. You feel as
though something is genuinely wrong."
It was 3:15. And the pain was no longer intermittent. It was constant.
Mr. Orr called Mr. Friedman and asked him to drive him to an emergency room.
A few minutes later, the two set off for Brigham and Women's Hospital, about
a 10-minute drive.
"Keith was hunched over and he didn't put his seat belt on," Mr. Friedman
said. "I kept asking him, 'Is it getting better or getting worse or staying
the same?' For the first 10 minutes he said, 'It's about the same.' Then,
when we were a block or so away, he said: 'I'm not doing well. I think it's
getting worse.' "
When they arrived at the hospital's emergency department, Mr. Friedman
explained that his friend was having chest pains. Immediately, Mr. Orr was
wheeled off for an electrocardiogram, showing his heart's electrical
signals. It was ominous, including one pattern called the tombstone T wave
because patients who had it died in the days before there were aggressive
treatments to open arteries.
The next thing Mr. Orr knew, he was being rushed to the cardiac
catheterization laboratory for a procedure to open his artery.
"They said: 'We're going now. We're going now,' " Mr. Orr recalled. "That
really scared me. Someone kept yelling: 'Do you have his labs? Do you have
his labs?' Someone else said, 'We'll transfer them later.' "
The electrocardiogram was at 3:45 p.m., roughly 30 minutes after his
symptoms changed from intermittent to constant and 5 minutes after he got to
the hospital.
At 3:52 p.m., Dr. Ashvin Pande, a cardiology fellow, was chatting in the
hallway when he was called to the catheterization lab.
"Big M.I. coming in," a nurse told Dr. Pande, using the abbreviation for
myocardial infarction, or heart attack. At the time, the room was occupied -
a patient was lying on the table for an elective procedure. He was quickly
wheeled out and Mr. Orr was wheeled in. It was 3:56 p.m.
Within minutes, Dr. James M. Kirshenbaum, director of acute interventional
cardiology, assisted by Dr. Pande, threaded a thin tube, like a long and
narrow straw, from an artery in Mr. Orr's groin to his heart. They injected
a dye to make Mr. Orr's arteries visible to an X-ray and they saw the
problem - a huge clot in his heart's left anterior descending artery,
blocking blood flow to most of his heart.
The quickest option was to open that artery with a balloon and keep it open
with a stent, a tiny mesh cage, if possible.
It worked - the balloon shattered the clot and pushed the debris against the
artery wall and the stent held the artery open. Then a different problem
arose. When the large clot was pushed aside, the debris was shoved against
the opening of a small artery that branched from the larger one, much as a
snowplow clearing a street can block a driveway.
"We made a calculated decision that it would be worth sacrificing the branch
to secure the main vessel," Dr. Pande said. But, fortunately, they were able
to insert another balloon through the stent and into the small artery,
opening it too.
At 4:43, the procedure was over and Mr. Orr was wheeled to the coronary
intensive care unit. He had been awake but sedated and experienced what he
said was the amazing feeling of having his artery opened. "As soon as the
balloon goes in, all the pain disappears," he said. "You know immediately."
The cardiologists who saved his life walked out of the room, grinning and
exhilarated.
"This adrenaline rush is why people like me go into cardiology," Dr. Pande
said.
The First Call: An Ambulance
Mr. Orr was incredibly lucky, said Dr. Elliott Antman, director of the
coronary care unit at Brigham and Women's Hospital. He ended up with little
or no damage to his heart, even though he teetered between lifesaving
decisions and critical miscalculations in his moments of crisis.
The first lifesaving decision was to go to a hospital soon after his chest
pain began. But the miscalculation was to call his friend for a ride. He
should have called an ambulance.
Had his friend gotten caught in traffic, Mr. Orr might have been dead or
sustained serious injury to his heart. He might have had to go to a
rehabilitation center and learn special tactics for conserving energy, like
sliding a coffeepot along a counter instead of lifting it.
What few patients realize, Dr. Antman said, is that a serious heart attack
is as much of an emergency as being shot.
"We deal with it as if it is a gunshot wound to the heart," Dr. Antman said.
Cardiologists call it the golden hour, that window of time when they have a
chance to save most of the heart muscle when an artery is blocked.
But that urgency, cardiologists say, has been one of the most difficult
messages to get across, in part because people often deny or fail to
appreciate the symptoms of a heart attack. The popular image of a heart
attack is all wrong.
It's the Hollywood heart attack, said Dr. Eric Peterson, a cardiologist and
heart disease researcher at Duke University.
"That's the man clutching his chest, grimacing in pain and going down," Dr.
Peterson said. "That's what people imagine a heart attack is like. What they
don't imagine is that it's not so much pain as pressure, a feeling of
heaviness, shortness of breath."
Most patients describe something like Mr. Orr's symptoms - discomfort in the
chest that may, or may not, radiate into the arms or neck, the back, the
jaw, or the stomach. Many also have nausea or shortness of breath. Or they
break out in a cold sweat, or have a feeling of anxiety or impending doom,
or have blue lips or hands or feet, or feel a sudden exhaustion.
But symptoms often are less distinctive in elderly patients, especially
women. Their only sign may be a sudden feeling of exhaustion just walking
across a room. Some say they broke out in a sweat. Afterward, they may
recall a feeling of pressure in their chest or pain radiating from their
chest but at the time, they say, they paid little attention.
Patients with diabetes might have no obvious symptoms at all other than
sudden, extreme fatigue. It's not clear why diabetics often have these
so-called silent heart attacks - one hypothesis attributes it to damage
diabetes can cause to nerves that carry pain signals.
"I say to patients, 'Be alert to the possibility that you may be short of
breath,' " Dr. Antman said. "Every day you walk down your driveway to go to
your mailbox. If you discover one day that you can only walk halfway there,
you are so fatigued that you can't walk another foot, I want to hear about
that. You might be having a heart attack."
Other times, said Dr. George Sopko, a cardiologist at the National Heart,
Lung and Blood Institute, symptoms like pressure in the chest come and go.
That is because a blood clot blocking an artery is breaking up a bit,
reforming, breaking and reforming. It was what happened to Mr. Orr when he
was at the gym and meeting his friend afterward.
"It's a pre-heart attack," Dr. Sopko said. A blood vessel is on its way to
being completely blocked. "You need to call 911."
But most people - often hoping it is not a heart attack, wondering if their
symptoms will fade, not wanting to be alarmist - hesitate far too long
before calling for help.
-
"The single biggest delay is from the onset of symptoms and calling 911,"
said Dr. Bernard Gersh, a cardiologist at the Mayo Clinic. "The average time
is 111 minutes, and it hasn't changed in 10 years."
'Time Is Muscle'
At least half of all patients never call an ambulance. Instead, in the
throes of a heart attack, they drive themselves to the emergency room or are
driven there by a friend or family member. Or they take a taxi. Or they
walk.
Patients often say they were embarrassed by the thought of an ambulance
arriving at their door.
"Calling 911 seems like such a project," Mr. Orr said. "I reserve it for car
accidents and exploding appliances. I feel like if I can walk and talk and
breathe I should just get here."
It is an understandable response, but one that can be fatal, cardiologists
say.
"If you come to the hospital unannounced or if you drive yourself there,
you're burning time," Dr. Antman said. "And time is muscle," he added,
meaning that heart muscle is dying as the minutes tick away.
There may be false alarms, Dr. Sopko said.
"But it is better to be checked out and find out it's not a problem than to
have a problem and not have the therapy," he said.
Calling an ambulance promptly is only part of the issue, heart researchers
say. There also is the question of how, or even whether, the patient gets
either of two types of treatment to open the blocked arteries, known as
reperfusion therapy.
One is to open arteries with a clot-dissolving drug like tPA, for tissue
plasminogen activator.
"These have been breakthrough therapies," said Dr. Joseph P. Ornato, a
cardiologist and emergency medicine specialist who is medical director for
the City of Richmond, Va. "But the hooker is that even the best of the clot
buster drugs typically only open up 60 to 70 percent of blocked arteries -
nowhere close to 100 percent."
The drugs also make patients vulnerable to bleeding, Dr. Ornato said.
One in 200 patients bleeds into the brain, having a stroke from the
treatment meant to save the heart.
The other way is with angioplasty, the procedure Mr. Orr got. Cardiologists
say it is the preferred method under ideal circumstances.
Stents have recently been questioned for those who are just having symptoms
like shortness of breath. In those cases, drugs often work as well as
stents. But during a heart attack or in the early hours afterward, stents
are the best way to open arteries and prevent damage. That, though, requires
a cardiac catheterization laboratory, practiced doctors and staff on call 24
hours a day. The result is that few get this treatment.
"We now are seeing really phenomenal results in experienced hands," Dr.
Ornato said. "We can open 95 to 96 percent of arteries, and bleeding in the
brain is virtually unheard of. It's a safer route if it is done by very
experienced people and if it is done promptly. Those are big ifs."
The ifs were not a problem for Mr. Orr. His decision to go to Brigham and
Women's Hospital proved exactly right. But he did not know that when he
chose the hospital - he chose it because his doctor was affiliated with
Brigham.
A Need for More Angioplasty
Currently, 30 percent of patients who are candidates for reperfusion do not
receive it, and of those who do, only 18 percent are treated with
angioplasty, said Dr. Alice Jacobs, director of the cardiac catheterization
laboratory at Boston University School of Medicine and a past president of
the American Heart Association. Of the nation's 5,000 acute care hospitals,
Dr. Jacobs said, only 1,200 provide angioplasty.
Most hospitals, she said, cannot offer angioplasty because they do not have
enough patients for a team of doctors to maintain their skills. An obvious
solution would be to make heart attack care more like trauma care - sending
patients to the nearest hospital that can provide angioplasty as quickly as
possible. But that is not always easy, Dr. Jacobs said, because hospitals do
not want to lose cardiac patients.
A major reason, she said, is financial. Hospitals are reimbursed by Medicare
according an index that measures the acuity of medical conditions they
treat.
"If your cardiac patients are transferred, your acuity index goes down,
which lowers overall Medicare reimbursement for other problems like
pneumonia and renal disease," Dr. Jacobs said.
It is also difficult for patients who live in rural areas, where community
hospitals are too small to offer angioplasty and larger hospitals that do
offer it are hours away. Minnesota is experimenting with a program using
helicopters to transport patients quickly. But for most rural patients
elsewhere, angioplasty is almost an impossibility.
Dr. Antman suggests that heart disease patients ask their doctor if there is
a hospital nearby that does angioplasty around the clock. If so, they might
want to discuss with their doctor whether to ask that an ambulance take them
there if they are having a heart attack.
It is the sort of advice that makes cardiologists nervous - they do not want
to encourage patients to dictate treatment. But, Dr. Antman said, if it is
feasible to get to an angioplasty-providing hospital within an hour, "in
most cases that would be preferable."
Getting the Proper Therapy
Opening an artery is only the start of treatment. The next part is at least
as problematic: Patients have to get the right drugs, in the right doses,
and have to take them for the rest of their lives.
"Care is getting a lot better," Dr. Peterson said. "But the only caveat is
that they are only really looking at, Did you get therapy? No one is looking
too closely at, Did you do it right?"
For example, he said, a recent study found that heart attack patients were
getting blood-thinning prescription drugs to prevent clots, as they should,
but up to 40 percent were getting the wrong dose, usually one too high.
And even if every prescription were exactly right, as many as half of all
patients do just what Mr. Orr did after his first heart attack. They stop
taking many or all of their drugs.
Sometimes it is a matter of communication.
"The information did not get to the primary doctor and the primary doctor
did not know to renew the prescription," Dr. Peterson said. "When we talk to
patients, they say: 'No one communicated to me the importance of being on
the medications long term. I thought I would only need them for three
months, I thought it would be like an antibiotic. I thought they put in a
stent so why do I need a drug?' "
But there may be more to it than ignorance. There also is the image those
pills convey of a sick person.
Mr. Orr said he did not like to think of himself as someone who had to take
a fistful of pills every day. Even the recommended daily aspirin seemed
superfluous, he thought.
"I think I sort of pooh-poohed the notion that one tablet of aspirin each
day would do anything," Mr. Orr said.
What it does is make blood less likely to clot. In Mr. Orr's case, Dr.
Antman said, it is likely that when Mr. Orr was exercising on the
cross-trainer, an area of plaque ruptured. Then a clot began to form in the
area, eventually blocking the artery.
The problem was not exercise, which is good for people with heart disease,
but Mr. Orr's decision not to take his medications, Dr. Antman said. If he
had been taking aspirin that clot would have had more difficulty forming and
growing.
Dr. Antman has a message for patients: With a disease as serious as heart
disease, those who take responsibility are often the ones who survive.
Having a heart attack, even if it turns out well, as his did, is a
life-altering experience, Mr. Orr said.
His first heart attack, Mr. Orr said, "came out of the blue." When he was
discharged from the hospital, he was terrified that it would happen again
when he was alone and unable to call for help. "I had a really hard time
with it," he said. "I only stayed in my own house for one night and then I
moved to a friend's house for two weeks."
Now Mr. Orr plans to be serious about taking his medication and getting back
to his diet and exercise program. He will call an ambulance if he ever has
symptoms again. Still, he hates to think of himself as a patient. "I'm a
little freaked out that I will have to take medication for the foreseeable
eternity," Mr. Orr said.
But the day after he got home from the hospital, he thought about what had
happened.
"The gravity of the situation just sort of clicked," Mr. Orr said. "I
started to cry."
-
New Prostate Cancer Test May Detect More Tumors
By David Brown
Washington Post Staff Writer
Thursday, April 26, 2007; A03
An experimental blood test for prostate cancer may help eliminate tens of thousands of unnecessary biopsies at the same time that it detects many tumors that are now missed by the test commonly used, its developers said yesterday.
PSA, the current test, measures a protein normally produced by the prostate, while the experimental one, called EPCA-2, detects a chemical made principally in cancerous tissue.
Prostate cancer, the most common malignancy in men, is one of the more perplexing areas of medicine. Physicians are unsure how to find it and when to treat it.
Today, about 80 percent of prostate biopsies find no tumor -- a percentage that is rising as physicians become more aggressive in searching for the disease.
"We hope this will minimize the number of unnecessary biopsies," said Robert H. Getzenberg, a molecular biologist at Johns Hopkins Hospital who developed the new test, which is still under study and not yet commercially available. A description of it appears today in the journal Urology.
"It's an exciting new marker," said Martin G. Sanda, a urologist at Harvard Medical School. "There certainly is a need for a better test than PSA. Everyone accepts that." His view was echoed by Gerald L. Andriole Jr., chief of urologic surgery at Washington University School of Medicine, who said that "if the data hold up, this marker will be a substantial improvement over PSA."
The PSA test casts a net that is too big and too full of holes. Finding a replacement that catches fewer healthy men, but more of those who do have cancer, would help settle at least one of the clinical conundrums concerning prostate cancer.
The new test is being developed by researchers at Johns Hopkins Hospital and Onconome Inc., a Seattle-based biomedical company. It could become commercially available in 2008.
Prostate cancer is diagnosed in about 230,000 American men each year, and about 30,000 die of it. The death rate is 2.5 times higher among blacks than among whites.
At the moment, men are screened for the disease in two ways -- by a rectal exam and by the PSA (prostate-specific antigen) test. If a lump is detected or if the PSA is above 2.5 (nanograms per milliliter of plasma), most physicians will suggest a biopsy.
EPCA-2 is a protein that is part of the "nuclear matrix," the scaffolding inside a cell's nucleus that helps it copy its genes. The Hopkins researchers measured it in different groups of men whose cancer status was known.
They tried the new test on 30 men with PSA readings above 2.5 and in whom biopsies found no cancer. All had normal EPCA-2 readings (below 30 ng per ml.). This suggested that the test may eliminate many of the "false-positive" PSA results -- readings that are abnormal but apparently do not denote cancer.
On the other hand, the EPCA-2 test appears able to detect cancer even when the tumor is small. It identified 36 out of 40 men who had cancer confined to the prostate gland, and 39 out of 40 men in whom the tumor had spread. It also identified many men -- 14 out of 18 -- who had cancer but whose PSAs were normal.
This last group is especially worrisome to physicians. A study published three years ago found that about 12 percent of men with normal PSA readings have cancer.
The new test is not perfect, though. Getzenberg and his colleagues tried it on 35 men with severe "benign prostatic hypertrophy" -- enlargement of the prostate that sometimes makes the PSA go up but is not cancer. In eight of them, the EPCA-2 was high, suggesting that the EPCA-2 test would flag some men who turn out not to have cancer -- although probably not as many as the PSA test does.
The new test will not help solve the other major clinical uncertainty in prostate cancer. It is unclear who will clearly benefit from aggressive treatment and who are likely to be able to live a normal life if the tumors are simply followed and removed only if they begin to cause symptoms.
-
Remedies: Dark Chocolate Similar to Blood Pressure Drugs
By NICHOLAS BAKALAR
Published: April 24, 2007
NY Times
Eating dark chocolate may be almost as effective at lowering blood pressure as taking the most common antihypertensive drugs, a review of studies has found. Tea, on the other hand, appears to be ineffective.
Effect of Cocoa and Tea Intake on Blood Pressure (Archives of Internal Medicine)The article says a diet rich in fruits and vegetables is healthy partly because plants contain chemical substances called polyphenols that help control blood pressure. In Western countries, the major sources of dietary polyphenols are tea and chocolate, but studies of their ties to blood pressure have had mixed results.
From more than 3,000 papers, researchers picked the largest randomized and controlled prospective studies and used statistical techniques to combine the data. The analysis included four studies of black tea, one of green tea and five of dark chocolate. It appears in the April 9 issue of The Archives of Internal Medicine.
Four of the five studies on chocolate found reduced blood pressure after eating, but none of the tea studies showed significant benefit. The magnitude of the effect of eating three and a half ounces of dark chocolate a day was clinically significant, comparable to that of beta-blockers like atenolol, known by the brand name Tenormin, or propranolol, known as Inderal. The authors acknowledge that the studies were short and that results may not apply to habitual use.
Milk proteins prevent the absorption of polyphenols, so milk chocolate is not effective. “I’ve been eating a little more dark chocolate,” said Dr. Dirk Taubert, the lead author and a professor of pharmacology at University Hospital in Cologne, Germany. “And my blood pressure has gone down. But I have no dietary recommendations for others.”
NY Times
-
Vegan couple gets life over baby's death Malnourished baby was fed soy milk and apple juice, weighed 3 1/2 pounds
The Associated Press
Updated: 2:55 p.m. ET May 9, 2007
ATLANTA - A vegan couple were sentenced Wednesday to life in prison for the death of their malnourished 6-week-old baby boy, who was fed a diet largely consisting of soy milk and apple juice.
Superior Court Judge L.A. McConnell imposed the mandatory sentences on Jade Sanders, 27, and Lamont Thomas, 31. Their son, Crown Shakur, weighed just 3 1/2 pounds when he died of starvation on April 25, 2004.
The couple were found guilty May 2 of malice murder, felony murder, involuntary manslaughter and cruelty to children. A jury deliberated about seven hours before returning the guilty verdicts.
Defense lawyers said the first-time parents did the best they could while adhering to the lifestyle of vegans, who typically use no animal products. They said Sanders and Thomas did not realize the baby, who was born at home, was in danger until minutes before he died.
But prosecutors said the couple intentionally neglected their child and refused to take him to the doctor even as the baby’s body wasted away.
“No matter how many times they want to say, ‘We’re vegans, we’re vegetarians,’ that’s not the issue in this case,” said prosecutor Chuck Boring. “The child died because he was not fed. Period.”
Although the life sentences were automatic, Sanders and Thomas begged for leniency before sentencing. Sanders urged the judge to look past his “perception” of the couple.
“I loved my son — and I did not starve him,” she said.
When the judge told the defendants they could ask for a new trial, Thomas hung his head low.
“I’m dying every day in there,” he said, “and that could take three years.”
======================
"A DEFICIENCY IN JUST ONE nutrient--vitamin B12--can halt the development of a baby's brain. The Centers for Disease Control (CDC) recently reported two cases of severe BI2 deficiency in toddlers who were breast-fed by vegan mothers. Vegans practice a strict form of vegetarianism, cutting all meat from their diet, as well as eggs, dairy and other animal by-products. The vitamin occurs naturally only in animal products and helps maintain nerve and blood cells.
The two mothers ( :-o ) who both lived in Georgia, were themselves deficient in B12. Although both morns said they intermittently took vitamin supplements, the deficiency caused developmental delays in the children, who were 15 months old and two and a half years old at the time of the study. Both had about half the language and motor skills of average kids their age. The rate of B12 deficiency in the general population is unknown, according to the CDC."
http://findarticles.com/p/articles/m...36/ai_n6028123
-
Wow, how sad ... personally I love steak but I dont eat too much red meat.
I thought I would share this and add a positive note..
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
http://www.vegansociety.com/html/people/lifestyle/families/parenting/vegan_children/
The Vegan Diet for Infants and Children
Reed Mangels, PhD, RD and Sandra Hood, BSc (Hons), SRD
(The Vegan, Autumn 2002)
It takes time and thought to feed infants and children, and all parents, should think carefully about what their children eat. The years from birth to adolescence are when eating habits are set, when growth rates are high, and to a large extent when the size of stores of essential nutrients such as calcium are determined. This article will examine the health benefits of vegan diets for children, address potential concerns, present information on key nutrients and provide guidelines for feeding vegan infants and children.
The number of vegans in the UK today is estimated at 0.5%(1) but we do not know how many of these are children. In the US, a poll commissioned by the Vegetarian Resource Group in the year 2000 found that about 0.5% of 6 to 17-year-olds were vegan and did not eat meat, fish, poultry, dairy products or eggs (2).
Health Benefits of Vegan Diets
Several studies have examined the nutrient intakes of vegan children. One study of British school-age children found that they had higher intakes of fibre and that intakes of all vitamins and minerals studied (with the exception of calcium) were comparable with those of meat-eating children(3). Vegan pre-schoolers in the US were found to have generous intakes of protein, vitamins, and minerals and their diets exceeded recommended intakes for all nutrients studied with the exception of calcium (4).
The study showing lower calcium intakes by vegan pre-schoolers was conducted before calcium-fortified products were readily available, so calcium intakes of vegan children may be higher now. Calcium is important for bone development. Around 45% of adult bone mass is accrued before 8 years of age, another 45% is added between 8-16 years of age and a further 10% accumulates in the next decade. Given the importance of calcium intake during childhood, all parents should ensure that their children's diets contain calcium-rich foods and meet current recommendations for calcium for their age group.
Regrettably, there have been few recent studies looking at the long-term effects of a vegan diet*, especially as it is believed that the foundations for many chronic diseases of adulthood have their beginnings in childhood. For instance, processes initiating atherosclerosis and high blood pressure are thought to start very early in life, and blood pressure and cholesterol levels have been shown to track from early childhood and to be related to childhood nutrient intakes(5,6). Body mass also tracks from early childhood, with obese children being at an increased risk of obesity in adulthood(7)
When we look at potential long-term health benefits of vegan diets, we find that vegan children have higher intakes of fruits and vegetables, foods that are important for health. Vegan children have been shown to have lower intakes of fat, saturated fat, and cholesterol than non-vegetarian children(9-10). This may be important in reducing the risk of developing chronic diseases such as heart disease and obesity. Finally, vegan diets may introduce children to a greater variety of whole plant foods, thus establishing healthful lifelong eating habits.
Vegan Infants
Up to the age of four to six months, the diets of many infants of vegan and of non-vegan parents are identical. The perfect food for the young infant is breast milk and supplementary foods should not be introduced until after four to six months of age. Breast-fed infants of well nourished vegan women tend to grow and develop normally(11). The infant receives many benefits from breast feeding, including some immune system enhancement, protection against infection, and reduced risk of allergies(12). Moreover, as human breast milk is the natural food for baby humans it also probably contains substances needed by growing infants which are not even known to be essential and are not included in infant formulas. Meanwhile, nursing mothers derive benefits such as reduced risk of premenopausal breast cancer, release of stress-relieving hormones and, for some, sheer convenience(12). For all these reasons, we strongly encourage breast feeding.
Vitamin B12 and vitamin D are key nutrients for a young infant being exclusively breast fed by a vegan woman. Mothers whose diets contain little or no vitamin B12 will produce milk with very low levels of vitamin B12(13). As this vitamin is important for the developing nervous system, it is crucial for the infant to have a reliable source of vitamin B12. Some vegan women opt to use a vitamin B12 supplement while others rely on fortified foods such as some breakfast cereals, fortified yeast extracts, non-dairy milks and some soya products in order to meet both their own and their baby's need for vitamin B12. If the mother's diet does not contain a reliable daily source of vitamin B12, the child itself should receive a daily source of vitamin B12.
The vitamin D content of breast milk varies with the mother's diet and her sun exposure, although vitamin D levels in breast milk are usually quite low. All children below three years of age have a high requirement for vitamin D to enable calcium deposition in bone. The Department of Health therefore recommends that vitamin drops containing vitamins A, C and D be used for all children from 6 months to 5 years of age, whether vegan, vegetarian or omnivore. Welfare vitamin drops which are available at low cost, or free to certain families, contain no animal products and are suitable for vegans.
-
A continuation from the above article
--------------------------------------------------------------
Readers may also have heard of docosahexaenoic acid or DHA, a fatty acid which appears to be important for eye and brain development and is found primarily in animal foods. However, vegans can make DHA from another fatty acid called alpha-linolenic acid, which will be contained in the breast milk if the mother's diet includes good sources such as flaxseed oil, ground flaxseed and rapeseed oil. Reducing the use of other oils such as corn oil, sunflower oil, and safflower oil and limiting foods containing hydrogenated fats will also help the breast fed infant to make more DHA. These oils contain linoleic acid and
hydrogenated fats contain trans-fatty acids which interfere with DHA production.If breast feeding is not possible or is contraindicated, there is just one formula feed suitable for vegan infants: Vegan Society trade mark holder Farley's Soya Formula by Heinz. On no account should soya milk, nut milk, rice milk, oat milk, pea milk or other home-prepared "formulas" be used as these do not contain the appropriate ratio of nutrients and can lead to potentially life-threatening conditions.
Introduction of Solid Foods
Solid foods should not be introduced before 4 months of age. Try to introduce one new food at a time, waiting 2 to 3 days before trying another. It is then easier to identify which food is responsible if any untoward reaction occurs.
First weaning foods may include rice based dishes, pureed and sieved fruits such as banana, pear and apple, and vegetables such as carrot, potato and spinach. At 6 months of age, wheat and oat based cereals can be introduced. Foods containing generous amounts of protein such as mashed cooked pulses, mashed tofu and soya yogurt are generally introduced at around 7 to 8 months of age. Children should progress from mashed or pureed foods to pieces of soft food. Smooth nut and seed butters spread on bread or crackers can be introduced after the first birthday. In an atopic family, where there is a history of allergies, peanuts and nuts should be avoided until the child is at least 3 years of age (14) to allow the gut to mature and the immune system to develop fully.
As solid foods become a larger part of the diet, consideration should be given to foods which provide concentrated sources of calories and nutrients. These include mashed firm tofu, bean spreads, mashed avocado and cooked dried fruits. Frequent meals and snacks help to ensure adequate energy intakes. The fat intake of healthy infants should not be restricted, and sources such as vegetable oils or soft vegan margarine should be included in the older infant's diet.
To minimize the risk of choking, foods such as whole nuts, crunchy nut butters, vegan hot dogs, large chunks of hard raw fruits and vegetables, whole grapes, hard sweets, and popcorn should not be fed to infants and children younger than 3. However, chopping the nuts, slicing the hot dogs and halving the grapes can reduce the risk and allow such foods to be eaten by toddlers age 1-3 years. Corn syrup and honey (the latter is always avoided by vegans in the UK anyway) should not be given to infants younger than one year because of the risk of botulism, a form of food poisoning.
A note on nuts. The American Academy of Pediatrics does not recommend any sort of nut butters for children under 3 years. In families where there is a history of allergy, eczema or asthma, it is recommended that peanuts and peanut products be delayed until the child is at least 3 years old. Other children may have peanuts and tree nuts of a suitable texture, such as smooth nut butter, from the age of 6 months or when weaned, but not before 4 months. In the UK, it is recommended that peanuts be avoided by pregnant or breastfeeding women if there is a history of allergies. It is suggested that women who are atopic, or where the father or any sibling has atopic disease, may wish to avoid peanuts in their diet to reduce the risk of their children developing peanut allergy, but this is simply precautionary as there has been no conclusive evidence.
Many parents choose to use commercially prepared baby foods and there are some product suitable for vegan infants, though careful label reading is recommended. As there is only a limited selection of commercial products for the older vegan infant, many parents opt to prepare their own baby foods. Foods should be well washed, cooked thoroughly and blended or mashed to an appropriate consistency. Home prepared foods can be kept in the refrigerator for up to 2 days or frozen in small quantities for later use.
By 6 months of age, iron stores in omnivorous, vegetarian and vegan infants will become depleted and it is important that iron-rich foods are included in the diet. Iron-fortified infant cereals are a good way to supply iron to vegan infants Other good sources include whole grains, pulses, green leafy vegetables and dried fruits. To enhance iron absorption, add a source of vitamin C such as green leafy vegetables, citrus fruits, blackcurrants or orange juice to the meal.
For the non-vegan child, cow's milk is typically introduced around age 1 year. Commercial fortified non-dairy milks can be added to the diet of vegan toddlers around the same age provided that the child is growing normally, has an appropriate weight and height for age, and is eating a variety of foods including soya products, pulses, grains, fruits and vegetables. For children with slower growth who have been weaned from breast milk, ensure that the diet is energy dense by adding some healthful oils such as olive or rapeseed oil or choosing Plamil's fortified non-dairy milk or Farley's Soy Formula; both are Vegan Society trade mark holders and these product are suitable as a primary beverage as they are higher in calories than other fortified non-dairy milks. Choosing unflavoured varieties of non-dairy milk rather than flavours such as vanilla, cocoa, or carob can help to avoid the development of a preference for very sweet beverages by the young child.
Vegan Toddlers and Preschoolers
Toddlers and preschoolers, whether vegan or not, tend to eat less than most parents think they should. This is generally due to a developing sense of independence and a slowing in growth. While nutrient needs are also relatively lower than during infancy, an adequate diet remains important to promote growth and development. These early years are also important for developing healthy eating patterns that can establish a foundation for a healthful adult diet.
One important consideration for young vegan children is the ability to get enough calories. Young children have small stomachs and too much high fibre food may make them feel full before they get all the calories they need. Foods such as avocados, nut and seed butters, dried fruits, and soya products provide a concentrated source of calories. If necessary, the fibre content of the diet can be reduced by giving some refined grain products, fruit juices and peeled fruits and vegetables. Eating more frequent meals, including nutritious snacks, can also help to ensure adequate energy intakes.
Growth of Vegan Children
If a child's diet contains enough calories, normal growth and development can be expected and studies of vegan children have shown that their caloric intake is close to recommended levels and similar to intakes of non-vegan children of the same age(16,17).
Vegan children in the UK and the US have been found to be slightly shorter and lighter in weight than average but appeared to be growing at a normal rate(15,16). Children need a lot of energy in relation to their size and although healthy eating should be encouraged it is important that the diet be energy dense. Including foods such as vegetable oils, avocados, seeds, nut butters and pulses can provide both calories and nutrients. Dried fruits are also a concentrated source of energy and are an attractive food for many children. Children from an early age should be encouraged to brush teeth after eating dried fruits and other sweet foods to prevent tooth decay.
Key Nutrients for Vegan Children
Protein needs can be easily met if children eat a variety of plant foods and have an adequate intake of calories. It is unnecessary to plan and complement amino acids precisely within each meal so long as children eat a variety of foods each day. Sources of protein for vegan children include pulses (peas, beans, lentils, soya), grains (wheat, oats, rice, barley, buckwheat, millet, pasta, bread), nuts, meat substitutes and nut butters.
Calcium is an important nutrient for growing bones and teeth. Good sources include fortified non-dairy milks and juices, calcium-set tofu, baked beans and dark green leafy vegetables low in oxalic acid such as spring greens and kale. Calcium supplementation may be indicated in cases of inadequate dietary intake.
Children regularly exposed to sunlight under appropriate conditions (two to three times per week for about 20-30 minutes on hands and face) appear to have no dietary requirement for vitamin D. Those children who have limited exposure to sunlight or who are dark skinned and have no dietary source of vitamin D require supplements. Only a few foods naturally contain vitamin D (D3, cholecalciferol) and all of these are animal products. Vitamin D3 is usually obtained from lanolin, which is derived from sheep's wool and therefore not acceptable to vegans. Foods fortified with a vegan source of vitamin D (D2, ergocalciferol) include argarine, some non-dairy milks and fortified breakfast cereals.
Iron deficiency anemia is the most common childhood nutritional problem and is no more likely to occur in vegan than om non-vegan children(8). Good sources of iron include whole or enriched grains and grain products, iron-fortified cereals, legumes, green leafy vegetables and dried fruits. Diets of vegan and non-vegan children often contain similar amounts of zinc, though zinc from plant foods is less well absorbed as they contain phytate, which interferes with zinc absorption. Emphasising foods that are good sources of zinc and protein such as pulses and nuts can increase the amount of zinc in the diet and promote absorption. Use of yeast-leavened bread and fermented soya products such as tempeh and miso can also improve zinc absorption(8). Zinc supplements may be needed for young vegan children whose diet is based on high-phytate cereals and legumes(19). FSC and Seven Seas produce vegan vitamin and mineral supplements suitable for children.
Vegan children should use foods fortified with vitamin B12 or take vitamin B12 supplements. A variety of foods fortified with vitamin B12 are available, including some brands of vegan milk, meat substitutes, yeast extract and some breakfast cereals. Vegan Society trade mark holders Quest and Vega Nutritionals produce vegan vitamin B12 supplements.
The Transition to a Vegan Diet
Although today more and more children are vegan from birth, many older children also become vegan. There are many ways to make the transition from a non-vegan to a vegan diet. Some families gradually eliminate dairy products and eggs while others make a more abrupt transition. Regardless of which approach you choose, be sure to explain what is going on and why in a way that the child can understand. Offer foods that look familiar at first. Peanut butter sandwiches seem to be universally popular and many children like pasta or baked beans. Gradually introduce new foods. Watch your child's weight closely.
Weight loss is likely at first, but if it continues or the child seems to be growing less rapidly, add more concentrated calories and reduce the amount of fibre in the diet.
What Foods are Popular with Vegan Children?
Many vegan children like:
Bagels with nut butter or hummous
Bean burritos or tacos
Fresh or dried fruit
Mashed potatoes
Oven-cooked chips
Pancakes and waffles
Pasta with tomato sauce
Peanut butter and yeast extract sandwiches
Pizza without cheese, topped with vegetables and pulses, tofu, or fake meat
Raw vegetables with dips
Shakes made with soya milk and fruit
Spaghetti with tomato sauce
Tofu/vegetarian dogs
Veggie burgers
Vegan diets planned in accord with current dietary recommendations can meet the nutritional needs of infants and children, give children a better start in life and help to establish lifelong healthy eating patterns.
*Since 1976 Plamil Foods has produced case histories on over 100 children and this is a glowing testimony to veganism.
References:
1. Gallup: The Realeat Survey 1997 Changing attitudes to meat consumption
Haldane Foods 1997
2. How many teens are vegetarian? Vegetarian Journal 2000; XX (1):10.
3. Sanders TAB, Manning J. The growth and development of vegan children. J
Hum Nutr Diet. 1992;5:11-21.
4. Fulton JR, Hutton CL, Stitt KR. Preschool vegetarian children. J Am Diet
Assoc. 1980;76:360-365.
5. McGill HC, McMahan CA, Herderick EE, Malcom GT, Tracy RE, Strong JP.
Origin of atherosclerosis in childhood and adolescence. Am J Clin Nutr.
2000;72(suppl):1307S-1315S.
6. Falkner B, Sherif K, Michel S, Kushner H. Dietary nutrients and blood
pressure in urban minority adolescents at risk for hypertension. Arch Pediatr
Adolesc Med. 2000;154:918-922.
7. Guo SS, Chumlea WC. Tracking of body mass index in children in relation to
overweight in adulthood. Am J Clin Nutr. 1999;70(suppl):145S-148S.
8. Messina V, Mangels AR. Considerations in planning vegan diets: Children. J
Am Diet Assoc. 2001;101:661-669.
9. Dwyer JT, Dietz WH,Jr, Andrews EM, Suskind RM. Nutritional status of
vegetarian children. Am J Clin Nutr. 1982;35:204-216.
10. vanStaveren WA, Dhuyvetter JHM, Bons A, Zeelen M, Hautvast JGAJ. Food
consumption and height/weight status of Dutch preschool children on
alternative diets. J Am Diet Assoc. 1985;85:1579-1584.
11. The American Dietetic Association. Position on vegetarian diets. J Am Diet
Assoc. 1997; 97:1317-1321.
12. American Dietetic Association. Promotion of breastfeeding. J Am Diet Assoc.
1997;97:662-666.
13. Specker BL, Black A, Allen L, Morrow F. Vitamin B12: Low milk
concentrations are related to low serum concentrations in vegetarian women
and to methylmalonic aciduria in their infants. Am J Clin Nutr. 1990;52:1073-
1076.
14. Committee on Nutrition, American Academy of Pediatrics. Pediatric
Nutrition Handbook. 4th ed. Elk Grove Village, IL: AAP; 1998.
15. Mangels AR, Messina V. Considerations in planning vegan diets: Infants. J
Am Diet Assoc. 2001;101:670-677.
16. O'Connell JM, Dibley MJ, Sierra J, Wallace B, Marks JS, Yip R. Growth of
vegetarian children. The Farm study. Pediatrics. 1989;84:475-481.
17. Sanders TAB. Growth and development of British vegan children. Am J Clin
Nutr. 1988;48:822-825.
18. Specker BL, Valanis B, Hertzberg V, Edwards N, Tsang RC. Sunshine
exposure and serum 25-hydroxyvitamin D concentrations in exclusively
breast-fed infants. J Pediatr. 1985;107:372-376.
19. Allen LH. Zinc and micronutrient supplements for children. Am J Clin Nutr.
1998;68(suppl):495S-498S.
-
Thank you Robert.
Here's this:
AFPA [American Fitness Professionals & Associates] May 2007 Health & Fitness Newsletter vol. 12 no. 5
A sense of humor is part of the art of leadership, of getting along with people, of getting things done.
- Dwight D. Eisenhower (1890 - 1969)
--------------------------------------------------------------------------------
Table of Contents:
Plant Sources of Omega-3 Fatty Acids Beneficial to Bone Health
Red Meat Linked to Heart Disease in Women with Diabetes
Fiber Lowers Breast Cancer Risk
Cancer-Related Hormones Associated with Protein and Dairy Consumption
Broccoli Compound Helps Destroy Breast Cancer Cells
Simple Fat Change Radically Improves Mental and Physical Health
Who Would Have Thought This Fat Could Improve Your Bones?
--------------------------------------------------------------------------------
Plant Sources of Omega-3 Fatty Acids Beneficial to Bone Health
A study at Pennsylvania State University showed that omega-3 fatty acids from plant sources (for example, walnuts and flaxseed) promote bone formation and inhibit bone loss. A randomized crossover study looked at 23 adult participants on three different diets with varying ratios of omega-6 to omega-3 acids. The group with the lowest omega-6-to-omega-3 ratio had significantly lower levels of a biomarker for bone loss compared with the other two groups. Experts often emphasize the ratio (with a smaller ratio being ideal) of omega-6 to omega-3 and not the total consumption of omega-3. Consumption of walnuts and flaxseed has also shown a beneficial effect on risk of cardiovascular disease.
Griel AE, Kris-Etherton PM, Hilpert KF, et al. An increase in dietary n-3 fatty acids decreases a marker of bone resorption in humans. Nutr J. January 16, 2007;6:2.
--------------------------------------------------------------------------------
Red Meat Linked to Heart Disease in Women with Diabetes
A new study finds increased iron intake and red meat consumption add additional risk for heart disease among women with type 2 diabetes. Researchers from the Harvard School of Public Health studied 6,161 women with type 2 diabetes from the Nurses' Health Study. Women with the highest intake of heme iron (iron found mainly in red meats, poultry, and fish) had a 50 percent greater risk of coronary heart disease than those with the lowest intake. Red meat in particular was associated with an increased risk. Adults with diabetes are already at least twice as likely as others to have heart disease or a stroke.
Qi L, VanDam RM, Rexrode K, Hu FB. Heme iron from diet as a risk factor for coronary heart disease in women with type 2 diabetes. Diabetes Care. 2007;30:101-106.
--------------------------------------------------------------------------------
Fiber Lowers Breast Cancer Risk
A follow-up of the U.K. Women's Cohort Study involving more than 35,000 women found that pre-menopausal women who ate 30 grams of fiber a day had half the risk of breast cancer compared with those who ate less than 20 grams per day. In addition, high protein consumption and low vitamin C intake were associated with increased breast cancer risk among pre-menopausal women. Researchers suspect that since estrogen levels are higher in pre-menopausal women, dietary fiber earlier in life may be more important for regulating female hormones and lowering breast cancer risk. Fiber helps the body remove excess hormones, carcinogens, and toxic compounds. Fiber is not present in animal products, but is found in virtually all plant foods: whole grains, legumes, vegetables, and fruit.
Cade JE, Burley VJ, Greenwood DC. Dietary fibre and risk of breast cancer in the UK Women's Cohort Study. Int J Epidemiology. Advance Access published on January 24, 2007
--------------------------------------------------------------------------------
Cancer-Related Hormones Associated with Protein and Dairy Consumption
A study recently published in the European Journal of Clinical Nutrition found that elevated insulin-like growth factor-I (IGF-I) levels were positively associated with the consumption of protein (mainly from animal sources), milk, cheese, calcium, magnesium, phosphorous, potassium, and vitamins B2 and B6. The study examined 2,109 women from eight European countries who had been subjects in a previous breast cancer study (the European Prospective Investigation into Cancer and Nutrition). Inverse relationships were found between IGF-I levels and the intake of vegetables and beta-carotene (found in orange-colored fruits and vegetables as well as dark leafy greens). Previous evidence has revealed that elevated IGF-I levels are associated with a variety of cancers, including colorectal, prostate, and premenopausal breast cancer.
Norat T, Dossus L, Rinaldi S, et al. Diet, serum insulin-like growth factor-1 and IGF-binding protein-3 in European women. Eur J Clin Nutr. January 2007; 61:91-98.
--------------------------------------------------------------------------------
Broccoli Compound Helps Destroy Breast Cancer Cells
New research suggests that a specific compound in cruciferous vegetables (broccoli, cauliflower, Brussels sprouts, cabbage, kale, etc.) may be especially helpful in inhibiting breast cancer development. Researchers at the University of Leicester looked at the effect of indole-3-carbinol (I3C) on four different types of breast cancer cells. Previous studies have shown that foods rich in indoles may help to kill breast cancer cells by diminishing the expression of the epidermal growth factor receptor, which protects cancer cells. This study found that I3C helped to reduce these receptors in three of the four types of breast cancer cells. Consuming cruciferous vegetables daily may significantly lower breast cancer risk and increase survival.
Moiseeva EP, Heukers R, Manson MM. EGFR and Src are involved in indole-3-carbinol-induced death and cell cycle arrest of human breast cancer cells. Carcinogenesis 2007. Feb;28:435-45
--------------------------------------------------------------------------------
Simple Fat Change Radically Improves Mental and Physical Health
A new study adds to the evidence suggesting that the imbalance of fatty acids in the typical American diet could be associated with a sharp increase in heart disease and depression over the course of the last century.
The more omega-6 fats people had in their blood compared with omega-3 fats, the more likely they were to suffer from depression, and the more likely they were to have higher blood levels of inflammation-promoting compounds.
Inflammation-promoting compounds, such as tumor necrosis factor alpha and interleukin-6, have been linked to heart disease, type 2 diabetes, arthritis and other ailments.
Omega-3 fats are found in foods such as fish, flax seed oil and walnuts. Omega-6 fats are found in refined vegetable oils, which in modern times are used in many products ranging from margarine to baked goods to snack foods.
The amount of omega-6 fats in the Western diet increased greatly when refined vegetable oils became part of the diet in the early 20th century.
Psychosomatic Medicine March 30, 2007
Reuters April 17, 2007
--------------------------------------------------------------------------------
Who Would Have Thought This Fat Could Improve Your Bones?
A study about the role fatty acids play in building the bone mineral density of young men found that concentrations of omega-3 fats were associated with positive bone mineral densities.
Researchers evaluated the bone health (hip, spine and body) and measured the concentrations of fatty acids in 78 teenage men over an eight-year span. In addition to the other benefits, docosahexaenoic acid (DHA) was linked to better total bone densities, particularly in the spine, as well as positive changes in the spine for men between the ages of 16 and 22.
American Journal of Clinical Nutrition March 2007; 85(3): 803-807 American Journal of Clinical Nutrition March 2007; 85(3): 647-648
--------------------------------------------------------------------------------
-
http://www.wired.com/medtech/health/news/2006/10/71925
Honey Remedy Could Save Limbs
Brandon Keim 10.11.06 | 1:00 AM
When Jennifer Eddy first saw an ulcer on the left foot of her patient, an elderly diabetic man, it was pink and quarter-sized. Fourteen months later, drug-resistant bacteria had made it an unrecognizable black mess.
Doctors tried everything they knew -- and failed. After five hospitalizations, four surgeries and regimens of antibiotics, the man had lost two toes. Doctors wanted to remove his entire foot.
"He preferred death to amputation, and everybody agreed he was going to die if he didn't get an amputation," said Eddy, a professor at the University of Wisconsin School of Medicine and Public Health.
With standard techniques exhausted, Eddy turned to a treatment used by ancient Sumerian physicians, touted in the Talmud and praised by Hippocrates: honey. Eddy dressed the wounds in honey-soaked gauze. In just two weeks, her patient's ulcers started to heal. Pink flesh replaced black. A year later, he could walk again.
"I've used honey in a dozen cases since then," said Eddy. "I've yet to have one that didn't improve."
Eddy is one of many doctors to recently rediscover honey as medicine. Abandoned with the advent of antibiotics in the 1940s and subsequently disregarded as folk quackery, a growing set of clinical literature and dozens of glowing anecdotes now recommend it.
Most tantalizingly, honey seems capable of combating the growing scourge of drug-resistant wound infections, including group A streptococcus -- the infamous flesh-eating bug -- and methicillin-resistant Staphylococcus aureus, or MRSA, which in its most severe forms also destroys flesh. These have become alarmingly more common in recent years, with MRSA alone now responsible for half of all skin infections treated in U.S. emergency rooms. So-called superbugs cause thousands of deaths and disfigurements every year, and public health officials are alarmed.
Though the practice is uncommon in the United States, honey is successfully used elsewhere on wounds and burns that are unresponsive to other treatments. Some of the most promising results come from Germany's Bonn University Children's Hospital, where doctors have used honey to treat wounds in 50 children whose normal healing processes were weakened by chemotherapy.
The children, said pediatric oncologist Arne Simon, fared consistently better than those with the usual applications of iodine, antibiotics and silver-coated dressings. The only adverse effects were pain in 2 percent of the children and one incidence of eczema. These risks, he said, compare favorably to iodine's possible thyroid effects and the unknowns of silver -- and honey is also cheaper.
"We're dealing with chronic wounds, and every intervention which heals a chronic wound is cost effective, because most of those patients have medical histories of months or years," he said.
While Eddy bought honey at a supermarket, Simon used Medihoney, one of several varieties made from species of Leptospermum flowers found in New Zealand and Australia.
Honey, formed when bees swallow, digest and regurgitate nectar, contains approximately 600 compounds, depending on the type of flower and bee. Leptospermum honeys are renowned for their efficacy and dominate the commercial market, though scientists aren't totally sure why they work.
"All honey is antibacterial, because the bees add an enzyme that makes hydrogen peroxide," said Peter Molan, director of the Honey Research Unit at the University of Waikato in New Zealand. "But we still haven't managed to identify the active components. All we know is (the honey) works on an extremely broad spectrum."
Attempts in the lab to induce a bacterial resistance to honey have failed, Molan and Simon said. Honey's complex attack, they said, might make adaptation impossible.
Two dozen German hospitals are experimenting with medical honeys, which are also used in the United Kingdom, Australia and New Zealand. In the United States, however, honey as an antibiotic is nearly unknown. American doctors remain skeptical because studies on honey come from abroad and some are imperfectly designed, Molan said.
In a review published this year, Molan collected positive results from more than 20 studies involving 2,000 people. Supported by extensive animal research, he said, the evidence should sway the medical community -- especially when faced by drug-resistant bacteria.
"In some, antibiotics won't work at all," he said. "People are dying from these infections."
Commercial medical honeys are available online in the United States, and one company has applied for Food and Drug Administration approval. In the meantime, more complete clinical research is imminent. The German hospitals are documenting their cases in a database built by Simon's team in Bonn, while Eddy is conducting the first double-blind study.
"The more we keep giving antibiotics, the more we breed these superbugs. Wounds end up being repositories for them," Eddy said. "By eradicating them, honey could do a great job for society and to improve public health."
1 This story was updated to clarify that there are a range of MRSA symptoms, of which the most severe is necroticizing fasciitis. 10.11.06 | 6:01 PM
-
http://featuresblogs.chicagotribune.com/features_julieshealthclub/2007/05/treadmill_desks.html
Originally posted: May 15, 2007
Treadmill desks cut obesity
Sitting is an occupational hazard for office workers, but there’s a new way to avoid it: a vertical work station that incorporates a treadmill at a desk.
These “walk-and-work” office desks could help obese employees lose weight, according to a small study published in the British Journal of Sports Medicine.
The participants were able to use the computer while walking without falling or injuring themselves. In fact, they enjoyed it so much, they wanted to keep the walking desks even after the study ended.
The idea builds on the notion that we all need high levels of spontaneous activity throughout the day, also called non-exercise activity thermogenesis (NEAT).
Obese people generally have low levels of NEAT. Lean people have high levels.
But does the desk treadmill really work? I checked with Nat Findlay, 52, who built a custom vertical workstation for $10,000, including $1,500 for the treadmill. (They're not all this expensive. The workstation described in the study can be purchased for about $1,000)
“I was a classic guy on conference calls all day,” said Findlay, whose voice doesn’t betray the fact that his treadmill begins moving at less than a mile an hour when he picks up the phone.
“I’d sit in my chair all day and have no energy. I thought, ‘this is nuts. I’m making a nice salary but the rest of me is going to hell by just sitting there.”
Findlay got the idea from Mayo Clinic researcher James Levin, a co-author of the BJSM study who has been touting the benefits of his walking desk for years.
“At the end of the day, this is what we should be doing,” said Findlay, the vice president of Canadian operations for Cardinal Health, a healthcare company. “We’ve degenerated into the corporate world. Instead of spending millions of dollars in health care for employees, buy them a treadmill for their desk.”
I’m ready to trade my exercise ball chair for a desk treadmill. Hello, Chicago Tribune? Will you spring for one?
-
That makes sense to me.
Here's this:
Contact: Liz Savage
jncimedia@oxfordjournals.org
301-841-1287
Journal of the National Cancer Institute
Heavy multivitamin use may be linked to advanced prostate cancer
The embargo has been lifted at the request of the submitting PIO.
While regular multivitamin use is not linked with early or localized prostate cancer, taking too many multivitamins may be associated with an increased risk for advanced or fatal prostate cancers, according to a study in the May 16 issue of the Journal of the National Cancer Institute.
Millions of Americans take multivitamins because of a belief in their potential health benefits, even though there is limited scientific evidence that they prevent chronic disease. Researchers have wondered what impact multivitamin use might have on cancer risk.
Karla Lawson, Ph.D., of the National Cancer Institute in Bethesda, Md., and colleagues followed 295,344 men enrolled in the National Institutes of Health-AARP Diet and Health Study to determine the association between multivitamin use and prostate cancer risk. After five years of follow-up, 10,241 men were diagnosed with prostate cancer, including 8,765 with localized cancers and 1,476 with advanced cancers.
The researchers found no association between multivitamin use and the risk of localized prostate cancer. But they did find an increased risk of advanced and fatal prostate cancer among men who used multivitamins more than seven times a week, compared with men who did not use multivitamins. The association was strongest in men with a family history of prostate cancer and men who also took selenium, beta-carotene, or zinc supplements.
“Because multivitamin supplements consist of a combination of several vitamins and men using high levels of multivitamins were also more likely to take a variety of individual supplements, we were unable to identify or quantify individual components responsible for the associations that we observed,” the authors write.
In an accompanying editorial, Goran Bjelakovic, M.D., of the University of Nis in Serbia, and Christian Gluud, M.D., of Copenhagen University Hospital in Denmark, discuss the positive and negative health effects of antioxidant supplements. “Lawson [and colleagues] add to the growing evidence that questions the beneficial value of antioxidant vitamin pills in generally well-nourished populations and underscore the possibility that antioxidant supplements could have unintended consequences for our health,” the authors write.
###
EMBARGOED FOR RELEASE: 15 MAY 2007 16:00 ET
Contact:
• Article: National Cancer Institute Media Relations Branch, 301-496-6641, ncipressofficers@mail.nih.gov
• Editorial:
o Goran Bjelakovic, goranb@junis.ni.ac.yu
o Christian Gluud, cgluud@ctu.rh.dk
Citations:
• Article: Lawson KA, Wright ME, Subar A, Mouw T, Schatzkin A, Leitzmann MF. Multivitamin Use and Risk of Prostate Cancer in the National Institutes of Health – AARP Diet and Health Study. J Natl Cancer Inst 2007; 99: 754-764
• Editorial: Bjelakovic G, Gluud C. Surviving Antioxidant Supplements. J Natl Cancer Inst 2007; 99: 742-743
Note: The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute. Attribution to the Journal of the National Cancer Institute is requested in all news coverage. Visit the Journal online at http://jnci.oxfordjournals.org/.
-
Here it comes. The government division on lard.
I get a kick about "mulling" the idea around to have on a child's report card that they are overweight (parents certainly need this).
Or the part with the nutritionist who thinks the idea is "commendable" (they always do).
Why don't they simply outlaw high caloric food? They could shutdown half the businesses in NJ. Instead of a pizza parlor on every corner for thousands of square miles we could have salad bars on every corner. Or tax each calorie served by one cent. Democrat Gov. Corzine must love that idea.
http://www.philly.com/philly/health_and_science/7722237.html
The treament for obesity is going to come from medicine and only medicine.
-
CCP, Strange story. In my narrow mind it would be the parents asking the school to watch what the kids are eating while under their watch. The parent-child-public school relationship keeps getting twisted. Now the school (or village) raises the child and the parents play a limited role. (?) My current perspective comes from sex ed taught in coed classes to 6th grade. They send my daughter (now 7th grade) home with family discussion questions to fill out, where I might think the teaching should come from the family and the questions go to the school to make sure they aren't undermine what we teach.
Your comment on the NJ Gov. is funny. I saw him advocate seatbelt use on a national commercial last night. Choosing more salad and less pizza is nice if it is market driven, and Orwellian if mandated. Maybe we can have surveillance cameras over the salt shakers - ok, this isn't very funny.
The role of the 'state' in obesity is inevitable if we accept the idea that the state is responsible for our health care. It was supposed to be a joke that after tobacco the government would go after fast food...
Back to the science, please expand on your idea that the answer to obesity will come from medicine when you get a chance.
-
Hi Doug,
I'm not against serving nutritional, healthy food in schools where the environment is controlled, per se.
But this is clearly the proverbial slippery slope. Isn't Clinton involved in obesity causes and the Hill of course wants to revamp all of health care. Well we can see where this is all heading.
Our desire to eat and eat well has backfired from an evolutionary point of view. When we were hunters and gatherers or farmers we expended trememdous amounts of energy to secure food. We needed tremendous internal controls that would drive us to seek food in order to survive. We didn't have lots of good tasting fatty and sugary foods simply lying around for the picking. We burned more calories and ingested less. Now those days are gone. Yet we still have the internal controls that drive us to eat. We really do not understand these controls very well at all. Years ago I read there were over 30 genes associated with being overweight. There must be more now. an endocrine friend researcher told me that all the studies he participated in appear to show that any one particular drug will cause ~ 7% weight loss before other metabolic factors begin to overcome this preventing further weight gain. "It's amazing, that 7% number keeps coming up," he says.
It is well known but rarely for whatever reason admitted in health care that getting people to lose weight and keep it off is extraordinarily difficult. The only effective means we have that often will work in the long term is bariatric surgery. Yet we all know how drastic this is and always with its own risks.
Until we have a better understanding on energy metabolism and weight metabolism all other methods are doomed to fail. Sure, low carb diets may work for a few, exercise will work for a few, but for every success story on long term weight loss and maitenance there are 19 that end in failure.
All these politicians with their political grandstanding. It drives me to eat! If they want to raise money for research or grants for the NIH or other university sponsored research than fine. Pharmaceutical research is done in private. There must be a lot of duplication going on. Data is not shared. We really don't need separate governmental "agencies" for this.
And *what about* all the abundance of fattening foods? You simply can't eat pizza and lose weight. (well maybe one slice) Will people have to show IDs at pizza parlors, Chinese restaurants, Jewish delis, and Dunkin Donuts?
Just my thoughts on the matter.
Glad to see you on the board.
-
We have all seen the news about the lawyer who flew around with this. What I have not seen is any conjecture as to where *he* picked up the bug. I find the furor over his travelling with it of no less a concern than the question of how he aquired it..
http://abcnews.go.com/GMA/OnCall/story?id=3231184&page=1
-
Friday Feature / Peter Huber: Germs and the City
Two centuries of success against infectious disease have left us complacent—and vulnerable.
There have been at work among us three great social agencies: the London City Mission; the novels of Mr. Dickens; the cholera.” Historian Gertrude Himmelfarb quotes this reductionist observation at the end of her chapter on Charles Dickens in The Moral Imagination; her debt is to an English nonconformist minister, addressing his flock in 1853. It comes as no surprise to find the author of Hard Times and Oliver Twist discussed alongside Edmund Burke and John Stuart Mill in a book on moral history. Nor is it puzzling to see Dickens honored in his own day alongside the City Mission, a movement founded to engage churches in aiding the poor. But what’s V. cholerae doing up there on the dais beside the Inimitable Boz? It’s being commended for the tens of millions of lives it’s going to save. The nastiness of this vile little bacterium has just transformed ancient sanitary rituals and taboos into a new science of epidemiology. And that science is about to launch a massive—and ultimately successful—public effort to rid the city of infectious disease.
The year 1853, when a Victorian doctor worked out that cholera spread through London’s water supply, was the turning point. Ordinary people would spend the next century crowding into the cities, bearing many children, and thus incubating and spreading infectious disease. Public authorities would do all they could to wipe it out. For the rest of the nineteenth century, they lost more ground than they gained, and microbes thrived as never before. Then the germ killers caught up—and pulled ahead. When Jonas Salk announced his polio vaccine to the press in April 1955, the war seemed all but over. “The time has come to close the book on infectious disease,” declared William Stewart, the U.S. surgeon general, a few years later. “We have basically wiped out infection in the United States.”
By then, however, infectious diseases had completed their social mission. Public authorities had taken over the germ-killing side of medicine completely. The focus shifted from germs to money—from social disease to social economics. As germs grew less dangerous, people gradually lost interest in them, and ended up fearing germ-killing medicines more than the germs themselves.
Government policies expressed that fear, putting the development, composition, performance, manufacture, price, and marketing of antibiotics and vaccines under closer scrutiny and control than any public utility’s operations and services. The manufacturers of these drugs, which took up the germ-killing mission where the sewer commission left off, must today operate like big defense contractors, mirror images of the insurers, regulatory agencies, and tort-litigation machines that they answer to. Most drug companies aren’t developing any vaccines or antibiotics any more. The industry’s critics discern no good reason for this at all: as they tell it, the big drug companies just can’t be bothered.
These problems capture our attention only now and again; they hardly figure in the much louder debate about how much we spend on doctors and drugs, and who should pay the bills. “Public health” (in the literal sense) now seems to be one thing, and—occasional lurid headlines notwithstanding—not a particularly important one, while “health care” is quite another.
We will bitterly regret this shift, and probably sooner rather than later. As another Victorian might have predicted—he published a book on the subject in 1859—germs have evolved to exploit our new weakness. Public authorities are ponderous and slow; the new germs are nimble and fast. Drug regulators are paralyzed by the knowledge that error is politically lethal; the new germs make genetic error—constant mutation—the key to their survival. The new germs don’t have to be smarter than our scientists, just faster than our lawyers. The demise of cholera, one could say, has been one of the great antisocial developments of modern times.
By withdrawing from the battlefield just long enough to let us drift into this state of indifference, the germs have set the stage for their own spectacular revival. Germs are never in fact defeated completely. If they retire for a while, it’s only to search, in their ingeniously stupid and methodically random way, for a bold new strategy. They’ve also contrived, of late, to get human sociopaths to add thought and order to the search. The germs will return. We won’t be ready.
Read Peter Huber’s Complete Article in the City Journal:
http://www.city-journal.org/html/17_2_germs.html
-
While researching some issues for personal reasons I came across the following site.
Long office chair sitting sessions have consequences more drastic in terms of degenerative disc disease and back pain than running an ultra-marathon!
http://www.easyvigour.net.nz/fitness/h_Chair_Sit1.htm
Office chairs come in one size. Humans come in many sizes. Small wonder that for many people, office chair sitting forces unsound habits of body positioning upon the base of their spine.
http://www.easyvigour.net.nz/fitness/h_Chair_Sit2.htm
Office chair sitting has major back pain related consequences: tight hamstrings, Iliopsoas trigger points & Erector Spinae muscle fatigue.
http://www.easyvigour.net.nz/fitness/h_Chair_Sit3.htm
-
By NICHOLAS WADE
Published: June 7, 2007
In a surprising advance that could sidestep the ethical debates surrounding stem cell biology, researchers have come much closer to a major goal of regenerative medicine, the conversion of a patient’s cells into specialized tissues that might replace those lost to disease.
Skip to next paragraph
Multimedia
Graphic
From Skin Cells to Stem Cells
Related
A Long, Uncertain Path for New Cell Technique (June 7, 2007)
Times Topics: Stem CellsThe advance is an easy-to-use technique for reprogramming a skin cell of a mouse back to the embryonic state. Embryonic cells can be induced in the laboratory to develop into many of the body’s major tissues.
If the technique can be adapted to human cells, researchers could use a patient’s skin cells to generate new heart, liver or kidney cells that might be transplantable and would not be rejected by the patient’s immune system. But scientists say they cannot predict when they can overcome the considerable problems in adapting the method to human cells.
Previously, the only way to convert adult cells to embryonic form has been by nuclear transfer, the insertion of an adult cell’s nucleus into an egg whose own nucleus has been removed. The egg somehow reprograms the nucleus back to an embryonic state. That procedure is known as therapeutic cloning when applied to people, but no one has yet succeeded in doing it.
The new technique, developed by Shinya Yamanaka of Kyoto University, depends on inserting just four genes into a skin cell. These accomplish the same reprogramming task as the egg does, or at least one that seems very similar.
The technique, if adaptable to human cells, is much easier to apply than nuclear transfer, would not involve the expensive and controversial use of human eggs, and should avoid all or almost all of the ethical criticism directed at the use of embryonic stem cells.
“From the point of view of moving biomedicine and regenerative medicine faster, this is about as big a deal as you could imagine,” said Irving Weissman, a leading stem cell biologist at Stanford University, who was not involved in the new research.
David Scadden, a stem cell biologist at the Harvard Medical School, said the finding that cells could be reprogrammed with simple biochemical techniques “is truly extraordinary and frankly something most assumed would take a decade to work out.”
The technique seems likely to be welcomed by many who have opposed human embryonic stem cell research. It “raises no serious moral problem, because it creates embryoniclike stem cells without creating, harming or destroying human lives at any stage,” said Richard Doerflinger, the United States Conference of Catholic Bishops’ spokesman on stem cell issues. In themselves, embryonic stem cells “have no moral status,” and the bishops’ objections to embryonic stem cell research rest solely on the fact that human embryos must be harmed or destroyed to obtain them, Mr. Doerflinger said.
Ronald Green, an ethicist at Dartmouth College, said it would be “very hard for people to say that what is created here is a nascent form of human life that should be protected.” The new technique, if adaptable to human cells, “will be one way this debate could end,” Mr. Green said.
Biologists learned how to generate human embryonic stem cells in 1998 from the few-day-old embryos discarded by fertility clinics, a procedure the embryos did not survive. This source proved controversial, and biologists supported by federal financing were unable to explore the new opportunity until August 2001 when President Bush, in a political compromise, decreed that research on human embryonic stem cells could begin, but only with cell lines already in existence by that date.
The restrictions have caused considerable frustration among biologists and other supporters of research on embryonic stem cells. Indeed, the House is expected to vote today to increase federal funds for such research. If approved, the bill, similar to one approved by the Senate, would go to the president. The White House has already said that the president will veto it.
The new technique, when adaptable to human cells, should sidestep all these problems. James Battey, vice chairman of the National Institutes of Health stem cell task force, said he saw “no impediment at all” to federal support of researchers using the new technique on human cells.
Ever since the creation of Dolly the sheep, the first cloned mammal, scientists have sought to lay hands on the mysterious chemicals with which an egg will reprogram a mature cell nucleus injected into it and set the cell on the same path of embryonic development as when egg and sperm combine.
Years of patient research have identified many of the genes that are active in the embryonic cell and maintain its pluripotency, or ability to morph into many different tissues. Last year, Dr. Yamanaka and his colleague Kazutoshi Takahashi, both at Kyoto University, published a remarkable report relating how they had guessed at 24 genes responsible for maintaining pluripotency in mouse embryonic stem cells.
===========
When they inserted all 24 genes into mouse skin cells, some of the cells showed signs of pluripotency. The Kyoto team then subtracted genes one by one until they had a set of four genes that were essential. The genes are inserted into viruses that infect the cell and become active as the virus replicates. The skin cell’s own copies of these genes are repressed since they would interfere with its function. “We were very surprised” that just four genes are sufficient to reprogram the skin cells, Dr. Yamanaka said.
Stem CellsDr. Yamanaka’s report riveted the attention of biologists elsewhere. Two teams set out to repeat and extend his findings, one led by Rudolf Jaenisch of the Whitehead Institute and the other by Kathrin Plath of the University of California, Los Angeles, and Konrad Hochedlinger of Massachusetts General Hospital. Dr. Yamanaka, too, set about refining his work.
In articles published today in Nature and a new journal, Cell-Stem Cell, the three teams show that injection of the four genes identified by Dr. Yamanaka can make mouse cells revert to cells indistinguishable from embryonic stem cells. Dr. Yamanaka’s report of last year showed that only some properties of embryonic stem cells were attained.
This clear confirmation of Dr. Yamanaka’s recipe is exciting to researchers because it throws open to study the key process of multicellular organisms, that of committing cells to a variety of different roles, even though all carry the same genetic information.
Recent studies have shown that the chromatin, the complex protein material that clads the DNA in chromosomes, is not passive packaging material but highly dynamic. It contains systems of switches that close down large suites of genes but allow others to be active, depending on the role each cell is assigned to perform.
Dr. Yamanaka’s four genes evidently reset the switch settings appropriate for a skin cell to ones that specify an embryonic stem cell. The technique is easy to use and “should revolutionize the field since every small lab can work on reprogramming,” said Alexander Meissner, a co-author of Dr. Jaenisch’s report.
An immediate issue is whether the technique can be reinvented for human cells. One problem is that the mice have to be interbred, which cannot be done with people. Another is that the cells must be infected with the gene-carrying virus, which is not ideal for cells to be used in therapy. A third issue is that two of the genes in the recipe can cause cancer. Indeed 20 percent of Dr. Yamanaka’s mice died of the disease. Nonetheless, several biologists expressed confidence that all these difficulties would be sidestepped somehow.
“The technical problems seem approachable — I don’t see anyone running into a brick wall,” said Owen Witte, a stem cell biologist at U.C.L.A. Dr. Jaenisch, in a Webcast about the research, predicted that the problems of adapting the technique to human cells would be solvable but he did not know when.
If a human version of Dr. Yamanaka’s recipe is developed, one important research use, Dr. Weissman said, will be to reprogram diseased cells from patients so as to study the molecular basis of how their disease develops.
Beyond that is the hope of generating cells for therapy. Researchers have learned how to make embryonic cells in the laboratory develop into neurons, heart muscle cells and other tissues. In principle, these might be injected into a patient to replace or supplement the cells of the diseased tissue, without fear of immune rejection.
No one really knows if the new cells would succumb to the same disease process, or if they would be well behaved, given that they developed in a laboratory dish without recapitulating the exact succession of environments they would have experienced in the embryo.
Still, repairing the body with its own cells should in principle be a superior to the surgeon’s knife and the oncologists’ poisons. Cloning Bill Defeated in House
WASHINGTON, June 6 (AP) — House Republicans united Wednesday to reject a bill supported by Democrats that would make it illegal to use cloning technology to initiate a pregnancy and create a cloned human being. The parties accused each other of using the legislation to score political points before the House votes Thursday on a stem cell bill that President Bush says he will veto.
-
MEDICAL EXAMINER: SPORTS CREAM CAUSES TEEN'S DEATH: A medical examiner blamed a 17-year-old track star's death on the use of too much muscle cream, the kind used to soothe aching legs after exercise. Arielle Newman, a cross-country runner at Notre Dame Academy on Staten Island, died after her body absorbed high levels of methyl salicylate, an anti-inflammatory found in sports creams such as Bengay and Icy Hot, the New York City medical examiner said Friday.
LBN news
-
Very possibly. He may have even had a shot at returning to a state he could have functioned as President:
http://cbs2chicago.com/homepage/local_story_138113430.html
-
IMO this is totally crazy. Anyone near enough can pick up RF. Why not implant a listening device or GPS device? I don't think anyone really understands what we are getting into. As a person who has been stalked by organized crime people this to me is just plain nuts. Why can't the person carry a small disc on their person rather than inside their body? I am totally against this. I don't know which doctors think this is a good idea but they IMO are darn fools.
http://news.yahoo.com/s/afp/20070626/hl_afp/ushealthsciencetechnology;_ylt=AguKQStm0.XY5conVnrV1usDW7oF
-
The carrying of a small disc would seem to solve the problem without the risks.
I agree with you that this is an area of grave concern. Already we are photographed in much of the public space with nary a bleat of concern and a complete absence of coalescence of coherent response.
Tangent: "Stalked by organized crime"? :-o You have me intrigued. If you would rather email me, please use Craftydog@dogbrothers.com
-
***The carrying of a small disc would seem to solve the problem without the risks***
This is exactly my opinion. Why not simply carry a disc with the infromation? We carry ID cards, credit cards, alert bracelets, and passports. There is *absolutely no* need to "imbed" devices into someone's body.
I do agree with moving medical information onto electronic medium. As a doctor I can say there would certianly be the potential for a massive improvement on saving, transferring, updating, and completing medical histories, and delivering care. But, this at the expense of very high risk of losing personal integrity. Especially if a company like MSFT is in control of the software. Don't think for a minute people at msft are immune to bribery. I have good reason to suspect they have ways of hacking into things and their excuse would probably be that it is for law enforcement purposes. The hardware is embedded in the devices so other companies are implicit. Just a thought. Does anyone think Sony which invents means to spy onto people's computers would be above seeing what musical creations someone might have on their computers? I don't.
With regards to the other question I refer to the illegal use of listening devices, tracking devices, probably minute cameras, and God knows what else by "affiliates" of the music "industry". From top to bottom there is a code of silence just like there is in sports industries regardinjg steroids. I can't go into further details at this time. All I am saying is that ID theft is absolutely only the very tip of the iceberg with regards to the criminal activity involving computers, and all the other means of data being placed onto digital records and moved around by electromagnetic spectrum. Law enforcement is so far behind and so poorly equipped it is not funny.
Yet many are in a hurry to move our medical records right onto hardware and software designed by the very companies who have history of not being trustworthy.
-
NY Times
AS the noon sun began to cook bathers in Long Beach, N.Y., last Sunday, members of the Sofferman family lounged on towels, each wearing a sun lotion chosen with the care usually given to picking out a new bathing suit.
Skip to next paragraph
Multimedia
Slide Show
What's Your S.P.F.?
Related
The Value of Seals (July 5, 2007)
Denise Sofferman and Ilene Sofferman, sisters who both work in the apparel industry in Manhattan, had put on tanning oil, their bodies already golden brown. Denise’s daughter, Lauren Levy, 21, a student at the University of Pennsylvania, had protected her pale skin with a heavy-duty S.P.F. 50 product formulated for children. Ilene’s 9-year-old daughter, Alison, had received a head-to-toe coating of S.P.F. 30.
Two hours later, the daughters were sunburned, their backs as pink as watermelon.
“It says waterproof, but Lauren didn’t even go swimming,” said Denise Sofferman, reapplying sunscreen to her daughter.
Ilene Sofferman, smearing another coat of lotion on Alison’s pink face, read from the back of the sunscreen bottle. “They have all these different marketing terms —S.P.F., UVA, UVB, waterproof, sweat-resistant — but you have to figure out what they mean by trial and error,” she said.
After decades of warnings about the dangers of sun exposure, an increasing number of Americans are making sunscreen part of their skin-care routines. Americans bought 60 million units of sunscreen last year, a 13 percent increase compared with 2005, according to Information Resources Inc., which tracks cosmetics sales.
But the increased demand has spurred an explosion of lotions, sprays, pads and gels with such diverse marketing claims — All-day Protection! Ultra Sweatproof! Total Block! Continuous Protection! Ultra Sport! Instant Protection! Extra UVA Protection! — that the Soffermans are not alone in their confusion over how to choose the most effective sunscreen.
In the nearly 30 years since the Food and Drug Administration issued its first regulations for sunscreen as an over-the-counter drug intended to reduce sunburn risk, the science surrounding skin and cancer has expanded dramatically.
Critics have clamored for the F.D.A to update the rules, saying that the standards have not kept pace. At the same time, they complain, the agency has allowed manufacturers to make vague and improbable-sounding marketing claims, leaving consumers confused and, worse, misled about what to use and how to use it to protect themselves.
The pressure on the agency has been mounting in recent weeks. Last month, reports by Consumer Reports and by the Environmental Working Group, a nonprofit group in Washington, found that a variety of popular sunscreens lacked sufficient broad protection against the sun’s harmful rays. And in May, Richard Blumenthal, Connecticut’s attorney general, sent a scathing petition to the F.D.A. saying that unclear sunscreen labels and inflated marketing put people at risk.
“Most sunscreens are deceptively and misleadingly labeled, most perniciously to give consumers a false sense of security,” Mr. Blumenthal said last week. “In my view, the F.D.A.’s failure to act is unconscionable and unjustifiable in any public sense.”
John Bailey, the executive vice president for science at the Cosmetics, Toiletry and Fragrance Association, an industry trade group, said that the directions on sunscreens adequately convey coverage. “These are very beneficial products which should be used to protect against the adverse effects of sunlight,” said Dr. Bailey, who has a Ph.D. in chemistry.
Nonetheless, the F.D.A. seems poised to address the labeling issue. Although it has been planning since 1999 to confirm new rules, Rita Chappelle, a spokeswoman for the F.D.A., said the agency expected to issue new sunscreen standards in the coming weeks. But until they are released, Ms. Chappelle said the agency would not answer questions about forthcoming regulations.
One fact about sunscreens is indisputable: They can impede sunburn and lower the incidence of at least one form of skin cancer in humans.
Dr. Allan C. Halpern, chief of dermatology at Memorial Sloan-Kettering Cancer Center in Manhattan, said that the regular use of sunscreen can inhibit squamous cell carcinoma, a cancer that kills 2,000 to 2,500 Americans a year.
In a study of about 1,600 residents of Nambour, Australia, volunteers who were given sunscreen to use every day for four and a half years had 40 percent fewer squamous cell cancers than a control group who maintained their normal skin-care routines. Even 10 years after the study concluded, the volunteers assigned to use sunscreen during the trial period had fewer cancers.
“It shows that using sun protection for almost five years gives you an intense, longer-term benefit against squamous cell carcinoma,” said Dr. Adèle C. Green, deputy director of the Queensland Institute of Medical Research in Brisbane, Australia, which ran the study.
Dr. Halpern said that sunscreen should also protect against melanoma, the deadliest skin cancer, and basal cell carcinoma, because the product can inhibit harmful ultraviolet rays that can contribute to the diseases.
Yet even after new F.D.A. labeling rules are published, it may take two years for the changes take effect.
============
Page 2 of 2)
Dr. James M. Spencer, a dermatologist in St. Petersburg, Fla., who specializes in skin cancer, said that he hopes the updated standards will clarify how much protection sunscreens provide, the dose needed to achieve significant protection, and the frequency with which a sunscreen should be reapplied.
Skip to next paragraph
Multimedia
Slide Show
What's Your S.P.F.?
Related
The Value of Seals (July 5, 2007)
The F.D.A. in 1978 first proposed a system of labeling products with an S.P.F. or Sun Protection Factor, which measures how effective the product is in preventing burn caused by the sun’s ultraviolet B rays. UVB radiation can also be a factor in skin cancer.
Dr. Spencer said that an S.P.F. 15 product screens about 94 percent of UVB rays while an S.P.F. 30 product screens 97 percent. Manufacturers determine the S.P.F. by dividing how many minutes it takes lab volunteers to burn wearing a thick layer of the product by the minutes they take to burn without the product.
But people rarely get the level of S.P.F. listed because labels do not explain how much to use, said Dr. Vincent A. DeLeo, chairman of dermatology at St. Luke’s-Roosevelt Hospital Center in Manhattan.
“Sunscreen is tested at 2 milligrams per square centimeter of skin, which means you should be using two ounces each time to cover your whole body,” Dr. DeLeo said. “But for most people an eight-ounce bottle lasts the whole summer.”
People who apply S.P.F. 30 too sparingly, for example, may end up with only S.P.F. 3 to S.P.F. 10, according to the Web site of the British Columbia Centre for Disease Control, www.bccdc.org/downloads/pdf/rps/reports/RIN15.pdf, which has comprehensive guidelines.
“The S.P.F. is a terrible system to guide consumers,” Dr. Spencer said. “Nobody is using sunscreen the way it is measured in a lab.” He said he hopes that the new standards will call for S.P.F. to be replaced with a system defining sun protection as high, medium or low.
Until then, Dr. Spencer said that people should use about a shot glass of sunscreen for the body and a teaspoon for the face to best achieve the S.P.F. protection listed on labels. It should be reapplied every few hours and immediately after swimming or sweating.
Dermatologists said that the agency is also likely to introduce a rating system for the sun’s ultraviolet A rays, which can contribute to cancer and skin aging. Many products already contain UVA screening agents, but under the current rules there is no rating for them.
Manufacturers are catching on that some consumers seek UVA protection. In print advertisements this month, Neutrogena and Banana Boat have been battling for UVA supremacy, including graphs in which each shows their product offering the highest coverage.
But Dr. David M. Pariser, the president-elect of the American Academy of Dermatology, said that without a standardized UVA rating system, consumers can’t be sure how much a sunscreen provides.
“Right now, we don’t know whether doubling the percentage of a UVA sunscreen ingredient doubles UVA protection or not,” Dr. Pariser said. “That is part of the muddled system we hope will be cleared up.”
Until then, Dr. Pariser said to choose sunscreens that contain ingredients known to filter UVA. These include Mexoryl SX, avobenzone, titanium dioxide and zinc oxide. He also recommended a database at www.cosmeticsdatabase.com/special/sunscreens/summary.php created by the Environmental Working Group that lists products with UVA protection.
Some doctors, along with Mr. Blumenthal of Connecticut, predicted that the new sunscreen rules would prohibit outsized marketing terms.
“ ‘All-day protection’ is just plain false since sunscreen has to be frequently reapplied,” Mr. Blumenthal said. “And ‘waterproof,’ which may be O.K. for an adult taking a quick dip in the pool but not for kids who are in and out of the water all day, is just plain deceptive.”
Dr. Green in Australia said the best way to prevent skin cancer is to stay out of the sun during peak hours and wear sun-protective clothing. But Dr. Halpern said you can’t keep Americans wrapped up.
“There is only a small subset of American society that is willing to wear long-sleeved shirts and wide-brimmed — defined as four inches wide — hats on a sunny day at the beach,” he said. “Until we can get that behavior, the next best thing is sunscreen. Put on two coats, so you won’t miss any spots.”
-
Several months ago I started screening patient's 25 OH vitamin D levels and am surprised to find how frequently it is coming back low. There is a quiet revolution going on with how medicine is viewing Vitamin D. I believe it should be standard to screen many if not alll patient's levels. The historicly recommended daily intake of 400IU per day is grossly inadequate and now outdated. It is now recommended that we take higher doses. Low levels of Vitamin D is linked to many more illnesses than just those relating to bone disorders. A very good review article was published in the recent New England Journal of Medicine. I don't know if I should post the entire article here, but here are the final conclusions. I think it very important that patients start asking their doctors about Vitamin D intake and even consider getting their vitamin D level checked. I also conclude it is important for doctors to talk more to patients about this.
I am convinced we will all be hearing a lot more about vitamin D in the lay media. It may likely be the next big topic for mass media coverage which just loves a good health story. OK Sanjay Gupta. Here is your chance to make up for your rather weak performance against Michael Moore.
Conclusions
Undiagnosed vitamin D deficiency is not uncommon,1,2,3,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,123 and 25-hydroxyvitamin D is the barometer for vitamin D status. Serum 25-hydroxyvitamin D is not only a predictor of bone health8 but is also an independent predictor of risk for cancer and other chronic diseases.8,54,59,60,61,62,63,64,71,72,73,74,75,83,84,85 The report that postmenopausal women who increased their vitamin D intake by 1100 IU of vitamin D3 reduced their relative risk of cancer by 60 to 77% is a compelling reason to be vitamin D–sufficient.124 Most commercial assays for 25-hydroxyvitamin D are good for detecting vitamin D deficiency. Radioimmunoassays measure total 25-hydroxyvitamin D, which includes levels of both 25-hydroxyvitamin D2 and 25-hydroxyvitamin D3. Some commercial laboratories measure 25-hydroxyvitamin D2 and 25-hydroxyvitamin D3 with liquid chromatography and tandem mass spectroscopy and report the values separately. As long as the combined total is 30 ng per milliliter or more, the patient has sufficient vitamin D.7,14,27 The 1,25-dihydroxyvitamin D assay should never be used for detecting vitamin D deficiency because levels will be normal or even elevated as a result of secondary hyperparathyroidism. Because the 25-hydroxyvitamin D assay is costly and may not always be available, providing children and adults with approximately at least 800 IU of vitamin D3 per day or its equivalent should guarantee vitamin D sufficiency unless there are mitigating circumstances (Table 2).
Much evidence suggests that the recommended adequate intakes are actually inadequate and need to be increased to at least 800 IU of vitamin D3 per day. Unless a person eats oily fish frequently, it is very difficult to obtain that much vitamin D3 on a daily basis from dietary sources. Excessive exposure to sunlight, especially sunlight that causes sunburn, will increase the risk of skin cancer.125,126 Thus, sensible sun exposure (or ultraviolet B irradiation) and the use of supplements are needed to fulfill the body's vitamin D requirement.
-
That's very interesting.
What are the symptoms and consequences of inadequate Vitamin D?
-
Hi CraftyD,
In the article are published reports of inadequate vitamin D with many illness and diseases but it is unclear how clinically significant these "links" are. The classic one is weak bone or osteoposis which is actually without symptoms until fractures in the spine occur, or in the hip or wrists or in the ribs after a fall occurs. In the article the author points a possible link of Vit D and several cancers:
Hodgkins lymphoma, ovarian, prostate, pancreatic, breast, colon.
Links with the malfunction of the immune system and
1) with autoimmune diseases:
Multiple sclerosis, Diabetes type 1, Crohn's, Sarcoidosis, rheumatoid arthritis
2) infections:
TB, Aids
Links with:
Schizophrenia and depression
With muscle strength and falls and osteoarthritis
With hypertension
With wheezing
With fibromyalgia, chronic fatigue syndrome, and achiness.
Some of these linkages are a bit tenuous and are based on observational studies which show an increased risk at those people who live at higher geographical latitudes (less sun exposure). But I take away from this article an impression that the overall large quantity of evidence supoorts the theory that vitamin D is far more important in *many more* aspects of our health than we have thought.
From the article is a table that summarizes sources of vitamin D. It is very difficult to get adequate amounts from our diet alone.
The source from UV radiation (the sun) depends on season, time of day latitude and skin sensitivity. Five to ten minutes a day might be enough to get the O.5 minimal erythemal dose. I have read in other places that this still does not give enough people adequate Vitamin D stores.
http://content.nejm.org/cgi/content/full/357/3/266/T1
-
One of my patients came in and told me he came up positive for lead in an employer urine drug screen. He said his daughter also was slightly positive.
We brainstormed to consider a source. His house was built in the 1990's so I doubt lead from paint would be implicated. He did not have an obvious work exposure. Then over the next few days came out the reports of Fisher-Price toys made in China have unexceptable lead levels. I mentioned this ASAP to the patient's wife whom I see regularly. They have a one year old and newly bought Fisher-Price toys. I recommended they not throw them out but of course store them far away from the family.
We are still waiting for the blood lead levels results to return.
-
Mattel apologizes:
http://www.wgrz.com/news/news_article.aspx?storyid=50073
-
Antibiotic Runoff
Sign In to E-Mail or Save This
Print
Share
Digg
Facebook
Newsvine
Permalink
Published: September 18, 2007
One of the persistent problems of industrial agriculture is the inappropriate use of antibiotics. It’s one thing to give antibiotics to individual animals, case by case, the way we treat humans. But it’s a common practice in the confinement hog industry to give antibiotics to the whole herd, to enhance growth and to fight off the risk of disease, which is increased by keeping so many animals in such close quarters. This is an ideal way to create organisms resistant to the drugs. That poses a risk to us all.
A recent study by the University of Illinois makes the risk even more apparent. Studying the groundwater around two confinement hog farms, scientists have identified the presence of several transferable genes that confer antibiotic resistance, specifically to tetracycline. There is the very real chance that in such a rich bacterial soup these genes might move from organism to organism, carrying the ability to resist tetracycline with them. And because the resistant genes were found in groundwater, they are already at large in the environment.
There are two interdependent solutions to this problem, and hog producers should embrace them both. The first solution — the least likely to be acceptable in the hog industry — is to ban the wholesale, herdwide use of antibiotics. The second solution is to continue to tighten the regulations and the monitoring of manure containment systems. The trouble, of course, is that there is no such thing as perfect containment.
The consumer has the choice to buy pork that doesn’t come from factory farms. The justification for that kind of farming has always been efficiency, and yet, as so often happens in agriculture, the argument breaks down once you look at all the side effects. The trouble with factory farms is that they are raising more than pigs. They are raising drug-resistant bugs as well.
NY Times
-
MIT finds cure for fear
Submitted by Vidura Panditaratne on Sun, 2007-07-15 19:37. MIT biochemists have identified a molecular mechanism behind fear, and successfully cured it in mice, according to an article in the journal Nature Neuroscience.
Researchers from MIT's Picower Institute for Learning and Memory hope that their work could lead to the first drug to treat the millions of adults who suffer each year from persistent, debilitating fears - including hundreds of soldiers returning from conflict in Iraq and Afghanistan.
Inhibiting a kinase, an enzyme that change proteins, called Cdk5 facilitates the extinction of fear learned in a particular context, Li-Huei Tsai, Picower Professor of Neuroscience in the Department of Brain and Cognitive Sciences, and colleagues showed.
Conversely, the learned fear persisted when the kinase's activity was increased in the hippocampus, the brain's center for storing memories, the scientists found.
Cdk5, paired with the protein p35, helps new brain cells, or neurons, form and migrate to their correct positions during early brain development, and the MIT researchers looked at how Cdk5 affects the ability to form and eliminate fear-related memories.
"Remarkably, inhibiting Cdk5 facilitated extinction of learned fear in mice," Tsai said. "This data points to a promising therapeutic avenue to treat emotional disorders and raises hope for patients suffering from post-traumatic stress disorder or phobia."
Emotional disorders such as post-traumatic stress and panic attacks stem from the inability of the brain to stop experiencing the fear associated with a specific incident or series of incidents.
For some people, upsetting memories of traumatic events do not go away on their own, or may even get worse over time, severely affecting their lives.
A study conducted by the Army in 2004 found that one in eight soldiers returning from Iraq reported symptoms of post-traumatic stress disorder (PTSD).
According to the National Center for PTSD in the United States, around eight percent of the population will have PTSD symptoms at some point in their lives. Some 5.2 million adults have PTSD during a given year, the center reports.
In the current research, genetically engineered mice received mild foot shocks in a certain environment and were re-exposed to the same environment without the foot shock.
The team found that mice with increased levels of Cdk5 activity had more trouble letting go of the memory of the foot shock and continued to freeze in fear.
The reverse was also true: in mice whose Cdk5 activity was inhibited, the bad memory of the shocks disappeared when the mice learned that they no longer needed to fear the environment where the foot shocks had once occurred.
"In our study, we employ mice to show that extinction of learned fear depends on counteracting components of a molecular pathway involving the protein kinase Cdk5," Tsai concluded. "We found that Cdk5 activity prevents extinction, at least in part by negatively affecting the activity of another key kinase."
-
NY Times
In 1988, the surgeon general, C. Everett Koop, proclaimed ice cream to a be public-health menace right up there with cigarettes. Alluding to his office’s famous 1964 report on the perils of smoking, Dr. Koop announced that the American diet was a problem of “comparable” magnitude, chiefly because of the high-fat foods that were causing coronary heart disease and other deadly ailments. He introduced his report with these words: “The depth of the science base underlying its findings is even more impressive than that for tobacco and health in 1964.”
That was a ludicrous statement, as Gary Taubes demonstrates in his new book meticulously debunking diet myths, “Good Calories, Bad Calories” (Knopf, 2007). The notion that fatty foods shorten your life began as a hypothesis based on dubious assumptions and data; when scientists tried to confirm it they failed repeatedly. The evidence against Häagen-Dazs was nothing like the evidence against Marlboros.
It may seem bizarre that a surgeon general could go so wrong. After all, wasn’t it his job to express the scientific consensus? But that was the problem. Dr. Koop was expressing the consensus. He, like the architects of the federal “food pyramid” telling Americans what to eat, went wrong by listening to everyone else. He was caught in what social scientists call a cascade.
We like to think that people improve their judgment by putting their minds together, and sometimes they do. The studio audience at “Who Wants to Be a Millionaire” usually votes for the right answer. But suppose, instead of the audience members voting silently in unison, they voted out loud one after another. And suppose the first person gets it wrong.
If the second person isn’t sure of the answer, he’s liable to go along with the first person’s guess. By then, even if the third person suspects another answer is right, she’s more liable to go along just because she assumes the first two together know more than she does. Thus begins an “informational cascade” as one person after another assumes that the rest can’t all be wrong.
Because of this effect, groups are surprisingly prone to reach mistaken conclusions even when most of the people started out knowing better, according to the economists Sushil Bikhchandani, David Hirshleifer and Ivo Welch. If, say, 60 percent of a group’s members have been given information pointing them to the right answer (while the rest have information pointing to the wrong answer), there is still about a one-in-three chance that the group will cascade to a mistaken consensus.
Cascades are especially common in medicine as doctors take their cues from others, leading them to overdiagnose some faddish ailments (called bandwagon diseases) and overprescribe certain treatments (like the tonsillectomies once popular for children). Unable to keep up with the volume of research, doctors look for guidance from an expert — or at least someone who sounds confident.
In the case of fatty foods, that confident voice belonged to Ancel Keys, a prominent diet researcher a half-century ago (the K-rations in World War II were said to be named after him). He became convinced in the 1950s that Americans were suffering from a new epidemic of heart disease because they were eating more fat than their ancestors.
There were two glaring problems with this theory, as Mr. Taubes, a correspondent for Science magazine, explains in his book. First, it wasn’t clear that traditional diets were especially lean. Nineteenth-century Americans consumed huge amounts of meat; the percentage of fat in the diet of ancient hunter-gatherers, according to the best estimate today, was as high or higher than the ratio in the modern Western diet.
Second, there wasn’t really a new epidemic of heart disease. Yes, more cases were being reported, but not because people were in worse health. It was mainly because they were living longer and were more likely to see a doctor who diagnosed the symptoms.
To bolster his theory, Dr. Keys in 1953 compared diets and heart disease rates in the United States, Japan and four other countries. Sure enough, more fat correlated with more disease (America topped the list). But critics at the time noted that if Dr. Keys had analyzed all 22 countries for which data were available, he would not have found a correlation. (And, as Mr. Taubes notes, no one would have puzzled over the so-called French Paradox of foie-gras connoisseurs with healthy hearts.)
===========
Diet and Fat: A Severe Case of Mistaken Consensus
E-Mail
Print
Single Page
Reprints
Save
Share
Del.icio.us
Digg
Facebook
Newsvine
Permalink
Published: October 9, 2007
(Page 2 of 2)
The evidence that dietary fat correlates with heart disease “does not stand up to critical examination,” the American Heart Association concluded in 1957. But three years later the association changed position — not because of new data, Mr. Taubes writes, but because Dr. Keys and an ally were on the committee issuing the new report. It asserted that “the best scientific evidence of the time” warranted a lower-fat diet for people at high risk of heart disease.
The association’s report was big news and put Dr. Keys, who died in 2004, on the cover of Time magazine. The magazine devoted four pages to the topic — and just one paragraph noting that Dr. Keys’s diet advice was “still questioned by some researchers.” That set the tone for decades of news media coverage. Journalists and their audiences were looking for clear guidance, not scientific ambiguity.
After the fat-is-bad theory became popular wisdom, the cascade accelerated in the 1970s when a committee led by Senator George McGovern issued a report advising Americans to lower their risk of heart disease by eating less fat. “McGovern’s staff were virtually unaware of the existence of any scientific controversy,” Mr. Taubes writes, and the committee’s report was written by a nonscientist “relying almost exclusively on a single Harvard nutritionist, Mark Hegsted.”
That report impressed another nonscientist, Carol Tucker Foreman, an assistant agriculture secretary, who hired Dr. Hegsted to draw up a set of national dietary guidelines. The Department of Agriculture’s advice against eating too much fat was issued in 1980 and would later be incorporated in its “food pyramid.”
Meanwhile, there still wasn’t good evidence to warrant recommending a low-fat diet for all Americans, as the National Academy of Sciences noted in a report shortly after the U.S.D.A. guidelines were issued. But the report’s authors were promptly excoriated on Capitol Hill and in the news media for denying a danger that had already been proclaimed by the American Heart Association, the McGovern committee and the U.S.D.A.
The scientists, despite their impressive credentials, were accused of bias because some of them had done research financed by the food industry. And so the informational cascade morphed into what the economist Timur Kuran calls a reputational cascade, in which it becomes a career risk for dissidents to question the popular wisdom.
With skeptical scientists ostracized, the public debate and research agenda became dominated by the fat-is-bad school. Later the National Institutes of Health would hold a “consensus conference” that concluded there was “no doubt” that low-fat diets “will afford significant protection against coronary heart disease” for every American over the age of 2. The American Cancer Society and the surgeon general recommended a low-fat diet to prevent cancer.
But when the theories were tested in clinical trials, the evidence kept turning up negative. As Mr. Taubes notes, the most rigorous meta-analysis of the clinical trials of low-fat diets, published in 2001 by the Cochrane Collaboration, concluded that they had no significant effect on mortality.
Mr. Taubes argues that the low-fat recommendations, besides being unjustified, may well have harmed Americans by encouraging them to switch to carbohydrates, which he believes cause obesity and disease. He acknowledges that that hypothesis is unproved, and that the low-carb diet fad could turn out to be another mistaken cascade. The problem, he says, is that the low-carb hypothesis hasn’t been seriously studied because it couldn’t be reconciled with the low-fat dogma.
Mr. Taubes told me he especially admired the iconoclasm of Dr. Edward H. Ahrens Jr., a lipids researcher who spoke out against the McGovern committee’s report. Mr. McGovern subsequently asked him at a hearing to reconcile his skepticism with a survey showing that the low-fat recommendations were endorsed by 92 percent of “the world’s leading doctors.”
“Senator McGovern, I recognize the disadvantage of being in the minority,” Dr. Ahrens replied. Then he pointed out that most of the doctors in the survey were relying on secondhand knowledge because they didn’t work in this field themselves.
“This is a matter,” he continued, “of such enormous social, economic and medical importance that it must be evaluated with our eyes completely open. Thus I would hate to see this issue settled by anything that smacks of a Gallup poll.” Or a cascade.
-
The New Ways We Fight Cancer
By SAMUEL WAXMAN and RICHARD GAMBINO
October 18, 2007; Page A17
WSJ
This week, the National Cancer Institute, in conjunction with other organizations that track cancers, reported that the death rate from cancer declined from 2002-2004 by an average of 2.1% per year. This is an improvement over the 1.1% annual declines from 1993-2002 and is very good news indeed. Each 1% decline represents 5,000 people living rather than dying, and, of course, this figure is compounded each year.
While some part of the declining death rate from cancer is the consequence of screening, much is the result of greatly improved treatments. And we believe that the successes achieved to date are only the modest beginning of a revolution in the research into and treatment of cancer.
During the last half of the 20th century, almost all treatments of cancers involved forms of chemotherapy in which cancerous and normal tissues were bombarded with nonselective cytoxic drugs. These drugs killed all cells, healthy as well as malignant. Worse, they did not kill all cancer cells, so the cancer progressed -- leading to the pessimism dominant in people's minds today, a reflection of years of articles and opinion pieces in the popular press expressing the view that "the war on cancer" has been waged incorrectly, if not lost.
Now, however, new therapeutic modes are in play, based on better understandings of cancers and great advances in technologies. Scientists are at last on the right track and making progress along three fronts. First, many cancers will be turned into chronic illnesses, each treated with far less toxic drugs with far fewer and less severe side effects, so that a patient can live a normal life span with a near normal quality of life. (A loose analogy would be to diabetics.) These treatments are probably closer to being realized than most people would guess.
Second, the prevention of entire types of cancers will occur through vaccinations, an approach already in clinical use. Third, cancers already growing in individuals will be eradicated. Here is just a partial list of the new approaches:
• Vaccines. Today, a newly developed vaccine is being administered to females, ages 11-26, that prevents cervical cancer (and anal cancer). The vaccine targets a certain virus, human papillomavirus (HPV), which is the cause of most cervical cancers. (Cervical cancer kills 4,000 women annually in the U.S., and 500,000 world-wide.) It is thought that infection with viruses or bacteria play a role in the development of other cancers, e.g., lymphoma and stomach cancer, and research is focused on vaccines and antibiotics to prevent these, and to eradicate those cancers already in existence in individuals.
Another area of vaccine research is Hepatitis C virus (HCV) infection, which causes most liver cancer in the Western world, and Hepatitis B virus (HBV), which causes liver cancer in Asia. (It should be noted that only in a very small percentage of people who have the infections do the viruses cause liver cancer.) Researchers are looking into the possible implications for humans of laboratory results which show that mammary (breast) cancer can be caused in mice by introduction of a virus, a virus which is normally passed from one mouse to another.
In the past, success in stimulating the human immune system to attack cancer cells has been elusive. But three novel research projects are underway, aimed at highly lethal metastatic melanoma. The first approach involves T cells (a group of white blood cells that play a critical role in immunity) which have a particular receptor on their surface known as "TCR" that activates the immune system. The process extracts T cells from a patient's blood sample and, in a laboratory, activates their TCR to turn the T cells into killers of the patient's melanoma cells, and not healthy cells, when reinjected into the patient.
The second approach involves genetic modification of a patient's white blood cells in a laboratory. The cells then produce a protein that enables the modified white cells to be detected and counted in tumors anywhere and everywhere in the patient's body using a noninvasive PET scan, a sophisticated X-ray technology.
In the third method, certain T cells which are derived from blood-forming stem cells are genetically manipulated to target and attack melanoma cells. These killer cells replicate in the body in response to the presence of melanoma tumors and attack the cancerous cells -- and because stem cells are long-lived, a large supply of the cancer-killing cells develop in the patient's body for as long as they are needed, i.e., as long as there are melanoma cells there.
- Epigenetics. Cancers are caused by mutations in DNA and abnormal control of genetic expressions. Epigenetic therapy involves correcting and reversing abnormal cancer-causing gene expressions through the use of drugs designed to target specific proteins involved in gene control.
In 1989, a drug removing the abnormal protein causing acute promyelocytic leukemia (APL) was first successfully used. Since then, the cure rate for APL has gone to 90% and 50,000 lives have been saved world-wide. In the past three years the FDA has approved three epigenetic drugs that can change the behavior of malignant genes by acting on the proteins that control them. They act on cutaneous lymphoma, acute leukemia and myelodysplastic syndrome (a common form of blood cancer).
The most difficult-to-treat cancers involve many mutations involving many gene "switches" that turn on or off the flow of information passed from one gene to another. In our high-speed information age, we are moving to the point where we can keep up with them, and thus "edit" and control them in specific, selective ways.
• Targeted therapies. The use of personalized malignant gene-expression profiles has advanced from research to therapy in patients, e.g., in breast cancer. Research is advancing in targeting specific mutations in some lymphomas, lung cancer and leukemia.
Progress is also well underway in learning to control abnormal genes which signal normal genes to aid in the nurturing of cancers or in metastases of cancers. For example, doctors now have drugs that are able to curtail the production of new blood vessels which cancer cells need and cause to be produced, thus depriving the cancers of nourishment, thereby killing them. Drugs have been designed to block abnormal signals from an individual patient's cancer, and are in use or development.
Biomarkers to detect ongoing cancers are another fruitful area of research. An example of a biomarker now being used clinically is an overabundance of a protein (called HER-2 neu) which is associated with many breast cancers. Such personalized molecular profiles lead to the use of specific, highly selective treatments with minimal toxicity.
• Cancer "stem cells." Intensive, continuing research has identified a type of cancer cells, found in small numbers, that are more capable of producing cancers and are more difficult to eradicate than ordinary cancer cells. In the last five years, knowledge has greatly advanced regarding how these types of cancer stem cells operate at the genetic level. Work is also well underway in the specific targeting, through the rapid expansion of computer data bases, of the genetic signatures of stem cells of different cancers, to inhibit or cancel their ability to communicate information that causes cancer growth, dormancy and metastasis.
This is but a very incomplete account of new and increasingly productive research in understanding and defeating cancers. In all, there is a 21st-century cancer treatment revolution unfolding. Defeating cancers involves incremental, time-consuming processes along many avenues -- and we are advancing on all of them.
The danger is that misconceived pessimism might result in a loss of popular moral support for the revolutionary new approaches to cancer research and treatment. This in turn could lead to diminishing private and governmental funds for research.
At the very least, pessimism about taming and ultimately eliminating cancers turns the minds of millions from what should be justified hope to needless despair.
Dr. Waxman, an oncologist, is professor of medicine at Mount Sinai Medical Center and scientific director of the Samuel Waxman Cancer Research Foundation. Mr. Gambino, who has a Ph. D. in philosophy, is professor emeritus at Queens College (CUNY).
-
Putting Superbugs on the Defensive
Hospitals Begin to Tout
Ability to Control Infection;
Mining the Available Data
By THEO FRANCIS
October 23, 2007; Page D1
Hospitals are prime breeding grounds for antibiotic-resistant "superbugs" that kill tens of thousands of Americans each year. But most people have had no way of knowing how well their hospital keeps these bacteria -- and infections in general -- under control.
Concern over the spread of Methicillin-resistant Staphylococcus aureus has prompted renewed calls for preventive measures such as handwashing and the cleaning of facilities and schools where cases have been found.
That is starting to change. Nineteen states have adopted laws in recent years requiring hospitals to report overall infection rates publicly, with more likely to follow suit. And Thursday, nearly two dozen federal lawmakers, headed by Pennsylvania Rep. Tim Murphy, proposed legislation requiring nationwide public reporting.
So far, just four states have published some infection rates for individual hospitals, and only one state, Pennsylvania, breaks out different types of infections. But even where patients can't find state-mandated infection reports, they can increasingly get information from their local hospital about practices to prevent superbugs and other infections. Some hospitals have found a marketing opportunity in infection prevention: They are pushing overall infection rates toward zero -- and advertising it. They are trumpeting prevention efforts, such as campaigns to improve hand washing. And some are tracking patients who have been infected with superbugs such as methicillin-resistant Staphylococcus aureus, or MRSA, and monitoring them to prevent the spread.
"This is one of those cases where quality is also the best business case," says Jonathan Perlin, chief medical officer at hospital chain HCA Inc., which has enlisted staffers and visitors alike in its own campaign to keep germs away from patients.
While antibiotic-resistant infections have gotten the attention of late, hospitals have long struggled with infections of all kinds. Common bacteria including Staphylococcus aureus can infect the bloodstream, urinary tract, lungs or surgical incisions of patients whose immune systems are already compromised. Over time, some strains of these bacteria have developed powerful defenses against antibiotics, leaving them harder to kill.
Hospitals have long attempted to keep infection rates low, but the spread of resistant strains has made the fight that much more urgent in recent years. Last week, concerns came to a head with a new study showing that antibiotic-resistant infections are probably far more extensive than previously thought. The study published in JAMA, the Journal of the American Medical Association, concluded that MRSA causes 94,000 infections a year. The study estimated that MRSA, one of the biggest infection concerns in hospitals, contributes to nearly 19,000 deaths. The vast majority were linked to health care, including hospitals, nursing homes, dialysis and others.
At the same time, recent student illnesses and deaths have prompted school closings in some states. (Please see related article.) And starting next year, Medicare will no longer reimburse hospitals for some infections acquired after admission, in an effort both to encourage vigilance and to save money.
BUG OFF
Hospital chain HCA has taken its campaign against antibiotic-resistant infections to the public as well as its medical staff. Below, links to a handout for visitors to HCA hospitals, and a poster aimed at employees.
• Handout: Stopping Infections Is In Your Hands
• Poster: Stopping MRSA Is In Your HandsAmong the four states that have published infection rates, Missouri and Vermont let consumers learn the number of blood infections related to central lines -- tubes inserted into or near the heart, often to give medications or fluids -- and how that compares with state or national averages. Pennsylvania provides multiple reports on different kinds of infections, and lets consumers look up infection-related mortality, length-of-stay and cost data for several kinds of infections. A Web site from Consumers Union, www.stophospitalinfections.org, has links to reports from each state, including Florida, according to Lisa McGiffert, director of the Stop Hospital Infections Campaign.
'Ahead of the Curve'
Information from Florida is nearly two years old, and Missouri's dates to December 2006. But the information released so far is an important start, say public-health experts, since most of the hospital-infection reports mandated by the new state laws won't be available before about 2009. "Those states that have already released data are ahead of the curve," says John Jernigan, a medical epidemiologist with the Centers for Disease Control and Prevention in Atlanta.
So far, infection reports available to the public aren't consistent enough to allow consumers to compare hospitals across state lines, and even comparing facilities within a state can be tricky. Some facilities may treat sicker patients, for example, who are more likely to become infected when exposed to MRSA or other resistant bugs.
Indeed, the data are probably too technical for most consumers, says Carlene Muto, medical director of infection control at the University of Pittsburgh Medical Center. Still, she is a strong supporter of the reporting requirements as a way to push hospitals to improve. "Clearly, it's a good idea just to measure adverse events," she says. "You can't change what you do not measure, because you won't know that it's broken."
In areas where patients can't learn actual infection rates, they can watch for key signs that a hospital is on top of preventing both superbugs and infections generally. National studies suggest, for example, that hospital personnel don't wash their hands nearly as often as they should.
Nashville, Tenn.-based HCA has been putting up posters exhorting doctors to wash their hands, and is even distributing a card to visitors that explains the importance of hand washing when coming in contact with patients. The company says its purchases of hand-sanitizing alcohol gel -- available from dispensers throughout its hospitals -- have risen 600% since early this year. (Company officials say they didn't measure infection rates at the start of the campaign and so don't know how much infections have fallen.)
Other hospitals say they have pushed antibiotic-resistant-infection rates down sharply through a combination of techniques. The University of Pittsburgh Medical Center, for example, has cut MRSA infection rates in half at its main hospital since 2001 in part by screening all intensive-care patients to see if they are carrying the bug; it is now expanding use of the tests.
To reduce certain kinds of bloodstream infections, the 19-hospital system bundles sterile material needed to insert central lines and has stepped up training; central-line associated blood-infection rates have fallen by 80% since 2002, to fewer than one per thousand such procedures.
It also has taken steps to deal with the emergence of a different strain of bacteria that can cause potentially fatal diarrhea. The hospital lets nurses order tests for the bug; requires longer isolation periods for those infected with it; gives their rooms an additional cleaning with bleach; and requires physicians to get approval from an antibiotic-management team when using certain high-powered antimicrobials that could affect the body's natural defenses against the bacteria. UPMC's infection rates for the organism, Clostridium difficile, have fallen two-thirds since a spike in 2000.
Intermountain Healthcare, a Salt Lake City-based chain of 21 hospitals, keeps a database of every patient who has been infected with MRSA. Those who return to the hospital for some other reason are immediately monitored by an infection-control nurse and tested to see if they are carrying the bacteria.
"Those patients are at higher risk of potentially getting it again, and at higher risk of spreading it to other patients," says the hospital's chief medical officer, Brent Wallace. Together with a concerted campaign to improve hand-washing, the database has helped stop an increase in the number of MRSA infections at the hospital over the past year, he says.
Broader Testing
Some states are also beginning to mandate broader testing specifically for MRSA, since patients can carry the bug and spread it without showing signs of infection. Pennsylvania will soon require hospitals to test high-risk patients, including those admitted from nursing homes. In August, New Jersey and Illinois adopted legislation requiring hospitals to identify patients carrying MRSA and isolate them, among other provisions.
Don Goldmann, senior vice president of the Institute for Health Care Improvement and a Harvard Medical School pediatrics professor, says that factors beyond infection rates should play into picking a hospital. "There may be a lot of information to weigh."
On their own, some hospitals have been turning to a variety of new technologies to try to cut down on infections, particularly superbugs, ranging from antibiotic-coated catheters to work surfaces made of copper, which has antimicrobial properties, as well as software. For several years, many hospitals have also participated in federally sponsored programs to reduce surgical complications, including infections acquired in the hospital.
Write to Theo Francis at theo.francis@wsj.com
WSJ
-
Wash Your Hands, and Don't Shave
Your Legs: Advice to Avoid Infection
By LAURA LANDRO
October 23, 2007; Page D1
As a virulent strain of antibiotic-resistant bacteria spreads beyond hospital walls, some communities are taking extreme measures such as closing schools for disinfection. But getting adults and children to pay better attention to a few simple personal-hygiene rules, and taking precautionary measures such as getting a flu shot, may be a far more effective weapon against the bugs.
New reports of deaths and infections across the country coincided with a report last week from the Centers for Disease Control and Prevention indicating that about 94,000 people annually are infected with methicillin-resistant staphylococcus aureus, or MRSA, a form of the common staph bacteria that has become resistant to penicillin and related antibiotics. While the CDC estimated that the majority of such infections occur in health-care settings, nearly 14% were so-called community-acquired, meaning that they struck otherwise healthy people who weren't in a hospital. Indeed, a number of the staph infections reported in recent weeks involved outbreaks among student athletes.
Staph bacteria frequently live on the skin and in the nose without causing any health problems, and at any time about a third of people are already "colonized." But if the bacteria enter the skin or bloodstream through a cut or lesion, or a person's immune system is weakened by flu or other causes, a staph infection can set in. Although the organism can be spread by patients who are colonized but not infected through casual contact or through contaminated objects, such spread can occur more quickly from patients with active skin infections unless the appropriate precautions are taken.
Staph infections can often be treated by simply cleaning and draining a wound. Even if the strain turns out to be MRSA, antibiotics may not be necessary, and severe cases may be treated with antibiotics such as vancomycin. But such cases can also progress to severe invasive disease and death.
CDC officials stress that the number of such infections is still relatively low, and children ages 5 to 17 years have the lowest rate of MRSA infection of any age group. The overall physical environment, moreover, hasn't played a significant role in the transmission of MRSA. Transmission occurs with direct contact with an infected person or contaminated items, such as sporting equipment or clothing. So scrubbing down locker-room walls as if they were a biohazard hot zone isn't going to protect kids as well as making sure that they keep their hands clean, cover open wounds with clean, dry bandages, and avoid sharing personal items such as towels, razors or uniforms. Says John Jernigan, an MRSA expert at the CDC: "If we can hammer that message home, we will go a long way towards preventing infections."
In team sports it is also important to exclude players who have potentially infected skin lesions if their wounds can't be covered. Other measures include washing clothes, especially uniforms and exercise gear, in hot water and laundry detergent and drying them in a hot dryer. (For more information on infection prevention techniques, check cdc.gov.)
Such common-sense measures apply to protecting yourself and your children from other kinds of infections as well. In most places where people share facilities or water, bacteria can spread. That resort hot tub may look inviting, but there is always a risk that the others sharing it don't have pristine personal hygiene; so-called recreational water illnesses can cause skin, ear, respiratory, eye, neurologic and wound infections. If you are getting a salon pedicure, don't shave your legs beforehand, because any bacteria in a salon's foot baths, including MRSA, can enter the skin or bloodstream through minor nicks. Ensure that the foot bath basin is thoroughly sanitized, and bring your own equipment, such as clippers.
Proper hand-washing techniques are critical, says Jason Newland, an infectious-disease expert at Children's Mercy Hospital in Kansas City, Mo., because bacteria often are transmitted when people touch their mouth or nose. The quick pass of the hands under a lukewarm or cool faucet many of us rely on won't do the trick; it is important to wash hands for at least 15 seconds in hot water and rub soap vigorously to create enough friction to rub off contaminants. If using an antibacterial gel, it is also important to create friction through rubbing -- and to make sure the gel dries completely. With flu season at hand, Dr. Newland says a flu shot is advisable because the fever and symptoms like congestion, runny nose and cough disrupt the area in the back of the throat and windpipe, allowing bacteria such as MRSA to enter the bloodstream or lungs, which could cause pneumonia.
Infectious-disease experts warn that the longer-term danger is that MRSA bacteria from the community will come back into the hospital in an even more-resistant form. Because overuse of antibiotics is the main culprit in antibiotic resistance, consumers can help by adhering to the CDC's guidelines for antibiotic use, which caution people to use the drugs only for bacterial infections, not viruses such as cold or flu. Ask health-care providers to wash their hands, and lobby local and state authorities to monitor and enforce infection control in health-care facilities.
WSJ
-
Low Buzz May Give Mice Better Bones and Less Fat
E-Mail
Print
Reprints
Save
Share
Del.icio.us
Digg
Facebook
Newsvine
Permalink
By GINA KOLATA
Published: October 30, 2007
Clinton T. Rubin knows full well that his recent results are surprising — that no one has been more taken aback than he. And he cautions that it is far too soon to leap to conclusions about humans. But still, he says, what if ... ?
Skip to next paragraph
FAT Abdominal scans of two mice show subcutaneous fat (gray) and visceral fat (red). The vibrated mouse, right, has less of both.
Multimedia
Less Fat in Vibrated Mice And no wonder, other scientists say. Dr. Rubin, director of the Center for Biotechnology at the State University of New York at Stony Brook, is reporting that in mice, a simple treatment that does not involve drugs appears to be directing cells to turn into bone instead of fat.
All he does is put mice on a platform that buzzes at such a low frequency that some people cannot even feel it. The mice stand there for 15 minutes a day, five days a week. Afterward, they have 27 percent less fat than mice that did not stand on the platform — and correspondingly more bone.
“I was the biggest skeptic in the world,” Dr. Rubin said. “And I sit here and say, ‘This can’t possibly be happening.’ I feel like the credibility of my scientific career is sitting on a razor’s edge between ‘Wow, this is really cool,’ and ‘These people are nuts.’”
The responses to his work bear out that feeling. While some scientists are enthusiastic, others are skeptical.
The mice may be less fat after standing on the platform, these researchers say, but they are not convinced of the explanation — that fat precursor cells are turning into bone.
Even so, the National Institutes of Health is sufficiently intrigued to investigate the effect in a large clinical trial in elderly people, said Joan A. McGowan, a division director at the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
Dr. McGowan notes that Dr. Rubin is a respected scientist and that her institute has helped pay for his research for the past 20 years, but she does caution against jumping to conclusions.
“I’d call it provocative,” she said of the new result. “It says, ‘Keep looking here; this is exciting.’ But it is crucial that we don’t oversell this.” For now, she added, “it is a fundamental scientific finding.”
The story of the finding, which was published online and will appear in the Nov. 6 issue of Proceedings of the National Academy of Sciences, began in 1981 when Dr. Rubin and his colleagues started asking why bone is lost in aging and inactivity.
“Bone is notorious for ‘use it or lose it,’” Dr. Rubin said. “Astronauts lose 2 percent of their bone a month. People lose 2 percent a decade after age 35. Then you look at the other side of the equation. Professional tennis players have 35 percent more bone in their playing arm. What is it about mechanical signals that makes Roger Federer’s arm so big?”
At first, he assumed that the exercise effect came from a forceful impact — the pounding on the leg bones as a runner’s feet hit the ground or the blow to the bones in a tennis player’s arm with every strike of the ball. But Dr. Rubin was trained as a biomechanical engineer, and that led him to consider other possibilities. Large signals can actually be counterproductive, he said, adding: “If I scream at you over the phone, you don’t hear me better. If I shine a bright light in your eyes, you don’t see better.”
Over the years, he and his colleagues discovered that high-magnitude signals, like the ones created by the impact as foot hits pavement, were not the predominant signals affecting bone. Instead, bone responded to signals that were high in frequency but low in magnitude, more like a buzzing than a pounding.
That makes sense, he went on, because muscles quiver when they contract, and that quivering is the predominant signal to bones. It occurs when people stand still, for example, and their muscles contract to keep them upright. As people age, they lose many of those postural muscles, making them less able to balance, more apt to fall and, perhaps, prone to loss of bone.
“Bone is bombarded with little, teeny signals from muscle contractions,” Dr. Rubin said.
He discovered that in mice, sheep and turkeys, at least, standing on a flat vibrating plate led to bone growth. Small studies in humans — children with cerebral palsy who could not move much on their own and young women with low bone density — indicated that the vibrations might build bone in people, too.
Dr. Rubin and his colleagues got a patent and formed a company to make the vibrating plates. But they and others caution that it is not known if standing on them strengthens bones in humans. Even if it does, no one knows the right dose. It is possible that even if there is an effect, people might overdose and make their bones worse instead of better.
Some answers may come from the federal clinical trial, which will include 200 elderly people in assisted living. It is being directed by Dr. Douglas P. Kiel, an osteoporosis researcher and director of medical research at the Institute for Aging Research at Harvard. The animal work made him hopeful that the buzzing platforms would have an effect on human bones.
“This work is fascinating and very legitimate,” Dr. Kiel said.
But then Dr. Rubin reported that the mice were also less fat, which led to the revised plans to look for changes in body fat as well.
Dr. Rubin says he decided to look at whether vibrations affect fat because he knows what happens with age: bone marrow fills with fat. In osteoporosis, the bones do not merely thin; their texture becomes lacy, and inside the holes is fat. And a few years ago, scientists discovered a stem cell in bone marrow that can turn into either fat or bone, depending on what signal it receives.
No one knows why the fat is in bone marrow — maybe it provides energy for failing bone cells, suggests Dr. Clifford J. Rosen, director of the Maine Center for Osteoporosis Research and Education. And no one knows whether human fat cells ever leave the bone marrow and take up residence elsewhere.
But Dr. Rubin had an idea. “We thought, Wait a second,” he said. “If we are mechanically stimulating cells to form bone, what isn’t happening? We thought maybe these bone progenitor cells are driving down a decision path. Maybe they are not becoming fat cells.”
He paid a visit to Jeffrey E. Pessin, a diabetes expert at Stony Brook, and presented his hypothesis. Dr. Pessin laughed uproariously. He “almost kicked me out of his office,” as Dr. Rubin put it.
But when Dr. Rubin decided to go ahead anyway, Dr. Pessin joined in. Their hope was to see a small effect on body fat after the mice stood on the platforms 15 minutes a day, 5 days a week, for 15 weeks. Dr. Rubin was stunned by the 27 percent reduction.
“Talk about your jaw dropping,” he said.
Some obesity researchers, though, say there may be other reasons that the mice were less fat.
“It is a very intriguing paper,” said Claude Bouchard, an obesity researcher who is director of the Pennington Center for Biomedical Research at Louisiana State University. But he wondered whether the mice on the platform were simply burning more calories.
“It seems to me,” Dr. Bouchard said, “that putting myself in the body of a mouse, if I was on a platform that was vibrating 90 times a minute, I would try to adhere to the surface and not be thrown off. I would probably tense my legs a little bit. That is energy expenditure.”
Stress may be another factor, he added. Standing on the platform may have frightened the mice, and they might have become sick.
Dr. Rudolph L. Leibel, an obesity researcher who is co-director of the Naomi Berrie Diabetes Center at Columbia University, had similar questions.
A platform that seems to be barely vibrating to a human could feel like an earthquake to a mouse, Dr. Leibel said, adding, “they could be scared to death,” which could affect the study data.
He also questioned the idea that precursor cells from bone marrow could turn into fat cells in the rest of the body, calling it “a contested and, I would say, incorrect notion.”
If the mice that stood on the platform became thinner and if they ate as much as mice that did not stand on the platform (as Dr. Rubin reported), they must be burning more calories, Dr. Leibel said.
Others are more hopeful.
“This is very, very cool,” said Dr. John B. Buse, a diabetes researcher at the University of North Carolina who is president for science and medicine at the American Diabetes Association. If it turned out to hold for people too, “it would be great for diabetes,” he added. He noted that people with Type 2 diabetes were likely not only to be overweight but also to have problems with their bones.
Still, Dr. Buse awaits more definitive studies in humans.
“It is almost too good to be true,” he said.
NY Times
-
Second post of the day:
Forwarded by David Gordon: http://www.utexas.edu/features/archive/2004/nutrition.html
-
Revolutionary Laser Technique Destroys Viruses And Bacteria Without Damaging Human Cells
ScienceDaily (Nov. 2, 2007) — Physicists in Arizona State University have designed a revolutionary laser technique which can destroy viruses and bacteria such as AIDS without damaging human cells and may also help reduce the spread of hospital infections such as MRSA.
The research, published on Thursday November 1 in the Institute of Physics' Journal of Physics: Condensed Matter, discusses how pulses from an infrared laser can be fine-tuned to discriminate between problem microorganisms and human cells.
Current laser treatments such as UV are indiscriminate and can cause ageing of the skin, damage to the DNA or, at worst, skin cancer, and are far from 100 per cent effective.
Femtosecond laser pulses, through a process called Impulsive Stimulated Raman Scattering (ISRS), produces lethal vibrations in the protein coat of microorganisms, thereby destroying them. The effect of the vibrations is similar to that of high-pitched noise shattering glass.
The physicists in Arizona have undertaken experiments to show that the coherent vibrations excited by infrared lasers with carefully selected wavelengths and pulse widths do no damage to human cells, most likely because of the different structural compositions in the protein coats of human cells vis a vis bacteria and viruses.
Professor K. T. Tsen from Arizona State University said, "Although it is not clear at the moment why there is a large difference in laser intensity for inactivation between human cells and microorganisms such as bacteria and viruses, the research so far suggests that ISRS will be ready for use in disinfection and could provide treatments against some of the worst, often drug-resistant, bacterial and viral pathogens."
Femtosecond lasers could find immediate application in hospitals as a way to disinfect blood supply or biomaterials and for the treatment of blood-borne diseases such as AIDS and Hepatitis.
http://www.sciencedaily.com/releases/2007/11/071101084950.htm
-
Out With the Trans Fats,
In With a Whole Lot of Others
By JULIE JARGON
November 6, 2007; Page D1
Food companies are scrambling to replace trans fat in everything from french fries to cookies, but health experts worry that what's good for the nation's heart might be bad for its waistline.
Read more about different kinds of fats
Trans fat is created when hydrogen is added to vegetable oil. The resulting ingredient, known as partially hydrogenated vegetable oil, is what makes french fries crispy and croissants flaky. But trans fat's effect on cholesterol -- it raises the bad kind and lowers the good -- has made it a food-industry villain.
Ever since the Food and Drug Administration required food companies to disclose the amount of trans fat in their products last year, the industry has been searching for replacement ingredients. Kraft Foods Inc., the world's second-largest food manufacturer by revenue, has removed trans fat from numerous products, including Oreo cookies, Wheat Thins crackers and Jell-O pudding snacks. PepsiCo's Frito-Lay has eliminated trans fat from all of its chips.
So what's going in food instead of trans fat? Some food makers are going back to ingredients high in cholesterol-raising saturated fat, such as palm oil, palm kernel oil and coconut oil. In Kellogg's Eggo blueberry waffles, for example, trans fats have been replaced with palm oil and palm kernel oil, while Oreos now contain "palm oil and/or canola oil."
Kraft says that while the saturated fat content of Oreos is higher, the overall fat content is the same, at 7 grams per serving. "The effort wasn't just about removing trans fat, but about keeping the nutrition profile the same," says spokeswoman Laurie Guzzinati.
MORE
• A Look at Trans-Fat ReplacementsThuy-An Wilkins, a spokeswoman for Kellogg, says the company has removed the trans fat in most of its products without increasing the amount of saturated fat, but it's still "a work in progress."
Other products are achieving trans-fat-free status through interesterification, a process in which fatty acids are redistributed on a fat molecule to make liquid fats behave more like solid fats. Products made with interesterified fat include Promise Buttery Spread and Enova cooking oil. Unilever, the maker of Promise, conducted its own study 10 years ago that found no adverse effects from food made with interesterified fat, says Doug Balentine, Unilever's director of nutrition sciences for the Americas.
But other nutrition experts say not enough is known about the safety of interesterified fat. There was little interest in researching the ingredient until the recent push for trans-fat alternatives. David Baer, a research physiologist at the U.S. Department of Agriculture's Beltsville Human Nutrition Research Center, says his own research has studied only blended fats, and offers no insights on interesterified fats specifically. "We're interested in trying to figure out the health effects," he says. "The nutrition community is puzzled by what might be the most healthful alternative to trans fat."
K.C. Hayes, director of the Foster Biomedical Research Lab at Brandeis University, says that while the ingredient is in relatively few products now, its use may grow before the health-care community fully understands its impact. Dr. Hayes, who conducted a small study funded by the palm-oil industry that did find negative health effects from interesterified fats, says, "The point is, we should know more before we go off trans fat and onto something else."
The American Heart Association recommends replacing trans fat with monounsaturated fats, which are found in olive, canola, peanut and sunflower oils, or with the polyunsaturated fats found in soybean, corn and safflower oils. For instance, a lot of the chicken sold at KFC is now fried in a type of soybean oil, and McDonald's in the U.S. is switching to a proprietary blend of canola, soybean and corn oils for its french fries.
The biggest danger of the trans-fat swap-out could be that consumers will eat more junk food because they think it's healthier. For one thing, zero doesn't necessarily mean zero. Products can still have up to half a gram of trans fat and carry a "zero trans fat per serving" label. So if someone eats more than a serving of cookies, they could still be consuming a few grams of trans fat.
• Email: healthjournal@wsj.com
-
For years health authorities have warned of the growing threat posed by drug-resistant bacteria, but most of us have been half-listening. Not anymore.
A virulent strain of bacteria that resists many antibiotics appears to be killing more people annually than AIDS, emphysema or homicide, taking an estimated 19,000 lives in 2005, according to a study published last week in the Journal of the American Medical Association. The recent death of a 17-year-old high school football player in Virginia is a tragic reminder that methicillin-resistant Staphylococcus aureus, or MRSA, can prey on otherwise healthy people.
The best defense against the potentially deadly infection is common sense and cleanliness. “We need to reinvent hygiene for the 21st century,’’ said Dr. Charles Gerba, professor of environmental microbiology at the University of Arizona at Tucson. “You go to a grocery store, and hundreds of thousands of people have touched those surfaces every day. Microorganisms are evolving very rapidly.’’
Here are answers to common questions about community-acquired staph infections, or CA-MRSA.
What does CA-MRSA look like?
CA-MRSA is primarily a skin infection. It often resembles a pimple, boil or spider bite, but it quickly worsens into an abscess or pus-filled blister or sore. Patients who have sores that won’t heal or are filled with pus should see a doctor and ask to be tested for staph infection. They should not squeeze the sore or try to drain it — that can spread the infection to other parts of the skin or deeper into the body.
Who is at risk?
The vast majority of MRSA cases happen in hospital settings, but 10 percent to 15 percent occur in the community at large among otherwise healthy people. Infections often occur among people who are prone to cuts and scrapes, such as children and athletes. MRSA typically spreads by skin-to-skin contact, crowded conditions and the sharing of contaminated personal items. Others who should be watchful: people who have regular contact with health care workers, those who have recently taken such antibiotics as fluoroquinolones or cephalosporin, homosexual men, military recruits and prisoners. Clusters of infections have appeared in certain ethnic groups, including Pacific Islanders, Alaskan Natives and Native Americans.
What can I do to lower my risk of contracting MRSA?
Bathing regularly and washing hands before meals is just a start. Wash your hands often or use an antibacterial sanitizer after you’ve been in public places or have touched handrails and other highly trafficked surfaces. Make sure cuts and scrapes are bandaged until they heal. Wash towels and sheets regularly, preferably in hot water, and leave clothes in the dryer until they are completely dry. “Staph is a pretty hardy organism,’’ said Dr. Gerba.
Remind kids and teenagers that personal items shouldn’t be shared with their friends, he added. This includes brushes, combs, razors, towels, makeup and cell phones. A teenager in Dr. Gerba’s own family once contracted MRSA, he said, and he eventually traced the bacteria to her cell phone. She had shared it with a friend whose mother worked in a nursing home. Dr. Gerba went on to discover MRSA on the friend’s cell phone and makeup compact and on a countertop in her home.
Where does MRSA lurk?
Staph bacteria may be found on the skin and in the noses of nearly 30 percent of the population without causing harm. Experts believe it survives on surfaces in 2 percent to 3 percent of homes, cars and public places.
But the bacteria are evolving, and the statistics may already underestimate the prevalence of MRSA. Be especially vigilant in health clubs and gyms — staph grows rapidly in warm, moist environments. The risks of infection and necessary precautions should be explained to student athletes, particularly those in contact sports who often suffer cuts and spend time in locker rooms. When working out at the gym, make sure you wipe down equipment before you use it. Many people clean just the sweaty benches, but Dr. Gerba notes that MRSA also has been found on the grips of workout machines. And if you have a scrape or sore, keep it clean and bandaged until it heals. Minor cuts and scrapes are the way MRSA takes hold.
What is the single best thing I can do to protect myself from MRSA?
Without question, people need to show far more respect for antibiotics. Misuse of antibiotics allows bacteria to evolve and develop resistance to drugs. But parents often pressure pediatricians to prescribe antibiotics even when they don’t help the vast majority of childhood infections. When you do take an antibiotic, finish the dose. Antibiotic resistance is bad for everyone, but your body can also become particularly vulnerable to resistant bacteria if you are careless with the drugs.
How do I find out more?
One of the most useful Web sites is a MRSA primer from Mayoclinic.com. The Centers for Disease Control and Prevention offers a useful Q&A about MRSA in schools. A patient website called MRSA Resources lists a few stories of patients affected by MSRA. Recent Stanford University grad Nick Yee chronicles his struggle with MRSA on his Web site, which includes graphic videos of his wound and treatment. (I couldn’t get through them.) And if you have the stomach for it, a number of people have — inexplicably — posted videos of their MRSA wounds on YouTube.
NY Times
-
WSJ
Booster-Shot Frequency
Is Questioned in Study
By SUZANNE SATALINE
November 8, 2007; Page D3
Vaccines against measles, mumps and tetanus can fight off diseases for decades, says a study that questions whether Americans need booster shots with the frequency they currently are being given.
In the study, published in the New England Journal of Medicine, researchers at Oregon Health & Science University in Beaverton said they found surprisingly high levels of disease-resisting antibodies in the blood of patients who had been vaccinated years earlier. Vaccines prompt antibody creation by giving patients a small dose of the virus that creates the disease.
The persistence of the antibodies suggests that current recommendations for booster shots for some common conditions could be revised, the study said. For instance, Mark K. Slifka, one of the study's authors, said that tetanus shots could be given once approximately every 30 years instead of once every 10 years, as currently is recommended.
The study found that protection from conditions such as measles, mumps and rubella following exposure to the diseases were, in most cases, maintained for life.
Although it isn't dangerous to get booster shots, the study's authors said it may be unnecessary in some circumstances. "If we can continue to improve our vaccines, someday we might be able to give one shot and give lifelong immunity," said Mr. Slifka, associate professor at the Oregon university's Vaccine and Gene Therapy Institute.
John Treanor, a physician specializing in infectious diseases at the University of Rochester in New York state, said that before the health-care system eliminates boosters, more study is needed on outbreaks of certain diseases and declining vaccine efficacy. "I think this is helpful and great to have," he said, referring to the study. "I don't know if this is so definitive."
The researchers said that the efficacy of vaccines doesn't apply across the board: children frequently need chickenpox booster shots after five years because the vaccine antibodies aren't as potent as the antibodies created by the disease itself, Mr. Slifka noted.
The researchers analyzed 630 stored blood samples from 45 patients. With each sample, the authors analyzed the decay rate for antibodies from vaccines for measles, mumps, rubella, varicella-zoster virus, and Epstein-Barr, the herpes virus that causes mononucleosis.
Write to Suzanne Sataline at suzanne.sataline@wsj.com
-
Editorial
Published: November 30, 2007
CT scans have long been cited as a prime example of how the overuse of fancy medical technologies can drive up the cost of health care. Now there are newly voiced concerns that computed tomography, or CT, may be a health risk as well.
The scans, which were introduced in the 1970s, have revolutionized medical imaging by producing three-dimensional views of organs and other tissues. The scans are undeniably of great value in helping doctors diagnose just what is causing a patient’s illness or pain. But a critique published in The New England Journal of Medicine by two researchers at Columbia University’s Center for Radiological Research warns that usage has spread so rapidly that high, lifetime doses of radiation are now becoming a pubic health hazard.
More than 62 million CT scans were performed in the United States last year, a huge increase from the 3 million performed in 1980. And each scan gives the patient a far higher dose of radiation than a conventional X-ray would. Unfortunately, even many doctors have no idea how much radiation a CT scan delivers.
The risk that a single CT scan might cause cancer is very small, and the medical benefits of diagnosing an ailment far outweigh the slight radiation risk. The problem comes when CT scans are not medically appropriate, such as full-body scans to screen patients who feel fine on the chance that some hidden disease might be detected, or when CT scans are repeated again and again as patients traipse from one doctor to another while their medical records lag behind.
The researchers cite previous estimates that a third of all CT scans performed in the United States could be replaced with less risky diagnostic technologies or not performed at all. If true, that means that some 20 million adults and 1 million children in this country are being irradiated unnecessarily each year. In coming decades, the researchers suggest, as many as 2 percent of all cancers in the United States may be because of radiation from CT scans performed today.
Even if these predictions are on the high side, as some radiologists and medical device manufacturers contend, the message for patients and their doctors is clear: Restrict the use of CT scans to cases where they can truly aid in diagnosis and consider other options, such as ultrasound or magnetic resonance imaging, which have no radiation risk.
NY Times
-
If you look at the 1809 picture of the 700 pound man one sees something that is becoming common. Even in my 25 years in medicine seeing patients over 300 or 400 pounds was not common. Now it is very common. We need better treatments for obesity and I await better pharmacologics for this; I've heard Merck is working on one but I have no further information on it. It was a big disappointment that rimonabant from
Sanofi did not get yet approved here (it is in Europe) since that would have helped. Anyone know people in Europe who have used it?
http://content.nejm.org/cgi/content/full/357/24/2526
-
Forgive my glibness, and please educate me if I miss the point, but what about:
1) hormones and anti-biotics in the food supply?
2) high fructose corn syrup and its brethren?
3) eating less?
Marc
-
Hi Crafty,
I am not sure I follow you.
Obesity is more complex and resistant to treatment than what you asked?
What fat person doesn't know they should eat less and exercise more?
-
What I was trying to ask, apparently too laconically, is that why does one need drugs to lose weight?
Anyway, what do you think of this?
=======================
The Dangers of High Fructose Corn Syrup
By John Mericle M.D.
High Fructose Corn Syrup
Before we get to high fructose corn syrup (HFCS), we will take a look at two other frequently used sweeteners, dextrose and maltodextrin.
Dextrose
Dextrose is more or less an industry term for glucose. Glucose isthe most prevalent sugar in the human and the only molecule that the brain can metabolize. Dextrose is refined from corn starch. It has a very high glycemic index (no surprise since it is glucose) and while it contains no fructose, it is still a simple sugar that is very readily absorbed. It is not as dangerous as sucrose but it still is a highly processed product that should be avoided.
Maltodextrin
Maltodextrin is also a refined product usually made from either corn or potatoes. It is multiple glucose units somewhat loosely hooked together (a polymer). Because the bonds between the glucose units are very weak, it is also very readily absorbed and has a very high glycemic index. Like dextrose it should be avoided as much as possible. It has been called a "sugar substitute"but that is based on a rather strict definition of sugar as "sucrose." It is a very common additive and I have found it in many packaged foods, including potato chips.
High Fructose Corn Syrup
High fructose corn syrup is made by treating corn (which is usually genetically modified corn) with a variety of enzymes, some of which are also genetically modified, to first extract the sugar glucose and then convert some of it into fructose, since fructose tastes sweeter than glucose. The end result is a mixture of 55% fructose and 45% glucose, that is called "high fructose corn syrup." Improvements in production occurred in the 1980's making it cheaper than most other sweeteners. I remember in the 1980's when the price of Pepsi dropped from about $3 for a sixpack to about $1.50. In 1966 refined sugar such as sucrose was the was the leading sweetener / additive. In 2001 corn sweeteners accounted for 55% of the sweetener market. Consumption of high fructose corn syrup went from zero in 1966 to 62.6 pounds per person in 2001. A 12 ounce soda can contain as much as 13 teaspoons of sugar in the form of high fructose corn syrup.
Once again, the dangerous combination: fructose and glucose.
When high fructose corn syrup breaks down in the intestine, we once again find near equal amounts of glucose and fructose entering the bloodstream. As covered in recent newsletters, the fructose short-circuits the glycolytic pathway for glucose. This leads to all the problems associated with sucrose. In addition, HFCS seems to be generating a few of its own problems, epidemic obesity being one of them. Fructose does not stimulate insulin production and also fails to increase "leptin" production, a hormone produced by the body's fat cells. Both of these act to turn off the appetite and control body weight. Also, fructose does not suppress ghrelin, a hormone that works to increase hunger. This interesting work is being done by Peter Havel at UC Davis.
Some of the problems associated with high fructose corn syrup:
Increased LDL's (the bad lipoprotein) leading to increased risk of heart disease.
Altered Magnesium balance leading to increased osteoporosis.
Increased risk of Adult Onset Diabetes Mellitus.
Fructose has no enzymes or vitamins thus robbing the body of precious micro-nutrients.
Fructose interacts with birth control pills and can elevate insulin levels in women on the pill.
Accelerated aging.
Fructose inhibits copper metabolism leading to a deficiency of copper, which can cause increased bone fragility, anemia, ischemic heart disease and defective connective tissue formation among others.
The list below is from The San Francisco Chronicle February 18, 2004
"How much is too much?
The list below shows how much sugar, mostly in the form of high fructose corn syrup, is in each of these single servings.
Sunkist soda: 10 1/2 teaspoons of sugar
Berkeley Farms low-fat yogurt with fruit: 10 teaspoons of sugar
Mott's applesauce: 5 teaspoons of sugar
Slim-Fast chocolate cookie dough meal bar: 5 teaspoons of sugar
1 tablespoon ketchup: 1 teaspoon of sugar
Hansen's Super Vita orange-carrot Smoothie: 10 teaspoons of sugar"
Today's health tip:
Cut down or stop any food or drink with high fructose corn syrup.
High fructose corn syrup is made from genetically modified corn treated with genetically modified enzymes.
Stop or limit all foods with either dextrose or maltodextrin.
Once again, read all your food labels carefully.
Consumption of the limited amounts of fructose that occur in fresh whole organic fruit is not a problem.
Reference:
Stryer Biochemistry Fourth Edition
"Sugar coated We're drowning in high fructose corn syrup. Do the risks go beyond our waistline?"
Kim Severson, San Francisco Chronicle Staff Writer
Wednesday, February 18, 2004
Kick the "sugar habit" with the only diet that is 100% Sugar-Free, the MericleDiet. Make the transition away from dangerous sugar additives to healty "organic" complex carbhydrates easy. To visit the MericleDiet follow the link below:
http://www.DrMericle.com
Thanks for your attention.
Copyright © John Mericle M.D. 2005 All Rights Reserved
-
I have been busy lately and not had a chance to respond.
I agree with the poor nutrional value of a lot of the high simple sugars we eat, but that does not get to the problem of obesity.
I plan on taking extra training in bariatric medicine over the next few months and will share here but I believe this theory accounts for the extreme difficulty for overweight people to lose weight and keep it off:
http://web.mit.edu/medical/pdf/set_point_theory.pdf
People who lose weight actually start to experience the same discomforts (if you will) that people who experience starvation experience. Eventually their every thought turns to getting more food. It becomes uncontrollable and overwhelming. Eventually most people give in and start eating again. The reward is not just the taste of food, but relief from the unbearably uncomfortable sensations one feels when your body thinks your starving - even though you are overweight.
It is evolution gone amuk!.
More at a later date.
-
Many companies working on weight loss drugs:
http://money.cnn.com/2008/01/03/news/companies/obesity_drugs.ap/index.htm?source=yahoo_quote
-
CCP: Concerning your post #74, what do you think of the Zone Diet's analysis of this point?
-
Crafty,
I am not familiar with Zone's diet on this point. Please help me here.
-
Body has two supplies of energy: glycogen and fat. When our body's hormones e.g. insulin are "in the zone" we burn both, but when we eat high glcemic foods we burn glycogen, but not fat. Brain requires glycogen, hence when we run low the body'd demand for fuel becomes irresistable. Over time weight ratchets upwards. But if we maitain hormonal balance by eating correct mix of carbs (low glycemic) protein and fat, then body burns fat as well as glycogen. Thus glycogen stores last longer before brain/body insists on more fuel and fat weight can truly be lost.
I hope I have explained this coherently and accurately, but guarantee neither :-)
-
http://www.medicalnewstoday.com/articles/93960.php
A study carried out in San Francisco and Boston, USA, found that sexually active gay men were many times more likely to acquire a new highly antibiotic-resistant strain of the MRSA superbug than the rest of the population.
The study is published in the January 15th early online issue of the Annals of Internal Medicine and was led by researchers at the University of California, San Francisco (UCSF).
Scientists have noticed that infection with the multidrug-resistant, community associated methicillin-resistant Staphylococcus aureus (MRSA) appears to occur in isolated pockets.
The new strain, called USA300, which is resistant to many more front line antibiotics, is a close relative of the MRSA strain that has begun to spread outside of hospitals and into the community in recent years (CA-MRSA, or community associated MRSA, but technically also known as USA300).
Both strains spread easily through skin to skin contact, and get into the skin and the underlying tissue, causing abscesses and ulcers that can become life-threatening quite quickly.
The UCSF researchers decided to investigate the risk factors for infection with the new USA300, which has gained a foothold in San Francisco and other US cities.
The study was in two parts: a population-based survey of 9 San Francisco hospitals and a cross-sectional study in 2 outpatient clinics in San Francisco and Boston. The data reviewed related to culture proven cases of MRSA infections spanning 2004 to 2006.
The researchers looked for: risk factors, annual incidence and spatial clustering for infection by multidrug-resistant USA300.
The strain of MRSA in the samples were identified using a range of methods such as: DNA sequencing (establishing the pattern of nucleotides in the DNA), polymerase chain reaction assays (amplifying DNA to help identify it), and pulse field gel electrophoresis (looking at very large DNA molecules).
The results for San Francisco showed that:
The overall incidence of USA300 infection in San Francisco was 26 cases per 100,000 of the population (ranging from 16 to 36).
The incidence was higher in 8 adjacent neighbourhoods (identified by ZIP codes) that had a higher proportion of male same-sex couples.
Men who have sex with men were 13 times more likely to be infected with USA300.
This risk was independent of previous history of MRSA infection or use of clindamycin (an antibiotic used to treat MRSA).
The risk also appeared to be independent of HIV infection.
USA300 infection mostly occurred in the buttocks, genitals, or perineum (the area between the anus and the penis).
The results for Boston showed that multi-drug resistant USA300 strains were recovered only from men who have sex with men.
The study concluded that:
"Infection with multidrug-resistant USA300 MRSA is common among men who have sex with men, and multidrug-resistant MRSA infection might be sexually transmitted in this population."
In a separate press statement, the researchers expressed their concern that the new MRSA strain could soon spread to the general population. It can be spread through skin to skin contact but appears to be trasmitted more easily through intimate sexual contact, they said.
Lead author of the study, Dr Binh Diep, who is a UCSF postdoctoral scientist at San Francisco General Hospital Medical Center, said:
"These multi-drug resistant infections often affect gay men at body sites in which skin-to-skin contact occurs during sexual activities."
"But because the bacteria can be spread by more casual contact, we are also very concerned about a potential spread of this strain into the general population," he added.
He explained that the most effective way to protect oneself against infection, especially after sex, was to scrub the skin well with soap and water.
Diep said he was alarmed by the rapid rise in infections. In the figures they collected, they found that San Francisco's Castro district, which has the highest proportion of gays in the country, the infection rate of MRSA was around 1 in 588 people. This compares with about 1 in 3,800 for the overall population of San Francisco, which is also high, said Diep.
Co-author Dr Henry Chambers, who is UCSF professor of medicine at San Francisco General Hospital Medical Center and lead scientist of a large multi-centered clinical trial recently funded by the National Institute of Health to study treatment of community-associated MRSA infections, said:
"Prompt diagnosis and the right treatment are crucial to prevent life-threatening infections and the spread of this bacteria to close contacts."
The authors pointed out that their study was limited by the fact it was retrospective, and they had not looked at the link between sexual risk behaviours and infection. They recommended that:
"Further research is needed to determine whether existing efforts to control epidemics of other sexually transmitted infections can control spread of community-associated multidrug-resistant MRSA."
"Emergence of Multidrug-Resistant, Community-Associated, Methicillin-Resistant Staphylococcus aureus Clone USA300 in Men Who Have Sex with Men."
B. A. Diep, H. F. Chambers, C. J. Graber, J. D. Szumowski, L. G. Miller, L. L. Han, J. H. Chen, F. Lin, J. Lin, T. HaiVan Phan, H. A. Carleton, L. K. McDougal, F. C. Tenover, D. E. Cohen, K. H. Mayer, G. F. Sensabaugh and F.ço. Perdreau-Remington.
Ann Intern Med, early online 15 January 2008; 60520-204.
Print issue: 19 February 2008, Volume 148 Issue 4.
-
Diabetes Study Partially Halted After Deaths
E-Mail
Print
Reprints
Save
Share
Del.icio.us
Digg
Facebook
Newsvine
Permalink
By GINA KOLATA
Published: February 7, 2008
For decades, researchers believed that if people with diabetes lowered their blood sugar to normal levels, they would no longer be at high risk of dying from heart disease. But a major federal study of more than 10,000 middle-aged and older people with Type 2 diabetes has found that lowering blood sugar actually increased their risk of death, researchers reported Wednesday.
The researchers announced that they were abruptly halting that part of the study, whose surprising results call into question how the disease, which affects 21 million Americans, should be managed.
The study’s investigators emphasized that patients should still consult with their doctors before considering changing their medications.
Among the study participants who were randomly assigned to get their blood sugar levels to nearly normal, there were 54 more deaths than in the group whose levels were less rigidly controlled. The patients were in the study for an average of four years when investigators called a halt to the intensive blood sugar lowering and put all of them on the less intense regimen.
The results do not mean blood sugar is meaningless. Lowered blood sugar can protect against kidney disease, blindness and amputations, but the findings inject an element of uncertainty into what has been dogma — that the lower the blood sugar the better and that lowering blood sugar levels to normal saves lives.
Medical experts were stunned.
“It’s confusing and disturbing that this happened,” said Dr. James Dove, president of the American College of Cardiology. “For 50 years, we’ve talked about getting blood sugar very low. Everything in the literature would suggest this is the right thing to do,” he added.
Dr. Irl Hirsch, a diabetes researcher at the University of Washington, said the study’s results would be hard to explain to some patients who have spent years and made an enormous effort, through diet and medication, getting and keeping their blood sugar down. They will not want to relax their vigilance, he said.
“It will be similar to what many women felt when they heard the news about estrogen,” Dr. Hirsch said. “Telling these patients to get their blood sugar up will be very difficult.”
Dr. Hirsch added that organizations like the American Diabetes Association would be in a quandary. Its guidelines call for blood sugar targets as close to normal as possible.
And some insurance companies pay doctors extra if their diabetic patients get their levels very low.
The low-blood sugar hypothesis was so entrenched that when the National Heart, Lung and Blood Institute and the National Institute of Diabetes and Digestive and Kidney Diseases proposed the study in the 1990s, they explained that it would be ethical. Even though most people assumed that lower blood sugar was better, no one had rigorously tested the idea. So the study would ask if very low blood sugar levels in people with Type 2 diabetes — the form that affects 95 percent of people with the disease — would protect against heart disease and save lives.
Some said that the study, even if ethical, would be impossible. They doubted that participants — whose average age was 62, who had had diabetes for about 10 years, who had higher than average blood sugar levels, and who also had heart disease or had other conditions, like high blood pressure and high cholesterol, that placed them at additional risk of heart disease — would ever achieve such low blood sugar levels.
Study patients were randomly assigned to one of three types of treatments: one comparing intensity of blood sugar control; another comparing intensity of cholesterol control; and the third comparing intensity of blood pressure control. The cholesterol and blood pressure parts of the study are continuing.
Dr. John Buse, the vice-chairman of the study’s steering committee and the president of medicine and science at the American Diabetes Association, described what was required to get blood sugar levels low, as measured by a protein, hemoglobin A1C, which was supposed to be at 6 percent or less.
“Many were taking four or five shots of insulin a day,” he said. “Some were using insulin pumps. Some were monitoring their blood sugar seven or eight times a day.”
They also took pills to lower their blood sugar, in addition to the pills they took for other medical conditions and to lower their blood pressure and cholesterol. They also came to a medical clinic every two months and had frequent telephone conversations with clinic staff.
Those assigned to the less stringent blood sugar control, an A1C level of 7.0 to 7.9 percent, had an easier time of it. They measured their blood sugar once or twice a day, went to the clinic every four months and took fewer drugs or lower doses.
So it was quite a surprise when the patients who had worked so hard to get their blood sugar low had a significantly higher death rate, the study investigators said.
The researchers asked whether there were any drugs or drug combinations that might have been to blame. They found none, said Dr. Denise G. Simons-Morton, a project officer for the study at the National Heart, Lung and Blood Institute. Even the drug Avandia, suspected of increasing the risk of heart attacks in diabetes, did not appear to contribute to the increased death rate.
Nor was there an unusual cause of death in the intensively treated group, Dr. Simons-Morton said. Most of the deaths in both groups were from heart attacks, she added.
For now, the reasons for the higher death rate are up for speculation. Clearly, people without diabetes are different from people who have diabetes and get their blood sugar low.
It might be that patients suffered unintended consequences from taking so many drugs, which might interact in unexpected ways, said Dr. Steven E. Nissen, chairman of the department of cardiovascular medicine at the Cleveland Clinic.
Or it may be that participants reduced their blood sugar too fast, Dr. Hirsch said. Years ago, researchers discovered that lowering blood sugar very quickly in diabetes could actually worsen blood vessel disease in the eyes, he said. But reducing levels more slowly protected those blood vessels.
And there are troubling questions about what the study means for people who are younger and who do not have cardiovascular disease. Should they forgo the low blood sugar targets?
No one knows.
Other medical experts say that they will be discussing and debating the results for some time.
“It is a great study and very well run,” Dr. Dove said. “And it certainly had the right principles behind it.”
But maybe, he said, “there may be some scientific principles that don’t hold water in a diabetic population.”
NY Times
-
Second post of the day
No Answers for Men With Prostate Cancer
NY Times
Last year, 218,000 men were diagnosed with prostate cancer, but nobody can tell them what type of treatment is most likely to save their life.
Those are the findings of a troubling new report from the Agency for Healthcare Research and Quality, which analyzed hundreds of studies in an effort to advise men about the best treatments for prostate cancer. The report compared the effectiveness and risks of eight prostate cancer treatments, ranging from prostate removal to radioactive implants to no treatment at all. None of the studies provided definitive answers. Surprisingly, no treatment emerged as superior to doing nothing at all.
“When it comes to prostate cancer, we have much to learn about which treatments work best,'’ said agency director Carolyn M. Clancy. “Patients should be informed about the benefits and harms of treatment options.”
But the study, published online in the Annals of Internal Medicine, gives men very little guidance. Prostate cancer is typically a slow-growing cancer, and many men can live with it for years, often dying of another cause. But some men have aggressive prostate cancers, and last year 27,050 men died from the disease. The lifetime risk of being diagnosed with prostate cancer has nearly doubled to 20 percent since the late 1980s, due mostly to expanded use of the prostate-specific antigen, or P.S.A., blood test. But the risk of dying of prostate cancer remains about 3 percent. “Considerable overdetection and overtreatment may exist,'’ an agency press release stated.
The agency review is based on analysis of 592 published articles of various treatment strategies. The studies looked at treatments that use rapid freezing and thawing (cryotherapy); minimally invasive surgery (laparoscopic or robotic-assisted radical prostatectomy); testicle removal or hormone therapy (androgen deprivation therapy); and high-intensity ultrasound or radiation therapy. The study also evaluated research on “watchful waiting,'’ which means monitoring the cancer and initiating treatment only if it appears the disease is progressing.
No one treatment emerged as the best option for prolonging life. And it was impossible to determine whether one treatment had fewer or less severe side effects.
Many of the treatments now in widespread use have never been evaluated in randomized controlled trials. In the research that is available, the characteristics of the men studied varied widely. And investigators used different definitions and methods, making reliable comparisons across studies impossible.
“Investigators’ definitions of adverse events and criteria to define event severity varied widely,'’ the report notes. “We could not derive precise estimates of specific adverse events for each treatment.'’
The report findings highlighted by the agency include:
All active treatments cause health problems, primarily urinary incontinence, bowel problems and erectile dysfunction. The chances of bowel problems or sexual dysfunction are similar for surgery and external radiation. Leaking of urine is at least six times more likely among surgery patients than those treated by external radiation.
Urinary leakage that occurs daily or more often was more common in men undergoing radical prostatectomy (35 percent) than external-beam radiation therapy (12 percent) or androgen deprivation (11 percent). Those were the findings of the 2003 Prostate Cancer Outcomes Study, a large, nationally representative survey of men with early prostate cancer.
External-beam radiation therapy and androgen deprivation were each associated with a higher frequency of bowel urgency (3 percent) compared with radical prostatectomy (1 percent), according to the 2003 report.
Inability to attain an erection was higher in men undergoing active intervention, especially androgen deprivation (86 percent) or radical prostatectomy (58 percent) than in men receiving watchful waiting (33 percent), according to the 2003 report.
One study showed that men who choose surgery over watchful waiting are less likely to die or have their cancer spread, but another study found no difference in survival between surgery and watchful waiting. The benefit, if any, appears to be limited to men under 65. However, few patients in the study had cancer detected through P.S.A. tests. As a result, it’s not clear if the results are applicable to the majority of men diagnosed with the disease.
Adding hormone therapy prior to prostate removal does not improve survival or decrease recurrence rates, but it does increase the chance of adverse events.
Combining radiation with hormone therapy may decrease mortality. But compared with radiation treatment alone, the combination increases the chances of impotence and abnormal breast development.
The most obvious trend identified in the complicated report is how little quality research exists for prostate cancer, despite the fact that it is the most diagnosed cancer in the country.
Studies comparing brachytherapy, radical prostatectomy, external-beam radiation therapy or cryotherapy were discontinued because of poor recruitment. Two ongoing trials, one in the United States and one in Britain, are evaluating surgery and radiation treatments compared with watchful waiting in men with early cancer. Other studies in progress or development include cryotherapy versus external-beam radiation and a trial evaluating radical prostatectomy versus watchful waiting.
“Successful completion of these studies is needed to provide accurate assessment of the comparative effectiveness and harms of therapies for localized prostate cancers,” the study authors said.
-
Your article is correct in pointing out some confusion with regard to treating prostate cancer. Screening for prostate cancer is also with controversy. A few experts are starting to wonder if we should do away with the screening blood test - PSA- altogether. This after some published reports that we should use 2.5 as the "normal" rather than the higher, less strict 4 which has been used for around 15 years or so.
When talking to patients who have never had a psa I try to point out the controversy in interpretation of the PSA.
I still recommend it. One reasonable rec is to offer it to men whose life expectancy is at least 10 years.
Speaking of confusion in medicine there was a study that just came out saying that calcium supplements may increase the risk for heart attacks in women taking it for the bones. Ughhhh!!!
-
50 Ways to Beat the Reaper
It's simple: Employ these scientific strategies now and add years of good living to your future
By: Denny Watkins & Alison Granell & Heather Loeb
We've been told that the only sure things are death and taxes. But just as creative accountants have helped many men triumph over their 1040s, we can help you outrun the reaper. Maybe it's a game you can't ultimately win. But by following these 50 tips, you sure as hell can send it into overtime.
1. Drink at Least Five 8-ounce Glasses of Water a Day
Scientists at Loma Linda University found that men who drank this amount of H2O were 54 percent less likely to suffer a fatal heart attack than those who drank two glasses or less every day.
2. Take a Laugh Break
Watching 15 minutes of funny video can improve bloodflow to your heart by 50 percent, report researchers at the University of Maryland. "This may reduce blood-clot formation, cholesterol deposition, and inflammation," says study author Michael Miller, M.D. For your daily dose, click on the "hilarious" video link at ebaumsworld.com.
3. Don't Go to Work Sick
Over a 3-year period, men who clocked in despite feeling under the weather had double the heart-attack risk of guys who stayed in bed, according to a U.K. study.
4. Put Out the Fire in Your Chest
Untreated heartburn can lead to a heart attack, according to a study in the International Journal of Cardiology. Scientists discovered that as acid levels in the esophagus rise, the incidence of blocked bloodflow to the heart also rises by 20 percent. A natural remedy: Analyze your diet. Don't make a habit of drinking wine, juice, or carbonated beverages, all of which are highly acidic and may trigger heartburn, say South Carolina researchers.
5. Indulge Your Chocolate Craving
In a 15-year study, Dutch scientists determined that men who ate just 4 grams of cocoa a day had half the risk of dying from heart disease than those who ate less. That's the equivalent of two 25-calorie Hershey's Kisses -- an amount that can fit into any diet.
6. Say No to Froot Loops
In a review of 53 studies, Australian researchers found that regularly eating cereal made from refined grains raises insulin and C-reactive protein, and lowers good cholesterol -- all factors that boost your odds of developing heart disease. A better choice for your morning bowl: Post Shredded Wheat cereal, which is made from 100 percent whole grains and contains no sugar.
7. Take a Magnesium Supplement
Over an 18-year period, French researchers determined that men with the highest blood levels of magnesium are 40 percent less likely to die of any cause than those with the lowest levels. Magnesium can make multivitamins too bulky, so add a 250 milligram (mg) pill from iherb.com or GNC to your daily regimen.
8. Burn 1,100 Calories a Week
Duke University scientists discovered that this amount of exercise prevents the accumulation of visceral adipose tissue -- the dangerous belly fat that causes arterial inflammation and hypertension. Falling short? Join a league: A recent British Medical Journal study reported that people who exercised in groups boosted their average calorie burn by 500 a week.
9. Take a Daily Multivitamin
Researchers at the University of California at Berkeley discovered that this helps prevent the DNA damage that causes cancer. We like Centrum Silver.
10. Hit the Weights
University of Michigan scientists found that men who completed three total-body weight workouts a week for 2 months lowered their diastolic blood pressure (the bottom number) by an average of eight points. That's enough to reduce the risk of stroke by 40 percent and heart attack by 15 percent.
11. Set a Three-Drink Limit
Harvard researchers determined that downing more than three drinks in a 24-hour period increases your risk of atrial fibrillation, a condition that may boost your odds of a stroke fivefold during that time. An important note: When the average man pours himself a glass of wine, it's typically twice the size of a standard drink (4 ounces), report researchers at Duke University.
IF YOU THINK YOU'RE HAVING A HEART ATTACK...
12. Plop an Alka-Seltzer
It contains 325 milligrams of aspirin, the same as a regular aspirin, and begins fighting blood clots almost 3 minutes faster than a pill, according to a study in Thrombosis Research.
13...and Call a Ride
Walk-in patients wait almost twice as long in the E.R. as those who arrive by ambulance, according to a University of New Mexico study.
14. Treat a Killer Bee Sting
You may not know if you're allergic to the venom of a bee, wasp, or hornet until you've already been stung. But if you start to experience the symptoms of a life-threatening reaction--hives, wheezing, abdominal cramping--you can save yourself in 3 steps:
Step 1. Call 911.
Step 2. Take a Benadryl.
Step 3. Lie on your back and elevate your legs while you wait for help, says Steven Kernerman, D.O., an allergist at the Spokane Allergy and Asthma Clinic. An allergic reaction can constrict your blood vessels, and our three-step strategy counteracts that by improving bloodflow to your heart.
15. Eat Produce at Every Meal
If you consume more than five servings of fruits and vegetables per day, you have a 26 percent lower risk of stroke than people who eat fewer than three servings, according to a recent U.K. study.
16. Monitor Your Blood Sugar
Johns Hopkins University researchers recently determined that people with the highest blood-sugar levels have twice the risk of heart disease as those with the lowest. A warning sign: fasting blood sugar that's greater than 100 mg per deciliter.
17. Think Positive
Purdue scientists discovered that constant worrying shortens your life span by 16 years.
18. Keep Your Cool
Men who frequently express anger outwardly are more than twice as likely to have a stroke than guys who control their tempers, according to the journal Stroke. If you have anger-management issues, try fish oil. National Institutes of Health scientists found that hostile, aggressive men often have low blood levels of DHA--one of the main omega-3 fats found in the oil. We like Nordic Naturals Ultimate Omega ($27 for 60 1,000-milligram (mg) softgels; nordicnaturals.com). Take 1,000 to 2,000 mg every day.
MAKE SURE YOU DON'T END UP AS FISH FOOD.
Most shark attacks occur at dawn and dusk, when sharks feed, says Alan Henningsen, a marine biologist and shark researcher at the National Aquarium in Baltimore. You can watch the sky for clues to their location: Seabirds eat the same fish as sharks. Here are three more ways to avoid a grisly death.
19. Dive with a Partner
This cuts the chance of a shark attack by 50 percent, say Australian scientists.
20. If You're Attacked, Hit the Shark in Its Eyes or Gills
These are its most sensitive areas. The snout might work as a target, but this tactic often results in a bitten arm, according to a University of Maryland study.
21. For God's Sake, Don't Pee in the Ocean
Bodily Fluids attract sharks
22. Try a Natural Remedy
According to Israeli scientists, eating one red grapefruit a day lowers LDL (bad) cholesterol by 20 percent, even in people who don't respond to statins.
23. Have Breakfast within 90 Minutes of Waking
A University of Massachusetts study found that men who waited longer than that were 50 percent more likely to become obese. And U.K. researchers determined that increases in body mass were directly proportionate to the likelihood of dying of gut cancers -- specifically rectal, bladder, colon, and liver.
24. Vacuum for 30 Minutes
Doing 150 calories' worth of chores a day can lower high blood pressure by 13 points, according to Medicine & Science in Sports & Exercise. The reduction lasts only 8 hours, but make it a daily habit and you can lower your BP in the long term. (Helping out more with housework may improve your sex life, too.)
25. Eat Berries
The antioxidants in cranberries, blueberries, strawberries, and raspberries have been shown to offer protection from a stroke, keep you mentally sharp as you age, and ward off cancer.
26. Drownproof Yourself
If you're dumped in the water without a life preserver, the key to survival is staying warm and conserving energy. Use the method taught to U.S. Navy pilots: Float facedown in the water with your knees tucked against your chest in the fetal position. (This slows the drop in body temperature.) Exhale bubbles slowly, turning your head to one side only to inhale deeply. Repeat until help arrives.
27. Sleep on Your Side
This can halve the number of sleep-apnea-related wakeups you experience during the night. Such interruptions make you up to six times more likely to be involved in an auto accident, due to residual fatigue, according to researchers at University Hospital in Bern, Switzerland. To keep from rolling over onto your back as you sleep, stuff a small, firm neck pillow down the back of your T-shirt before dozing off.
28. Light a Jasmine-Scented Candle
Men who did this for just 1 minute before bed fell asleep faster, tossed and turned less, and felt more refreshed in the morning than those who didn't inhale the aroma, report scientists at Wheeling Jesuit University. That's important, because insufficient sleep boosts your risk of diabetes, and restless sleep increases your odds of a stroke.
29. Live Life in a Smoke-free Zone
Secondhand smoke, besides boosting your risk of lung cancer, raises your diabetes risk by 40 percent -- nearly the same as smoking does.
30. Dodge a Deadly Lightning Bolt
Stay off the toilet during severe thunderstorms. If lightning hits within even 60 feet of your house, it can not only jump through phone and electrical lines but also run through plumbing, according to the National Weather Service.
31. Put Your iPod on a Mount
Reaching for an unsecured object as you drive makes you eight times more likely to swerve into a road barrier, according to the Mayo Clinic.
32. Check Your Smoke Alarms
The most likely reason a house fire ends in a fatality: no early warning. While just about every U.S. residence has smoke alarms, a Morehouse School of Medicine study revealed that the devices were nonfunctioning in one-third of homes due to dead or absent batteries. If you've ever let the juice in any of your detectors dwindle -- or removed the battery simply to disable the low-power beep -- consider installing at least one DuPont self-charging smoke alarm ($26; target.com). It screws into a ceiling light socket and feeds off your home's electricity.
33. Sip on Mint Tea
It contains the powerful antioxidant hesperidin, which reduces the inflammation and oxidative stress associated with diabetes by 52 percent, according to a study at the University of Buffalo. And despite its lack of caffeine, mint tea also increases alertness.
34. Don't Jaywalk
This is particularly good advice if you've had too much to drink, because 77 percent of pedestrians killed while crossing the road aren't at intersections. And 53 percent of those killed at night had blood-alcohol concentrations at or above .08 percent, the legal limit in all 50 states.
35. Don't Get Blown to Bits
Keep bleach, paint stripper, fabric softener, glue, and sidewalk salt away from gas appliances. The chlorine or fluorine in these products breaks down into ionized gas, which can eat holes in the pipes that deliver the fuel for your furnace, range, or dryer. Think you smell fumes? Don't call for help from inside your house; using your phone could create an electric spark and set off an explosion.
IMPROVE YOUR OUTLOOK, SAVE YOUR LIFE
Scandinavian researchers have observed that deep depression (and its spinoff, suicide) is often caused by job stress. Here's how to lower stress, boost your mood, and simultaneously improve your overall health.
36. Find Time to Exercise...
People who exercise at any intensity for 2 hours a week--an average of about 17 minutes a day--are 61 percent less likely to feel highly stressed than their sedentary counterparts, according to researchers in Denmark.
37...Then Take it Outside
British researchers found that people who exercised outdoors reduced their depression by 71 percent, while indoor exercisers' depression decreased by only 45 percent after their workouts.
38. Cut Out the Sweet Stuff
Tufts University researchers found that men on low-sugar diets had lower levels of depression and anxiety than those who consumed all types of carbs. The happier people also limited their total carb intake to 40 percent of total calories.
39. Douse Your Salad with Oil and Vinegar
European scientists determined that unheated olive oil reduces cancer risk. As for vinegar, eating it prior to a high-carbohydrate meal (like pasta) slows the absorption of carbs into your bloodstream. This prevents the spikes in blood sugar and insulin that signal your body to store fat.
40. Add Curry to Vegetables
Rutgers University scientists discovered that a combination of turmeric (found in curry powder) and phenethyl isothiocyanate (a compound in broccoli, brussels sprouts, and cauliflower) helps fight prostate cancer. The researchers believe that dusting your vegetables just once a week will provide protection.
41. Be a Career Coach
A man married to a woman who is upset by her work is 2.7 times more likely to develop heart disease. If your wife won't find a new job, help her practice her negotiating skills. A Harvard study found that due to anxiety, women don't initiate money talks at work as often as men do, especially when the boss is male.
42. Stash a Cinnamon Air Freshener in your car
The strong, spicy smell can help you stay alert as you drive. Researchers at Wheeling Jesuit University found that a whiff increases alertness by 25 percent. Sucking on an Altoid may work, too.
43. Test Yourself for HIV
A recent British study confirms that early detection is the key to extending your life. You can order a take-home HIV test online ($44, homeaccess.com), mail in your blood sample, and receive your results in the mail just 7 days later.
44. Fall on Your Butt
If you feel yourself losing balance on the stairs, crouch so that your butt hits first, says Robert Nirschl, M.D., a spokesman for the American Academy of Orthopaedic Surgeons. Don't be afraid to bounce down a few steps -- it'll make a fatal blow less likely.
45. Design a Colorful Menu
Colorado State University scientists discovered that men who eat the widest variety of fruits and vegetables gain greater cancer-fighting benefits than those who eat more total servings but choose from a smaller assortment. That's because the plant chemicals that protect against disease vary between botanical families. Mix it up by choosing one serving from five different color groups: blues and purples, greens, whites, reds, and yellows and oranges.
46. Take a Noontime Nap
Breaking up your day with a 30-minute snooze can reduce coronary mortality by 37 percent, report Greek researchers. Why? It reduces stress that can damage your heart. Even a short nap once or twice a week was found to decrease the risk of early death.
47. Steep Your Tea for at Least 3 Minutes
Any less than that lowers the number of disease-fighting antioxidants.
48. Use Watercress in Your Salad
A study from the American Journal of Clinical Nutrition reveals that eating 3 ounces of watercress every day increases levels of the cancer-fighting anti-oxidants lutein and beta-carotene by 100 and 33 percent, respectively.
49. Enjoy Your Joe
Brooklyn College researchers recently discovered that drinking 4 cups of coffee a day lowers your risk of dying of heart disease by 53 percent. If you like Starbucks, choose a Caffè Americano: A grande counts as 4 cups and contains just 15 calories.
50. Ask for the Heel
Bread crust has up to eight times more pronyl lysine -- an antioxidant that fights cancer -- than what's in the center. Similarly, the skin of produce is loaded with healthy nutrients, too.
http://www.menshealth.com/cda/article.do
?site=MensHealth&channel=health&category=other.diseases.ailments
&conitem=1030ce756ff75110VgnVCM20000012281eac____&page=0
-
Mobile phones 'more dangerous than smoking'
Brain expert warns of huge rise in tumours and calls on industry to take immediate steps to reduce radiation
ALAMY
Young people are at particular risk from exposure to radiation
enlarge Print Email Search
Search
Go
Independent.co.uk Web
Bookmark & Share
Digg It
del.icio.us
Facebook
Stumbleupon
What are these?
Change font size: A | A | ABy Geoffrey Lean
Sunday, 30 March 2008
Mobile phones could kill far more people than smoking or asbestos, a study by an award-winning cancer expert has concluded. He says people should avoid using them wherever possible and that governments and the mobile phone industry must take "immediate steps" to reduce exposure to their radiation.
The study, by Dr Vini Khurana, is the most devastating indictment yet published of the health risks.
It draws on growing evidence – exclusively reported in the IoS in October – that using handsets for 10 years or more can double the risk of brain cancer. Cancers take at least a decade to develop, invalidating official safety assurances based on earlier studies which included few, if any, people who had used the phones for that long.
Earlier this year, the French government warned against the use of mobile phones, especially by children. Germany also advises its people to minimise handset use, and the European Environment Agency has called for exposures to be reduced.
Professor Khurana – a top neurosurgeon who has received 14 awards over the past 16 years, has published more than three dozen scientific papers – reviewed more than 100 studies on the effects of mobile phones. He has put the results on a brain surgery website, and a paper based on the research is currently being peer-reviewed for publication in a scientific journal.
He admits that mobiles can save lives in emergencies, but concludes that "there is a significant and increasing body of evidence for a link between mobile phone usage and certain brain tumours". He believes this will be "definitively proven" in the next decade.
Noting that malignant brain tumours represent "a life-ending diagnosis", he adds: "We are currently experiencing a reactively unchecked and dangerous situation." He fears that "unless the industry and governments take immediate and decisive steps", the incidence of malignant brain tumours and associated death rate will be observed to rise globally within a decade from now, by which time it may be far too late to intervene medically.
"It is anticipated that this danger has far broader public health ramifications than asbestos and smoking," says Professor Khurana, who told the IoS his assessment is partly based on the fact that three billion people now use the phones worldwide, three times as many as smoke. Smoking kills some five million worldwide each year, and exposure to asbestos is responsible for as many deaths in Britain as road accidents.
Late last week, the Mobile Operators Association dismissed Khurana's study as "a selective discussion of scientific literature by one individual". It believes he "does not present a balanced analysis" of the published science, and "reaches opposite conclusions to the WHO and more than 30 other independent expert scientific reviews".
http://www.independent.co.uk/life-style/health-and-wellbeing/health-news/mobile-phones-more-dangerous-than-smoking-or-asbestos-802602.html?r=RSS
-
Sidney Wolf is a shameless self promoter. Don't pay any attention to him. chantix is one of the greatest medicines that has come out in years. I can't tell you how many patients I have who have been able to quit smoking because of this revolutionary drug. No it is not perfect but the risks are so overblown. Don't for one minute think that the holier than thou anti-pharma crowd doesn't make money off their side of the equation. And this includes some of the narcissistic self promoters at the Cleveland clinic:
http://news.yahoo.com/s/ap/20080508/ap_on_he_me/smoking_advice;_ylt=AtHFokMug6NoMmLVPfsPJ9us0NUE
Chantix recommended to quit smoking despite safety concerns
By CARLA K. JOHNSON, Associated Press Writer Wed May 7, 11:32 PM ET
CHICAGO - The federal government's new advice to doctors for helping smokers quit recommends the drug Chantix, which has recently been linked with depression and suicidal behavior. The new guidelines mention the psychiatric risks but also say the popular Pfizer Inc. drug is the most effective at helping people get off cigarettes.
ADVERTISEMENT
The guidelines mention other options, too, and highly recommend combining counseling and medication. But doctors are encouraged to talk to all smokers who want to quit about trying medication.
Consumer advocates cautioned that the safety picture on Chantix is incomplete because it's a relatively new drug, on the market just since 2006.
"It is somewhat better than other therapies; on the other hand, it appears to have more risk," said Dr. Sidney Wolfe of the watchdog group Public Citizen. "That part of the risk-benefit equation is missing, and it's changing rapidly."
Another issue with the quit-smoking guidelines, released this week by the U.S. Public Health Service, is the lead author's past connections with Pfizer. Dr. Michael Fiore, an expert on smoking and health issues, was a consultant to the maker of Chantix. But he said he cut those ties in 2005.
Fiore's views are shaped by his past ties to the drug industry, and those ties still pose a conflict, at least one consumer advocate said. John Polito, a smoking cessation educator who runs the WhyQuit.com site advocating quitting "cold turkey," called the revised guidelines "a sales pitch" for the drug industry.
The task force overlooked research showing that quitting cold turkey works, Polito said, and studies showing Chantix is superior don't reflect how it's used "in the real world."
"People are quitting smoking to save their lives," Polito said. If Chantix's risks outweigh its benefits, "then it's insane for people to risk their lives" by using it, he said.
The guidelines are based on an extensive review of scientific evidence, were reviewed by 90 independent experts and were endorsed by 60 public health entities, Fiore said, adding that his past financial ties to the drug industry had no influence.
"Independent reviewers of it came to the conclusion that this is a document that reflects the science, and that's what we were charged to do," Fiore said.
The guideline authors analyzed 83 studies and found that Chantix helped 33 percent stay off tobacco for six months after quitting, compared with a nearly 14 percent abstinence rate for dummy pills.
The guidelines recommend combining counseling and medication as the most effective way to kick the tobacco habit, stating "both counseling and medication should be provided to patients trying to quit smoking."
Medications have not been shown to be effective in certain groups, the guidelines say. Those groups include pregnant women, smokeless tobacco users, light smokers and adolescents.
The guidelines say doctors should consider asking about their patients' psychiatric history before prescribing Chantix. Doctors also should monitor patients for changes in mood and behavior while on the drug.
-
I really can't believe I am reading this stuff about chantix. I can't tell you the miracle this drug has been for some patients. I am telling you some of these anti-pharma people are total crack pots. They are making lots of money with their anti-pharma agenda.
The truth is in my practice that people who complain of side effects from this drug are almost without exception people who really didn't want to quit to start with. They are using any excuse, consciously or unconsciously, to say they "can't" quit. The people who tell me before starting the drug they *really want* to quit and want to try the drug or anything else that works, do very well with it. I am saying without any uncertain terms that this guy sidney wolfe, and his like, are doing far more harm then good. Now I get people who have smoked for decades who are now reluctant to use chantix because of all the negative publicity from these self important big mouth jerks.
Someone should start investigating these prima donnas like Wolfe, like Nissan, like Topol from the Cleveland Clinic. I guarantee they are getting rich.
http://body.aol.com/condition-center/smoking-cessation/news/article/_a/drug-recommended-to-help-quit-smoking/20080508123709990001
-
While listening to the cable news this am, I notice two well know causes of seizures in older folks where conveniently left off the list; what should be included are cancers, primary and metastatic, and either intoxication or withdrawal from alcohol use.
Even sleep deprivation can in certain circumstances trigger one.
-
Well, I certainly have seen some humor at Teddy's expense about withdrawal symptoms :lol:
-
I have found this to be true at times. It is certainly one of the hardest things in medicine. There are different reasons for this. Sometimes the patients only hear what they want to hear, and that they *were* told. Sometimes they refuse to give up so the doctor keeps trying things that he/she knows would be a near miracle to work. Sometimes I just wonder if the doctor just doesn't have the guts (or the heart) to tell the patient. There are some cultures where it may actually be considered rude to tell a patient h/she is going to die (such as Japanese). Could there be a financial incentive to push chemo that will have (if no chance) almost no chance to work? I have no direct knowledge of this but in this world nothing would surprise me frankly. I wonder what was told to Ed Kennedy? I would like to think it was all an honorable try at making every possible, remote, theoretical, or otherwise experimental stab at trying to prolong his life but there is something just so self serving from these people at Duke in all this celebration of their supposed leadership in this area of medicine - I just don't know.
***AP
Most cancer doctors avoid saying it's the end
By MARILYNN MARCHIONE, AP Medical Writer Sun Jun 15, 2:08 PM ET
CHICAGO - One look at Eileen Mulligan lying soberly on the exam table and Dr. John Marshall knew the time for the Big Talk had arrived.
ADVERTISEMENT
He began gently. The chemotherapy is not helping. The cancer is advanced. There are no good options left to try. It would be good to look into hospice care.
"At first I was really shocked. But after, I thought it was a really good way of handling a situation like that," said Mulligan, who now is making a "bucket list" — things to do before she dies. Top priority: getting her busy sons to come for a weekend at her Washington, D.C., home.
Many people do not get such straight talk from doctors, who often think they are doing patients a favor by keeping hope alive.
New research shows they are wrong.
Only one-third of terminally ill cancer patients in a new, federally funded study said their doctors had discussed end-of-life care.
Surprisingly, patients who had these talks were no more likely to become depressed than those who did not, the study found. They were less likely to spend their final days in hospitals, tethered to machines. They avoided costly, futile care. And their loved ones were more at peace after they died.
Convinced of such benefits and that patients have a right to know, the California Assembly just passed a bill to require that health care providers give complete answers to dying patients who ask about their options. The bill now goes to the state Senate.
Some doctors' groups are fighting the bill, saying it interferes with medical practice. But at an American Society of Clinical Oncology conference in Chicago earlier this month, where the federally funded study was presented, the society's president said she was upset at its finding that most doctors were not having honest talks.
"That is distressing if it's true. It says we have a lot of homework to do," said Dr. Nancy Davidson, a cancer specialist at Johns Hopkins University in Baltimore.
Doctors mistakenly fear that frank conversations will harm patients, said Barbara Coombs Lee, president of the advocacy group Compassionate Choices.
"Boiled down, it's 'Talking about dying will kill you,'" she said. In reality, "people crave these conversations, because without a full and candid discussion of what they're up against and what their options are, they feel abandoned and forlorn, as though they have to face this alone. No one is willing to talk about it."
The new study is the first to look at what happens to patients if they are or are not asked what kind of care they'd like to receive if they were dying, said lead researcher Dr. Alexi Wright of the Dana-Farber Cancer Institute in Boston.
It involved 603 people in Massachusetts, New Hampshire, Connecticut and Texas. All had failed chemotherapy for advanced cancer and had life expectancies of less than a year. They were interviewed at the start of the study and are being followed until their deaths. Records were used to document their care.
Of the 323 who have died so far, those who had end-of-life talks were three times less likely to spend their final week in intensive care, four times less likely to be on breathing machines, and six times less likely to be resuscitated.
About 7 percent of all patients in the study developed depression. Feeling nervous or worried was no more common among those who had end-of-life talks than those who did not.
That rings true, said Marshall, who is Mulligan's doctor at Georgetown University's Lombardi Comprehensive Cancer Center. Patients often are relieved, and can plan for a "good death" and make decisions, such as do-not-resuscitate orders.
"It's sad, and it's not good news, but you can see the tension begin to fall" as soon as the patient and the family come to grips with a situation they may have suspected but were afraid to bring up, he said.
From an ethics point of view, "it's easy — patients ought to know," said Dr. Anthony Lee Back of the Fred Hutchinson Cancer Center in Seattle. "Talking about prognosis is where the rubber meets the road. It's a make-or-break moment — you earn that trust or you blow it," he told doctors at a training session at the cancer conference on how to break bad news.
People react differently, though, said Dr. James Vredenburgh, a brain tumor specialist at Duke University.
"There are patients who want to talk about death and dying when I first meet them, before I ever treat them. There's other people who never will talk about it," he said.
"Most patients know in their heart" that the situation is grim, "but people have an amazing capacity to deny or just keep fighting. For a majority of patients it's a relief to know and to just be able to talk about it," he said.
Sometimes it's doctors who have trouble accepting that the end is near, or think they've failed the patient unless they keep trying to beat the disease, said Dr. Otis Brawley, chief medical officer at the American Cancer Society.
"I had seven patients die in one week once," Brawley said. "I actually had some personal regrets in some patients where I did not stop treatment and in retrospect, I think I should have."
James Rogers, 67 of Durham, N.C., wants no such regrets. Diagnosed with advanced lung cancer last October, he had only one question for the doctor who recommended treatment.
"I said 'Can you get rid of it?' She said 'no,'" and he decided to simply enjoy his final days with the help of the hospice staff at Duke.
"I like being told what my health condition is. I don't like beating around the bush," he said. "We all have to die. I've had a very good life. Death is not something that was fearful to me."***
-
For those from the old DMG board recall the poster that passed away from melanoma? He had gone to Germany to try experimental immune therapy. It appears at least for some patients it works if done right. A patient of mine who had a form of testicular that does not respond to chemo also tried this form of therapy in Germany. He recently didn't make it. He was only 29. What he went through was horrendous. He fought far harder than Lance Armstrong. He was not lucky like him to have happened to have a cancer that responded to chemo (and didn't cheat and take performance enhancing drugs like him either and later lie about it).
Hopefully this will be a major breakthrough at least for some:
***Study: Melanoma Cured 100% through Blood Cell Therapy
By Alexander Toldt
11:36, June 22nd 2008 3 votes
Vote this story
Study: Melanoma Cured 100% through Blood Cell Therapy
The results of a new study conducted by a researcher team at the Fred Hutchinson Cancer Research Center in Seattle, give hope for those suffering from melanoma, one of the rarer types of skin cancer but the one which causes the majority of skin cancer related deaths.
Researchers who took part in the study used a patient's cloned T cells (helper cells) to put an advanced cancer into complete remission. Nine patients took part in the experimental melanoma treatment program.
The researchers were very surprised after they treated a 52-year-old man from Oregon of his Stage 4 melanoma. The research team led by Cassian Yee, M.D., an associate member of the Clinical Research Division at the Center, took CD4+T cells (white blood cells) from the patient’s body and during the next three months it grew approximately 5 billion of the cells in the lab. Then the cells grown in the lab were injected back into the patient.
After just two months, PET and CT scans revealed no sign of tumors anywhere in the patient's body and there were no harmful side effects. Two years later, patient "Number Four" was checked again and he was still disease free.
However, the first three patients, who received a smaller dose, had no response at all. Some other patients who received the same dose didn’t respond as well as patient number 4 did, but did saw some improvement.
Steven Rosenberg, chief surgeon at the National Cancer Institute, described the form of treatment as “the ultimate personalized medicine,” but also added that the fact that it’s a labor intensive treatment doesn’t make very attractive to commercial development.
The results of the study have been published in this week's issue of the New England Journal of Medicine, and are the latest findings in the field of "adoptive immunotherapy," a theory according to which the human body can be taught to fight off its own cancers.***
-
WOW!
"the fact that it’s a labor intensive treatment doesn’t make very attractive to commercial development"
:cry: :x :cry:
-
More on low Vitamin D ---
The only negative article was from I think New Zealand which noted in a small group of people a negative associated with increased Vitamin D intake and coronarly artery calcification but everything else I read suggested Vitamin D deficiency or insufficiency is under treated and diagnosed. Vit D level over 40 is associated with decreased bone fracture risk this that is the goal I shoot for.
Proabably half the people I measure 25 hydroxy vitamin D levels in are below this level.
***Lack of sunshine vitamin may cloud survival odds By LINDSEY TANNER, AP Medical Writer
Mon Jun 23, 4:00 PM ET
CHICAGO - New research linking low vitamin D levels with deaths from heart disease and other causes bolsters mounting evidence about the "sunshine" vitamin's role in good health.
ADVERTISEMENT
Patients with the lowest blood levels of vitamin D were about two times more likely to die from any cause during the next eight years than those with the highest levels, the study found. The link with heart-related deaths was particularly strong in those with low vitamin D levels.
Experts say the results shouldn't be seen as a reason to start popping vitamin D pills or to spend hours in the sun, which is the main source for vitamin D.
For one thing, megadoses of vitamin D pills can be dangerous and skin cancer risks from too much sunshine are well-known. But also, it can't be determined from this type of study whether lack of vitamin D caused the deaths, or whether increasing vitamin D intake would make any difference.
Low vitamin D levels could reflect age, lack of physical activity and other lifestyle factors that also affect health, said American Heart Association spokeswoman Alice Lichtenstein, director of the Cardiovascular Nutrition Laboratory at Tufts University.
Still, she said the study is an important addition to an emerging area of research.
"This is something that should not be ignored," Lichtenstein said.
The study led by Austrian researchers involved 3,258 men and women in southwest Germany. Participants were aged 62 on average, most with heart disease, whose vitamin D levels were checked in weekly blood tests. During roughly eight years of follow-up, 737 died, including 463 from heart-related problems.
According to one of the vitamin tests they used, there were 307 deaths in patients with the lowest levels, versus 103 deaths in those with the highest levels. Counting age, physical activity and other factors, the researchers calculated that deaths from all causes were about twice as common in patients in the lowest-level group.
Results appear in Monday's Archives of Internal Medicine.
The study's lead author, Dr. Harald Dobnig of the Medical University of Graz in Austria, said the results don't prove that low levels of vitamin D are harmful "but the evidence is just becoming overwhelming at this point."
Scientists used to think that the only role of vitamin D was to prevent rickets and strengthen bones, Dobnig said.
"Now we are beginning to realize that there is much more into it," he said
Exactly how low vitamin D levels might contribute to heart problems and deaths from other illnesses is uncertain, although it is has been shown to help regulate the body's disease-fighting immune system, he said.
Earlier this month, the same journal included research led by Harvard scientists linking low vitamin D levels with heart attacks. And previous research has linked low vitamin D with high blood pressure, diabetes and obesity, which all can contribute to heart disease.
The new research "provides the strongest evidence to date for a link between vitamin D deficiency and cardiovascular mortality," said Dr. Edward Giovannucci of the Harvard study of 18,225 men.
Low vitamin D levels also have been linked with several kinds of cancer and some researchers believe the vitamin could even be used to help prevent malignancies.
It has been estimated that at least 50 percent of older adults worldwide have low vitamin D levels, and the problem is also thought to affect substantial numbers of younger people. Possible reasons include decreased outdoor activities, air pollution and, as people age, a decline in the skin's ability to produce vitamin D from ultraviolet rays, the study authors said.
Some doctors believe overuse of sunscreen lotions has contributed, and say just 10 to 15 minutes daily in the sun without sunscreen is safe and enough to ensure adequate vitamin D, although there's no consensus on that.
Diet sources include fortified milk, which generally contains 100 international units of vitamin D per cup, and fatty fish — 3 ounces of canned tuna has 200 units.
The Institute of Medicine's current vitamin D recommendations are 200 units daily for children and adults up to age 50, and 400 to 600 units for older adults. But some doctors believe these amounts are far too low and recommend taking supplements.
The American Medical Association at its annual meeting last week agreed to urge a review of the recommendations.***
-
for later discovered ill effects from drugs approved by the FDA?
Interesting legal issue:
****Why Doctors Should Worry about Preemption
Gregory D. Curfman, M.D., Stephen Morrissey, Ph.D., and Jeffrey M. Drazen, M.D.
A leading drug company may be poised to win a landmark legal victory next fall. If the drug manufacturer, Wyeth, prevails in a case soon to be argued before the U.S. Supreme Court (Wyeth v. Levine),1 drug companies could effectively be immunized against state-level tort litigation if their products that have been approved by the Food and Drug Administration (FDA) are later found to be defective.
A medical-device company won such a victory in April. In Riegel v. Medtronic,2 the Supreme Court determined that a product-liability lawsuit against Medtronic in a state court was preempted because the device had received FDA approval. Preemption is a legal doctrine based on the supremacy clause of the U.S. Constitution, which states that when federal and state laws are at odds, federal law takes precedence. Its application to state tort litigation is a radical extension of its original meaning.
Medtronic won its case because the 1976 law that grants the FDA authority to regulate medical devices contains a clause asserting that state requirements with regard to medical devices are preempted by federal requirements. Although the preemption clause is silent on common-law tort actions, the Supreme Court (with Justice Antonin Scalia writing for the Court) interpreted the preemption clause broadly to include such actions.
Unlike the law governing medical devices, the Food, Drug, and Cosmetic Act, which provides the statutory framework for the regulation of drugs by the FDA, contains no such preemption clause. Thus, in Wyeth v. Levine — which concerns a patient who lost her arm after an injection of Wyeth's antiemetic drug Phenergan — the Court will decide whether preemption of state tort litigation is implied by the law, even though it is not explicitly stated.
Previous administrations and the FDA considered tort litigation to be an important part of an overall regulatory framework for drugs and devices; product-liability litigation by consumers was believed to complement the FDA's regulatory actions and enhance patient safety. Margaret Jane Porter, former chief counsel of the FDA, wrote, "FDA product approval and state tort liability usually operate independently, each providing a significant, yet distinct, layer of consumer protection."3 Persons who are harmed have the right to seek legal redress. Preemption would erase that right.
But in the past few years, the government's views have shifted, and the FDA has reversed its position, now claiming that common-law tort actions are preempted. The FDA argues that tort liability stifles innovation in product development and delays the approval process, and that lay juries are incapable of making determinations about product safety. It has been argued, however, that Congress, not unelected appointees of a federal agency, has the power to decide whether preemption should apply.
Drug and device companies have chosen an inauspicious moment to attack the right of patients to seek redress. A series of pivotal reports on patient safety from the Institute of Medicine, as well as numerous articles in scholarly journals, has put the issue of patient safety in the national spotlight. Although frivolous lawsuits should not be condoned, product-liability litigation has unquestionably helped to remove unsafe products from the market and to prevent others from entering it. Through the process of legal discovery, litigation may also uncover information about drug toxicity that would otherwise not be known. Preemption will thus result in drugs and devices that are less safe and will thereby undermine a national effort to improve patient safety.
Owing in part to a lack of resources, approval of a new drug by the FDA is not a guarantee of its safety (see timeline).4 As the Institute of Medicine has reported, FDA approval is usually based on short-term efficacy studies, not long-term safety studies.5 Despite the diligent attention of the FDA, serious safety issues often come to light only after a drug has entered the market. The FDA, which — unlike most other federal agencies — has no subpoena power, knows only what manufacturers reveal.
Figure 1
View larger version (41K):
[in this window]
[in a new window]
Get Slide
Four Drugs with Safety Problems Discovered after FDA Approval.
Why should doctors be concerned about preemption? In stripping patients of their right to seek redress through due process of law, preemption of common-law tort actions is not only unjust but will also result in the reduced safety of drugs and medical devices for the American people. Preemption will undermine the confidence that doctors and patients have in the safety of drugs and devices. If injured patients are unable to seek legal redress from manufacturers of defective products, they may instead turn elsewhere.
In May, a Congressional hearing on preemption was held by Representative Henry Waxman (D-CA) and the House Committee on Oversight and Government Reform. As we stated in our testimony to the committee, to ensure the safety of medical devices, we urge Congress to act quickly to reverse the Riegel decision. Congressman Waxman and Congressman Frank Pallone, Jr. (D-NJ), are poised to introduce legislation that would unambiguously eliminate the possibility of preemption of common-law tort actions for medical devices. And if the Supreme Court rules for preemption in Wyeth v. Levine, which we hope it will not, Congress should consider similar legislation for drugs. Such legislation is in the best interest of the health and safety of the American public.
Source Information
Dr. Curfman is the executive editor, Dr. Morrissey the managing editor, and Dr. Drazen the editor-in-chief of the Journal.
An interactive timeline is available with the full text of this article at www.nejm.org.
References
1. Wyeth v. Levine, cert. granted, 128 S. Ct. 1118 (2008).
2. Riegel v. Medtronic, 128 S. Ct. 999 (2008).
3. Porter MJ. The Lohr decision: FDA perspective and position. Food Drug Law J 1997;52:7-11. [ISI][Medline]
4. Kessler DA, Vladeck DC. A critical examination of the FDA's efforts to preempt failure-to-warn claims. Georgetown Law J 2008;96(2). (Accessed June 13, 2008, at http://lsr.nellco.org/georgetown/ois/papers/2/.)
5. Baciu A, Stratton K, Burke SP, eds. The future of drug safety: promoting and protecting the health of the public. Washington, DC: National Academies Press, 2007.
The New England Journal of Medicine is owned, published, and copyrighted © 2008 Massachusetts Medical Society. All rights reserved.****
-
Nutritionist and author Jonny Bowden has created several lists of healthful foods people should be eating but aren’t. But some of his favorites, like purslane, guava and goji berries, aren’t always available at regular grocery stores. I asked Dr. Bowden, author of “The 150 Healthiest Foods on Earth,” to update his list with some favorite foods that are easy to find but don’t always find their way into our shopping carts. Here’s his advice.
Beets: Think of beets as red spinach, Dr. Bowden said, because they are a rich source of folate as well as natural red pigments that may be cancer fighters.
How to eat: Fresh, raw and grated to make a salad. Heating decreases the antioxidant power.
Cabbage: Loaded with nutrients like sulforaphane, a chemical said to boost cancer-fighting enzymes.
How to eat: Asian-style slaw or as a crunchy topping on burgers and sandwiches.
Swiss chard: A leafy green vegetable packed with carotenoids that protect aging eyes.
How to eat it: Chop and saute in olive oil.
Cinnamon: May help control blood sugar and cholesterol.
How to eat it: Sprinkle on coffee or oatmeal.
Pomegranate juice: Appears to lower blood pressure and loaded with antioxidants.
How to eat: Just drink it.
Dried plums: Okay, so they are really prunes, but they are packed with antioxidants.
How to eat: Wrapped in prosciutto and baked.
Pumpkin seeds: The most nutritious part of the pumpkin and packed with magnesium; high levels of the mineral are associated with lower risk for early death.
How to eat: Roasted as a snack, or sprinkled on salad.
Sardines: Dr. Bowden calls them “health food in a can.'’ They are high in omega-3’s, contain virtually no mercury and are loaded with calcium. They also contain iron, magnesium, phosphorus, potassium, zinc, copper and manganese as well as a full complement of B vitamins.
How to eat: Choose sardines packed in olive or sardine oil. Eat plain, mixed with salad, on toast, or mashed with dijon mustard and onions as a spread.
Turmeric: The “superstar of spices,'’ it may have anti-inflammatory and anti-cancer properties.
How to eat: Mix with scrambled eggs or in any vegetable dish.
Frozen blueberries: Even though freezing can degrade some of the nutrients in fruits and vegetables, frozen blueberries are available year-round and don’t spoil; associated with better memory in animal studies.
How to eat: Blended with yogurt or chocolate soy milk and sprinkled with crushed almonds.
Canned pumpkin: A low-calorie vegetable that is high in fiber and immune-stimulating vitamin A; fills you up on very few calories.
How to eat: Mix with a little butter, cinnamon and nutmeg.
-
Study: Low-Carb Diet Best for Weight, Cholesterol
Wednesday, July 16, 2008
ATLANTA —
The Atkins diet may have proved itself after all: A low-carb diet and a Mediterranean-style regimen helped people lose more weight than a traditional low-fat diet in one of the longest and largest studies to compare the dueling weight-loss techniques.
A bigger surprise: The low-carb diet improved cholesterol more than the other two. Some critics had predicted the opposite.
"It is a vindication," said Abby Bloch of the Dr. Robert C. and Veronica Atkins Foundation, a philanthropy group that honors the Atkins' diet's creator and was the study's main funder.
However, all three approaches — the low-carb diet, a low-fat diet and a so-called Mediterranean diet — achieved weight loss and improved cholesterol.
The study is remarkable not only because it lasted two years, much longer than most, but also because of the huge proportion of people who stuck with the diets — 85 percent.
Researchers approached the Atkins Foundation with the idea for the study. But the foundation played no role in the study's design or reporting of the results, said the lead author, Iris Shai of Ben-Gurion University of the Negev.
Other experts said the study — being published Thursday in the New England Journal of Medicine — was highly credible.
"This is a very good group of researchers," said Kelly Brownell, director of Yale University's Rudd Center for Food Policy and Obesity.
The research was done in a controlled environment — an isolated nuclear research facility in Israel. The 322 participants got their main meal of the day, lunch, at a central cafeteria.
"The workers can't easily just go out to lunch at a nearby Subway or McDonald's," said Dr. Meir Stampfer, the study's senior author and a professor of epidemiology and nutrition at the Harvard School of Public Health.
In the cafeteria, the appropriate foods for each diet were identified with colored dots, using red for low-fat, green for Mediterranean and blue for low-carb.
As for breakfast and dinner, the dieters were counseled on how to stick to their eating plans and were asked to fill out questionnaires on what they ate, Stampfer said.
The low-fat diet — no more than 30 percent of calories from fat — restricted calories and cholesterol and focused on low-fat grains, vegetables and fruits as options. The Mediterranean diet had similar calorie, fat and cholesterol restrictions, emphasizing poultry, fish, olive oil and nuts.
The low-carb diet set limits for carbohydrates, but none for calories or fat. It urged dieters to choose vegetarian sources of fat and protein.
"So not a lot of butter and eggs and cream," said Madelyn Fernstrom, a University of Pittsburgh Medical Center weight management expert who reviewed the study but was not involved in it.
Most of the participants were men; all men and women in the study got roughly equal amounts of exercise, the study's authors said.
Average weight loss for those in the low-carb group was 10.3 pounds after two years. Those in the Mediterranean diet lost 10 pounds, and those on the low-fat regimen dropped 6.5.
More surprising were the measures of cholesterol. Critics have long acknowledged that an Atkins-style diet could help people lose weight but feared that over the long term, it may drive up cholesterol because it allows more fat.
But the low-carb approach seemed to trigger the most improvement in several cholesterol measures, including the ratio of total cholesterol to HDL, the "good" cholesterol. For example, someone with total cholesterol of 200 and an HDL of 50 would have a ratio of 4 to 1. The optimum ratio is 3.5 to 1, according to the American Heart Association.
Doctors see that ratio as a sign of a patient's risk for hardening of the arteries. "You want that low," Stampfer said.
The ratio declined by 20 percent in people on the low-carb diet, compared to 16 percent in those on the Mediterranean and 12 percent in low-fat dieters.
The study is not the first to offer a favorable comparison of an Atkins-like diet. Research published in the Journal of the American Medical Association last year found overweight women on the Atkins plan had slightly better blood pressure and cholesterol readings than those on the low-carb Zone diet, the low-fat Ornish diet and a low-fat diet that followed U.S. government guidelines.
The heart association has long recommended low-fat diets to reduce heart risks, but some of its leaders have noted the Mediterranean diet has also proven safe and effective.
The heart association recommends a low-fat diet even more restrictive than the one in the study, said Dr. Robert Eckel, the association's past president who is a professor of medicine at the University of Colorado-Denver.
It does not recommend the Atkins diet. However, a low-carb approach is consistent with heart association guidelines so long as there are limitations on the kinds of saturated fats often consumed by people on the Atkins diet, Eckel said.
The new study's results favored the Atkins-like approach less when subgroups such as diabetics and women were examined.
Among the 36 diabetics, only those on the Mediterranean diet lowered blood sugar levels. Among the 45 women, those on the Mediterranean diet lost the most weight.
"I think these data suggest that men may be much more responsive to a diet in which there are clear limits on what foods can be consumed," such as an Atkins-like diet, said Dr. William Dietz, of the Centers for Disease Control and Prevention.
"It suggests that because women have had more experience dieting or losing weight, they're more capable of implementing a more complicated diet," said Dietz, who heads CDC's nutrition unit.
-
Second post of the morning
A Threat in a Grassy Stroll: Lyme Disease
By JANE E. BRODY
Published: July 15, 2008
My friend Anne and her husband, Richard, spend summers at a resort in Westchester County that has a swimming lake, tennis courts, gardens and beautiful grounds surrounded by woods. But Anne never sets foot on the grass.
The reason is Lyme disease. Anne says just about everyone she knows who partakes of the greenery and gardens outside the cabins has contracted the disease. So not only is she cautious about venturing out, but she and her husband also check each other daily from head to toe for the much-feared deer tick, which can transmit the disease when it attaches to skin and feeds on blood.
This tick, which is the size of a pinhead when it starts searching for a bloody meal, is responsible for about 20,000 reported cases of Lyme disease each year in the United States (the actual number is believed to be 10 times that) and 60,000 reported cases in Europe. Cases have been reported in every state, with residents of the Northeast, the Great Lakes region, northwestern Washington and parts of California the most frequent victims.
In some areas, as many as half of the deer ticks are infected with Borrelia, the Lyme disease bacteria. The disease got its name in 1975 from the first identified cluster of cases, among children in Lyme, Conn., who had rheumatoid-like symptoms of swollen, painful joints.
The white-tailed deer and white-footed mouse are the tick’s most frequent hosts, but it also feeds on birds, dogs and other rodents, including squirrels. The tiny nymphal form that emerges in spring and early summer presents the greatest hazard to humans. It is also the hardest to spot, especially on body parts covered with hair.
People usually acquire the tick while walking through grassy or wooded areas. Sometimes pet dogs are the source: in Minnesota one summer, our dog got more than 30 deer ticks on his face, apparently from sticking his nose into a fresh carcass. Unlike the common dog tick, which is round and very dark, the deer tick is elongated and brownish.
A Challenging Diagnosis
The disease can be maddeningly difficult to diagnose. Only 50 to 70 percent of patients recall being bitten by a tick. Ordinary laboratory tests are rarely helpful. Tests for antibodies to the bacterium or for its genetic footprints result in many false-negative and false-positive findings.
Rather, according to Dr. Robert L. Bratton and colleagues at the Mayo Clinic in Scottsdale, Ariz., who reviewed the recent literature on Lyme disease in the May issue of Mayo Clinic Proceedings, most cases are best diagnosed and treated based on patients’ symptoms. Thus, doctors everywhere must be alert when dealing with patients who live or travel in areas where Lyme disease is prevalent, and they must be willing to use appropriate antibiotics based on a clinical assessment rather than laboratory findings.
Since signs and symptoms vary and often do not appear until one to four weeks — or even months — after exposure, anyone bitten by a deer tick may be wise to obtain preventive treatment with an antibiotic, according to Lyme disease experts consulted by Constance A. Bean, the author with Dr. Lesley Ann Fein of the new book “Beating Lyme” (Amacom Books).
The most common sign is a reddish rash called erythema migrans that often resembles a spreading bull’s-eye, though up to 20 percent of patients never develop it. Common sites of the rash are the thigh, groin, buttock and underarm. It may be accompanied by flulike symptoms: fever, chills, body aches, headache and fatigue.
If untreated or inadequately treated, the infection can cause severe migrating joint pain and swelling, most often in the knees, weeks or months later. In addition, several weeks, months or even years after an untreated infection, the bacterium can cause meningitis, temporary facial paralysis, numbness or weakness of the arms and legs, memory and concentration difficulties and changes in mood, personality or sleep habits. Some untreated patients develop temporary heart rhythm abnormalities, eye inflammation or hepatitis.
Controversial Guidelines
Antibiotics for early Lyme disease should be taken for at least two to three weeks. The treatments recommended by the Infectious Diseases Society of America include doxycycline for nonpregnant patients and children 9 and older, or amoxicillin for pregnant women and younger children. Other options include cefuroxime axetil (Ceftin) and erythromycin.
But these guidelines are controversial. They have been challenged by a nonprofit medical group, the International Lyme and Associated Diseases Society, which says they are inadequate to combat the infection in a significant number of patients, who go on to develop debilitating chronic symptoms.
In May, the Infectious Diseases Society agreed to review its guidelines as a result of an antitrust lawsuit by the Connecticut attorney general, Richard Blumenthal, who said some of the society’s experts had financial interests that could bias their judgment. (The society denied that accusation.)
Although I cannot state with authority which side is correct, I have encountered enough previously healthy people who have suffered for months or years after initial treatment to suggest that there is often more to this disease than “official” diagnostic and treatment guidelines suggest.
Pamela Weintraub, a senior editor at Discover magazine, has produced a thoroughly researched and well-written account of the disease’s controversial history in her new book “Cure Unknown: Inside the Lyme Epidemic” (St. Martin’s Press).
Treatment and Prevention
The Mayo doctors concluded that patients who developed arthritis related to Lyme disease should be treated for one to two months and that those with late or severe disease, including neurological and cardiac symptoms, required intravenous antibiotics. Although two studies, neither of which was long-term, found that repeated antibiotic treatment did not reverse the pain and altered cognition associated with Lyme disease, the experience of thousands of patients, including Ms. Bean, contradict these findings.
There are no vaccines to prevent Lyme disease; an early attempt was taken off the market in 2002 because of side effects and limited effectiveness. Those who will not or cannot avoid grassy and wooded areas should wear long sleeves and long pants with legs tucked into socks, and spray exposed skin and clothing with tick repellent containing 20 to 30 percent DEET. Repellents should not be used on children under 2.
Since the tick must usually feed for 24 hours to transmit significant amounts of bacteria, daily body checks and showering with a washcloth can help prevent infection. Clothing should be washed and dried in a dryer. Additional preventive actions are described in “Beating Lyme.”
If a tick is attached to skin, it should be removed with tweezers, not fingers. Press into the skin, grasp the front of the tick’s head and pull at right angles to the skin. Place the tick in a sealed plastic bag for later identification. Then wash the area and your hands thoroughly.
More Articles in Health »
========================================
http://health.nytimes.com/health/guides/disease/lyme-disease/overview.html
Lyme disease is an inflammatory disease spread through a tick bite.
This article offers a general overview on Lyme disease. For specific information see:
Stage 1 Lyme disease
Stage 2 Lyme disease
Stage 3 Lyme disease
See All » News & Features
A Threat in a Grassy Stroll: Lyme Disease
Prognosis: Prolonged Use of Antibiotics After Lyme May Not Help
Reference from A.D.A.M.
Back to TopAlternative Names
Borreliosis
Back to TopCauses
Lyme disease is caused by the bacteria Borrelia burgdorferi (B. burgdorferi). Certain ticks carry the bacteria. The ticks pick up the bacteria when they bite mice or deer that are infected with Lyme disease. You can get the disease if you are bitten by an infected tick.
Lyme disease was first reported in the United States in the town of Old Lyme, Connecticut in 1975. Cases have now been reported in most parts of the United States. Most occur in the Northeast, upper Midwest, and along the Pacific coast. Lyme disease is usually seen during the late spring, summer, and early fall.
There are three stages of Lyme disease.
Stage 1 is called primary Lyme disease.
Stage 2 is called secondary Lyme disease.
Stage 3 is called tertiary Lyme disease.
Risk factors for Lyme disease include walking in high grasses, taking place in activities that increase tick exposure, and having a pet that may carry ticks home.
Back to TopSymptoms »
Not everyone infected with the bacteria gets ill. If a person does become ill, the first symptoms resemble the flu and include fever, headache, chills, muscle pain, and lethargy.
There may be a "bulls-eye" rash, a flat or slightly raised red spot at the site of the tick bite often with a clear area in the center. This lesion can be larger than 1 to 3 inches wide.
Stiff neck, joint inflammation, body-wide itching, unusual or strange behavior, and other symptoms may be seen in persons with later stages of the disease.
Note: Deer ticks can be so small that they are almost impossible to see. Therefore, many people with Lyme disease never even saw a tick. These people are more likely to develop symptoms because the tick remained on their body longer.
In-Depth Symptoms »
Back to TopExams and Tests »
A blood test can be done to check for antibodies to the bacteria that causes Lyme disease. The most common one used is the ELISA for Lyme disease test. A western blot test is done to confirm ELISA results.
A physical exam may reveal signs of joint, heart, or brain problems in persons with advanced Lyme disease.
In-Depth Diagnosis »
Back to TopTreatment »
Antibiotics are used to treat Lyme disease. The specific antibiotic used depends on the stage of the disease and your symptoms.
Anti-inflammatory medications, such as ibuprofen, are sometimes prescribed to relieve joint stiffness.
In-Depth Treatment »
Back to TopOutlook (Prognosis)
If diagnosed in the early stages, Lyme disease can be cured with antibiotics. Without treatment, complications involving joints, the heart, and the nervous system can occur.
Back to TopPossible Complications
Advanced stages of Lyme disease can cause long-term joint inflammation (Lyme arthritis) and heart rhythm problems. Neurological problems are also possible, and may include:
Decreased concentration
Memory disorders
Nerve damage
Numbness
Pain
Paralysis of the facial muscles
Sleep disorders
Visual disturbances
Back to TopWhen to Contact a Medical Professional
Call your health care provider if symptoms of Lyme disease develop.
Back to TopPrevention »
When walking or hiking in wooded or grassy areas, tuck long pants into socks to protect the legs, and wear shoes and light-colored, long-sleeved shirts. Ticks show up better on white or light colored-clothing than dark items. Spray your clothes with insect repellant.
Check yourself and your pets frequently. If you find ticks, remove them immediately by using tweezers, pulling carefully and steadily.
Ticks that carry Lyme disease are usually so small that they are almost impossible to see. After returning home, remove your clothes and thoroughly inspect all skin surface areas, including your scalp.
In-Depth Prevention »
More Information on This Topic
Background
Symptoms
Risk Factors
Complications
Diseases With Similar Symptoms
Diagnosis
Treatment
Prevention
Human Granulocytic Anaplasmosis (HGA)
Babesiosis
References
News & Features
-
In the late eighties I was involved in the care of a patient who had this rash. The only explanation for his getting this rash that we could come up with was over-the-counter advil. We contemplated the thought - why everyone takes advil. There are reports of the rash being associated with many other things. It is extremely rare.
***Drugmaker Not Liable in Motrin Case
Jury Finds Johnson & Johnson Doesn't Have to Pay Damages for Girl's Blindness
By Kathleen Doheny
WebMD Health News
Reviewed by Louise Chang, MD
The jury in the $1 billion lawsuit against Children's Motrin, a widely-used pain reliever, has decided that the drugmaker, Johnson & Johnson, is not liable for damages experienced by Sabrina Johnson, a California girl, now 11, whose parents say she suffered pain and blindness after they gave her recommended doses of the drug in 2003.
Deliberating in Malibu, Calif., in Los Angeles Superior Court, the jurors took three and a half days to come to their decision.
The verdict, which came down Thursday afternoon, sparked outrage from the attorney of the girl's family and a reaffirmation from McNeil Consumer Health Care, the J & J subsidiary that makes Children's Motrin (Ibuprofen), that their drug is safe and effective.
Children's Motrin Case: Attorney of Girl's Family Reacts
"The jury found in this case that Johnson & Johnson and McNeil, their wholly owned subsidiary, knew of the dangerous risk of side effects inherent in this drug," says Browne Greene of Greene, Broillet, and Wheeler in Santa Monica, Calif. "It found they failed to warn adequately of these risks and yet found the failing to warn had nothing to do with the injuries. In other word they found that a better warning would not have made a difference."
His reaction? ''Incredible beyond the evidence," he says.
Children's Motrin Case: McNeil Responds
In a prepared statement, spokesman Marc Boston of McNeil says: ''McNeil PPC Inc., agrees with the outcome of today's verdict. As the makers of Children's Motrin (ibuprofen), we are deeply concerned about all matters related to our medicines and are committed to providing safe and effective medicines. While we are sympathetic to the pain and hardship suffered by Sabrina Johnson, Children's Motrin has been proven safe and effective for the treatment of minor aches and pains and fever when used as directed and the medicine is labeled appropriately. We strongly recommend consumers read the product label for dosing information and warnings and talk with their health care professional if they have any questions or concerns."
Children's Motrin Case: Back Story
Sabrina Johnson's parents gave her the drug to treat a fever when she returned from school one afternoon and again that night, Greene says, "and all that led to Stevens-Johnson syndrome."
Stevens-Johnson syndrome is a rare and serious disorder of the skin and mucous membranes. The cause is not always clear, according to experts at Mayo Clinic, but is usually a type of allergic reaction in response to medication or infection.
Among the symptoms and signs are facial swelling, blisters on the skin, and mucous membranes, especially in the eyes, nose and mouth.
The next morning, according to the lawsuit, Sabrina woke with a high fever. Her eyes had turned pink and her mouth was swollen and had sores. At the hospital, she was diagnosed with Stevens-Johnson syndrome. The damage to the eyes caused great pain, Greene says, and eventually blinded her. While prescription versions of ibuprofen have the warning about the link to Stevens-Johnson, he says, over-the -counter versions do not.
The Malibu case is one of about 60 such lawsuits against Children's Motrin, according to Greene, who is representing two other families. Greene's clients asked for slightly less than a billion dollars, he tells WebMD, including actual damages, pain and suffering, and punitive damages.
The verdict may not mean other cases won't go the other way, says Miles Cooper, an attorney with The Veen Firm in San Francisco, who has experience in product liability cases.
"One verdict is not enough to predict the outcomes of the 60 cases," he tells WebMD. "I expect this case will be appealed by the plaintiffs. And there would need to be at least four to six more cases tried to see what the jurors' trends are."
A physician who has testified in product liability cases says he is not surprised by the verdict. "Many, many OTC [over-the-counter] drugs can cause Stevens-Johnson syndrome," says Neal Benowitz, MD, a professor of medicine and biopharmaceutical sciences at the University of California San Francisco School of Medicine. "It's very rare," he adds.
"Manufacturers cannot put every side effect down on a label, there is just not room. What manufacturers have to do is just pick out the most common and the most serious."***
-
WELL; Experts Revive Debate Over Cellphones and Cancer
By TARA PARKER-POPE
Published: June 3, 2008
What do brain surgeons know about cellphone safety that the rest of us don't?
Last week, three prominent neurosurgeons told the CNN interviewer Larry King that they did not hold cellphones next to their ears. ''I think the safe practice,'' said Dr. Keith Black, a surgeon at Cedars-Sinai Medical Center in Los Angeles, ''is to use an earpiece so you keep the microwave antenna away from your brain.''
Dr. Vini Khurana, an associate professor of neurosurgery at the Australian National University who is an outspoken critic of cellphones, said: ''I use it on the speaker-phone mode. I do not hold it to my ear.'' And CNN's chief medical correspondent, Dr. Sanjay Gupta, a neurosurgeon at Emory University Hospital, said that like Dr. Black he used an earpiece.
Along with Senator Edward M. Kennedy's recent diagnosis of a glioma, a type of tumor that critics have long associated with cellphone use, the doctors' remarks have helped reignite a long-simmering debate about cellphones and cancer.
That supposed link has been largely dismissed by many experts, including the American Cancer Society. The theory that cellphones cause brain tumors ''defies credulity,'' said Dr. Eugene Flamm, chairman of neurosurgery at Montefiore Medical Center.
According to the Food and Drug Administration, three large epidemiology studies since 2000 have shown no harmful effects. CTIA -- the Wireless Association, the leading industry trade group, said in a statement, ''The overwhelming majority of studies that have been published in scientific journals around the globe show that wireless phones do not pose a health risk.''
The F.D.A. notes, however, that the average period of phone use in the studies it cites was about three years, so the research doesn't answer questions about long-term exposures. Critics say many studies are flawed for that reason, and also because they do not distinguish between casual and heavy use.
Cellphones emit non-ionizing radiation, waves of energy that are too weak to break chemical bonds or to set off the DNA damage known to cause cancer. There is no known biological mechanism to explain how non-ionizing radiation might lead to cancer.
But researchers who have raised concerns say that just because science can't explain the mechanism doesn't mean one doesn't exist. Concerns have focused on the heat generated by cellphones and the fact that the radio frequencies are absorbed mostly by the head and neck. In recent studies that suggest a risk, the tumors tend to occur on the same side of the head where the patient typically holds the phone.
Like most research on the subject, the studies are observational, showing only an association between cellphone use and cancer, not a causal relationship. The most important of these studies is called Interphone, a vast research effort in 13 countries, including Canada, Israel and several in Europe.
Some of the research suggests a link between cellphone use and three types of tumors: glioma; cancer of the parotid, a salivary gland near the ear; and acoustic neuroma, a tumor that essentially occurs where the ear meets the brain. All these cancers are rare, so even if cellphone use does increase risk, the risk is still very low.
Last year, The American Journal of Epidemiology published data from Israel finding a 58 percent higher risk of parotid gland tumors among heavy cellphone users. Also last year, a Swedish analysis of 16 studies in the journal Occupational and Environmental Medicine showed a doubling of risk for acoustic neuroma and glioma after 10 years of heavy cellphone use.
''What we're seeing is suggestions in epidemiological studies that have looked at people using phones for 10 or more years,'' says Louis Slesin, editor of Microwave News, an industry publication that tracks the research. ''There are some very disconcerting findings that suggest a problem, although it's much too early to reach a conclusive view.''
----------------
TARA PARKER-POPE
Published: June 3, 2008
Some doctors say the real concern is not older cellphone users, who began using phones as adults, but children who are beginning to use phones today and face a lifetime of exposure.
''More and more kids are using cellphones,'' said Dr. Paul J. Rosch, clinical professor of medicine and psychiatry at New York Medical College. ''They may be much more affected. Their brains are growing rapidly, and their skulls are thinner.''
For people who are concerned about any possible risk, a simple solution is to use a headset. Of course, that option isn't always convenient, and some critics have raised worries about wireless devices like the Bluetooth that essentially place a transmitter in the ear.
The fear is that even if the individual risk of using a cellphone is low, with three billion users worldwide, even a minuscule risk would translate into a major public health concern.
''We cannot say with any certainty that cellphones are either safe or not safe,'' Dr. Black said on CNN. ''My concern is that with the widespread use of cellphones, the worst scenario would be that we get the definitive study 10 years from now, and we find out there is a correlation.''
=============================
Does Fructose Make You Fatter?
High-fructose corn syrup is a sweetener used in many processed foods ranging from sodas to baked goods. While the ingredient is cheaper and sweeter than regular sugar, new research suggests that it can also make you fatter.
In a small study, Texas researchers showed that the body converts fructose to body fat with “surprising speed,'’ said Elizabeth Parks, associate professor of clinical nutrition at the University of Texas Southwestern Medical Center in Dallas. The study, which appears in The Journal of Nutrition, shows how glucose and fructose, which are forms of sugar, are metabolized differently.
In humans, triglycerides, which are a type of fat in the blood, are mostly formed in the liver. Dr. Parks said the liver acts like “a traffic cop” who coordinates how the body uses dietary sugars. When the liver encounters glucose, it decides whether the body needs to store it, burn it for energy or turn it into triglycerides.
But when fructose enters the body, it bypasses the process and ends up being quickly converted to body fat.
“It’s basically sneaking into the rock concert through the fence,” Dr. Parks said. “It’s a less-controlled movement of fructose through these pathways that causes it to contribute to greater triglyceride synthesis. The bottom line of this study is that fructose very quickly gets made into fat in the body.”
For the study, six people were given three different drinks. In one test, the breakfast drink was 100 percent glucose. In the second test, they drank half glucose and half fructose; and in the third, they drank 25 percent glucose and 75 percent fructose. The drinks were given at random, and neither the study subjects nor the evaluators were aware who was drinking what. The subjects ate a regular lunch about four hours later.
The researchers found that lipogenesis, the process by which sugars are turned into body fat, increased significantly when the study subjects drank the drinks with fructose. When fructose was given at breakfast, the body was more likely to store the fats eaten at lunch.
Dr. Parks noted that the study likely underestimates the fat-building effect of fructose because the study subjects were lean and healthy. In overweight people, the effect may be amplified.
Although fruit contains fructose, it also contains many beneficial nutrients, so dieters shouldn’t eliminate fruit from their diets. But limiting processed foods containing high-fructose corn syrup as well as curbing calories is a good idea, Dr. Parks said.
“There are lots of people out there who want to demonize fructose as the cause of the obesity epidemic,” she said. “I think it may be a contributor, but it’s not the only problem. Americans are eating too many calories for their activity level. We’re overeating fat, we’re overeating protein and we’re overeating all sugars.”
-
First of all it *is* genetically and physiologically for all adult Americans to become overweight. Second there are medicines and combinations of medicines that will turn this trend coming. Probably within five and certainly within ten years we will start to see thse medicines coming to the market place. So the answer lies in the pharmaceutical industry.
I've read other evaulations that point out the trend towards heavier weights is starting to level out. That is not to say we don't have a "huge" problem or we shouldn't do more to right this.
But wild extrapolations like this make for good pc correct policy fodder. The "food" police are a wing of the "green" police. They are part of the same weed family whose natural habitat is San Fransisco.
****All U.S. adults could be overweight in 40 years
By Amy Norton Wed Aug 6, 3:12 PM ET
NEW YORK (Reuters Health) - If the trends of the past three decades continue, it's possible that every American adult could be overweight 40 years from now, a government-funded study projects.
The figure might sound alarming, or impossible, but researchers say that even if the actual rate never reaches the 100-percent mark, any upward movement is worrying; two-thirds of the population is already overweight.
"Genetically and physiologically, it should be impossible" for all U.S. adults to become overweight, said Dr. Lan Liang of the federal government's Agency for Healthcare Research and Quality, one of the researchers on the study.
However, she told Reuters Health, the data suggest that if the trends of the past 30 years persist, "that is the direction we're going."
Already, she and her colleagues point out, some groups of U.S. adults have extremely high rates of overweight and obesity; among African- American women, for instance, 78 percent are currently overweight or obese.
The new projections, published in the journal Obesity, are based on government survey data collected between the 1970s and 2004.
If the trends of those years continue, the researchers estimate that 86 percent of American adults will be overweight by 2030, with an obesity rate of 51 percent. By 2048, all U.S. adults could be at least mildly overweight.
Weight problems will be most acute among African-Americans and Mexican- Americans, the study projects. All black women could be overweight by 2034, according to the researchers, as could more than 90 percent of Mexican-American men.
All of this rests on the "big assumption" that the trends of recent decades will march on unabated, Liang acknowledged.
"This is really intended as a wake-up call to show what could happen if nothing changes," she said.
Waistlines aren't the only thing poised to balloon in the future, according to Liang and her colleagues. They estimate that the healthcare costs directly related to excess pounds will double each decade, reaching $957 billion in 2030 -- accounting for one of every six healthcare dollars spent in the
U.S.
Those financial projections are based on Census data and published estimates of the current healthcare costs attributed to excess weight -- and they are probably a "huge underestimate" of what the actual costs will be, Liang said.
The findings highlight a need for widespread efforts to improve Americans' lifestyles and keep their weight in check, according to the researchers. Simply telling people to eat less and exercise more is not enough, Liang noted.
Broader social changes are needed as well, she said -- such as making communities more pedestrian-friendly so that people can walk regularly, or getting the food industry to offer healthier, calorie-conscious choices.
"It really needs to be more than an individual effort," Liang said. "It needs to be a societal effort."
SOURCE: Obesity, online July 24, 2008.****
-
Hospital Infections:
Preventable and Unacceptable
By BETSY MCCAUGHEY
August 14, 2008; Page A11
On July 30, a jury awarded over $2.5 million to James Klotz and his wife Mary in a medical malpractice lawsuit against a heart surgeon, his group practice and St. Anthony's Medical Center in St. Louis, Mo. In 2004 Mr. Klotz, now 69, was rushed to the hospital with a heart attack and a pacemaker was surgically implanted. He developed a drug-resistant staph infection called methicillin-resistant Staphylococcus aureus (MRSA). It was so severe that he underwent 15 additional operations, spent 84 days in the hospital and lost his right leg, part of his left foot, a kidney and most of his hearing.
This verdict should send a warning to physicians, hospitals and hospital board members. Until recently, infection was considered an unavoidable risk. But now there is proof that nearly all hospital infections are avoidable when doctors and staff clean their hands and rigorously practice proper hygiene and other preventive measures.
Hospital infections will cause the next wave of class-action lawsuits, bigger than the litigation over asbestos. The germ that Mr. Klotz contracted, hospital-acquired MRSA, infects about 880,000 patients a year and accounts for only 8% of all hospital infections. Hospital infections caused by all kinds of bacteria sicken millions.
The Klotz verdict is not the first sign that hospitals are in a new legal environment. In 2004, Tenet Healthcare Corporation agreed to pay $31 million to settle 106 lawsuits by patients who contracted infections after heart surgery at Palm Beach Gardens Medical Center in Florida. Since then, numerous lawsuits have been filed against hospitals in Florida, Kentucky and elsewhere by infected patients. Hospitals being sued are saying that their infection rates are within national norms. But for most infections, the only acceptable rate is zero.
Medicare calls certain device-related bloodstream infections, urinary tract infections and surgical infections after orthopedic and heart surgery "never events." Starting in October, Medicare will stop reimbursing hospitals for treatment of these infections. Hospitals will be barred from billing patients for what Medicare doesn't pay, forcing them to take a loss. Next year Medicare will add other types of infections to the list of "never events."
The evidence justifying Medicare's new policy is compelling. Central line bloodstream infections, caused by the contamination of certain devices, are preventable. Hospital patients in intensive care are commonly medicated through a tube inserted into a vein. The risk is that bacteria will invade the tube and enter the bloodstream. Rigorous hygiene, including clean hands, sterile drapes, and careful cleaning of the insertion site with chlorhexidine soap, can keep bacteria away from the tube.
Beth Israel Medical Center in New York City reports that it hasn't had a central line bloodstream infection in the cardiac intensive care unit in over 1,000 days. Dr. Brian Koll, chief of infection control there, explains that the key is using a checklist that doctors and nurses must follow. Implementing the checklist cost $30,000 and saved $1.5 million in treatment costs. Lives saved: priceless.
Other hospitals -- from Johns Hopkins Medical Center in Baltimore to Sutter Roseville Medical Center in Sacramento -- have reached the goal of zero central line bloodstream infections. No wonder Medicare calls these infections "never events." Why should jurors reach a different conclusion in a lawsuit?
We have the knowledge to prevent infections. What has been lacking is the will. A recent survey from the patient-safety organization Leapfrog found that 87% of hospitals fail to consistently practice infection prevention measures. Insurance companies that sell liability coverage to hospitals could change that by offering lower premiums to hospitals that rigorously follow infection-prevention protocols.
To be sure, lawsuits are not the best way to improve patient care. Many verdicts are unjustified, and few truly injured patients find a lawyer to take their case. Still, the coming wave of lawsuits, as well as financial incentives from Medicare and insurers, will fight complacency about hospital hygiene.
Ms. McCaughey, a former lieutenant governor of New York State, is chairman of the Committee to Reduce Infection Deaths.
See all of today's editorials and op-eds, plus video commentary, on Opinion Journal.
-
Herbal Legends
By SCOTT GOTTLIEB
August 19, 2008; Page A15
Trick or Treatment
By Simon Singh and Edzard Ernst, M.D.
(Norton, 342 pages, $24.95)
When I was practicing medicine in the Elmhurst section of New York about five years ago, my colleagues and I confronted an epidemic of liver damage among the recently arrived Chinese immigrants who live there. We put these patients through an exhaustive battery of tests for conventional sources of hepatitis, the most likely culprit, but found none. The mysterious illness, we decided, must have been caused by the folk therapies, usually herbal, that our patients often used but rarely disclosed to their doctors. There was little we could do but counsel them to stop. Instead of following our professional advice, though, they usually just added new herbs to their regimen, hoping to solve their liver problems but sometimes making themselves even more ill.
The Elmhurst epidemic was a classic example of the clash -- both cultural and scientific -- between "alternative" and conventional medicine. In this case, the inability of doctors to treat a liver ailment strengthened the false faith of patients in other cures. Usually, alternative medicine is a harmless distraction. And some treatments actually do offer benefits. But going outside modern medical practice also carries dangers.
Luckily, hundreds of studies have examined the purported benefits of various alternative-medicine treatments. In "Trick or Treatment," Simon Singh and Dr. Edzard Ernst report on the results. Ginseng has been proposed as a cure-all for everything from cancer to common colds, but there's no evidence that it does any good. Shiatsu massage appears to be a "waste of effort and expense," the authors say. Many aspects of traditional Chinese medicine, like the use of the herbs aristolochia and liquorice, are potentially harmful. Aromatherapy can relieve stress, but there is not a lick of evidence that it can treat a specific illness. Chelation therapy -- a legitimate method of removing heavy metals such as lead or mercury from the body, but now pitched in alternative-medicine circles as a cure for heart disease and other ailments -- is "disproven, expensive, and dangerous," according to Mr. Singh and Dr. Ernst. They urge patients "not to use this treatment."
Some alternative remedies, it should be said, do appear to have value. There is evidence that St. John's Wort can help mild depression, although probably not as well as conventional antidepressants. Echinacea may be able to help relieve symptoms of the common cold, and perhaps reduce the length of illness, but so can many better understood conventional remedies that are sold over the counter. "It seems bizarre," the authors note, in light of the disappointing results, "that alternative treatments are touted as though they offer marvelous benefits."
Dr. Ernst is not a dispassionate observer. He is a pioneer in the field of complementary medicine -- a branch of the medical profession whose practitioners prescribe selective alternative treatments. But he is also a scourge of too-large claims made for his field. Based at the University of Exeter in England, he leads a research group that has spent 15 years studying alternative remedies, trying to separate snake oil from science. Mr. Singh, his co-author, is a science journalist whose books include "Fermat's Enigma" and "Big Bang." Together they conclude, after cataloging the evidence, that most of the popular forms of alternative medicine are "a throwback to the dark ages." Too many alternative practitioners, they say, are "uninterested in determining the safety and efficacy of their interventions."
And safety is a real concern. "Chiropractors who manipulate the neck can cause a stroke . . . some herbs can cause adverse reactions or can interfere with conventional drugs." The authors are particularly hard on homeopathy, the practice of using ultradilute solutions of common substances. The solutions are so dilute, though, that they are often little more than water. "Homeopathic remedies, which of course contain no active ingredient, can be dangerous if they delay or replace a more orthodox treatment," Mr. Singh and Dr. Ernst write, calling homeopathy "the worst therapy encountered so far -- it is an implausible therapy that has failed to prove itself after two centuries and some 200 clinical studies."
"Trick or Treatment" includes a brisk history of our evidence-based approach to medicine, tracing the development of the modern clinical trial from its earliest days, when scurvy was shown to be caused by insufficient vitamin C and bleeding was debunked as a medical cure. Unfortunately, the evidence of clinical trials is largely ignored when it comes to alternative medicine.
So the treatments persist: Americans spend an astonishing $3 billion annually on chiropractors and about $1.5 billion on homeopathy, not to mention billions more for herbal remedies. Government is complicit: Most states mandate health-insurance coverage for chiropractic visits, and many states direct insurers to cover the cost of acupuncture -- another remedy with far fewer benefits than are commonly claimed for it.
Why is there so much blind faith? Mr. Singh and Dr. Ernst blame media hype, celebrities and even certain doctors -- complementary-medicine doctors for shading facts but also, importantly, conventional doctors whose high-handedness breeds patient frustration, opening the door to the seductions of alternative medicine.
"Alternative medicine is not so much about the treatments we discuss in this book," the authors write, "but about the therapeutic relationship. Many alternative practitioners develop an excellent relationship with their patients that helps to maximize the placebo effect of an otherwise useless treatment." To bring all treatments in line with rigorous science, an "excellent relationship" between doctor and patient is a good place to start.
Dr. Gottlieb, a resident fellow at the American Enterprise Institute, is a former official at the Food and Drug Administration and the Centers for Medicare and Medicaid Services.
-
Scientists Reprogram Adult Cells' Function
Advance Stirs Up Debate on Embryos
By Rob Stein
Washington Post Staff Writer
Thursday, August 28, 2008; A01
Scientists have transformed one type of fully developed adult cell directly into another inside a living animal, a startling advance that could lead to cures for a variety of illnesses and sidestep the political and ethical quagmires
associated with embryonic stem cell research.
Through a series of painstaking experiments involving mice, the Harvard biologists pinpointed three crucial molecular switches that, when flipped, completely convert a common cell in the pancreas into the more precious insulin-producing ones that diabetics need to survive.
The experiments, detailed online yesterday in the journal Nature, raise the prospect that patients suffering from not only diabetes but also heart disease, strokes and many other ailments could eventually have some of their cells reprogrammed to cure their afflictions without the need for drugs, transplants or other therapies.
"It's kind of an extreme makeover of a cell," said Douglas A. Melton, co-director of the Harvard Stem Cell Institute, who led the research. "The goal is to create cells that are missing or defective in people. It's very exciting."
The work was hailed as a welcome development even by critics of research involving embryonic stem cells, which can be coaxed to become any tissue in the body but are highly controversial because they are obtained by destroying embryos.
"I see no moral problem in this basic technique," said Richard Doerflinger of the U.S. Conference of Catholic Bishops, a leading opponent of embryonic stems cell research. "This is a 'win-win' situation for medicine and ethics."
Researchers in the field, who have become accustomed to rapid advances, said they, too, were surprised by the advance.
"I'm stunned," said Robert Lanza, chief scientific officer of Advanced Cell Technology in Worcester, Mass., a developer of stem cell therapies. "It introduces a whole new paradigm for treating disease."
Melton and other researchers cautioned that many years of research lay ahead to prove whether the development would translate into cures.
"It's an important proof of concept," said Lawrence Goldstein, a stem cell researcher at the University of California at San Diego. "But these things always look easier on the blackboard than when you have to do them in actual patients."
Although the experiment involved mice, Melton and other researchers were optimistic that the approach would work in people.
"You never know for sure -- mice aren't humans," said George Q. Daley, a stem cell researcher at Children's Hospital in Boston. "But the biology of pancreatic development is very closely related in mice and humans."
Melton has already started experimenting with human cells in the laboratory and hopes that within a year he can start planning the first studies involving people with diabetes. "I would say within five years, we could be ready to start human trials," Melton said.
Other scientists have begun trying the approach on other cells, including those that could be used to treat spinal cord injuries and neurodegenerative disorders such as Lou Gehrig's disease.
"The idea to be able to reprogram one adult neuron type into another for repair in the nervous system is very exciting," said Paola Arlotta, who is working in the Center for Regenerative Medicine at Massachusetts General Hospital-Harvard Medical School in Boston.
The research is the latest development in the explosive field of regenerative medicine, which seeks to create replacement tissues and body parts tailored to patients. That objective appeared within reach after scientists discovered stem cells. But stem cell research has been hampered by objections from President Bush and others who believe that the earliest stages of human life have moral standing.
Scientists last year shocked the field when they announced they had discovered how to manipulate the genes of adult cells to turn them back into the equivalent of embryonic cells -- entities dubbed "induced pluripotent stem" or "iPS" cells -- which could then be coaxed into any type of cell in the body.
The new work takes further advantage of the increasing ability scientists have developed in harnessing the once-mysterious inner workings of cells -- this time to skip the intermediary step of iPS cells and directly transform adult cells.
"This experiment proves you don't have to go all the way back to an embryonic state," Daley said. "You can use a related cell. That may be easier to do and more practical to do."
Doerflinger argued that the discovery was the latest evidence that research involving human embryos is no longer necessary. "This adds to the large and growing list of studies helping to make embryonic stem cells irrelevant to medical progress," Doerflinger wrote in an e-mail.
But other researchers disputed that, saying it remains unclear which approach will ultimately prove most useful.
"Embryonic stem cells offer a unique window in human disease and remain a key to the long-term progress of regenerative medicine," Melton said.
For their work, Melton and his colleagues systematically studied cells from the pancreas of adult mice, slowly winnowing the list of genes necessary to make a "beta" cell that produces insulin. After narrowing the candidate genes to nine, the researchers genetically engineered viruses known as adenoviruses to ferry the genes into other pancreatic cells, known as exocrine cells, which normally secrete enzymes to help digest food. That finally enabled the researchers to identify the three crucial genes needed take control of the rest of the cell's genes to convert an exocrine cell into a beta cell.
"It was a mixture of work, luck and guessing," Melton said. "We achieved a complete transformation, or re-purposing, of cells from one type to another. We were delighted."
When the scientists tried the approach on diabetic mice, the animals became able to control their blood sugar levels.
"It didn't cure the mouse, but they were able to reduce their blood sugar levels to near-normal," Melton said.
Melton and others said it remains to be seen whether it will be necessary to use genetically engineered viruses, which could face obstacles obtaining regulatory approval because of concerns about unforeseen risks, or whether chemicals might be found to do the same thing.
If preliminary studies in the laboratory are promising, Melton said he might first try converting liver cells to insulin-producing pancreatic cells, because that would be safer than using the pancreas. An alternative strategy would be to use the approach to grow beta cells in the laboratory and transplant them into patients.
Lanza said he is optimistic.
"One day, this may allow the doctor to replace the scalpel with a sort of genetic surgery," Lanza said. "If this can be perfected, it would represent one of the holy grails of medicine."
http://www.washingtonpost.com/wp-dyn/content/article/2008/08/27/AR2008082701829.html?hpid%3Dmoreheadlines&sub=AR
-
WOW.
Any way to invest in this?
-
Sorry, I lost the URL for this:
Does Fructose Make You Fatter?
High-fructose corn syrup is a sweetener used in many processed foods ranging
from sodas to baked goods. While the ingredient is cheaper and sweeter than
regular sugar, new research suggests that it can also make you fatter.
In a small study, Texas researchers showed that the body converts fructose
to body fat with "surprising speed,'' said Elizabeth Parks, associate
professor of clinical nutrition at the University of Texas Southwestern
Medical Center in Dallas. The study, which appears in The Journal of
Nutrition, shows how glucose and fructose, which are forms of sugar, are
metabolized differently.
In humans, triglycerides, which are a type of fat in the blood, are mostly
formed in the liver. Dr. Parks said the liver acts like "a traffic cop" who
coordinates how the body uses dietary sugars. When the liver encounters
glucose, it decides whether the body needs to store it, burn it for energy
or turn it into triglycerides.
But when fructose enters the body, it bypasses the process and ends up being
quickly converted to body fat.
"It's basically sneaking into the rock concert through the fence," Dr. Parks
said. "It's a less-controlled movement of fructose through these pathways
that causes it to contribute to greater triglyceride synthesis. The bottom
line of this study is that fructose very quickly gets made into fat in the
body."
For the study, six people were given three different drinks. In one test,
the breakfast drink was 100 percent glucose. In the second test, they drank
half glucose and half fructose; and in the third, they drank 25 percent
glucose and 75 percent fructose. The drinks were given at random, and
neither the study subjects nor the evaluators were aware who was drinking
what. The subjects ate a regular lunch about four hours later.
The researchers found that lipogenesis, the process by which sugars are
turned into body fat, increased significantly when the study subjects drank
the drinks with fructose. When fructose was given at breakfast, the body was
more likely to store the fats eaten at lunch.
Dr. Parks noted that the study likely underestimates the fat-building effect
of fructose because the study subjects were lean and healthy. In overweight
people, the effect may be amplified.
Although fruit contains fructose, it also contains many beneficial
nutrients, so dieters shouldn't eliminate fruit from their diets. But
limiting processed foods containing high-fructose corn syrup as well as
curbing calories is a good idea, Dr. Parks said.
"There are lots of people out there who want to demonize fructose as the
cause of the obesity epidemic," she said. "I think it may be a contributor,
but it's not the only problem. Americans are eating too many calories for
their activity level. We're overeating fat, we're overeating protein and we're
overeating all sugars."
-
Kind of funny actually. From the new New England Journal of Medicine and very aprepo (sp?) with the times of public outrage against the corporate executive now demoted to the status below that of used car salesman:
****Executive Physicals — Bad Medicine on Three Counts
Brian Rank, M.D.
In corporate boardrooms throughout the United States, executives are wrestling with the management of health care costs. They are demanding health care services that are effective and evidence-based and that don't entail excess or unjust costs. They are meticulously assessing insurers and providers on all these counts as never before. And rightly so. There's some irony, then, in the fact that many of these executives leave these boardrooms for days at a time to take part in one of modern medicine's most expensive and least proven approaches to care: the executive physical.
If you want to have an executive physical (and have the money to pay for one), you won't have to look far. These services are marketed heavily by many of the country's largest and most highly regarded health systems and hospitals, including the Mayo Clinic, the Cleveland Clinic, and dozens of others. Although the specific components of these programs vary, certain traits are common. Most involve a dedicated block of time — a day or two — during which the executive undergoes an extensive and comprehensive battery of in-depth medical tests and evaluations, with results made available immediately. Most such physicals are marketed as a yearly event. Most cost thousands of dollars and are not covered by insurance. Many of the centers that provide them tout an environment of exclusivity, personal attention, and luxury of the type one might expect to see at a four-star hotel or high-end resort. Those who undergo these physicals clearly appreciate the indulgent touches, such as complimentary bathrobes and slippers or the performance of the whole process in a so-called VIP area.1
It's easy to understand the appeal of the executive physical to companies and their executives. With executive compensation high and competition for top talent fierce, it's not surprising that companies want to do everything they can to protect the investment they make in senior management. Nor is it surprising that the executives themselves, with heavy demands on their time, would be drawn to the convenience of one-stop shopping, the pampering, and the peace of mind that the executive physical seems to represent. Like a four-star hotel, the executive physical is, at least outwardly, "the best" — just what executives are accustomed to getting.
It's also easy to understand why the executive physical appeals to the hospitals and systems that offer it. The physical represents an opportunity for the provider to show off its ability to serve high-profile patients with the most advanced testing available. It also represents a new and attractive revenue stream.
Nevertheless, in my view, the emergence of executive physicals is not a good thing. It's not good for the patients who undergo them, it's not good for the companies that pay for them, and it's not good for the health care system overall. As an example of progressive medicine, the executive physical fails on three important counts: efficacy, cost, and equity.
Inherent in the provision of this service is the notion that the most health care is the best health care. If a standard physical exam entails three tests, the thinking goes, then an exam with a dozen tests must be better. Similarly, an exam that takes 2 days must be better than one that takes an hour. Of course, there is no evidence for either premise, and indeed a growing body of research suggests quite the opposite — that unnecessary testing may cause more harm than good, owing to false positive findings, unwarranted follow-up visits and costs, needless worry, and harmful side effects of the tests themselves.
Consider, for example, the inclusion in many executive physicals of a computed tomographic (CT) scan of the heart to determine the executive's calcium score. Although most patients would probably find information gleaned from this examination interesting, it is rarely meaningful as a predictor of disease. In its current summary of recommendations, the U.S. Preventive Services Task Force concludes that the potential harms of routine screening for coronary heart disease in low-risk adults exceed the potential benefits.2
Among the battery of screening tools that executive physicals include with little regard to medical evidence are whole-body CT scans, electrocardiograms, and chest radiographs. As clinicians, we should be applying increasingly rigorous standards of justification and efficacy to every test we request for our patients. Our goal should be to limit tests to those warranted by medical evidence to improve health, lengthen life, and do more good than harm. The executive physical seeks, by its very structure, to broaden testing, under the false assumption that more is better.
According to a 2006 study by Wennberg et al.,3 evidence-based medicine does not play a role in governing the use of supply-sensitive services — services whose supply has a major influence on their use. Wennberg said of the study, "Three issues drive the differences in the cost and quality of care. Variation is the result of an unmanaged supply of resources, limited evidence about what kind of care really contributes to the health and longevity of the chronically ill, and falsely optimistic assumptions about the benefits of more aggressive treatment of people who are severely ill with medical conditions that must be managed but can't be cured."
Executive physicals also reinforce a related misperception — that costlier is better, that a $3,000 examination must be worth more than one that costs 1/10 of that amount. This is an indefensible idea that should not be promoted by the health care industry. Even as individual hospitals sell these services for exorbitant fees, gratuitously overusing our health care resources, our system as a whole is appropriately straining in precisely the opposite direction, toward cost-effectiveness, transparency, competition, and accountability. With its outrageous cost and unproven efficacy, the executive physical is almost a parody of the high-cost, low-return procedures that prudent companies rightly want clinicians to eliminate for other employees.
But perhaps the most lamentable idea perpetuated by the executive physical is the implication that some patients — namely, those who have the ability to pay out of pocket or with company resources — are more worthy of effective, respectful, and personalized treatment than others. Much good work is being done these days to identify and reduce health care disparities that are based on income, race, geography, or other demographic factors. The executive physical runs exactly counter to these efforts, suggesting that a company is justified in paying thousands of dollars to maintain the health of its wealthy senior executives while relegating the masses to something less.
As efforts to reform the health care system continue, the executive physical is a perfect example of what American medicine should be working to expunge: the expensive, the ineffective, and the inequitable. Perhaps if it didn't fail on all three of these counts, allowances could be made for it as a whimsical extravagance that satisfies certain people's need for exclusivity. As it stands, however, there is little to excuse it. As an industry, we can't expect to get credit for working to make health care affordable and effective for all if we're offering the "best" health care, for a price, to a few — when it isn't.
Dr. Rank is the medical director of HealthPartners Medical Group and Clinics, Minneapolis. The HealthPartners Medical Group does not have an executive physical program.
References
Brink S. For the busy exec, a $2000 physical. Los Angeles Times. February 18, 2008:F1.
Screening for coronary heart disease. Rockville, MD: Agency for Healthcare Research and Quality, February 2004. (Accessed September 12, 2008, at http://www.ahrq.gov/clinic/uspstf/uspsacad.htm.)
Wennberg JE, Fisher ES, Sharp SM, McAndrew M, Bronner KK. The care of patients with severe chronic illness: a report on the Medicare program by the Dartmouth Atlas Project. Lebanon, NH: The Trustees of Dartmouth College, 2006. (Accessed September 12, 2008, at http://www.dartmouthatlas.org/atlases/2006_Chronic_Care_Atlas.pdf.)
The New England Journal of Medicine is owned, published, and copyrighted © 2008 Massachusetts Medical Society. All rights reserved. *********
-
Staph Germs Are Getting More Difficult to Treat, Studies Say
Associated Press
WASHINGTON -- Drug-resistant staph bacteria picked up in ordinary community settings are increasingly acquiring "superbug" powers and causing far more serious illnesses than they have in the past, doctors reported Monday.
These widespread germs used to be easier to treat than the dangerous forms of staph found in hospitals and nursing homes.
"Until recently we rarely thought of it as a problem among healthy people in the community," said Rachel Gorwitz of the federal Centers for Disease Control and Prevention.
Now, the germs causing outbreaks in schools, on sports teams and in other social situations are posing a growing threat. A CDC study found that at least 10% of cases involving the most common community strain were able to evade the antibiotics typically used to treat them.
"They're becoming more resistant and they're coming into the hospitals," where they swap gene components with other bacteria and grow even more dangerous, said Keith Klugman, an infectious disease expert at Emory University. "It's really a major epidemic."
The germ is methicillin-resistant Staphylococcus aureus, or MRSA. People can carry it on their skin or in their noses with no symptoms and still infect others -- the reason many hospitals isolate and test new patients to see if they harbor the bug.
MRSA mostly causes skin infections. Cleveland Browns tight end Kellen Winslow was just hospitalized for a staph infection, his second in recent years, and the team reportedly has had at least six cases in the past three years.
But the germ can be life-threatening if it gets into the bloodstream, lungs or organs. Pneumonia, sinus infections and even "flesh-eating" wounds due to MRSA are on the rise, doctors reported Monday at an infectious diseases conference in Washington.
About 95,000 serious infections and 20,000 deaths due to drug-resistant staph bacteria occur in the United States each year.
To treat them, "we've had to dust off antibiotics so old that they've lost their patent," said Robert Daum, a pediatrician at the University of Chicago.
The CDC used a network of hospitals in nine cities and states to test samples of the most common community MRSA strain, USA300, over the last few years.
MRSA usually is resistant only to penicillin-type drugs. But 10% of the 824 samples checked also could evade clindamycin, tetracycline, Bactrim or other antibiotics.
"The drugs that doctors have typically used to treat staph infections are not effective against MRSA," and family doctors increasingly are seeing a problem only hospital infection specialists once did, Dr. Gorwitz said.
Even more worrisome: many of these community strains had features allowing them to easily swap genes and become even hardier.
Also at the conference:
-Doctors from Spain reported the first hospital outbreak of MRSA resistant to linezolid, a last-resort drug sold by Pfizer Inc. as Zyvox in the U.S. and Zyvoxid in Europe. A dozen intensive care patients got pneumonia and bloodstream infections last spring and the outbreak was controlled after use of the antibiotic was severely curbed, said Dr. Miguel Sanchez of Hospital Clinico San Carlos in Madrid.
-Georgetown University saw a spike in sinus infections due to MRSA. The germ accounted for 69% of the staph-caused cases in the hospital between 2004 and 2006 compared with 30% from 2001 to 2003.
-Henry Ford Hospital in Detroit found that more than half of staph-caused pneumonia cases from 2005 through 2007 were due to MRSA.
-Doctors from Case Western Reserve University and the VA Medical Center in Cleveland found that by the time hospitals isolated and tested new patients to see if they harbored MRSA, many had already contaminated their skin and surroundings. Within about a day of being admitted, roughly a third had already started to spread the germ.
Hospital screening is controversial, and has had mixed success, said M. Lindsay Grayson, an infectious diseases expert at the University of Melbourne in Australia.
The nation's Veterans Affairs hospitals began universal MRSA testing in 2007. Illinois and some other states have adopted or are considering laws requiring hospitals to test high-risk and intensive-care patients for MRSA.
The conference is a joint meeting of the American Society for Microbiology and the Infectious Diseases Society of America.
Copyright © 2008 Associated Press\
=========================
Experts Say Staph Is Common Problem for Athletes
E-Mail
Print
Reprints
Save
Share
Linkedin
Digg
Facebook
Mixx
Yahoo! Buzz
Permalink
By KATIE THOMAS
Published: October 24, 2008
The news in football this week often seemed ripped from the pages of a journal on infectious disease.
Skip to next paragraph
Tony Dejak/Associated Press
The Browns’ Kellen Winslow had his second staph infection in three years.
Analysis and discussion of the N.F.L. on the New York Times pro football blog.
Go to The Fifth Down Blog »
N.F.L.
Scoreboard
Schedules: A.F.C. | N.F.C.
Standings: A.F.C. | N.F.C.
Teams | Statistics
Transactions
Injuries: A.F.C. | N.F.C.
Giants
Schedule/Results
Statistics | Roster
Depth Chart
Jets
Schedule/Results
Statistics | Roster
Depth Chart
First there was Kellen Winslow, who received a one-game suspension after accusing the Browns of concealing his staph infection. Then there was the news that Peyton Manning had developed a similar condition in his left knee earlier this year. Finally, there was Tom Brady, whose rehabilitation from knee surgery has reportedly been delayed because of an unidentified infection, also in his left knee.
Despite the outbreak of headlines, several experts in sports medicine and epidemiology said the news only served to highlight how prevalent infections — especially staph infections — are among professional athletes and in the community at large.
“It seems like most of these are single-case episodes,” said Jeff Hageman, an epidemiologist for the Centers for Disease Control and Prevention. “What we know is that staph is one of the most common causes of skin infection in the community,” he said, accounting for between 12 million to 14 million doctor visits a year.
Like athletes in other contact sports, football players are prone to staph infections because of their sport’s skin-on-skin contact, the frequency of cuts and the warm, moist conditions in locker rooms, which encourage the growth of bacteria. Because they are regulars in surgery wards, athletes are susceptible to infections there, too.
Garden-variety versions of the staphylococcus bacteria are easily treated and have lurked in locker rooms for years, but the problem has received heightened attention in recent years because of the emergence of a strain known as MRSA, or methicillin-resistant Staphylococcus aureus, which is resistant to some types of antibiotics. Serious cases of MRSA have derailed the careers of a handful of N.F.L. players, including Brandon Noble, a former defensive tackle for the Washington Redskins, and Jeff Novak, a guard for the Jacksonville Jaguars who later sued the team doctor for malpractice.
“These things are here, they’re very serious,” said Noble, who had two bouts of MRSA in 2005 and is now the defensive line coach at West Chester University in Pennsylvania. With high-profile players in the news, he said, “maybe it’ll wake some people up and get the ball rolling.”
Winslow has not said whether his staph infection — his second in three years — was MRSA, but Manning’s infection was not, according to a statement the Colts released Friday. Brady, who contracted his infection after surgery, has not categorized it.
Greg Aiello, a spokesman for the National Football League, said the teams’ trainers and doctors met annually to discuss infections and other health concerns. “It’s an issue across the country,” he said. “It’s not an N.F.L. or a football player issue.”
A 2005 survey by the N.F.L. Team Physicians Society found that of the 30 teams that responded, 13 said a player had contracted a MRSA infection in recent years, for a total of 60 infections across the league. Andrew Tucker, the president of the society and the team doctor for the Ravens, said teams had access to information about staph infections through an internal injury reporting database, but the N.F.L. declined to release the data.
Football teams increased their efforts to battle staph after 2003, when a MRSA outbreak among the Rams resulted in eight infections. The Rams invited the C.D.C. to investigate their facility, and a 2005 study revealed some nose-wrinkling results — towels were being shared by as many as three players on the field, trainers did not always wash their hands when treating wounds, and players did not take showers before entering whirlpools. Football players were also taking antimicrobial drugs at 10 times the rate of the general public.
Jim Anderson, the Rams’ head trainer, said he was surprised when MRSA even turned up on ultrasound equipment and in the cold pools. Since then, the Rams have been more diligent about disinfecting surfaces in the locker rooms and other facilities. Like other teams, they speak to players before each season about sanitary practices, imparting common-sense advice like washing one’s hands, treating open cuts, and not sharing drinks.
“The biggest thing was making them aware of it,” Anderson said. Since then, although a handful of Rams players have developed staph, none have been MRSA.
After Winslow criticized the Browns for concealing his illness from teammates — a claim the team denies and that led to his suspension, which he is appealing — several news media reports noted that the Browns have had six cases of staph infections since 2005. Bill Bonsiewicz, a Browns spokesman, said in an e-mail message that Browns players have contracted seven cases of staph since 1999, including two MRSA cases separated by a few years. “Both players were aggressively treated and each returned to the field within a few weeks,” Bonsiewicz said. He declined to name the players, citing privacy reasons.
Tucker and Hageman said the frequency of staph infections among Browns players — spread over so many years — did not appear to be out of the ordinary. “You’re talking about one or two per year,” Tucker said. “That’s not a lot.”
Noble said that although teams were making an effort to prevent MRSA, eradicating the bacteria was nearly impossible. Locker rooms, after all, are filthy places. “There’s mud, there’s blood, there’s sweat, there’s spit,” he said. “It’s just a bunch of big, gross guys in a room together.”
-
Drug Traces Common in Tap Water
--------------------------------------------------------------------------------
Drug Traces Common in Tap Water
By THE ASSOCIATED PRESS
Published: March 10, 2008 Filed at 9:18 a.m. ET
A vast array of pharmaceuticals -- including antibiotics, anti-convulsants,
mood stabilizers and sex hormones -- have been found in the drinking water
supplies of at least 41 million Americans, an Associated Press investigation
shows.
To be sure, the concentrations of these pharmaceuticals are tiny, measured
in quantities of parts per billion or trillion, far below the levels of a
medical dose. Also, utilities insist their water is safe.
But the presence of so many prescription drugs -- and over-the-counter
medicines like acetaminophen and ibuprofen -- in so much of our drinking
water is heightening worries among scientists of long-term consequences to
human health.
In the course of a five-month inquiry, the AP discovered that drugs have
been detected in the drinking water supplies of 24 major metropolitan
areas -- from Southern California to Northern New Jersey, from Detroit to
Louisville, Ky.
Water providers rarely disclose results of pharmaceutical screenings, unless
pressed, the AP found. For example, the head of a group representing major
California suppliers said the public ''doesn't know how to interpret the
information'' and might be unduly alarmed.
How do the drugs get into the water?
People take pills. Their bodies absorb some of the medication, but the rest
of it passes through and is flushed down the toilet. The wastewater is
treated before it is discharged into reservoirs, rivers or lakes. Then, some
of the water is cleansed again at drinking water treatment plants and piped
to consumers. But most treatments do not remove all drug residue.
And while researchers do not yet understand the exact risks from decades of
persistent exposure to random combinations of low levels of pharmaceuticals,
recent studies -- which have gone virtually unnoticed by the general
public -- have found alarming effects on human cells and wildlife.
''We recognize it is a growing concern and we're taking it very seriously,''
said Benjamin H. Grumbles, assistant administrator for water at the U.S.
Environmental Protection Agency.
Members of the AP National Investigative Team reviewed hundreds of
scientific reports, analyzed federal drinking water databases, visited
environmental study sites and treatment plants and interviewed more than 230
officials, academics and scientists. They also surveyed the nation's 50
largest cities and a dozen other major water providers, as well as smaller
community water providers in all 50 states.
Here are some of the key test results obtained by the AP:
--Officials in Philadelphia said testing there discovered 56 pharmaceuticals
or byproducts in treated drinking water, including medicines for pain,
infection, high cholesterol, asthma, epilepsy, mental illness and heart
problems. Sixty-three pharmaceuticals or byproducts were found in the city's
watersheds.
--Anti-epileptic and anti-anxiety medications were detected in a portion of
the treated drinking water for 18.5 million people in Southern California.
--Researchers at the U.S. Geological Survey analyzed a Passaic Valley Water
Commission drinking water treatment plant, which serves 850,000 people in
Northern New Jersey, and found a metabolized angina medicine and the
mood-stabilizing carbamazepine in drinking water.
--A sex hormone was detected in San Francisco's drinking water.
--The drinking water for Washington, D.C., and surrounding areas tested
positive for six pharmaceuticals.
--Three medications, including an antibiotic, were found in drinking water
supplied to Tucson, Ariz.
The situation is undoubtedly worse than suggested by the positive test
results in the major population centers documented by the AP.
The federal government doesn't require any testing and hasn't set safety
limits for drugs in water. Of the 62 major water providers contacted, the
drinking water for only 28 was tested. Among the 34 that haven't: Houston,
Chicago, Miami, Baltimore, Phoenix, Boston and New York City's Department of
Environmental Protection, which delivers water to 9 million people.
Some providers screen only for one or two pharmaceuticals, leaving open the
possibility that others are present.
The AP's investigation also indicates that watersheds, the natural sources
of most of the nation's water supply, also are contaminated. Tests were
conducted in the watersheds of 35 of the 62 major providers surveyed by the
AP, and pharmaceuticals were detected in 28.
http://www.nytimes.com/aponline/us/A...pagewanted=all
===============
Cont.
Yet officials in six of those 28 metropolitan areas said they did not go on
to test their drinking water -- Fairfax, Va.; Montgomery County in Maryland;
Omaha, Neb.; Oklahoma City; Santa Clara, Calif., and New York City.
The New York state health department and the USGS tested the source of the
city's water, upstate. They found trace concentrations of heart medicine,
infection fighters, estrogen, anti-convulsants, a mood stabilizer and a
tranquilizer.
City water officials declined repeated requests for an interview. In a
statement, they insisted that ''New York City's drinking water continues to
meet all federal and state regulations regarding drinking water quality in
the watershed and the distribution system'' -- regulations that do not
address trace pharmaceuticals.
In several cases, officials at municipal or regional water providers told
the AP that pharmaceuticals had not been detected, but the AP obtained the
results of tests conducted by independent researchers that showed otherwise.
For example, water department officials in New Orleans said their water had
not been tested for pharmaceuticals, but a Tulane University researcher and
his students have published a study that found the pain reliever naproxen,
the sex hormone estrone and the anti-cholesterol drug byproduct clofibric
acid in treated drinking water.
Of the 28 major metropolitan areas where tests were performed on drinking
water supplies, only Albuquerque; Austin, Texas; and Virginia Beach, Va.;
said tests were negative. The drinking water in Dallas has been tested, but
officials are awaiting results. Arlington, Texas, acknowledged that traces
of a pharmaceutical were detected in its drinking water but cited post-9/11
security concerns in refusing to identify the drug.
The AP also contacted 52 small water providers -- one in each state, and two
each in Missouri and Texas -- that serve communities with populations around
25,000. All but one said their drinking water had not been screened for
pharmaceuticals; officials in Emporia, Kan., refused to answer AP's
questions, also citing post-9/11 issues.
Rural consumers who draw water from their own wells aren't in the clear
either, experts say.
The Stroud Water Research Center, in Avondale, Pa., has measured water
samples from New York City's upstate watershed for caffeine, a common
contaminant that scientists often look for as a possible signal for the
presence of other pharmaceuticals. Though more caffeine was detected at
suburban sites, researcher Anthony Aufdenkampe was struck by the relatively
high levels even in less populated areas.
He suspects it escapes from failed septic tanks, maybe with other drugs.
''Septic systems are essentially small treatment plants that are essentially
unmanaged and therefore tend to fail,'' Aufdenkampe said.
Even users of bottled water and home filtration systems don't necessarily
avoid exposure. Bottlers, some of which simply repackage tap water, do not
typically treat or test for pharmaceuticals, according to the industry's
main trade group. The same goes for the makers of home filtration systems.
Contamination is not confined to the United States. More than 100 different
pharmaceuticals have been detected in lakes, rivers, reservoirs and streams
throughout the world. Studies have detected pharmaceuticals in waters
throughout Asia, Australia, Canada and Europe -- even in Swiss lakes and the
North Sea.
For example, in Canada, a study of 20 Ontario drinking water treatment
plants by a national research institute found nine different drugs in water
samples. Japanese health officials in December called for human health
impact studies after detecting prescription drugs in drinking water at seven
different sites.
In the United States, the problem isn't confined to surface waters.
Pharmaceuticals also permeate aquifers deep underground, source of 40
percent of the nation's water supply. Federal scientists who drew water in
24 states from aquifers near contaminant sources such as landfills and
animal feed lots found minuscule levels of hormones, antibiotics and other
drugs.
Perhaps it's because Americans have been taking drugs -- and flushing them
unmetabolized or unused -- in growing amounts. Over the past five years, the
number of U.S. prescriptions rose 12 percent to a record 3.7 billion, while
nonprescription drug purchases held steady around 3.3 billion, according to
IMS Health and The Nielsen Co.
=========
Cont.
''People think that if they take a medication, their body absorbs it and it
disappears, but of course that's not the case,'' said EPA scientist
Christian Daughton, one of the first to draw attention to the issue of
pharmaceuticals in water in the United States.
Some drugs, including widely used cholesterol fighters, tranquilizers and
anti-epileptic medications, resist modern drinking water and wastewater
treatment processes. Plus, the EPA says there are no sewage treatment
systems specifically engineered to remove pharmaceuticals.
One technology, reverse osmosis, removes virtually all pharmaceutical
contaminants but is very expensive for large-scale use and leaves several
gallons of polluted water for every one that is made drinkable.
Another issue: There's evidence that adding chlorine, a common process in
conventional drinking water treatment plants, makes some pharmaceuticals
more toxic.
Human waste isn't the only source of contamination. Cattle, for example, are
given ear implants that provide a slow release of trenbolone, an anabolic
steroid used by some bodybuilders, which causes cattle to bulk up. But not
all the trenbolone circulating in a steer is metabolized. A German study
showed 10 percent of the steroid passed right through the animals.
Water sampled downstream of a Nebraska feedlot had steroid levels four times
as high as the water taken upstream. Male fathead minnows living in that
downstream area had low testosterone levels and small heads.
Other veterinary drugs also play a role. Pets are now treated for arthritis,
cancer, heart disease, diabetes, allergies, dementia, and even obesity --
sometimes with the same drugs as humans. The inflation-adjusted value of
veterinary drugs rose by 8 percent, to $5.2 billion, over the past five
years, according to an analysis of data from the Animal Health Institute.
Ask the pharmaceutical industry whether the contamination of water supplies
is a problem, and officials will tell you no. ''Based on what we now know, I
would say we find there's little or no risk from pharmaceuticals in the
environment to human health,'' said microbiologist Thomas White, a
consultant for the Pharmaceutical Research and Manufacturers of America.
But at a conference last summer, Mary Buzby -- director of environmental
technology for drug maker Merck & Co. Inc. -- said: ''There's no doubt about
it, pharmaceuticals are being detected in the environment and there is
genuine concern that these compounds, in the small concentrations that
they're at, could be causing impacts to human health or to aquatic
organisms.''
Recent laboratory research has found that small amounts of medication have
affected human embryonic kidney cells, human blood cells and human breast
cancer cells. The cancer cells proliferated too quickly; the kidney cells
grew too slowly; and the blood cells showed biological activity associated
with inflammation.
Also, pharmaceuticals in waterways are damaging wildlife across the nation
and around the globe, research shows. Notably, male fish are being
feminized, creating egg yolk proteins, a process usually restricted to
females. Pharmaceuticals also are affecting sentinel species at the
foundation of the pyramid of life -- such as earth worms in the wild and
zooplankton in the laboratory, studies show.
Some scientists stress that the research is extremely limited, and there are
too many unknowns. They say, though, that the documented health problems in
wildlife are disconcerting.
''It brings a question to people's minds that if the fish were affected ...
might there be a potential problem for humans?'' EPA research biologist
Vickie Wilson told the AP. ''It could be that the fish are just exquisitely
sensitive because of their physiology or something. We haven't gotten far
enough along.''
With limited research funds, said Shane Snyder, research and development
project manager at the Southern Nevada Water Authority, a greater emphasis
should be put on studying the effects of drugs in water.
==============
Cont.
''I think it's a shame that so much money is going into monitoring to figure
out if these things are out there, and so little is being spent on human
health,'' said Snyder. ''They need to just accept that these things are
everywhere -- every chemical and pharmaceutical could be there. It's time
for the EPA to step up to the plate and make a statement about the need to
study effects, both human and environmental.''
To the degree that the EPA is focused on the issue, it appears to be looking
at detection. Grumbles acknowledged that just late last year the agency
developed three new methods to ''detect and quantify pharmaceuticals'' in
wastewater. ''We realize that we have a limited amount of data on the
concentrations,'' he said. ''We're going to be able to learn a lot more.''
While Grumbles said the EPA had analyzed 287 pharmaceuticals for possible
inclusion on a draft list of candidates for regulation under the Safe
Drinking Water Act, he said only one, nitroglycerin, was on the list.
Nitroglycerin can be used as a drug for heart problems, but the key reason
it's being considered is its widespread use in making explosives.
So much is unknown. Many independent scientists are skeptical that trace
concentrations will ultimately prove to be harmful to humans. Confidence
about human safety is based largely on studies that poison lab animals with
much higher amounts.
There's growing concern in the scientific community, meanwhile, that certain
drugs -- or combinations of drugs -- may harm humans over decades because
water, unlike most specific foods, is consumed in sizable amounts every day.
Our bodies may shrug off a relatively big one-time dose, yet suffer from a
smaller amount delivered continuously over a half century, perhaps subtly
stirring allergies or nerve damage. Pregnant women, the elderly and the very
ill might be more sensitive.
Many concerns about chronic low-level exposure focus on certain drug
classes: chemotherapy that can act as a powerful poison; hormones that can
hamper reproduction or development; medicines for depression and epilepsy
that can damage the brain or change behavior; antibiotics that can allow
human germs to mutate into more dangerous forms; pain relievers and
blood-pressure diuretics.
For several decades, federal environmental officials and nonprofit watchdog
environmental groups have focused on regulated contaminants -- pesticides,
lead, PCBs -- which are present in higher concentrations and clearly pose a
health risk.
However, some experts say medications may pose a unique danger because,
unlike most pollutants, they were crafted to act on the human body.
''These are chemicals that are designed to have very specific effects at
very low concentrations. That's what pharmaceuticals do. So when they get
out to the environment, it should not be a shock to people that they have
effects,'' says zoologist John Sumpter at Brunel University in London, who
has studied trace hormones, heart medicine and other drugs.
And while drugs are tested to be safe for humans, the timeframe is usually
over a matter of months, not a lifetime. Pharmaceuticals also can produce
side effects and interact with other drugs at normal medical doses. That's
why -- aside from therapeutic doses of fluoride injected into potable water
supplies -- pharmaceuticals are prescribed to people who need them, not
delivered to everyone in their drinking water.
''We know we are being exposed to other people's drugs through our drinking
water, and that can't be good,'' says Dr. David Carpenter, who directs the
Institute for Health and the Environment of the State University of New York
at Albany.
http://www.nytimes.com/aponline/us/A...pagewanted=all
-
A Food and Drug Administration advisory panel this week will consider three proposed antibiotics designed to treat serious skin infections, including some caused by a type of staph bacterium resistant to many antibiotics.
The bacterium -- methicillin-resistant staph aureus, or MRSA -- has sparked concern as the super bug has moved into community settings like schools and locker rooms in recent years after once being largely confined to hospital settings. But it's not clear if any of the three drugs will reach the bar for FDA approval because of safety concerns or questions about how well the drugs work compared with other available medications.
On Wednesday the panel is expected to vote on Theravance Inc.'s telavancin and Targanta Therapeutics Corp.'s oritavancin before considering iclaprim by Swiss biotech company Arpida Ltd. Thursday.
The FDA posted a review Monday of telavancin and oritavancin ahead of the meeting. Iclaprim's review is expected Tuesday.
Telavancin has already faced trouble gaining FDA approval. Last year, the agency refused to approve the drug and asked for additional clinical data. Earlier this year, the agency canceled an advisory panel meeting for telavancin after it had discovered violations of good clinical practice at some study sites involved in telavancin's clinical trials.
On Monday, the FDA said that, after tossing data from five sites out of about 200 study sites, the rest of the study information used to evaluate telavancin was "reliable," thereby allowing the agency to consider it as part of the drug application submitted by Theravance.
Overall, the agency said both telavancin and oritavancin met study goals of being at least as good as a vancomycin -- an older, generic antibiotic -- at treating skin infections.
However, the FDA said it was concerned about an "imbalance" in the number of serious adverse events that involved the kidneys, with more patients receiving Theravance's telavancin having some problems when compared with those receiving vancomycin.
The agency also said it would ask the FDA panel for advice about whether a risk-management program would be needed to keep pregnant women from receiving the drug because of concerns about the drug's effect on a developing fetus, based on results from animal studies. The agency also noted that 18 patients receiving telavancin or vancomycin died during studies and said some deaths in both groups were possibly drug-related.
Theravance said in a statement that "the safety profile of telavancin in these studies was compatible with treatment of patients with serious infections."
In a review of Targanta's oritavancin, the FDA looked at the impact of the drug on 11 types of bacteria -- including MRSA -- compared with vancomycin's effects. The agency said one of the studies showed that a lower percentage of oritavancin patients were considered a treatment success for MRSA, and it will ask the panel to comment on that finding.
Targanta, in briefing documents posted on FDA's Web site, said oritavancin was "safe and well-tolerated."
Write to Jennifer Corbett Dooren at jennifer.corbett-dooren@dowjones.com
-
New Products Bring Side Effect: Nanophobia
By NATASHA SINGER
Published: December 3, 2008
IT sounds like a plot straight out of a science-fiction novel by Michael Crichton. Toiletry companies formulate new cutting-edge creams and lotions that contain tiny components designed to work more effectively. But those minuscule building blocks have an unexpected drawback: the ability to penetrate the skin, swarm through the body and overwhelm organs like the liver.
Humans have long lived in dread of such nightmare scenarios in which swarms of creatures attack. Alfred Hitchcock envisioned menacing flocks in “The Birds.” In the 1990 film “Arachnophobia” a killer spider arrives in the United States, where it attacks and multiplies.
And now comes nanophobia, the fear that tiny components engineered on the nanoscale — that is, 100 nanometers or less — could run amok inside the body. A human hair, for example, is 50,000 to 100,000 nanometers in diameter. A nanoparticle of titanium dioxide in a sunscreen could be as small as 15 nanometers. (One nanometer equals a billionth of a meter.)
“The smaller a particle, the further it can travel through tissue, along airways or in blood vessels,” said Dr. Adnan Nasir, a clinical assistant professor of dermatology at the University of North Carolina at Chapel Hill. “Especially if the nanoparticles are indestructible and accumulate and are not metabolized, if you accumulate them in the organs, the organs could fail.”
Indeed, some doctors, scientists and consumer advocates are concerned that many industries are adopting nanotechnology ahead of studies that would establish whether regular ingestion, inhalation or dermal penetration of these particles constitute a health or environmental hazard. Personal care products are simply the lowest hanging fruit.
But people are already exposed to nanoparticles. Stoves and toaster ovens emit ultrafine particles of 2 to 30 nanometers, according to the National Institute of Standards and Technology; the researchers reported last month that long-term contact with such appliances could constitute a large exposure to the smallest of nanoparticles.
Several products already use nano-engineered materials. There are “nano pants,” stain-resistant chinos and jeans whose fabric contain nano-sized whiskers that repel oil and dirt, and nanocycles made from carbon nanotubes that are stronger and lighter than standard steel bicycles. And in lotions and creams, the use of nanocomponents may create a more cosmetically elegant effect — like uniformity or spreadability.
Some ingredients may behave differently as nanoparticles than they do in larger forms. Nano-sized silver, for example, can act as an antibacterial agent on the skin. Larger particles of zinc oxide and titanium dioxide result in white pasty sunscreens; but as nanoparticles, they appear more transparent.
When it comes to beauty products, however, some consumer advocates are concerned that dynamic nanoparticles could pose risks to the skin or, if they penetrate the skin, to other parts of the body. Mineral sunscreens have attracted the most attention.
“Substances that are perfectly benign could be toxic at the nano scale,” said Michael Hansen, a senior scientist at Consumers Union, the company behind Consumer Reports. “Because they are so small, they could go places in the body that could not be done before.”
This month, the magazine published a study it had commissioned that found mineral nanoparticles in five sunscreens, even though four of the companies had denied using them. In October, Dr. Hansen sent a letter to the Food and Drug Administration commissioner, asking the agency to require cosmetics and sunscreen manufacturers to run safety tests on nano scale ingredients. In the letter, he cited a few studies published in scientific journals that reported that exposure to nanoparticles of titanium dioxide caused damage to the organs of laboratory animals and human cell cultures.
But cosmetics industry representatives said there was no evidence that personal care products that contain nano-size components constitute a health hazard. Furthermore, no rigorous clinical trials have been published showing that cosmetics with nanocomponents caused health problems. A review of the potential risks of nanomaterials, carried out for the European Center for Toxicology in 2006, concluded that sunscreens with metal nanoparticles were unlikely to penetrate healthy skin, but it did raise the question of whether safety studies should examine if such materials may penetrate damaged skin.
“It’s very difficult to get anything through the skin,” said John Bailey, the executive vice president for science of the Personal Care Products Council, an industry trade group in Washington. “The skin is a very effective barrier.”
Indeed, some nanotechnology researchers said it was illogical to assume that a nano-size component inherently carries greater risk than a larger component. Furthermore, some say cosmetics may contain molecules like a silicone fluid called cyclopentasiloxane that are even smaller than nanomaterials.
===================
New Products Bring Side Effect: Nanophobia
(Page 2 of 2)
“I think it’s a double standard because nanoparticles are less likely to go through the skin than solutions where you are using single molecules,” said Robert S. Langer, a chemical engineering professor at the Massachusetts Institute of Technology in Cambridge. He is developing nanoparticles for the targeted delivery of cancer medications, and is a founder of Living Proof, a cosmetics company that makes hair products. “The molecules in a cream are certainly going to be smaller than a nanoparticle.”
The Food and Drug Administration does not require manufacturers to list the format of ingredients on labels. The agency does require cosmetics manufacturers to ensure that their products are safe for use; in 2006, the agency created its own task force to investigate the safety of engineered nanomaterials.
Ken Marenus, the senior vice president of regulatory affairs worldwide at the Estée Lauder companies, said nanomaterials had to undergo the same kind of assessment for exposure, risk and dosage levels as any other cosmetic component. “The same toxicological standards for every chemical will apply to nano,” he said.
Dr. Bailey of the Personal Care Products Council estimated that several thousand sunscreens and cosmetics currently use some kind of nanoscale component.
Cor soap, for example, uses 50-nanometer particles of silver combined with silica that are smaller than the size of a skin pore. The material is designed to enter the pores and kill bacteria.
“The silver suffocates the bacteria and then you rinse it off with water,” said Jennifer McKinley, the chief executive of Cor. Although a study has shown that nanosilver can permeate broken skin, Ms. McKinley said the soap was safe because it contains only a limited amount of nanosilver and the particles do not remain on the skin.
Indeed, using nanoderivatives of precious metals is becoming a trend. Last year, Chantecaille introduced Nano Gold Energizing Cream, a $420 face cream that contains 5-nanometer particles of 24-carat gold encapsulated in silk fibers. Sylvie Chantecaille, the chief executive of the company, said the capsules delivered the gold particles, which work as an antioxidant, into the surface layers of the skin. “It’s a very effective way to transport beneficial ingredients,” she said.
But many beauty companies are shying away from discussing minuscule particles in their cosmetics. And that kind of avoidance may itself stoke nanophobia. For example, when La Prairie introduced its Cellular Cream Platinum Rare earlier this year, the company sent out press materials promoting “nano-sized Hesperidin Smart Crystals to protect DNA” in the formula. But, in a phone interview, Sven Gohla, the company’s vice president for research and development, distanced the brand from nanotechnology. Just because the particles of hesperidin, a flavonoid, in the formula are small does not mean they are manufactured nanotechnology, he said.
Last month, a consumer group in London called Which? published a survey it had conducted of 67 cosmetics companies on the prevalence and safety testing of nanomaterials in personal care products. Only 17 companies responded, of which eight acknowledged using nanomaterials.
“When nanotechnology was hot, everybody wanted to talk about ‘nano this, nano that.’ Look at the iPod nano,” said Dr. Hansen of Consumers Union. “But now that the concerns have come out, people are not so sure the word nano is a good thing to be touted.”
-
A Coat of Many Proteins May Be This Parasite’s Downfall
NYT
By NICHOLAS WADE
Published: December 15, 2008
If you return from a trip abroad to find you have projectile vomiting, roaring flatulence, sulfurous belching and explosive diarrhea, the bad news is that you won’t die; you just have an attack of giardiasis, a form of purgatory devised by the single-celled parasite known as giardia.
SHIFTY When giardia must wear all its 190 coat proteins at once instead of selecting one and changing it often, it cannot hide from the immune system.
Giardia infections can linger for months because the parasite plays a cunning defense against the body’s immune system. In its genomic wardrobe, it has 190 coats to choose from. As soon as the immune system has generated antibodies against one coat, giardia switches to another. Because of the parasite’s persistence and infectivity, some 280 million cases of giardiasis occur in the world each year, the World Health Organization estimates, though most of these are in developing countries where people are more inured to the disease.
Giardia’s offensive game could have a fatal weakness, however. Biologists led by Hugo D. Luján at the Catholic University of Córdoba in Argentina have gained a striking insight into its coat-shuffling stratagem.
With this knowledge, they have accomplished a cunning counterploy: they have forced the parasite to make and wear all its coat proteins at the same time. This altered parasite, they hope, should serve as the perfect vaccine, because it immunizes the body to the full repertoire of giardia’s coat proteins all at once. The idea has worked well in animal tests, Dr. Luján said.
He thinks the same general approach — forcing expression of all coat proteins simultaneously — might help produce vaccines against the other protozoan parasites that rely on coat switching to dodge the immune system. These include malaria and the trypanosomes that cause sleeping sickness and Leishmaniasis.
Dr. Luján and his team have identified the mechanism by which giardia controls its coat proteins, they report in the current issue of Nature. Each of the parasite’s 190 coat genes is the recipe for making a different protein, and the parasite switches its coat every 10 generations or so. To produce the coat, giardia does not switch these genes on one at a time, as might be expected. Instead, it seems to leave them all turned on, allowing each to generate a messenger RNA copy of itself. Usually the messenger RNAs would direct the synthesis of proteins, but giardia then destroys all but one of the messengers, and the survivor makes the coat of the day.
To kill its messenger RNAs, giardia has adapted an ancient cellular system known as RNA interference. The system is designed to destroy foreign RNA, like that of invading viruses, so it was surprising to find it regulating a cell’s own RNAs, Dr. Luján said.
He proved this was the case by disrupting giardia’s production of enzymes, like those known as Dicer and Argonaute, that are components of the RNA interference system. With its RNA selection system out of business, giardia produces many — Dr. Luján believes probably all — of the coat proteins in its repertoire and inserts them into its outer covering.
He said he did not yet know how the organism shifted between coats but suspected that the RNA interference system favored whichever messenger RNA happened to be the most abundant at the time, and destroyed all others.
In an experiment that has not yet been published, Dr. Luján has tested gerbils, the laboratory animal often used in giardia work, with a vaccine consisting just of giardia with its RNA interference system blocked. “We saw complete protection,” he said.
Dr. Theodore E. Nash, a leading expert on giardia at the National Institutes of Health, said the new report was “a major advance in the field.” Since 1979, Dr. Nash has developed many of the methods to study giardia and its coat shuffling, several of which were used by Dr. Luján, who worked for five years in Dr. Nash’s lab.
Another giardia expert, Dr. Rodney Adam of the University of Arizona, said Dr. Luján’s work on giardia’s coat gene control was interesting “but not the whole story.” As for making a vaccine, he said that “this is not an organism to which natural infection will confer immunity.” People in developing countries may get one infection after another, although they do get a much less severe form of the disease.
Malaria also evades the immune system by switching its protein coat. Dr. Kirk Deitsch, an expert on malaria coat genes at the Weill Cornell Medical College, said Dr. Luján’s new finding “may be conceptually applicable to malaria,” although the malaria parasite does not use RNA interference and no one yet knows how to make it display all its 60 coat protein genes at once.
A human vaccine for giardia could be of great benefit if the many mild cases in the developing world do in fact undermine health. Some experts believe persistent giardia infection causes malnutrition, but others are less sure of this.
For the much smaller number of Westerners who are not inured to the disease, a vaccine would be a welcome addition to the few available drugs. It would have been a godsend for the Crusaders, who are known from historical accounts to have suffered terribly from a variety of intestinal diseases that had no respect for rank. In 1249 King Louis IX, who led the Seventh Crusade, had such serious diarrhea that part of the monarch’s breeches were cut away to ease his personal hygiene. Giardia may well have been his tormentor. Using a sensitive immunological test, researchers who excavated a medieval latrine in the city of Acre, once part of the Crusader kingdom of Jerusalem, detected the presence of giardia, they reported in the July issue of The Journal of Archaeological Science.
Giardia itself is far more ancient than any Crusader kingdom. Though a single-celled organism, it belongs to the eukaryotes, the domain that includes all plants and animals. In the tree of eukaryotic life, giardia belongs to one of the earliest branches. It lacks mitochondria, the energy-producing organelles that are almost a badge of eukaryote identity. Even stranger, each giardia cell possesses two nuclei; no one knows what benefit offsets the cost of maintaining the second. Before this enigmatic microbe plagued people, it was doubtless the scourge of many earlier species. Dr. Luján’s discovery may be a critical step in curbing giardia’s merciless torment of its fellow eukaryotes.
-
Predicting pandemics: HealthMap.org tracks emerging hot spots in real time
December 24th, 2008 in Medicine & Health / Diseases
Enlarge
Disease outbreaks appear on the HealthMap as yellow push-pins. When the user clicks on a particular push-pin, a window opens with links to information about a disease outbreak report.
(PhysOrg.com) -- At the end of July 2008, major news agencies reported an outbreak of jalapeño-related salmonella that sickened more than 1,000 people in Mexico and the United States. It was the biggest outbreak of its kind in decades.
Two months earlier, HealthMap.org had flagged the uptick in gastrointestinal illness, which signaled the emergence of a novel strain of salmonella. HealthMap had culled the information from a story that appeared in a local newspaper in New Mexico. HealthMap’s warning was a little yellow balloon that popped onto the site’s map, linking it to the news story. The Centers for Disease Control and Prevention (CDC) had yet to make an announcement.
HealthMap.org was launched in 2006 by epidemiologist John Brownstein, a Harvard Medical School assistant professor of pediatrics based in the Informatics Program at Children’s Hospital Boston, and software developer Clark Freifeld of the Informatics Program. Today it combs 24,000 Web sites per hour, tracking and mapping 75 infectious diseases, including malaria, cholera, plague, Ebola, avian flu, and the ominous-sounding “not yet classified.” Receiving about 30,000 hits a month, HealthMap’s most frequent visitors are the World Health Organization and the CDC, who check the site daily.
A visit to the site reveals red and yellow warnings popping up across the continents. “If you look at the map, you see that no place is protected from diseases,” said Brownstein. “Infectious disease is a major problem in the developing world, but the emergence of diseases is a huge public health threat everywhere, especially with the impact of being able to travel to any point in the world in a day. Diseases don’t respect borders.”
Brownstein and Freifeld started HealthMap as an unfunded side project. Frustrated by privacy issues regarding the use of clinical data, Brownstein approached Freifeld to see how they could tap into publicly accessible information to paint a real-time picture of outbreaks of contagious disease.
“We were thinking about all the information that exists on the Web in an unorganized sense,” said Brownstein. “Information is distributed across different types of data sources and different types of Web sites, and we thought, what if we tried to organize that information and make it freely available on a simple interface like a map?”
Freifeld built a Web-crawler that seeks key words about diseases, symptoms, and locations from local newspapers, news feeds, and blogs. One of the biggest tasks was creating a dictionary of diseases, names, and locations.
“The dictionaries needed constant refining,” said Freifeld. “For example, Crimean-Congo hemorrhagic fever is a tick-borne disease. Initially, when the program picked up any references to the disease, it put the alert in the Congo. To avoid this problem, we created a string of words to label the disease, so the program would not confuse the disease with the location.”
The site merges this data with clinical reports created by content partner ProMED-mail. ProMED members all over the world generate and upload public health information. By blending clinical data from the frontlines with automatically generated information, the site achieves Brownstein’s goals of timeliness and accuracy. The map interface displays emerging patterns geographically, giving visitors greater insight into where epidemics are most likely to spread.
With so much information being processed so rapidly, there are bound to be a few quirks. “A horse named Antarctica had equine herpes,” said Brownstein, “which led the program to detect an outbreak of herpes in Antarctica, which of course was wrong.”
Soon after the site launched, it generated attention when an article titled “Get Your Daily Plague Forecast” appeared in Wired Magazine (Oct. 19, 2006). Brownstein and Freifeld landed a grant from Google.org and obtained funding from the CDC to expand the site. They added new diseases and more news sources and increased the number of searched languages, a feature that was necessary to create a global tool. Today, the program searches for information in English, French, Spanish, Chinese, and Russian. Portuguese and Arabic will be added in the next few months, followed by Khmer, Malay, and Thai.
The CDC is one of the site’s biggest users. The agency incorporates information from HealthMap into the daily reports they distribute to public health leaders all over the world. Jean O’Connor, policy officer for the Office of Critical Information Integration and Exchange at the CDC, is enthusiastic about HealthMap’s potential to aid public health officials in prevention efforts. “HealthMap was really the first Web site to take informal public health information and anecdotal reports and make it possible for a public health leader to look at all of those pieces of information globally,” said O’Connor. O’Connor also noted that the site’s display of disease outbreaks among domesticated animals and wildlife can help pinpoint potential threats, since many diseases spread from animals to people.
The New England Journal of Medicine started using the site recently. "We just added HealthMap to the tools we use for gathering health-related news from around the world," said Stephen Morrissey, managing editor of the New England Journal of Medicine. "The geographic interface is extremely useful, and we look forward to seeing whether this approach will alert us earlier to important events that should be brought to the attention of physicians and health policy experts."
Brownstein and Freifeld are off to Geneva this month to consult with the World Health Organization on another project, and hope to gain insight into how that organization is using HealthMap while they’re there.
Brownstein’s passion for public health was ignited during a semester spent in Africa as an undergraduate in 1998. “I went to Kenya and Uganda, where I spent a lot of time in the field studying wildlife,” said Brownstein. “I began to realize the incredible impact infectious diseases have on human populations, things like malaria and HIV, the linkage between infectious diseases and the environment, and how human encroachment into wildlife areas led to the emergence of infectious diseases. Almost every infectious disease you can look at, at one point came out of an animal population.”
Today, with a second Google grant, Brownstein envisions the site moving beyond its role as an information provider to becoming an engaged, online community. “Everyone is talking about social networks like Facebook. HealthMap will be a social network of disease experts engaged in the global public health good,” said Brownstein. “The real vision is that we are going to be much more integrated with our user base. We will be relying on people reporting, commenting, and verifying outbreaks that are happening. They will really be interacting with the data, collaborating with the data, and making use of it.”
On the Web: http://www.healthmap.org/en
Provided by Harvard University
-
World's oldest woman dies in Portugal aged 115
I keep telling my elderly we are going for the record of 122 and take back the title for world's oldest person (a woman) from the French (oldest man was Japanese). But...
None of my patients want to live that long.
***LISBON, Portugal (AP) - A woman who lived to see five of her great-great grandchildren born and was believed to have been the world's oldest person living, has died in northwest Portugal at the age of 115, officials said Friday.
Maria de Jesus, who was born September 10, 1893 and was listed by the Guinness Book of World Records and the Gerontology Research Group as the world's oldest person, died in an ambulance near the town of Tomar.
De Jesus, who outlived three of her six children, had 11 grandchildren and 16 great-grandchildren, had eaten breakfast normally but was being taken to hospital because of a swelling, her daughter Maria Madalena told state news agency Lusa.
Corvelo Sousa, president of the town council of Tomar, 66 kilometers (40 miles) north of the port city of Porto, confirmed the death.
"I regret the death of this lady, she really was the sweetest person," said Tomar town councilor Ivo Santos.
De Jesus was left a widow when she was 57 and lived to reach 115 years and 114 days.***
-
Personal Health
Babies Know: A Little Dirt Is Good for You
E-Mail
Print
Reprints
Share
Linkedin
Digg
Facebook
Mixx
By JANE E. BRODY
Published: January 26, 2009
Ask mothers why babies are constantly picking things up from the floor or ground and putting them in their mouths, and chances are they’ll say that it’s instinctive — that that’s how babies explore the world. But why the mouth, when sight, hearing, touch and even scent are far better at identifying things?
When my young sons were exploring the streets of Brooklyn, I couldn’t help but wonder how good crushed rock or dried dog droppings could taste when delicious mashed potatoes were routinely rejected.
Since all instinctive behaviors have an evolutionary advantage or they would not have been retained for millions of years, chances are that this one too has helped us survive as a species. And, indeed, accumulating evidence strongly suggests that eating dirt is good for you.
In studies of what is called the hygiene hypothesis, researchers are concluding that organisms like the millions of bacteria, viruses and especially worms that enter the body along with “dirt” spur the development of a healthy immune system. Several continuing studies suggest that worms may help to redirect an immune system that has gone awry and resulted in autoimmune disorders, allergies and asthma.
These studies, along with epidemiological observations, seem to explain why immune system disorders like multiple sclerosis, Type 1 diabetes, inflammatory bowel disease, asthma and allergies have risen significantly in the United States and other developed countries.
Training the Immune System
“What a child is doing when he puts things in his mouth is allowing his immune response to explore his environment,” Mary Ruebush, a microbiology and immunology instructor, wrote in her new book, “Why Dirt Is Good” (Kaplan). “Not only does this allow for ‘practice’ of immune responses, which will be necessary for protection, but it also plays a critical role in teaching the immature immune response what is best ignored.”
One leading researcher, Dr. Joel V. Weinstock, the director of gastroenterology and hepatology at Tufts Medical Center in Boston, said in an interview that the immune system at birth “is like an unprogrammed computer. It needs instruction.”
He said that public health measures like cleaning up contaminated water and food have saved the lives of countless children, but they “also eliminated exposure to many organisms that are probably good for us.”
“Children raised in an ultraclean environment,” he added, “are not being exposed to organisms that help them develop appropriate immune regulatory circuits.”
Studies he has conducted with Dr. David Elliott, a gastroenterologist and immunologist at the University of Iowa, indicate that intestinal worms, which have been all but eliminated in developed countries, are “likely to be the biggest player” in regulating the immune system to respond appropriately, Dr. Elliott said in an interview. He added that bacterial and viral infections seem to influence the immune system in the same way, but not as forcefully.
Most worms are harmless, especially in well-nourished people, Dr. Weinstock said.
“There are very few diseases that people get from worms,” he said. “Humans have adapted to the presence of most of them.”
Worms for Health
In studies in mice, Dr. Weinstock and Dr. Elliott have used worms to both prevent and reverse autoimmune disease. Dr. Elliott said that in Argentina, researchers found that patients with multiple sclerosis who were infected with the human whipworm had milder cases and fewer flare-ups of their disease over a period of four and a half years. At the University of Wisconsin, Madison, Dr. John Fleming, a neurologist, is testing whether the pig whipworm can temper the effects of multiple sclerosis.
In Gambia, the eradication of worms in some villages led to children’s having increased skin reactions to allergens, Dr. Elliott said. And pig whipworms, which reside only briefly in the human intestinal tract, have had “good effects” in treating the inflammatory bowel diseases, Crohn’s disease and ulcerative colitis, he said.
How may worms affect the immune system? Dr. Elliott explained that immune regulation is now known to be more complex than scientists thought when the hygiene hypothesis was first introduced by a British epidemiologist, David P. Strachan, in 1989. Dr. Strachan noted an association between large family size and reduced rates of asthma and allergies. Immunologists now recognize a four-point response system of helper T cells: Th 1, Th 2, Th 17 and regulatory T cells. Th 1 inhibits Th 2 and Th 17; Th 2 inhibits Th 1 and Th 17; and regulatory T cells inhibit all three, Dr. Elliott said.
“A lot of inflammatory diseases — multiple sclerosis, Crohn’s disease, ulcerative colitis and asthma — are due to the activity of Th 17,” he explained. “If you infect mice with worms, Th 17 drops dramatically, and the activity of regulatory T cells is augmented.”
In answer to the question, “Are we too clean?” Dr. Elliott said: “Dirtiness comes with a price. But cleanliness comes with a price, too. We’re not proposing a return to the germ-filled environment of the 1850s. But if we properly understand how organisms in the environment protect us, maybe we can give a vaccine or mimic their effects with some innocuous stimulus.”
Wash in Moderation
Dr. Ruebush, the “Why Dirt Is Good” author, does not suggest a return to filth, either. But she correctly points out that bacteria are everywhere: on us, in us and all around us. Most of these micro-organisms cause no problem, and many, like the ones that normally live in the digestive tract and produce life-sustaining nutrients, are essential to good health.
“The typical human probably harbors some 90 trillion microbes,” she wrote. “The very fact that you have so many microbes of so many different kinds is what keeps you healthy most of the time.”
Dr. Ruebush deplores the current fetish for the hundreds of antibacterial products that convey a false sense of security and may actually foster the development of antibiotic-resistant, disease-causing bacteria. Plain soap and water are all that are needed to become clean, she noted.
“I certainly recommend washing your hands after using the bathroom, before eating, after changing a diaper, before and after handling food,” and whenever they’re visibly soiled, she wrote. When no running water is available and cleaning hands is essential, she suggests an alcohol-based hand sanitizer.
Dr. Weinstock goes even further. “Children should be allowed to go barefoot in the dirt, play in the dirt, and not have to wash their hands when they come in to eat,” he said. He and Dr. Elliott pointed out that children who grow up on farms and are frequently exposed to worms and other organisms from farm animals are much less likely to develop allergies and autoimmune diseases.
Also helpful, he said, is to “let kids have two dogs and a cat,” which will expose them to intestinal worms that can promote a healthy immune system.
-
Coming health care "reforms" will likely be couched in comparative outcome schemes that pretend an empirical methodology, but which in fact fully embrace the perverse incentives government regulation already imposes on the health sector. This piece charts how this scheme has impacted other national health systems.
February 4, 2009
Comparative Effectiveness in Health Care Reform: Lessons from Abroad
by Helen Evans, Ph.D.
Backgrounder #2239
President Barack Obama has proposed the creation of an Institute for Comparative Effectiveness as a key component of an ambitious health care reform.[1] The institute would have the authority to make official determinations of the clinical effectiveness and cost-effectiveness of medical treatments, procedures, drugs, and medical devices.
President Obama's initial nominee as Secretary of Health and Human Services (HHS), former Senator Tom Daschle (D-SD), has likewise proposed the creation of a supremely powerful Federal Health Board, which would have similar authority to make decisions that would be binding on health plans and providers financed by federal taxpayers, and potentially on private health insurance coverage.[2] While Senator Daschle has withdrawn his name from Senate consideration, the concept of such a board or institute is strongly indicative of the Obama Administration's policy orientation toward centralized health policy decision-making.
The U.S. House of Representatives has just passed the $850 billion American Recovery and Reinvestment Act (H.R. 1), the so-called economic stimulus bill, which would establish a Federal Coordinating Council for Comparative Effectiveness Research. The bill would provide $1.1 billion for the new council and delegate spending authority to the HHS Secretary to investigate the effectiveness of different drugs and medical devices.[3] The Senate version of the economic stimulus package contains a similar provision.
Of course, there is no reason why private-sector or government officials should not have access to the best information on what works and what doesn't. Nor is there any reason why such scientific evaluations should not be widely available to doctors and patients alike. But studies of the comparative effectiveness of medical devices, drugs, and technology should be conducted primarily within the private sector, and there should be no government monopoly over either the research or the distribution of information. The key issue is the personal freedom of patients to be able to choose the health care that, in the professional judgment of their doctors, best serves their personal needs.
Focus on Medical Technology. Technology, in particular, can be expensive. Over the past 20 years, health technology assessment (HTA)--the synthetic coordination of information assessing medicines and treatments--has become increasingly popular with policymakers and legislators around the world. Advocates of HTA invariably believe that such an approach has the capacity to provide decision-makers in the public and private sectors with objective information on the value of medical technologies, devices, and medicines. Driven by concerned perceptions of "unproven technology," "spiralling costs" and "increasing consumer expectations," its proponents aim to produce synthesized research information that they believe sheds light on the effects and costs of various forms of health technology.
Such an approach, however, would guarantee the incremental advance of government control of private medical decisions. While formally touted as an instrument of efficiency and effectiveness, it would distort scientific research in the service of political or budgetary objectives while denying individual freedom of choice. In that sense, this approach would serve as a propaganda tool designed to legitimize anti-consumerist rationing.
Comparative Effectiveness in Health Care: How It Started
The intellectual roots of effectiveness research can be traced back to mid-18th century Scotland and the "arithmetical medicine" practiced by the graduates of the Edinburgh medical school. It was there that James Lind famously undertook a controlled trial of six separate treatments for scurvy.[4] During the 1830s, Pierre Louis developed the méthode numérique in Paris, whereby he demonstrated that phlebotomy did not actually improve the survival rates of patients suffering from pneumonia.
At the beginning of the 20th century, Ernest Codman, an American physician, founded what is today known as "outcomes management" in patient care. Shunned by established institutions, he set up his own unit, the End Result Hospital. In line with his teachingsand the findings from this unit, end results were made public in a privately published book, A Study in Hospital Efficiency.[5] Of 337 patients discharged from the hospital between 1911 and 1916, Codman recorded and publicized 123 errors.
In England, the 1930s saw the development of health services research. In a world increasingly obsessed with egalitarian uniformity, J. A. Glover found a tenfold variation in tonsillectomy.[6] Subsequently, following several decades of socialized health care in the United Kingdom, the 1970s and 1980s witnessed the release of a range of studies that highlighted wide geographical variations in general medical admissions including operations such as appendectomy, caesarean section, cholecystectomy, hysterectomy, tonsillectomy, and prostatectomy.[7] Such variations not only demonstrated the inequities of the National Health Service (NHS), but also raised questions about the probity and cost-effectiveness of many of its treatments.
Following the publication of Archie Cochrane's Effectiveness and Efficiency: Random Reflections on Health Services[8] in the United States, researchers demonstrated large variations in the rates of prostatectomy for patients with benign prostatic hyperplasia.[9] This work and others suggested that such variations "meant either under-provision in some places and/or over-provision (and possibly ineffective treatment) in others."[10] While "comparative effectiveness" builds on skepticism, the investigation of variations, randomized control trials, and cost-benefit analysis, its reviews purport to be systematic. As such, they attempt to go beyond the more narrative-based reviews that used to dominate the typical review article in medical literature.
Comparative Effectiveness: The Rationale
In recent decades, health care has advanced in significant ways. Across the developed world, not only has medical knowledge progressed, but investment in equipment and drugs has delivered unprecedented gains. Treatments are safer and more effective than ever before. Quality of life and life expectancy have been enhanced. Alongside aging populations has come the world of ever-increasing consumer expectations.
The rapid growth of medical knowledge and technology means it is much harder for doctors and other health care providers to keep up to date. Indeed, the problem of information and practice transference is rendered almost impossible by the fact that health care is now a highly statist and corporatist venture. Today, there is no such thing as a free market in health care, and many of the problems popularly associated with it are in fact the result of state failure.
Today, in virtually every country in the world, health care is heavily influenced by government policy and fosters professional monopoly of supply and strict top-down regulation.[11] While there is nothing inherent in health care that guarantees such an outcome, governments, either actively or passively, grant special legislative favor to interest groups when it comes to people's medical treatments and insurance.
The idea that government is intrinsically a superior agent, over and above a spontaneous and free market, is groundless. As David Friedman, a professor of law at Santa Clara University in California, has argued, both the notion of market failure in health economics and its popularity with most opinion leaders have arisen because many health policy analysts "interpret the problem in terms of fairness rather than efficiency."[12] This almost unconscious adherence to the notion of market failure in health care is rooted in:
the error of judging a system by the comparison between its outcome and the best outcome that can be described, rather than judging it by a comparison between its outcome and the outcome that would actually be produced by the best alternative system available. If, as seems likely, all possible sets of institutions fall short of producing perfect outcomes, then a policy of comparing observed outcomes to ideal ones will reject any existing system…. The question we should ask, and try to answer, is not what outcome would be ideal but what outcome we can expect from each of various alternative sets of institutions, and which, from that limited set of alternatives, we prefer.… My conclusion is that there is no good reason to expect government involvement in the medical market, either the extensive involvement that now exists or the still more extensive involvement that many advocated, to produce desirable results.[13]
Curiously, it is within the context of government control and anti-competitive corporatism that new and innovative medical treatments are met with initiatives for even more rationing by government officials, as well as other highly regulated players including private medical insurers. In recent years, many countries have introduced comparative effectiveness or HTA programs, ostensibly to improve their decision-making and their allocation of relatively scarce medical resources. In reality, many politicians and officials have done so not least because they are trying to get themselves off the hook of past promises they made concerning the provision of comprehensive, unlimited, or, as in the case of the United Kingdom, seemingly "free" health care at the point of service.
Since extensive government intervention has distorted health care markets and has made it impossible for individuals to determine a clear and transparent value of the costs and benefits of health care technology through a normally functioning price system, the proponents of comparative effectiveness, or health technology assessment, have instead resorted to a predictably pseudoscientific methodology to give their bureaucratic determinations a sheen of objectivity. As with other forms of centralized government planning, the practitioners of these bureaucratic arts attempt to capture and mathematically profile and model their assessments; in assessing health technology, they seek "to compare and prioritize new technologies based on different units that aggregate…benefits."[14]
In a study of HTA for the Stockholm Network, a prominent European think tank, research has focused on these assessments in terms of the value of human life:
In HTA, the dominant aggregate natural unit is called quality-adjusted life years (QALYs). Generally, QALYs factor in both the quantity and the quality of life generated by new health care interventions. It is the arithmetic calculation of life expectancy and a measure of the quality of the remaining life years…. To date QALYs are the preferred indicator of HTAs calculations, although one may find additional tools in use by HTA bodies such as HRQol ("health related quality of life," which considers physical function, social function, cognitive function, distress, pain: in brief, anything to do with quality of life), DALYs ("disability life adjusted years"--of life lost due to premature mortality in the population and the years lost due to disability for incidents of the studied health condition), and healthy-year equivalents (HYEs).[15]
Despite the pretense of scientific objectivity, this type of health technology assessment is nothing of the sort. It is designed primarily to provide policymakers with a legitimizing rubric by which they can mimic a few elements of the market and therefore deploy a degree of fake economic rationality in justifying their decisions. In this way, practitioners of HTA attempt to balance the requirement to provide innovative health care technologies with ham-fisted efforts at controlling the costs of those technologies.
Consider the quality of human life and lifespan. The use of QALYs is pseudoscience. It is nothing more than a tool for central planning that attempts to objectify what is inherently subjective. The limited attempts to capture accurately the various "units of healthcare benefit" mean that there is an inevitable gulf between the theoretical underpinnings of QALYs and the actual behavior of ordinary people. Moreover, the artificial prioritization of so-called cost-based considerations by practitioners of health technology assessment is invariably made at the expense of other considerations. As Dr. Meir Pugatch and Francesca Ficai of the Stockholm Network note, "Thus, a decision to prioritize a less therapeutically effective medicine because of cost-based considerations over an effective, but more expensive, medicine could lead to some serious political, social and moral dilemmas."[16]
Not only is this type of health technology assessment methodologically flawed: It is incompatible with personal freedom and contradicts the subjective choices of genuine economic agents. When deployed at the national level through the power of a government agency, it is inevitably subject to additional political pressures. Indeed, in 2009, it is clear that national organizations that conduct these assessments--such as the National Institute for Health and Clinical Excellence in the United Kingdom or the Institute for Quality and Efficiency in Health Care in Germany--are in the business of rationing health care technologies so that they mesh with the politically fixed budgetary allocations of the national government.
Today, it is clear that the political economy of these government bodies means that their structures, processes, and pseudoscientific constructs have a significant and detrimental impact on the practice of, and even the public discourse on, health care. Far from reflecting scientific rationality and economics, health technology assessments often reflect either politically driven social judgments of the decision-makers in these agencies or, worse, a thinly veiled attempt to accommodate whatever political pressures happen to be momentarily dominant.
-
How Comparative Effectiveness Works in Europe
According to the International Network of Agencies for Health Technology Assessments (INAHTA),[17] many industrialized countries have bodies that are charged with health technology assessments or comparative effectiveness studies. Despite this, the evolution of these bodies and their responsibilities at the national decision-making level has been far from uniform.
For example, some of these bodies have an advisory role. They make reimbursements or pricing recommendations to a national or regional governing body, as is the case in Denmark. Others have a more explicit regulatory role. They are accountable to government ministers and are responsible for listing and pricing medicines and devices. This is the case in France, Germany, and the United Kingdom.
The United Kingdom. The experience of the United Kingdom in making the difficult decisions about what kind of health care technologies, devices, drugs, and medical treatments and procedures should be favored in Britain's National Health Service has been cited favorably by Senator Daschle.
The NHS was established in 1948. It is a single-payer health care system, directly administered by the British government, funded through taxation, and provided mainly by public-sector institutions. Because the NHS is a fully nationalized entity, the central government specifies the capital and current budgets of its regional health authorities and determines the expenditure on drugs by controlling the budgets given to each general practitioner. Overall, NHS health care is rationed through long waiting lists and, in some cases, omission of various treatments.[18]
For the British government, the practice of HTA facilitates rationing by delay. It is a tool that aims to ensure that expensive new technologies are initially provided only in hospitals that have the technical capacity to evaluate them. While the NHS Research and Development Health Technology Assessment Programme is funded by the Department of Health and, according to its criteria, researches the costs, effectiveness, and impact of health technologies, the Medicines and Healthcare Products Regulatory Agency (MHRA) ensures that drugs and devices are safe.[19]
In 1999, the government went a step further and set up the National Institute of Health and Clinical Excellence (NICE).[20] At its heart is the Centre for Health Technology Evaluation that issues formal guidance on the use of new and existing medicines based on rigid and proscriptive "economic" and clinical formulas. With the NHS obliged to adhere to NICE's pronouncements, criticism of NICE has been ceaseless, particularly from various patient organizations.
NICE is a controversial body. It has tried repeatedly to stop breast cancer patients from receiving the powerful breakthrough drug Herceptin and patients with Alzheimer's disease from receiving the drug Aricept. The criteria by which this agency makes its decisions have been kept largely secret from the public. As is inevitable with any nationalized health care system, life-extending medicines such as those to treat renal cancers are refused on the grounds of limited resources and the need to make decisions based not on genuine market economics but on an artificial assessment of the benefit that may be gained by the patient and society "as a whole."
In 2001, NICE deliberately restricted state-insured sufferers of multiple sclerosis from receiving the innovative medicine Beta Interferon. Claiming that its relatively high price jeopardized the efficacy of the NHS, patients with the more severe forms of the disease were told that they would have to go on suffering in the name of politically defined equity.[21]
In more recent years, patients with painful and debilitating forms of rheumatoid arthritis have been informed by NICE that in many instances they will not be allowed to receive a sequential range of medicines that have often been proved to be of significant benefit. Instead, the institute decreed that "people will be prevented from trying a second anti-TNF treatment if the first does not work for their condition."[22]
Similarly, in August 2008, patients with kidney cancer continued to be denied effective treatments designed to prolong their lives, often by months or even a few years. The calculations used by NICE have been systematically disputed by clinical experts who are more concerned with patient welfare than with vote-seeking, but the institute has also come under fire for not involving doctors who are active on the front line of medicine: "With Sutent for instance, there was just one oncologist on the panel."[23]
In January 2009, patients with osteoporosis also fell foul of NICE. The institute declared that only a small minority of patients with this debilitating disease would receive the medicine Protelos, and even they would receive it only as an extreme last resort. While clinicians and osteoporosis support groups have pointed out that more than 70,000 hip fractures result in 13,000 premature deaths in the U.K. each year and that these otherwise avoidable episodes needlessly cost the NHS billions of pounds, not only are patients being denied necessary treatments, but taxpayers' money is wasted.[24]
Indeed, according to its annual reports and accounts, NICE is now spending more money on communicating its decisions than would be spent if it allowed patients access to many of the medicines it is so busy denying them. The money that the institute now spends on public relations campaigns "could have paid for 5,000 Alzheimer's sufferers to get £2.50-a-day drugs for a year," according to The Daily Mail.[25]
Devoid of a market and the language of price, this top-down system ironically ignores many of the societal costs associated with failure to treat severe illness, such as illness-related unemployment. Moreover, the fact that preventing access to more costly medicines may save money in the short term overlooks the costs for the future. If older medicines lead to more rapid deterioration of a condition, the effect could be a more expensive hospital or nursing home episode later.
Denmark. The Danish health care system is completely state-funded, with public provision of hospital beds representing more than 90 percent of thehospital sector. Under the Healthcare Act, citizens are covered for all or part of expenditures for treatment, including reimbursement for all pharmaceutical products listed with the Danish Medicines Agency. Therefore, there is no need for price regulation of drugs. With central and municipal government having significant control of the funding and provision of health care, the acquisition of new technology is left initially to the five regions that run the hospitals.
Denmark's national HTA system was explicitly established on the basis of its making prioritized resource-allocation decisions. Carried out by the unit known as the Danish Centre for Evaluation and Health Technology Assessment (DACEHTA), it operates within the framework of the National Board of Health (NBH), itself a part of the Danish Ministry of Health.[26] In reality, this means that "[t]he Ministry keeps a close watch on it in order to neutralize 'expensive' healthcare technologies, as their adoption results in requests for extra funding from the regions."[27]
France. In France, health care is a statutory right enshrined in the Constitution of the Fifth Republic. Unlike in Denmark or the United Kingdom, however, French health care is financed mainly by social insurance and delivered by a mixture of public and private providers. While two-thirds of French hospitals are state-owned, one-third are private, with half of the latter group being not-for-profit.
There have been various attempts in recent years to extend government control of health care costs. In 1991, the French government extended its Health Map system by which it controls the capital construction of all hospitals as well as their budgets, the purchase of medical equipment, the rates charged by private hospitals, the number of pharmacies per head, and even the price of drugs.[28]
In 2005, the government went a stage further with the establishment of a centralized High Health Authority. While this body has had only a limited impact--and France continues to enjoy a comparatively higher diffusion rate for new technologies than is found in many other countries in Europe--it is nevertheless designed to stipulate the benefits of medicines and determine their price-reimbursement levels. As such, it is set to raise the focus on cost-containment and bring its decision-making under closer state control.
Germany. As in France, health care in Germany is financed primarily by social insurance and provided by a mixture of public and private providers. While all services are contracted instead of being provided directly by the government, more than 10 percent of Germans opt for full private medical insurance.[29] Providing a potent source of exit from the state, the regulated private sector puts pressure on the government to ensure that the sectoral differences in service do not become so wide that ever-larger numbers of young, high-income consumers defect by going private and delegitimizing a central pillar of the Bismarckian philosophy.
While the pressure to maintain some semblance of parity with the private sector meant that state spending rose dramatically for many years after the introduction of a formal reference pricing system in 1989, the strategic objective of the German Ministry of Health has been to reduce supply, particularly through the use ofpublished positive and negative lists concerning medicines and treatments. Through these lists, pressure is applied to the statutory sick funds to control costs.[30]
It is in this context that health technology assessment has played an ever-greater role in German health policy since the 1990s. In 1990, the Office of Technology Assessment at the German Parliament (TAB) was established, and in 2004, the government set up the Institute for Quality and Economic Efficiency in the Healthcare Sector (IQWiG).
Tasked with the central goal of efficiency, IQWiG investigates and stipulates which therapeutic and diagnostic services are appropriate.[31] Disseminating its pronouncements to various self-governing bodies, its information is used concerning the coverage of technologies in the benefits catalogue. With such ventures being funded primarily by the German Ministry for Health and Social Affairs, assessment bodies can refuse a hospital's claim for reimbursement for the unauthorized use of new technology.
Lessons for American Policymakers
There is a pervasive European mythology: a widespread belief that American health care is rooted in the free market. In reality, much of American health care is a highly planned, regulated, and government-funded system. Through major entitlement and welfare programs such as Medicare and Medicaid, which contribute to rapidly growing American health care costs, government takes a historically higher proportion of gross domestic product than does even the British NHS. Moreover, by virtue of the structure and financing of private-sector health insurance, there is little consumer control over health care dollars.
Nonetheless, the United States is not only a major consumer of health care services, but also the world's largest producer of medical technology. Investment in new medical technology is comparatively high, as is its rate of diffusion: "This is demonstrated by cross-national examinations of the comparative availability of selected medical technologies such as radiation therapy and open-heart surgery. Measured in units per million, the United States experiences levels of availability up to three times greater than in Canada and Germany."[32]
During the presidential campaign, Barack Obama proposed an Institute for Comparative Effectiveness that would make formal recommendations on medical technologies, devices, and drugs. In Congress, champions of comprehensive overhaul of U.S. health care favor policies that would explicitly accelerate America's trajectory downward toward a European-style medical interventionism.
Fearing the impact of the rising costs of Medicare, Medicaid, and the highly regulated arrangements of the private insurance sector, many American legislators and other top policymakers are becoming attracted to the idea of a body that would make top-down pronouncements on the cost-effectiveness of new medical technologies. The idea of a statutorily created agency charged with system-wide cost containment and rationing of medical services and technologies is becoming surprisingly fashionable in Washington policy circles.
-
The implications of this trend are alarming for U.S. citizens, particularly when one considers that the technology a society uses reflects the wider and underlying incentive structures it adopts for using it: "An incentive structure that encourages providers to trade off the costs and benefits of health care gives providers little incentive to use expensive technologies and thus researchers will have little incentive to create it."[33]
In the long term, a statist, centralized control of medical technology offers little if any regulatory benefit. Through its own logic, it not only stifles innovation, but also, in doing so, ends up precluding those very inventions that could turn out to be of immeasurable benefit to individuals and to society in general.
If comparative effectiveness and health technology assessment especially are to be useful, they must be generated primarily by the private sector on a competitive and non-coercive basis. In avoiding the imposition of a uniformity of rules that comes with government intervention, physicians and other medical professionals would and should remain free to pick and choose from the best practices and professional insights into the treatment of medical conditions as they see fit (with, of course, the informed consent of their patients).
It is only by returning health care to a genuinely patient-centered and consumer-driven health care marketplace that information, innovation, and best practice will permeate the complex array of health care arrangements in both the public and the private sectors. It is only through open competition and the economic discipline of the free market that real progress and productivity can be secured.
Therefore, in framing a policy on comparative effectiveness, America's policymakers should be governed by four principles:
They should reject the statutory creation of a board, council, or institute that would centralize government control of patient access to drugs, devices, medical technologies, treatments, or procedures. This is especially the case if such an agency were to have the power to override the considered judgment of competing professional expertise, especially the professional judgment of a patient's attending physician.
Comparative effectiveness research and health technology assessments should be undertaken primarily by the private sector. While government can contribute to research efforts and promote the widespread availability of the best information, it must not exercise monopoly power over the conduct of research itself or the distribution of information.
Comparative effectiveness research should be patient-centered and supportive of quality and value, not focused simply on cost-containment. In this respect, it should foster scientific advances, health information technology, and the emerging science of personalized medicine.
Comparative effectiveness research must move beyond randomized clinical trials and embrace practical clinical trials. It should include observational data, and its methodologies should fully address issues such as the validity and applicability of findings.
Conclusion
As is clear from the British experience and other international examples, a comparative effectiveness strategy that relies on central planning and coercion would not only be counterproductive in the long run--because it would undermine the incentives for medical innovation--but would also lead to the imposition of cost constraints that would worsen patients' medical conditions and damage the quality of their lives.
Helen Evans, Ph.D., is a citizen of the United Kingdom. A registered general nurse, she is the Director of Nurses for Reform and a Health Fellow with the Adam Smith Institute of London, England.
[1]For a brief discussion of the Obama proposal, see Robert E. Moffit and Nina Owcharenko, "The Obama Health Plan: More Power to Washington," Heritage Foundation Backgrounder No. 2197, October 15, 2008, at http://www.heritage.org/research/healthcare/bg2197.cfm.
[2]For a brief discussion of Daschle's proposed Federal Health Board, see Senator Tom Daschle, with Scott S. Greenberger and Jeanne M. Lambrew, Critical: What We Can Do About the Health Care Crisis (New York: Thomas Dunne Books, 2008). See also Robert E. Moffit, "How a Federal Health Board Will Cancel Private Coverage and Care," Heritage Foundation WebMemo No. 2155, December 4, 2008, at http://www.heritage.org/research/healthcare/wm2155.cfm.
[3]The provision is included in Title IX of Subtitle B of the American Recovery and Reinvestment Act of 2009. According to the report language accompanying the House bill, "By knowing what works best and presenting this information more broadly to patients and health care professionals, those items, procedures, and interventions that are most effective to prevent, control and treat health conditions will be utilized, while those that are found to be less effective and in some cases, more expensive, will no longer be prescribed."
[4]Stephen R. Brown, Scurvy: How a Surgeon, a Mariner, and a Gentleman Solved the Greatest Medical Mystery of the Age of Sail (New York: St. Martin's Press, 2003).
[5]Ernest A. Codman, A Study in Hospital Efficiency (Boston, Mass.: Privately printed, 1916).
[6]J. A. Glover, "The Incidence of Tonsillectomy in School Children," Proceedings of the Royal Society of Medicine, Vol. XXXI (1938), pp. 1219-1236.
[7]D. Sanders, A. Coulter, K. McPherson, Variations in Hospital Admission Rates: A Review of the Literature (London: King Edward's Hospital Fund for London, 1989), p. 31.
[8]Archie Cochrane, Effectiveness and Efficiency: Random Reflections on Health Services (Leeds: Nuffield Provincial Hospitals Trust, 1972).
[9]J. E. Wennberg, A. G. Mulley, D. Hanley, et al., "An Assessment of Prostatectomy for Benign Urinary Tract Obstruction: Geographic Variations and the Evaluation of Medical Care Outcomes," JAMA, Vol. 259, No. 20 (1988), pp. 3027-3030.
[10]Andrew Stevens, Ruairidh Milne, and Amanda Burls, "Health Technology Assessment: History and Demand," Journal of Public Health Medicine, Vol. 25, No. 2 (1998), p. 99.
[11]Brian Micklethwait, "How and How Not to Demonopolise Medicine," Political Notes No. 56, Libertarian Alliance, London, 1991.
[12]David Friedman, "Should Medicine Be a Commodity? An Economist's Perspective," Philosophy and Medicine: Rights to Health Care, Vol. 38 (1991), at http://www.daviddfriedman.com/Academic/Medicine_Commodity/Me
dicine_Commodity.html (January 29, 2009).
[13]Ibid.
[14]Meir P. Pugatch and Francesca Ficai, "A Healthy Market? An Introduction to Health Technology Assessment," Stockholm Network, London, 2007, p. 5.
[15]Ibid.
[16]Ibid., p. 6.
[17]See INAHTA home page at http://www.inahta.org (January 30, 2009).
[18]Helen Evans, Sixty Years On--Who Cares for the NHS? (London: Institute of Economic Affairs, 2008), pp. 26-54.
[19]See MHRA home page at http://www.mhra.gov.uk (January 30, 2009).
[20]Pugatch and Ficai, "A Healthy Market? An Introduction to Health Technology Assessment," p. 8.
[21]"MS Research Urges End of NHS Bar on Drug," The Daily Telegraph, June 19, 2001.
[22]See press release, "NICE Limits Options for People with Rheumatoid Arthritis," Arthritis Cares, London, July 21, 2008.
[23]"Nasty Truth About NICE: It's the Body that Rations NHS Drugs. But This Leading Cancer Specialist Says Its Decisions Are Deeply Flawed," The Daily Mail, August 8, 2008.
[24]"NICE Decision to Block Osteoporosis Drug Access Was 'Irrational,'" The Daily Telegraph, January 20, 2009.
[25]"Drug Watchdog NICE 'Spends More on "Spin" than Tests on New Treatments,'" The Daily Mail, September 10, 2008, at http://www.dailymail.co.uk/health/article-1054049/Drug-watchdog-N
ICE-spends-spin-tests-new-treatments.html (January 30, 2009).
[26]See National Board of Health home page at http://www.sst.dk (January 30, 2009).
[27]Meir P. Pugatch and Helen Davison, "A Healthy Market? Health Assessment Technology in Context," Stockholm Network, London, 2007, p. 9.
[28]Brian Abel-Smith and Elias Mossialos, "Cost Containment and Health Care Reform: A Study of the European Union," London School of Economics and Political Science Occasional Paper in Health Policy No. 2, 1994, pp. 33-35.
[29]Pugatch and Davison, "A Healthy Market? Health Assessment Technology in Context," p. 10.
[30]Ibid., p. 11.
[31]Ibid.
[32]"American Democracy and Health Care," British Journal of Political Science, Vol. 27, No. 4 (October 1997), p. 573.
[33]Pugatch and Davison, "A Healthy Market? Health Assessment Technology in Context," p. 16.
http://www.heritage.org/Research/HealthCare/bg2239.cfm
-
Apparantly there are no laws governing in vitro fertilization. Usually medical malpractice is a civil liability. Since the lady with the loose screw has no apparant intention of claiming harn from the doctor who performed the procedure it would be up to the state llicensing board to sanction him or revoke his license as IMO they absolutely should do.
But it appears the "good" doctor is a tax fraud as well. So fortunately he may, afterall, get the jail time he deserves. His wife too:
Medical society probes octuplet fertility doctor By SHAYA TAYEFE MOHAJER, Associated Press Writer
Tue Feb 10, 6:55 PM ET
LOS ANGELES - A national medical society is investigating whether a fertility doctor followed its guidelines when he implanted six embryos into a Southern California woman who gave birth to octuplets last month.
The American Society for Reproductive Medicine confirmed Tuesday that it's investigating because Nadya Suleman says she received in-vitro fertilization for all 14 of her children at the same Beverly Hills fertility clinic.
Suleman, 33, told NBC's "Today" show that she was implanted with six embryos in each of her six pregnancies, resulting in four single births, a set of twins and the octuplets. No more than three embryos are considered the norm for a woman her age, and fertility experts and medical ethicists have been critical of the Jan. 26 birth of the octuplets.
The society has contacted Suleman and her doctor, and is prepared to assist the Medical Board of California, which is also looking into the pregnancy, the society's president, Dr. R. Dale McClure, said in a statement.
"Our guidelines provide the flexibility to give each patient treatment individualized to her needs, and her best chance to become pregnant without risking high-order multiple pregnancy," said McClure. "However, it seems that the guidelines may not have been followed in Ms. Suleman's case."
Neither the society or the medical board identified Suleman's physician, Dr. Michael Kamrava.
Kamrava, a specialist who pioneered a method of implantation, was identified Monday as a result of an NBC interview with Suleman, who said she went to the West Coast IVF Clinic in Beverly Hills and that all 14 of her children were conceived with help from the same doctor. In 2006, Los Angeles TV station KTLA ran a story on infertility that showed Kamrava, the center's director, treating Suleman and discussing embryo implantation.
Kamrava, 57, did not return calls seeking comment Monday or Tuesday. When confronted by reporters outside his clinic Monday, he said he had granted a television interview but would not give details.
The state medical board said last week it was looking into the Suleman case to see if there was a "violation of the standard of care." The medical board said it had not taken any previous disciplinary action against Kamrava.
Kamrava's clinic is a member of the Society for Assisted Reproductive Technology, a sister organization of the American Society for Reproductive Medicine.
Clinics that clearly violate guidelines can be kicked out of SART. Neither group is a regulatory agency so a removed doctor could still practice medicine.
The state medical board cannot close the clinic if it is found at fault, but it can censure the doctor, putting the violation on his record.
Kamrava's clinic performed 52 in-vitro procedures in 2006, according to the most recent national report compiled by the Centers for Disease Control and Prevention. Of those, five resulted in pregnancies and two in births. One of the births were Suleman's twins.
Kamrava's pregnancy rate that year was among the lowest in the country. Experts say many factors affect a clinic's success rate, including a patient's health and types of procedures done.
Several lawsuits have been filed against Kamrava over the past two decades, including one in which a former employee accused him and his wife of hiding income to avoid taxes and defrauding insurance companies.
Former office administrator Shirin Afshar sued Kamrava in 1998, claiming discrimination, harassment, wrongful termination and infliction of emotional distress.
Over a seven-year period, Afshar said, Kamrava and his wife didn't report about $400,000 in income to the state and the Internal Revenue Service. Afshar claims Kamrava made patients who had no insurance pay in cash and that money was turned over to Kamrava's wife. The transactions were neither entered into an office computer nor deposited in a bank, the lawsuit said.
She said she was fired when she complained to Kamrava about what was going on.
Afshar also claimed she had an abortion in 1992 because she feared she would lose her job. When she told Kamrava she was pregnant, she claims her boss chastised her.
"How can you take care of this baby with no job, no family and no money?" Afshar claimed Kamrava said.
The lawsuit was settled in 1999 for an undisclosed amount.
___
Associated Press Television News videographer John Mone and Associated Press Writers Alicia Chang, Thomas Watkins and Greg Risling contributed to this report.
-
Vitamin Pills: A False Hope?
By TARA PARKER-POPE
NYT
Published: February 16, 2009
Ever since the Nobel Prize-winning biochemist Linus Pauling first promoted “megadoses” of essential nutrients 40 years ago, Americans have been devoted to their vitamins. Today about half of all adults use some form of dietary supplement, at a cost of $23 billion a year.
But are vitamins worth it? In the past few years, several high-quality studies have failed to show that extra vitamins, at least in pill form, help prevent chronic disease or prolong life.
The latest news came last week after researchers in the Women’s Health Initiative study tracked eight years of multivitamin use among more than 161,000 older women. Despite earlier findings suggesting that multivitamins might lower the risk for heart disease and certain cancers, the study, published in The Archives of Internal Medicine, found no such benefit.
Last year, a study that tracked almost 15,000 male physicians for a decade reported no differences in cancer or heart disease rates among those using vitamins E and C compared with those taking a placebo. And in October, a study of 35,000 men dashed hopes that high doses of vitamin E and selenium could lower the risk of prostate cancer.
Of course, consumers are regularly subjected to conflicting reports and claims about the benefits of vitamins, and they seem undeterred by the news — to the dismay of some experts.
“I’m puzzled why the public in general ignores the results of well-done trials,” said Dr. Eric Klein, national study coordinator for the prostate cancer trial and chairman of the Cleveland Clinic’s Glickman Urological and Kidney Institute. “The public’s belief in the benefits of vitamins and nutrients is not supported by the available scientific data.”
Everyone needs vitamins, which are essential nutrients that the body can’t produce on its own. Inadequate vitamin C leads to scurvy, for instance, and a lack of vitamin D can cause rickets.
But a balanced diet typically provides an adequate level of these nutrients, and today many popular foods are fortified with extra vitamins and minerals. As a result, diseases caused by nutrient deficiency are rare in the United States.
In any event, most major vitamin studies in recent years have focused not on deficiencies but on whether high doses of vitamins can prevent or treat a host of chronic illnesses. While people who eat lots of nutrient-rich fruits and vegetables have long been known to have lower rates of heart disease and cancer, it hasn’t been clear whether ingesting high doses of those same nutrients in pill form results in a similar benefit.
In January, an editorial in The Journal of the National Cancer Institute noted that most trials had shown no cancer benefits from vitamins — with a few exceptions, like a finding that calcium appeared to lower the recurrence of precancerous colon polyps by 15 percent.
But some vitamin studies have also shown unexpected harm, like higher lung cancer rates in two studies of beta carotene use. Another study suggested a higher risk of precancerous polyps among users of folic acid compared with those in a placebo group.
In 2007, The Journal of the American Medical Association reviewed mortality rates in randomized trials of antioxidant supplements. In 47 trials of 181,000 participants, the rate was 5 percent higher among the antioxidant users. The main culprits were vitamin A, beta carotene and vitamin E; vitamin C and selenium seemed to have no meaningful effect.
“We call them essential nutrients because they are,” said Marian L. Neuhouser, an associate member in cancer prevention at the Fred Hutchinson Cancer Research Center in Seattle. “But there has been a leap into thinking that vitamins and minerals can prevent anything from fatigue to cancer to Alzheimer’s. That’s where the science didn’t pan out.”
Everyone is struggling to make sense of the conflicting data, said Andrew Shao, vice president for scientific and regulatory affairs at the Council for Responsible Nutrition, a vitamin industry trade group. Consumers and researchers need to “redefine our expectations for these nutrients,” he said. “They aren’t magic bullets.”
Part of the problem, he said, may stem from an inherent flaw in the way vitamins are studied. With drugs, the gold standard for research is a randomized clinical trial in which some patients take a drug and others a placebo. But vitamins are essential nutrients that people ingest in their daily diets; there is no way to withhold them altogether from research subjects.
Vitamins given in high doses may also have effects that science is only beginning to understand. In a test tube, cancer cells gobble up vitamin C, and studies have shown far higher levels of vitamin C in tumor cells than are found in normal tissue.
The selling point of antioxidant vitamins is that they mop up free radicals, the damaging molecular fragments linked to aging and disease. But some free radicals are essential to proper immune function, and wiping them out may inadvertently cause harm.
In a study at the University of North Carolina, mice with brain cancer were given both normal and vitamin-depleted diets. The ones who were deprived of antioxidants had smaller tumors, and 20 percent of the tumor cells were undergoing a type of cell death called apoptosis, which is fueled by free radicals. In the fully nourished mice, only 3 percent of tumor cells were dying.
“Most antioxidants are also pro-oxidants,” said Dr. Peter H. Gann, professor and director of research in the department of pathology at the University of Illinois at Chicago. “In the right context and the right dose, they may be able to cause problems rather than prevent them.”
Scientists suspect that the benefits of a healthful diet come from eating the whole fruit or vegetable, not just the individual vitamins found in it. “There may not be a single component of broccoli or green leafy vegetables that is responsible for the health benefits,” Dr. Gann said. “Why are we taking a reductionist approach and plucking out one or two chemicals given in isolation?”
Even so, some individual vitamin research is continuing. Scientists are beginning to study whether high doses of whole-food extracts can replicate the benefits of a vegetable-rich diet. And Harvard researchers are planning to study whether higher doses of vitamin D in 20,000 men and women can lower risk for cancer and other chronic diseases.
“Vitamin D looks really promising,” said Dr. JoAnn E. Manson, the chief of preventive medicine at Brigham and Women’s Hospital and an investigator on several Harvard vitamin studies. “But we need to learn the lessons from the past. We should wait for large-scale clinical trials before jumping on the vitamin bandwagon and taking high doses.”
-
http://www.sciencedaily.com/releases/2009/02/090222142139.htm
-
Even though this is the LA Times, this is close to my thinking on this.
======================
A healthy resistance to antibiotics
The overuse of the medications in humans and animals is believed to be responsible for the rise of dangerous superbugs. Now the time may be right for some limits in agribusiness.
March 19, 2009
Ayear and a half ago, researchers found that a deadly form of staph infection was prevalent on Canadian pig farms. This year, the superbug was found in both swine and workers at U.S. farms.
The rise of bacteria such as methicillin-resistant Staphylococcus aureus, or MRSA, which kills more people in this country each year than AIDS, is believed to be a consequence of the overuse of antibiotics in humans and animals. Low doses of the medications have become ubiquitous in the livestock industry, mixed into feed to enhance growth and prevent the diseases that sweep through crowded pens.
Ads by Google
Farming Industry Study
Report finds risks to U.S. health, environment. Read more.
www.PewTrusts.org
"I cured my painful UTI"
Here's my urinary tract infection home cure that works in 12 hours...
AmysUTIcure.com
Antibiotics without a R-x
Amoxi, Zithro, Tetra & More! Low Prices - Overnight Shipping
www.rxonlinestore.com
A panel of experts found "clear evidence of adverse human health consequences due to resistant organisms resulting from nonhuman usage of antimicrobials," the World Health Organization reported in 2004. "These consequences include infections that would not have otherwise occurred, increased frequency of treatment failures (in some cases death) and increased severity of infections."
The European Union has already banned non-therapeutic use of antibiotics in farm animals, but each year lobbying by agribusiness in this country dooms legislation that would do the same. On Tuesday, Rep. Louise M. Slaughter (D-N.Y.) introduced a bill that would restrict the use of antibiotics that are important to human health in farming operations. The medications could be used to treat illness, but not as a growth promoter or as a substitute for cleaner living conditions. The bill might have a better chance of passing now, with a stronger Democratic majority in Congress.
The timing is right in other ways as well. In January, the Department of Agriculture -- responsible for promoting the meat industry as well as consumer health -- reported that, except during the nursery stage for young pigs, the costs of using preventive or growth-promoting antibiotics slightly outweighed the economic benefits for farms. That's not counting the added costs to consumers in prescription prices for more exotic antibiotics or the $4 billion a year this country spends to combat resistant infections. Some farms are successfully using better sanitation and tracking of illnesses among their herds instead of preventive antibiotics.
It would be a mistake to delay restrictions on antibiotic use until the situation has a chance to reach dire proportions; there is no guarantee that specialized antibiotics could be developed in time to thwart a new wave of drug-resistant bacteria. Humans don't need antibiotics to treat common colds, which are caused by viruses rather than bacteria, and animals don't need them to grow.
-
As far as I know epidural hematomas are not at all common. I have never seen or heard of another case in 20 years though I would not usually see any like say a neurosurgeon or ER physician would. Usually they are from trauma or fracture over the skull near the temple are with rupture to the middle meningeal artery that runs through that vicinity. Contrast these to the common subdural or subarachnoid hematomas.
If say someone got a skull fracture over the temple with a club this could be the result. Any serious blow to this area has to be evaulated with extreme care.
As for the actress it is all too sad. She, as far as I know, is now much more famous for her death then her life. I never heard of her before this.
****Autopsy: Richardson died of impact to the head
NEW YORK – The New York City medical examiner's office says actress Natasha Richardson died of blunt impact to the head. Medical examiner spokeswoman Ellen Borakove said the death was ruled an accident. The cause of death was "epidural hematoma due to blunt impact to the head."
The 45-year-old actress reportedly suffered a head injury after a fall during a private lesson Monday at a resort in Quebec. Richardson was seemingly fine after she fell, but about an hour later, she complained that she didn't feel well. She was hospitalized Tuesday in Montreal and later flown to a hospital in New York, where she died.
Alan Nierob, the Los Angeles-based publicist for Richardson's husband, Liam Neeson, confirmed her death Wednesday without giving details on the cause. There were no details on funeral arrangements.
Funeral arrangements for the 45-year-old actress will be handled by the Greenwich Village Funeral Home.
Broadway theaters will dim their lights Thursday in honor of Richardson. Theater marquees will be dimmed for one minute at 8 p.m. EDT, the traditional starting time for evening performances of Broadway shows.
"The Broadway community is shocked and deeply saddened by the tragic loss of one of our finest young actresses, Natasha Richardson. Her theatrical lineage is legendary, but her own singular talent shined memorably on any stage she appeared," said Charlotte St. Martin, executive director of The Broadway League, the trade organization for Broadway theaters and producers.
Sam Mendes, who directed the Broadway musical "Cabaret" for which Richardson won a Tony, said, "It defies belief that this gifted, brave, tenacious, wonderful woman is gone."
Actress Judi Dench told the BBC that Richardson was "a really great actress" who had "an incredibly luminous quality, that you seldom see, and a great sense of humor."
"It's just so shocking, really shocking, and I hope that everybody leaves the family quietly to somehow pick up the pieces," Dench said.
"She was a wonderful woman and actress and treated me like I was her own," said Lindsay Lohan, who as a preteen starred with Richardson in a remake of "The Parent Trap" in 1998. "My heart goes out to her family. This is a tragic loss."
Neeson and Richardson's sister, actress Joely Richardson, were seen leaving Lenox Hill hospital Wednesday. Actress Lauren Bacall also visited the hospital.
Yves Coderre, director of operations at the emergency services company that sent paramedics to the Mont Tremblant resort where Richardson suffered her fall, told The Globe and Mail newspaper Wednesday the paramedics who responded were told they were not needed.
"They never saw the patient," Coderre told The Globe and Mail. "So they turned around."
Coderre said another ambulance was called later to Richardson's luxury hotel. By that point, her condition had gotten worse and she was rushed to a hospital.
Richardson's career highlights included the film "Patty Hearst" and a Tony-winning performance in a stage revival of "Cabaret."
She was a proper Londoner who came to love the noise of New York, an elegant blonde with large, lively eyes, a bright smile and a hearty laugh.
Jane Fonda on Wednesday recalled meeting a young Richardson on the set of "Julia," the 1977 film Fonda starred in opposite Richardson's mother, Vanessa Redgrave.
"She was a little girl but already beautiful and graceful. It didn't surprise me that she became such a talented actor," Fonda recalled on her blog. "It is hard to even imagine what it must be like for her family. My heart is heavy."
As an actress, Richardson was equally adept at passion and restraint, able to portray besieged women both confessional (Tennessee Williams' Blanche DuBois) and confined (the concubine in the futuristic horror of "The Handmaid's Tale").
Like other family members, she divided her time between stage and screen. On Broadway, she portrayed Sally Bowles in the 1998 revival of "Cabaret." She also appeared in New York in a production of Patrick Marber's "Closer" (1999) as well as the 2005 revival of Tennessee Williams' "A Streetcar Named Desire," in which she played Blanche opposite John C. Reilly's Stanley Kowalski.
She met Neeson when they made their Broadway debuts in 1993, co-starring in "Anna Christie," Eugene O'Neill's drama about a former prostitute and the sailor who falls in love with her.
The New York Times critic Frank Rich called her "astonishing" and said she "gives what may prove to be the performance of the season."
Her most notable film roles came earlier in her career. Richardson played the title character in Paul Schrader's "Patty Hearst," a 1988 biopic about the kidnapped heiress for which the actress became so immersed that even between scenes she wore a blindfold, the better to identify with her real-life counterpart.
Richardson was directed again by Schrader in a 1990 adaptation of Ian McEwan's "The Comfort of Strangers" and, also in 1990, starred in the screen version of Margaret Atwood's "The Handmaid's Tale."
She later co-starred with Neeson in "Nell" and with Mia Farrow in "Widows' Peak." More recent movies, none of them widely seen, included "Wild Child," "Evening" and "Asylum."
Richardson was born in London in 1963, the performing gene inherited not just from her parents (Redgrave and director Tony Richardson), but from her maternal grandparents (Michael Redgrave and Rachel Kempson), an aunt (Lynn Redgrave) and an uncle (Corin Redgrave). Her younger sister, Joely Richardson, also joined the family business.
She also is survived by two sons, Micheal, 13, and Daniel, 12.
Friends and family members remembered Natasha as an unusually poised child, perhaps forced to grow up early when her father left her mother in the late '60s for Jeanne Moreau. (Tony Richardson died in 1991).
Interviewed by The Associated Press in 2001, Natasha Richardson said she related well to her family if only because, "We've all been through it in one way or another and so we've had to be strong. Also we embrace life. We are not cynical about life."
Her screen debut came at 4, when she appeared as a flower girl in "The Charge of the Light Brigade," directed by her father, whose movies included "Tom Jones" and "The Entertainer." The show business wand had already tapped her the year before, when she saw her mother in the 1967 film version of the Broadway show "Camelot."
"She was so beautiful. I still look at that movie and I can't believe it. It still makes me cry, the beauty of it," Richardson said.
She studied at London's Central School of Speech and Drama and was an experienced stage actress by her early 20s, appearing in "On the Razzle," "Charley's Aunt" and "The Seagull," for which the London Drama Critics awarded her most promising newcomer.
She and her mother acted together, most recently on Broadway to play the roles of mother and daughter in a one-night benefit concert version of "A Little Night Music," the Stephen Sondheim-Hugh Wheeler musical.
Before meeting up with Neeson, Richardson was married to producer Robert Fox, whose credits include the 1985 staging of "The Seagull" in which his future wife appeared.
She sometimes remarked on the differences between her and her second husband — she from a theatrical dynasty and he from a working-class background in Northern Ireland.
"He's more laid back, happy to see what happens, whereas I'm a doer and I plan ahead," Richardson told The Independent on Sunday newspaper in 2003. "The differences sometimes get in the way but they can be the very things that feed a marriage, too."
She once said that Neeson's serious injury in a 2000 motorcycle accident — he suffered a crushed pelvis after colliding with a deer in upstate New York — had made her really appreciate life.
"I wake up every morning feeling lucky — which is driven by fear, no doubt, since I know it could all go away," she told The Daily Telegraph newspaper in 2003.****
-
CPR WHEN ALONE ~~ NOT A JOKE!
What are you to do if you have a heart attack
while you are alone.
If you've already received this,
it means people care about you.
The Johnson City Medical Center staff
actually discovered this,
and did an in-depth study on it in our ICU.
The two individuals that discovered this
then wrote an article on it, had it published and
have had it incorporated into ACLS and CPR classes.
It is very true - and has, and does, work.
It is called Cough CPR.
If everyone who gets this sends it to 10 people,
you can bet that we'll save at least one life.
It could save your life!
Let's say it's 6:15 p.m. and you're driving home
(alone of course), after an usually hard day on the job.
You're really tired, upset and frustrated.
Suddenly you start experiencing severe pain
in your chest that starts to radiate out
into your arm and up into your jaw.
You are only about five miles from the hospital
nearest your home.
Unfortunately, you don't know
if you'll be able to make it that far.
What can you do?
You've been trained in CPR
but the guy that taught the course didn't tell you
what to do if it happened to yourself.
Since many people are alone when they suffer a heart attack, this article seemed to be in order.
Without help, the person whose heart is
beating improperly and who begins to feel faint,
has only about 10 seconds left before losing consciousness.
However, these victims can help themselves by coughing repeatedly and very vigorously.
A deep breath should be taken before each cough,
and the cough must be deep and prolonged,
as when producing sputum from
deep inside the chest.
A breath and a cough must be repeated
about every two seconds without let up
until help arrives, or until the heart is felt to be beating normally again.
Deep breaths get oxygen into the lungs and coughing movements squeeze the heart and
keep the blood circulating.
The squeezing pressure on the heart
also helps it regain normal rhythm.
In this way, heart attack victims can get to a hospital.
Tell as many other people as possible about this,
it could save their lives!
From Health Cares, Rochester General Hospital via Chapter 240s newsletter 'AND THE BEAT GOES ON '
(reprint from The Mended Hearts, Inc. Publication, Heart Response)
BE A FRIEND AND
PLEASE SEND THIS ARTICLE
TO AS MANY FRIENDS AS POSSIBLE :-)
-
My opinion:
****"It's one of the classic presentations of head injuries, `talking and dying,' where they may lose consciousness for a minute, but then feel fine," said Razek.****
Yes but banging your head and talking and *not* dying is a thousand times more common.
The classic blame game. She wasn't instantaneously brought to an operating room right off the slopes in some remote area of Quebec with neurosurgeon (Sanjay Gupta) waiting to do the perfect operation.
Which one of these good doctors will be the lucky chosen one to be expert witness for the plaintiff's team.
To me this was a tragic accident. We can always in every single negatvie human outcome ask, "what if"? Why this has to turn into a lawsuit is beyond me. And now we will have a billion dollars more in head cat scans as a result.
****Doctor: Lack of medical helicopter cost actress
Death: Freak Accident ABC News NEW YORK – As a steady stream of celebrities pay their last respects to Natasha Richardson, questions are arising over whether a medical helicopter might have been able to save the ailing actress.
The province of Quebec lacks a medical helicopter system, common in the United States and other parts of Canada, to airlift stricken patients to major trauma centers. Montreal's top head trauma doctor said Friday that may have played a role in Richardson's death.
"It's impossible for me to comment specifically about her case, but what I could say is ... driving to Mont Tremblant from the city (Montreal) is a 2 1/2-hour trip, and the closest trauma center is in the city. Our system isn't set up for traumas and doesn't match what's available in other Canadian cities, let alone in the States," said Tarek Razek, director of trauma services for the McGill University Health Centre, which represents six of Montreal's hospitals.
While Richardson's initial refusal of medical treatment cost her two hours, she also had to be driven to two hospitals. She didn't arrive at a specialized hospital in Montreal until about four hours after the second 911 call from her hotel room at the Mont Tremblant resort, according to a timeline published by Canada's The Globe and Mail newspaper.
Not being airlifted directly to a trauma center could have cost Richardson crucial moments, Razek said.
"A helicopter is obviously the fastest way to get from Point A to Point B," he said.
After Richardson fell and hit her head on a beginner ski slope at the Mont Tremblant resort in Quebec, the first ambulance crew left upon spotting a sled taking the still-conscious actress away to the resort's on-site clinic.
A second 911 call was made two hours later from Richardson's luxury hotel room as the actress deteriorated. Medics tended to her for a half-hour before taking her to a hospital about a 40-minute drive away.
Centre Hospitalier Laurentien in Ste-Agathe does not specialize in head traumas, so her speedy transfer to Sacre Coeur Hospital in Montreal was critical, said Razek.
"It's one of the classic presentations of head injuries, `talking and dying,' where they may lose consciousness for a minute, but then feel fine," said Razek.
Richardson, 45, died Wednesday at Lenox Hill Hospital in New York. The New York City medical examiner's office ruled her death was an accident.****
-
this is a very difficult topic. Euthanasia. I feel very uncomfortable about it. I have "pulled the plug" with family permission only on patients that were brain dead but the idea of helping someone die even if they are terminal and suffering would be very hard for me to do. Yet this debate is only going to get bigger. The worst part is the reason won't be for the goodness of humanity. But for dollars and cents. I worked for 30 days with other physicians to keep alive an 85 year old lady. She made it and went off to the nursing home. I recently got word she died after two weeks there anyway.
Not only was I saddened by her passing - she was a sweet little old lady - but saddened by the fact she really suffered for a month struggling to survive and pull through - only to die anyway. that said the issue to society that is going to cause this to be something we will hear about a lot in the near future is the cost>
suppose she died 6 weeks earlier. 100k Would not have been spent. Something like a quarter of all health care expenditures are for the last 6 months of life. With a broken system that is going bankrupt and driving us all into the gutter people are going to start to raise the taboo questions we all try to avoid:
http://medicaleconomics.modernmedicine.com/memag/article/articleDetail.jsp?id=587095&sk=a76544f67ebabb8029168ea3bd20baae
-
Hmm, agreeable + non-neurotic = longevity. I'm doomed.
Researchers identify personality traits
(Boston) - Researchers from Boston University School of Medicine's (BUSM) New England Centenarian Study have noted specific personality traits associated with healthy aging and longevity amongst the children of centenarians. The work was conducted in collaboration with scientists from the National Institute on Aging. These findings currently appear on-line in the Journal of the American Geriatrics Society.
Previous research on siblings and offspring of centenarians have documented that exceptional longevity runs strongly in families. Studies of the offspring of centenarians showed that their mortality is 120 percent lower than other members of their birth cohort and that they also have markedly lower prevalence rates and delayed onsets of cardiovascular disease, hypertension, and diabetes mellitus. Because personality traits have been shown to have substantial heritable components, the researchers hypothesized that certain personality features may be important to the healthy aging observed in the offspring of centenarians.
Using the NEO-Five-Factor Inventory (NEO-FFI) questionnaire, measures of the personality traits for neuroticism, extraversion, openness, agreeableness, and conscientiousness were obtained from 246 (125 women and 121 men) unrelated offspring of centenarians with an average age of 75.
Both the male and female offspring of centenarians scored in the low range of published norms for neuroticism and in the high range for extraversion. The women also scored comparatively high in agreeableness. Otherwise, both sexes scored within normal range for conscientiousness and openness, and the men scored within normal range for agreeableness.
According to the researchers, personality traits in the offspring of centenarians appear to have distinctive characteristics that may have important implications for their longevity. "Interestingly, whereas men and women generally differ substantially in their personality characteristics, the male and female offspring tended to be similar, which speaks to the importance of these traits, irrespective of gender, for health aging and longevity.
It's likely that the low neuroticism and higher extraversion will confer health benefits for these subjects," said senior author Thomas Perls, MD, MPH, director of the New England Centenarian Study. "For example, people who are lower in neuroticism are able to manage or regulate stressful situations more effectively than those with higher neuroticism levels. Similarly, high extraversion levels have been associated with establishing friendships and looking after yourself," he said.
Perl's added, "These findings suggest that personality is an important characteristic to include in studies that assess genetic and environmental determinants of longevity. Such studies are currently underway."
http://www.eurekalert.org/pub_releases/2009-04/bu-rip040309.php
-
Suppose you wanted to test the effects of halving the amount of salt in people’s diets. If you were an academic researcher, you’d have to persuade your institutional review board that you had considered the risks and obtained informed consent from the participants.
Skip to next paragraph
TierneyLab
Do you want New York’s mayor and health commissioner leading a nationwide initiative to halve the salt in your food? Join the discussion.
Go to TierneyLab »
Further Reading
Throwing the Book at Salt. Kim Severson, N.Y. Times, 2009.
NYC Starts a Nationwide Initiative. N.Y.C. Department of Health.
The (Political) Science of Salt Gary Taubes, Science, 1998.
A Call for Higher Standards of Evidence for Dietary Guidelines." Marantz PR, Bird ED, Alderman MH. American Journal of Preventive Medicine, 2008.
Effects of Low Sodium Diet Versus High Sodium Diet." G. Jürgens, N.A.Graudal, Cochrane Collaboration, 2003.
The Influence of Dietary Sodium on Blood Pressure. Norman K. Hollenberg, Journal of the American College of Nutrition, 2006.
Salt Craving: The Psychobiology of Pathogenic Sodium Intake." M.J. Morris, E.S. Na, A.K. Johnson. Physiology & Beahvior, 2008.
Reducing the Public Health Burden From Elevated Blood Pressure Levels. S. Havas, E. Roccella, C. Lenfant. American Journal of Public Health, 2004.
More From Dr. Frieden. Diner's Journal, New York Times, 2009.
RSS Feed
Get Science News From The New York Times »
Enlarge This Image
Viktor Koen
You might, for instance, take note of a recent clinical trial in which heart patients put on a restricted-sodium diet fared worse than those on a normal diet. In light of new research suggesting that eating salt improves mood and combats depression, you might be alert for psychological effects of the new diet. You might worry that people would react to less-salty food by eating more of it, a trend you could monitor by comparing them with a control group.
But if you are the mayor of New York, no such constraints apply. You can simply announce, as Michael Bloomberg did, that the city is starting a “nationwide initiative” to pressure the food industry and restaurant chains to cut salt intake by half over the next decade. Why bother with consent forms when you can automatically enroll everyone in the experiment?
And why bother with a control group when you already know the experiment’s outcome? The city’s health commissioner, Thomas R. Frieden, has enumerated the results. If the food industry follows the city’s wishes, the health department’s Web site announces, “that action will lower health care costs and prevent 150,000 premature deaths every year.”
But that prediction is based on an estimate based on extrapolations based on assumptions that have yet to be demonstrated despite a half-century of efforts. No one knows how people would react to less-salty food, much less what would happen to their health.
Dr. Frieden has justified the new policy by pointing to the “compelling evidence” for the link between salt and blood pressure. It’s true that lowering salt has been shown to lower blood pressure on average, but that doesn’t mean it has been demonstrated to improve your health, for a couple of reasons.
First, a reduced-salt diet doesn’t lower everyone’s blood pressure. Some individuals’ blood pressure can actually rise in response to less salt, and most people aren’t affected much either way. The more notable drop in blood pressure tends to occur in some — but by no means all — people with hypertension, a condition that affects more than a quarter of American adults.
Second, even though lower blood pressure correlates with less heart disease, scientists haven’t demonstrated that eating less salt leads to better health and longer life. The results from observational studies have too often been inconclusive and contradictory. After reviewing the literature for the Cochrane Collaboration in 2003, researchers from Copenhagen University concluded that “there is little evidence for long-term benefit from reducing salt intake.”
A similar conclusion was reached in 2006 by Norman K. Hollenberg of Harvard Medical School. While it might make sense for some individuals to change their diets, he wrote, “the available evidence shows that the influence of salt intake is too inconsistent and generally too small to mandate policy decisions at the community level.”
In the past year, researchers led by Salvatore Paterna of the University of Palermo have reported one of the most rigorous experiments so far: a randomized clinical trial of heart patients who were put on different diets. Those on a low-sodium diet were more likely to be rehospitalized and to die, results that prompted the researchers to ask, “Is sodium an old enemy or a new friend?”
Those results, while hardly a reason for you to start eating more salt, are a reminder that salt affects a great deal more than blood pressure. Lowering it can cause problems with blood flow to the kidneys and insulin resistance, which can increase the risk of strokes and heart attacks.
Salt deprivation might also darken your mood, according to recent research by Alan Kim Johnson and colleagues at the University of Iowa. After analyzing the behavior and brain chemistry of salt-deprived rats, the psychologists found that salt, like chocolate and cocaine, affected reward circuitry in the brain, and that salt-deprived rats exhibited anhedonia, a symptom of depression characterized by the inability to enjoy normally pleasurable activities.
Dr. Frieden has predicted that people “won’t notice the difference” if salt is gradually reduced, but how can he be sure? What if they respond by eating more food, or a different mix of foods and stimulants? What if the food industry turns to salt substitutes that cause new health problems? “We have no way of knowing the health effects of eating less salt, yet we’re supposed to forge ahead with this new policy that affects the whole population,” said Michael Alderman, an expert in hypertension at the Albert Einstein College of Medicine. Like other critics, he has compared the antisalt campaign to the campaign against fat that began several decades ago.
That antifat campaign, like the antisalt campaign, was endorsed by prominent groups and federal agencies before the campaigners’ theory was tested in rigorous trials. It too seemed quite logical — in theory.
But in practice the results were dismal, as demonstrated eventually by clinical trials and by the expanding waistlines of Americans. People followed the advice in the “food pyramid” to reduce the percentage of fat in the diet, but they got more obese, perhaps because they ate so many other ingredients in foods with “low fat” labels.
You might think that experience would inspire caution among public health officials, but instead they seem to be gaining confidence. When Dr. Frieden and Mr. Bloomberg decided several years ago that trans fats were dangerous, they didn’t simply issue a warning or a set of voluntary guidelines. They insisted on outlawing trans fats in New York’s restaurants.
At the time, it seemed extraordinary for a city to be forbidding its diners to order a legal food product, particularly given the scientific uncertainties about trans fats and the possible harms resulting from the ban (see TierneyLab at nytimes.com/tierneylab).
But that local restaurant policy now seems fairly modest by comparison with Mr. Bloomberg’s and Dr. Frieden’s plans for salt. Soon, wherever you live, wherever you eat, you could be part of their experiment.
-
[youtube]http://www.youtube.com/watch?v=PPTUXXSV-3w&feature=player_embedded[/youtube]
http://www.straighttothebar.com/therotater/ (http://www.straighttothebar.com/therotater/)
.
The Rotater is a brilliant thing.
Following years of shoulder abuse and injury (particularly whilst experimenting during training for the OAC), I was more than a little keen to try out The Rotater. And I have to say, it easily exceeded expectations.
Rather than relive my own shoulder-training trials however, here are a couple of thoughts from my father, who has been using The Rotater for a few days now. As you'll see, it really is an incredible piece of equipment.
When Scott asked me to test the Rotater my response was keen but somewhat apprehensive. Following years of bodily abuse in various sporting activities (several breaks, dislocations & tears) I am now, at age 67, suffering early stages of arthritis. One area of concern is my shoulders - not so much because of pain and stiffness but the limitations this places on my ability to exercise on a regular basis.
When I first used The Rotater for a few minutes my feelings were confused. How could such a simple device create the feeling of freedom I was now experiencing? Having now used The Rotater for several days I have come to the following conclusions :
1. After a few minutes of stretching with The Rotater I can now comfortably exercise my shoulders using my home gym & appropriate free weights.
2. Until recent years I have done twists on a daily basis using a broomstick across my shoulders. This had become impossible as holding the stick behind my neck was too painful. After a suitable warm up I can now once again twist for as long as I choose.
The results of my test of the Rotater are surprising, amazing, & in my case stimulating.
A look at The Rotater in action
Here's a brief look at The Rotater in action. As you can see, it's an incredibly simple device; yet you can feel a difference almost immediately. If years of squatting have robbed you of a bit of shoulder mobility, you'll be amazed at just how great this feels.
Final Thought on The Rotater
If you've ever experienced shoulder pain, you'll understand just how frustrating it can be. Apart from the pain itself, it's perhaps the fact that it prevents you from doing your normal exercise routine that's the biggest source of aggravation.
In my case - and in my dad's - The Rotater ended that frustration. An incredible feeling.
-
WHO ready with antivirals to combat swine flu
Fri Apr 24, 2009 5:11pm EDT Email | Print | Share| Reprints | Single Page[-] Text
By Stephanie Nebehay
GENEVA (Reuters) - The World Health Organization (WHO) said on Friday that it was prepared with rapid containment measures including antivirals if needed to combat the swine flu outbreaks in Mexico and the United States.
The Geneva-based agency has been stockpiling doses of Roche Holding's Tamiflu, known generically as oseltamivir, a pill that can both treat flu and prevent infection.
The new virus, not previously detected in pigs or humans, has proved sensitive to the drug, the WHO said in a statement.
The WHO and its regional office in Washington, D.C., are also sending experts to Mexico to help health authorities with disease surveillance, laboratory diagnosis and clinical management of cases.
Mexican health officials have reported more than 850 cases of pneumonia in the capital, Mexico City, including 59 who died. In San Luis Potosi, in central Mexico, 24 cases including 3 deaths have been detected.
They have also informed the WHO about a third suspected outbreak of swine flu in Mexicali, near the U.S. border, with four suspect cases and no deaths so far.
The U.S. Centers for Disease Control have said there were 8 cases of swine influenza in California and Texas and no deaths.
Health authorities in the two North American countries have the resources required already in place, including Tamiflu, and are "well equipped," according to the WHO.
"WHO is prepared with rapid containment measures should it be necessary to be deployed," WHO spokeswoman Aphaluck Bhatiasevi told Reuters.
The United Nations agency saw no need at this point to issue travel advisories warning travelers not to go to parts of Mexico or the United States. "However, the situation may change depending on what the situation in the field is," she said.
The WHO will convene a meeting of its Emergency Committee on international health regulations, probably on Saturday afternoon, she added.
WHO director-general Margaret Chan was flying back to Geneva overnight from Washington, D.C., for the emergency discussions which would link public health authorities and experts in various parts of world in a virtual meeting, she said.
The emergency committee could make recommendations including whether to change the pandemic alert level, she added.
"Because there are human cases associated with an animal influenza virus, and because of the geographical spread of multiple community outbreaks, plus the somewhat unusual age groups affected, these events are of high concern," the WHO said in a statement.
-
Im not entirely sure where this fits in it could be environmental but it is also a part of health. My girlfriend and I have been seriously looking into Aquaponics. Anyone else do / tried this?
http://www.aquaponics.com/index.htm (http://www.aquaponics.com/index.htm)
[youtube]http://www.youtube.com/watch?v=wS3sej53gx0[/youtube]
-
Shaggy Dog does something quite like this too in his backyard in the San Fernando Valley in Los Angeles. For the fish, he uses Tilapia, which are an excellent clean protein source as well.
-
Shaggy Dog does something quite like this too in his backyard in the San Fernando Valley in Los Angeles. For the fish, he uses Tilapia, which are an excellent clean protein source as well.
Actually, I got the idea after reading a post from Shaggy to DogZilla on Facebook. After doing some research there is a farm here on Oahu that has classes as well as a family on the big island that does it commercially. I think we will start out with Tilapia but I have also been reading that other people use Koi, Crawdads, Goldfish, and Perch. Interesting stuff. The more I read the more excited I get.
A small step to being self sufficient.
(geez, just realized that I totally misspelled the subject)
-
I've seen Shaggy's setup. It's quite impressive. I wish I'd had my camera with me!
-
I've seen Shaggy's setup. It's quite impressive. I wish I'd had my camera with me!
Oooh maybe I can email him for tips and suggestions!
-
I just tried emailing him but it bounced back. I will have to give him a call.
-
Awesome, looking forward to hearing \ reading his input. Thanks Guro Crafty.
-
Hey Robert I would be happy to answer any of your questions. I tried to upload some pics of my system but every time I tried I got an error...
-
Howzit Shaggy! I just ordered a DVD "Aquaponics made Easy" or something like that. I'll post some questions soon!
-
Shaggy:
Please email Cindy and me at info@dogbrothers.com and if Cindy does not have the answer I will forward you it to our webmaster for a solution.
BTW, what you have going has really got me thinking about all this. Glad to see you here.
-
Well I am here to inspire...
I really believe this is one of the most viable farming methods on earth. In Ca. we are having a major water shortage and becoming a problem for traditional farmers. Most Aquaponic farms use 10% of the water regular farming methods use per acreage and can grow up to 44% more produce. There are no nutrient run off that can go into the environment which regular farming has a major problem with. The system if run by solar power or wind power it has almost 0 impact on the environment other than taking water out of it but in my system I only go thru 15 gallons a day which is less than a shower.
With this system you also have the benefit of harvesting some type of freshwater species. Most systems use Tilapia but you can use any freshwater creature that poops. You can use Trout, Bass, Fresh Water Prawn, Crawfish, Catfish the list goes on. Some people even use gold fish or Koi. Koi is a more viable fish to use because you can sell Koi at a high price but Goldfish are pretty much a waste of space you can't eat them and they don't sell for much.
The system works fairly simple...The fish effluent is pumped into grow beds using some sort of substrate usually pea gravel. Then a bacteria called Notrosomonas converts ammonia into nitrites and another bacteria named Nitrobacter converts the nitrite to nitrate which is consumed by the plants. The water then is drained into a return tank and then pumped back into the fish tank and is 97% pure water when it has gone thru the grow beds.
Tilapia is one of the most popular fish to use because it is a warm water fish and the system does better because the bacteria like it warm. For most of the year average water temp. is around 82 degrees which the bacteria thrive in. Also Tilapia is a very fast growing fish where it can become full size within 7-12 months averaging around a pound and a half.
Well I will leave you with this much info for now if any body has any questions about it feel free to ask.
Shaggy Dog
-
You live in the San Fernando Valley-- which for many months of the year, is A LOT hotter than 82 degrees. How do you handle this?
-
Shade cloth and fans is how I keep it cool during the summer. Most of the year the tank is solar heated because the tank is black. The water temp. may rise during the day but it falls back down at night. 82 is for most of the year but during the summer the water temp. can get up to 88 degrees.
-
Well I am here to inspire...
I really believe this is one of the most viable farming methods on earth. In Ca. we are having a major water shortage and becoming a problem for traditional farmers. Most Aquaponic farms use 10% of the water regular farming methods use per acreage and can grow up to 44% more produce. There are no nutrient run off that can go into the environment which regular farming has a major problem with. The system if run by solar power or wind power it has almost 0 impact on the environment other than taking water out of it but in my system I only go thru 15 gallons a day which is less than a shower.
With this system you also have the benefit of harvesting some type of freshwater species. Most systems use Tilapia but you can use any freshwater creature that poops. You can use Trout, Bass, Fresh Water Prawn, Crawfish, Catfish the list goes on. Some people even use gold fish or Koi. Koi is a more viable fish to use because you can sell Koi at a high price but Goldfish are pretty much a waste of space you can't eat them and they don't sell for much.
The system works fairly simple...The fish effluent is pumped into grow beds using some sort of substrate usually pea gravel. Then a bacteria called Notrosomonas converts ammonia into nitrites and another bacteria named Nitrobacter converts the nitrite to nitrate which is consumed by the plants. The water then is drained into a return tank and then pumped back into the fish tank and is 97% pure water when it has gone thru the grow beds.
Tilapia is one of the most popular fish to use because it is a warm water fish and the system does better because the bacteria like it warm. For most of the year average water temp. is around 82 degrees which the bacteria thrive in. Also Tilapia is a very fast growing fish where it can become full size within 7-12 months averaging around a pound and a half.
Well I will leave you with this much info for now if any body has any questions about it feel free to ask.
Shaggy Dog
Ah well.. that answered some questions. I was wondering why some people used Koi. Fortunately Im in Hawai'i so the weater is usually pretty warm and so I believe well start with Tilapia. Ive seen some kits that have the option of using solar again being in Hawaii I think that would be the obvious choice I am also interested in trying out some other type of fish too.
We are also thinking about starting an adult foster home and using the Aquaponic garden to raise most of our vegetables and gardens but first I wanna get a small kit / or make our own and start small. Eventually once I get going and feel comfortable we thought about contacting homeless shelters (possibly provided some food for the shelter) and / or sell fish and veggies at the farmers market and / or get involved with a co-op.
Oh.. what about the cycle betweeen harvesting the fish and adding new fish i.e. initially start with 15 fish and then maybe 60 days later add in more?
Mahalo Shaggy Dog!
-
There are a couple Yahoo Discussion groups I belong to that are a valuable resource for info the first one you might be interested in is the aeroponics_aquaponics group which has allot of info on Barrelponics which are usually very small systems a good one for you to start out with. Another group I belong to is aquaponicfarm Group which has allot of info on larger systems and homemade equipment such as diagrams for wind powered pumps and such.
Cycling between fish harvest is not really an issue on an established tank. The more problematic one is the initial start of your system. I like to start off with Goldfish, if they die no big deal because they are very cheap. Some aquaponics set ups use a very high ratio of fish per gallon of water. I've seen up to 1 fish per gallon but many things can go wrong quickly with that dense of a population. I have had best results in 1 - 1 1/2 Lb. fish per 4 gallons of water but it differs from the size of fish that is going to be raised.
-
There are a couple Yahoo Discussion groups I belong to that are a valuable resource for info the first one you might be interested in is the aeroponics_aquaponics group which has allot of info on Barrelponics which are usually very small systems a good one for you to start out with. Another group I belong to is aquaponicfarm Group which has allot of info on larger systems and homemade equipment such as diagrams for wind powered pumps and such.
Cycling between fish harvest is not really an issue on an established tank. The more problematic one is the initial start of your system. I like to start off with Goldfish, if they die no big deal because they are very cheap. Some aquaponics set ups use a very high ratio of fish per gallon of water. I've seen up to 1 fish per gallon but many things can go wrong quickly with that dense of a population. I have had best results in 1 - 1 1/2 Lb. fish per 4 gallons of water but it differs from the size of fish that is going to be raised
.
OK. Ill be checking that out later today, thanks for the info.
-
This is only a small portion of an informative article @ http://attra.ncat.org/attra-pub/aquaponic.html (http://attra.ncat.org/attra-pub/aquaponic.html) it is also available in PDF format here - http://attra.ncat.org/attra-pub/PDF/aquaponic.pdf (http://attra.ncat.org/attra-pub/PDF/aquaponic.pdf)
Aquaponics—Integration of Hydroponics with Aquaculture
By Steve Diver
NCAT Agriculture Specialist
Published 2006
ATTRA Publication #IP163
Abstract
Aquaponic vegetable bed in Australia.
Photo by Joel Malcolm, Backyard Aquaponics. (with permission)
Aquaponics is a bio-integrated system that links recirculating aquaculture with hydroponic vegetable, flower, and/or herb production. Recent advances by researchers and growers alike have turned aquaponics into a working model of sustainable food production. This publication provides an introduction to aquaponics with brief profiles of working units around the country. An extensive list of resources point the reader to print and Web-based educational materials for further technical assistance.
Table of Contents
Introduction
Aquaponics: Key Elements and Considerations
Aquaponic Systems
The North Carolina State University System
The Speraneo System
The University of the Virgin Islands System
The Freshwater Institute System
The Cabbage Hill Farm System
The New Alchemy Institute
Miscellaneous Systems
Organic Aquaculture
Evaluating an Aquaponic Enterprise
References
Resources
Appendix: Bibliography on Aquaponics
Dissertations
Introduction
Aquaponics, also known as the integration of hydroponics with aquaculture, is gaining increased attention as a bio-integrated food production system.
Aquaponics serves as a model of sustainable food production by following certain principles:
The waste products of one biological system serve as nutrients for a second biological system.
The integration of fish and plants results in a polyculture that increases diversity and yields multiple products.
Water is re-used through biological filtration and recirculation.
Local food production provides access to healthy foods and enhances the local economy.
In aquaponics, nutrient-rich effluent from fish tanks is used to fertigate hydroponic production beds. This is good for the fish because plant roots and rhizobacteria remove nutrients from the water. These nutrients – generated from fish manure, algae, and decomposing fish feed – are contaminants that would otherwise build up to toxic levels in the fish tanks, but instead serve as liquid fertilizer to hydroponically grown plants. In turn, the hydroponic beds function as a biofilter – stripping off ammonia, nitrates, nitrites, and phosphorus – so the freshly cleansed water can then be recirculated back into the fish tanks. The nitrifying bacteria living in the gravel and in association with the plant roots play a critical role in nutrient cycling; without these microorganisms the whole system would stop functioning.
Greenhouse growers and farmers are taking note of aquaponics for several reasons:
Hydroponic growers view fish-manured irrigation water as a source of organic fertilizer that enables plants to grow well.
Fish farmers view hydroponics as a biofiltration method to facilitate intensive recirculating aquaculture.
Greenhouse growers view aquaponics as a way to introduce organic hydroponic produce into the marketplace, since the only fertility input is fish feed and all of the nutrients pass through a biological process.
Food-producing greenhouses – yielding two products from one production unit – are naturally appealing for niche marketing and green labeling.
Aquaponics can enable the production of fresh vegetables and fish protein in arid regions and on water-limited farms, since it is a water re-use system.
Aquaponics is a working model of sustainable food production wherein plant and animal agriculture are integrated and recycling of nutrients and water filtration are linked.
In addition to commercial application, aquaponics has become a popular training aid on integrated bio-systems with vocational agriculture programs and high school biology classes.
The technology associated with aquaponics is complex. It requires the ability to simultaneously manage the production and marketing of two different agricultural products. Until the 1980s, most attempts at integrated hydroponics and aquaculture had limited success. However, innovations since the 1980s have transformed aquaponics technology into a viable system of food production. Modern aquaponic systems can be highly successful, but they require intensive management and they have special considerations.
This publication provides an introduction to aquaponics, it profiles successful aquaponic greenhouses, and it provides extensive resources. It does not attempt to describe production methods in comprehensive technical detail, but it does provide a summary of key elements and considerations.
Related ATTRA Publications
Aquaculture Enterprises: Considerations and Strategies Agricultural Business Planning Templates and Resources
Back to top
Aquaponics: Key Elements and Considerations
A successful aquaponics enterprise requires special training, skills, and management. The following items point to key elements and considerations to help prospective growers evaluate the integration of hydroponics with aquaculture.
Hydroponics: Hydroponics is the production of plants in a soilless medium whereby all of the nutrients supplied to the crop are dissolved in water. Liquid hydroponic systems employ the nutrient film technique (NFT), floating rafts, and noncirculating water culture. Aggregate hydroponic systems employ inert, organic, and mixed media contained in bag, trough, trench, pipe, or bench setups. Aggregate media used in these systems include perlite, vermiculite, gravel, sand, expanded clay, peat, and sawdust. Normally, hydroponic plants are fertigated (soluble fertilizers injected into irrigation water) on a periodical cycle to maintain moist roots and provide a constant supply of nutrients. These hydroponic nutrients are usually derived from synthetic commercial fertilizers, such as calcium nitrate, that are highly soluble in water. However, hydro-organics – based on soluble organic fertilizers such as fish hydrosylate – is an emerging practice. Hydroponic recipes are based on chemical formulations that deliver precise concentrations of mineral elements. The controlled delivery of nutrients, water, and environmental modifications under greenhouse conditions is a major reason why hydroponics is so successful.
Nutrients in Aquaculture Effluent: Greenhouse growers normally control the delivery of precise quantities of mineral elements to hydroponic plants. However, in aquaponics, nutrients are delivered via aquacultural effluent. Fish effluent contains sufficient levels of ammonia, nitrate, nitrite, phosphorus, potassium, and other secondary and micronutrients to produce hydroponic plants. Naturally, some plant species are better adapted to this system than others. The technical literature on aquaponics provides greater detail on hydroponic nutrient delivery; especially see papers cited in the Bibliography by James Rakocy, PhD.
Plants Adapted to Aquaponics: The selection of plant species adapted to hydroponic culture in aquaponic greenhouses is related to stocking density of fish tanks and subsequent nutrient concentration of aquacultural effluent. Lettuce, herbs, and specialty greens (spinach, chives, basil, and watercress) have low to medium nutritional requirements and are well adapted to aquaponic systems. Plants yielding fruit (tomatoes, bell peppers, and cucumbers) have a higher nutritional demand and perform better in a heavily stocked, well established aquaponic system. Greenhouse varieties of tomatoes are better adapted to low light, high humidity conditions in greenhouses than field varieties.
Male tilapia fish.
AARM - Aquaculture & Aquatic Resources Management Asian Institute of Technology, Thailand.
Fish Species: Several warm-water and cold-water fish species are adapted to recirculating aquaculture systems, including tilapia, trout, perch, Arctic char, and bass. However, most commercial aquaponic systems in North America are based on tilapia. Tilapia is a warm-water species that grows well in a recirculating tank culture. Furthermore, tilapia is tolerant of fluctuating water conditions such as pH, temperature, oxygen, and dissolved solids. Tilapia produces a white-fleshed meat suitable to local and wholesale markets. The literature on tilapia contains extensive technical documentation and cultural procedures. Barramundi and Murray cod fish species are raised in recirculating aquaponic systems in Australia.
Tilapia is a warm-water species that grows well in a recirculating tank culture.
Water Quality Characteristics: Fish raised in recirculating tank culture require good water quality conditions. Water quality testing kits from aquacultural supply companies are fundamental. Critical water quality parameters include dissolved oxygen, carbon dioxide, ammonia, nitrate, nitrite, pH, chlorine, and other characteristics. The stocking density of fish, growth rate of fish, feeding rate and volume, and related environmental fluctuations can elicit rapid changes in water quality; constant and vigilant water quality monitoring is essential.
Biofiltration and Suspended Solids: Aquaculture effluent contains nutrients, dissolved solids, and waste byproducts. Some aquaponic systems are designed with intermediate filters and cartridges to collect suspended solids in fish effluent, and to facilitate conversion of ammonia and other waste products to forms more available to plants prior to delivery to hydroponic vegetable beds. Other systems deliver fish effluent directly to gravel-cultured hydroponic vegetable beds. The gravel functions as a “fluidized bed bioreactor,” removing dissolved solids and providing habitat for nitrifying bacteria involved in nutrient conversions. The design manuals and technical documentation available in the Resources section can help growers decide which system is most appropriate.
Component Ratio: Matching the volume of fish tank water to volume of hydroponic media is known as component ratio. Early aquaponics systems were based on a ratio of 1:1, but 1:2 is now common and tank: bed ratios as high as 1:4 are employed. The variation in range depends on type of hydroponic system (gravel vs. raft), fish species, fish density, feeding rate, plant species, etc. For example, the Speraneo system described below is designed for one cubic foot of water to two cubic feet of grow bed media (pea gravel). Further, when shallow bed systems only three inches in depth are employed for the production of specialty greens such as lettuce and basil, the square footage of grow space will increase four times. Depending on the system design, the component ratio can favor greater outputs of either hydroponic produce or fish protein. A “node” is a configuration that links one fish tank to a certain number of hydroponic beds. Thus, one greenhouse may contain a multiple number of fish tanks and associated growing beds, each arranged in a separate node.
-
Hey Marc I just heard of this thru one of my Aquaponics groups I belong to....Tell me if you know of this tree. I bought some seeds for it online.
The Moringa Oleifera tree
The leaves of this tree have been used to reverse malnutrition in children in India. Excellent stock and fish feed too....
Nature's Most Nutritious Vegetable Tree
* A Nutritional Miracle - Nature's Best Kept Nutritional Secret
* Leaves Contain almost ALL the Nutrients Required for Perfect Health
* One of the few plants on Earth that contain ALL the Essential Amino Acids required for Human Protein Synthesis
* One of Nature's Richest Sources of Vitamins, Minerals and Anti-Oxidants
* The Perfect Food for Vegetarians
Imagine leaves that grow ABUNDANTLY on a tree that contain:
* 27 % Protein (dry weight)
* 8.5 times more Protein than yogurt (dry weight)
* Rich Source of Vitamins B, B1, B2, B3
* 7 times more Vitamin C than Oranges (wet weight)
* 16.5 times more Calcium than Milk (dry weight)
* 10.5 times more Vitamin A than Carrots (dry weight)
* 15 times more Potassium than Bananas
* 12 times more Iron than Spinach
The Moringa Vegetable Tree is by far the most important Vegetable Tree on Earth.
It is a veritable powerhouse of nutrients, vitamins, minerals and anti-oxidants that have been well-established to enhance and maintain your health and your immune system.
The Leaves, Pods and Flowers of the Moringa Tree are highly nutritious.
Moringa Leaves provide the answer to the perfectly balanced Vegetarian Diet which so often lacks in essential amino acids and other essential nutrients.
The evergreen or deciduous leaves (depending on climate) are 1-2 cm in diameter. They have a lovely soft texture and taste somewhere between lettuce and spinach.
Possibly the most nutritious of all leaf crops, Moringa leaves are 27% protein (dry weight) and have extremely high levels of folates, vitamin C, carotenes, calcium, iron, and niacin.
Moringa leaves make the perfect Green Leaf Base in any salad. Eat them in abundance and you will ensure that your body is receiving excellent nutrition far surpassing any artificial supplements.
As with any food that contains significant amounts of nutrients the leaves are best eaten raw so that the nutritional value remains intact. However, the leaves can also be prepared in the same way as Spinach.
The leaves can also be dried into a powder and used in soups and sauces.
Even though fresh and raw is always best, the nutritional value remains almost perfectly intact in the powdered form and is the best way to store the Moringa Leaves (avoid direct sunlight when drying them).
If you would like to add the powder to cooked dishes remember the less heat the better.
The Moringa Tree is native to Northern India on the Southern Slopes of the Himalayas. In Southern India it is said that no meal is complete without Moringa. In Ayurvedic Medicine it is said to cure over 300 `conditions' and was even revered in ancient Sanskrit texts.
The tree has since been intentionally cultivated in Africa and South America and is naturalized all the way down East Africa and has for a long while already been Naturalized in South Africa in the Limpopo and Kwazulu Natal.
The Moringa Tree has many different names in different cultures. Common names include: the Miracle Tree, the Drum Stick Tree (the pods are called Drum Sticks), the Clarifier Tree (referring to the ground seeds use as an amazingly effective flocculant - settling out of particles in fluids such as water, honey, wine, even industrial waste), the Ben-Oil Tree (the pods yield an excellent high quality nutritious oil called Ben-Oil), the Benzolive Tree, the Never-Die Tree, Mother's Best Friend, the Horseradish Tree and many more in different cultures throughout Africa and India.
Seems like a miracle tree...
-
A friend writes:
Never mind that “windows to your soul” stuff—your eyes may reveal your risk of stroke.
In a study of 3,654 people, Australian scientists took retinal photographs of participants’ eyes, then tracked their medical records for seven years. The finding: Those with microscopic damage to their ocular blood vessels were 70 percent more likely to have a hemorrhagic stroke—the type where a blood vessel bursts—than those without any damage.
“Blood vessels in the eyes are structurally similar to those in the brain,” says lead author Paul Mitchell, M.D., speculating that a congenital weakness in one area might be mirrored in the other.
Ask your ophthalmologist to snap a “stereoscopic retinal photograph” at your next eye exam and send the images to a neurologist, especially if you have a family history of stroke.
============
Another friend responds:
We opthalmologists do this analysis for decades ourselves, calling this "fundus hypertonicus"(hypertension). This name was given about 100 years ago when we thought that arterial hypertension was the cause. Hypertension can be the cause for the damage of the blood vessels, but there are also other causes. The striking point is that blood vessels of the retina are blood vessels of our brains from the anatomical point of view. Usually neurologists ask us for a diagnosis as we see a multiple number of blood vessels than neurologists do. It is routine for literally every patient. Neurologists have problems in diffential diagnosis in relation to opthalmological diseases. And patients with fundus hypertonicus seem to be prone to a variety of non-neurological diseases, which makes the observation not interesting for neurologists alone.
If your opthalmologist spots a fundus hypertonicus, he/she won't send you to the neurologist but preferably to a specialist for internal medicine to find the cause of the damage of your vessels. Usually it it not the damage of the retinal vessels alone but a damage of the vessel system. Question No 1: which vessels are affected (between top and toe) Question No 2: Why is that so?
From the many thousands of retinal bood vessels I have seen, there were a significant number with fundus hypertonicus. Above a certain age stadium I was quite common but people were usually without a serious disease. Stadium III had the usual mix of hypertension, diabetes, obesity, angina pectoris, very heavy smoking and some more. There was only one patient I remember. He is a friend of mine. There was nothing special, no complaints and he wanted the usual check up. I diagnosed a fundus hypertonicus (I forgot the stadium, guess it was more than II), sent him to the internal medicine department, they diagnosed an aneurisma of the Aorta. The aneurima was operated and maybe I saved his life. But incidents like this are rare, very rare.
And - there are a lot of strokes without fundus hypertonicus.
Now a bit statistics: let us presume there are 1,827 patients (of the 3654) with damage of blood vessels and 1,827 without, the same age groups and the same risk groups. The group without damage has 10 stoke in 7 years, the group with damage 17. That is a difference of about 1 stroke per 1827 patients/per year. As these patiens often suffer from other artheriosclerosis diseases the retinal changes are self explaining, just adding another observation. .....
For the layman this sounds a bit different than the 70%. Presenting these 70% alone is misleading at best. I would like to see whole the study, the original.
The same statistical trap we can observe with breast cancer screening. Just a couple of days ago a review went through the press, a review which was a bit more critical than the usual bla bla.
Bob
-
Well that is the question that everyone asks. And everyone has their own answer - half wrong and half right.
No one knows but you'd think everyone does listening to the opinions.
Politicians are darned if they do and darned if they don't.
Remember when the Bush haters railed against W for Katrina. Naturally the whole thing from lack of preparedness to a slow response was his.
So BO could ignore the hypothetical threat of H1N1 and more likely then not it will fizzle out like the previous flu scares.
And risk another great pandemic the likes not seen in 81 years.
Or he can push for preparedness with funds, a vaccine that could pose unknown health risks and take no risk.
Either way there is someone to ciritcize him.
****Hospitals May Face Severe Disruption From Swine Flu
By Tom Randall and Alex Nussbaum
Aug. 25 (Bloomberg) -- Swine flu may hospitalize 1.8 million patients in the U.S. this year, filling intensive care units to capacity and causing “severe disruptions” during a fall resurgence, scientific advisers to the White House warned.
Swine flu, also known as H1N1, may infect as much as half of the population and kill 30,000 to 90,000 people, double the deaths caused by the typical seasonal flu, according to the planning scenario issued yesterday by the President’s Council of Advisers on Science and Technology. Intensive care units in hospitals, some of which use 80 percent of their space in normal operation, may need every bed for flu cases, the report said.
The virus has sickened more than 1 million people in the U.S., and infections may increase this month as pupils return to school, according to the Centers for Disease Control and Prevention in Atlanta. If swine flu patients fill too many beds, hospitals may be forced to put off elective surgeries such as heart bypass or hernia operations, said James Bentley with the American Hospital Association.
“If you have 1.8 million hospital admissions across six months, that’s a whole lot different than if you have it across six weeks,” said Bentley, a senior vice-president of the Washington-based association, which represents 5,000 hospitals.
The scenario projections were “developed from models put together for planning purposes only,” said Tom Skinner, a spokesman for the CDC, at a briefing in Atlanta today. “At the end of the day, we simply don’t know what this upcoming flu season is going to look like. It could be severe, it could be mild, we just don’t know.”
Past Pandemics
The models were based on past pandemics, and the CDC is working on new projections based on the latest data gathered from swine flu patients, Skinner said. Those estimates should be available “soon,” he said, without further specifying.
President Barack Obama was urged by his scientific advisory council to speed vaccine production as the best way to ease the burden on the health care system. Initial doses should be accelerated to mid-September to provide shots for as many as 40 million people, the panel said in a report released yesterday. Members also recommended Obama name a senior member of the White House staff, preferably the homeland security adviser, to take responsibility for decision-making on the pandemic.
“This isn’t the flu that we’re used to,” said Kathleen Sebelius, U.S. health and human services secretary. “The 2009 H1N1 virus will cause a more serious threat this fall. We won’t know until we’re in the middle of the flu season how serious the threat is, but because it’s a new strain, it’s likely to infect more people than usual.”
Clinical Trials
Data from clinical trials to assess the safety and effectiveness of swine flu vaccines will start to become available in mid-September, health officials reported Aug. 21. Full results from the two-dose trials won’t be available until mid-October.
“We are making every preparation effort assuming a safe and effective vaccine will be available in mid-October,” Sebelius said today at the CDC’s Atlanta offices.
H1N1 has already reached more than 170 countries and territories in the four months since being identified, the Geneva-based World Health Organization said. Swine flu causes similar symptoms as seasonal strains. It has so far resulted in worse than normal flu seasons, with increased hospitalizations and cases of severe illness, the WHO said in an Aug. 12 release.
New Zealand and Australia, in the midst of their normal flu seasons, have reported intensive care units taxed to capacity by swine flu patients. The experience provides clues to what the U.S., Europe and Japan may see when the H1N1 virus returns.
President’s Advisers
The president’s advisory council describes as a “plausible scenario,” that 30 percent to 50 percent of the U.S. population will be infected in the fall and winter. As many as 300,000 patients may be treated in hospital intensive care units, filling 50 percent to 100 percent of the available beds, and 30,000 to 90,000 people may die, the group’s report said.
“This is a planning scenario, not a prediction,” according to the report. “But the scenario illustrates that an H1N1 resurgence could cause serious disruption of social and medical capacities in our country in the coming months.”
Peter Gross, chief medical officer at Hackensack University Medical Center in New Jersey, said if the group’s scenario comes true, “I think every hospital in America is going to be in a crunch. We’ll be hard pressed to deal with those predictions,” he said.
‘Overblown’ Estimates
The estimates seem “overblown,” Gross said, given that swine-flu outbreaks in 1968 and 1957 failed to cause as many deaths, even with medical technology and disease surveillance less advanced than today.
“Influenza, you can make all the predictions you want, but it’s more difficult than predicting the weather,” Gross said yesterday in a telephone interview, after the advisory report was made public. “If influenza was a stock, I wouldn’t touch it.”
The 775-bed hospital is planning for an outbreak, upping its order of flu medications and discussing where to put patients if the worst occurs, Gross said.
The President’s Council of Advisers on Science and Technology is chaired by John Holdren, the director of the White House Office of Science and Technology, Eric Lander, the head of the Broad Institute of Massachusetts Institute of Technology and Harvard University in Cambridge, Massachusetts, and Harold Varmus, the chief executive officer of Memorial Sloan-Kettering Cancer Center in New York.
The 21-member group of scientists and engineers, created by Congress in 1976, advises the president on policy involving scientific matters.
New Estimates
Seasonal flu usually kills about 36,000 Americans, Skinner said. Swine flu causes more severe illness needing hospitalization among younger people than seasonal flu, while leaving people 65 and older relatively unscathed, said Mike Shaw of the CDC.
The median age of those with the pandemic virus has been 12 to 17 years, the WHO said on July 24, citing data from Canada, Chile, Japan, U.K. and the U.S.
“We don’t know whether the number of severe illnesses will be much greater, but we do know that it’s a new virus and therefore people are very vulnerable,” said Anne Schuchat, director of the CDC’s Center for Immunization and Respiratory Diseases, in an interview yesterday.
Disease Burden
About 100 million people in the U.S. get the annual flu shot, Schuchat said. Pregnant women, who have “a disturbingly high burden of disease” from swine flu, only get vaccinated for seasonal flu about 15 percent of the time. Pregnant women are a top priority for vaccinations, she said.
Seasonal flu usually kills about 36,000 Americans. Swine flu causes more severe illness needing hospitalization among younger people than seasonal flu, while leaving people 65 and older relatively unscathed, said Mike Shaw, associate director of laboratory science at the CDC’s flu division.
The median age of those with the pandemic virus has been 12 to 17 years, the WHO said on July 24, citing data from Canada, Chile, Japan, U.K. and the U.S.
“People who get infected with this strain happen to be the healthiest members of our society,” said Shaw in a presentation yesterday at the agency.
The H1N1 strain is genetically related to the 1918 Spanish Flu that killed an estimated 50 million people. Variations of the Spanish Flu circulated widely until about 1957, when they were pushed aside by other flu strains. People whose first exposure to a flu virus was one of those Spanish Flu relatives may have greater immunity to the current pandemic, Shaw said.
To contact the reporters on this story: Tom Randall in New York at trandall6@bloomberg.net; Alex Nussbaum in New York at anussbaum1@bloomberg.net ****
-
Online antibiotic sales may be fueling drug-resistance trend, researchers report
Antibiotics are widely available for purchase online without a prescription, making it easy for patients to self-medicate and potentially contributing to antibiotic resistance, a recent study found.
Researchers conducted searches on Google and Yahoo using the keywords “purchase antibiotics without a prescription” and “online” and compared vendors according to classes of drugs, quantity, shipping locations and shipping time. Of the 138 vendors found, almost all shipped to the U.S., 36.2% sold antibiotics without a prescription and 63.8% provided an online prescription. Available antibiotics included penicillins (94.2% of sites), macrolides (96.4%), fluoroquinolones (61.6%) and cephalosporins (56.5%), and drugs were often sold in higher quantities than a single course. The results appear in the September-October Annals of Family Medicine.
The findings suggest that many antibiotics taken in the U.S. are not impacted by physician prescribing practices and may be contributing to antibiotic resistance, the authors said. The Web sites studied promote self-diagnosis and self-medication, they added, and drugs are likely to be used in inappropriate dosages. In addition, because the drugs are available in large quantities and take a week or more to be delivered, it is likely that they are being stored for future use or to sell.
The results indicate that the observed decline in overall antibiotic prescribing for viral illnesses may be misleading because patients are able to go online for medications when they can’t get a prescription from their physician. Physicians can play a role in mitigating the problem, the authors continued, by educating patients who self-medicate about antibiotic resistance and potential drug interactions.
Among other limitations, the study does not analyze how customers in the U.S. are using the Web sites and the quantities being purchased, the authors acknowledged. Nonetheless, the results highlight a need for increased regulation of Internet sites beyond controlled substances, they concluded.
-
Insulin boost restores muscle growth in elderly
GALVESTON, Texas — When most people think of insulin, they think of diabetes — a disease that arises when, for one reason or another, insulin can't do the critical job of helping the body process sugar. But the hormone has another, less well-known function. It's also necessary for muscle growth, increasing blood flow through muscle tissue, encouraging nutrients to disperse from blood vessels and itself serving as a biochemical signal to boost muscle protein synthesis and cell proliferation.
Recently, scientists have recognized that loss of responsiveness to insulin plays a major role in the loss of physical strength that occurs as people grow older. Now, University of Texas Medical Branch at Galveston researchers have demonstrated that by increasing insulin levels above the normal range in elderly test subjects, they can restore the impaired muscle-building process responsible for age-related physical weakness.
"Insulin is normally secreted during food intake," said Dr. Elena Volpi, senior author of a paper on the study published in the September issue of Diabetologia. "When you give insulin intravenously and increase the blood insulin levels to the same amount produced after a meal, you see that in young people it stimulates protein synthesis and muscle growth, while in older people it really doesn't. But when we gave seniors double the insulin they would normally produce after eating, their muscles were stimulated like those of young people."
Volpi and her co-authors — postdoctoral fellows Satoshi Fujita and Kyle Timmerman, graduate student Erin Glynn and Professor Blake B. Rasmussen — worked with 14 elderly volunteers to examine the response of thigh muscle to the two different blood insulin levels, established by infusion into the thigh's main artery. Blood samples taken from catheters inserted in the femoral artery and vein of each subject enabled the researchers to calculate blood flow and muscle protein synthesis, and muscle biopsies allowed them to measure levels of signaling molecules involved in muscle protein growth.
All the data pointed in the same direction, showing that a blood insulin level double that produced by a typical meal seems to turn back the clock on elderly thigh muscle.
"While we had called this 'insulin resistance' in the past, we didn't really have evidence that you can get an elderly person's muscle to grow if you give it a lot more insulin, which is what we needed to truly say this is insulin resistance," Volpi said. At the same time, she said, the phenomenon is also quite different from the insulin resistance seen in diabetes. "These were older subjects with perfect glucose tolerance," she said. "So what we have identified is a novel kind of insulin resistance that's not related to sugar control."
Instead, Volpi said, the UTMB researchers attribute this new kind of insulin resistance to age-related changes in the vascular system — in particular, changes in the endothelium, the single-cell-thick layer that lines blood vessels. The endothelium controls blood flow by increasing or decreasing the diameter of capillaries (the smallest blood vessels), and regulates the release of oxygen, nutrients, water and other blood-borne cargo through the capillary walls and into muscles and other body tissues. "Having a capillary dilation induced by insulin is important, because it exposes more muscle to the nutrients and hormones and everything flows better and gets stored away better," Volpi said. "But in even healthy older people, this dilation response doesn't work, because they have this endothelial dysfunction."
The UTMB researchers are now testing whether using drugs to dilate muscle blood vessels during insulin exposure can improve muscle growth in older people. "Preliminary data suggest that this treatment may be effective, but these data are not yet published," Volpi said. "On the other hand, in a paper we published two years ago in Diabetes, we showed that a single bout of aerobic exercise — a staple of diabetes treatment — may also improve muscle growth in response to insulin in older nondiabetic people."
###
Volpi's group is now conducting a larger, NIH-funded clinical trial to determine if aerobic exercise and nutritional supplementation for six months can also boost muscle size and function in sedentary but otherwise healthy seniors. UTMB's Sealy Center on Aging and Claude D. Pepper Older Americans Independence Center are recruiting seniors from the Galveston-Houston area for the study. For more information, call 800-298-7015.
The University of Texas Medical Branch at Galveston
Public Affairs Office
301 University Boulevard, Suite 3.102
Galveston, Texas 77555-0144
www.utmb.edu
http://www.eurekalert.org/pub_releases/2009-09/uotm-ibr092509.php
-
Get the benefits of reduced caloric intake without having to decrease intake - to good to be true?
****The fountain of youth may exist after all, as a study showed that scientist...
‘The Future of Us’: Is Human Life Expectancy About to Increase Dramatically?
The fountain of youth may exist after all, as a study showed that scientists have discovered means to extend the lifespan of mice and primates.
The key to eternal -- or at least prolonged -- youth lies in genetic manipulation that mimics the health benefits of reducing calorie intake, suggesting that aging and age-related diseases can be treated.
Scientists from the Institute of Healthy Ageing at University College London (UCL) extended the lifespan of mice by up to a fifth and reduced the number of age-related diseases affecting the animals after they genetically manipulated them to block production of the S6 Kinase 1 (S6K1) protein.
Scientists have shown since the 1930s that reducing the calorie intake by 30 percent for rats, mice and -- in a more recent finding -- primates can extend their lifespan by 40 percent and have health benefits.
By blocking S6K1, which is involved in the body's response to changes in food intake, similar benefits were obtained without reducing food intake, according to the study published in the US journal Science.
The results corroborated those of other recent studies.
"Blocking the action of the S6K1 protein helps prevent a number of age-related conditions in female mice," explained UCL professor Dominic Withers, the study's lead author.
"The mice lived longer and were leaner, more active and generally healthier than the control group. We added 'life to their years' as well as 'years to their lives.'"
The genetically altered female mice lived 20 percent longer -- living a total of 950 days -- or over 160 days more than their normal counterparts.
At age 600 days, the equivalent of middle age in humans, the altered female mice were leaner, had stronger bones, were protected from type 2 diabetes, performed better at motor tasks and demonstrated better senses and cognition, according to the study.
Their T-cells, a key component of the immune system also seemed more "youthful," the researchers said, which points to a slowing of the declining immunity that usually accompanies aging.
Male mice showed little difference in lifespan although they also demonstrated some of the health benefits, including less resistance to insulin and healthier T-cells. Researchers said reasons for the differences between the two sexes were unclear.
"We are suddenly much closer to treatments for aging than we thought," said David Gems of UCL's Institute of Healthy Aging, one of the authors of the study, which was primarily funded by the Wellcome Trust.
"We have moved from initial findings in worm models to having 'druggable' targets in mice. The next logical step is to see if drugs like metformin can slow the aging process in humans."
Other studies have also found that blocking S6K1 were channeled through increased activity of a second molecule, AMPK, which regulates energy levels within cells.
AMPK, also known as a master "fuel gauge," is activated when cellular energy levels fall, as takes place when calorie intake is reduced.
Drugs, such as the widely-used metformin, that activate AMPK are already being used in human patients to treat type 2 diabetes.
Recent studies by Russian scientists suggested that metformin can extend mice's lifespan.
Another drug, rapamycin, was found to extend the lifespan of mice, according to a study published in the British journal Nature.
As rapamycin is already used in humans as an immunosuppresant -- to prevent a patient from rejecting an organ after transplant -- it could not be administered as an anti-ageing drug in its current form.
But rapamycin blocks S6K1 activity and could thus extend lifespan through its impact on S6K1.
Seizing on the potential, US firm Sirtris Pharmaceuticals uses resveratrol, a powerful anti-oxidant found in red wine, as well as other fruits than raisin.
Sirtris scientists -- including co-founder David Sinclair, also a researcher at Harvard Medical School -- have found that resveratrol activates the production of sirtuin proteins, which also unleash the same physiological effects as reducing calorie intake.
Sirtris has produced highly concentrated doses of resveratrol and is currently leading clinical trials with diabetes patients and others suffering from liver and colon cancer.
Copyright AFP 2008***
-
Ever wonder just how much sugar is in the common food items you eat?
http://www.sugarstacks.com/
-
LONGEVITY TIED TO GENES THAT PRESERVE TIPS OF CHROMOSOMES
November 11, 2009 — (BRONX, NY) — A team led by researchers at Albert Einstein College of Medicine of Yeshiva University has found a clear link between living to 100 and inheriting a hyperactive version of an enzyme that rebuilds telomeres — the tip ends of chromosomes. The findings appear in the latest issue of the Proceedings of the National Academy of Sciences.
Yousin Suh, Ph.D.Telomeres play crucial roles in aging, cancer and other biological processes. Their importance was recognized last month, when three scientists were awarded the 2009 Nobel Prize in Physiology and Medicine for determining the structure of telomeres and discovering how they protect chromosomes from degrading.
Telomeres are relatively short sections of specialized DNA that sit at the ends of all chromosomes. One of the Nobel Prize winners, Elizabeth Blackburn, Ph.D., of the University of California at San Francisco, has compared telomeres to the plastic tips at the ends of shoelaces that prevent the laces from unraveling.
Each time a cell divides, its telomeres erode slightly and become progressively shorter with each cell division. Eventually, telomeres become so short that their host cells stop dividing and lapse into a condition called cell senescence. As a result, vital tissues and important organs begin to fail and the classical signs of aging ensue.
In investigating the role of telomeres in aging, the Einstein researchers studied Ashkenazi Jews because they are a homogeneous population that was already well studied genetically. Three groups were enrolled: 86 very old — but generally healthy — people (average age 97); 175 of their offspring; and 93 controls (offspring of parents who had lived a normal lifespan).
"Telomeres are one piece of the puzzle that accounts for why some people can live so long," says Gil Atzmon, Ph.D., assistant professor of medicine and of genetics at Einstein, Genetic Core Leader for The LonGenity Project at Einstein's Institute for Aging Research, and a lead author of the paper. "Our research was meant to answer two questions: Do people who live long lives tend to have long telomeres? And if so, could variations in their genes that code for telomerase account for their long telomeres?"
The answer to both questions was "yes."
"As we suspected, humans of exceptional longevity are better able to maintain the length of their telomeres," said Yousin Suh, Ph.D., associate professor of medicine and of genetics at Einstein and senior author of the paper. "And we found that they owe their longevity, at least in part, to advantageous variants of genes involved in telomere maintenance."
More specifically, the researchers found that participants who have lived to a very old age have inherited mutant genes that make their telomerase-making system extra active and able to maintain telomere length more effectively. For the most part, these people were spared age-related diseases such as cardiovascular disease and diabetes, which cause most deaths among elderly people.
"Telomeres are one piece of the puzzle that accounts for why some people can live so long."
"Our findings suggest that telomere length and variants of telomerase genes combine to help people live very long lives, perhaps by protecting them from the diseases of old age," says Dr. Suh. "We're now trying to understand the mechanism by which these genetic variants of telomerase maintain telomere length in centenarians. Ultimately, it may be possible to develop drugs that mimic the telomerase that our centenarians have been blessed with."
The study, "Genetic Variation in Human Telomerase is Associated with Telomere Length in Ashkenazi Centenarians," appears in the November 9 online issue of the Proceedings of the National Academy of Sciences. In addition to Drs. Atzmon and Suh, the study's other Einstein researchers were co-lead author Miook Cho, M.S., Temuri Budagov, M.S., Micol Katz, M.D., Xiaoman Yang, M.D., Glenn Siegel, M.D., Aviv Bergman, Ph.D., Derek M. Huffman, Ph.D., Clyde B. Schechter, M.D., and Nir Barzilai, M.D.
http://www.einstein.yu.edu/home/news.asp?id=435
-
Very interesting.
-
Phys Ed: The Best Exercises for Healthy Bones
By GRETCHEN REYNOLDS
Digital Images/Getty Images
Several weeks ago, The Journal of the American Medical Association published a study that should give pause to anyone who plans to live a long and independent life. The study looked at the incidence of hip fractures among older Americans and the mortality rates associated with them. Although the number of hip fractures has declined in recent decades, the study found that the 12-month mortality rate associated with the injury still hovers at more than 20 percent, meaning that, in the year after fracturing a hip, about one in five people over age 65 will die.
Meanwhile, another group of articles, published this month as a special section of Medicine & Science in Sports & Exercise, the journal of the American College of Sports Medicine, underscore why that statistic should be relevant even to active people who are years, or decades, away from eligibility for Medicare. The articles detailed a continuing controversy within the field of sports science about exactly how exercise works on bone and why sometimes, apparently, it doesn’t.
“There was a time, not so long ago,” when most researchers assumed “that any and all activity would be beneficial for bone health,” says Dr. Daniel W. Barry, an assistant professor of medicine at the University of Colorado, at Denver, and a researcher who has studied the bones of the elderly and of athletes. Then came a raft of unexpected findings, some showing that competitive swimmers had lower-than-anticipated bone density, others that, as an earlier Phys Ed column pointed out, competitive cyclists sometimes had fragile bones and, finally, some studies suggesting, to the surprise of many researchers, that weight lifting did not necessarily strengthen bones much. In one representative study from a few years ago, researchers found no significant differences in the spine or neck-bone densities of young women who did resistance-style exercise training (not heavy weight lifting) and a similar group who did not.
Researchers readily admit that they don’t fully understand why some exercise is good for bones and some just isn’t. As the articles in this month’s Medicine & Science in Sports & Exercise make clear, scientists actually seem to be becoming less certain about how exercise affects bone. Until fairly recently, many thought that the pounding or impact that you get from running, for instance, deformed the bone slightly. It bowed in response to the forces moving up the leg from the ground, stretching the various bone cells and forcing them to adapt, usually by adding cells, which made the bone denser. This, by the way, is how muscle adapts to exercise. But many scientists now think that that process doesn’t apply to bones. “If you stretch bone cells” in a Petri dish, says Alexander G. Robling, an assistant professor in the department of anatomy and cell biology at Indiana University School of Medicine and the author of an article in Medicine & Science in Sports & Exercise, “you have to stretch them so far to get a response that the bone would break.”
So he and many other researchers now maintain that bone receives the message to strengthen itself in response to exercise by a different means. He says that during certain types of exercise, the bone bends, but this doesn’t stretch cells; it squeezes fluids from one part of the bone matrix to another. The extra fluid inspires the cells bathed with it to respond by adding denser bone.
Related
More Phys Ed columns
Faster, Higher, Stronger
Fitness and Nutrition News
.
Why should it matter what kind of message bones are receiving? Because, Professor Robling and others say, only certain types of exercise adequately bend bones and move the fluid to the necessary bone cells. An emerging scientific consensus seems to be, he says, that “large forces released in a relatively big burst” are probably crucial. The bone, he says, “needs a loud signal, coming fast.” For most of us, weight lifting isn’t explosive enough to stimulate such bone bending. Neither is swimming. Running can be, although for unknown reasons, it doesn’t seem to stimulate bone building in some people. Surprisingly, brisk walking has been found to be effective at increasing bone density in older women, Dr. Barry says. But it must be truly brisk. “The faster the pace,” he says — and presumably the greater the bending within the bones — the lower the risk that a person will fracture a bone.
There seems to be a plateau, however, that has also surprised and confounded some researchers. Too much endurance exercise, it appears, may reduce bone density. In one small study completed by Dr. Barry and his colleagues, competitive cyclists lost bone density over the course of a long training season. Dr. Barry says that it’s possible, but not yet proved, that exercise that is too prolonged or intense may lead to excessive calcium loss through sweat. The body’s endocrine system may interpret this loss of calcium as serious enough to warrant leaching the mineral from bone. Dr. Barry is in the middle of a long-term study to determine whether supplementing with calcium-fortified chews before and after exercise reduces the bone-thinning response in competitive cyclists. He expects results in a year or so.
In the meantime, the current state-of-the-science message about exercise and bone building may be that, silly as it sounds, the best exercise is to simply jump up and down, for as long as the downstairs neighbor will tolerate. “Jumping is great, if your bones are strong enough to begin with,” Dr. Barry says. “You probably don’t need to do a lot either.” (If you have any history of fractures or a family history of osteoporosis, check with a physician before jumping.) In studies in Japan, having mice jump up and land 40 times during a week increased their bone density significantly after 24 weeks, a gain they maintained by hopping up and down only about 20 or 30 times each week after that.
If hopping seems an undignified exercise regimen, bear in mind that it has one additional benefit: It tends to aid in balance, which may be as important as bone strength in keeping fractures at bay. Most of the time, Dr. Barry says, “fragile bones don’t matter, from a clinical standpoint, if you don’t fall down.”
-
Phys Ed: The Best Exercises for Healthy Bones
By GRETCHEN REYNOLDS
Digital Images/Getty Images
Several weeks ago, The Journal of the American Medical Association published
a study that should give pause to anyone who plans to live a long and
independent life. The study looked at the incidence of hip fractures among
older Americans and the mortality rates associated with them. Although the
number of hip fractures has declined in recent decades, the study found that
the 12-month mortality rate associated with the injury still hovers at more
than 20 percent, meaning that, in the year after fracturing a hip, about one
in five people over age 65 will die.
Meanwhile, another group of articles, published this month as a special
section of Medicine & Science in Sports & Exercise, the journal of the
American College of Sports Medicine, underscore why that statistic should be
relevant even to active people who are years, or decades, away from
eligibility for Medicare. The articles detailed a continuing controversy
within the field of sports science about exactly how exercise works on bone
and why sometimes, apparently, it doesn't.
"There was a time, not so long ago," when most researchers assumed "that any
and all activity would be beneficial for bone health," says Dr. Daniel W.
Barry, an assistant professor of medicine at the University of Colorado, at
Denver, and a researcher who has studied the bones of the elderly and of
athletes. Then came a raft of unexpected findings, some showing that
competitive swimmers had lower-than-anticipated bone density, others that,
as an earlier Phys Ed column pointed out, competitive cyclists sometimes had
fragile bones and, finally, some studies suggesting, to the surprise of many
researchers, that weight lifting did not necessarily strengthen bones much.
In one representative study from a few years ago, researchers found no
significant differences in the spine or neck-bone densities of young women
who did resistance-style exercise training (not heavy weight lifting) and a
similar group who did not.
Researchers readily admit that they don't fully understand why some exercise
is good for bones and some just isn't. As the articles in this month's
Medicine & Science in Sports & Exercise make clear, scientists actually seem
to be becoming less certain about how exercise affects bone. Until fairly
recently, many thought that the pounding or impact that you get from
running, for instance, deformed the bone slightly. It bowed in response to
the forces moving up the leg from the ground, stretching the various bone
cells and forcing them to adapt, usually by adding cells, which made the
bone denser. This, by the way, is how muscle adapts to exercise. But many
scientists now think that that process doesn't apply to bones. "If you
stretch bone cells" in a Petri dish, says Alexander G. Robling, an assistant
professor in the department of anatomy and cell biology at Indiana
University School of Medicine and the author of an article in Medicine &
Science in Sports & Exercise, "you have to stretch them so far to get a
response that the bone would break."
So he and many other researchers now maintain that bone receives the message
to strengthen itself in response to exercise by a different means. He says
that during certain types of exercise, the bone bends, but this doesn't
stretch cells; it squeezes fluids from one part of the bone matrix to
another. The extra fluid inspires the cells bathed with it to respond by
adding denser bone.
Related
a.. More Phys Ed columns
b.. Faster, Higher, Stronger
c.. Fitness and Nutrition News
Why should it matter what kind of message bones are receiving? Because,
Professor Robling and others say, only certain types of exercise adequately
bend bones and move the fluid to the necessary bone cells. An emerging
scientific consensus seems to be, he says, that "large forces released in a
relatively big burst" are probably crucial. The bone, he says, "needs a loud
signal, coming fast." For most of us, weight lifting isn't explosive enough
to stimulate such bone bending. Neither is swimming. Running can be,
although for unknown reasons, it doesn't seem to stimulate bone building in
some people. Surprisingly, brisk walking has been found to be effective at
increasing bone density in older women, Dr. Barry says. But it must be truly
brisk. "The faster the pace," he says - and presumably the greater the
bending within the bones - the lower the risk that a person will fracture a
bone.
There seems to be a plateau, however, that has also surprised and confounded
some researchers. Too much endurance exercise, it appears, may reduce bone
density. In one small study completed by Dr. Barry and his colleagues,
competitive cyclists lost bone density over the course of a long training
season. Dr. Barry says that it's possible, but not yet proved, that exercise
that is too prolonged or intense may lead to excessive calcium loss through
sweat. The body's endocrine system may interpret this loss of calcium as
serious enough to warrant leaching the mineral from bone. Dr. Barry is in
the middle of a long-term study to determine whether supplementing with
calcium-fortified chews before and after exercise reduces the bone-thinning
response in competitive cyclists. He expects results in a year or so.
In the meantime, the current state-of-the-science message about exercise and
bone building may be that, silly as it sounds, the best exercise is to
simply jump up and down, for as long as the downstairs neighbor will
tolerate. "Jumping is great, if your bones are strong enough to begin with,"
Dr. Barry says. "You probably don't need to do a lot either." (If you have
any history of fractures or a family history of osteoporosis, check with a
physician before jumping.) In studies in Japan, having mice jump up and land
40 times during a week increased their bone density significantly after 24
weeks, a gain they maintained by hopping up and down only about 20 or 30
times each week after that.
If hopping seems an undignified exercise regimen, bear in mind that it has
one additional benefit: It tends to aid in balance, which may be as
important as bone strength in keeping fractures at bay. Most of the time,
Dr. Barry says, "fragile bones don't matter, from a clinical standpoint, if
you don't fall down."
-
My Mom (60+) has been "working out" for years to maintain bone density, she is stornger than some men her age too. No big weights either, just enough to feel a load and keep the reps under 15. She has also been running an aqua aerobics class as well, just to get some of her older friends active again. Many of them had balance problems- and a fear of falling- which the water resolved, being a good catcher/buffer.
Those that have been working out with er at the class have started "dry" workouts too. They feel the way they went from little balance to easy balance and now are thinking of some strength as well.
The research that it is not just resistence (weight) training that builds bones is not so much an issue, the issue is retaining bone strength. I think that it is impact training that builds bone, the ability to take shock, isn't it. Walking on concrete would work up to a point, then you have adapted and need to find another method.
Mom always says ACTIVITY is the key for having a fun old age, the dogs won't have THAT problem will they? :mrgreen:
-
Obesity-Causing Bacteria -- and the Cure
There’s little doubt that diet and lifestyle choices play a major role in the obesity epidemic in America. But investigators have recently uncovered another intriguing theory about the causes of obesity -- it turns out that obese people have different gut bacteria. Though this is not the sole factor, experts now are delving further to learn all they can about what role these tiny microbes play in this big threat to our health.
Obese People Host a Different Mix of Bacteria than Lean Individuals
The human body is host to trillions of microbes (bacteria), some that support our health and others that threaten it, notes Andrew Rubman, ND. There is lots of research underway on the connection between obesity and gut bacteria, but early findings already demonstrate that different people are host to different colonies of microorganisms in their guts and these variations affect weight as well as health. Some of the differences may be genetic, others are a result of our unique dietary environments. Several studies in particular highlight the connection...
At Washington University School of Medicine in St. Louis, Missouri, scientists found that the intestinal tracts of obese and thin people have different ratios of two types of bacteria that normally predominate in the human gut -- Firmicutes and Bacteroidetes. Obese individuals had higher percentages of Firmicutes and lower percentages of Bacteroidetesbacteria, while the lean group had roughly the opposite balance. After the obese individuals lost weight by following a low-calorie diet for one year, the ratio of these two types of bacteria in the obese individuals became more like that of the lean group.
In another experiment, also at Washington University, scientists bred mice to be free of intestinal flora, then fed them gut bacteria taken from obese mice -- and they got fat. In contrast, flora-free mice given gut bacteria from skinny mice gained little weight. The researchers concluded that differences in gut flora may contribute to obesity.
The Ecology of the Gut
While there is more to learn about the influence of gut ecology on weight, keeping the bacteria of your digestive system in proper balance is essential to maintaining optimal health, says Dr. Rubman. He told me it is well-documented that problems in the large intestine -- the hub of the body’s immune system -- quickly lead to problems elsewhere in the body. Beneficial bacteria help your body break down food and absorb nutrients, so it makes sense that having more healthful bacteria helps digestion. Poor diet, emotional stress or physical disease, along with other factors, disturb the natural balance, allowing harmful bacteria to proliferate, so it is harder for good bacteria to protect the mucosal walls of the intestines. When these become more permeable, toxins leak out, challenging immunity and causing inflammation locally and elsewhere in the body.
Our bodies are programmed to protect us from negative external influences and challenges, so threats (such as inflammation) may lead to an increase in energy storage (i.e., calories) to meet the challenge. If this mistaken attempt at self-protection persists, the ecology of the gut adjusts to favor bacteria that are more proficient at extracting calories from food. Over time, these calorie-hungry microbes contribute to weight gain, making it even harder for overweight people to shed unwanted pounds -- an all-too-common complaint. So, the theory goes, people who are already overweight can eat the same meals as lean people, but they’ll absorb more calories. Harmful bacteria also slow the passage of food through the digestive tract, and the more time food spends in the body, the more calories you absorb from it.
Fortunately, there are steps that you can take to encourage and restore a proper microbial balance in your gut.
One way to optimize your balance of intestinal bacteria is to follow a probiotic diet, which will rev up your metabolism and spur weight loss, according to Joseph Brasco, MD, a gastroenterologist in private practice in Huntsville, Alabama. Especially if you are doing everything right -- eating nutritiously, watching portion size and exercising regularly -- if you still cannot lose weight, the problem may be related to an imbalance of gut flora.
To tip the scales toward weight loss, Dr. Brasco recommends these simple strategies:
Consume more fresh fruits and vegetables and fewer processed foods. What you don’t eat is just as important as what you do, Dr. Brasco emphasizes. Fresh produce encourages the production of friendly microbes. Fiber in fruits and vegetables (especially the skin) helps speed food through the digestive tract. This improves the health of the intestinal lining by nurturing the right bacteria. Toxins don’t linger as long, so they do less damage. In contrast, processed foods, such as breads, doughnuts and cookies, are loaded with starch and simple sugars -- exactly what harmful bacteria thrive upon.
Eat fermented foods every day. To restore proper gut balance, regularly eat yogurt with active cultures, chutneys, unpasteurized sauerkraut, pickles, kimchi, kefir and miso. Try a new type each day -- for example, snack on yogurt... add chutney to a dinner stew... slice some pickles into your salad. Beneficial organisms associated with fermentation colonize the gut and discourage the growth of harmful bacteria.
Take a daily probiotic supplement. When diet and exercise still fail to generate weight loss, Dr. Brasco has seen patients get good results with probiotics. His favorite brands: Garden of Life’s Primal Defense Ultra and Align (Procter & Gamble), both available at health-food stores and online, and HLC (Pharmax), available through your health care provider. If a probiotic supplement makes you gassy or bloated, try taking it on an empty stomach, suggests Dr. Brasco. Most doctors advise patients to take probiotics with food, but he says trying them away from meals sometimes helps this problem. Other solutions include taking a probiotic supplement every other day to start and working your way up to daily... or you could try a different product based on a different mix of bacteria, since there are a variety available. Ask your doctor for help in identifying the right mix for you.
Source(s):
Andrew Rubman, ND, director, Southbury Clinic for Traditional Medicines, Southbury, Connecticut.
Joseph Brasco, MD, Center for Colon and Digestive Disease, Huntsville, Alabama. Dr. Brasco is coauthor of Restoring Your Digestive Health (Kensington Press) and the upcoming Probiotic Diet
-
Probiotics: Your Secret Weapon for Better Health
Gary B. Huffnagle, PhD
University of Michigan Medical School
The small and large intestines (gut) do most of the work involved in digesting the 20 tons of food that the average person consumes in a lifetime. This process involves trillions of bacteria -- some of them harmful and others beneficial.
What you may not know: While the gut is most commonly associated with digestion, it's estimated that at least 60% of a person's immune system is located there. "Good" bacteria protect against the growth of harmful bacteria to help prevent infections, such as vaginal yeast infections and urinary tract infections.
Probiotic bacteria (a subset of good bacteria) also secrete substances that act on intestinal muscles and help regulate motility (the intestinal contractions that move food and waste through the intestine at the proper rate). Because these good bacteria play a key role in preventing infections as well as keeping the digestive system functioning properly, "probiotics" -- dietary supplements or foods that contain beneficial bacteria or yeasts similar to those found in the human gut -- have become increasingly popular, particularly among people who take antibiotics.
Reason: Antibiotics kill not only harmful microorganisms that cause disease, but also the body's beneficial bacteria, sometimes leading to gas, cramping and such conditions as diarrhea. People who take antibiotics regularly may have permanent reductions in probiotic organisms unless they replenish the body's natural supply. For most people, the occasional use of antibiotics -- such as a 10-day course -- is unlikely to cause lasting problems.
WHEN SUPPLEMENTS HELP
Probiotics are live microorganisms. Two of the most beneficial types of probiotics --Lactobacilli and Bifida organisms -- thrive in the naturally acidic environments of the stomach and small intestine.
Probiotics are often recommended for digestion (to help reduce such problems as gas, bloating, constipation and diarrhea), but they appear to be equally important -- if not more so -- for the immune system.
Probiotics in the intestine stimulate production of white blood cells known as regulatory T cells, which help fight inflammation associated with such disorders as eczema, seasonal allergies and inflammatory bowel disease (IBD), a condition in which the bowel becomes inflamed, often resulting in abdominal cramps and diarrhea.
Probiotics also help prevent and treat diarrhea related to Clostridium difficile infection.
There are many dozens of species of probiotic organisms. The most reliable probiotic formulations now available in the US are in capsule form. Most probiotic capsules should be refrigerated.
Two highly effective products are used primarily for digestive problems. Use the one that most closely matches your symptoms... *
Culturelle. Studies over the past 30 years have shown that Lactobacillus rhamnosus GG (the active organism in this product) reduces the severity and duration of traveler's diarrhea, as well as diarrhea associated with antibiotic therapy.
Typical dose: One to two daily supplements (each containing 30 billion organisms), taken at the onset of diarrhea. Continue for one week after symptoms stop. To prevent antibiotic-related diarrhea, take the supplements during antibiotic therapy and for at least one week afterward.
Important: To ensure optimal effectiveness of the antibiotic, do not take it at the same time of day you are taking the probiotic.
Align contains Bifidobacterium infantis 35624, an organism shown in studies to decrease symptoms of irritable bowel syndrome (IBS), a condition that causes diarrhea and/or constipation and other digestive problems.
Typical dose: One capsule (containing one billion live organisms) daily -- taken indefinitely if symptoms are ongoing. If the IBS is associated with stomach flu, take the probiotic supplement during symptoms and continue for one week after they subside.
IMMUNE-BOOSTING BENEFITS
To ensure that your immune system is working at its best, it's a good idea to take probiotic supplements and/or to eat foods containing probiotics daily even if you don't have a particular condition that you're trying to treat.
To boost immunity, look for probiotic supplements and foods that contain the bacterium Lactobacillus casei or several probiotic bacteria strains.
My favorite multistrain supplements are Jarro-Dophilus EPS and Theralac. Follow the dosage instructions on the label.
Helpful: Probiotics are stimulated by soluble dietary fiber, so they’re more likely to proliferate in the intestine when you also eat complex carbohydrates, such as legumes, vegetables and whole grains. These foods contain "prebiotics," which provide the nutrition that probiotics need to multiply.
PROBIOTIC FOODS
In the last few years, food manufacturers have begun to promote probiotic-enriched foods, such as the low-fat yogurt Activia and the probiotic dairy drink DanActive (both by Dannon). These products contain the well-researched probiotic bacteriaBifidobacterium animalis and L. casei, respectively.
When these foods are bought in a grocery store and analyzed in a laboratory, they consistently contain about the same number of active organisms as listed on the labels.
Other probiotic food products...
Yogurt. Best choices: Foods with the "live and active cultures" seal from the National Yogurt Association. These products must contain 100 million live bacteria per gram at the time of their manufacture.
Aged cheeses, such as cheddar or blue cheese, typically contain three billion to 10 billion organisms per serving. Generally, the longer a cheese is aged, the higher the probiotic load.
Kefir, a type of fermented milk, usually has at least three billion organisms per serving.
Caution: Aged cheeses and kefir should be avoided by people who have food sensitivities to milk products.
*If you have an immune deficiency, talk to your doctor before taking probiotics
-
When listening to medical advise from PhDs be careful.
Sometimes what they see in the labe does not jive with reality.
They are not the ones treating people.
Case in point:
"""Typical dose: One to two daily supplements (each containing 30 billion organisms), taken at the onset of diarrhea. Continue for one week after symptoms stop. To prevent antibiotic-related diarrhea, take the supplements during antibiotic therapy and for at least one week afterward.
Important: To ensure optimal effectiveness of the antibiotic, do not take it at the same time of day you are taking the probiotic.""""
So which is it?
It is amazing how the legaleze experts spend their careers going after pharm companies for a one in a million rare drug reaction yet we have all these know it alls all over the airwaves hawking their "natural" products with complete freedom to make all kinds of medical claims for cures to cancer, Alzheimers, prostate health, colon health, heart health, brain health, weight loss, sex health, joint health. Most of it pure nonsense quakery and fraud to make a buck.
Yet that is ok . But let a FDA approved drug turn out to cause a rare reaction and the response to that is outrage.
To me this is amazing. Yet not a peep.
Hey the media makes billions from the advertising from these quacks. So what do they care?
I am off my soap box.
-
I don't know. Is taking advantage of an endless stream of beautiful women offerring up everything to a healthy male an addiction, poor judgement or simply inability to say no to raging hormonal juices?
I guess if the psycho-babalists (who are happy to sell books, give therapy for this "ailment" in return for cash) can make a case that this behavior is some sort of disease for a healthy male to want to have sex with beautiful women than I guess it gives tiger an out too.
Frankly, if all men had this situation I think "sex addiction" would be as prevalent as obesity.
You know what a few have admitted about the fooling around that goes on in baseball. Reports over the years have suggested very few baseball players don't have their girlfriends in the various cities.
http://www.radaronline.com/exclusives/2010/01/exclusive-tiger-woods-sex-rehab-mississippi
-
Scientists discover the secret of ageing
By Clive Cookson in London
Published: February 15 2010 23:00 | Last updated: February 15 2010 23:00
One of the biggest puzzles in biology – how and why living cells age – has been solved by an international team based at Newcastle University, in north-east England.
The answer is complex, and will not produce an elixir of eternal life in the foreseeable future.
But the scientists expect better drugs for age-related illnesses, such as diabetes and heart disease, to emerge from their discovery of the biochemical pathway involved in ageing.
The Newcastle team, working with the University of Ulm in Germany, used a comprehensive “systems biology” approach, involving computer modelling and experiments with cell cultures and genetically modified mice, to investigate why cells become senescent. In this aged state, cells stop dividing and the tissues they make up show physical signs of deterioration, from wrinkling skin to a failing heart.
The research, published by the journal Molecular Systems Biology, shows that when an ageing cell detects serious damage to its DNA – caused by the wear and tear of life – it sends out specific internal signals.
These distress signals trigger the cell’s mitochondria, its tiny energy-producing power packs, to make oxidising “free radical” molecules, which in turn tell the cell either to destroy itself or to stop dividing. The aim is to avoid the damaged DNA that causes cancer.
The Newcastle discovery plays down the role of telomeres, the protective tips on the ends of human chromosomes, which gradually become shorter as we grow older.
“There has been a huge amount of speculation about how blocking telomere erosion might cure ageing and age-related diseases,” said Tom Kirkwood, director of Newcastle’s Institute of Ageing and Health. “The telomere story has over-promised and the biology is more complicated.”
He added: “Our breakthrough means that we stand a very much better chance of making a successful attack on age-related diseases while at the same time avoiding the risk of unwanted side-effects like cancer.”
His colleague Thomas von Zglinicki emphasised caution in the research’s next stage – to investigate ways to prevent cellular senescence.
“It is absolutely essential to tread carefully in trying to alter processes that cause cells to age, because the last thing we want is to help age-damaged cells from breaking out to become malignant,” said Mr von Zglinicki.
http://www.ft.com/cms/s/0/436a39a0-1a6e-11df-a2e3-00144feab49a.html?nclick_check=1
-
I know someone whose only son died choking on a hot dog. This doesn't mean I am necessarily for more micromangement of our society:
"HealthDay Reporter by Amanda Gardner
healthday Reporter – 1 hr 39 mins ago
MONDAY, Feb. 22 (HealthDay News) -- The leading group of pediatricians in the United States is pushing for a redesign of common foods such as hot dogs and candies, along with new warning labels placed on food packaging, to help curb sometimes fatal incidents of child choking.
"We know what shape, sizes and consistencies pose the greatest risk for choking in children and whenever possible food manufacturers should design foods to avoid those characteristics, or redesign existing foods when possible, to change those characteristics to reduce the choking risk," said Dr. Gary Smith, immediate-past chairman of the American Academy of Pediatrics' Committee on Injury, Violence and Poison Prevention and lead author of the organization's new policy statement on preventing choking.
"Any food that has a cylindrical or round shape poses a risk," he pointed out. Smith said that hot dogs were high on the list of foods that could be redesigned -- perhaps the shape, although he said it would be up to the manufacturers to figure out the specifics.
Hard candies, on the other hand, could be designed so they're flat rather than round, said Smith, who is also director of the Center for Injury Research & Policy at Nationwide Children's Hospital in Columbus, Ohio.
The AAP policy statement appears in the March issue of Pediatrics and is the first such guidance on the subject from that group.
"There's a general recognition that more needed to be done to protect children from choking," according to Smith. "We have a number of laws and regulations that help prevent choking due to toys. There are no such similar regulations for food."
Health experts welcomed the suggestions.
"I think it's very reasonable to strengthen regulations to prevent choking injuries for children," said Dr. Lee Sanders, associate professor of pediatrics at the University of Miami Miller School of Medicine. "The most common cause of death for kids aged roughly 1 to 5 is choking but it's also one of the most common reasons for visits to the emergency room and, for kids who don't die of these injuries, sometimes there are long-lasting injuries or implications," Sanders said. "It's a significant public health issue."
"People should know that grapes are a choking hazard for a certain-age child, that hot dogs are of risk," added Dr. Mike Gittelman, associate professor of clinical pediatrics in the division of emergency medicine at Cincinnati Children's Hospital.
The U.S. Food and Drug Administration (FDA) said it would "carefully review the analysis and recommendations."
"The FDA is concerned about the deaths and serious injuries caused by choking," said agency spokeswoman Rita Chappelle. "We will also continue to consult with the Consumer Product Safety Commission on assessing choking hazards associated with food and take action against food products that are 'unfit for food' on a case-by-case basis."
Hot dogs are a prime offender, accounting for 17 percent of food-related asphyxiations in children under the age of 10, according to one study.
"If you were to take the best engineers in the world and asked them to design a perfect plug for a child's airway, you couldn't do better than a hot dog," Smith said. "It's the right size, right shape. It's compressible so it wedges itself in. When they're in that tight [it's] almost impossible, even with the correct training and the correct equipment, to get out. When it's wedged in tightly, that child is going to die."
Other high-risk foods include hard candy, peanuts and nuts, even peanut butter.
The policy statement called for the government to establish a "mandatory system . . . to label foods with appropriate warnings according to their choking risk, to conduct detailed surveillance and investigate food-related choking incidents, and to warn the public about emerging food-related choking hazards."
Manufacturers' responsibility would be to affix "choking hazard" labels to high-risk products and to consider shapes, sizes and textures when designing products.
"I think there should be a commitment from the entire industry to label not only hot dogs but all high-risk foods with some type of informational label that allows consumers to make informed decisions," Smith said, adding that he thought companies would figure out that "safety sells."
The AAP also called on parents, pediatricians and other health-care workers to pay more attention to the issue.
The Grocery Manufacturers Association (GMA) responded, but put special emphasis on the role of parents, teachers and other child care providers in helping keep kids safe.
"Food safety and consumer confidence is the number-one priority of the food and beverage industry. We applaud the attention the American Academy of Pediatrics is bringing to the prevention of choking among children," the GMA said in a statement.
"We especially agree that the education of parents, teachers, child care workers, and other child caregivers encouraging them to supervise and create safer environments for children is paramount to the prevention of choking among children. We also strongly agree that pediatricians, doctors and other infant and toddler care professionals should intensify choking prevention counseling including providing parents and care givers guidance on developmentally appropriate food selection for their children. We take our working relationships with FDA and USDA [U.S. Department of Agriculture] very seriously and look forward to continuing to work with the agencies to ensure that our products are as safe as possible," the GMA said."
-
Do CT Scans Cause Cancer?
The last several months have presented one worrisome story after another regarding the dangers of CT scans, including more than 200 patients receiving radiation overdoses while undergoing brain scans at a California hospital... unpredictable and widespread variation in radiation dosing for cardiac scans from one hospital to the next... and a new research report revealing that the cancer risk from radiation in a CT scan may be far higher than was thought. Two studies on this topic were published in the December 2009 issue of Archives of Internal Medicine. One of the studies reports that just one scan can deliver enough radiation to cause cancer and predicts that 29,000 new cancers will develop that can be linked to CT scans received in just the year 2007. Making matters much worse is the fact that the use of CT scans in medicine has grown explosively -- more than tripling in the US since the 1990s, with more than 70 million given each year.
Where it was previously thought that only those who underwent numerous scans were in danger, the second of the published studies shows that having had even one can boost cancer risk notably -- for example, a heart scan at age 40 would later result in cancer in one in 270 women and one in 600 men. Abdominal and pelvic CT scans raise the risk for cancer more than brain scans, and the risk is far greater in younger patients, especially children.
The same researchers also noted huge variability in how much radiation patients get, with some patients getting 10 or more times as much radiation as others. There are a variety of reasons for this, including equipment settings that aren’t standardized and the radiologist’s decision about how much is necessary to capture a high-quality image of a particular part of the body. Also, methods for reducing radiation, such as adjusting for the size of the patient, are underutilized. Yet another danger -- when equipment is new and unfamiliar (as was the case with the California patients who received overdoses) and technicians aren’t properly trained, the patient may receive unintended excess radiation.
This is frightening stuff -- but let’s put it in context. E. Stephen Amis, Jr., MD, chair of radiology at both the Albert Einstein College of Medicine and Montefiore Medical Center in the Bronx, New York, gave his thoughts on the risk versus reward and what people should do to protect themselves from the risks of radiation exposure in imaging procedures. He said it is important to realize that in many cases CT scan technology is truly "lifesaving" and that, when used properly, the benefits obtained by getting the comprehensive information on what’s currently wrong outweigh the future risks presented by the radiation. For instance, if you have suspected acute appendicitis or head trauma as a result of a car accident, your doctor needs to know that -- fast. Dr. Amis also pointed out that no direct evidence shows particular cancers are related to CT scans -- rather the relationship is "inferred, based on increased cancers in survivors of the atomic bombing of Japan and in those exposed to the fallout from Chernobyl (among others)."
What you need to know
The radiology community is working to get these problems under control. Meanwhile, however, it is not safe for each of us as patients to pretend these problems don’t exist while the system sorts itself out -- at best, that will take years. It is important to take steps now to minimize your risk. Here is what you can do...
Keep notes on all the scans you’ve had that you can remember(ask family members if you are unsure), including the body area and type of scan (x-ray or CT). If you have a chronic condition, such as colitis or chronic lung disease, that necessitates multiple imaging procedures, ask your doctor about other imaging options that might be a good substitute for CT scans.
Carry records with you. Keep and update a wallet-sized card listing the imaging tests that you’ve had and where and when each was done.
If and when your doctor advises you to have a CT scan, ask lots of questions. This is particularly important for tests like cardiac CT scans that may not be strictly necessary, but that your doctor may order to gather more information about your overall health. Ask about the possibility of using alternative imaging methods, such as MRI or ultrasound, neither of which uses radiation. Dr. Amis suggests using language something like this: "I’ve seen a lot of articles lately about some of these tests increasing your radiation exposure. Please tell me what knowledge you hope to gain by having me go through this CT scan. Is this test really necessary?"
Be aware of dosages. Dr. Amis also advises asking about the radiation dosage required for the specific test your doctor has prescribed, noting that sites such as RadiologyInfo.org list typical doses, comparing exposures among various types of x-ray and CT examinations. "It never hurts for patients to look at such Web sites so that they are informed," he said, advising asking the technician about the dose to be sure it is in a reasonable range.
The bottom line? Know the risks and be careful. As Dr. Amis told me, "the point is to be aware, but not overly concerned."
Do (other) Medical Tests Give You Cancer?
MRI, CT, ultrasound; these and other imaging tests are now so commonplace that we tend to take their use for granted. And indeed, these sophisticated imaging technologies have advanced medicine in previously unimaginable ways by enabling doctors to look inside our bodies. But (isn’t there always a but?), it is important to be aware that everything has its price. Among the downsides to all this testing...
Cumulative exposure to radiation from imaging tests over your lifetime increases your risk for cancer.
Imaging equipment is expensive, and doctors and hospitals may need to recoup the investment as quickly as possible. Some experts believe that overuse has been a significant contributor to our exorbitant health-care costs.
The images are not as precise as we’d like to think... in fact, in many cases, they’re actually interpretations (based on calculations performed by computer software) and not pictures at all.
All this information adds up to many instances of "false positive" results, which in turn can lead to unnecessary anxiety and stress for patients and unnecessary (and often risky) medical procedures.
To Save Yourself from Unnecessary Tests
Once again, we need to advocate for ourselves. First and foremost, do not make the assumption that every imaging test suggested by your doctors is necessary and important. Knowing something about the risks and benefits of the different types will help you discuss intelligently with your doctor what’s right for you. Having this knowledge will also help you understand and keep track of your imaging-test history so that you don’t have radiation-based exams that are redundant or for problems that could be diagnosed with a different technique.
Ultrasound (also called sonography)
Ultrasound uses high-frequency sound waves to create real-time images of organs and blood as it flows through vessels. Commonly used to monitor fetal development, ultrasound can also be used to diagnose abdominal organ abnormalities, gallbladder or kidney stones or an aneurysm in the aorta.
Pros: Ultrasound requires no ionizing radiation and, Dr. Amis said, "presents no known dangers." The scans can be done quickly. Ultrasound is among the least expensive imaging procedures, and the machines it uses are small and portable.
Cons: Ultrasound scans show less detail than CT and MRI scans, and not all structures can be visualized with this technology.
Best used for: Ultrasound is best for evaluating abdominal and reproductive organs, the developing fetus, vascular structures (such as the abdominal aorta) and joints.
Magnetic Resonance Imaging (MRI)
This procedure uses a powerful magnet and radio frequency pulses to "view" most internal body structures. It utilizes a large scanner that transmits the data to a computer, providing a detailed interpretive image of the structures in the body. Sometimes a contrast dye is used to heighten image quality. MRI is especially useful in neurological, cardiovascular, musculoskeletal and oncological imaging.
Pros: MRI uses no ionizing radiation and produces sharp, high-contrast images of different tissues, especially valuable in visualizing the brain and its blood vessels.
Cons: Some people find having an MRI scan quite uncomfortable (two common complaints -- obese people don’t fit easily into the machines, and being inside can create claustrophobic feelings, for which some people require mild sedation). Scans take a long time -- often 30 minutes to an hour -- and patients must remain perfectly still and may be required to hold their breath for short periods. A small percentage of people are allergic to the contrast dye, and it’s not known whether MRI is totally safe for pregnant women. A particularly dangerous problem is that the magnets exert powerful force on anything and everything metallic that is on or in the body, and as a result, MRI scanners have been known to cause pacemakers to malfunction.
Best used for: MRI is the best choice for soft tissue imaging, including to diagnose cardiovascular disease, as well as for oncological and musculoskeletal imaging.
X-ray
These are created by sending beams of radiation through the area of concern to capture an image on photographic film -- or these days, more typically on a digital image recording plate. To obtain real-time images of functioning organs or blood vessels, X-ray technology is sometimes combined with contrast dyes injected into the body (called fluoroscopy).
Pros: X-ray technology is relatively inexpensive, is easy to use and produces high-resolution images of bone with less radiation than CT scan.
Cons: The type of radiation used, called ionizing radiation, is carcinogenic, albeit weakly. The radiation accumulates over the course of a lifetime, and excessive doses are believed to increase risk for cancer.
Best used for: X-ray is typically the first choice for diagnosing or monitoring calcium-dense tissue (broken bones, dental cavities) and pneumonia and other chest diseases.
Computed Tomography (CT or CAT scan)
A CT scan is like an X-ray taken to the next level. The patient lies on a table that moves through a machine as numerous X-ray beams and electronic detectors rotate, following a spiral path, around the body. Computers use the resulting data to create two-dimensional cross-sectional views of parts of the body -- these can be further manipulated to create multidimensional views as well. CT scans are most widely used for diagnosing causes of abdominal pain, diseases of internal organs and injuries to the liver, spleen, etc.
Pros: Scans can be completed in a matter of seconds, making CT scans indispensable in emergencies. CT scans produce very detailed images of bone, soft tissue and blood vessels, and can be used in patients with pacemakers and other metallic implants.
Cons: CT scan delivers higher doses of ionizing radiation than X-ray... so with multiple scans, in particular, cancer risk is increased. X-rays, including CT scans, are not recommended for pregnant women -- in emergencies, however, they may be required.
Best used for: CT scan is the imaging test doctors use for diagnosing severe headache, chest pain, abdominal pain and trauma and generally in emergency-room settings. This technology is also often used for diagnostic "work-ups" for cancer, stroke and brain problems, among other illnesses and injuries.
Nuclear imaging
In nuclear imaging, patients are injected with (or, alternately, ingest or inhale) a minute amount of radioactive material. A scanner or camera is then used to gather images from specific organs in the body. The process is similar to an X-ray, but the radiation beams emanate from the inside out, which enables doctors to see clearly what’s deep inside the body. This technique is often used to diagnose or measure the progression of specific diseases, such as cancer or cardiovascular disease.
Pros: Nuclear images provide a view that no other technique can obtain.
Cons: It can take hours or days for the radioactive tracer to accumulate in the body and then additional hours to perform the imaging test. Image resolution may not be as clear as those taken with other forms of imaging. Though the radioactive contrast material is designed to exit the body via the urine or stool within a day or two, the radioactive waste then remains in leaching fields and septic systems and is unaffected by sewage treatment methods, so there are concerns about the cumulative environmental impact of this particular form of imaging. Also, it’s quite rare, but some patients have reactions to injected materials -- typically these are mild, though severe reactions have been reported.
Informed Decision Making
Patients aren’t the ones who should demand one type of imaging test over another -- even doctors, when they are patients, take counsel from their physicians. But, as a patient, you absolutely should feel comfortable questioning your doctors about the risks and benefits -- and necessity -- of any imaging study.
Important: Always bring up the scans you’ve had before -- the type, how many and what they were for -- so that your doctor can make an informed recommendation about what you need next. If you’re interested in learning more about imaging techniques, Dr. Amis recommends visiting RadiologyInfo.org, which is co-sponsored by the American College of Radiology and the Radiological Society of North America.
-
Second post:
Is Your Shower Water Dangerous?
A recent study reported that in some communities people regularly shower with a dangerous microbe called Mycobacterium avium -- a cousin of the tuberculosis-causing bacteria and one that is quite infectious in its own right.
The University of Colorado-Boulder study is part of a larger research project focused on bacteria we’re exposed to in daily life. This particular study examined showerheads because they provide ideal conditions for the formation of slimy biofilms -- an assemblage of bacteria that attach themselves to a surface and excrete a protective mesh layer around themselves (dental plaque is an example), making them difficult to eradicate. Theorizing that the shower might be the point of entry for this infection, lead researcher Leah Feazel told me that researchers collected samples from the insides of 45 showerheads in nine US cities one, two or three times over two and one-half years. They found M. avium in both Denver and New York showerheads.
Confirming the finding, small amounts of M. avium were also detected in the water systems in both Denver and New York City. In those cities, the concentration of Mycobacteria (of which M. avium is one species) in some showerheads was more than 100 times that in the background water. Researchers theorize that this happened because the biofilms were able to establish colonies of such significant size that they could not be dislodged even by water regularly flowing through. Both municipalities treat their water systems with chlorine, ostensibly to eradicate such dangers, but M. avium are known to be resistant, so the bacteria that survive become even stronger. Since many species of Mycobacteria have been implicated in respiratory and other kinds of infections, this is a cause for concern.
Why Showers Are Especially Risky
M. avium is common in soil and water, but it’s especially dangerous in showerheads because it is dispersed in aerosol form, which is inhaled and can travel deep into the lungs. Like its relative, Mycobacterium tuberculosis, M. aviumprimarily causes lung disease, but it has also been known to cause digestive and lymphatic system infections. According to Feazel, M. avium infections are rare in people with healthy immune systems and "fairly rare" among the immune-compromised -- but they’re on the rise here in the US as well as in the rest of the developed world. The infections caused by M. avium can lead to especially severe illness for people with compromised immune systems, often requiring antibiotic treatment that may be only marginally effective.
How to Be Sure You’re Safe
Since M. avium is so difficult to kill, individuals known to be immune deficient -- including pregnant women... people with asthma or bronchitis... those who’ve had an organ transplant... and those with cancer or other chronic disease -- should ask their doctors whether they should bathe instead of showering. Alternatively, Feazel suggests that people with compromised immune systems would do well to change their showerheads every six months (researchers found no M. avium in showerheads less than six months old) and to choose metal ones, which are less hospitable to biofilms than plastic.
Source(s):
Leah M. Feazel was the lead researcher on the showerhead study. She was head technician at the Pace Laboratory, University of Colorado-Boulder, and is currently a graduate student in Environmental Science and Engineering at the Colorado School of Mines, Golden, Colorado.
-
I think the radiation exposure to CT scans can very well be significant and over time (possibly decades) dangerous.
There is no question in my mind that CT scans are overused and used by many without the slightet regard to the radiation debit.
Doses are cummulative over time.
Many physicians seem to use CT scans like we used to order plain xrays. The difference is that CT scans give a radiation does roughly 100 or more times that of a simple Xray.
I've seen some pts. getting 10, 15, 20, or more CT scans over a few years.
I don't know what some doctors are thinking.
20 CT scans would be like getting 2000 Xrays.
You can't tell me that kind of radiation dose doesn't at least in a few patients cause cancer.
I would seriously recommend telling pts. to ask their doctor if there is an alternative when getting a CT scan or if it is really necessary before being told to get it.
Not that they aren't often needed, or that they don't offer many life saving pieces of information.
Just that they are definitely overused and I think the long term risks are only now just getting the attention they deserve.
-
This is what I am talking about. Quacks making a buck suckering people into buying natural substances with false claims.
These substances alone or in combination are supposed to suppress appetite? Or cause weight loss by some other magic?
FYI, caffeine is actually considered an appetite stimulant:
"citrus aurantium, the pills contain guarana and coffee bean extract".
I am glad she is being sued. I am saddened to see her say something like I standby my products etc.
What is the logic to make pharmaceutical companies spend a billion dollars to show a drug works and go after them for millions when a rare problem shows up but otherwise ok for quacks to sell snake oil by making up nonsense claims of efficacy just because it is "natural"? Wasn't a cereal maker just slapped by the FDA for making some sort of heart claims on one of it's products?
'Biggest Loser' trainer Jillian Michaels hit with third lawsuit over weight loss supplement pills
BY Rosemary Black
DAILY NEWS STAFF WRITER
Thursday, February 18th 2010, 2:25 PM
Haaseth/NBC/© NBC Universal, Inc.Jillian Michaels, who whips contestants into shape on NBC's 'The Biggest Loser,' is facing a series of lawsuits over her brand of weight loss supplements. Related NewsArticles'Biggest Loser' trainer Jillian Michaels sued over weight loss supplement pillsJillian Michaels weight loss pills won't help shed long term pounds: experts“Biggest Loser” celeb trainer Jillian Michaels isn’t winning any support from dieters frustrated with her weight-loss supplements.
A third lawsuit against the Jillian Michaels Maximum Strength Calorie Control pills was filed Tuesday in Los Angeles County Court, according to Us Weekly.
Kathy Hensley charges that the supplements are made with a “potentially lethal” ingredient, citrus aurantium, which can in rare cases cause heart problems and high blood pressure, according to Us Weekly. Hensley, who’s suing for less than $5,000, also names the supplements’ maker Thin Care, Basic Research and Walgreens.
Michaels, 36, who calls herself “America’s Toughest Trainer,” told Us Weekly in a statement after the first lawsuit was filed that the claims against her supplements are “entirely without merit.” Besides citrus aurantium, the pills contain guarana and coffee bean extract.
“I stand behind all my products,” Michaels’ statement said.
ThinCare also responded to Us Weekly: “We are confident we will prevail.”
-
Cows on Drugs
By DONALD KENNEDY
Published: April 17, 2010
NYT
Stanford, Calif.
NOW that Congress has pushed through its complicated legislation to reform the health insurance system, it could take one more simple step to protect the health of all Americans. This one wouldn’t raise any taxes or make any further changes to our health insurance system, so it could be quickly passed by Congress with an outpouring of bipartisan support. Or could it?
More than 30 years ago, when I was commissioner of the United States Food and Drug Administration, we proposed eliminating the use of penicillin and two other antibiotics to promote growth in animals raised for food. When agribusiness interests persuaded Congress not to approve that regulation, we saw firsthand how strong politics can trump wise policy and good science.
Even back then, this nontherapeutic use of antibiotics was being linked to the evolution of antibiotic resistance in bacteria that infect humans. To the leading microbiologists on the F.D.A.’s advisory committee, it was clearly a very bad idea to fatten animals with the same antibiotics used to treat people. But the American Meat Institute and its lobbyists in Washington blocked the F.D.A. proposal.
In 2005, one class of antibiotics, fluoroquinolones, was banned in the production of poultry in the United States. But the total number of antibiotics used in agriculture is continuing to grow. According to the Union of Concerned Scientists, 70 percent of this use is in animals that are healthy but are vulnerable to transmissible diseases because they live in crowded and unsanitary conditions.
In testimony to Congress last summer, Joshua Sharfstein, the principal deputy commissioner of the F.D.A., estimated that 90,000 Americans die each year from bacterial infections they acquire in hospitals. About 70 percent of those infections are caused by bacteria that are resistant to at least one powerful antibiotic.
That’s why the American Medical Association, the American Academy of Pediatrics, the American Pharmacists Association, the Infectious Diseases Society of America, the American Public Health Association and the National Association of County and City Health Officials are urging Congress to phase out the nontherapeutic use in livestock of antibiotics that are important to humans.
Antibiotic resistance is an expensive problem. A person who cannot be treated with ordinary antibiotics is at risk of having a large number of bacterial infections, and of needing to be treated in the hospital for weeks or even months. The extra costs to the American health care system are as much as $26 billion a year, according to estimates by Cook County Hospital in Chicago and the Alliance for the Prudent Use of Antibiotics, a health policy advocacy group.
Agribusiness argues — as it has for 30 years — that livestock need to be given antibiotics to help them grow properly and keep them free of disease. But consider what has happened in Denmark since the late 1990s, when that country banned the use of antibiotics in farm animals except for therapeutic purposes. The reservoir of resistant bacteria in Danish livestock shrank considerably, a World Health Organization report found. And although some animals lost weight, and some developed infections that needed to be treated with antimicrobial drugs, the benefits of the rule exceeded those costs.
It’s 30 years late, but Congress should now pass the Preservation of Antibiotics for Medical Treatment Act, which would ban industrial farms from using seven classes of antibiotics that are important to human health unless animals or herds are ill, or pharmaceutical companies can prove the drugs’ use in livestock does not harm human health.
The pharmaceutical industry and agribusiness face the difficult challenge of developing antimicrobials that work specifically against animal infections without undermining the fight against bacteria that cause disease in humans. But we don’t have the luxury of waiting any longer to protect those at risk of increasing antibiotic resistance.
Donald Kennedy, a former commissioner of the United States Food and Drug Administration, is a professor emeritus of environmental science at Stanford.
-
Attention Whole Foods Shoppers
Stop obsessing about arugula. Your "sustainable" mantra -- organic, local, and slow -- is no recipe for saving the world's hungry millions.
BY ROBERT PAARLBERG | MAY/JUNE 2010
From Whole Foods recyclable cloth bags to Michelle Obama's organic White House garden, modern eco-foodies are full of good intentions. We want to save the planet. Help local farmers. Fight climate change -- and childhood obesity, too. But though it's certainly a good thing to be thinking about global welfare while chopping our certified organic onions, the hope that we can help others by changing our shopping and eating habits is being wildly oversold to Western consumers. Food has become an elite preoccupation in the West, ironically, just as the most effective ways to address hunger in poor countries have fallen out of fashion.
Helping the world's poor feed themselves is no longer the rallying cry it once was. Food may be today's cause célèbre, but in the pampered West, that means trendy causes like making food "sustainable" -- in other words, organic, local, and slow. Appealing as that might sound, it is the wrong recipe for helping those who need it the most. Even our understanding of the global food problem is wrong these days, driven too much by the single issue of international prices. In April 2008, when the cost of rice for export had tripled in just six months and wheat reached its highest price in 28 years, a New York Times editorial branded this a "World Food Crisis." World Bank President Robert Zoellick warned that high food prices would be particularly damaging in poor countries, where "there is no margin for survival." Now that international rice prices are down 40 percent from their peak and wheat prices have fallen by more than half, we too quickly conclude that the crisis is over. Yet 850 million people in poor countries were chronically undernourished before the 2008 price spike, and the number is even larger now, thanks in part to last year's global recession. This is the real food crisis we face.
It turns out that food prices on the world market tell us very little about global hunger. International markets for food, like most other international markets, are used most heavily by the well-to-do, who are far from hungry. The majority of truly undernourished people -- 62 percent, according to the U.N. Food and Agriculture Organization -- live in either Africa or South Asia, and most are small farmers or rural landless laborers living in the countryside of Africa and South Asia. They are significantly shielded from global price fluctuations both by the trade policies of their own governments and by poor roads and infrastructure. In Africa, more than 70 percent of rural households are cut off from the closest urban markets because, for instance, they live more than a 30-minute walk from the nearest all-weather road.
Poverty -- caused by the low income productivity of farmers' labor -- is the primary source of hunger in Africa, and the problem is only getting worse. The number of "food insecure" people in Africa (those consuming less than 2,100 calories a day) will increase 30 percent over the next decade without significant reforms, to 645 million, the U.S. Agriculture Department projects.
What's so tragic about this is that we know from experience how to fix the problem. Wherever the rural poor have gained access to improved roads, modern seeds, less expensive fertilizer, electrical power, and better schools and clinics, their productivity and their income have increased. But recent efforts to deliver such essentials have been undercut by deeply misguided (if sometimes well-meaning) advocacy against agricultural modernization and foreign aid.
In Europe and the United States, a new line of thinking has emerged in elite circles that opposes bringing improved seeds and fertilizers to traditional farmers and opposes linking those farmers more closely to international markets. Influential food writers, advocates, and celebrity restaurant owners are repeating the mantra that "sustainable food" in the future must be organic, local, and slow. But guess what: Rural Africa already has such a system, and it doesn't work. Few smallholder farmers in Africa use any synthetic chemicals, so their food is de facto organic. High transportation costs force them to purchase and sell almost all of their food locally. And food preparation is painfully slow. The result is nothing to celebrate: average income levels of only $1 a day and a one-in-three chance of being malnourished.
If we are going to get serious about solving global hunger, we need to de-romanticize our view of preindustrial food and farming. And that means learning to appreciate the modern, science-intensive, and highly capitalized agricultural system we've developed in the West. Without it, our food would be more expensive and less safe. In other words, a lot like the hunger-plagued rest of the world.
Justin Sullivan/Getty Images
Original Sins
Thirty years ago, had someone asserted in a prominent journal or newspaper that the Green Revolution was a failure, he or she would have been quickly dismissed. Today the charge is surprisingly common. Celebrity author and eco-activist Vandana Shiva claims the Green Revolution has brought nothing to India except "indebted and discontented farmers." A 2002 meeting in Rome of 500 prominent international NGOs, including Friends of the Earth and Greenpeace, even blamed the Green Revolution for the rise in world hunger. Let's set the record straight.
The development and introduction of high-yielding wheat and rice seeds into poor countries, led by American scientist Norman Borlaug and others in the 1960s and 70s, paid huge dividends. In Asia these new seeds lifted tens of millions of small farmers out of desperate poverty and finally ended the threat of periodic famine. India, for instance, doubled its wheat production between 1964 and 1970 and was able to terminate all dependence on international food aid by 1975. As for indebted and discontented farmers, India's rural poverty rate fell from 60 percent to just 27 percent today. Dismissing these great achievements as a "myth" (the official view of Food First, a California-based organization that campaigns globally against agricultural modernization) is just silly.
It's true that the story of the Green Revolution is not everywhere a happy one. When powerful new farming technologies are introduced into deeply unjust rural social systems, the poor tend to lose out. In Latin America, where access to good agricultural land and credit has been narrowly controlled by traditional elites, the improved seeds made available by the Green Revolution increased income gaps. Absentee landlords in Central America, who previously allowed peasants to plant subsistence crops on underutilized land, pushed them off to sell or rent the land to commercial growers who could turn a profit using the new seeds. Many of the displaced rural poor became slum dwellers. Yet even in Latin America, the prevalence of hunger declined more than 50 percent between 1980 and 2005.
In Asia, the Green Revolution seeds performed just as well on small nonmechanized farms as on larger farms. Wherever small farmers had sufficient access to credit, they took up the new technology just as quickly as big farmers, which led to dramatic income gains and no increase in inequality or social friction. Even poor landless laborers gained, because more abundant crops meant more work at harvest time, increasing rural wages. In Asia, the Green Revolution was good for both agriculture and social justice.
And Africa? Africa has a relatively equitable and secure distribution of land, making it more like Asia than Latin America and increasing the chances that improvements in farm technology will help the poor. If Africa were to put greater resources into farm technology, irrigation, and rural roads, small farmers would benefit.
ALEXANDER JOE/AFP/Getty Images
Organic Myths
There are other common objections to doing what is necessary to solve the real hunger crisis. Most revolve around caveats that purist critics raise regarding food systems in the United States and Western Europe. Yet such concerns, though well-intentioned, are often misinformed and counterproductive -- especially when applied to the developing world.
Take industrial food systems, the current bugaboo of American food writers. Yes, they have many unappealing aspects, but without them food would be not only less abundant but also less safe. Traditional food systems lacking in reliable refrigeration and sanitary packaging are dangerous vectors for diseases. Surveys over the past several decades by the Centers for Disease Control and Prevention have found that the U.S. food supply became steadily safer over time, thanks in part to the introduction of industrial-scale technical improvements. Since 2000, the incidence of E. coli contamination in beef has fallen 45 percent. Today in the United States, most hospitalizations and fatalities from unsafe food come not from sales of contaminated products at supermarkets, but from the mishandling or improper preparation of food inside the home. Illness outbreaks from contaminated foods sold in stores still occur, but the fatalities are typically quite limited. A nationwide scare over unsafe spinach in 2006 triggered the virtual suspension of all fresh and bagged spinach sales, but only three known deaths were recorded. Incidents such as these command attention in part because they are now so rare. Food Inc. should be criticized for filling our plates with too many foods that are unhealthy, but not foods that are unsafe.
Where industrial-scale food technologies have not yet reached into the developing world, contaminated food remains a major risk. In Africa, where many foods are still purchased in open-air markets (often uninspected, unpackaged, unlabeled, unrefrigerated, unpasteurized, and unwashed), an estimated 700,000 people die every year from food- and water-borne diseases, compared with an estimated 5,000 in the United States.
Food grown organically -- that is, without any synthetic nitrogen fertilizers or pesticides -- is not an answer to the health and safety issues. The American Journal of Clinical Nutrition last year published a study of 162 scientific papers from the past 50 years on the health benefits of organically grown foods and found no nutritional advantage over conventionally grown foods. According to the Mayo Clinic, "No conclusive evidence shows that organic food is more nutritious than is conventionally grown food."
Health professionals also reject the claim that organic food is safer to eat due to lower pesticide residues. Food and Drug Administration surveys have revealed that the highest dietary exposures to pesticide residues on foods in the United States are so trivial (less than one one-thousandth of a level that would cause toxicity) that the safety gains from buying organic are insignificant. Pesticide exposures remain a serious problem in the developing world, where farm chemical use is not as well regulated, yet even there they are more an occupational risk for unprotected farmworkers than a residue risk for food consumers.
-
When it comes to protecting the environment, assessments of organic farming become more complex. Excess nitrogen fertilizer use on conventional farms in the United States has polluted rivers and created a "dead zone" in the Gulf of Mexico, but halting synthetic nitrogen fertilizer use entirely (as farmers must do in the United States to get organic certification from the Agriculture Department) would cause environmental problems far worse.
Here's why: Less than 1 percent of American cropland is under certified organic production. If the other 99 percent were to switch to organic and had to fertilize crops without any synthetic nitrogen fertilizer, that would require a lot more composted animal manure. To supply enough organic fertilizer, the U.S. cattle population would have to increase roughly fivefold. And because those animals would have to be raised organically on forage crops, much of the land in the lower 48 states would need to be converted to pasture. Organic field crops also have lower yields per hectare. If Europe tried to feed itself organically, it would need an additional 28 million hectares of cropland, equal to all of the remaining forest cover in France, Germany, Britain, and Denmark combined.
Mass deforestation probably isn't what organic advocates intend. The smart way to protect against nitrogen runoff is to reduce synthetic fertilizer applications with taxes, regulations, and cuts in farm subsidies, but not try to go all the way to zero as required by the official organic standard. Scaling up registered organic farming would be on balance harmful, not helpful, to the natural environment.
WILLIAM WEST/AFP/Getty Images
Not only is organic farming less friendly to the environment than assumed, but modern conventional farming is becoming significantly more sustainable. High-tech farming in rich countries today is far safer for the environment, per bushel of production, than it was in the 1960s, when Rachel Carson criticized the indiscriminate farm use of DDT in her environmental classic, Silent Spring. Thanks in part to Carson's devastating critique, that era's most damaging insecticides were banned and replaced by chemicals that could be applied in lower volume and were less persistent in the environment. Chemical use in American agriculture peaked soon thereafter, in 1973. This was a major victory for environmental advocacy.
And it was just the beginning of what has continued as a significant greening of modern farming in the United States. Soil erosion on farms dropped sharply in the 1970s with the introduction of "no-till" seed planting, an innovation that also reduced dependence on diesel fuel because fields no longer had to be plowed every spring. Farmers then began conserving water by moving to drip irrigation and by leveling their fields with lasers to minimize wasteful runoff. In the 1990s, GPS equipment was added to tractors, autosteering the machines in straighter paths and telling farmers exactly where they were in the field to within one square meter, allowing precise adjustments in chemical use. Infrared sensors were brought in to detect the greenness of the crop, telling a farmer exactly how much more (or less) nitrogen might be needed as the growing season went forward. To reduce wasteful nitrogen use, equipment was developed that can insert fertilizers into the ground at exactly the depth needed and in perfect rows, only where it will be taken up by the plant roots.
These "precision farming" techniques have significantly reduced the environmental footprint of modern agriculture relative to the quantity of food being produced. In 2008, the Organization for Economic Cooperation and Development published a review of the "environmental performance of agriculture" in the world's 30 most advanced industrial countries -- those with the most highly capitalized and science-intensive farming systems. The results showed that between 1990 and 2004, food production in these countries continued to increase (by 5 percent in volume), yet adverse environmental impacts were reduced in every category. The land area taken up by farming declined 4 percent, soil erosion from both wind and water fell, gross greenhouse gas emissions from farming declined 3 percent, and excessive nitrogen fertilizer use fell 17 percent. Biodiversity also improved, as increased numbers of crop varieties and livestock breeds came into use.
Seeding the Future
Africa faces a food crisis, but it's not because the continent's population is growing faster than its potential to produce food, as vintage Malthusians such as environmental advocate Lester Brown and advocacy organizations such as Population Action International would have it. Food production in Africa is vastly less than the region's known potential, and that is why so many millions are going hungry there. African farmers still use almost no fertilizer; only 4 percent of cropland has been improved with irrigation; and most of the continent's cropped area is not planted with seeds improved through scientific plant breeding, so cereal yields are only a fraction of what they could be. Africa is failing to keep up with population growth not because it has exhausted its potential, but instead because too little has been invested in reaching that potential.
One reason for this failure has been sharply diminished assistance from international donors. When agricultural modernization went out of fashion among elites in the developed world beginning in the 1980s, development assistance to farming in poor countries collapsed. Per capita food production in Africa was declining during the 1980s and 1990s and the number of hungry people on the continent was doubling, but the U.S. response was to withdraw development assistance and simply ship more food aid to Africa. Food aid doesn't help farmers become more productive -- and it can create long-term dependency. But in recent years, the dollar value of U.S. food aid to Africa has reached 20 times the dollar value of agricultural development assistance.
The alternative is right in front of us. Foreign assistance to support agricultural improvements has a strong record of success, when undertaken with purpose. In the 1960s, international assistance from the Rockefeller Foundation, the Ford Foundation, and donor governments led by the United States made Asia's original Green Revolution possible. U.S. assistance to India provided critical help in improving agricultural education, launching a successful agricultural extension service, and funding advanced degrees for Indian agricultural specialists at universities in the United States. The U.S. Agency for International Development, with the World Bank, helped finance fertilizer plants and infrastructure projects, including rural roads and irrigation. India could not have done this on its own -- the country was on the brink of famine at the time and dangerously dependent on food aid. But instead of suffering a famine in 1975, as some naysayers had predicted, India that year celebrated a final and permanent end to its need for food aid.
Foreign assistance to farming has been a high-payoff investment everywhere, including Africa. The World Bank has documented average rates of return on investments in agricultural research in Africa of 35 percent a year, accompanied by significant reductions in poverty. Some research investments in African agriculture have brought rates of return estimated at 68 percent. Blind to these realities, the United States cut its assistance to agricultural research in Africa 77 percent between 1980 and 2006.
When it comes to Africa's growing hunger, governments in rich countries face a stark choice: They can decide to support a steady new infusion of financial and technical assistance to help local governments and farmers become more productive, or they can take a "worry later" approach and be forced to address hunger problems with increasingly expensive shipments of food aid. Development skeptics and farm modernization critics keep pushing us toward this unappealing second path. It's time for leaders with vision and political courage to push back.
GEORGES GOBET/AFP/Getty Images
Save big when you subscribe to FP.
Justin Sullivan/Getty Images
Robert Paarlberg is B.F. Johnson professor of political science at Wellesley College, an associate at Harvard University's Weatherhead Center for International Affairs, and author of Food Politics: What Everyone Needs to Know.
http://www.foreignpolicy.com/articles/2010/04/26/attention_whole_foods_shoppers?page=full
-
Why do certain diseases go into remission during pregnancy?
University of Michigan and NIH scientists find a biological mechanism to explain the phenomenon
ANN ARBOR, Mich. -- During pregnancy, many women experience remission of autoimmune diseases like multiple sclerosis and uveitis. Now, scientists have described a biological mechanism responsible for changes in the immune system that helps to explain the remission.
The expression of an enzyme known as pyruvate kinase is reduced in immune cells in pregnant women compared to non-pregnant women, according to Howard R. Petty, Ph.D., biophysicist at the University of Michigan Kellogg Eye Center and Roberto Romero, M.D., of the National Institutes for Health.
The study, which appears online ahead of print in the August issue of the American Journal of Reproductive Immunology, also reports that expression of the enzyme is lower in pregnant women compared to those with pre-eclampsia, a condition with inflammatory components.
The study is significant because the newly discovered mechanism points to a pathway that could be targeted for treatment. “It may be possible to design drugs that mildly suppress pyruvate kinase activity as a means of replicating the immune status of normal pregnancy,” says Petty.
In addition to pre-eclampsia, he believes that rheumatoid arthritis, type 1 diabetes, and uveitis may eventually yield to similarly designed drugs.
In his search to explain the phenomenon, Petty knew to look for a metabolic pathway or mechanism with two characteristics. It had to “dial down” the intensity of the normal immune response, an action needed so that a pregnant woman does not reject the fetus, which has proteins from the father that are “foreign” to the mother. At the same time, such a mechanism must support cell growth needed by the developing fetus.
The activity of the enzyme pyruvate kinase—and and its product, pyruvate—fills both roles: promoting cell growth while modifying the immune response. Because pyruvate kinase activity is depressed during pregnancy, cell metabolism supports an increased production of lipids, carbohydrates, amino acids, and other substances that support cell growth.
Petty explains that our normal robust immune response depends upon pyruvate to promote calcium signaling, which, in turn, stimulates the production of messenger molecules called cytokines. When pyruvate is decreased during pregnancy, calcium signaling is also reduced, and the immune response is different than that in non-pregnant individuals. Says Petty, “Modification of signaling along this pathway allows the pregnant woman to maintain an immune response, but at a level that will not harm the fetus.”
The study included 21 women in their third trimester of a normal pregnancy, 25 women with pre-eclampsia, and a control group of non-pregnant women. Petty and colleagues used a variety of methods to confirm their findings, including fluorescence microscopy and flow cytometry, which are used to study cell signaling.
The higher levels of the enzyme seen in women with pre-eclampsia bolster the study’s findings, says Petty. “Pre-eclampsia has features of inflammatory disease. If you don’t reduce these pyruvate levels, you heighten inflammatory disease,” he adds. Petty wonders whether one day enzyme levels could be tested early in pregnancy to predict the likelihood of developing pre-eclampsia or other complications.
It is possible, says Petty, that the general mechanisms described in the current study may apply to more than one complication of pregnancy. This possibility—and that of designing drugs to suppress pyruvate kinase activity—is the focus of future research. “I have a long list of things I’d like to see developed for the clinic in the next five years,” adds Petty.
Romero is chief of the Perinatology Research Branch (PRB) of the National Institute of Child Health and Human Development/National Institutes of Health (NICHD/NIH)
# # #
Reference: Leukocyte Pyruvate Kinase Expression Is Reduced in Normal Human Pregnancy but Not in Pre-eclampsia. Amer J Reprod Immunol, online 6.15.10 at http://www3.interscience.wiley.com/cgi-bin/fulltext/123525215/HTMLSTART
http://www2.med.umich.edu/prmc/media/newsroom/details.cfm?ID=1632
-
My Mom (60+) has been "working out" for years to maintain bone density, she is stornger than some men her age too. No big weights either, just enough to feel a load and keep the reps under 15. She has also been running an aqua aerobics class as well, just to get some of her older friends active again. Many of them had balance problems- and a fear of falling- which the water resolved, being a good catcher/buffer.
Those that have been working out with er at the class have started "dry" workouts too. They feel the way they went from little balance to easy balance and now are thinking of some strength as well.
The research that it is not just resistence (weight) training that builds bones is not so much an issue, the issue is retaining bone strength. I think that it is impact training that builds bone, the ability to take shock, isn't it. Walking on concrete would work up to a point, then you have adapted and need to find another method.
Mom always says ACTIVITY is the key for having a fun old age, the dogs won't have THAT problem will they? :mrgreen:
scrolling through the old stuff here
wolfs law
davis' law
one states that bones re-enforce themselves along the lines of stress
one states that muscles re-enforce themselves along the lines of stress
the only thing that doesn't move was either never alive or is about to go the way of reasoned debate on television
-
""Nations have passed away and left no traces, And history gives the naked cause of it - One single simple reason in all cases; They fell because their peoples were not fit."-Rudyard Kipling"
2/3 of us in the US are overweight or obese.
We are fat on our own success.
The end for us too??
-
"2/3 of us in the US are overweight or obese. We are fat on our own success."
I think the same studies will bear out that those we call poor are among the most overweight as a group. In the business of 'welfare rights', they are also victims of their own success - success at achieving inactivity, with bountiful food and third party pay.
-
I wonder if the fact that many insurers as well as Medicare do not pay providers for treating people who are overweight has anyhting to do with this.
That said it would make no difference anyway. Clinics would not do any better then the thousands of commercial plans around, such as weight watchers, nutrisystem, and the rest.
***US. Report Finds Too Few Clinics Target Diabetes, Obesity
Email Print Share
--------------------------------------------------------------------------------
THURSDAY, June 24 (HealthDay News) — Too few local health clinics in the United States offer diabetes screening or obesity prevention programs, according to a nationwide study from the U.S. Centers for Disease Control and Prevention.
The clinics, which tend to serve poor clients, need to be “armed and equipped” to respond to the increasing threat of obesity and diabetes in the nation, study co-author Ann Albright said in a Center for the Advancement of Health news release.
She and her colleagues analyzed data from a 2005 survey of 2,300 health clinics and found that about 56 percent of them offered obesity prevention programs, 51 percent offered diabetes screening, and only one third offered both.
The findings were of particular concern since the percentage of obese American adults has doubled from 1980 to 2004, and the percentage of Americans diagnosed with diabetes may have doubled as well, according to researchers. People with diabetes and lower incomes run a higher risk of dying of the disease, research has shown.
Albright directs the Division of Diabetes Translation, which translates diabetes research into daily practice, at the CDC’s National Center for Chronic Disease Prevention and Health Promotion.
One expert questioned the value of obesity and diabetes screening programs alone. Such programs “are not a big part of the solution. After all, they are designed to find the trouble, not necessarily fix it,” Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine, said in the news release.
“We should define what contributions health departments can, and should, be making to global efforts at obesity and diabetes prevention and control, and then distribute resources to make sure they can all make these contributions. Otherwise, some will be doing far less than is needed, and some will be doing more than what is truly useful,” Katz said.
The CDC findings appear online and in the August print issue of the American Journal of Public Health.
More information
The U.S. Centers for Disease Control and Prevention has more about overweight and obesity.
— Robert Preidt
SOURCE: Center for the Advancement of Health, June 22, 2010, news release.
Last Updated: June 25, 2010
Copyright © 2010 HealthDay. All rights reserved.***
-
"2/3 of us in the US are overweight or obese. We are fat on our own success."
I think the same studies will bear out that those we call poor are among the most overweight as a group. In the business of 'welfare rights', they are also victims of their own success - success at achieving inactivity, with bountiful food and third party pay.
That is a concept I have formed from personal observation, I see a lot of welfare types that are massively overweight (I hear them talking about their food stamps or some other new program to get on so this is not an uninformed conclusion). If they are poor, they should be more on the skinny side, you would think.........
-
Yes one would think so. It does seem turned upside down when one thinks of it. In what other country are poor people FAT?
I suppose that is one of the knocks against inexpensive fast food, the types we see rapant in poor neighborhoods - that it is very high in calories.
No one goes to these places to eat salad and yogurt.
Some of the cheapest foods are fattening. Like pasta, cakes, rice.
I think that has something to do with it as well as cultural, social etc.
It beats burning the calories like the illegals who after some years here will look more like us I guess.
-
The poor (in America) are not poor in terms of food dollars. Food is free and plentiful if you are poor.
CCP: "Some of the cheapest foods are fattening. Like pasta, cakes, rice."
I would clarify that these food eaten to excess are fattening, like the bloated stomach you might see on photos from an impoverished country. I honestly don't believe you will see a difference other than cultural in the diet or at least the availability of all the right food choices. Food stamps aka SNAP works for virtually anything you can buy in a grocery store, steak salad fruits vegetables whole grains, and for the other items like candy or cigarettes they can trade food debit dollars away for cash at fifty cents on the dollar on the street and on the sidewalk in front of the store.
The problem I was trying to point out is that our 'poor' are not poor, they just face a twisted set of life incentives: they are paid to stay inactive and have virtually unlimited time and money for eating.
-
"The problem I was trying to point out is that our 'poor' are not poor, they just face a twisted set of life incentives: they are paid to stay inactive and have virtually unlimited time and money for eating."
I agree and would add...
And strip club and casino hopping. CNN reports welfare payments are used for these as well. I don't know why anyone would be surprised though.
Sometimes I still get astonished at how little many people know about what they eat and the number of calories in their foods.
I guess that is not surprising either when we hear often how little many of the kids today know. For example they wouldn't know who George Washington was. Ot they don't know we were originally a Bristish colony and so forth.
-
OMG, I actually agree with a POTH editorial :-o
The life of animals raised in confinement on industrial farms is slowly improving, thanks to pressure from consumers, animal rights advocates, farmers and legislators. In late June, a compromise was reached in Ohio that will gradually put an end to the tiny pens used for raising veal calves and holding pregnant sows, spaces so small the animals can barely move.
In California last week, Gov. Arnold Schwarzenegger signed a law requiring that all whole eggs sold in the state conform to the provisions of Proposition 2, the humane farming law that was embraced by state voters in a landslide in 2008. By 2015, every whole egg sold in the state must come from a hen that is able to stretch her wings, standing or lying, without touching another bird or the edges of her cage. This requirement would at least relieve the worst of the production horrors that are common in the industry now.
Since California does not produce all the eggs it eats, this new law will have a wider effect on the industry; every producer who hopes to sell eggs in the state must meet its regulations.
Heartening as these developments are, there is also strong resistance from the food industry and from fake consumer-advocacy groups that are shilling for it.
In fact, there is no justification, economic or otherwise, for the abusive practice of confining animals in spaces barely larger than the volume of their bodies. Animals with more space are healthier, and they are no less productive.
Industrial confinement is cruel and senseless and will turn out to be, we hope, a relatively short-lived anomaly in modern farming.
-
Gel that can help decayed teeth grow back could end fillings
By Pat Hagan
Open wide: Thanks to a new gel, soon this won't hurt
A gel that can help decayed teeth grow back in just weeks may mean an end to fillings.
The gel, which is being developed by scientists in France, works by prompting cells in teeth to start multiplying. They then form healthy new tooth tissue that gradually replaces what has been lost to decay.
Researchers say in lab studies it took just four weeks to restore teeth back to their original healthy state. The gel contains melanocyte-stimulating hormone, or MSH.
We produce this in the pituitary gland, a pea-sized gland just behind the bridge of the nose.
MSH is already known to play an important part in determining skin colour - the more you have, the darker your flesh tone.
But recent studies suggest MSH may also play a crucial role in stimulating bone regeneration.
As bone and teeth are very similar in their structure, a team of scientists at the National Institute for Health and Medical Research in Paris tested if the hormone could stimulate tooth growth.
Their findings, published in the American Chemical Society journal ACS Nano, could signal hurtnot just an end to fillings, but the dreaded dentist drill as well. Tooth decay is a major public health problem in Britain. Around £45m a year is spent treating decayed teeth and by the age of 15, teenagers have had an average of 2.5 teeth filled or removed.
Decay is caused by bacteria, called streptococcus mutans, that live in the mouth and feed on sugar in the diet. Once the bacteria stick to the enamel, they trigger a process called demineralisation - they turn sugar in the diet into a harmful acid that starts to create holes in the teeth.
For decades, the main treatment for cavities has been to 'drill and fill'. However, an estimated one in five Britons suffers from dental phobia, a fear of dentists which means some would rather endure pain and suffering than face the prospect of having their teeth drilled.
The new treatment is painless. And although fillings halt decay, they can come loose and sometimes need refilling.
Experts believe new tooth cells would be stronger and a permanent solution.
The French team mixed MSH with a chemical called poly-L-glutamic acid. This is a substance often used to transport drugs inside the body because it can survive the harsh environments, such as the stomach, that might destroy medicines before they get a chance to work.
The mixture was then turned into a gel and rubbed on to cells, called dental pulp fibroblasts, taken from extracted human teeth. These cells are the kind that help new tooth tissue to grow.
But until now there has been no way of 'switching' them back on once they have been destroyed by dental decay. The researchers found the gel triggered the growth of new cells and also helped with adhesion - the process by which new dental cells 'lock' together.
This is important because it produces strong tooth pulp and enamel which could make the decayed tooth as good as new.
In a separate experiment, the French scientists applied the gel to the teeth of mice with dental cavities. In just one month, the cavities had disappeared. The gel is still undergoing testing but could be available for use within three to five years.
Professor Damien Walmsley, the British Dental Association's scientific adviser, said the gel could be an interesting new development, but stressed it is unlikely to be able to repair teeth that have been extensively damaged by decay.
'There are a lot of exciting developments in this field, of which this is one,' he said. 'It looks promising, but we will have to wait for the results to come back from clinical trials and its use will be restricted to treating small areas of dental decay.'
Scientists have developed a 'tongue' gel as part of a new approach to tackling bad breath and preventing tooth decay.
Halitosis is usually caused by bacteria in the mouth. The latest treatment, developed by Meridol, takes a mechanical and chemical approach. It consists of a tongue scraper, gel and mouth wash.
The extra-flat tongue cleaner is used to scrape bacteria off the tongue. The tongue gel and mouthwash are anti-bacterial and contain chemicals that attach themselves to odour-producing compounds, which are then flushed out with the mouthwash. Both gel and mouthwash contain fluoride.
-
I'm going to live a very long time.
==================
http://www.themedguru.com/20091206/newsfeature/stare-boobs-longer-life-study-86131320.html
====================
Frankfurt, Germany, December 6 -- A rather bizarre study carried out by German researchers suggests that staring at women's breasts is good for men's health and increases their life expectancy.
According to Dr. Karen Weatherby, a gerontologist and author of the study, gawking at women’s breasts is a healthy practice, almost at par with an intense exercise regime, that prolongs the lifespan of a man by five years.
She added, "Just 10 minutes of staring at the charms of a well-endowed female, is roughly equivalent to a 30-minute aerobics work-out."
A five-year research on 500 men
Researchers at three hospitals in Frankfurt, Germany did an in-depth analysis of 200 healthy males over a period of five years. Half the volunteers were instructed to ogle at the breasts of women daily, while the rest were told to refrain from doing so.
At the close of the study, the researchers noted that the men who stared at the breasts of females on a regular basis exhibited lower blood pressure, slower resting pulse rates and lesser episodes of coronary artery disease.
Sexual desire linked to better blood circulation
The researchers declared that sexual desire gives rise to better blood circulation that signifies an overall improved health.
Weatherby explained the concept stating, "Sexual excitement gets the heart pumping and improves blood circulation. There's no question: Gazing at breasts makes men healthy.
"Our study indicates that engaging in this activity a few minutes daily cuts the risk of stroke and heart attack in half. We believe that by doing so consistently, the average man can extend his life four to five years."
In addition, she also recommended that men over 40 should gaze at larger breasts daily for 10 minutes.
The German research is believed to be published in the New England Journal of Medicine.
-
I dunno....
Should I start recommending this to my male patients?
Should I rec. to my female pts they start staring at mens private parts ten minutes a day?
Maybe we should change the magazine selection in the waiting room. I mean it is all in the name of improving health.
My practice might even take off.....
-
CCP, The female equivalent might be shopping, not gazing at men. I think the brains are wired differently. Who thinks up these studies anyway, charts the minutes that they stare, proves they lived longer and then bills back the government for research? Pretty good work if you can arrange it.
-
(http://i603.photobucket.com/albums/tt114/dougmacg/ObamacareChart.jpg)
-
"CCP, The female equivalent might be shopping, not gazing at men."
Yes you are right! I could have a shelf titled "men's health" with playboy and penthouse mags and a "women's health" shelf loaded with retail catalogues.
Patients may not mind waiting for their doctor too! :-D
Hugh Hefner will pick up on this and promote his mag and website claiming them for health benefits. Hey look at the master breast connoiseur himself - what is he 90 and still going?
-
I don't know the details. Persistant hoarseness in an older person especially one who smokes is always a red flag. OTOH is not unusaul for someone to smoke for 50 years knowing full well of the risks and then when they do come down with something turn around a blame the doctors because they didn't catch it fast enough or something else doesn't turn out perfect.
Irregardless, Michael Douglas, and his father are two of my favorite actors so I am saddned to hear this. I wish them well.
***Catherine Zeta-Jones furious Douglas' cancer went undetected
LOS ANGELES (Reuters) – Actress Catherine Zeta-Jones admits having a hard time watching husband Michael Douglas battle throat cancer and has told People magazine she is furious with doctors for not detecting his disease sooner.
Douglas, the Oscar winner of "Wall Street" and a veteran of Hollywood movies and television, told the celebrity magazine that he spent months seeking attention for persistent throat and ear pain only to be told nothing was wrong until August.
The son of actor Kirk Douglas announced on August 16 that doctors had found a tumor in his throat and that he would undergo radiation and chemotherapy, which he has now started.
"It makes me furious they didn't detect it earlier," Zeta-Jones told People. "He sought every option and nothing was found."
The actress, herself an Oscar winner for "Chicago," has been married to Douglas for 10 years and the couple have two children together, Dylan, 10, and Carys, 7.
Douglas, 65, is now undergoing radiation and chemotherapy five days-a-week every three weeks to rid himself of a walnut-sized tumor at the base of his tongue.
Zeta-Jones said she can't stand the thought of watching her husband undergoing chemotherapy and radiation and loosing his strength as he battles the disease.
"I know maybe I should be stronger, but emotionally I just don't want to see that," she said, later adding, "the hardest part is seeing his fatigue, because Michael is never tired."
Douglas made his first post-announcement TV appearance on Tuesday on "The Late Show with David Letterman," and told the talk show audience that although his cancer was late "stage four," doctors say he has an 80 percent chance of recovery.
He told People magazine that he was optimistic about his odds. "I'm treating this as a curable disease," he said. "It's a fight. I'll beat this."
But he admitted that he was uncertain about the future, and noted that "you just never think it's going to be you."
Still, after months of feeling the pain creep up on him, of having a dry throat and hoarse voice, the news of his cancer came as little surprise to both Hollywood stars.
"It wasn't a huge shock. I knew something was up. He knew something was up," said Zeta-Jones.
And while she is furious about the lack of an early diagnosis, Douglas seems more understanding. "Without having to blame anybody ... these things sometimes just don't show up," he said.***
-
Typical Liberal think- why didn't SOMEBODY ELSE take responsibility for me/ mine? Sorry to hear about the cancer tho' he was a good actor. "Was" is used because he is definately a medical retiree now, not because I am already burying him.
-
"he spent months seeking attention for persistent throat and ear pain only to be told nothing was wrong until August."
I can understand CZJ's emotions.
-
"Three months after the last taped visit, patients whose doctors communicated in an empathic way lost an average of 3.8 pounds -- a substantial achievement"
Some "achievement". When you are talking an epidemic of people being 40 to hundreds of pounds overweight this is a drop in the bucket.
That is why I say real weight loss gains will only come from the pharmaceutical industry not government. And not endless Nanny programs on CNN - the Cable Nanny Network with topics like bullying, healthy eating, minority in America and on and on. Or, we all go for bariatric surgery.
***WEDNESDAY, Oct. 6 (HealthDay News) -- American doctors spend a lot of time discussing diet and weight with their patients, but it has little effect unless doctors have the right communication style, a new study finds.
Patients were much more likely to lose weight if their doctor talked about diet and weight loss in a motivational way, rather than in a judgmental or confrontational manner, researchers found.
In taped conversations between 40 primary care physicians and 461 of their patients over 18 months, doctors discussed weight in 69 percent of those visits, said the Duke University Medical Center researchers.
"We found that on average, physicians spent about three and a half minutes talking about diet and weight loss. That may not sound like much, but it amounts to about 15 percent of the time of the average office visit, which ran about 20 minutes. So the good news is, physicians realize how important the issue is, and they are making a point to talk about it," lead author Kathryn Pollak, of the Cancer Prevention Program at the Duke Comprehensive Cancer Center, said in a Duke news release.
There was little difference in weight loss between patients who did and didn't receive weight counseling, but researchers found that communication style did have an impact.
Three months after the last taped visit, patients whose doctors communicated in an empathic way lost an average of 3.8 pounds -- a substantial achievement given that most overweight or obese patients tend to gain weight over time, the researchers noted.
"Patients don't like to be told what to do [although] they are generally not going to question or talk back to their doctor. But what happens when doctors used reflective statements or a more motivational or empathic approach? It changes the relationship; the patient becomes more of an equal, more of a partner in care," Pollak explained.
"So, for example, instead of asking a question like 'So, you can't fit exercise into your day?' a physician might say something like 'It sounds like you're finding it hard to find time to exercise.' That kind of reflection seems to help patients open up more and give more meaningful information to doctors."
The study appears in the current issue of the American Journal of Preventive Medicine.***
-
Eating less calories and more real food is always an option too :lol:
-
"Eating less calories and more real food is always an option too"
Crafty,
I am afraid it isn't that simple. Most people are not as disciplined as you or professional athletes who burn tons of calories each day.
Almost everyone knows to eat less, and better foods, and to exercise.
Yet 2 out of three are overweight or obese.
It isn't simply an "option". I wish it was.
If it was we wouldn't have thousands of weight loss diets, plans, programs, pills, hoaxes, quacks, regimens, biggest losers and the rest.
And a failure rate for maintenance of over 95%!
I don't have the time at the moment but it is not just "will power" unfortunately. It is a result evolution that due to mankinds' achievments has run amuck.
-
I travel a fair amount and notice that the US is a seriously fatter country than anyway else I go. Switzerland has lots of red meat, cheese, carbs, and sweet in its diet but hardly ever will you see someone there of the gargantuan proportions see so often in the US, let alone the epidemic % of obese people we have here. The Swiss have plenty of money too, so its not a question of we eat too much if we have enough money to do so.
In short, sorry, but I'm not buying your line of thought. :-)
-
Obesity is a disease. No doubt the US is either the leader or up there in obesity rates.
It is hugely complex.
It is the evidence. The facts.
It is not simply a choice. If it was no one would choose to be obese and few would be.
There are cultural, environmental, psychiatric, learned, genetic, metabolic and other issues involved.
The multiple chemical pathways and the interactions "cross talk" between them is incredibly mind baffling.
I've read some of the scientific articles describing them and it is so complex one could easily spend a lifetime trying to understand them. And if that isn't enough we are only beginning to unlock the secrets of energy homeostasis.
Some of the articles are written by people who are incredibly brilliant (far more than the ONE :wink:).
Thank God there are people smart enough who try and figure these things out.
-
I don't mean to question the chosen ONE :-) but I too think with
rare medical exceptions that it is choice.
I choose to eat healthy. I choose to exercise. But I also choose (bad habits) to drink and smoke cigars.
I watch people gorge themselves. Their choice; if they are happy well again it's their choice, but again, if they are
unhappy it's their choice to either intake fewer calories or burn more calories. It's a simple mathematical
equation. Variation comes from personal choice.
I too travel a lot. People seem to watch consciously or unconsciously what they eat. Most are not obese.
Americans are obese because they choose to be obese.
-
JDN and Crafty,
Your opinions are respected.
My only comment is I wasn't referring to myself as the ONE. I was referring to THE "Chosen One". :-)
-
CCP:
I submit the proposition that your analysis is disproven by the countries/places where people have esentiallly all they want to eat and most are of proportionate, suitable weight.
-
a side point
food is a drug when it is manufactured rather than grown
opioid response from fat/sweet/salt
the chemists working for major food producers are tasked with utilizing that response
stress causes a decrease is lipolysis and cellular protein uptake, and an increase in the amount of glucose and fat that us in the blood stream
the idea that it is a choice is silly frankly
no one chooses to place themselves in a socially and physically detrimental state
no one chooses to be in a position of ridicule and in which they will be held in contempt by their fellow man
we are social and highly emotional creatures that require interaction with other creates of our kind to survive in a healthy manner
there may be some rare exceptions
those folks will likely tell you " it took a while to get used to, but I became my own company"
if I take food, synthesize it, remove all of the nutrients and replace the "food with chemical substances that mimic the food in the body, then price those substances lower than food, am I a drug pusher or a captain of industry
being a person that helps people lose, manage, and overcome the obstacles to their physique issues, I deal with folks that come in all shapes and sizes
I de-stress their bodies and minds with movement, educated them about nutrition and how food works in the chemical processes of our bodies, show them exercises theycan use to make it easy
and they get better
no one consciously chooses worse
that is bs
not so humble opinion there
it's fact
everyone wants better
some people don't have access to better, physically, mentally, emotionally or through some other limiting factor
but they would not turn better away if they could get
better
-
Good points.
I have done bariatric medicine. And I can tell you that getting overweight people to lose 10 or 15% of there overall weight and maintaining that loss is a MAJOR achievement. I recall listening to a lecture from one physician who specializes in weight loss medicine. And he said if I have had 2 or 3 people go from BMI of 45 to 25 in twenty five years that is "a lot".
I advise my patients to target 10 and hopefully 15% weight loss even if they are still obese. Because I know any more is unrealistic and almost impossible.
To be able to lose more is without a doubt, as another weight loss psychiatrist pointed out, "a full time job".
Crafty and JDN with all due respect you don't understand.
That is why progressives want to legislate a cap and trade on whatever they want to label as "fattening". To be able to control what people are unable to do for themselves.
They did studies on prisoners I think in the 70's. They underfed them 100 calories a day. As they lost more and more weight there thoughts started to turn towards getting more food. This was true even if they were overweight to start with. The theory is that something goes wrong or haywire. The brain sets a point to maintain weight a a certain level even if it is more than needed for survival or healthy weight. As they lose more and more weight the thoughts of obtaining food becomes overwhelming. The brain senses they are starving even if they aren't. Every single waking thought, their dreams their cravings, their desires, theri focus is turned toward obtaining food. It becomes truly overwhelming. To the point that the person cannot think of anything else. To the point where they cannot perform any other function except dream of food. It is a result of evolution. We evovled with multiple chemical, hormonal, neurologic, intestinal pathways that work in sync to keep us motiveated to obtain food. If we didn't have these overlapping pathways that drive us to obtain food we would have perished on the grasslands from lack of will to chase mammoths, or gather nuts berries etc. We can block one of these pathways and hence the person will lose around 6 % of weight before other pathways start to compensate and then kick in and thus overwhelm our brain with drive to start seeking food again.
THAT is why it is so hard for Americans to lose weight. There are already at least (the last I read) over 100 genes associated with obesity. One size does not fit all.
Saying a person lacks the will to lose 10 or 15% of their weight is reasonable. I tell people that with any motivation and discipline they should be able to do that, otherwise they are just lazy, don't get it, don't care etc. But more than that is nearly IMPOSSIBLE.
I could try to find scientific artilce and post when I have more time.
-
I agree with 5 Rings about the consequences of psuedo food; its why I called for "less calories and more real food". I disagree with this though:
"no one chooses to place themselves in a socially and physically detrimental state
no one chooses to be in a position of ridicule and in which they will be held in contempt by their fellow man".
IMHO lots of people do exactly that. Pair that notion with this:
"That is why progressives want to legislate a cap and trade on whatever they want to label as "fattening". To be able to control what people are unable to do for themselves."
and we have a formula that lays the foundation for destruction of freedom. We may humorously call it "food nazi fascism" but the underlying point is actually a serious one. To be a free society we must be a society wherein people are responsible for themselves.
I resubmit the proposition that your theory is disproved by the numerous countries which have enough money and food to overeat, but don't do so.
-
"I resubmit the proposition that your theory is disproved"
What theory? that obesity is not a disease?
That it is free choice?
I've already pointed out there are cultural environmental social and economic issues at play.
the fact the US is the most obese does not disprove anything about freedom of choice.
In 1969 the average chopped steak at a diner was 8 ounces. In 1999 it was 16 oz.
we are eating them. People are putting their healths at risk. Why because it ain't easy not too.
Your point about other countries only strengthens the argument that we need to legislate what people cannot do for themselves.
We should put all fattening foods out of business following *your* argument. Education alone is not enough. Like tax and spend dems are trying to do with cigarettes.
-
"Your point about other countries only strengthens the argument that we need to legislate what people cannot do for themselves."
No, that people elsewhere (e.g. Switzerland)with enough money and food to get fat do not get fat proves quite the contrary.
"We should put all fattening foods out of business following *your* argument. Education alone is not enough. Like tax and spend dems are trying to do with cigarettes."
Not my thinking in the slightest. My suggestion is to CHOOSE to replace psuedo food with real food; the idea being that to do so will greatly assist losing weight. Period.
The nanny argument is yours alone.
-
"I resubmit the proposition that your theory is disproved"
Crafty,
That is exactly the problem with your argument.
We can only choose to a limited degree and not completely as I think you suggest. As 5 rings points out,
the science is irrefutable.
Yet you want to ignore this and suggest it is free choice. I submit this is misguided. Certainly there is some choice involved but this does not explain all of it by any long shot. I am not a Democrat or a progressive. I don't want a nanny state. That is the progressive agenda. Not "my argument".
As 5 rings points out,
You probably burn hundreds and possibly thousands of calories a day. Most people don't and some couldn't whether they choose to or not. With regard to excercise the studies are quite clear. Very few people can lose and keep weight off without significant excercise.
I can't speak for other countries. Perhaps they walk more I don't know.
I don't want a nanny state. That is the progressive agenda. Not "my argument".
-
http://www.psyking.net/id36.htm
dig this
-
Reminds me of the smoking argument. It IS an addiction yet people quit everyday, so there is both choice and addiction. Food is as addicting i would think as a cigarette, probably more so because you always need to have some. People eat out of boredom, a routine and availability probably more than out of hunger. I think it is the deferred gratification argument. What do you want most versus what do you want now. Maybe you want a flat stomach and less load on yours knees, but what you want right now is to eat big, eat well, and eat often. I am definitely on the 'choice' side of this argument for most people and we know people make good and bad choices about all kinds of things. There are plenty of others where as the good doctor has pointed out, that it just won't ever happen and a staple in the stomach or a pill or other artificial solution is the best course of action.
Back to public policy and freedom, being out of shape is a lousy way to go through but shouldn't be illegal, shouldn't be decided by someone else and really isn't much of the government's business. When we turn to the government for health care is when someone else's personal behavior seems to become everyone's business - and that is mostly wrong IMO. Part of the problem is a consequence of wealth and part is tied to paying other people to do nothing and part has to so with so many people becoming wealthy enough that the cost of unlimited food is no issue. Either way, 25% of fresh foods get thrown out. I notice that friends who travel with expense accounts tend to eat excessively well. We have huge numbers of people who receive free food and have nothing but time available to consume it all because their productive activities were stopped by program eligibility requirements. How are they supposed to round up the will power to limit their diet to match their inactivity when nothing much else going on? Along with drug testing for welfare, we could put some limits on free food programs or change the structure of those programs for those who are unable to otherwise control their intake.
-
"As 5 rings points out,
the science is irrefutable."
Actually, I have not seen the "irrefutable science" Nor does the most recent article posted by 5RingsFitness support or refute
that being fat is not choice. A "theory" of us having a brain in the gut is just an unproven unscientific theory.
As Crafty points out, given that human beings are similar, why across the globe are people less fat than Americans? Are Frenchmen,
Italians, and Englishmen, forget the politics :-) so anatomically different from Americans that only Americans seem to be obese?
Perhaps "they do walk more"; but that is a choice. In Japan I am constantly walking and going up and down stairs. I don't need
to exercise so often plus the food is healthy. Here, I need to watch my diet and exercise since I travel everywhere by car. My choice.
Or perhaps Crafty because of his occupation does burn more calories; but that too is a choice.
In my Sensitometry Class (I like photography) last night, I watched an obese girl eat two burritos and french fries for a snack.
I had a banana. We both made a choice.
The "irrefutable" math is eat less calories and you will lose weight. Eat zero and you will waste away and die. Eat more and you will gain.
Further, burning or not burning calories will also affect weight. Exercise is important. Again, it is choice.
CCP said, "In 1969 the average chopped steak at a diner was 8 ounces. In 1999 it was 16 oz." Again that is choice.
My wife and I, when we do eat beef will split a prime steak (quality versus quantity). Again, that is choice.
Baring thyroid issues and a few minor other medical issues, it's all choice.
To be fair, as CCP pointed out, I'm not saying "choice" is easy. It's much easier to eat fast food than cook. It's easier to and perhaps tasty to buy
a dozen donuts. It's definitely not easy to lose a great deal of weight as CCP points out; but then again, don't gain it. That is choice.
5RingsFitness points out;
"no one chooses to place themselves in a socially and physically detrimental state
no one chooses to be in a position of ridicule and in which they will be held in contempt by their fellow man"
But that is not true; through choice, i.e. I'ld rather go home and have a beer than hit the gym is a choice. The consequences
are that you you have possibly put yourself "in a socially and physically detrimental state"
I think 5RingsFitness is confusing wants with choice. No one "wants" to be fat, or socially disadvantaged, but they choose not to do something
about it. To paraphrase another post on "talent" I suppose we all want to be good golfers like Doug, but are not willing to
make the choice to practice diligently. But that is my choice, my fault for not practicing. I can hardly blame Doug if he cleans my clock.
Back to Crafty's argument. Why throughout the world are American's the fattest? The answer cannot be found in medical science
that American's stomach's are any different, the answer lies that Americans choose to eat more and eat unhealthy. And/or burn less calories.
It's not rocket science; eat fewer calories or burn the calories and you will lose weight! But it's hard. It's easy to not practice my golf
and go ride my motorcycle instead. And it's easy to pop that beer and have some chips versus going to the gym. I like beer and chips,
so denying myself is hard. But that is still choice.
As a side note, I am not in favor of a nanny state either. If you choose to eat, that is your choice. And if it makes you happy,
well good for you. Perhaps the joy of eating excessively an unhealthily offsets the higher morbidity and mortality of obese individuals.
Fine; that too is a choice.
Is Obesity an illness? An analogy I've always liked is pregnancy. Medical plans used to not cover pregnancy. The theory being that becoming
pregnant was a "choice" (assuming no complications which were always covered) and medical insurance was for the unexpected. If you want to
have a baby, well then you should pay for it. While I have no desire to to debate the social and political merits of covering pregnancy, there was a certain logic I thought. The law changed and pregnancy is now covered as an "illness". The same "logic" applies to obesity. Social norms, not medical science
may dictate that obesity be covered as an illness. It's the nanny state...
-
5 Rings: Haven't looked at your piece yet.
CCP:
In essence you are saying "All swans are white". My personal case is irrelevant and I make no reliance on it whatsover. Rather, if I can show even one black swan then your science/theory is disproved; I go further than one black swan though-- I say that "No, there are plenty of swans that are black".
I remember a wonderful dinner in Bern, Switzerland where we had people from many, many Euro countries and the question of national stereotypes was being bantered about (Italian women-- hot lingerie; Germans good work ethic, punctual; that sort of thing). So I asked for the stereotype of Americans. Came the answer: "Fat people in shorts and white socks." Ouch.
Seriously though, one simply does not see the extraordinary numbers of grotesquesly obese people we have here elsewhere, though plenty of "elsewheres" have more than enough money and food to be obese if they were to so choose.
Just like in fighting and other aspects of Life, empiricism trumps theory :lol:
-
Choice....
______
Healthy eating: The best (Mediterranean diet) and the worst (umm, some Southern fare)?
Was there ever a time when we didn't have a bottle of olive oil in the kitchen?
The traditional Mediterranean diet was introduced to Americans about 17 years ago after it officially was endorsed by the Harvard School of Public Health and the World Health Organization. With an emphasis on fruits, vegetables, nuts and whole grains as well as more fish and less red meat, the diet continues to be the darling of doctors and nutritionists.
If you aren't familiar with the details of this food plan, MayoClinic.com provides a food pyramid and easy-to-follow steps in "Mediterranean diet: Choose this heart-healthy diet option."
So what are the worst foods to have in your diet? We hate to single out any particular cuisine for finger-wagging purposes; instead we'll let you draw your own conclusions from the photo essay "Southern heart attack foods."
-- Mary Forgione / Los Angeles Times
-
First let us define our terms-Socrates
define healthy
define choice
define theory
-
Oh heck, define "define." :evil:
-
Define Healthy...
It's subjective; no one is quibbling over a few pounds. But I like your quote;
"Nations have passed away and left no traces, And history gives the naked cause of it - One single simple reason in all cases; They fell because their peoples were not fit."-Rudyard Kipling
As for "choice" I like the dictionary's definition "the act of choosing" or "the power to choose"
As for "theory" how about "contemplation or speculation". Or a "guess or conjecture" or "an unproven assumption".
-
So probably hundreds of millions of people who cannot maintain weight loss despite Jenny Craig, Weight Watchers, countless other plans, Medit. diets. low fat diets, low carb diets, a trillion excercise programs and billions spent trying to lose weight are simply unmotivated people who "choose" to be overweight?
I was speaking today to a nurse at one of the hospitals and we were talking about weight loss. She asked if I have ever seen the biggest loser? I said a few times for a few minutes. I don't need to watch what I already know. I can tell you that after their 15 minutes of fame is up, that within five years 95% of all those on that program will have gained back all their weight. So you are telling me these are unmotivated gluttens who "choose" to be fat?
What are all you guys nuts?
-
And I forgot to add that the nurse said - these people are going through "torture". And that IS what it is for these people. Torture. Imagine going throught torture to lose all that weight. And then imagine expecting these people to literally plan on torturing themselves for the REST of their lives to maintain. With temptation every single minute of every single day! Forever.
Except for those very few unless they move to a deserted island it ain't gonna happen.
You want to say well then, it is their "choice", be my guest.
I say the evidence is clear that 10 or 15% weight loss is as much as almost all motivated *and* disciplined people are able to achieve over extended periods of time.
Whether due to too much food availability, too much TV or message boarding, too little exercise or what we can all theorize. But in the USA we have an epidemic of a disease called obesity.
That said I don't want Bamster or anyone else telling what I can eat or not.
The answer will hopefully come from the pharm industry but it is unlikely to be one pill that fits all. It might be combinations. Or brain and gut surgery. I don't know.
Or we cap and trade and try to tax are way out. Or we have a disaster and we all starve.
Thems the facts folks.
(Yes I have seen the motivational types showing us how we can eat like slobs and not gain weight and how delicious it is - so long as we eat vast quantities of lettuce, vegetables, and tofu.)
-
"So I asked for the stereotype of Americans. Came the answer: "Fat people in shorts and white socks." Ouch."
I have heard the same thing here from an doctor from India. The line I recall is Americans are "fat, lazy, and waste a lot".
-
"So I asked for the stereotype of Americans. Came the answer: "Fat people in shorts and white socks." Ouch."
I have heard the same thing here from an doctor from India. The line I recall is Americans are "fat, lazy, and waste a lot".
I never said it's easy to lose weight. But it is a choice.
I'm still waiting for your explanation to Crafty and my question; why primarily Americans, not your Indian physician friend, or my Japanese friends, or Italians, or French, or English or German people in general are not fat or obese.
The answer seems to be choice. Not some anatomical reason.
The "science is irrefutable" :evil:
Or are American stomach's different? :? :-o
-
China's new prosperity has resulted in a big spike in obesity and obesity related diseases, including type II diabetes.
-
"I'm still waiting for your explanation to Crafty and my question; why primarily Americans, not your Indian physician friend, or my Japanese friends, or Italians, or French, or English or German people in general are not fat or obese."
they are smarter than us :-P
-
"I'm still waiting for your explanation to Crafty and my question; why primarily Americans, not your Indian physician friend, or my Japanese friends, or Italians, or French, or English or German people in general are not fat or obese."
they are smarter than us :-P
Then we agree! They make better choices! 8-)
-
And since there has been no comment since his request for
definitions, I guess 5RingsFitness agrees too! :-)
IT'S ALL CHOICE!
We have a consensus. 8-)
-
http://www.pbs.org/newshour/bb/health/jan-june10/china_06-01.html
China's cities are getting bigger. Vast apartment complexes rise from land cleared for rebuilding. There's a constant hum of construction cranes and motion across the horizon. China's middle class is getting bigger, better educated, better paid. Millions of new consumers flock to the new shopping centers, freed from the hard physical labor of their parents and grandparents.
All that change has consequences. The Chinese are getting bigger, too, and fast. "The New England Journal of Medicine" reports that 19 million people in China are now obese. And while the small percentage of overweight people here still falls well short of America's epidemic, China's rapid rate of increased obesity, 30 to 50 percent annually -- that's six million to 10 million more each year -- has alarmed health officials.
In the course of just a few decades, China has moved from being a society with a fear of periodic famine to one where the rapidly rising rate of obesity is a serious public health threat.
Dr. Mi Jie is a pediatrician who is studying the phenomenon.
DR. MI JIE, pediatrician (through translator): During the last 30 years of economic development, people's living standards have improved rapidly. Their lifestyles have changed enormously. More money means more food.
RAY SUAREZ: Dr. Mi is trying to convince parents that giving their children more food just because they can afford more food will eventually become a health burden for that child.
DR. MI JIE (through translator): Most obese children don't have an immediate health risk, but health problems, such as high blood pressure, diabetes and cardiovascular diseases, will occur in 20 or 30 years, when they become adults, because health problems don't appear until adulthood. Parents don't see the problems. And they don't take action.
In fact, the traditional thinking in China is that children need to be fat, and that means the child is healthy and strong. This concept, of course, is wrong.
RAY SUAREZ: Western fast-food restaurants have become part of urban Chinese culture.
I just want to know what everybody's favorite food is at McDonald's.
CHILD: Hamburger. Coke.
WOMAN (through translator): The kids these days, they can eat whatever they want. When I was young, I was from a poor family, and we didn't have enough to eat. All we had were potatoes.
RAY SUAREZ: Paul French is the author of a soon-to-be-released book titled "Fat China."
PAUL FRENCH, author, "Fat China": They are extremely proud. And what we have here, of course, is a one-child policy, which is not enforced everywhere, but is still the norm.
So, now we have a generation coming through that not only have no siblings, but have no aunts and uncles. This has led to what we might term here the six-pocket syndrome, which is where every child, or little emperor, as they're known here, has two parents and four grandparents.
And those four grandparents and two parents don't really have anything to spend their money on except that child. So, they are lavishing that child. They are arguably spoiling that one child. And, of course, after generations of -- of not having enough, people don't want to say no to children. They want to give them everything. They want to let them enjoy the prosperity, rather than the austerity that they knew in their childhood.
RAY SUAREZ: According to the World Health Organization, between 5 percent and 10 percent of Chinese youth are now obese. Some of them make their way to the equivalent of a fat farm.
Here at the Aimin Fat Reduction Hospital, patients are not only introduced to healthier foods and daily exercise; they're also given traditional Chinese medical treatments, like acupuncture.
DR. SHI LIDONG, chief executive, Aimin Fat Reduction Hospital (through translator): With acupuncture, we want to control the appetite, the desire of eating, and so they won't feel very hungry. We use it to improve digestion and to break down the fat.
RAY SUAREZ: Dr. Shi Lidong is the hospital's chief executive.
DR. SHI LIDONG (through translator): The appearance of the body is not important to us. Our goal is to change their lifestyle, help them understand what to eat and what not to eat.
RAY SUAREZ: The parents of 19-year-old Ma Chanwang paid for his visit to Aimin. His goal is to lose 40 pounds. Now in his fifth day, he's already lost 15.
MAN (through translator): I started gaining weight when I was 8 years old. And I never stopped gaining. I like to eat deep-fried food, and I can't control my appetite.
RAY SUAREZ: As American-owned fast-food joints pop up around the country, they have been followed by another American cultural symbol: Weight Watchers. At Weight Watchers in Shanghai, program director Shan Jin works with clients to limit the amount of food at mealtime.
-
Isn't China's population over 1.3 Billion?
And per the New England Journal of Medicine "19 million people in China are now obese."
Do the math.
That's less than 1.5% of China's population.
In America 32.2% of the population is Obese!
Another 30% are considered "overweight".
Now that's a serious problem! As some say a "health emergency"!!!
Don't worry about China at 1.5%
-
IIRC GM wrote that obesity is following the spread of wealth in China. Wealth has not yet spread across the countryside and I would doubt that healthcare enough even to check them for obesity has spread that far either. The proportion I think you are looking for would be 19 million out of how many checked and my curiosity would ask that out of the 19 million, how many are linked to newer wealth and how many are linked to poverty. In America I think that obesity link goes both ways. In China I doubt that coal miners, workers in the fields or kids in sweatshops are immersed in sugar and soda or suffering from inactivity.
-
between a full time job
private clients, teaching classes
and filling in for Sifu whilst he is out if town
have not had time to come back to this
choice= options available, ability to make a decision
health= somewhat ambiguous though I think most would agree that being free of disease and able to meet the daily exigencies of life would fit the bill
theory= a proven hypothesis, a set of facts based on observation that can be used to predict future outcomes
if any one takes the time to google rats, obesity, addiction they will find some entertaining and compelling research
fact stress hormone cascade causes reduction in flow to the cortex ( we get stupid, make worse choices) reduction in cellular protein uptake ( eat all you want, only about 3 of 10 grams of protein will be used for cell turnover, the other 7 become fat ) reduction of GABA which leads to more fuzzy thinking and bad sleep patterns, add all of that to a sedentary lifestyle, bad food available in massive quantities at low cost, good food being hard to find in some areas and near nonexistent in others, the reaction our brain has to said bad food (wired for feelings of satiety with fat salt sweet) .....
yep
them obese folk are just stupid rubes that don't had the sense to see that they are dying a slow and horrific death, ostracized from the pack (society), if the could just choose to not be biologically the same as the rest of he human specie they would be better.....
selah
-
In the US, the poor have lots of food and little activity. In China, their poor have little food and lots of physical activity. It's in the cities, with the new wealth and "American-like" lifestyles that you'll find obesity a problem.
-
R Rings, truly I get what you are saying, but if your theories were true then they would be true across the board. So, to put a specific name to one of the many examples that contradict the conclusions of your theories: What do you make of the case of Switzerland? There is a very high standard of living, all the food that one could want-- including the best fg chocolate in the world!- and fatness is quite rare.
-
precisely so
"a high standard of living"
less stress
more leisure time
more active life styles
less access to the kinds of "food" we have here
does not disprove, rather highlights the point I am making
and as stated by other members
activity level is a determining factor
most folks here in the US spend more time prone or seated than moving
and when they do move, it tends to ne in a seated position
with little regard for function, chasing caloric intake goals and unreasonable body images
six pack abs are a producible low bodyfat percentage not muscular development
a giant ass can be the result of deadlifting as easily as never moving it
we have not even addressed body image dystopia and parietal lobe disorders
or feedback loops stemming from trauma
choice is pretty vague
sometimes as active and fit individuals we may find ourselves falling into the trap of thinking since we find it easy than everyone should be able to do it as easily, whatever it is
talk to a mugging victim about stick fighting
if they were successful in defending themselves they will likely be receptive
if not however the terror just talking about it can bring up is a thing to behold
if mom gave you a candy bar whenever you did right
you will have that wired in
the neurons that wire together fire together
food is a drug
addiction is no joke
do junkie choose to be junkies or is it a process that starts witha choice and ends with the monkey
-
Choice is not vague.
As pointed out, obesity is minimal in "rich" countries like Switzerland, Germany, Italy, France, England (heck most of Western Europe) plus Japan, South Korea et al.
Are they anatomically different than us? Of course not. Are they neurobiologically different than us? No. They simply make better choices!
I agree "most folks here in the US spend more time prone or seated than moving
and when they do move, it tends to ne in a seated position
with little regard for function, chasing caloric intake goals and unreasonable body images"
But that is choice.
Simply look at the overwhelming empirical evidence. Not unproven theory.
-
***When the full explanation for the modern epidemic of obesity has emerged***
Of course the explanation to many of my friends here on this forum is that it is simply a matter of choice but I post this for fun anyway:
****Obesity
Does light make you fat?
When—not just what—mice eat affects how much weight they put on
Oct 14th 2010
Illuminating the cause of obesityTHE blame for rising obesity rates has been pinned on many things, including a more calorific diet, the spread of processed food, a lack of exercise and modern man’s generally more stressful lot. Something else may soon be included in the list: brighter nights.
Light regulates the body’s biological clock—priming an individual’s metabolism for predictable events such as meals and slumber. Previous research has shown that, in mice at least, the genes responsible for this can be manipulated so as to make the animals plumper and more susceptible to problems associated with obesity, including diabetes and heart disease. It was not known, though, whether simply altering ambient light intensity might have similar effects.
A team of researchers led by Laura Fonken of Ohio State University has cleared the matter up. As they report in the Proceedings of the National Academy of Sciences, they examined how nocturnal light affects weight, body fat and glucose intolerance (the underlying cause of late-onset diabetes) in male mice. They found that persistent exposure to even a little night-time light leads to increases in all three.
To reach this conclusion Dr Fonken split her murine subjects into three groups. Some were kept in cages lit constantly, so as to resemble a never-ending overcast day. A second group lived in conditions akin to their natural habitat, with 16 hours of overcast day-like light, followed by eight hours of darkness. The remaining rodents were also exposed to a cycle, but the dark was replaced with a dim glow equivalent to the twilight at the first flickers of dawn.
Over the eight-week period of the experiment the mice in the first and third groups gained almost 50% more weight than those exposed to the natural light-dark cycle. They also put on more fat and exhibited reduced tolerance of glucose, despite eating comparable amounts of food and moving around just as much.
The only thing that seemed to differ was when the mice ate. In the wild, mice are nocturnal. Unsurprisingly, then, those in the quasi-natural conditions consumed only about a third of their food in the “day” phase. For a mouse exposed to the twilight cycle, however, the figure was over 55%.
In a follow-up experiment, Dr Fonken looked at whether the timing of food consumption alone could explain the observed differences. It turned out that those forced to eat during the “day”—ie, out of whack with their biological clock—did indeed gain about 10% more weight than those fed at “night” (be it dark or just dim) or those with uninterrupted access to grub.
How this might relate to people will require further investigation. Mice and humans are physiologically alike, so a similar effect might be expected for people, but the fact that mice are nocturnal and humans diurnal is a serious complicating factor. It is true, though, that the spread of electric lighting means many people eat their main meal when natural daylight is long gone—the obverse of a mouse eating during daylight hours. And that tendency to eat late, though it has never been tested properly, is believed by many nutritionists to be a factor in putting on weight.
When the full explanation for the modern epidemic of obesity has emerged, it is unlikely that the spread of artificial lighting will be the whole of it. But this work suggests it might be a part. When you eat could be as important as what you eat.
Science and Technology****
-
CCP, interesting stuff. Your position on this surprised me. I learned some things from your posts and I have learned a lot from 5 rings as well. He says he isn't a doctor but his view has the endorsement of ours. We all (IMHO) should acknowledge that in certain extreme cases obesity is caused by bodily defect like gland/hormone appetite metabolism dysfunction. I think you are mainly talking about problems that set in after major weight gain. It seems to me that losing weight is a different matter than maintaining good weight. Curing chronic obesity on your own or with the quick fix plans is maybe as easy as getting your virginity back after a few years of shall we say undisciplined behavior. It sounds like the body of the obese sends false signals for more food than it needs. So this wound may have started as self-inflicted, but grows into an illness. I can buy that. From the point of view of the MD, prescribing a pill or a procedure may be a big part of the only strategy with a real chance for success.
But why is it so common for the masses was the question. Because the right choice seems so distant or inconvenient or difficult in the environment we live in. An environment of immediate gratification, widespread inactivity and the (almost) unlimited availability of lousy choices.
All of that said, I still side with the others as to the preponderance of obesity. As I posted regarding economics, decline is a choice.
After my first full week of white shirt, dark tie and suit type work as a young adult I felt exhausted, but with nearly no exercise. First order getting off non-physical work may be to go have a drink. Add the social side to that and you find that people like to go out, which mostly means eat and drink. After a drink or two and you don't crave exercise, you crave food. Eat to excess and you still don't crave the exercise you missed. More likely that person ends up on the couch at home until they start thinking about more food and then go to bed with a full stomach and still no exercise.
Add parenting to that. Stay home more and life revolves around the kitchen. Drive the kids to soccer, tennis, scouts, you name it. Cheer and support them all you want but you still end up tired, hungry and thirsty without exercise.
Crafty at some point went from white collar training to this very disciplined and physical career choice. In my case I had a very strong involvement in more than one sport. My decision to keep going in those sports as a young adult kept me with immediate feedback from opponents if and when i lose a step, and that kept me coming beck to reasonable levels of fitness for a number of decades. It is easy to see how others without an interest in a sport or exercise could start to slide.
For the poor it gets even worse as I have previously posted. You are paid for your unproductivity, paid to try to get a note from your doctor that you are incapable of substantial economic gain, paid to have more children - literally, and then given a virtually unlimited food card good at all grocers without supervision.
I don't buy that people are unaware when this is happening to them. People know they had to replace their wardrobe every time they grew another size.
It comes back to what 5 rings wrote: "define choice"
Yes. That is exactly the nut of the matter. The right choice might not have seemed like it was one of the choices offered. The choice maybe seemed to be go to the bar or drink at home or at friends' houses.. Choosing between the all you eat buffet or super-size fast food. It was only 39 cents extra to super-size, batter value, why not? But those weren't really the only choices. Go to the casino or read at home. Watch television or pop in a movie. Hire to have the lawn mowed or move to a place where they take care of that etc. Now we have video game and internet addiction to add to all of that. Some have a spouse who is a great cook but pushes the eating agenda even further to the top. The right choice didn't always seem to be on the menu. Push away from the table. Portion your lunch and build it at home. We can make exceptions for all people with a bodily or medical defect, but for the rest - choices were made along the way. A choice not to do what it takes to stay reasonably fit. A choice not to push away from the table when you knew that really was enough. No one is saying easy choices if everything in your environment is pulling you the other direction. Sometimes not obvious choices. But they were choices that needed to be made to stay in any kind of shape. Otherwise, decline of your health and fitness is your choice. (MHO)
-
Humans are hunter-gatherers by nature. Our existence using agriculture and high tech is but a tick of the evolutionary clock. As a hunter-gatherer, very few environments have an easy access to sweet or fatty food. We crave them because they are very useful/valuable and rare in that setting. No hunter-gatherers suffered from obesity. They ate as much as possible, because one never knew when/if the next meal was coming. Now we still have the same inborn impulses, but a very different access to food and much less in the way of physical demands for most of us.
-
Doug,
I too think CCP as an MD has made some excellent points about when a person is already truly obese that "prescribing a pill or a procedure may be a big part of the only strategy with a real chance for success." Also, I concur that we "all (IMHO) should acknowledge that in certain extreme cases obesity is caused by bodily defect like gland/hormone appetite metabolism dysfunction"
And I think 5RingsFitness as a Personal Trainer has brought an interesting perspective making some good points about the difficulty of losing weight.
But the cause of, the preponderance of the evidence supports that it is choice. You point out that the decision is not easy. That's true. Yet, some here in America, most throughout Europe and Asia are able to make that choice not to be obese or overweight. It' not easy, but in the long making a difficult/healthy choice now will pay off later. Maybe it is like economics? :-)
-
All great points.
I think GM sums up with this:
"Now we still have the same inborn impulses, but a very different access to food and much less in the way of physical demands for most of us."
With regards to Doug's comment:
"I don't buy that people are unaware when this is happening to them"
Generally I agree but the insidious nature of obesity and weight gain is more incredible than I ever realized. Anyone ever watch that show on calbe, "I eat 33,000 calories a day"? There is a scene where a 350 or 400 pound lady was followed around for a day and they wrote down everything that she ate in a course of an average day.
Next the went and fixed her several full plates of food the exact same she ate and laid out all these plates on a round table. They brought her into the room and said to her THIS IS WHAT YOU EAT IN A TYPICAL DAY!!!
Well her repsonse was astonishing. Her eyes bugged open, her mouth fell agape and she just stood there in shock saying, "I eat all this in a day!?. This is disgusting."
Well, now I am sitting there watching this the same as everyone else thinking how on earth could this fat lady be stuffing all this food in her fat mouth all day long and NOT know it?
The denial some people have is being belief. Of course she is extreme, but my point is that it isn't as straight forward as some would like to think.
There have been other shows about this. One followed around three people who are succesful in losing large amount of weight and keeping it off. But when I tell you it is a FULL time job I mean it. These people spend all day long fighting and planning and motivating, and excercising, and cooking, and avoiding and keeping themselves focused. They show one woman woaling around her house in excercise leotards. She teaches aerobics and does her own at home as well. Another guy is shown running for two hours a day and spending lots of time planning and cooking his healthy meals.
Folks you have no idea how hard it is in our society to keep and lose weight off for most people. That is why a 10 to 15 % goal is reasonable and achievable for most with discipline and motivation. More maybe for some but not many.
-
Regarding the 33,000 calorie lady, we used to have freak shows at the state fair. Now we don't have the shows and they aren't called freaks anymore. Obesity in general raises moral, moral hazard and libertarian issues. One argument to legalize drugs was the law of natural consequences and learning. People can choose not to be a heroin addict if we allow that path and let people see where it leads. One consequence of the 33,000 calorie lady is that at some point she would lose her ability to hunt and gather. A self correcting problem. Enter public policies. As she becomes unable to function, the consequence is the opposite. We put her on public payroll and buy her more food. And healthcare, no matter the cost. In the name and spirit of being humane we took away the corrective mechanism that worked for tens of thousands of years.
-
"Regarding the 33,000 calorie lady, we used to have freak shows at the state fair. Now we don't have the shows and they aren't called freaks anymore."
Actually we kind of do have these shows. They are reality shows. Just not Barnum and Bailey.
There is a ladly in Old Bridge NJ who is vying to be the heaviest woman in the world.
I know the doctor who reluctantly is her phsyician.
She has made clear she wants to become the heaviest for the explicit reason of making money off it - reality show and whatever else she can get from it.
http://www.nypost.com/p/news/local/nj_woman_attempting_to_become_world_pco3O4qPWiCg3yjEWaxx9N
-
"the doctor who reluctantly is her physician"
The oath: do no harm?
-
She actually asked him if he would want to be on the reality show.
I know this guy well and he is excellent and would never do anything to harm anyone.
Who wants to be known as the doctor who keeps the heaviest woman alive so she can be the heviest woman?
-
I know this guy well and he is excellent and would never do anything to harm anyone.
Hmmm with no offense to your friend, but given the terrible impact of obesity upon one's health,
it seems to be that by "assisting" her to become fat he is in essence "harming" her.
Obesity is an epidemic in America (I still wonder why only America?). And expensive.
17 percent of U.S. medical costs is due to obesity, new study says
http://www.msnbc.msn.com/id/39693316/ns/health-diet_and_nutrition
Who should have to pay? I find it interesting that some companies are instituting a no smoking
policy in their hiring practices for health insurance cost savings, yet obesity costs far more than smoking. Perhaps we need to
institute a no obesity policy i.e. if your weight (BMI) is above a certain level you will not be
hired and/or if it reaches a certain level you will be fired. Similar to the corporate no smoking policies.
Seems logical and fair... And cost effective.
Then again I am for individual freedom so I don't agree with any of these policies.
-
"by "assisting" her to become fat he is in essence "harming" her"
Did I use the word "assisting"?
He saw her once I think.
He is not assisting her to become fat.
He would be trying to treat her obesity as well as any other health issues but that doesn't mean he could succeed.
Just because a doctor keeps an alcoholic alive doesn't mean he is helping him/her stay an alcoholic.
I risk the line above; no matter what I say it becomes interpreted backwards.
-
No, you did not use the word "assisting". My mistake CCP. I apologize. However I did put it in quotes.
I understand but am not sure your analogy applies in this instance.
This particular woman "has made clear she wants to become the heaviest for the explicit reason of making money off it"
Doug's comment "do no harm" made me wonder how a physician could even be party to this abomination.
Yet you are right; merely treating her and hopefully advising her against her reality show quest to become even more obese
is not "assisting" her. And eventually, if not now, she will truly need medical care (the main point of my posting). And we will
all pay for her poor choice....
-
"Doug's comment "do no harm" made me wonder how a physician could even be party to this abomination."
Yes, and that is what I meant when I noted he is "reluctantly" her doctor.
On the other hand as I noted (I thnk) he only saw her once and I am not sure what the outcome is/was.
The only reason I brought it up is to suggest some reality shows are analagous to "freak shows" of old.
-
Almost filed this under Pathological Science. . . .
Lies, Damned Lies, and Medical Science
MUCH OF WHAT MEDICAL RESEARCHERS CONCLUDE IN THEIR STUDIES IS MISLEADING, EXAGGERATED, OR FLAT-OUT WRONG. SO WHY ARE DOCTORS—TO A STRIKING EXTENT—STILL DRAWING UPON MISINFORMATION IN THEIR EVERYDAY PRACTICE? DR. JOHN IOANNIDIS HAS SPENT HIS CAREER CHALLENGING HIS PEERS BY EXPOSING THEIR BAD SCIENCE.
By David H. Freedman
IMAGE CREDIT: ROBYN TWOMEY/REDUX
IN 2001, RUMORS were circulating in Greek hospitals that surgery residents, eager to rack up scalpel time, were falsely diagnosing hapless Albanian immigrants with appendicitis. At the University of Ioannina medical school’s teaching hospital, a newly minted doctor named Athina Tatsioni was discussing the rumors with colleagues when a professor who had overheard asked her if she’d like to try to prove whether they were true—he seemed to be almost daring her. She accepted the challenge and, with the professor’s and other colleagues’ help, eventually produced a formal study showing that, for whatever reason, the appendices removed from patients with Albanian names in six Greek hospitals were more than three times as likely to be perfectly healthy as those removed from patients with Greek names. “It was hard to find a journal willing to publish it, but we did,” recalls Tatsioni. “I also discovered that I really liked research.” Good thing, because the study had actually been a sort of audition. The professor, it turned out, had been putting together a team of exceptionally brash and curious young clinicians and Ph.D.s to join him in tackling an unusual and controversial agenda.
Last spring, I sat in on one of the team’s weekly meetings on the medical school’s campus, which is plunked crazily across a series of sharp hills. The building in which we met, like most at the school, had the look of a barracks and was festooned with political graffiti. But the group convened in a spacious conference room that would have been at home at a Silicon Valley start-up. Sprawled around a large table were Tatsioni and eight other youngish Greek researchers and physicians who, in contrast to the pasty younger staff frequently seen in U.S. hospitals, looked like the casually glamorous cast of a television medical drama. The professor, a dapper and soft-spoken man named John Ioannidis, loosely presided.
One of the researchers, a biostatistician named Georgia Salanti, fired up a laptop and projector and started to take the group through a study she and a few colleagues were completing that asked this question: were drug companies manipulating published research to make their drugs look good? Salanti ticked off data that seemed to indicate they were, but the other team members almost immediately started interrupting. One noted that Salanti’s study didn’t address the fact that drug-company research wasn’t measuring critically important “hard” outcomes for patients, such as survival versus death, and instead tended to measure “softer” outcomes, such as self-reported symptoms (“my chest doesn’t hurt as much today”). Another pointed out that Salanti’s study ignored the fact that when drug-company data seemed to show patients’ health improving, the data often failed to show that the drug was responsible, or that the improvement was more than marginal.
Salanti remained poised, as if the grilling were par for the course, and gamely acknowledged that the suggestions were all good—but a single study can’t prove everything, she said. Just as I was getting the sense that the data in drug studies were endlessly malleable, Ioannidis, who had mostly been listening, delivered what felt like a coup de grâce: wasn’t it possible, he asked, that drug companies were carefully selecting the topics of their studies—for example, comparing their new drugs against those already known to be inferior to others on the market—so that they were ahead of the game even before the data juggling began? “Maybe sometimes it’s the questions that are biased, not the answers,” he said, flashing a friendly smile. Everyone nodded. Though the results of drug studies often make newspaper headlines, you have to wonder whether they prove anything at all. Indeed, given the breadth of the potential problems raised at the meeting, can any medical-research studies be trusted?
That question has been central to Ioannidis’s career. He’s what’s known as a meta-researcher, and he’s become one of the world’s foremost experts on the credibility of medical research. He and his team have shown, again and again, and in many different ways, that much of what biomedical researchers conclude in published studies—conclusions that doctors keep in mind when they prescribe antibiotics or blood-pressure medication, or when they advise us to consume more fiber or less meat, or when they recommend surgery for heart disease or back pain—is misleading, exaggerated, and often flat-out wrong. He charges that as much as 90 percent of the published medical information that doctors rely on is flawed. His work has been widely accepted by the medical community; it has been published in the field’s top journals, where it is heavily cited; and he is a big draw at conferences. Given this exposure, and the fact that his work broadly targets everyone else’s work in medicine, as well as everything that physicians do and all the health advice we get, Ioannidis may be one of the most influential scientists alive. Yet for all his influence, he worries that the field of medical research is so pervasively flawed, and so riddled with conflicts of interest, that it might be chronically resistant to change—or even to publicly admitting that there’s a problem.
THE CITY OF IOANNINA is a big college town a short drive from the ruins of a 20,000-seat amphitheater and a Zeusian sanctuary built at the site of the Dodona oracle. The oracle was said to have issued pronouncements to priests through the rustling of a sacred oak tree. Today, a different oak tree at the site provides visitors with a chance to try their own hands at extracting a prophecy. “I take all the researchers who visit me here, and almost every single one of them asks the tree the same question,” Ioannidis tells me, as we contemplate the tree the day after the team’s meeting. “‘Will my research grant be approved?’” He chuckles, but Ioannidis (pronounced yo-NEE-dees) tends to laugh not so much in mirth as to soften the sting of his attack. And sure enough, he goes on to suggest that an obsession with winning funding has gone a long way toward weakening the reliability of medical research.
He first stumbled on the sorts of problems plaguing the field, he explains, as a young physician-researcher in the early 1990s at Harvard. At the time, he was interested in diagnosing rare diseases, for which a lack of case data can leave doctors with little to go on other than intuition and rules of thumb. But he noticed that doctors seemed to proceed in much the same manner even when it came to cancer, heart disease, and other common ailments. Where were the hard data that would back up their treatment decisions? There was plenty of published research, but much of it was remarkably unscientific, based largely on observations of a small number of cases. A new “evidence-based medicine” movement was just starting to gather force, and Ioannidis decided to throw himself into it, working first with prominent researchers at Tufts University and then taking positions at Johns Hopkins University and the National Institutes of Health. He was unusually well armed: he had been a math prodigy of near-celebrity status in high school in Greece, and had followed his parents, who were both physician-researchers, into medicine. Now he’d have a chance to combine math and medicine by applying rigorous statistical analysis to what seemed a surprisingly sloppy field. “I assumed that everything we physicians did was basically right, but now I was going to help verify it,” he says. “All we’d have to do was systematically review the evidence, trust what it told us, and then everything would be perfect.”
It didn’t turn out that way. In poring over medical journals, he was struck by how many findings of all types were refuted by later findings. Of course, medical-science “never minds” are hardly secret. And they sometimes make headlines, as when in recent years large studies or growing consensuses of researchers concluded that mammograms, colonoscopies, and PSA tests are far less useful cancer-detection tools than we had been told; or when widely prescribed antidepressants such as Prozac, Zoloft, and Paxil were revealed to be no more effective than a placebo for most cases of depression; or when we learned that staying out of the sun entirely can actually increase cancer risks; or when we were told that the advice to drink lots of water during intense exercise was potentially fatal; or when, last April, we were informed that taking fish oil, exercising, and doing puzzles doesn’t really help fend off Alzheimer’s disease, as long claimed. Peer-reviewed studies have come to opposite conclusions on whether using cell phones can cause brain cancer, whether sleeping more than eight hours a night is healthful or dangerous, whether taking aspirin every day is more likely to save your life or cut it short, and whether routine angioplasty works better than pills to unclog heart arteries.
But beyond the headlines, Ioannidis was shocked at the range and reach of the reversals he was seeing in everyday medical research. “Randomized controlled trials,” which compare how one group responds to a treatment against how an identical group fares without the treatment, had long been considered nearly unshakable evidence, but they, too, ended up being wrong some of the time. “I realized even our gold-standard research had a lot of problems,” he says. Baffled, he started looking for the specific ways in which studies were going wrong. And before long he discovered that the range of errors being committed was astonishing: from what questions researchers posed, to how they set up the studies, to which patients they recruited for the studies, to which measurements they took, to how they analyzed the data, to how they presented their results, to how particular studies came to be published in medical journals.
This array suggested a bigger, underlying dysfunction, and Ioannidis thought he knew what it was. “The studies were biased,” he says. “Sometimes they were overtly biased. Sometimes it was difficult to see the bias, but it was there.” Researchers headed into their studies wanting certain results—and, lo and behold, they were getting them. We think of the scientific process as being objective, rigorous, and even ruthless in separating out what is true from what we merely wish to be true, but in fact it’s easy to manipulate results, even unintentionally or unconsciously. “At every step in the process, there is room to distort results, a way to make a stronger claim or to select what is going to be concluded,” says Ioannidis. “There is an intellectual conflict of interest that pressures researchers to find whatever it is that is most likely to get them funded.”
Perhaps only a minority of researchers were succumbing to this bias, but their distorted findings were having an outsize effect on published research. To get funding and tenured positions, and often merely to stay afloat, researchers have to get their work published in well-regarded journals, where rejection rates can climb above 90 percent. Not surprisingly, the studies that tend to make the grade are those with eye-catching findings. But while coming up with eye-catching theories is relatively easy, getting reality to bear them out is another matter. The great majority collapse under the weight of contradictory data when studied rigorously. Imagine, though, that five different research teams test an interesting theory that’s making the rounds, and four of the groups correctly prove the idea false, while the one less cautious group incorrectly “proves” it true through some combination of error, fluke, and clever selection of data. Guess whose findings your doctor ends up reading about in the journal, and you end up hearing about on the evening news? Researchers can sometimes win attention by refuting a prominent finding, which can help to at least raise doubts about results, but in general it is far more rewarding to add a new insight or exciting-sounding twist to existing research than to retest its basic premises—after all, simply re-proving someone else’s results is unlikely to get you published, and attempting to undermine the work of respected colleagues can have ugly professional repercussions.
In the late 1990s, Ioannidis set up a base at the University of Ioannina. He pulled together his team, which remains largely intact today, and started chipping away at the problem in a series of papers that pointed out specific ways certain studies were getting misleading results. Other meta-researchers were also starting to spotlight disturbingly high rates of error in the medical literature. But Ioannidis wanted to get the big picture across, and to do so with solid data, clear reasoning, and good statistical analysis. The project dragged on, until finally he retreated to the tiny island of Sikinos in the Aegean Sea, where he drew inspiration from the relatively primitive surroundings and the intellectual traditions they recalled. “A pervasive theme of ancient Greek literature is that you need to pursue the truth, no matter what the truth might be,” he says. In 2005, he unleashed two papers that challenged the foundations of medical research.
He chose to publish one paper, fittingly, in the online journal PLoS Medicine, which is committed to running any methodologically sound article without regard to how “interesting” the results may be. In the paper, Ioannidis laid out a detailed mathematical proof that, assuming modest levels of researcher bias, typically imperfect research techniques, and the well-known tendency to focus on exciting rather than highly plausible theories, researchers will come up with wrong findings most of the time. Simply put, if you’re attracted to ideas that have a good chance of being wrong, and if you’re motivated to prove them right, and if you have a little wiggle room in how you assemble the evidence, you’ll probably succeed in proving wrong theories right. His model predicted, in different fields of medical research, rates of wrongness roughly corresponding to the observed rates at which findings were later convincingly refuted: 80 percent of non-randomized studies (by far the most common type) turn out to be wrong, as do 25 percent of supposedly gold-standard randomized trials, and as much as 10 percent of the platinum-standard large randomized trials. The article spelled out his belief that researchers were frequently manipulating data analyses, chasing career-advancing findings rather than good science, and even using the peer-review process—in which journals ask researchers to help decide which studies to publish—to suppress opposing views. “You can question some of the details of John’s calculations, but it’s hard to argue that the essential ideas aren’t absolutely correct,” says Doug Altman, an Oxford University researcher who directs the Centre for Statistics in Medicine.
-
Still, Ioannidis anticipated that the community might shrug off his findings: sure, a lot of dubious research makes it into journals, but we researchers and physicians know to ignore it and focus on the good stuff, so what’s the big deal? The other paper headed off that claim. He zoomed in on 49 of the most highly regarded research findings in medicine over the previous 13 years, as judged by the science community’s two standard measures: the papers had appeared in the journals most widely cited in research articles, and the 49 articles themselves were the most widely cited articles in these journals. These were articles that helped lead to the widespread popularity of treatments such as the use of hormone-replacement therapy for menopausal women, vitamin E to reduce the risk of heart disease, coronary stents to ward off heart attacks, and daily low-dose aspirin to control blood pressure and prevent heart attacks and strokes. Ioannidis was putting his contentions to the test not against run-of-the-mill research, or even merely well-accepted research, but against the absolute tip of the research pyramid. Of the 49 articles, 45 claimed to have uncovered effective interventions. Thirty-four of these claims had been retested, and 14 of these, or 41 percent, had been convincingly shown to be wrong or significantly exaggerated. If between a third and a half of the most acclaimed research in medicine was proving untrustworthy, the scope and impact of the problem were undeniable. That article was published in the Journal of the American Medical Association.
DRIVING ME BACK to campus in his smallish SUV—after insisting, as he apparently does with all his visitors, on showing me a nearby lake and the six monasteries situated on an islet within it—Ioannidis apologized profusely for running a yellow light, explaining with a laugh that he didn’t trust the truck behind him to stop. Considering his willingness, even eagerness, to slap the face of the medical-research community, Ioannidis comes off as thoughtful, upbeat, and deeply civil. He’s a careful listener, and his frequent grin and semi-apologetic chuckle can make the sharp prodding of his arguments seem almost good-natured. He is as quick, if not quicker, to question his own motives and competence as anyone else’s. A neat and compact 45-year-old with a trim mustache, he presents as a sort of dashing nerd—Giancarlo Giannini with a bit of Mr. Bean.
The humility and graciousness seem to serve him well in getting across a message that is not easy to digest or, for that matter, believe: that even highly regarded researchers at prestigious institutions sometimes churn out attention-grabbing findings rather than findings likely to be right. But Ioannidis points out that obviously questionable findings cram the pages of top medical journals, not to mention the morning headlines. Consider, he says, the endless stream of results from nutritional studies in which researchers follow thousands of people for some number of years, tracking what they eat and what supplements they take, and how their health changes over the course of the study. “Then the researchers start asking, ‘What did vitamin E do? What did vitamin C or D or A do? What changed with calorie intake, or protein or fat intake? What happened to cholesterol levels? Who got what type of cancer?’” he says. “They run everything through the mill, one at a time, and they start finding associations, and eventually conclude that vitamin X lowers the risk of cancer Y, or this food helps with the risk of that disease.” In a single week this fall, Google’s news page offered these headlines: “More Omega-3 Fats Didn’t Aid Heart Patients”; “Fruits, Vegetables Cut Cancer Risk for Smokers”; “Soy May Ease Sleep Problems in Older Women”; and dozens of similar stories.
When a five-year study of 10,000 people finds that those who take more vitamin X are less likely to get cancer Y, you’d think you have pretty good reason to take more vitamin X, and physicians routinely pass these recommendations on to patients. But these studies often sharply conflict with one another. Studies have gone back and forth on the cancer-preventing powers of vitamins A, D, and E; on the heart-health benefits of eating fat and carbs; and even on the question of whether being overweight is more likely to extend or shorten your life. How should we choose among these dueling, high-profile nutritional findings? Ioannidis suggests a simple approach: ignore them all.
For starters, he explains, the odds are that in any large database of many nutritional and health factors, there will be a few apparent connections that are in fact merely flukes, not real health effects—it’s a bit like combing through long, random strings of letters and claiming there’s an important message in any words that happen to turn up. But even if a study managed to highlight a genuine health connection to some nutrient, you’re unlikely to benefit much from taking more of it, because we consume thousands of nutrients that act together as a sort of network, and changing intake of just one of them is bound to cause ripples throughout the network that are far too complex for these studies to detect, and that may be as likely to harm you as help you. Even if changing that one factor does bring on the claimed improvement, there’s still a good chance that it won’t do you much good in the long run, because these studies rarely go on long enough to track the decades-long course of disease and ultimately death. Instead, they track easily measurable health “markers” such as cholesterol levels, blood pressure, and blood-sugar levels, and meta-experts have shown that changes in these markers often don’t correlate as well with long-term health as we have been led to believe.
On the relatively rare occasions when a study does go on long enough to track mortality, the findings frequently upend those of the shorter studies. (For example, though the vast majority of studies of overweight individuals link excess weight to ill health, the longest of them haven’t convincingly shown that overweight people are likely to die sooner, and a few of them have seemingly demonstrated that moderately overweight people are likely to live longer.) And these problems are aside from ubiquitous measurement errors (for example, people habitually misreport their diets in studies), routine misanalysis (researchers rely on complex software capable of juggling results in ways they don’t always understand), and the less common, but serious, problem of outright fraud (which has been revealed, in confidential surveys, to be much more widespread than scientists like to acknowledge).
If a study somehow avoids every one of these problems and finds a real connection to long-term changes in health, you’re still not guaranteed to benefit, because studies report average results that typically represent a vast range of individual outcomes. Should you be among the lucky minority that stands to benefit, don’t expect a noticeable improvement in your health, because studies usually detect only modest effects that merely tend to whittle your chances of succumbing to a particular disease from small to somewhat smaller. “The odds that anything useful will survive from any of these studies are poor,” says Ioannidis—dismissing in a breath a good chunk of the research into which we sink about $100 billion a year in the United States alone.
And so it goes for all medical studies, he says. Indeed, nutritional studies aren’t the worst. Drug studies have the added corruptive force of financial conflict of interest. The exciting links between genes and various diseases and traits that are relentlessly hyped in the press for heralding miraculous around-the-corner treatments for everything from colon cancer to schizophrenia have in the past proved so vulnerable to error and distortion, Ioannidis has found, that in some cases you’d have done about as well by throwing darts at a chart of the genome. (These studies seem to have improved somewhat in recent years, but whether they will hold up or be useful in treatment are still open questions.) Vioxx, Zelnorm, and Baycol were among the widely prescribed drugs found to be safe and effective in large randomized controlled trials before the drugs were yanked from the market as unsafe or not so effective, or both.
“Often the claims made by studies are so extravagant that you can immediately cross them out without needing to know much about the specific problems with the studies,” Ioannidis says. But of course it’s that very extravagance of claim (one large randomized controlled trial even proved that secret prayer by unknown parties can save the lives of heart-surgery patients, while another proved that secret prayer can harm them) that helps gets these findings into journals and then into our treatments and lifestyles, especially when the claim builds on impressive-sounding evidence. “Even when the evidence shows that a particular research idea is wrong, if you have thousands of scientists who have invested their careers in it, they’ll continue to publish papers on it,” he says. “It’s like an epidemic, in the sense that they’re infected with these wrong ideas, and they’re spreading it to other researchers through journals.”
THOUGH SCIENTISTS AND science journalists are constantly talking up the value of the peer-review process, researchers admit among themselves that biased, erroneous, and even blatantly fraudulent studies easily slip through it. Nature, the grande dame of science journals, stated in a 2006 editorial, “Scientists understand that peer review per se provides only a minimal assurance of quality, and that the public conception of peer review as a stamp of authentication is far from the truth.” What’s more, the peer-review process often pressures researchers to shy away from striking out in genuinely new directions, and instead to build on the findings of their colleagues (that is, their potential reviewers) in ways that only seem like breakthroughs—as with the exciting-sounding gene linkages (autism genes identified!) and nutritional findings (olive oil lowers blood pressure!) that are really just dubious and conflicting variations on a theme.
Most journal editors don’t even claim to protect against the problems that plague these studies. University and government research overseers rarely step in to directly enforce research quality, and when they do, the science community goes ballistic over the outside interference. The ultimate protection against research error and bias is supposed to come from the way scientists constantly retest each other’s results—except they don’t. Only the most prominent findings are likely to be put to the test, because there’s likely to be publication payoff in firming up the proof, or contradicting it.
But even for medicine’s most influential studies, the evidence sometimes remains surprisingly narrow. Of those 45 super-cited studies that Ioannidis focused on, 11 had never been retested. Perhaps worse, Ioannidis found that even when a research error is outed, it typically persists for years or even decades. He looked at three prominent health studies from the 1980s and 1990s that were each later soundly refuted, and discovered that researchers continued to cite the original results as correct more often than as flawed—in one case for at least 12 years after the results were discredited.
-
Doctors may notice that their patients don’t seem to fare as well with certain treatments as the literature would lead them to expect, but the field is appropriately conditioned to subjugate such anecdotal evidence to study findings. Yet much, perhaps even most, of what doctors do has never been formally put to the test in credible studies, given that the need to do so became obvious to the field only in the 1990s, leaving it playing catch-up with a century or more of non-evidence-based medicine, and contributing to Ioannidis’s shockingly high estimate of the degree to which medical knowledge is flawed. That we’re not routinely made seriously ill by this shortfall, he argues, is due largely to the fact that most medical interventions and advice don’t address life-and-death situations, but rather aim to leave us marginally healthier or less unhealthy, so we usually neither gain nor risk all that much.
Medical research is not especially plagued with wrongness. Other meta-research experts have confirmed that similar issues distort research in all fields of science, from physics to economics (where the highly regarded economists J. Bradford DeLong and Kevin Lang once showed how a remarkably consistent paucity of strong evidence in published economics studies made it unlikely that any of them were right). And needless to say, things only get worse when it comes to the pop expertise that endlessly spews at us from diet, relationship, investment, and parenting gurus and pundits. But we expect more of scientists, and especially of medical scientists, given that we believe we are staking our lives on their results. The public hardly recognizes how bad a bet this is. The medical community itself might still be largely oblivious to the scope of the problem, if Ioannidis hadn’t forced a confrontation when he published his studies in 2005.
Ioannidis initially thought the community might come out fighting. Instead, it seemed relieved, as if it had been guiltily waiting for someone to blow the whistle, and eager to hear more. David Gorski, a surgeon and researcher at Detroit’s Barbara Ann Karmanos Cancer Institute, noted in his prominent medical blog that when he presented Ioannidis’s paper on highly cited research at a professional meeting, “not a single one of my surgical colleagues was the least bit surprised or disturbed by its findings.” Ioannidis offers a theory for the relatively calm reception. “I think that people didn’t feel I was only trying to provoke them, because I showed that it was a community problem, instead of pointing fingers at individual examples of bad research,” he says. In a sense, he gave scientists an opportunity to cluck about the wrongness without having to acknowledge that they themselves succumb to it—it was something everyone else did.
To say that Ioannidis’s work has been embraced would be an understatement. His PLoS Medicine paper is the most downloaded in the journal’s history, and it’s not even Ioannidis’s most-cited work—that would be a paper he published in Nature Genetics on the problems with gene-link studies. Other researchers are eager to work with him: he has published papers with 1,328 different co-authors at 538 institutions in 43 countries, he says. Last year he received, by his estimate, invitations to speak at 1,000 conferences and institutions around the world, and he was accepting an average of about five invitations a month until a case last year of excessive-travel-induced vertigo led him to cut back. Even so, in the weeks before I visited him he had addressed an AIDS conference in San Francisco, the European Society for Clinical Investigation, Harvard’s School of Public Health, and the medical schools at Stanford and Tufts.
The irony of his having achieved this sort of success by accusing the medical-research community of chasing after success is not lost on him, and he notes that it ought to raise the question of whether he himself might be pumping up his findings. “If I did a study and the results showed that in fact there wasn’t really much bias in research, would I be willing to publish it?” he asks. “That would create a real psychological conflict for me.” But his bigger worry, he says, is that while his fellow researchers seem to be getting the message, he hasn’t necessarily forced anyone to do a better job. He fears he won’t in the end have done much to improve anyone’s health. “There may not be fierce objections to what I’m saying,” he explains. “But it’s difficult to change the way that everyday doctors, patients, and healthy people think and behave.”
AS HELTER-SKELTER as the University of Ioannina Medical School campus looks, the hospital abutting it looks reassuringly stolid. Athina Tatsioni has offered to take me on a tour of the facility, but we make it only as far as the entrance when she is greeted—accosted, really—by a worried-looking older woman. Tatsioni, normally a bit reserved, is warm and animated with the woman, and the two have a brief but intense conversation before embracing and saying goodbye. Tatsioni explains to me that the woman and her husband were patients of hers years ago; now the husband has been admitted to the hospital with abdominal pains, and Tatsioni has promised she’ll stop by his room later to say hello. Recalling the appendicitis story, I prod a bit, and she confesses she plans to do her own exam. She needs to be circumspect, though, so she won’t appear to be second-guessing the other doctors.
Tatsioni doesn’t so much fear that someone will carve out the man’s healthy appendix. Rather, she’s concerned that, like many patients, he’ll end up with prescriptions for multiple drugs that will do little to help him, and may well harm him. “Usually what happens is that the doctor will ask for a suite of biochemical tests—liver fat, pancreas function, and so on,” she tells me. “The tests could turn up something, but they’re probably irrelevant. Just having a good talk with the patient and getting a close history is much more likely to tell me what’s wrong.” Of course, the doctors have all been trained to order these tests, she notes, and doing so is a lot quicker than a long bedside chat. They’re also trained to ply the patient with whatever drugs might help whack any errant test numbers back into line. What they’re not trained to do is to go back and look at the research papers that helped make these drugs the standard of care. “When you look the papers up, you often find the drugs didn’t even work better than a placebo. And no one tested how they worked in combination with the other drugs,” she says. “Just taking the patient off everything can improve their health right away.” But not only is checking out the research another time-consuming task, patients often don’t even like it when they’re taken off their drugs, she explains; they find their prescriptions reassuring.
Later, Ioannidis tells me he makes a point of having several clinicians on his team. “Researchers and physicians often don’t understand each other; they speak different languages,” he says. Knowing that some of his researchers are spending more than half their time seeing patients makes him feel the team is better positioned to bridge that gap; their experience informs the team’s research with firsthand knowledge, and helps the team shape its papers in a way more likely to hit home with physicians. It’s not that he envisions doctors making all their decisions based solely on solid evidence—there’s simply too much complexity in patient treatment to pin down every situation with a great study. “Doctors need to rely on instinct and judgment to make choices,” he says. “But these choices should be as informed as possible by the evidence. And if the evidence isn’t good, doctors should know that, too. And so should patients.”
In fact, the question of whether the problems with medical research should be broadcast to the public is a sticky one in the meta-research community. Already feeling that they’re fighting to keep patients from turning to alternative medical treatments such as homeopathy, or misdiagnosing themselves on the Internet, or simply neglecting medical treatment altogether, many researchers and physicians aren’t eager to provide even more reason to be skeptical of what doctors do—not to mention how public disenchantment with medicine could affect research funding. Ioannidis dismisses these concerns. “If we don’t tell the public about these problems, then we’re no better than nonscientists who falsely claim they can heal,” he says. “If the drugs don’t work and we’re not sure how to treat something, why should we claim differently? Some fear that there may be less funding because we stop claiming we can prove we have miraculous treatments. But if we can’t really provide those miracles, how long will we be able to fool the public anyway? The scientific enterprise is probably the most fantastic achievement in human history, but that doesn’t mean we have a right to overstate what we’re accomplishing.”
We could solve much of the wrongness problem, Ioannidis says, if the world simply stopped expecting scientists to be right. That’s because being wrong in science is fine, and even necessary—as long as scientists recognize that they blew it, report their mistake openly instead of disguising it as a success, and then move on to the next thing, until they come up with the very occasional genuine breakthrough. But as long as careers remain contingent on producing a stream of research that’s dressed up to seem more right than it is, scientists will keep delivering exactly that.
“Science is a noble endeavor, but it’s also a low-yield endeavor,” he says. “I’m not sure that more than a very small percentage of medical research is ever likely to lead to major improvements in clinical outcomes and quality of life. We should be very comfortable with that fact.”
This article available online at:
http://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-medical-science/8269/
-
"“I’m not sure that more than a very small percentage of medical research is ever likely to lead to major improvements in clinical outcomes and quality of life. We should be very comfortable with that fact.”
Very few studies lead to changes in the way we practice. Much more leads to quackery in the media, wall street, and homeopathic industry as well as the "established" medical community.
But before we jump on this author's bandwagon one thing is certain.
His view is exactly the view held by those who are have constructed battle plans to take over our health care and to decide what does and what does not get paid for.
They will make it almost impossible to prove a benefit for something and hence be able to say it ain't proven thus we do not see a reason to pay for it. They will force it the other way.
Some of these guys also have an agenda.
-
Overweight/obese? It is depressing just looking at the people on the street. And it's getting worse.
And yet it truly is all choice.
Contrary to some thought, excluding the few with a true medical condition (thyroid, etc.)
People do choose to place themselves in a socially and physically detrimental state
And people do choose to be in a position of ridicule and in which they will be held in contempt by their fellow man.
Otherwise they would choose to do something positive about it.
NOT doing anything, not making a choice to change, is still a choice.
Dr. Sanjay Gupta points out it's not easy, but it is simple...
Just choose to do something about it.
http://www.cnn.com/2010/HEALTH/11/11/weight.loss.race/index.html?hpt=Sbin
The bottom-line diet: Eat less!
"He practiced what he had always heard -- he reduced portion sizes and ate healthy."
"The basics of weight loss are simple: Eat less. Move more."
Consumers need to understand that health and the ideal body weight are not found from a gimmick. It takes hard work.
The end result is long-lasting success."
-
""The basics of weight loss are simple: Eat less. Move more."
Thanks Sanjay. I never thought of telling patients that. And all these overweight people never thought of that either.
-
'Eat less. Move more...all these overweight people never thought of that either.'
Doc, It doesn't work if they only think about it, they have to do it for it to work. :-)
Same advice might likely apply to most knee, hip, back issues - the load bearing areas of the body being asked to carry the wrong sized load. Also the location of the load moves outward with increases in size. Just tell them to lose the excess baggage and get back to you... I think you will lose your license if you do. They are looking for staples and pills by the time they come to you for weight loss. Sometimes that is what they need.
My grandpa always enjoyed telling us that in the early 1960s I think, WAY before warning labels, his doctor told him to quit smoking - 'Neal, those cigarettes are going to kill you.' No one told him about addiction or offered him patches, pills or hypnosis, but he did quit - right then. Everybody is different.
-
this is interesting for a lot of reasons
http://video.google.com/videoplay?docid=4362041487661765149#
a calorie is not indeed a calorie
-
Great lecture five rings. I watched it all with interest.
Ok we have three hypotheses:
1) obesity is a behavorial choice; the experts here :-D (cold)
2) obesity is a result of positie energy balance but not a choice; Gupta and most of the rest of the poorly advised medical community :-) (warm)
3) obesity is a result of the accumulation of fat; Gary Taubes :-o (hot)
4) obesity is still a mystery; me :cry: (hottest)
-
Gupta I guess goes to number 1 with the experts here. He thinks it is a simple choice.
And number four (me) is not a hypothesis as much as a conclusion.
-
Gupta I guess goes to number 1 with the experts here. He thinks it is a simple choice.
And number four (me) is not a hypothesis as much as a conclusion.
Yep, CCP you are right, Gupta goes with nearly all the medical/scientific experts (no reason to count
best seller authors trying to sell weight loss books), it's a simple choice, i.e.
1.) obesity is a behavioral choice.
Now, how to convince people to make the appropriate behavioral choice is still a mystery to me! :-)
-
JDN,
Did you see the video?
It is 70 minutes long.
The speaker goes into great depth explaining why it is not simple choice.
He also theorizes that it is not a matter of eating too much or excercising too little. He makes a good case that these behaviors are symptoms and not the cause of a disorder.
His way of looking at the problem does make a lot of sense. But I don't think he explains what happens to cause this. He goes into carbs and insulin and glucose uptake needed to convert fatty acids to storage with trigylcerides in the fat cell which is an endocrine organ and not simply a storage bin. But it is unclear to me and I think him as well (if I understand him right) as to what goes haywire in affecting this pathway leading to lipohypertrophy.
My thinking is this is only one piece of the puzzle.
I am not a fan of Gupta. I like you far more. Yet this video points out the strategy of consciously eating less and moving more is only marginally helpful and almost always doomed to fail.
Doug,
As for cigarettes your uncle's story is a good one. I have examples from that extreme (pt quits simply because he is asked) to those that cannot or will not quit no matter what I or anyone says or tries to do.
In my experience getting people to quit cigarettes is far easier than getting people to lose and keep off large amounts of weight. Even people who do treat weight loss for a living and are far better than me at it will tell you it is quite a challenge at best (if they are honest; surely there are a lot of huskers out there).
Doug, do you have relative who was obese and lost mega amounts of weight simply because he/she decided he/she was too fat? And kept it off for many years?
My guess (based on probability) is you don't. Neither do I. Except for one who had to have bariatric surgery.
-
Taube is a cool bit as he mostly concerns himself with investigating whether science is actually science or not
and in the clip he goes over some of the studies showing decreased caloric intake and obesity being concomittant
and
in a couple cases obesity on the bottom and
emaciation on the top
did those folks starve their faces and feed their butts?
south park it's not ;)
interesting eh?
choices are not all made at the conscious level
some are made at the genetic level
then ther is the enteric nervous system
-
CCP, You are exactly right. In the one example I would cite, the weight came off seemingly easily to a very healthy level but did not stay off, nor did he ever repeat the weight loss - ever. For most that I know, the excess weight seems stable, just not near levels considered healthy.
One thing I have learned in this discussion is to make a distinction between the obese with the difficulty in losing weight compared with the fit with their challenge of staying fit. In this forum, most people likely range from extremely fit to fanatically fit. The self discipline referred to by the fit is to keep doing what has always worked, where life is centered around awareness, health and fitness. The obesity problem is a wholly different challenge - to change everything about a person whose lifestyle and history is very much the opposite. I have not watched the video yet but what 5rings says make sense to me. Conscious choice is only a part of behavioral choice. I assume the conscious part of the brain and nervous system is a small part (1%?) of all that is going on. The martial artist likely is unusually proficient at controlling the rest of the system, with mind very in tune with and in control of body, extremes in awareness and self control. The obese patient is, I assume, very much the opposite. Innate within us, someone else mentioned, is the subconscious survival urge to eat all that you can, when you can, because it might not be there tomorrow.
Anther observation is that with a smoker, an alcoholic, a coke, meth or heroin addict after withdrawal and treatment, if successful, would hopefully never try it or use again. With food, it is necessary and keeps getting reintroduced. It would be like training an alcoholic or addict to get high in moderation 3 times a day with complete self control instead of quitting.
-
roflol
wow that last bit is spot on about training an addict to partake three times a day
that is priceless
yoink!
lifestyle
education
attitude
reason
need
or
learn
a model I have seen used for body comp
what is funny is in all honesty, the majority of the folks I deal with or have contact with I try to impress on them that if they stop focusing on weight, and rather focus in moving well and moving often, getting rid of the compensations physical or otherwise that are there to overcome the lack of mobility at some part of their body, and become as strong as they can, that by just eating whole and as close to original state foods they will be changed
my question everytime is
"if you could feel good all the time, move like an athlete, eat what you like and weigh the same would that be ok?"
common answer is yes
but people have to apply to work with me, and I charge a lot ;) so the level of commitment tends to be high
-
*In this forum, most people likely range from extremely fit to fanatically fit*
I used to work out like a madman on a stairmaster. Burned 2000 to over 4000 calories a workout couple of times a week. And did weight machines and free weights.
My weight was 15 pounds lighter than now.
Why because I can't overwhelm my appetite with extreme excersice anymore. I am too old.
Even when I worked out say 2000 calories a day and you add that to the say 1800 a day that I was burning at rest I could easily eat 3800 calories and still be very hungry.
Why, because excercise is an appetite stimulant. But for me that worked overall. I would earn a negative caloric balance of, say 3800 calories, so I could eatmore yet still control myself so I could lose and keep the weight off.
And that is just me. Everyone is different. Would worked for me might not work for another. Or they wouldn't or couldn't work out as hard as I did. Or wouldn't want to.
-
my question everytime is
"if you could feel good all the time, move like an athlete, eat what you like and weigh the same would that be ok?"
common answer is yes
but people have to apply to work with me, and I charge a lot ;) so the level of commitment tends to be high
With no offense meant, I am sure you are a good personal trainer, but if if an obese person came to you, then truly "weighed the
same" after being with you (no weight loss?), but was able to "feel good all the time" and "move like an athlete" and "eat what you like"
the customers would be lined up at your door regardless of your hourly training price. But then I have a bridge to sell. :-o
CCP
I did watch the video; it's good. I guess my cynicism is caused because he is an author, not a scientist or physician. His objective
is to sell his book. Nothing wrong with that, but... And the overwhelming scientific and medical community says it's a "choice".
Genetics, enteric nervous system etc. do affect weight; but then why only Americans? As I travel the world I marvel at the physique
of most of the citizens compared to Americans. Or do they have a different enteric nervous system? :-D
But I do agree with you that once a person is obese, truly obese it is very difficult to lose the weight and keep it off. For everyone one I see
lose the weight, I will see 10 maybe 20+ either not lose the weight after beginning a diet, or lose some weight only to gain it back
in the near future.
Probably you are right; surgery may be the only answer. For example my wife (she was never fat) after her pancreaticoduodenectomy (Whipple
Procedure) is able to eat anything and any amount and not gain weight. While she is the envy of her girlfriends, I think given a choice
my wife would rather exercise more and eat less than having needed surgery. Surgery should be last resort.
The key I think is to challenge them to lose weight before they become obese. For example, I'm cheap; I simply won't buy new pants for example. I don't need a scale to tell me I've gained a few pounds. And I also agree, while I do think it's just calories, counting those calories is a major lifestyle change requiring education, attitude, reason and need.
-
"And the overwhelming scientific and medical community says it's a "choice".
I don't know that people in the scientific and medical community who really treat weight loss would agree with that at all!
Gupta is a neurosurgeon. Frankly, he doesn't know what he is talking about when he speaks of obesity.
Most of us in medicine do not get real training when we are dealing with the treatment of overweight people. That is a gigantic void in our education.
All doctors tell their patients to eat less and excerise. It almost never works. And if it does only for short periods and only becasue the pt. was able to find some way to do it. Just telling patients to eat less and move more is essentially the dumbest thing we do.
Why do we than tell people this when we know it doesn't work? Because most doctors don't know anything else. Also it takes a lot of time which we don't have or get reimbursed to do. Most experts who treat obesity will tell you a 15% maintained weight loss over years in a average population of motivated patients who can stay with a program is a remarkable achievement.
To me Gupta is just as much a quack as the snake oil salesman down the corner push cart.
He may be a good neurosurgeon, or was. He couldnt be now at the same time he is a talking head. But he is not a leading expert on many subjects he talks about.
-
I like the focus on movement the positive instead of weight the negative, also to changing the types of foods. Carrots and spinach are not as addicting as MSG loaded potato chips dripping in salt and fat. You can't quit eating but it seems to me you would have to commit to quitting forever certain named junk foods that are causing you the most problem (or resign to living a shortened and immobile life). For example, if you are 100 pounds long term overweight and serious about improving your health, and french fries, glazed donuts and all you can eat buffets are your 3 worst violators, you need to make a conscious yes-no list for all the foods you have been eating and commit to never again eat certain named worst violators, as serious as drug addiction withdrawal, and add an equal number of new, healthy choices for sustenance to your list that don't sound as good right now to replace them. And then stick with it, everyday, like a recovering alcoholic refusing to have one beer.
Regarding mobility, I'm no expert but there are forms of swimming and water exercise that might be lower impact on the joints than even going for a walk.
Other helpful hints: Scale down to one small refrigerator and one small television and put them in opposite corners of the house. The conscious brain can limit some choices of the subconscious brain. Instead of a midnight snack, go to bed earlier. You will be more tired if you worked on mobility during the day.
-
Now that we are going to have pictures of death and disease on cigarette packages.
How about pictures like this being required on all Big Macs wrappers:
http://images.search.yahoo.com/images/view?back=http%3A%2F%2Fsearch.yahoo.com%2Fsearch%3Fei%3DUTF-8%26p%3Djon%2Bbrower%2Bminnoch%2Bphoto&w=160&h=109&imgurl=www.bing.com%2Fimages%2Fsearch%3Fq%3Djon%2Bbrower%2Bminnoch%2Bphoto%23focal%3D1d93e2af336b9a18bc2a244c10e49213%26furl%3Dhttp%253a%252f%252fwww.weightlossdietwatch.com%252fwp-content%252fuploads%252f2009%252f07%252fjon-brower-minnoch.jpg&size=&name=search&rcurl=http%3A%2F%2Fwww.bing.com%2Fimages%2Fsearch%3Fq%3Djon%2Bbrower%2Bminnoch%2Bphoto%23focal%3D1d93e2af336b9a18bc2a244c10e49213%26furl%3Dhttp%253a%252f%252fwww.weightlossdietwatch.com%252fwp-content%252fuploads%252f2009%252f07%252fjon-brower-minnoch.jpg&rurl=http%3A%2F%2Fwww.bing.com%2Fimages%2Fsearch%3Fq%3Djon%2Bbrower%2Bminnoch%2Bphoto%23focal%3D1d93e2af336b9a18bc2a244c10e49213%26furl%3Dhttp%253a%252f%252fwww.weightlossdietwatch.com%252fwp-content%252fuploads%252f2009%252f07%252fjon-brower-minnoch.jpg&p=jon+brower+minnoch&type=&no=2&tt=108&oid=http%3A%2F%2Fts2.mm.bing.net%2Fimages%2Fthumbnail.aspx%3Fq%3D318756296117%26id%3D2d582f77c482fd04496fef3a30897221&tit=Name%3A+Jon+Brower+Minnoch&sigr=16dbhq8nl&sigi=166mgvsjb&sigb=122ci9j2g&fr=yfp-t-892#FCar=f61a987420285132e11db896cbdef033
For all beer and alcohol a simple picture of Charlie Sheen should scare the begeebies out of anyone into sobriety.
-
CCP
While i am not in particular a fan of Gupta, I don't agree that he is "just as much a quack as the snake oil salesman down the corner push cart."
http://www.cnn.com/CNN/anchors_reporters/gupta.sanjay.html?iref=allsearch
I guess it comes back to Marc's question/comment; how are people in other countries able to avoid obesity and we are not?
As for "Also it takes a lot of time which we don't have or get reimbursed to do." I agree. One of the advantages of a National Health Care Plan
(there are many disadvantages too; I am not looking to debate that subject here) is that doctors get reimbursed for visits, often for minor
ailments. My point is that in Japan for example doctors will frequently see patients for the common cold. Not much they can truly do,
BUT seeing and being reimbursed to see a patient on a frequent basis before something serious i.e. obesity develops problem presents itself
offers an opportunity to address the issue before it's too late. I agree, once a patient is truly obese, the options are limited and the success
ratio of doing something about it is low. It's probably is too late simply to say eat less and move more...
Doug just posted; he too is identifying "choice" i.e. "focus on movement". I agree. The few successes I have seen combined
"movement" with diet.
As for your pictures on Big Mac's, well, why not? Obesity kills, and costs a lot more than cigarettes.
As for alcohol I kind of like Charlie Sheen's show so his picture might not do it for me... :-D
-
***I guess it comes back to Marc's question/comment; how are people in other countries able to avoid obesity and we are not?***
JDN and Crafty,
Well this IS a great question. I was speaking to one of the dieticians I refer patients to and the book "why are french women so thin?" came up.
I just looked it up on line and there are multiple links to discussions that came out in 2005. This one seems to sum it up:
http://www.medicinenet.com/script/main/art.asp?articlekey=62088
Yet when I read the explanations as to how French babes stay so hot it comes down to different behavior. More walking, smaller portion size, being aware of internal satiety cues.
This is not different from what we try to teach people who are overweight here. Eat smaller portions, stop eating when you feel full, don't finish everything on your plate, eat more slowly, drink more water and on and on. This is cognitive behavior therapy.
I've tried it. But it only works marginally well. Indeed, I can't even follow my own advice. Food is just too good! And old habits are hard to change.
-
The French women article's reference to yogurt prompts me to proffer a pet theory of mine:
We are continuously dosed by antibiotics via our consumption of industrial poultry and beef. The results is our natural intestinal flora is disrupted and diminished. This I think has consequences-- one of which may be to increase digestive disorders and susceptibility to weight gain.
-
There may be something to the intestinal flora thing yet my understanding is the research is mixed.
Though that doesn't stop the army of sales people hawking everything from capsule with bacteria to yogurt to Lord knows what else.
Some doctors also Rx it too. Even in the hospital. Yet when I read up on reviews the data is contradictory.
If it was a drug company seeking approval from the FDA they would be shot down. As long it is "natural" then anyone can say and sell whatever anyone is willing to listen to and buy into.
I don't write it off at all. Just that I think it all is murky.
-
Fair enough.
I would also add the question of what are the cumulative consequences of taking antibiotic medicines various times in one's life? How does the flora re-establish itself? Is the mix the same? Or do other less positive bacterias increase their place in the mix?
-
A couple of random thoughts:
a) One way of thinking about things is that our sweet tooth is nature's way of cluing us to eat certain things that are sweet e.g. fruit. Instead we eat sugar and our body is confused. Its near for carbo fuel is sated, but it remains hungry for the nutrition which it was intended to receive by eating the fruit.
b) Muscles consume calories, even at rest. Part of healthy living is to realize the natural potential for muscle mass. Genetic disposition to eat (appetite) has a tendency to be suitable for the intended muscle mass of the human in question. If natural muscle mass is not achieved, there will be an inherent contradiction between the disposition to eat and the disposition to eat a certain amount.
Just rambling here , , ,
-
Vitamin D levels that are consdiered deficient or insufficient in the blood is quite prevalent. It seems half of all of us are in that range. What is the optimal level of blood Vitamin D? No one is certain. I shoot for 40 because I've read that lower levels are associated with osteoporotic bone fractures. Some experts are advocating massive Vit D dosing in order to get people's levels up. I did this for some months till I read that there is an association of massive dosing and cardiovascular events like heart attacks. Is it possible that too much can contribute to heart attacks? No one is quite sure. However, coronary artery CT scans are actually looking for calcium in the coronaries arteries that is associated with plaque. Therefore one could question if the high doses of Vit D can increase plaque buildup.
In any case, the cost of measuring Vitamin D is around $200 or 250. Medicare will only pay for one measurement per year. Don't think they aren't pissed off about doctors who are ordering a lot of these. While nothing I read about the below article is wrong per se, don't forget the hidden agenda about the dollars and cents behind this from our government who is going to tell us what we can and cannot have paid for. This is a good example of what we are in store for:
Google NewsReport: A bit more vitamin D is good, not too much
(AP) – 10 hours ago
WASHINGTON (AP) — Got milk? You may need a couple cups more than today's food labels say to get enough vitamin D for strong bones. But don't go overboard: Long-awaited new dietary guidelines say there's no proof that megadoses prevent cancer or other ailments — sure to frustrate backers of the so-called sunshine vitamin.
The decision by the prestigious Institute of Medicine, the health arm of the National Academy of Sciences, could put some brakes on the nation's vitamin D craze, warning that super-high levels could be risky.
"More is not necessarily better," cautioned Dr. Joann Manson of Harvard Medical School, who co-authored the Institute of Medicine's report being released Tuesday.
Most people in the U.S. and Canada — from age 1 to age 70 — need to consume no more than 600 international units of vitamin D a day to maintain health, the report found. People in their 70s and older need as much as 800 IUs. The report set those levels as the "recommended dietary allowance" for vitamin D.
That's a bit higher than the target of 400 IUs set by today's government-mandated food labels, and higher than 1997 recommendations by the Institute of Medicine that ranged from 200 to 600 IUs, depending on age.
But it's far below the 2,000 IUs a day that some scientists recommend, pointing to studies that suggest people with low levels of vitamin D are at increased risk of certain cancers or heart disease.
"This is a stunning disappointment," said Dr. Cedric Garland of the University of California, San Diego, who wasn't part of the institute's study and says the risk of colon cancer in particular could be slashed if people consumed enough vitamin D.
"Have they gone far enough? In my opinion probably not, but it's a step in the right direction," added prominent vitamin D researcher Dr. Michael Holick of Boston University Medical Center, who said the new levels draw needed attention to the vitamin D debate and encourage more food fortification.
Vitamin D and calcium go hand in hand, and you need a lifetime of both to build and maintain strong bones. But the two-year study by the Institute of Medicine's panel of experts concluded research into vitamin's D possible roles in other diseases is conflicting. Some studies show no effect, or even signs of harm.
A National Cancer Institute study last summer was the latest to report no cancer protection from vitamin D and the possibility of an increased risk of pancreatic cancer in people with the very highest D levels. Super-high doses — above 10,000 IUs a day — are known to cause kidney damage, and Tuesday's report sets 4,000 IUs as an upper daily limit — but not the amount people should strive for.
And Manson pointed to history's cautionary tales: A list of other supplements — vitamins C and E and beta carotene — plus menopause hormone pills that once were believed to prevent cancer or heart disease didn't pan out, and sometimes caused harm, when put to rigorous testing.
Stay tuned: To help settle the issue, Manson is heading a government-funded study that's recruiting 20,000 healthy older Americans to test whether taking 2,000 IUs of vitamin D really will lower their risk for heart disease, a stroke or certain cancers.
In the meantime, it's hard to consume 600 IUs of vitamin D from food alone. A cup of D-fortified milk or orange juice has about 100 IUs. The best sources may be fatty fish — some servings of salmon can provide about a day's supply. Other good sources are D-fortified cereals.
But here's the report's big surprise: While some people truly are seriously deficient in vitamin D, the average American in fact already has enough circulating in his or her blood — because we also make vitamin D from sun exposure, and because many people already take multivitamins or other D-containing dietary supplements.
Wait a minute: Headlines in recent years have insisted the opposite, that a majority of people don't get enough vitamin D, especially during the winter. What explains the contradiction?
Most testing laboratories are using a too-high cutoff for those blood levels, said report co-author Dr. Clifford Rosen of the Maine Medical Center. The report says at least 20 nanograms is adequate for bone health, while many labs instead list people as low if their blood levels are below 30 ng. Serious vitamin D deficiencies are diagnosed when levels dip well below 20, something that hasn't changed.
Rosen called the state of vitamin D testing "the wild, wild West," and said he hoped that "with this report, we can at least temper people's enthusiasm for just taking tons of supplements."
As for calcium, the report recommended already accepted levels to go along with your daily D — about 1,000 milligrams of calcium a day for most adults, 700 to 1,000 mg for young children, and 1,300 mg for teenagers and menopausal women. Too much can cause kidney stones; the report said that risk increases once people pass 2,000 mg a day.
It's true that most studies link poor health to vitamin D levels that are below 20 ng, said preventive cardiologist Dr. Erin Michos, a Johns Hopkins University School of Medicine professor who wasn't part of the study.
But, "I'm not sure I'm going to dramatically change my practice," said Michos, who pushes her patients to boost their levels until they're between 30 and 50 ng.
EDITOR'S NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
Copyright © 2010 The Associated Press. All rights reserved.
-
I am shocked by this rec. by an FDA panel of experts. Lap bands have a failure rate of 80% over a couple of years. To think that the FDA approves doing this for people who are only class 1 obese is wrong. It is a very costly procedure with not great results. The surgeons will get rich though. As well as the hospitals that do this. WE will go broke paying for these through skyrocketing insurance costs. I don't get it.
While obesity is hard to treat this ain't the answer. Someone was bribed or owns stock options.
****By MATTHEW PERRONE, Associated Press Matthew Perrone, Associated Press – Sat Dec 4, 1:18 am ET
WASHINGTON – About 12 million more obese Americans could soon qualify for surgery to implant a small, flexible stomach band designed to help them lose weight by dramatically limiting their food intake. The Food and Drug Administration will make a final decision on the Lap-Band in the coming months.
The device from Allergan Inc. is currently implanted in roughly 100,000 people each year and usually helps patients lose 50 pounds or more. Under federal guidelines, it has been limited to patients who are morbidly obese.
On Friday, a panel of FDA advisers recommended expanding use of the device to include patients who are less obese. The panel voted 8-2 that the benefits of broader approval outweighed the risks.
If approved for wider use, the Lap-Band could be available to patients like Angela Denson, a 37-year-old Indianapolis woman who wants to lose 80 or 85 pounds. She said she has struggled with obesity since she started having children 20 years ago.
"I've tried diet pills. I've tried Weight Watchers ... all different types of diet plans," she said.
Denson is not quite obese enough for the surgery under the current standards, but she still wants to pursue the procedure to ward off future health problems and feel better.
But experts stress that the Lap-Band cannot stop deeply ingrained behavior that drives people to overeat. And the high cost of the procedure will remain a barrier for many potential patients.
More than a third of all American adults are obese. About 15 million of them meet criteria for gastric banding surgery under existing guidelines, which say a person should have a body mass index of 40 or higher, or a BMI of 35 or higher if the person suffers from a weight-related medical problem such as diabetes or high blood pressure.
If adopted, the proposal would lower the Lap-Band requirement to a BMI of 35 or higher, or as low as 30 with one related health problem.
Doing so would increase the number of eligible patients to 27 million, according to federal health data.
Denson said her insurer denied her doctor's request for a band procedure because her BMI was 39.3, and she had no serious conditions.
Dr. Jack Ditslear said broader approval could help people with lower BMIs avoid dangerous complications down the road.
"We know that being overweight increases the risk of diabetes, high blood pressure and heart disease," said Ditslear, a surgeon at Clarian Bariatrics in Indianapolis. "Ideally you want to lose the weight before you have the onset of those diseases."
The adjustable band has been available in the U.S. since 2001 but far longer in Europe and Australia, where it is dominant. A ring is placed over the top of the stomach and inflated with saline to tighten it and restrict how much food can enter and pass through the stomach.
The device was developed as an alternative to gastric bypass surgery, a permanent procedure in which food is rerouted from a pouch in the stomach to the small intestine.
There were about 220,000 gastric surgeries last year, with banding accounting for an estimated 40 percent. Surgeons say the fact that the procedure is reversible and relatively low-risk accounts for its growing popularity.
"As a clinician, it's pretty common for patients to come in because they've heard about banding," said Dr. Eric DeMaria, a surgeon at Durham Regional Hospital. "It's probably the lowest-risk surgical procedure available for morbid obesity."
But there are hurdles to wider use of the procedure, particularly its cost, which can range from $14,000 to $20,000. The device itself costs $3,000.
Susquehanna International analyst Gary Nachman says both insurers and patients are often reluctant to pay.
"It's a very expensive procedure and even if someone has coverage, they may have to pay a copay of a few thousand dollars," Nachman said. "And that's why in a tough economy, we've seen this franchise struggle more than you would normally."
According to Nachman, the payment issues for Lap-Band will only increase if it is approved for patients with less severe obesity. He projects a modest 8 percent rise in Allergan's business through 2014 to about $258 million.
Susan Pisano, a spokeswoman for the industry trade group America's Health Insurance Plans, said she believes a majority of insurers now cover bariatric surgeries.
"They may approach this surgery in a cautious way, but I think there is a broad acknowledgment that there is a place for surgery in the treatment of morbidly obese people," she said, noting that some employers who provide group health coverage choose not cover the procedure in their plans.
The FDA's consideration of the Lap-Band comes as rising health care costs threaten to consume nearly a fifth of the U.S. economy. Obesity-related health care spending is estimated at $147 billion, double the level of a decade ago.
While experts say the Lap-Band can help patients control their weight, it cannot replace healthy lifestyle choices.
"It is a tool to make the lifestyle easier, but not easy. It doesn't help people exercise more or resolve their behavioral issues," said Madelyn Fernstrom, director of the University of Pittsburgh's weight management center. "It's most important for people to understand what it can and can't do."
To change eating behavior, the drug industry has invested billions of dollars to develop weight-loss medications, most of which have not proven effective.
The FDA has rejected two such medications this year alone because of safety concerns.
On Friday the agency issued a lackluster review of a third drug called Contrave, which combines an antidepressant with an anti-addiction drug used to treat alcoholism.
Experts say such drugs have been largely unsuccessful at addressing the main obstacle to weight loss: the brain's fundamental drive to eat enough food to maintain current weight.
Dr. Derek Lowe, a pharmaceutical researcher and blogger, says unless medicine finds a way to address that issue, devices like the Lap-Band will have mixed effectiveness.
"There are certainly people who've had gastric bypass surgery and managed to turn themselves back into their original size by sipping on milkshakes all day," he said.****
___
-
http://www.tobiasbuckell.com/2010/12/04/how-i-lost-30-pounds-while-eating-a-donut-every-day/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+TobiasBuckell+%28Tobias+S.+Buckell+Online%29&utm_content=FaceBook
How I lost 30 pounds while eating a donut every day
-
The procedure, particularly its cost, which can range from $14,000 to $20,000. The device itself costs $3,000.
Now based on FDA experts 100,000,000 people total will qulify for the procedure. That's right 100 million.
Using the above numbers that means we could spend 1.5 TRILLION for the people who qualify.
It should NOT be covered by insurance or Medicare for people who are with BMI 30 to 35. If they choose to pay out of pocket - be my guest.
I do not want to subsidize this.
Why is everything ass backwards with the government????
-
I don't recall where I read it but the longer term results of lap band are not very good. Most people will gain most of the weight back.
That is not true for the gastric bypass which does work much better.
When I do a search all I see are advertisements from surgeons telling you how wonderful the procedure is and how state of the art they are.
But then again most diet business will not tell you that almost all fail after five years 95% of people.
GM,
I cannot pull up the link in your post.
I heard something about the donut man's diet. Isn't he some guy at Rutgers?
-
CCP,
That's a different guy with the same basic idea. Burn more calories than you consume and you lose weight. Even if some of your food choices are less than ideal.
-
Update from CDC on influenza.
One can go back in time to see how it is spreading throughout the US over the past month up to 11/27:
http://www.cdc.gov/flu/weekly/WeeklyFluActivityMap.htm
-
the simplest explanation is often the right one. And the simplest explanation for the dramatic rise in obesity rates — roughly doubling as a percentage of the total population in just a quarter-century — is the surge in our daily caloric intake. Excess food now, excess weight later.
http://www.latimes.com/news/opinion/commentary/la-oe-gratzer-obesity-20101208,0,7040118.story
-
My quote from Dec. 4:
"someone was bribed or owns stock options"
Well here it is,
http://www.cnn.com/video/#/video/health/2010/12/16/ac.weight.loss.surgery.questions.cnn?iref=allsearch
Gee I wonder who were the ones to vote for enlarging the population of people elligible for the lap band. They don't give the stats here but the evidence is the lap band fails for more than it succeeds over a couple of years.
-
http://www.ncbi.nlm.nih.gov/pubmed/20054459 The full text article is free.
Int J Environ Res Public Health. 2009 Oct;6(10):2626-38. Epub 2009 Oct 12.
Food choices and coronary heart disease: a population based cohort study of rural Swedish men with 12 years of follow-up.
Holmberg S, Thelin A, Stiernström EL.
Research and Development Centre, Kronoberg County Council, Box 1223, SE-351 12 Växjö, Sweden. sara.holmberg@ltkronoberg.se
Abstract
Coronary heart disease is associated with diet. Nutritional recommendations are frequently provided, but few long term studies on the effect of food choices on heart disease are available. We followed coronary heart disease morbidity and mortality in a cohort of rural men (N = 1,752) participating in a prospective observational study. Dietary choices were assessed at baseline with a 15-item food questionnaire. 138 men were hospitalized or deceased owing to coronary heart disease during the 12 year follow-up. Daily intake of fruit and vegetables was associated with a lower risk of coronary heart disease when combined with a high dairy fat consumption (odds ratio 0.39, 95% CI 0.21-0.73), but not when combined with a low dairy fat consumption (odds ratio 1.70, 95% CI 0.97-2.98). Choosing wholemeal bread or eating fish at least twice a week showed no association with the outcome.
PMID: 20054459 [PubMed - in process]PMCID: PMC2790097Free PMC Article
-
The Claim: Humming Can Ease Sinus Problems
By ANAHAD O’CONNOR
Published: December 20, 2010
NYTimes
THE FACTS
Dealing with a cold is bad enough, but when it leads to a sinus infection, the misery can double. Some researchers have proposed a surprising remedy: channeling your inner Sinatra.
Sinus infections — which afflict more than 37 million Americans every year — generally occur when the lining of the sinuses becomes inflamed, trapping air and pus and other secretions, and leading to pain, headaches and congestion. Because the inflammation is often caused by upper-respiratory infections, people with asthma and allergies are more vulnerable than others to chronic sinusitis.
Keeping the sinuses healthy and infection-free requires ventilation — keeping air flowing smoothly between the sinus and nasal cavities. And what better way to keep air moving through the sinuses and nasal cavity than by humming a tune?
In a study in The American Journal of Respiratory and Critical Care Medicine, researchers examined this by comparing airflow in people when they hummed and when they quietly exhaled. Specifically, they looked to see if humming led to greater levels of exhaled nitric oxide, a gas produced in the sinuses. Ultimately, nitric oxides during humming rose 15-fold.
Another study a year later in The European Respiratory Journal found a similar effect: humming resulted in a large increase in nasal nitric oxide, “caused by a rapid gas exchange in the paranasal sinuses.” Since reduced airflow plays a major role in sinus infections, the researchers suggested that daily periods of humming might help people lower their risk of chronic problems. But further study is needed, they said.
THE BOTTOM LINE
Studies show that humming helps increase airflow between the sinus and nasal cavities, which could potentially help protect against sinus infections.
ANAHAD O’CONNOR scitimes@nytimes.com
-
Next step.
Get a Federal grant to study this. (tax payers would never know)
It must be for a university from a Democratic district.
One study group must hum a total of two hours a day. Another study group three hours a day.
A control group with no humming allowed. The groups would be monitored for a year. at the end of the year compare sinus trouble rates between the groups.
Think of the jobs created with this money. A professor who does nothing but put his name on the paper at the end and take credit even though he/she did nothing. A phD candidate or medical fellow who does ALL the work, and one nurse (who is already employed by the univeristy ENT department). Eventually a statistician could be consulted, a secretary to type it up, the study sent in to the NEJM for publication.
This would undoubetdly get money for a professor who has to get government grants to keep his post at the university, the phD candidate works for free, or for little pay, or even pays into his training, and the secretary and statistian could continue to get minimum wage.
And like ALMOST ALL studies in medicine the results whether positive or negative in their findings of a link between humming and "sinus health" the conclusion WILL BE more study is needed to investigate this further!
Sinus health, prostate health, breast health, colon health, healthy heart.....well at least Americans do have healthy appetites.
-
http://www.cdc.gov/flu/weekly/usmap.htm
-
Comments?
===============================
An easy-to-follow 5-step plan to make yourself diabetic in as short a time as possible...
1) Cut your fat and eat healthy, whole grains: Yes, reduce satiety-inducing foods and replace the calories with appetite-increasing foods, such as whole grain bread, that skyrocket blood sugar higher than a candy bar.
2) Consume one or more servings of juice or soda per day: The fructose from the sucrose or high-fructose corn syrup will grow visceral fat and cultivate resistance to insulin.
3) Follow the Institute of Medicine's advice on vitamin D: Take no more than 600 units vitamin D per day, which will allow abnormal levels of insulin resistance to persist, driving up blood sugar, grow visceral fat, and allow abnormal inflammatory phenomena to persist.
4) Have a bowl of oatmeal or oat cereal every morning: Because oat products skyrocket blood sugar, the repeated high sugars will damage the pancreatic beta cells ("glucose toxicity"), eventually impairing pancreatic insulin production. (Add insult to injury by adding a little honey with your oatmeal.) To make your diabetes-creating breakfast concoction even more effective, make the oatmeal using bottled water. Many popular bottled waters, like Coca Cola's Dasani or Pepsi's Aquafina, are filtered waters. This means they are devoid of magnesium, a mineral important for regulating insulin responses.
5) Take a diuretic (like hydrochlorothiazide, or HCTZ) or beta blocker (like metoprolol or atenolol) for blood pressure: Likelihood of diabetes increases 30% with these common blood pressure agents.
-
yep
diet of fat, protein, veggies and leafy greens= less chance
diet prescribed by big Agra and big pharma= customer for life, even though the quality and span will be reduced
-
Each year, federal inspectors find illegal levels of antibiotics in hundreds of older dairy cows bound for the slaughterhouse. Concerned that those antibiotics might also be contaminating the milk Americans drink, the Food and Drug Administration intended to begin tests this month on the milk from farms that had repeatedly sold cows tainted by drug residue.
But the testing plan met with fierce protest from the dairy industry, which said that it could force farmers to needlessly dump millions of gallons of milk while they waited for test results. Industry officials and state regulators said the testing program was poorly conceived and could lead to costly recalls that could be avoided with a better plan for testing.
In response, the F.D.A. postponed the testing, and now the two sides are sparring over how much danger the antibiotics pose and the best way to ensure that the drugs do not end up in the milk supply.
“What has been served up, up to this point, by Food and Drug has been potentially very damaging to innocent dairy farmers,” said John J. Wilson, a senior vice president for Dairy Farmers of America, the nation’s largest dairy cooperative. He said that that the nation’s milk was safe and that there was little reason to think that the slaughterhouse findings would be replicated in tests of the milk supply.
But food safety advocates said that the F.D.A.’s preliminary findings raised issues about the possible overuse of antibiotics in livestock, which many fear could undermine the effectiveness of drugs to combat human illnesses.
“Consumers certainly don’t want to be taking small amounts of drugs every time they drink milk,” said Caroline Smith DeWaal, food safety director of the Center for Science in the Public Interest, an advocacy group. “They want products that are appropriately managed to ensure those drug residues aren’t there, and the dairy farmer is the one who can control that.”
The F.D.A. said that it would confer with the industry before deciding how to proceed. “The agency remains committed to gathering the information necessary to address its concern with respect to this important potential public health issue,” it said in a statement.
The concerns of federal regulators stem from tests done by the Department of Agriculture on dairy cows sent to be slaughtered at meat plants. For years, those tests have found a small but persistent number of animals with drug residues, mostly antibiotics, that violate legal limits.
The tests found 788 dairy cows with residue violations in 2008, the most recent year for which data was available. That was a tiny fraction of the 2.6 million dairy cows slaughtered that year, but regulators say the violations are warning signs because the problem persists from year to year and some of the drugs detected are not approved for use in dairy cows.
The question for the F.D.A. is whether cows that are producing milk also have improper levels of such drugs in their bodies and whether traces of those drugs are getting into the milk.
Regulators and veterinarians say that high levels of drugs can persist in an animal’s system because of misuse of medicines on the farm.
That can include exceeding the prescribed dose or injecting a drug into muscle instead of a vein. Problems can also occur if farmers do not follow rules that require them to wait for a specified number of days after administering medication before sending an animal to slaughter or putting it into milk production.
“F.D.A. is concerned that the same poor management practices which led to the meat residues may also result in drug residues in milk,” the agency said in a document explaining its plan to the industry. In the same document, the F.D.A. said it believed that the nation’s milk supply was safe.
Today, every truckload of milk is tested for four to six antibiotics that are commonly used on dairy farms. The list includes drugs like penicillin and ampicillin, which are also prescribed for people. Each year, only a small number of truckloads are found to be “hot milk,” containing trace amounts of antibiotics. In those cases, the milk is destroyed.
But dairy farmers use many more drugs that are not regularly tested for in milk. Regulators are concerned because some of those other drugs have been showing up in the slaughterhouse testing.
Federal officials have discussed expanded testing for years. But industry executives said that it was not until last month that the F.D.A. told them it was finally going to begin.
The agency said that it planned to test milk from about 900 dairy farms that had repeatedly been caught sending cows to slaughter with illegal levels of drugs in their systems.
It said it would test for about two dozen antibiotics beyond the six that are typically tested for. The testing would also look for a painkiller and anti-inflammatory drug popular on dairy farms, called flunixin, which often shows up in the slaughterhouse testing.
The problem, from the industry’s point of view, is the lengthy time it takes for test results.
The tests currently done for antibiotics in milk take just minutes to complete. But the new tests could take a week or more to determine if the drugs were present in the milk.
Milk moves quickly onto store shelves or to factories where it is made into cheese or other products. The industry worried that, under the F.D.A. plan, by the time a load of milk was found to be contaminated, it could already be in consumers’ refrigerators, and that could lead to recalls.
One Northeast cooperative, Agri-Mark, sent a letter to its members last month instructing them to dump milk if it had been tested by the F.D.A. “Agri-Mark must ensure that all of our milk sales, cheese, butter and other products are in no danger of recall,” the letter said.
Other industry executives said that processing plants would refuse to take any milk from a farm that had been tested until the results showed it was drug-free, meaning farmers could end up dumping milk for a week or more while waiting.
The F.D.A. plan was also criticized by state officials that regulate the dairy industry.
In a sharply worded Dec. 29 letter, the top agriculture officials of 10 Northeastern states, including New York and Pennsylvania, which are both leading dairy producers, told the F.D.A. that its plan was badly flawed. Among other problems, the letter said, forcing farmers to dump large quantities of milk could create environmental problems.
The F.D.A. said it would consider the regulators’ comments as it reviewed its testing plan.
-
http://sports.yahoo.com/mma/news?slug=dm-mmavegetarians021711
-
Lotta folks I respect use chiropractors, though the stuff has always looked too poorly documented for me to check it out. Ran into a piece that explains what to look for in a good one:
The Image of Chiropractic: Consensus Based on Belief
from Science-Based Medicine by Sam Homola
As a chiropractor, I am often asked why the image of chiropractic is so bad. “Why is chiropractic so often ignored by the media and ridiculed by physicians?” Journalists and health professionals tend to judge chiropractic by the worst of what they see, and what they see is often bad. This March 15, 2011, post from a chiropractic group asking for money to provide chiropractic services for earthquake and tsunami victims in Japan is a good example of why chiropractic has a bad image:
Please consider donating whatever you can to the SOTO-I/PAAC [Sacro Occipital Teaching Organization International-Pacific Asian Association of Chiropractic] Japan Relief Fund. 100% of your donation will go directly to helping the needy Japanese people through SOT Chiropractic treatments and services.
Please consider this avenue of donation rather than the Red Cross etc. While they are worthy organizations, we have ZERO overhead to administration and the funds will provide CHIROPRACTIC services to the needy. Please recommend this avenue of aid to your patients and friends also. Any and everything will help!
Practitioners of Sacro Occipital Technic (SOT) and SOT Craniopathy claim to restore innate healing capacity by removing neurological interference and improving the flow of cerebrospinal fluid (“craniosacral respiration”). Vertebral subluxations affecting certain organs are found by palpating tendon insertions at the base of the skull. Craniosacral respiration is improved by adjusting the bones of the skull and the sacroiliac joint.
There are dozens of such nonsensical chiropractic treatment methods foisted on the public through “press releases” and junk-science journals. NUCCA (upper cervical technique), which identifies slight misalignment of the atlas as a major cause of human ailments, is a commonly-promoted technique based on chiropractic vertebral subluxation theory.
This press release further illustrates the reason for chiropractic’s bad image:
A revolutionary neuro relief technique is being used by chiropractors across the United States and Canada to treat a wide-array of Symptoms and Chronic Disorders they were never before able to handle. This technique, when applied correctly performs absolute miracles for patients who have been suffering for an extensive period in their lives. Thus patients are happier and chiropractors are increasing their visibility and incomes!
Online PR News – 12-March-2011
An article titled “Second Opinion: Of Chiropractors & Christians,” published in a Baptist news magazine, describes an “inherently unbelievable” chiropractic message:
My back hurt, so I went to a chiropractor. He is helping my back pain. That’s a good thing.
But that is not what this article is about.
My chiropractor is an evangelist for his particular brand of chiropractic. Literally, he and his staff are religious about it. They preach the word. They offer written materials. They make promises of a greater life. I am unmoved. I just want him to make my back feel better.
I have a better understanding now of how nonbelievers may react to Christian witness. My reactions to the “message” I get at my chiropractor’s office could also be the reactions of someone you know to church, Christianity or the gospel message of Christ:
These folks are extremely nice, and I appreciate that, but that does not mean I am going to believe what they believe or what they tell me to believe.
They sincerely believe what they say. I do not doubt that. Their sincerity does not persuade me to change my mind.
They walk the walk. They cleanse their toxins, go to burst training, take supplements and get regular adjustments. As far as I can tell, they are not hypocrites. But I am not moved.
They go out of their way to educate me. They offer written information. They invite me to seminars, dinners and meetings. I do not have the excuse that “I don’t understand.”
These folks care about me. I believe that.
So, why am I not fully sold? Why won’t I buy into the full program instead of just “settling” with having them make my back feel better?
Their message is inherently unbelievable.
Their message runs counter to what I know and to what I read and hear everywhere else.
Their message is too demanding of my time, energies and commitments.
Sound familiar? Those are reasons why people routinely reject our Christian witness…
Published: March 11, 2011 (The Baptist Standard)
Sorting out a Few Good Apples
As illustrated by the above clips, it’s not hard to understand why chiropractic has such a bad image. If the chiropractic profession does not take steps to eliminate the nonsense in chiropractic, it may be difficult for ethical, science-based chiropractors to separate themselves from questionable treatment methods that have been traditionally supported by chiropractic subluxation theory. The practice-centered approach of chiropractors who disseminate misinformation, whether they are true believers or not, hurts the public as well as the profession. It is unlikely that unethical chiropractors will voluntarily give-up a faith-based or money-based approach they are using to make a living. Ethical chiropractors, many of whom are well-meaning but misinformed, struggle while pitch masters thrive. Guardians of public health feel compelled to issue warnings about chiropractic. Science-based chiropractors, as individuals, are forced to distance themselves from misguided colleagues and from purveyors of bogus methods based on the tenets of chiropractic. My heart goes out to those well-meaning chiropractors whose education left them totally dependent upon belief-based self-employment. Few of them have the faculties or the means needed to take a different path.
While it would be painful for chiropractors to point out and renounce obviously worthless diagnostic and treatment methods used by some of their colleagues, it might be prudent for chiropractic associations to do so to establish credibility in the eyes of the public. No other health profession has such a negative image. Good chiropractors are mixed in with bad chiropractors, like a crate of partially spoiled fruit that still contains a few good apples but is often discarded.
The chiropractic profession has to face the reality that chiropractic as a method of treating human ailments by adjusting vertebral subluxations is not acceptable in the scientific community and is unrelated to the generic spinal manipulation now being used by physical therapists and science-based chiropractors. A look at chiropractic journals, advertisements, and office procedures, however, reveals that a large number of chiropractors still cling to Palmer’s subluxation theory, some combining science with pseudoscience. I suspect that chiropractic has survived primarily because its use of manipulation in the treatment of back pain has provided a service not readily available in medical care, that is, symptomatic relief for mechanical-type neck and back pain or a good back-cracking back rub for providing pleasure and relieving tension. I believe the chiropractic profession today would be better off if it renounced the subluxation theory that gave it birth and concentrated on caring for back pain. So far, there is no indication that this will happen any time soon. Until the chiropractic profession does discard the vertebral subluxation theory, it will be difficult for the profession to condemn a multitude of popular, wacky chiropractic techniques based on a theory that defines the profession.
Entrenched Subluxation Theory
When the Council on Chiropractic Education (CCE) proposed new accreditation standards for chiropractic colleges, subject to take effect in January of 2012, all reference to “subluxation” was omitted. (“The CCE does not define or support any specific philosophy regarding the principles and practice of chiropractic, nor do the CCE Standards support or accommodate any specific or political position. The Standards do not establish the scope of chiropractic practice. They specify core educational requirements but do not otherwise limit the educational process, program curricular content, or topics of study.”) The American Chiropractic Association (ACA), the largest association in America representing the chiropractic profession, responded, in part, with this comment regarding the subluxation:
The document removes all references to the term “subluxation” – a core element of the practice of chiropractic that has been integral since the profession’s beginnings over 100 years ago. While the term “subluxation” and its role in the practice of chiropractic is sometimes misunderstood or not fully appreciated by all parties involved in medical related research and the delivery of health care, the term is one which is explicitly recognized in federal law (Section 1861(r) of the Social Security Act) and has been widely recognized by the courts, state legislative bodies and licensing authorities. The elimination of any reference to this term in the proposed standards will be viewed by many within the profession as a counter-productive action that will, in the long-term, likely weaken the profession’s collaborative strength and historic identity. We would propose placing “subluxation theory” back into Section 2, H. Educational Program for the Doctor of Chiropractic Degree and Vertebral Subluxation Complex into Section 3 Initial assessment and diagnosis as a required component.
As a chiropractor and a critic of chiropractic, I often found common ground with other health-care professionals by noting the value of generic spinal manipulation while providing guidelines to separate science-based chiropractors from subluxation-based chiropractors. Failure to point out obvious chiropractic nonsense may simply allow a believing public to assume that all chiropractors are the same, most of whom do not deserve to feed off the positive image projected by a few ethical, science-based chiropractors. Subluxation-based chiropractors peddle dubious services without opposition from their colleagues or from their associations, alienating chiropractic from the scientific community.
When I published my book Bonesetting, Chiropractic and Cultism in 1963, I renounced the vertebral subluxation theory and recommended that chiropractic be developed as a back specialty. It has always been my hope that chiropractic would become a form of physical medicine, a sub-specialty of medicine offering physical treatment methods for mechanical-type neck and back problems. If chiropractic aspires to become an independent, primary non-surgical specialty capable of accepting full responsibility for treating neck and back pain and related problems, it would have to have access to certain prescription medications and all available rehabilitative and physical treatment methods as well as access to hospital facilities, requiring changes in state laws and chiropractic college curriculum. As a back-pain specialty or sub-specialty, the chiropractic profession could be sustained by referrals from other health-care professionals.
Back Specialists?
In 2005, the World Federation of Chiropractic defined chiropractors as “…spinal health care experts in the health care system…with emphasis on the relationship between the spine and the nervous system…” This ambiguous definition fails to place proper limitations on the practice of chiropractic, leaving the door open for subluxation-based chiropractors who use spinal adjustments to treat general health problems. Such chiropractors, with only a hammer in their tool box, cannot qualify as a legitimate “back specialist” or “spine specialist.”
According to the Agency for Healthcare Policy and Research, low-back trouble is the second most common reason for office visits to primary care physicians and the most common reason for office visits to orthopedic surgeons, neurosurgeons, and occupational medicine physicians. Back problems are the most common cause of disability among persons under the age of 45 (Acute Low Back Problems in Adults, 1994). Despite the fact that back pain is one of this nation’s most common ailments, the niche for a back-pain specialty remains unfilled. With changes, chiropractic could have filled this niche (specializing like optometry or chiropody), but instead chose to be defined as a form of alternative medicine with a limited treatment method and an unlimited scope of practice .
Most people think of a chiropractor as a “back doctor.” And most people who go to a chiropractor go for treatment of a neck or back problem. It is certainly ironic that many chiropractors consider it demeaning to be called a “back specialist,” preferring to “treat human ailments without use of drugs and surgery.” Unfortunately, most state laws define chiropractic in this way, resulting in scientific and societal suspicion that hinders change and keeps utilization of chiropractic low.
Today, 48 years after publication of my Bonesetting book, I am still of the opinion that the chiropractic profession is not properly defined and limited. Chiropractic associations continue to tolerate implausible theories that provide an umbrella for inappropriate use of spinal manipulation and a variety of proprietary treatment methods applied to the gamut of human ailments. Many subluxation-based chiropractors seek support in the camp of alternative medicine where they are more readily accepted and where quackery is rampant. They are not representative of chiropractors who follow the guidelines of science in limiting their scope of practice. The uncontested proclamations of chiropractors who make vague and all-inclusive claims continue to drag the profession down, as indicated by figures showing that the percentage of the population seeing chiropractors annually decreased from 9.9% in 1997 to 7.4% in 2002 (Altern Ther Health Med. 2005;11:42-49), despite increasing popularity of alternative medicine.
Scientific presentations will not eliminate a belief system such as homeopathy or subluxation-based chiropractic, nor will the actions of a few science-based chiropractors. It seems likely that there will always be subluxation-based chiropractors. Until the majority of chiropractors make a clean break from what has traditionally been known as chiropractic (adjusting the spine to restore and maintain health), changes for the better in the profession as a whole will be problematic. Chiropractic associations will tend to represent the views of the majority, even if these views are scientifically indefensible. And the definition of chiropractic will continue to be based upon consensus rather than upon science.
Since physical therapy as a sub-specialty of medicine is now incorporating use of science-based manipulation in an armamentarium designed for treatment of neck and back pain and other musculoskeletal problems, it might be too late for the chiropractic profession to establish itself as a preferred back-pain specialty or sub-specialty. Forty-six states now allow direct access to the services of a physical therapist without physician referral. According to the American Physical Therapy Association, physical therapy, by the year 2020, will be provided by physical therapists who are doctors of physical therapy and who may be board-certified specialists.
The Majority Rules
Chiropractors who use manipulation appropriately may be in the minority, making it necessary for them to seek refuge and camaraderie in small groups of like-minded chiropractors who voluntarily follow the guidelines of science in offering patient-centered care. It would certainly be nice if these chiropractors could be separated from the herd with a special degree in a separate camp until they become a majority and the national associations are forced to follow suit.
Until then, I hope that good chiropractors will offer their patients (and the public) tips on how to recognize questionable claims so that good judgment can be exercised in selecting a chiropractor. It may be necessary for chiropractors themselves to openly criticize esoteric techniques used to locate and correct the mysterious, asymptomatic, and undetectable chiropractic vertebral subluxations alleged to be a cause of disease. Scientifically indefensible theories and treatment methods must be labeled as such to discourage use by the public as well as by chiropractors. As the undesirable aspects of chiropractic (e.g., “killer subluxations”) become less acceptable in the eyes of the public, fewer chiropractors will tout such nonsense. When science-based chiropractors are in the majority, if that ever happens, chiropractic associations might then define chiropractic properly and make appropriate changes in state laws.
Finding a Good Chiropractor
Here are the guidelines I offer patients who might want chiropractic treatment for back pain:
While a good chiropractor can do a good job treating back pain, not all chiropractors are the same; some follow the guidelines of science, some do not.
Look for a chiropractor who limits his/her practice to care of musculoskeletal problems and who uses hands-on generic spinal manipulation in combination with physical therapy modalities. Such a chiropractor can often be found working in a multi-disciplinary back-pain clinic.
Avoid chiropractors who propose to locate and adjust “vertebral subluxations” as a treatment for disease or to “restore and maintain health.”
Avoid chiropractors who ask for payment in advance for a long course of treatment. As a general rule, treatment should be discontinued if symptoms worsen after one week or have not improved after two weeks.
Avoid chiropractors who routinely x-ray new patients or who do full-spine x-rays on every patient. Remember that simple back strain will usually resolve on its own in a few weeks and does not require an x-ray exam.
Do not accept the services of a chiropractor who refuses to share his/her records with your family physician or a medical specialist. An orthopedist who has exchanged office notes with chiropractors can often offer guidance in selecting a chiropractor.
Persons who want manipulative therapy for a back problem but are reluctant to see a chiropractor should ask for a referral to a physiatrist, a physical therapist, or an orthopedic manual therapist who has been trained in the use of spinal manipulation.
http://www.sciencebasedmedicine.org/?p=11757
-
Herbal Remedies, Street Drugs, and Pharmacology
from Science-Based Medicine by Harriet Hall
David Kroll’s recent article on thunder god vine is a great example of what can be learned by using science to study plants identified by herbalists as therapeutic. The herbalists’ arsenal can be a rich source of potential knowledge. But Kroll’s article is also a reminder that blindly trusting herbalists’ recommendations for treatment can be risky.
Herbal medicine has always fascinated me. How did early humans determine which plants worked? They had no record-keeping, no scientific methods, only trial and error and word of mouth. How many intrepid investigators poisoned themselves and died in the quest? Imagine yourself in the jungle: which plants would you be willing to try? How would you decide whether to use the leaf or the root? How would you decide whether to chew the raw leaf or brew an infusion? It is truly remarkable that our forbears were able to identify useful natural medicines and pass the knowledge down to us.
It is equally remarkable that modern humans with all the advantages of science are willing to put useless and potentially dangerous plant products into their bodies based on nothing better than prescientific hearsay.
Ancient Sumerians used willow, a salicylate-rich plant that foreshadowed modern aspirin. Digitalis was used by the ancient Romans long before William Withering wrote about its use for heart failure. South American natives discovered that chinchona bark, a source of quinine, was an effective treatment for malaria. These early herbal remedies pointed the way to modern pharmaceuticals. How many other early remedies fell by the wayside? What else did the Sumerians, the Romans, and the natives use that did more harm than good? If “ancient wisdom” exists, so does “ancient stupidity.”
Plants undeniably produce lots of good stuff. Today researchers are finding useful medicines in plants that have no tradition of use. Taxol, the cancer-fighting product of Pacific yew trees, was discovered by the National Cancer Institute only by screening compounds from thousands of plants.
There is a reason pharmacology abandoned whole plant extracts in favor of isolated active ingredients. The amount of active ingredient in a plant can vary with factors like the variety, the geographic location, the weather, the season, the time of harvest, soil conditions, storage conditions, and the method of preparation. Foxglove contains a mixture of digitalis-type active ingredients but it is difficult to control the dosage. The therapeutic dose of digitalis is very close to the toxic dose. Pharmacologists succeeded in preparing a synthetic version: now the dosage can be controlled, the blood levels can be measured, and an antibody is even available to reverse the drug’s effects if needed.
“Ancient wisdom” argues that if an herbal remedy has been used for centuries, it must be both effective and safe. That’s a fallacy. Bloodletting was used for centuries but it wasn’t effective and it did more harm than good. If a serious side effect occurred in one in a thousand recipients of an herb, or even one in a hundred, no individual herbalist would be likely to detect it. If a patient died, they would be more likely to attribute the cause to other factors than to herbs that they believed were safe. Even with prescription drugs, widespread use regularly uncovers problems that were not detected with pre-marketing studies.
Arguments in favor of herbal remedies include:
They’re natural. (So what? Strychnine is natural.)
They’re safer than prescription drugs. (Maybe some are, some aren’t; how would you know?)
They’re milder than prescription drugs. (That would depend on the dosage of active ingredient.)
They’re less likely to cause side effects. (When they have been as well studied as prescription drugs, they may turn out to have just as many or more side effects. All effective drugs have side effects, and if an herbal medicine has fewer side effects it might have fewer therapeutic effects too. Formal systems for reporting adverse effects have long been in place for prescription drugs; not so for herbal remedies.)
They’re different from prescription drugs. (Some are identical to prescription drugs, like red yeast rice which contains the same ingredient as prescription lovastatin; and some herbal products have been found contaminated with prescription drugs.)
They’re less expensive. (True, but is a cheaper, inferior product a good bargain?)
They’re easier to obtain. (True, you don’t have to make an appointment with a doctor; but that means you don’t get the benefit of a doctor’s knowledge.)
The mixture of ingredients in a plant can have synergistic effects. (This is widely claimed but almost never substantiated. The other ingredients are just as likely to counteract the desired effect or to cause unwanted adverse effects.)
For every disease, God has provided a natural remedy. (Perhaps this is a comforting thought for believers, but it is not based on any evidence and is not convincing to atheists and agnostics. And it doesn’t help us find that natural remedy.)
Even when an herbal remedy works, finding a safe and reliable source is problematic. Horror stories abound:
Contaminants (such as heavy metals, pesticides, carcinogens, toxic herbs, and insect parts).
Wild variation in content (from no active ingredient to many times the amount on the label).
Mislabeled products that contain an entirely different herb.
I won’t list specific examples here; they are easy enough to find. I’ll just say that natural medicines are not regulated the way prescription drugs are, thanks to the infamous Diet Supplement and Health Education Act (DSHEA) of 1994.
When you take an herbal remedy, you are taking
An active ingredient that usually has not been adequately tested,
Other components that have not even been identified, much less tested,
An uncertain amount, and
Possible contaminants.
The term “street drugs” comes to mind: you don’t really know what you’re getting.
http://www.sciencebasedmedicine.org/?p=11595
-
Compare and Contrast
from Science-Based Medicine by Mark Crislip
5 people liked this
I have been in Infectious Diseases for almost 25 years. I have two major jobs: I see inpatient consults and I chair the Infection Control program. I have been involved in quality improvement, especially as it relates to hospital acquired infections, for my entire career. It has been an interesting quarter century. Year after year we have driven down infection rates and other kinds of mortality and morbidity in hospitalized patients. Everyone recognizes that medicine is difficult and dangerous and its biggest problem is medicine is practiced by humans, who, I would venture to observe, are prone to mistakes and any number of cognitive errors.
It has not been a easy journey. People hate change and there has not always been certainty as to the best options to choose to solve a problem, a problem that continues today. For example, how best to treat a patient with potential methicillin resistant Staphylococcus aureus colonization (MRSA). Should we screen everyone? Screen high risk patients? Surgical patients? Do we decolonize, with the long term consequence of accelerating antibiotic resistance? Do we place everyone with MRSA in isolation, with the known decrease in care that patients in isolation may have? Everything we do has potential downsides and unintended consequences. No good deed ever goes unpunished.
When I was a resident every PVC (preventricular contractions) in cardiac patents was suppressed as we thought PVC’s were the sentinel event that led to ventricular tachycardia and death. So patients received IV lidocaine and we often sent patients home on quinidine or other antiarrhythmics. Subsequent studies demonstrated that antiarrhythmics may have killed more people than they saved, and doctors no longer suppress every PVC in the ICU. Medicine changes, one hopes for the better, offering old geezers like me the opportunity to ‘reminisce’ about the old days, when I tied an onion to my belt, which was the style at the time. Now, to take the ferry cost a nickel, and in those days, nickels had pictures of bumblebees on ‘em. Give me five bees for a quarter, you’d say. Now where were we? Oh yeah: the important thing was I had an onion on my belt, which was the style at the time.
Sorry. I digress. A couple of months ago I had a patient with severe malaria that needed IV quinidine (the dextrorotatory diastereoisomer of quinine, but that is obvious) and there was none in the pharmacy; we had to get some shipped in by our dealer, er, distributor. In medicine, if it discovered that what was thought to be a beneficial intervention turns out to cause more harm than good, the intervention is abandoned.
When To Err is Human was published, it caused quite a brouhaha. Depending on whose numbers you want to believe, 44 to 98 thousand Americans died each year from medical errors. I did not have issues with the numbers. There are about 5700 hospitals in the US, so that would be about one death every month and a half. Knowing what I did about infections and other complications in the hospital, that did not seem like an unreasonable estimate. A bit high, perhaps, but in the ballpark of my understanding of reality.
That is old data, and no longer applicable. Due, in part, to To Err is Human, the last decade has led to innumerable studies evaluating the causes of infections and complications in hospitals and the best approaches to decrease them. My institutions have invested huge time and effort to implement these quality improvements with great success.
When I started in Infection Control, the infection data was considered protected. The thought was that institutions would be more likely to collect and evaluate data about infections if there were not discoverable by lawyers. The downside was, as I was informed, if I informed anyone about the data, it would no longer be protected, and the institutions would be open to expensive lawsuits. This century my institutions are much more transparent about disseminating information about our practice. I thought I would have a conniption the first time I saw the infection data for the ICU posted in the ICU for all too see. It turns out, like so many deeply held convictions, that keeping the data protected was a bad idea. Transparency has not led to an increase in lawsuits but it has led to a decline in all manner of hospital associated complications. Our staff takes a great deal of pride in their work. They took the data as a personal affront and worked to improve all aspects of patient care. When they saw harm potentially occurring, practice changed for the better.
So there are three reactions to new data in medicine that demonstrates that a given medical practice may cause harm.
First, the data and the conclusions are challenged, as they should be. All studies are open to analysis and improvement. In medicine we continuously try to improve care, and that requires good information.
Second, further studies are done to confirm and refine the problem and other studies are done to see how practice can be improved.
The third is practice change, which is often slower than we like. But change we do. I am old enough that I often bore the residents with how it used to be in the old days. Medicine today is drastically different than 20 years ago, and many logs better.
The most impressive example of improvement in the last 20 years is hand hygiene. Hand washing adherence 20 years ago was an embarrassment. Part of the problem was the time it took to wash hands; I have heard that if a nurse spent her time appropriately washing her hands, 80% of his shift would be spent at the sink.
Alcohol foam changed that. When we introduced the foam in the hospital, even when compliance was only 20%, we had a 50% drop in hospital infections, and as compliance has increased to 90 to 95%, the infections had a parallel decline. And the effects of alcohol foam improved once I discovered it was not a po agent, to be used like Cheez Whiz. Our biggest problem now is fall prevention. Most falls occur when the patient doesn’t want to bother the nurse and, in the process of moving about the room without help, falls. We are investigating ways to remove gravity from the hospital.
The threshold for changing and abandoning a therapy can be very small. Last century there was a drug called trovafloxacin that caused several hundred cases of hepatitis and a half a dozen deaths when it was being prescribed at a rate of 300,000 new prescriptions a month. Hepatitis was an extremely unusual complication, but the small risk was not worth the potential benefits since there were equally efficacious alternatives.
Compare and contrast medicine and alt med.
Most alt med interventions are, of course, based on eternal truths that cannot be improved or changed. They are often immune to reality induced change. Studies that confirm their eternal truth are always accepted. Studies that show harm or lack of efficacy? Not so much.
Certainly, when complications of alternative medicines are published the data is up for discussion. That is good and as it should be. But that is where the similarities with medicine ends.
There is an ongoing issue of safety in the two most invasive alternative interventions: acupuncture and chiropractic.
There were two reviews concerning chiropractic safety published recently. Safety of chiropractic interventions: a systematic review, which found
A total of 376 potential relevant articles were identified, 330 of which were discarded after abstract or complete article analysis. The search identified 46 articles that included data concerning adverse events: 1 randomized controlled trial, 2 case-control studies, 7 prospective studies, 12 surveys, 3 retrospective studies, and 115 case reports. Most of the adverse events reported were benign and transitory, however, there are reports of complications that were life threatening, such as arterial dissection, myelopathy, vertebral disc extrusion, and epidural hematoma. The frequency of adverse events varied between 33% and 60.9%, and the frequency of serious adverse events varied between 5 strokes/100,000 manipulations to 1.46 serious adverse events/10,000,000 manipulations and 2.68 deaths/10,000,000 manipulations.
CONCLUSION: There is no robust data concerning the incidence or prevalence of adverse reactions after chiropractic. Further investigations are urgently needed to assess definite conclusions regarding this issue.
That is impressive complication rates, although the authors suggest the data to support the rates are not robust, for an intervention that only has at best proven efficacy for low back pain and safer alternatives. Also published recently was Deaths after chiropractic: a review of published cases.
Twenty six fatalities were published in the medical literature and many more might have remained unpublished. The alleged pathology usually was a vascular accident involving the dissection of a vertebral artery.
That is about three times the number of deaths from trovafloxacin, an excellent antibiotic that we abandoned in the U.S. as too dangerous. Of course, we have safer alternatives with equal efficacy.
Also recently published was Acupuncture-related adverse events: a systematic review of the Chinese literature which found
that in total reported on 479 cases of adverse events after acupuncture. Fourteen patients died. Acupuncture-related adverse events were classified into three categories: traumatic, infectious and “other”. The most frequent adverse events were pneumothorax, fainting, subarachnoid haemorrhage and infection, while the most serious ones were cardiovascular injuries, subarachnoid haemorrhage, pneumothorax and recurrent cerebral haemorrhage.
Based on the reported complications of the two interventions, if they were a medical therapy regulated in a manner similar to medications and medical devices, they would certainly have, at a minimum, a black box warning and, in the case of chiropractic, no longer be used. Especially as there are no good indications for chiropractic or acupuncture.
What you do not see in the medical literature or the chiropractic blogs is any concern that harm may be done and investigations into changes in practice that could minimize the morbidity and mortality.
Instead you get The Self Importance of Being Ernst and Death by Chiropractic Another Misbegotten Review
Two essay that show zero interest in considering that chiropractic could potentially cause harm, the latter including the argument that it is real doctors that kill people and in comparison out ‘an order of magnitude greater than the side-effects attributed to spinal manipulation.’ See. If you kill small numbers of people, it is not important. Safety only matters when you kill people in large numbers. In the risk/benefit calculus of medicine, an intervention that has no benefit should cause no harm.
If there are concerns in the chiropractic community expressed about these complications, I can’t find them. If there is to improve chiropractic care, I can’t find it. If there is any quality/safety research being done, please rub my nose in it. I would love to know and those involved or aware of such research should trumpet the results for all to read. All the literature and letters to the editor I can find concerns denying there is a problem at all.
At least I could find concerns in the acupuncture literature : ‘A single injury – let alone a fatality – caused by acupuncture is one too many.” Exactly right. If you are practicing prescientific magic, it should have a mortality and morbidity of zero. Again if there is ongoing research into improving the safety of acupuncture, I cannot find it either.
Both seem far more interested in the messenger (Dr. Ernst) and his malevolent intent rather than the message.
It is, I think, a key difference between medicine and its ‘alternatives’. The former takes safety and quality seriously and strives constantly with research and its application to improve care. The alternatives? Nope. Not yet. And probably never.
Addendum. This may be the last post of 2010. I would like to say on behalf of myself and the other authors of SBM (who can disagree in the comments if they desire): Happy New Year. Enjoy 2011 since the world will end in 2012. With one exception, we have a wonderful group of readers and commenters and at times I learn more from the comments that I do preparing my posts. Stay healthy, my friends.
http://www.sciencebasedmedicine.org/?p=9448
-
INteresting article. The scrutiny of the pharmaceutical, mainstream medical "industry" if vast.
Scrutiny of chiropractic, alternative, or natural "medicine" is nill.
We see all day long law firms advertising for anyone injured by any drug whatsover, even if rare, that went through a billion dollars of testing to get approved and get to market. Yet not a peep about "homeopathic" substances being sold to us by mostly non medical doctors all day long on radio, cable, internet etc.
As for chiropracters once in awhile I have a patient who states they made their pain worse. I have never heard or seen any serious injury and have read as alluded in this article that serious injuries are guite rare. More often I do hear patients tell me they feel better after manipulation. How much is placebo affect and real is often hard to sort out.
One study years ago comparing treatment from a primary docotr, vs orthopedic doctor, vs a chiropractor doctor for low back pain should no differences in outcomes three months out suggesting that no matter what any of us do the outcomes are the same. Most times the person simply just gets better.
Indeed, the chiropractic group even did a little better. At three months out everyone felt about the same level of improvement though earlier on those with manipulation felt better sooner.
-
What does a new drug cost?
from Science-Based Medicine by Scott Gavura
Despite the variety of health systems across hundreds of different countries, one feature is near-universal: We all depend on private industry to commercialize and market drug products. And because drugs are such an integral part of our health care system, that industry is generally heavily regulated. Yet despite this regulation, little is publicly known about drug development costs. But aggregate research and development (R&D) data are available, and the pharmaceutical industry spends billions per year.
A huge challenge facing consumers, insurers, and governments worldwide are the acquisition costs of drugs. On this point, the pharmaceutical industry makes a consistent argument: This is a risky business, and it costs a lot to bring a new drug to market. According to PhRMA, the U.S. pharmaceutical industry’s advocacy group, it cost $1.3 billion (in 2005 dollars) to bring a new drug to market. The industry argues that high acquisition costs are necessary to support the multi-year R&D investment, and considerable risks, in to meet the regulatory requirements demanded for new drugs.
But what goes into this $1.3 billion figure? To understand the cost of a new drug, we need to consider both the cost of drugs that were marketed, but also factor in the costs of the failures – those discontinued during development. While most pharmaceutical companies are publicly held, no company produces detailed breakdowns of “per marketed drug” R&D costs, or the specific amounts spent on drugs that were later abandoned. Yet there have been attempts to estimate these values. The most detailed and perhaps controversial paper is a 2003 paper from DiMasi et al, entitled, The Price of Innovation: New Estimates of Drug Development Costs.[PDF] DiMasi’s estimates has been subject to considerable criticism, most recently in a paper by Light and Warburton, entitled Demythologizing the high costs of pharmaceutical research. They claim the median R&D cost is a fraction of DiMasi’s estimate: Just $43.4 million. “Big Pharma lies about R&D to justify illicit profits” shouted Natural News. Who’s right?
Drug Development
Drugs can be developed in different ways, but the usual model used describes a series of phases. The pre-clinical development stage constitutes preliminary studies of chemicals that have been synthesized or isolated, and are then screened. This process can take years: Identifying promising leads, validating them, tweaking with their chemical structures, and conducting endless in vitro studies. Only a fraction of drugs that show promise in pre-clinical studies will every progress to clinical trials. Clinical trials are generally grouped into three stages, each one representing an important milestone in a drug’s development. Phase I studies are small studies in healthy volunteers designed to help understand the basic pharmacology and pharmacokinetics in humans: how a drug is absorbed, distributed, metabolized, and eliminated. It’s in Phase II that the drug is tested in groups with the condition of interest. These trials are larger, and may be randomized, with multiple arms, possibly evaluating different dosing regimens. Endpoints are usually related to basic efficacy and safety parameters. Phase III studies are the largest studies, that may be randomized and double-blind, in order to establish a drug’s efficacy against a given condition. Regulators like the FDA will usually require one or more Phase III trials to support an approval to market a drug. In cases where real outcomes need to be measured (like mortality or morbidity), phase III studies can be massive. (Like this one, with over 18,000 participants!).
While the trial pathway is usually illustrated as a straight-line path, that’s a post hoc view: A tree may be a more appropriate model. Clinical trials may be conducted in different doses, treating different patient groups, using different protocols, in order to understand a drug’s effectiveness.
At any one time, multiple drugs may be in development, so only the most promising products may move forward in the development pathway, as subsequent phases of development mean a significant increase in costs. A drug’s development can be discontinued at any point along the path. Developers may identify toxicity issues, or lack of effectiveness issues. Or clinical practice may change, and all of a sudden, the clinical trials are measuring the wrong endpoints in the wrong patients. Decisions are always made in the face of uncertain evidence about efficacy and toxicity, and for every drug that moves forward that is eventually found to fail, it could be that there is an effective drug that didn’t reveal itself as promising, and went back on the shelf.
The development process is laborious and typically takes several years from discovery to clinical trials. The pharmaceutical industry estimates that it takes 10,000 molecules developed to bring a single drug to market. Without validating that number (a whole other post), it’s fair to say that the number of drugs that make it to market is a tiny fraction of the number of products identified or synthesized that enter initial screening. So there will be a substantial investment into drugs that never make it to market. Without including the cost of abandoned drugs into the costs of drugs that are marketed, we’d be underestimating the investment incurred. So any analysis needs to consider this cost, too.
The DiMasi Paper
The DiMasi paper, from the Tufts Center for the Study of Drug Development is the most widely cited paper on drug development costs. While the methodology they use is described in detail, some essential information is unfortunately (though perhaps understandably) opaque. The authors used a sample of drug costs drawn from ten companies that volunteered (out of 24 that were asked) that were willing to provide R&D data on a per-chemical basis. Data were collected, and stratified by development phase. Only the costs of self-originated drugs (i.e., they developed the drug themselves) were included. In total, data on 68 products were collected, and the sample consisted of mostly small-molecule drugs, but also included four recombinant proteins, two monoclonal antibodies, and one vaccine. No further information is provided, so there’s no way to know just how representative this sample is.
The methodology for the different calculations is fairly well detailed, but as I noted, the underlying data are not provided. Whether this basket of drugs studied represents a fair measure of the market is impossible to determine. The authors compiled actual costs wherever possible, broken down by development phase. A notable exception is the “preclinical” development period where it’s difficult to draw a direct link between expenditures and a specific drug that ends up being commercialized. For this segment, they inferred, using their own database, costs of $121 million per approved new drug.
To account for the costs of drugs that were abandoned (for any reason) during development, the authors used their own database of investigational drugs to estimate the odds any given new drug would reach a particular development milestone. Setting aside a detailed analysis of the methodology, let’s look at the two biggest cost drivers of the final that have been subject to repeated criticism: Tax issues, and the cost of capital.
Tax Issues
A major criticism of the DiMasi paper has been that the preferential taxation provisions for R&D expenses have not been factored into the analysis. Essentially, if R&D costs are given preferential tax treatment, this should reduce the net cost of R&D to the company. I have no particular insight into this issue other than to flag it as one that has caused controversy. Given preferential treatment of R&D expenses isn’t unique to the pharmaceutical sector, the extent to which this biases the validity of this particular analysis isn’t clear to me. But I’m a pharmacist, not a tax expert.
The Cost of Capital
Probably the biggest criticism of the DiMasi paper is that the authors factor in what’s called the cost of capital into the development cost. Looking at the calculations, DiMasi estimated the out-of-pocket costs per new drug at $403 million (2000 dollars). But this is then capitalized, based on the opportunity cost of that investment – at 11%, bringing the “total” cost up to $802 million. Adjusting this cost to 2005 dollars, and we’re at the $1.3 billion that PhRMA is calling “the average cost to develop one new drug.”
The cost of capital can be a bit baffling to understand. If I’m going to invest my money in something now, with a possible payoff down the road, I need to factor in the opportunity cost of something else I could have invested in – but decided not to. It is a true cost, because by choosing to invest in one thing, you’re forgoing the investment in another.
DiMasi uses a cost of capital of 11% – that is, they assumed that the drug developers, by moving forward with the development of a drug, where forgoing investments which would be expected to yield 11%. Is 11% valid? From a personal investment perspective, 11% seems rich. But the cost of capital that companies use is dependent on the risk involved. Different industries have different business risks. The DiMasi paper bases the 11% estimate based (in part) on historic returns in the industry. Given that half of the reported “cost” of a new drug is based on the cost of capital, the value we use use has a massive influence on what the final “cost” of a new drug will be. But is 11% appropriate? Many argue no – that current returns don’t match past returns, and therefore the CoC should be lower. I took a look at a cost of capital table created by Aswath Damodaran, a Professor of Finance at the Stern School of Business at New York University. He calculates that pharma’s cost of capital is 8.59%. But there is no single “right” answer here. It’s an assumption that goes into our calculation.
Other Reviews
Other authors have made their own attempt at estimating the cost of a new drug. Paul Adams of the Federal Trade Commission, writing in Health Economics estimates that the DiMasi estimate is low, and the 2003 cost is closer to $1 billion per new drug, but noted there is significant variation between products. A 2006 Congressional Budget Office report on drug development [PDF] largely supports the DiMasi estimates. Most recently, Light and Warburton argued that, “based on independent sources and reasonable arguments, R&D costs companies a median of $43.4 million per new drug, just as company supported analysts can conclude they are over 18 times larger, or $802 million.” This figure seems implausibly small, given a single clinical trial can involve hundreds to thousands of patients. (For a more detailed critique of the Light and Warburton paper, I’ll refer the interested reader to Derek Lowe’s excellent In the Pipeline blog (and its comments) where it was dissected in detail here and here.) One of the best ways to contemplate the costs and calculations is to manipulate the numbers yourself: There’s a model developed by venture capitalist Bruce Booth, where you can enter your own estimates and see what cost it spits out. I tried working with the model for a while, and I couldn’t get it anywhere near $43 million – it was always in the hundreds of millions.
Other considerations
One important factor that isn’t considered in any of these analyses (from what I can see) are the costs of new indications for existing chemical entities. Consider the case of cancer drugs, where drugs are often approved for the treatment of metastatic disease, and only after efficacy is demonstrated, is it studied as a potential “adjuvant” treatment for early stages of disease. Additionally, the DiMasi analysis only looked at drugs developed solely in-house. Given the growing role of smaller biotech companies that develop, and then sell, promising drugs to pharmaceutical companies, the impact on costs isn’t clear. In contrast, the cost of the “me-too” drugs that seem to fill the pharmaceutical marketplace aren’t discussed explicitly, either. When your new drug is a variation on a competitor’s (or your own) product, how does this influence overall R&D expense? Again, it’s not clear.
Conclusion
Is the $1.3 billion new drug a myth? New drugs could be hitting, or even exceeding this mark – it depends on what your assumptions are. When we try to summarize all the variables of drug development into a single number, accounting for the hits and the misses, we can end up with a number that sounds impressive. But is it meaningful? Without transparency, only the manufacturer will know what it cost for their own drugs. It’s probably more important to understand the key drivers of R&D costs, noting that there are a huge number of variables that may influence the final cost of bringing a new drug to market.
http://www.sciencebasedmedicine.org/?p=11948
-
Interesting article BBG. Perhaps it IS an industry generated myth that drugs are 1 billion dollars to get to market.
I agree most "new" drugs are not much more than variations of existing ones and probably do not cost nearly that much to bring to market.
As for truly new advances in drug I guess we really have no clue what it costs:
https://s3.amazonaws.com/s3.documentcloud.org/documents/81465/col-drugcosts-new-study.pdf
It would certainly not be far fetched to hear the drug industry publically inflating the costs. Not unlike our politicians playing fast and loose with the financial numbers being flung around over trillions of dollars. Sums so vast no one can really have any idea what is really going on.
-
DIANE COLE
This is the story of how my husband's circumcision saved my life.
It's a personal story, but let it also serve as a public health rebuttal to the proposed ban on male circumcision that will be on the San Francisco ballot this November.
San Francisco's ballot initiative would prohibit circumcision on all males under the age of 18. It would allow no religious exemptions, and it apparently gives no regard to the numerous studies demonstrating that male circumcision can substantially reduce—by more than 50%—the transmission of the HIV virus during sex.
"Communities, and especially women, may benefit much more from circumcision interventions than had previously been predicted, and these results provide an even greater imperative to increase scale-up of safe male circumcision services," concludes a study published this year in the peer-reviewed journal Sexually Transmitted Infections.
Peter, my husband, was born with hemophilia, best known as the disease of Victorian royals (and for good reason, since the guilty gene passed through the brood of Queen Victoria right down to the doomed young son of Russia's last czar). Those who suffer from hemophilia lack the crucial factor in the blood that makes it clot.
When we are cut, we all bleed—usually, we need only a Band-Aid and some pressure to stem the flow. Except for the most minor injuries, hemophiliacs almost always need more. Specifically, they need a transfusion of the blood factor of which their DNA made them bankrupt.
As a result of one such clotting factor transfusion prior to 1985, Peter became HIV-positive.
A baby rests on a pillow sounded by family members, immediately following his Bris, a Jewish circumcision ceremony in San Francisco. San Francisco voters in November will be asked to weigh in on what was until now a private family matter: male circumcision.
.Today, the U.S. blood supply has been cleaned up significantly, reducing the chance of such transmission to almost nil. But before the risk was known and blood screening had been introduced, the risk to hemophiliacs was enormous.
Peter and I had met and fallen in love at college. We married in 1977, and by the 1980s we were getting ready to have children. I had already suffered two lost pregnancies and we were eager to try again.
I remember reading the earliest news stories about AIDS, a mysterious new blood-borne disease, and freezing with the intuitive knowledge that whatever was borne through the blood could be borne into Peter's blood—and, by accident, perhaps mine, too. Since we were trying to get me pregnant, we had stopped using any birth control. How innocent it seems in retrospect that even when I suffered our second lost pregnancy in 1984, Peter had gamely whispered in my ear, "Don't worry. I'll knock you up again."
But we had no chance. Soon thereafter, it was confirmed that the very blood products that had helped save and heal and improve the lives of so many hemophiliacs also had the power to infect them with AIDS. As for sex—as they say in Brooklyn, fuggedaboutit. In politer terms, Peter's hematologists advised us to cease and desist getting pregnant again. Our mutual, sad assumption in the months that ensued: Not only had our love not produced a baby, but it may well have doomed me, too.
And then our very own HIV test results—his and hers—arrived. Peter was positive. I was negative. How had it happened that I never became HIV-positive myself?
It wasn't until recently that we knew: He was circumcised. Actually, I should say, now I know. Peter died in 1999.
But here is the reason I am alive today: In the same way that circumcision vastly diminishes the chance of infecting women with the human papillomavirus that causes cervical cancer, studies suggest that circumcision also helps guard against the transmission of the HIV virus. In both cases, cells on the inside of the male foreskin are implicated in spreading the virus. But if the foreskin is removed, a source of infection is also removed.
So there you have it: My husband's circumcision saved my life.
That reprieve allowed us to make the decision to adopt a child (our son, now 22, who will soon graduate from college). And it impressed on me the importance of public health decisions that unwittingly can save a life—which in this case happened to be mine. If the San Francisco initiative passes, and encourages other communities to do the same, who knows whose lives won't be saved.
Ms. Cole is the author of the memoir "After Great Pain: A New Life Emerges" (Simon & Schuster, 1992) and the book columnist for the Psychotherapy Networker.
-
The article about circumcision saving a woman's life is the most unsubstantiated piece I've ever read on the topic.
"So there you have it: My husband's circumcision saved my life. The wife was spared HIV infection because she had a healthy vagina that kills the HIV virus, not circumcision. " The wife was spared HIV infection because she had a healthy vagina that kills the HIV virus in the semen. Likewise, her husband may elect to have a circumcision as an adult.
Also from the article " apparently gives no regard to the numerous studies demonstrating that male circumcision can substantially reduce—by more than 50%—the transmission of the HIV virus during sex"
The African studies are about circumcision reducing HIV transmission from HIV-infected *women* to *men* in sex.
The two primary HIV transmission paths in the US are 1) anal reception of hiv-infected semen and 2) intravenous reception of HIV-infected blood. A third, but less common, is vaginal reception of HIV-infected sperm. Largely circumcised US has a higher rate of HIV infection than uncircumcised developed countries such as any European Union nation or Japan/Taiwan, so one may be inclined to conclude the opposite, perhaps that circumcised men shun condoms and engage in riskier sexual activity.
There is always an off laundry list of "health benefits" used to justify circumcision on men, but never on women. Rarely are the complications of circumcision, which include one US death and a dozen penises rendered useless per year, listed. Wouldn't female genitalia be cleaner and less prone to disease transmission, general infection or clitoral cancer if, say, the smegma-producing clitoral hood and labia minora were trimmed or amputated? If mom is circumcised, isn't it important for daughter to look just like mom? If men learned to prefer the appearance of surgically-altered female genitalia (i.e a hood-free clitoris or shortened/shaped labia minora) isn't that enough of a reason to order the procedure on infant girls ? I'm not a proponent of circumcision of any kind, but I interchange male and female in the description of circumcision for the sake of argument.
1996 : US federal law bans infant/minor circumcision of any degree on females but not males
201? : US federal law bans infant/minor circumcision of any degree on females and males
2% of the circumcisions may have a religious justification. However, the San Francisco circumcision ban proposal will be an interesting bout between freedom of religious expression (on males but not females) and equal protection.
-
a) Well, as a first person layman's story, of course it is not sicentific. :-)
b) "2) intravenous reception of HIV-infected semen". Ummm , , , I am almost too afraid to ask, but when I read "intravenous" I think of a needle connected to a tube connected to a bag of some fluid inserted into the forearm of a patient in a hospita. I hope we are not talking about this with bags of semen? :-o
c) "The African studies are about circumcision reducing HIV transmission from HIV-infected *women* to *men* in sex." I could be wrong, but this is not my understanding. Do you have a citation?
d) "The wife was spared HIV infection because she had a healthy vagina that kills the HIV virus in the semen." I am well aware of the power of the vagina over my mind and body, but did not know that its powers extended to killing HIV. Any citations?
e) " Likewise, her husband may elect to have a circumcision as an adult." A lot more problematic in adulthood!
f) All procedures have their risks, and accepting your data for this conversation the risks are rather small in contrast to the benefits.
Anyway, sounds like you are against circumcission and that is fine. The problem is when personal matters are subjected to mob rule. As for female circumcission, can you really not tell the difference?
-
I should have written " intravenous reception of HIV-infected blood" as in recreational drug use. Sorry about my error, and I've corrected it with an edit. Whew.
-
"intravenous reception of HIV-infected semen".
Just wait, it'll be in Chuck Palahniuk's next novel
-
I'll deal with a few points quickly.
"As for female circumcission, can you really not tell the difference?"
There are various types of female circumcision just as there have been various types of male circumcision, according to my research. Nonetheless, all types of female circumcision, including a ceremonial pin-prick for the purposes of a Covenant with God with a religious or cultural justification, are illegal in the US.
A "US version" could keep the entire clitoris intact and remove the clitoral hood - the analog of the modern male circumcision. No parent would accept such a procedure on their daughter. So why is that procedure accepted on a son?
"a) Well, as a first person layman's story, of course it is not sicentific. "
It was published in the Wall Street Journal, on-line with the title "Circumcision Saved My Life" in the case of a woman married to a hemophiliac. Well, in the case of women married to hemophiliacs ...
"c) "The African studies are about circumcision reducing HIV transmission from HIV-infected *women* to *men* in sex." I could be wrong, but this is not my understanding. Do you have a citation? "
From the CDC. Since the study participants were (obviously) men, the reduction rates are comparing uncircumcised to circumcised men for HIV transmission. In the US, female to male HIV transmission is a minority of the roughly
http://www.cdc.gov/hiv/resources/factsheets/circumcision.htm
Here is a good one on transmission routes. I need an update. Current data shows heterosexual sex overtaking drug injection.
http://www.avert.org/usa-transmission-gender.htm
A report from Johns Hopkins University on HIV spread factors:
http://www.measuredhs.com/pubs/pdf/CR22/CR22.pdf
p.109 states that in 18 African countries and India, 10 showed more and 8 showed less HIV infection among circumcised men.
"e) " Likewise, her husband may elect to have a circumcision as an adult." A lot more problematic in adulthood!"
While problematic, why is this more problematic in adulthood? Days of recovery? Memory of pain? The infant procedure entails separating skin from flesh as the foreskin is fused to the penis for the first few years of a male's life. The pain is similar to pulling fingernails or separating less sensitive skin from flesh despite the topical anesthetic that lasts at most an hour or two. The procedure on an adult is cutting loose but nerve-laden skin. Infant circumcision takes advantage of an infant's inability to articulate pain.
"f) All procedures have their risks, and accepting your data for this conversation the risks are rather small in contrast to the benefits."
Not a single major US medical association makes this conclusion. The American Academy of Pediatrics (AAP) has repeatedly issued statements that it can not recommend circumcision even after careful review of the potential medical benefits. In any case, all Western nations are moving away from the trend of circumcision and their circumcision rate has fallen to the low single digits. The benefits are not obvious to the medical professionals of these countries, either.
http://www.cdc.gov/hiv/resources/factsheets/circumcision.htm
-
"There is something I like about the clitoris, but I can't quite put my finger on it". -George Carlin
-
Even though this is a POTH editorial, I concur. I would add to this editorial that the anti-biotics in the animals are not destroyed by cooking and diminish our own good flora which has negative health consequences.
======================
The High Cost of Cheap MeatPublished: June 2, 2011
The point of factory farming is cheap meat, made possible by confining large numbers of animals in small spaces. Perhaps the greatest hidden cost is its potential effect on human health.
Small doses of antibiotics — too small to kill bacteria — are fed to factory farm animals as part of their regular diet to promote growth and offset the risks of overcrowding. What factory farms are really raising is antibiotic-resistant bacteria, which means that several classes of antibiotics no longer work the way they should in humans. We pay for cheap meat by sacrificing some of the most important drugs ever developed.
Last week, the Natural Resources Defense Council, joined by other advocacy groups, sued the Food and Drug Administration to compel it to end the nontherapeutic use of penicillin and tetracycline in farm animals. Veterinarians would still be able to treat sick animals with these drugs but could not routinely add the drugs to their diets.
For years, the F.D.A. has had the scientific studies and the authority to ban these drugs. But it has always bowed to pressure from the pharmaceutical and farm lobbies, despite the well-founded objections of groups like the American Medical Association and the World Health Organization, which support an antibiotic ban.
It is time for the F.D.A. to stop corporate factory farms from squandering valuable drugs just to promote growth among animals confined in conditions that inherently create the risk of disease. According to recent estimates, 70 percent of the antibiotics sold in this country end up in farm animals. The F.D.A. can change that by honoring its own scientific conclusions and its statutory obligation to end its approval of unsafe drug uses.
-
http://recipe.cicadayear.com/
-
SANTA MONICA, Calif. — When a group of activists proposed banning circumcision in San Francisco last fall, many people simply brushed them aside. Even in that liberal seaside city, it seemed implausible that thousands of people would support an effort to outlaw an ancient ritual that Jews and Muslims believe fulfills a commandment issued by God.
But last month, the group collected the more than 7,100 signatures needed to get a measure on the fall ballot that would make it illegal to snip the foreskin of a minor within city limits. Now a similar effort is under way in Santa Monica to get such a measure on the ballot for November 2012.
If the anticircumcision activists (they prefer the term “intactivists”) have their way, cities across the country may be voting on whether to criminalize a practice that is common in many American hospitals. Activists say the measures would protect children from an unnecessary medical procedure, calling it “male genital mutilation.”
“This is the furthest we’ve gotten, and it is a huge step for us,” said Matthew Hess, an activist based in San Diego who wrote both bills.
Mr. Hess has created similar legislation for states across the country, but those measures never had much traction. Now he is fielding calls from people who want to organize similar movements in their cities.
“This is a conversation we are long overdue to have in this country,” he said. “The end goal for us is making cutting boys’ foreskin a federal crime.”
Jewish groups see the ballot measures as a very real threat, likening them to bans on circumcision that existed in Soviet-era Russia and Eastern Europe and in ancient Roman and Greek times. The circumcision of males is an inviolable requirement of Jewish law that dates back to Abraham’s circumcision of himself in the Book of Genesis.
They say the proposed ban is an assault on religious freedom that could have a widespread impact all over the country. Beyond the biblical, there are emotional connections: checking for circumcision was one of the ways Jewish children could be culled from their peers by Nazis and the czar’s armies.
“People are shocked that it has reached this level because there has never been this kind of a direct assault on a Jewish practice here,” said Marc Stern, associate general counsel for the American Jewish Committee, an advocacy group. “This is something that American Jews have always taken for granted — that something that was so contested elsewhere but here, we’re safe and we’re secure.”
Mr. Hess also writes an online comic book, “Foreskin Man,” with villains like “Monster Mohel.” On Friday, the Anti-Defamation League issued a statement saying the comic employed “grotesque anti-Semitic imagery.”
Jena Troutman, the mother of two young boys who is promoting the ballot measure in Santa Monica, said she did not think of herself as a crusader against religion. Instead, she views her work as a chance to educate would-be parents against a procedure that “can really do serious damage to the child.”
“I am just a mom trying to save the little babies,” Ms. Troutman said. “I’d rather be on the beach, but nobody is talking about this, so I have to.”
Ms. Troutman has run the Web site wholebabyrevolution.com for two years, and she is fond of rattling off sayings like “Your baby is perfect, no snipping required.” Well versed in the stories of circumcisions gone awry, she said the recent death of a New York City toddler who was circumcised at a hospital convinced her that she should push for the ballot measure.
Ms. Troutman, who has worked as a lactation educator and a doula, said she often approached women on the beach to warn them about the dangers of circumcising, but she has declined to answer questions about her own children.
Although precise numbers are not known, several studies have indicated that circumcision rates have been declining in the United States for the past several years and now range from 30 percent to 50 percent of all male infants.
Many medical groups take a neutral approach, saying that the practice is not harmful and that there is not enough scientific evidence to conclude that it is necessary, and leave the decision to parents and their doctor. Several studies have linked circumcision with a reduction in the spread of H.I.V. Roughly half of the 694 baby boys born in the Santa Monica-U.C.L.A. Medical Center and Orthopaedic Hospital in 2010 were circumcised before they left the hospital, officials there said.
Dr. David Baron, a family physician, certified mohel — someone who performs ritual circumcision — and former chief of staff at Santa Monica-U.C.L.A., said that he would not press any parent to circumcise a son but that he viewed the effort to ban the procedure as “ridiculous and dishonest.”
“To say it is mutilation is wrong from the get-go,” Dr. Baron said. “It is a perfectly valid decision to say that it is not what you want for your child. Any doctor who says it is needed is not being honest, but to say that it needs to be banned is shocking.”
If the ballot measure passed, it would certainly face legal challenges. But several legal experts said it was far from certain that it would be struck down in a court. Ms. Troutman said she considered putting religious exemptions in the measure, but then decided, “Why should only some babies be protected?”
Rabbi Yehuda Lebovics, an Orthodox mohel based in Los Angeles who says he has performed some 20,000 circumcisions over several decades, said he often had to soothe nervous mothers.
“I am now doing the sons of the boys I did 30 years ago,” Rabbi Lebovics said. “So I turn to the new mother and ask, ‘Do you have any complaints in the way it turned out?’ ”
-
Scientific American:
Health Fat Substitutes May Make You Fatter
Research with rats reveals that fat substitutes may prime the body to consider all fats to be low-calorie and thus decrease the ability to burn real fats efficiently--leading to weight gain. Karen Hopkin reports
| June 24, 2011 | 3
Counting on food with fake fats to help you slip into last year’s bathing suit? Better count again. Because a new study with rats shows that low-cal fat substitutes can actually promote weight gain. The work appears in the journal Behavioral Neuroscience. [Susan Swithers, Sean Ogden and Terry Davidson, "Fat Substitutes Promote Weight Gain in Rats Consuming High-Fat Diets"]
Dieters can choose from an array of snacktackular options in which sugars and fats are replaced by artificial, low-calorie substitutes. That sleight of hand seems ingenious. You can let your body think it’s getting the sweets and fats it craves while keeping the calorie count to a minimum.
But the new study suggests that this strategy is likely to backfire. Rats that consumed a mix of full-fat chips and chips with olestra wound up eating more and got fatter than rats that noshed on regular chips alone.
Their bodies were apparently getting mixed messages. A mouthful of fat is usually a signal that calories are coming, and the body reacts by getting ready to burn fuel. But olestra, which tastes like fat, carries no calories at all. So the body soon learns to stand down in the face of fat. All fat. Even real fat. Because as Shakespeare almost said, a chip by any other name still swells your seat.
—Karen Hopkin
[
-
Should we call this itchology? From Scientific American to the University of Washington itch study center.
Itch was once considered a milder form of pain on a spectrum. Not these days. When one feels pain one reflexively withdraws away from the stimilus that leads to pain sensation.
When one feels itch one reflexively moves the limb toward the itch sensation:
****Center for the Study of Itch opens
March 17, 2011
By Jim Dryden
Forward Facebook this Tweet this Share more
Audio download available
In the spinal cord, neurons expressing GRPR, which appears blue in this image, carry itch signals to the brain.
Chen lab, Washington University School of Medicine
Washington University School of Medicine in St. Louis has launched its new Center for the Study of Itch, believed to be the world’s first multidisciplinary program designed solely to understand and treat itch.
The center was established to bring scientists and clinicians together to conduct research on the mechanisms that transmit itch and, ultimately, to translate those findings into better treatments for chronic sufferers.
Patients with chronic itch include those with certain types of cancer and those with liver and kidney disease. Some also may develop itching as a result of certain medical treatments or in response to pain-killing drugs. Skin diseases, such as psoriasis and atopic dermatitis, as well as allergic reactions, also cause itching. Antihistamines often are prescribed to treat itching caused by these latter conditions. The great majority of conditions that cause chronic itch, however, are resistant to antihistamine treatment, and some can be very debilitating.
“This center represents an important step in science’s understanding of a poorly understood phenomenon that can negatively affect quality of life for many people,” says Larry J. Shapiro, MD, executive vice chancellor for medical affairs and dean of the School of Medicine. “The new center should help speed the pace of discoveries into the basic, biological causes of itch and quickly translate them into more effective therapies.”
Historically, itch was regarded as a less intense version of pain. As a result, basic research on itching has been neglected. Only in the last few years has itch been studied as its own entity at a molecular level using mouse genetics, an approach that has long been employed to advance our understanding of numerous diseases in many other fields.
In fact, Zhou-Feng Chen, PhD, director of the new center and professor of anesthesiology, of psychiatry and of developmental biology, became interested in itch while looking for genes in the spinal cord’s pain pathway. Among the potential pain-sensing genes his team found was gastrin-releasing peptide receptor (GRPR), which turned out to be the first itch-specific receptor to be identified. Chen’s team showed that when mice were exposed to things that make them itchy, those without a GRPR gene scratched less than their normal littermates.
That led to other findings about itch and how itch signals travel along the spinal cord to the brain. Chen’s studies strongly suggest that itch and pain signals are transmitted along different pathways, so he says the time has arrived to study itch as a disease in its own right.
“There are many pain centers around the world, but we believe this will be the first center to focus on itch exclusively,” Chen says. “In fact, chronic itch is a disease of the nervous system manifested in the skin, but we understand very little about basic mechanisms and effective treatments.”
Center for the Study of Itch
To determine whether the itch signal in different conditions is transmitted through the same pathway, the center plans to establish animal models that mimic certain aspects of human chronic itch.
The center has two primary sections: the basic research and behavioral core based in the Department of Anesthesiology; and the section on clinical research, trials and patient care. Chen, who directs the basic research section, and his colleagues work with animal models and focus on genes and molecules related to itch. Lynn A. Cornelius, MD, co-director of the center and chief of the Division of Dermatology in the Department of Medicine, will direct the clinical side. As the research progresses and better insights into the mechanisms driving itch are gained, her team ultimately will evaluate and treat patients with chronic itch.
Researchers plan to collect skin biopsies from current patients who itch to create a clinical research database and biobank, providing a unique resource for identifying genetic susceptibilities for chronic itch in humans. Cornelius and her colleagues also will conduct clinical trials of potential therapeutic agents and treatment approaches.
“Itch is not just a reflex but a unique sensation,” Cornelius says. “Similar to pain, it is likely transmitted through unique neural pathways from the skin to the brain. We envision that functional imaging will be an important part of the clinical research effort. With our colleagues in neurology, we hope to both identify specific areas of the brain that are active when a person perceives the sensation of itch. Similarly, we would use imaging to track changes in these specific areas as effective treatments are administered.”
In addition to basic and translational research, the center will provide educational training opportunities for scientists interested in studying itch. The center is hiring three full-time faculty members to initiate more studies that focus on itch, its causes and potential treatments.
Chen and Cornelius also will collaborate with faculty members from other centers, departments and divisions.
“One of our major goals is to spur translational research that can bring discoveries from the bench to the clinic,” Chen says. “That requires many different kinds of expertise, so we are very excited to be joining forces with scientists whose expertise complements our own.”****
-
The only reason to decriminalize this drug is to take the profit motive out of it. That may be a good reason to make it legal but no other reason I can see is legitimate. Not to tax it and not for "medicinal" purposes in vast majority of most cases. Medically it is a sham except for maybe those who are otherwise in unusual situations like on chemotherapy or terminally ill. People who want it legal are mostly hippies, druggies, or those who want to profit from it. With all the problems facing this country we need to debate over pot?
Personally I agree with the following:
****Obama administration slams medical marijuana
By Liz Goodwin
National Affairs Reporter
PostsEmailRSSBy Liz Goodwin | The Lookout – 20 hrs agotweet48EmailPrint
Medical marijuana in Denver (Ed Andrieski/AP)
The Obama administration's newly released drug control strategy slams states that have legalized medical marijuana, arguing that smoking any drug is unsafe--and that marijuana's medical benefits have yet to be evaluated by the FDA.
"While there may be medical value for some of the individual components of the cannabis plant, the fact remains that smoking marijuana is an inefficient and harmful method for delivering the constituent elements that have or may have medicinal value," the White House's National Drug Control Strategy for 2011 says.
The strongly anti-marijuana report comes on the heels of the Justice Department's decision against reclassifying marijuana as a less dangerous drug. As The Los Angeles Times reports, the government took nine years to respond to marijuana advocates' request that they take into account studies that show marijuana has medical benefits and reclassify the drug. At the end of its review, the Justice Department held firm to its earlier decision that marijuana should be classified alongside other dangerous drugs such as heroin. The Americans for Safe Access group is now appealing the decision in federal court, the paper says.
It's unclear what the consequences will be for people involved in the medical marijuana business in the 16 states (and Washington, D.C.) that currently allow it. The report states unequivocally that "outside the context of Federally approved research, the use and distribution of marijuana is prohibited in the United States," and the Justice Department recently suggested in a memo that state-approved marijuana dispensaries and growers could face prosecution.
The report also made a detailed case against legalization or decriminalization of marijuana, an idea that has won the endorsement of a group of ex-global leaders who called the war on drugs a "failure." The report says that while tobacco and alcohol are legalized and taxed, neither provide a "net economic benefit to society," due to health-care expenses and various criminal justice costs, such as drunken driving arrests.
Neil Franklin, the director of a pro-legalization group of former police and other law-enforcement agents called Law Enforcement Against Prohibition, said in a statement that the anti-marijuana tone of the administration is disappointing.
"It's sad that the drug czar decided to insert a multi-page rant against legalizing and regulating drugs into the National Drug Control Strategy instead of actually doing his job and shifting limited resources to combat the public health problem of drug abuse," Franklin said.****
-
I don't know too many people that would keep marijuana from a chemo patient, but medical marijuana seems to be most often used by people who have some mysterious disease that allows them to snowboard 5 days a week.
-
"...most often used by people who have some mysterious disease that allows them to snowboard 5 days a week."
The Colorado system is full of abuse including no oversight of the 'doctors' and leaving the dispensaries unregulated. It seems like the recommending doctors could be vulnerable for the mockery of medicine and law.
GM, Those snowboarders may have a crippling disease comparable to terminal cancer called ... 'inflammation'!
http://coloradomedicalmarijuana.com/medical-marijuana-doctor-referrals.htm
For CCP: "The use of medical marijuana in Colorado patients suffering from severe chronic pain has shown in multiple studies to lift moods of depression and reduce or even sometimes completely alleviate pain symptoms without drugs." http://coloradomedicalmarijuana.com/qualifying-conditions.htm
- THC is not a drug?
I prefer decriminalization with minor penalties for small quantities to this scam that drags in the medical profession. Real medical uses should of course be permitted, and exemptions from rules for the terminal should extend to whatever their doctor thinks would be helpful.
But it's hard to know who is terminal these days after the amazing recovery of the Lockerbie bomber.
-
I am sure there are some doctors along with everyone else who are abusing the drug prescirption thing.
"The Colorado system is full of abuse including no oversight of the 'doctors' and leaving the dispensaries unregulated."
We don't need doctors prescribing this garbage (pot). We can't even control the narcotics prescriptions. I do my best yet I have a single digit number of patients who I suspect are taking advantage of the drugs yet I can't prove it. One actually did tell me she went snowboarding! :? She shut up fast when I just glared at her. :x I thought she was in such pain. :roll:
The doctors who blatantly participate in the drug dispensing scams are I truly think a small minority. Although I don't have a good handle as to how many do this. I really think most of us *cannot stand* the scammers who come in trying to con us for drugs. Most of druggies can be filtered out but a few are really tough to tell from people truly in need in my estimations. Some are superb bullshit artists - like the people in the music/entertainment industry.
-
Katherine is insulin dependent diabetic. She does not have a pump. We have thought that a pump would be very dangerous since every single thing she does is monitored by the organized criminals stealing her lyrics. There is no electronic device that cannot be hacked if wireless capable or physically accessed if wireline or not wireless. We have certainly thought of this. Most people have no clue the threat to us of this threat with regards to criminal activity. It is rampant. It is going on. Katherine even wondered if the dentist could not have implanted a "bug" in her teeth at one point. The criminals thought this hilarious and even used it in a Progressive auto insurance commerical when that obnoxious broad claims she had to get the "bugs out of her teeth" from riding a motorcycle. That was a direct mock to us. Sound crazy. It is not. I kid you not.
To my knowledge there is no law enforcement taking any of this even remotely seriously. Yet I know they are all worried about their pensions and early retirement schemes. Sorry for the dig but yes I am angry.
****Insulin pumps, monitors vulnerable to hacking
By JORDAN ROBERTSON - AP Technology Writer | AP – Fri, Aug 5, 2011tweet48ShareEmailPrintRelated ContentJay Radcliffe, displays a radio device he uses to perform an attack on an insulin …
Jay Radcliffe, who wrote a program to attack an insulin pump, taking control of the …
LAS VEGAS (AP) — Even the human bloodstream isn't safe from computer hackers.
A security researcher who is diabetic has identified flaws that could allow an attacker to remotely control insulin pumps and alter the readouts of blood-sugar monitors. As a result, diabetics could get too much or too little insulin, a hormone they need for proper metabolism.
Jay Radcliffe, a diabetic who experimented on his own equipment, shared his findings with The Associated Press before releasing them Thursday at the Black Hat computer security conference in Las Vegas.
"My initial reaction was that this was really cool from a technical perspective," Radcliffe said. "The second reaction was one of maybe sheer terror, to know that there's no security around the devices which are a very active part of keeping me alive."
Increasingly, medical devices such as pacemakers, operating room monitors and surgical instruments including deep-brain stimulators are being made with the ability to transmit vital health information from a patient's body to doctors and other professionals. Some devices can be remotely controlled by medical professionals.
Although there's no evidence that anyone has used Radcliffe's techniques, his findings raise fears about the safety of medical devices as they're brought into the Internet age. Serious attacks have already been demonstrated against pacemakers and defibrillators.
Medical device makers downplay the threat from such attacks. They argue that the demonstrated attacks have been performed by skilled security researchers and are unlikely to occur in the real world.
But hacking is like athletics. Showing that a far-fetched attack is possible is like cracking the 4-minute mile. Once someone does it, others often follow. Free or inexpensive programs eventually pop up online to help malicious hackers automate obscure attacks.
Though there has been a push to automate medical devices and include wireless chips, the devices are typically too small to house processors powerful enough to perform advanced encryption to scramble their communications. As a result, most devices are vulnerable.
Radcliffe wears an insulin pump that can be used with a special remote control to administer insulin. He found that the pump can be reprogrammed to respond to a stranger's remote. All he needed was a USB device that can be easily obtained from eBay or medical supply companies. Radcliffe also applied his skill for eavesdropping on computer traffic. By looking at the data being transmitted from the computer with the USB device to the insulin pump, he could instruct the USB device to tell the pump what to do.
Radcliffe, who is 33 and lives in Meridian, Idaho, tested only one brand of insulin pump — his own — but said others could be vulnerable as well.
Although an attacker would need to be within a couple hundred feet of the patient to pull this off, a stranger wandering a hospital or sitting behind a target on an airplane would be close enough.
Radcliffe also found that it was possible to tamper with a second device he wears. He found that he could intercept signals sent wirelessly from a sensor to a machine that displays blood-sugar levels. By broadcasting a signal that is stronger than the real-time, authentic readings, the monitor would be tricked into displaying old information over and over. As a result, a patient who didn't notice wouldn't adjust insulin dosage properly.
With a powerful enough antenna, Radcliffe said, an attacker could be up to half a mile away. This attack worked on two different blood-sugar monitors, Radcliffe said.
"Everybody's pushing the technology to do more and more and more, and like any technology that's pushed like that, security is an afterthought," Radcliffe said.
Radcliffe refused to identify any of the three device makers, in part out of concern for his own safety. He is concerned that the devices don't appear to have an easy way to be updated with new software to fix the problems. He said he intends to notify the manufacturers after Thursday's presentation outlining the weaknesses.
The hacking fears come on top of human errors and technical glitches tied to medical devices. The U.S. Food and Drug Administration has identified software and design errors as critical concerns in investigating hundreds of deaths potentially linked to drug pumps.
FDA officials declined to comment specifically on Radcliffe's findings, saying they hadn't seen the research. But the FDA said that any medical device with wireless communication components can fall victim to eavesdropping. It warns device makers that they are responsible for making sure they can update equipment after it's sold.
Industry officials downplay the potential threat.
"The risk to a patient with diabetes of having their monitors hacked is extraordinarily small, and there's a greater health risk of not monitoring than the risk of being hacked," said Wanda Moebius, a vice president at the Advanced Medical Technology Association, an industry group.
Few public studies have been done on the susceptibility of medical devices to hacking.
One such study, which appeared in 2008 from a consortium of academics, found that a popular type of device that acted as both a pacemaker and defibrillator could be remotely reprogrammed to deliver potentially deadly shocks or run out its battery.
The problem was the way the device transmitted data unencrypted and accepted commands wirelessly from unauthorized devices. One limitation of the study was that researchers only examined an attack from a few centimeters away from the targeted device.
Yoshi Kohno, a University of Washington professor of computer science who was a co-author of that study, said that Radcliffe's new research reinforces the urgency of addressing security issues in medical devices before attacks move out of research labs.
"The threat hasn't manifested yet, so what they and we are trying to do is see what the risk could be in the future," said Kohno, who wasn't part of Radcliffe's research.
Radcliffe said the point of his research is not to alarm people. He said the issues he's discovered are important to address publicly as the medical industry moves aggressively toward more networked devices.
"It would only take one person to do this to kill someone and then you have a catastrophe," he said.****
-
I guess my only question is the extra three years of life span spent on the treadmill :-):
****15 Minutes' Daily Exercise May Boost Life Expectancy By Three Years.
ABC World News (8/15, story 9, 0:30, Sawyer) reported, "If you need any more convincing that a little bit of exercise can make a huge difference in your life, here's some powerful new proof: A study in the medical journal Lancet looked at 400,000 people and found just 15 minutes of exercise a day increases life expectancy three years."
The AP (8/16, Chang) reports that "researchers at the National Health Research Institutes in Taiwan" noting that World Health Organization guidance , CDC recommendations , and guidelines from "other countries recommend that adults get at least a half-hour of moderate workout most days of the week," conducted the study to determine whether "exercising less than the recommended half-hour was still helpful." They asked "about 416,000 Taiwanese adults" how much exercising they "did the previous month" and recorded study participants' "progress for eight years on average." The research team found those who "exercised just 15 minutes a day -- or 90 minutes a week -- cut their risk of death by 14 percent" compared with those who did not exercise; and both men and women "benefited equally" from exercising.****
-
The Richmond Times-Dispatch reported that Christian Alexander Strickland, 9, of Henrico County, became infected after he went to a fishing camp in the state.
The child died from meningitis Aug. 5 and Bonnie Strickland, his aunt, told the paper that Naegleria fowleri — or "brain-eating ameba" as it is sometimes known — was a suspected cause of the illness.
"The doctor described it to us as such a slight chance that they didn't even think it would be possible," Bonnie Strickland told the Times-Dispatch.
Health department officials told the paper they do not comment on individual cases. However, they confirmed a case of meningitis and an infection by the bug.
"Sadly, we have had a Naegleria infection in Virginia this summer," Dr. Keri Hall, state epidemiologist at the Virginia Department of Health, in a statement, according to the Times-Dispatch. "It's important that people be aware of … safe swimming messages."
Naegleria fowleri moves into the body through the nose and destroys brain tissue. It almost always causes meningitis, the paper said.
It is usually found warm, stagnant water in freshwater lakes, ponds and rivers. It can also be found in wells.
'I didn't get my miracle'
Earlier this month, Courtney Nash, 16, died as a result of a Naegleria fowleri infection in Florida after swimming in the St. John's River, ABC News reported.
NBC-affiliate WESH.com reported that she was diving off a dock with family at her grandmother's house when it is thought that she caught the disease.
Courtney's mother, Patricia Nash, said that shortly before her death, Courtney had decided to become an organ donor.
She told WESH that both lungs were transplanted and Courtney's liver and pancreas were "performing another miracle for someone else." Her kidneys were also being transplanted.
"I didn't get my miracle, but she has performed other miracles," Patricia Nash said, according to WESH. "If we can save other people's lives so they don't have to go through what I just went though, this could be a blessing in disguise."
According to the Centers for Disease Control and Prevention, the ameba "enters the nasal passages ... and migrates to the olfactory nerves, eventually invading the brain."
"From 1995 to 2004, N. fowleri killed 23 persons in the United States, including 2 children in the Phoenix, Arizona, area in 2002, who had been exposed to well water but had not consumed it. There have been 6 documented deaths in 2007, all in warmer regions (Arizona, Texas, Florida)," according to the CDC.
© 2011 msnbc.com Reprints
http://www.msnbc.msn.com/id/44171292/ns/health-health_care/ (http://www.msnbc.msn.com/id/44171292/ns/health-health_care/)
P.C.
-
Vampire bats could save stroke victims
Stroke victims are being treated with saliva from vampire bats as part of a trial at ten NHS hospitals.
A drug derived the saliva of vampire bats can thin blood and dissolve blood clots in the brain, saving lives and limiting the damage caused by strokes. By Laura Donnelly, Health Correspondent
Research has found that a drug derived from the substance can thin blood and dissolve blood clots in the brain, saving lives and limiting the damage caused by strokes.
Currently, patients who suffer most types of strokes need to have clot-busting injections within four hours of the attack for the treatment to work.
But studies have found that jabs using a medicine derived from protein in bats' saliva can have the same effect for up to nine hours.
The difference means the drug called Desmoteplase could be given to patients who suffer a stroke while asleep and then wake up hours later.
Vampire bats have been chosen because they use their spit to keep the blood of their prey thin enough to drink.
Related Articles
Vampire bats use infra-red sensors to guide them to blood
03 Aug 2011
Vampire clot-buster
10 Jan 2003
Killer vampire bats attack 500
13 Aug 2010
Doctors at the University Hospital of North Staffordshire are among the first in the UK to test whether vampire bat saliva can save more lives among stroke victims than other treatments.
Consultant Dr Christine Roffe said the NHS trial was in its early stages, but that if it went well, it could be in widespread use within three years.
NHS stroke units in Newcastle, London, Bournemouth, Glasgow, Liverpool and Exeter are also among more than 40 hospitals taking part in the international research, involving about 400 patients.
Researchers who carried out a previous smaller study said the drug showed such promise that it was "the biggest breakthrough" in stroke treatment for two decades.
More than 80 per cent of strokes occur when the blood supply stops because of a clot in the brain. This type of stroke – called an ischaemic attack – can respond to clot-busting injections.
A second type of attack, called a haemorrhagic stroke, occurs when a weakened blood vessel supplying the brain bursts and causes brain damage.
Emergency surgery is often needed to treat such strokes in order to remove blood from the brain and repair burst blood vessels.
P.C.
-
Time to Revive Home EcBy HELEN ZOE VEIT
Published: September 5, 2011
NOBODY likes home economics. For most people, the phrase evokes bland food, bad sewing and self-righteous fussiness.
But home economics is more than a 1950s teacher in cat’s-eye glasses showing her female students how to make a white sauce. Reviving the program, and its original premises — that producing good, nutritious food is profoundly important, that it takes study and practice, and that it can and should be taught through the public school system — could help us in the fight against obesity and chronic disease today.
The home economics movement was founded on the belief that housework and food preparation were important subjects that should be studied scientifically. The first classes occurred in the agricultural and technical colleges that were built from the proceeds of federal land grants in the 1860s. By the early 20th century, and increasingly after the passage of federal legislation like the 1917 Smith-Hughes Act, which provided support for the training of teachers in home economics, there were classes in elementary, middle and high schools across the country. When universities excluded women from most departments, home economics was a back door into higher education. Once there, women worked hard to make the case that “domestic science” was in fact a scientific discipline, linked to chemistry, biology and bacteriology.
Indeed, in the early 20th century, home economics was a serious subject. When few understood germ theory and almost no one had heard of vitamins, home economics classes offered vital information about washing hands regularly, eating fruits and vegetables and not feeding coffee to babies, among other lessons.
Eventually, however, the discipline’s basic tenets about health and hygiene became so thoroughly popularized that they came to seem like common sense. As a result, their early proponents came to look like old maids stating the obvious instead of the innovators and scientists that many of them really were. Increasingly, home economists’ eagerness to dispense advice on everything from eating to sleeping to posture galled.
Today we remember only the stereotypes about home economics, while forgetting the movement’s crucial lessons on healthy eating and cooking.
Too many Americans simply don’t know how to cook. Our diets, consisting of highly processed foods made cheaply outside the home thanks to subsidized corn and soy, have contributed to an enormous health crisis. More than half of all adults and more than a third of all children are overweight or obese. Chronic diseases associated with weight gain, like heart disease and diabetes, are hobbling more and more Americans.
In the last decade, many cities and states have tried — and generally failed — to tax junk food or to ban the use of food stamps to buy soda. Clearly, many people are leery of any governmental steps to promote healthy eating; Michelle Obama’s campaign against childhood obesity has inspired right-wing panic about a secret food police.
But what if the government put the tools of obesity prevention in the hands of children themselves, by teaching them how to cook?
My first brush with home economics, as a seventh grader in a North Carolina public school two decades ago, was grim. The most sophisticated cooking we did was opening a can of pre-made biscuit dough, sticking our thumbs in the center of each raw biscuit to make a hole, and then handing them over to the teacher, who dipped them in hot grease to make doughnuts.
Cooking classes for public school students need not be so utterly stripped of content, or so cynical about students’ abilities to cook and enjoy high-quality food.
A year later, my father’s job took our family to Wales, where I attended, for a few months, a large school in a mid-size industrial city. There, students brought ingredients from home and learned to follow recipes, some simple and some not-so-simple, eventually making vegetable soups and meat and potato pies from scratch. It was the first time I had ever really cooked anything. I remember that it was fun, and with an instructor standing by, it wasn’t hard. Those were deeply empowering lessons, ones that stuck with me when I first started cooking for myself in earnest after college.
In the midst of contracting school budgets and test-oriented curricula, the idea of reviving home economics as part of a broad offensive against obesity might sound outlandish. But teaching cooking — real cooking — in public schools could help address a host of problems facing Americans today. The history of home economics shows it’s possible.
Helen Zoe Veit, an assistant professor of history at Michigan State University, is the author of the forthcoming “Victory Over Ourselves: American Food in the Era of the Great War.”
-
This seems to me a very good thing.
======================================
By BILL TOMSON
U.S. inspectors on Monday started using more sensitive tests to detect antibiotics in pork, part of a stepped-up effort to ensure meat safety after a government report last year suggested consumers might be at risk from harmful drug residues.
While a small, but growing amount of meat products are touted as being free of antibiotics, most meat isn't.
Livestock owners feed millions of pounds of antibiotics such as penicillin each year to cattle, hogs, chickens and turkeys to prevent disease and promote rapid growth. Conventional beef and pork are supposed to meet strict limits on levels of these drugs, and U.S. Department of Agriculture inspectors test tens of thousands of animals a year for compliance.
Enlarge Image
CloseGetty Images
Ground beef often comes from older dairy cows that receive antibiotics.
.USDA officials say the new tests will expand the number of antibiotics they can detect in pork, and that the agency can withhold meat with too much antibiotic residue from the market. More contaminated meat "will consequently be removed from the food supply," said USDA spokesman Dirk Fillpot. The new measures come as the agency is broadening its scrutiny of disease-causing E. coli bacteria in beef to a total of seven strains, instead of just one.
The new tests follow a report in March of 2010 by the USDA's inspector general citing "serious shortcomings" in the agency's inspection program. The report said the USDA allowed meat from certain slaughterhouses into the market even when it consistently found samples with excessive drug levels.
Inspection results from 2009, the latest available, showed the vast majority of cattle and pigs fell within the accepted limit for antibiotic residues.
"Using a more sensitive test should not be interpreted as a sign of a growing problem," said Janet Riley, a spokeswoman for the American Meat Institute, an industry group. "It means that new technology is being put to use to garner more information."
The new tests of pork follow the agency's updating of its beef testing last year.
The USDA inspector general's report said, "the effects of these residues on human beings who consume such meat are a growing concern." It said residue of penicillin in meat could trigger reactions in people with an allergy to the drug, though it didn't cite any cases.
The effect on people of consuming over a lifetime tiny quantities of penicillin, neomycin and other drugs left over in meat is little studied. Scott Hurd, an associate professor at Iowa State University's College of Veterinary Medicine, said there is no evidence of ill effects from such consumption.
The Food and Drug Administration also has been concerned about the rise of drug-resistant pathogens, and last year asked livestock producers to limit the amount of antibiotics they use.
Ingesting the drugs over an extended period could, in theory, promote the evolution of antibiotic-resistant bacteria in the body, making medical treatments more difficult if they spread in the population, said Kim Lewis, a microbiology professor and director of the Antimicrobial Discovery Center at Northeastern University.
Concern about how the heavy use of antibiotics might spur the growth of drug-resistant bugs has grown following the discovery in ground turkey of salmonella Heidelberg bacteria, which is resistant to several common antibiotics.
Two weeks after recalling 36 million pounds of contaminated ground turkey that sickened more than 100 people, Cargill Inc. announced a second recall on Sunday.
Mr. Fillpot said the USDA hasn't decided yet whether to introduce new, more stringent antibiotic-residue testing of turkey or chicken.
To check for antibiotic residues, USDA inspectors swab the kidneys of animals. Each year, the USDA takes a random sampling and a more targeted one in which inspectors test carcasses deemed more likely to be a source of contamination, such as those with lesions or other signs of illness.
Results from a 2009 targeted inspection showed the highest levels of antibiotic residues in older dairy cows sent for slaughter—the main source of hamburger in the U.S.—and young calves known as bob veal born from those cows.
About 1% each of the 80,000 dairy cows and 37,000 bob veal calves tested carried residues above FDA tolerance levels. In a quarter of the cases, penicillin was the culprit. The updated tests are better at finding 14 kinds of antibiotics that prior tests screened for, and can detect three other antibiotics that the older ones couldn't, the agency said.
Earlier tests suggested that pork was nearly 100% free of problematic antibiotic levels. The USDA's food-inspection service expects to find more contaminated meat with the new tests, Mr. Fillpot said.
A poor showing on tests typically doesn't trigger a recall because the government can't show eating a single serving of meat with antibiotic residue causes immediate sickness or death, according to the inspector general's report.
The USDA publishes weekly online a "Residue Repeat Violator" report documenting persistent antibiotic-residue problems at meat-packing plants.
Write to Bill Tomson at bill.tomson@dowjones.com
-
By LAURA LANDRO
With more medical information than ever before at their fingertips, patients increasingly feel empowered to make their own decisions about care—or overpowered by all that data.
In "Your Medical Mind," oncologist Jerome Groopman, and his wife, endocrinologist Pamela Hartzband, offer a road map for navigating the medical maze and the mountains of information that Google searches produce. In an era when the magisterial physician who dictates care is obsolete, the book may be a welcome guide for those who are daunted by the choices they face, ranging from taking a cholesterol-lowering drug to making end-of-life decisions for a loved one.
Dr. Groopman is the author of four other books that have helped demystify medicine for a lay audience, including "How Doctors Think." "Your Medical Mind" analyzes how patients think as they weigh the pros and cons of different options, especially when they are presented with conflicting evidence and advice. "The unsettling reality," the authors note, "is that much of medicine still exists in a gray zone, where there is no black or white answer about when to treat or how to treat."
The books draws heavily on the approach known as shared medical decision-making, which has been promoted by researchers at Dartmouth College and others. This approach holds that doctor and patient together should review information about the risks and benefits of any given treatment and then customize care according to the patient's values and preferences.
To illustrate, the authors use anecdotes from real patients like Dave Simon, an avid tennis player diagnosed with atrial fibrillation, an abnormal heart rhythm. He must choose whether to take a blood-thinning medication that may prevent stroke from a clot but that can also cause internal bleeding. He is afraid to take the medication but is more terrified of having a stroke. Complicating matters: There is a new blood thinner on the market with a smaller risk of bleeding—but slightly more risk of heart attack. Mr. Simon, with his doctor, reviews the data on the risks, but he also thinks hard about his own mind-set: He's a doubter when it comes to new treatments. He goes with the more established medication.
The authors categorize patients like Mr. Simon by their biases: Are they believers in the benefits of medical intervention or has experience or upbringing made them skeptics? Are they apt to go for the maximum amount of care or the minimal amount that's still likely to get the job done? Do they embrace technology or are they inclined to natural solutions?
Enlarge Image
Close.Your Medical Mind
By Jerome Groopman and Pamela Hartzband
(The Penguin Press, 308 pages, $27.95)
.Drs. Groopman and Hartzband have had their own experiences as patients, including Dr. Groopman's disastrous and well-chronicled experience with back surgery, which changed him from a maximalist to a more risk-averse patient. Dr. Hartzband says that she is a minimalist, avoiding medicines and supplements unless absolutely necessary. Both say that they are mindful in their practices not to impose their preferences on patients.
A dilemma often arises, though: where to draw the line between a patient's preference and the strongest medical evidence. The authors acknowledge that patient autonomy is taken too far when a doctor neglects his role as guide and puts the burden of choice entirely on the patient's shoulders. The closest that "Your Medical Mind" comes to a solution is noting that when patients want to know what their doctors think, the answer should be offered only "after information is presented in a neutral way."
One approach the authors examine is a formula for rational decision-making often used in economics: Measure the probability of an outcome and place a numerical value on the outcome itself. In medicine, that would mean finding out the probability of a particular outcome from a proposed medical treatment and then placing a numerical value on the state of health that such an outcome would bring about. Simple multiplication (the probability-percentage times the numerical value) will yield a number that can be compared with the numbers derived from other treatments. The highest number indicates the most rational or "best" choice.
The best choice, of course, may differ from patient to patient. For example, the treatments for Graves' disease, which results from an overactive thyroid gland, include radioactive iodine, surgery and medication, but there are differences in potential negative outcomes and side effects. The authors tell us about Lily Chan, a 27-year-old social worker who has the disease. She fears radioactive iodine and worries that it may increase the risk of cancer, so she chooses surgery. Anna Gonzales, a 42-year-old journalist with three kids, has no fear of radioactive iodine and isn't bothered that the treatment will also require her to take a thyroid-hormone pill every day for the rest of her life—a prospect that 36-year-old Patrick Baptiste, another Graves' patient, can't bear to contemplate.
Naturally, it can be hard to imagine a disease's progress or the effects of possible treatments, and weighing all the options can be exhausting. "Having many options," the authors observe, "can be more distressing than having fewer options and can impede our ability to make a sound decision, or any decision." Even when a choice doesn't turn out as we had hoped, though, "we often underestimate the reservoir of our resilience."
Prostate cancer patients, for example, face choices that include watchful waiting, radiation and surgery. Concerning the two medical interventions, the specialists advising their patients may well focus on the bad side effects of the other's approach (incontinence, impotence). One prostate-cancer patient that Drs. Groopman and Hartzband discuss, Matt Conlin, speaks to 20 doctors about his disease, and he quizzes other patients about their experiences—even if he is embarrassed by asking about their sex lives or bladder issues. He decides to go ahead with robotic surgery, a newer approach, and does suffer some bad side effects. But he is rid of his cancer, and he resolves that it is time to move forward without regret—a choice that may be the best outcome for any medical decision.
Ms. Landro writes The Informed Patient column for the Journal.
-
That is the question without an answer.
Just we know, universal single payer government sponsored health care would not be recommending that we not do this test. It would be *dictating* and refusing to pay for this.
The talking heads on all the cable shows will have a field day with all their usual specialist guests, et. al. "debating" the cons and pros ad nauseum.
Thanks to the greats from Harvard who have seemed to have decided on the future of the world for the rest of us:
****prostate cancer test advice overturns dogma
Oct. 7, 2011, 5:36 p.m. EDTAPWASHINGTON (AP) — Men finally may be getting a clearer message about undergoing PSA screening for prostate cancer: Don't do it.
They may not listen. After all, the vast majority of men over 50 already get tested.
The idea that finding cancer early can harm instead of help is a hard one to understand. But it's at the heart of a government panel's draft recommendation that those PSA blood tests should no longer be part of routine screening for healthy men.
The U.S. Preventive Services Task Force examined all the evidence and found little if any reduction in deaths from routine PSA screening. But it did conclude that too many men are diagnosed with tumors that never would have killed them and suffer serious side effects from resulting treatment.
That recommendation isn't final — it's a draft open for public comment. But it goes a step further than several major cancer groups including the American Cancer Society, which urges that men be told the pros and cons and decide for themselves.
The new advice is sure to be hugely controversial. Already some doctors are rejecting it.
"We all agree that we've got to do a better job of figuring out who would benefit from PSA screening. But a blanket statement of just doing away with it altogether ... seems over-aggressive and irresponsible," said Dr. Scott Eggener, a prostate cancer specialist at the University of Chicago.
In the exam room, explaining the flaws in PSA testing has long been difficult.
"Men have been confused about this for a very long time, not just men patients but men doctors," said Dr. Yul Ejnes, a Cranston, R.I., internal medicine specialist who chairs the American College of Physicians' board of regents.
He turned down his own physician's offer of a PSA test after personally reviewing the research.
"There's this dogma ... that early detection saves lives. It's not necessarily true for all cancers," Ejnes said.
That's an emotional shift, as the American Cancer Society's Dr. Len Lichtenfeld voiced on his blog on Friday.
"We have invested over 20 years of belief that PSA testing works. ... And here we are all of these years later, and we don't know for sure," Lichtenfeld wrote. "We have been poked and probed, we have been operated on by doctors and robots, we have been radiated with fancy machines, we have spent literally billions of dollars. And what do we have? A mess of false hope?"
Too much PSA, or prostate-specific antigen, in the blood only sometimes signals prostate cancer is brewing. It also can mean a benign enlarged prostate or an infection. In fact, most men who undergo a biopsy for an abnormal PSA test don't turn out to have prostate cancer.
Screening often detects small tumors that will prove too slow-growing to be deadly — by one estimate, in 2 of every 5 men whose cancer is caught through a PSA test. But there's no way to tell in advance who needs treatment.
"If we had a test that could distinguish between a cancer that was going to be aggressive and a cancer that was not, that would be fabulous," said Dr. Virginia Moyer of the Baylor College of Medicine, who chairs the task force, an independent expert group that reviews medical evidence for the government.
About 1 in 6 U.S. men will be diagnosed with prostate cancer at some point in their life. Yet the cancer society notes that in Western European countries where screening isn't common, 1 in 10 men are diagnosed and the risk of death in both places is the same. In the U.S., about 217,000 men are diagnosed with prostate cancer each year, and 32,000 die.
Why not screen in case there's a mortality benefit that studies have yet to tease out? The task force outlined the problem with that:
—Up to 5 in every 1,000 men die within a month of prostate cancer surgery, and between 10 and 70 more suffer serious complications.
—At least 200 to 300 of every 1,000 men treated with surgery or radiation suffer incontinence or impotence.
—Overall, Moyer said 30 percent of men who are treated for PSA-discovered prostate cancer suffer significant side effects from the resulting treatment.
Among the questions sure to be raised during the public comment period are how doctors should advise men with prostate cancer in the family or black men, who are at increased risk.
PSA testing also is used to examine men with prostate symptoms, and to check men who already have had prostate cancer. The new recommendation doesn't affect those uses.
Congress requires that Medicare cover PSA tests, at a cost of $41 million in 2009. Other insurers follow Medicare's lead, especially in light of conflicting recommendations.
Nor does the new recommendation mean that men who want a PSA test can't have one. If the rule is adopted — something the government will review once the task force hears comments and finalizes its guidance — it would just advise against doctors pushing it routinely.
"The truth is that like so many things in medicine, there's no one-size-fits-all," said Dr. Michael Barry of Massachusetts General Hospital who heads the Foundation for Informed Medical Decision-Making that backs ways to help patients make their own choices.***
-
hoping this is the right thread for this news item. this is why i try NOT to take "medicine" if i can help it
-----------
Nguyen Thi Phuong, Vietnamese Woman, 'Ages' 50 Years In Days
The thought of going from age 23 to age 73 can be pretty daunting, but could you imagine going through the physical 50 year aging process in a matter of days?
Nguyen Thi Phuong was 23 years old when she switched medications to treat an itchy allergic reaction to seafood. A mixture of drugs left her skin sagging and wrinkled in a matter of days.
Neighbors said Phuong, now 26, is unrecognizable from her former self; her voice and black hair are the sole indicators of her true age, Tuoi Tre News reports.
more of the article here along with a video of her...
http://www.huffingtonpost.com/2011/10/14/vietnamese-woman-ages-50-years_n_1011181.html
-
The case for dietary supplements is collapsing.
WSJ:
A succession of large-scale human studies, including two published earlier this month in leading medical journals, suggests that multivitamins and many other dietary supplements often don't have health benefits—and in some cases may even cause harm.
After decades of research on the possible benefits of nutritional supplements, the handwriting is on the wall: Vitamins look to be a bust for the majority of people, many leading scientists are concluding. Shirley Wang has details on Lunch Break.
.The data have prompted some nutrition researchers to say taking vitamins is a waste of money for those without a specific nutrient deficiency or chronic illness. Such findings have also fueled a debate about whether the field should continue conducting expensive human trials to figure out whether particular supplements affect health.
"The better the quality of the research, the less benefit [supplements] showed," says Marion Nestle, professor of nutrition, food studies, and public health at New York University. "It's fair to say from the research that supplements don't make healthy people healthier."
For instance, vitamins B-6 and B-12 are often touted as being good for the heart, but several studies have failed to find that they lower risk of cardiovascular disease, according the Office of Dietary Supplements, part of the National Institutes of Health. Vitamin C hasn't been shown in many studies to lower a person's risk of getting a cold. Calcium, while important to bone health, doesn't lower risk of heart disease or cancer and may increase risk of kidney stones.
"We have an enormous body of data telling us that plant-rich diets are very healthy," says Josephine Briggs, head of the National Center for Complementary and Alternative Medicine, another NIH center. "As soon as we take these various antioxidants[and other nutrients] out and put them in a pill, we're not consistently getting a benefit."
Researchers and nutritionists are still recommending dietary supplements for the malnourished or people with certain nutrient deficiencies or medical conditions. For instance folic acid—the supplement form of folate——reduces the likelihood of a common birth defect if taken by pregnant women.
Studying the effects of vitamins and supplements in the real world is difficult, since people eat foods with multiple nutrients that can interact with supplements and skew results. And observational trials can only show an association, not cause and effect.
Enlarge Image
Close(l-r) F. Martin Ramin for The Wall Street Journal (3); Diane Fields for The Wall Street Journal
.That is one reason the Council on Responsible Nutrition, which represents the supplement industry, says it is too early to say supplements don't have health benefits. Duffy MacKay, the group's vice president of regulatory and scientific affairs, says lengthier studies may be required to show the benefits of some supplements.
Micronutrients, which include antioxidants like vitamin C, hormones like vitamin D and metals like iron, are essential to the body in small amounts because they help facilitate important reactions in and between cells. Too much of them, however, can cause problems.
The effectiveness of many dietary supplements remains untested and makers aren't required to do tests before selling a product. Still, about half of Americans reported taking at least one supplement a month in 2006, in the National Health and Nutrition Examination Survey published in April of this year. The supplement industry brought in $28 billion in sales in 2010, up 4.4% from 2009, according to Nutrition Business Journal, an industry trade publication.
Vitamin users may derive a benefit from the placebo effect, experts say. And they often are convinced the supplements make them feel better, regardless of what studies show.
"The thing you do with [reports of studies] is just ride them out, and literally we see no impact on our business," said Joseph Fortunato, chief executive of supplement retailer GNC Corp., according to a transcript of the company's third-quarter conference call with analysts last week.
"Consumers believe in our products," a spokesman for GNC said. GNC's revenue grew 15.5% in the third quarter of this year compared to a year ago and the stock, which closed at $25.08, is up 0.5% year-to-date.
Of growing concern to many scientists are the increasing hints of harm from vitamins.
The first red flags started emerging nearly 20 years ago. Researchers thought from early work that extra beta-carotene could help prevent lung cancer, but two randomized trials published in 1994 and 1996 showed an increased rate of lung cancer among smokers who took beta-carotene supplements.
Oncologist Mark Heaney of Memorial Sloan-Kettering Cancer Center in New York showed in laboratory work in 2008 that vitamin C appeared to inhibit the effect of chemotherapy drugs for cancer treatment. Subsequent research has shown vitamin C may inadvertently protect cancer cells more than normal cells.
A study published this month in the Journal of the American Medical Association, known as the SELECT trial, found that vitamin E—previously thought to lower risk of prostate cancer—actually increased the chance slightly. The risk could be mitigated by the simultaneous consumption of another micronutrient, selenium, the study says.
Multivitamins aren't faring much better. Results from the Iowa Women's Health Study, published earlier this month in the Archives of Internal Medicine, found in a sample of over 38,000 older women, multivitamin use over time was linked with a slight but statistically significant increased risk of earlier mortality.
A studyof 1,900 men and women in 15 cities across Europe published in 2008 in the European Journal of Nutrition followed healthy elderly individuals for 10 years. Among smokers in the study, those who took multivitamins were more likely to die younger than smokers who didn't.
Another large trial examining postmenopausal women in the NIH's Women's Health Initiative found no discernible impact from taking a multivitamin on preventing breast, lung or colorectal cancer, cardiovascular disease or premature death, according to the 2009 study published in the Archives of Internal Medicine.
Some experts warn against overemphasizing the potential harm of multivitamins because it isn't clear how that statistical uptick in risk of death would translate into actual increased risk in real life.
The consistent failure to show benefits has led researchers at the National Center for Complementary and Alternative Medicine and elsewhere to call for more lab experiments and small-scale studies of how the nutrients work, after over a decade of pursuing large, clinical trials of particular supplements' effectiveness.
"We've missed a step," says Alan Kristal, a professor of epidemiology at the University of Washington who studies the links between diet and cancer. "We need to understand the mechanism by which these things are acting."
Roberta Anding, a nutritionist at Texas Children's Hospital in Houston, says some people need multivitamins and other supplements, but she is cautious about the risk from high doses of micronutrients. "It's no longer nutrition when the doses become high, it's pharmacology," she says.
The best way to get micronutrients is through a balanced diet, she says.
"If you're looking at this as, 'At least I'm [taking a multivitamin],' but you're not exercising or eating well, then it is a waste of money," says Ms. Anding, a spokeswoman for the American Dietetic Association, a research and advocacy group
-
I agree with vaccinating the males too. Makes no sense to vaccinate the females but not the males who are giving it to them. Besides who wants venereal warts some strains of which will be prevented:
ATLANTA (AP) -- The controversial HPV shot given to girls should also be given to boys, in part to help prevent the spread of the virus through sex, a government medical panel said Tuesday.
The expensive vaccine, which protects females against cervical cancer, hasn't been popular. And doctors admit it will be a tough sell to parents of 11- and 12-year-old males, too.
For males, the vaccine is licensed to prevent genital warts and anal cancer. Experts say another key benefit of routinely vaccinating boys could be preventing the spread of the human papilloma virus to others through sex - making up somewhat for the disappointing vaccination rate in girls.
The Advisory Committee on Immunization Practices made the recommendation Tuesday. Federal health officials usually adopt what the panel says and asks doctors and patients to follow the advice.
The vaccine has been available to boys for two years but Tuesday's vote was the first to strongly recommend routine vaccination. Officials acknowledged the disappointing rate in girls encouraged them to take a new, hard look.
Just 49 percent of adolescent girls have gotten at least the first of the recommended three HPV shots, which have been recommended for girls for five years. Only a third had gotten all three doses by last year.
"Pretty terrible," said Dr. Anne Schuchat, a U.S. Centers for Disease Control and Prevention administrator who oversees the agency's immunization programs.
She attributed the low rates for girls to confusion or misunderstanding by parents that they can wait until their daughter becomes sexually active. It works best if the shots are given before a girl begins having sex.
The vaccine is approved for use in boys and girls ages 9 to 26; but it is usually given to 11- and 12-year olds when they are scheduled to get other vaccines.
The committee also recommended the vaccination for males 13 through 21 years who have not been vaccinated previously or who have not completed the three-dose series.
Tuesday's vote follows recent studies that indicate the vaccine prevents anal cancer in males. A study that focused on gay men found it to be 75 percent effective. But while anal cancer has been increasing, it's still a fairly rare cancer in males, with only about 7,000 cases in the U.S. each year that are tied to the strains of viruses targeted in the HPV vaccine. In contrast, about vaccine-preventable 15,000 cervical cancers occur annually.
Some feel it's unlikely that most families will agree to get their sons vaccinated primarily to protect girls. An estimated 50 percent to 80 percent of men and women are infected with HPV in their lifetimes, although most clear the infection without developing symptoms or illness, according to the CDC.
The threat of genital warts hasn't been persuasive yet, either: Some data suggest that less than 1.5 percent of adolescent males have gotten the vaccine.
Its use against anal cancer may not be much of a selling point, said Dr. Ranit Mishori, a family practice doctor in Washington, D.C., and an assistant professor at the Georgetown University School of Medicine.
Some parents may say "`Why are you vaccinating my son against anal cancer? He's not gay! He's not ever going to be gay!' I can see that will come up," said Mishori, who supports the committee's recommendation.
There are two vaccines against HPV, but Tuesday's vote applies only to Merck & Co.'s Gardasil, which costs $130 a dose. The other vaccine wasn't tested for males.
---
Online:
HPV info: http://www.cdc.gov/hpv/
© 2011 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. Learn more about our Privacy Policy and Terms of Use.
-
Woof,
Readied to donate organs 21 year old in coma since Oct. and thought brain dead, wakes up.
http://gma.yahoo.com/readied-donate-organs-21-old-emerges-coma-204904805.html
P.C.
-
There is NO question whatsoever antidepressants work in people. Not always, not in all people, with possible side effects, but they absolutely do work overall. That said we continue to see stuff like this:
NEW YORK (Reuters Health) - Neither antidepressants nor "talk therapy" were able to outperform inactive placebo pills in a new clinical trial on depression treatment -- though there were hints that the effects varied based on people's sex and race, researchers report.
The findings, published in the Journal of Clinical Psychiatry, add to evidence that people receiving "real" depression treatment in studies -- from antidepressants to St. John's wort -- often do no better than people given a placebo.
A recent review found that a minority of antidepressant users even fared worse than placebo users.
In this latest study, researchers randomly assigned 156 depression patients to either take the antidepressant sertraline (Zoloft and other brands) daily for 16 weeks; undergo a form of psychotherapy called supportive-expressive therapy (twice a week for four weeks, then weekly for 12 weeks); or be in a placebo group given inactive pills.
After 16 weeks, there were no overall differences in how the three groups fared.
Of antidepressant patients, 31 percent were treatment "responders" (meaning they'd fallen below a certain score on a standard measure of depression symptoms, or had seen their score drop at least 50 percent.)
The same was true of about 28 percent of patients in the talk-therapy group, and 24 percent in the placebo group. The differences among the three groups were so small as to be likely due to chance.
"I was surprised by the results. They weren't what I'd expected," said lead researcher Jacques P. Barber, dean of the Institute of Advanced Psychological Studies at Adelphi University in Garden City, New York.
Still, he stressed in an interview, the lack of benefit over placebo does not mean that depression therapies are pointless.
For one, Barber said, receiving a placebo in a clinical trial "is not the same as getting no treatment."
Study participants in placebo groups have contact with health professionals who are asking about their symptoms and well-being, Barber pointed out. And for some people, that attention can make a difference -- and may help explain the placebo response seen in studies.
In addition, at least some people in placebo groups believe they are getting the real treatment. And some studies have suggested that people's beliefs about their therapy play a key role in whether they get better.
But apart from that, different people may respond differently to a given type of depression therapy. Barber's team found some evidence of that.
The study, which focused on urban, low-income adults with major depression, had an unusually large minority population for a clinical trial on depression: Of the 156 patients, 45 percent were African American.
And Barber's team found that African-American men tended to improve more quickly with talk therapy than with medication or placebo.
In contrast, white men fared best on placebo, while black women showed no differences in their responses to the three treatments.
Only white women, Barber said, showed the expected pattern: a quicker response to both medication and talk therapy than to the placebo.
But all of that is based on fairly small numbers of people, and more research is needed to see if the gender and racial differences are real, according to Barber.
A psychiatrist not involved in the study agreed. "Those findings are interesting, but need to be interpreted with a grain of salt," said Dr. David Mischoulon, an associate professor of psychiatry at Harvard Medical School.
EVERYTHING WORKS TO SOME DEGREE?
As for the overall lack of benefit from the real treatments over placebo -- in this and other studies -- Mischoulon cautioned against reading that as "nothing works for depression."
"I think it's the opposite," he told Reuters Health, "It's more that, everything seems to work to some degree."
Like Barber, Mischoulon said that the placebo condition in clinical trials is not really "no treatment."
His advice for people suffering from depression symptoms is to talk with your doctor about the pros and cons of all the treatment options, including different forms of talk therapy and medication.
"I try to offer as broad a menu of options as possible, because all may potentially help," said Mischoulon, who has also studied alternative depression remedies, like fish oil and acupuncture.
Another caveat from the current study, he noted, is that it looked only at two types of medication. (Some patients were switched to another drug, venlafaxine (Effexor), if they did not respond to sertraline after eight weeks). And it tested just one type of talk therapy.
Supportive-expressive therapy is a short-term form of psychoanalysis that aims to help people understand how their personal relationships are related to their symptoms.
It's different from cognitive behavioral therapy, the best-studied form of talk therapy for depression. Both Barber and Mischoulon said it's not clear if the current findings would extend to psychotherapies other than supportive-expressive therapy.
"This is one type of psychotherapy, and it's two antidepressants," Mischoulon said. "It would be wrong to conclude that psychotherapy doesn't work, and antidepressants don't work."
The study was funded by the National Institutes of Health. Some of Barber's co-researchers have received funding from the pharmaceutical industry.
SOURCE: http://bit.ly/vjbLCM Journal of Clinical Psychiatry, online November 29, 2011
-
Arizona coma patient now speaking, walking
By TERRY TANG | AP – 5 hrs ago
PHOENIX (AP) — It will be a special Christmas for the family of a 21-year-old University of Arizona student who was nearly taken off life support before awaking from a coma.
Sam Schmid was walking and speaking Friday at a Phoenix hospital. Dressed in a T-shirt, shorts and sneakers, he was able to use a walker and talk in brief sentences.
"Right now, I'm feeling all right ... except for the rehabilitation, I'm feeling pretty good," Schmid said.
Doctors at Barrow Neurological Institute say Schmid has a long recovery ahead of him to regain full speech, balance and memory abilities.
Schmid was involved in an Oct. 19 car crash in Tucson that left him with a brain aneurysm, among other life-threatening injuries. Because of the complexity of his brain injury, Schmid was flown to Phoenix.
He underwent surgery performed by Dr. Robert Spetzler. With no responsive signs, staff discussed taking Schmid off life support.
"They never approached me to say would I donate his organs," said Susan Regan, Schmid's mother. "The people that were surrounding us were just asking about Sam, his quality of life, what would Sam want if we had to come to a difficult decision."
Spetzler said Schmid was never officially classified as a potential organ donor. And after an MRI scan showed he wasn't at a point of no hope of survival, Spetzler recommended keeping him alive for one more week.
Then on Oct. 24, Schmid shocked doctors by following commands to hold up two fingers.
"It may not seem like a lot to you," Spetzler said. "It's an incredible loop to show brain ability. That was like fireworks going off."
Since then, Schmid has been spending his days in physical rehabilitation. Dr. Christina Kwasnica, who is overseeing Schmid's rehabilitation, said he has gone from practicing sitting in a chair to doing rehab three hours a day. She described his recovery so far as amazing but hesitated to make any predictions of what "normal" would be for him.
"It's so early in Sam's injury. We have no idea where the ceiling is," Kwasnica said.
While he will be able to spend Christmas day with family in Phoenix, Schmid will not officially be released until next week. His brother, John, based in Tucson, will relocate to Phoenix so Schmid can continue rehabilitation on an out-patient basis.
Schmid, who is a business major and was coaching basketball at a University of Arizona recreation center, is holding onto the belief that he can get back to what his life was like before the accident.
"I see myself leaving the house, going to school, work, basic things like that," Schmid said. "I just want my life to be what it used to be."
P.C.
-
Head injuries can result in unknowable outcomes.
Severe brain injury from lack of oxygen often called anoxic encephalopathy do not generally reverse.
I remember s woman who had a heart attack and was resucitated only to the extent her heart was revived. She was brain dead except for some primitive brain function. She was on a breathing machine and required total care and over ther period of around a year and half with endless hospital admissions, and infections, and bedsores, contractures, catheters, etc.
Her husband and son often would sit at the bedside. Doctors approached them now and then to "pull the plug".
For the longest time they refused. The response was always, suppose she is the one in million we read about in the news, on TV?
Hundreds of thousands of dollars (if not more) was spent on what after only a few weeks seemed futile. All of it paid for by Medicaid. Zero out of pocket. Some will say that even my mentioning the dollars makes me some sort of monster.
Eventually they finally agreed, I heard (I was just an occasional covering doctor), to "pulling the plug".
The patient's body and her family could finally let go.
-
FDA changing course on antibiotics in livestock
The debate over the drug use in food animals continues as federal regulators tackle the issues of drug-resistance and shorter supplies.
J. Adams, Special to the Los Angeles Times
January 9, 2012
Only 20% of the antibiotics sold in the U.S. are given to people who are sick with bacterial infections, such as ear and urinary tract infections and pneumonia. Most of the penicillin, tetracycline and other antibiotic drugs used in this country are given to livestock that are perfectly healthy.
Farmers have been putting these medicines in animal feed since the 1950s. They say the drugs help protect herds from infectious diseases and help animals grow faster.
But for at least 40 years, the U.S. Food and Drug Administration has been concerned that the widespread practice may be fueling the growth of human pathogens that are no longer vulnerable to doctors' front-line drugs.
In the last few weeks, the U.S. Food and Drug Administration has made two rulings addressing the use of antibiotics in animals that will end up as food on our dinner tables:
• On Dec. 22, the FDA pulled the plug on procedures, begun in 1977, that might have ended the practice of feeding penicillin and tetracycline to livestock.
• On Jan. 4, the agency issued an order that prohibits certain uses, including preventive uses, of another class of antibiotics also used to treat pneumonia and other infections in people.
The two moves may seem contradictory. But the FDA asserts that both decisions were made in the interest of preserving antibiotics that are medically important for humans.
Some public health advocates agree that the latest moves indicate a new willingness by the government to tackle the longstanding issue.
In finally dropping its long-stalled plans to limit the use of penicillin and tetracycline in farm animals, the FDA signaled that it intends "to regulate more than just a few drugs," said Laura Rogers, who directs the Pew Charitable Trusts' campaign on human health and industrial farming. Seen in that light, last week's ruling limiting the use of cephalosporin antibiotics in agriculture "is the first step toward a broader regulatory approach," she said. (The Pew campaign opposes routine use of antibiotics in food animals.)
The science behind antibiotic resistance is a classic story of survival of the fittest. Antibiotics target key life functions in bacteria, killing them or preventing them from multiplying. But individual bugs that survive a drug's assault will grow and multiply, potentially creating a whole population of drug-resistant bacteria.
Resistance to antibiotics is a growing public health problem across the globe. People infected with resistant pathogens tend to get more severely ill and are harder to treat. Antibiotic resistance adds an estimated $20 billion to healthcare costs in the U.S. each year, including longer hospital stays and the need for more expensive drugs, according to the Centers for Disease Control and Prevention.
However, it's not clear how much the use of antibiotics in cattle, pigs, chickens and other animals contributes to problems in people.
Those who oppose the practice of putting antibiotics in animals' food or water point to studies that have found livestock-associated strains of bugs such as salmonella and Staphylococcus aureus in humans.
Decades ago, the FDA commissioned Seattle's public health department to study salmonella and campylobacter found on meat and in people sick with enteritis. In a 1984 report, researchers found that illness-inducing campylobacter was similar to that found on poultry products. In addition, about 30% of bacteria from both sources were resistant to tetracycline.
Eating contaminated meat isn't the only way people can become colonized with antibiotic-resistant bacteria. Those who work with farm animals are also at risk. For instance, a Chinese study published in 2010 found antibiotic-resistant Escherichia coli in animals and farmworkers. The year before, researchers in Iowa reported that they found a livestock-associated strain of antibiotic-resistant staphylococcus in pig farm workers.
The World Health Organization, the American Medical Assn. and other major health groups have denounced the practice of feeding human antibiotics to animals. The mere threat that agricultural use could cripple drugs for people is reason enough to take action, they say.
Advocates of the practice refer to scientific reviews that discount the risk to human health. A 2004 paper in the Journal of Antimicrobial Chemotherapy argued that cross-contamination between farm animals and people is a two-way street, with most antibiotic-resistant disease stemming from human use of these drugs. In any event, the authors wrote, illness from bacteria on meat can be prevented with proper cooking — even if the bacteria are resistant to drugs.
Blanket regulations limiting how the drugs are used on animals would remove valuable tools from the veterinarian's medical bag, according to the American Veterinary Medical Assn. Using the drugs prophylactically allows farmers and ranchers to prevent or control disease outbreaks, especially when animals are kept in close quarters. If drugs are only given to animals after they are visibly ill, disease can spread quickly and risk the lives of an entire herd or flock.
There's little dispute that livestock animals carry antibiotic-resistant organisms. But there's all sorts of barriers that prevent those bugs from infecting humans, said Dr. Liz Wagstrom, chief veterinarian for the National Pork Producers Council. They'd have to contaminate the meat at slaughter, survive cooking and be ingested in a large enough dose to make someone ill.
In ending its long-stalled initiative to reconsider penicillin's and tetracycline's use in agriculture, the FDA said the "notices of opportunity for a hearing" issued in 1997 were so old that they were essentially useless. Though there was evidence back then that the practice fuels antibiotic resistance, new data would have to be taken into account for such a decision to be made today.
At a minimum, any effort to move forward at this point would have to consider other classes of antibiotics that have become popular since the 1970s and include a rationale for which ones should be targeted, according to the agency.
The FDA's move may have been prompted by a lawsuit filed by advocacy groups including the Natural Resources Defense Council and the Food Animal Concerns Trust. Convinced that feeding antibiotics to animals is a major public health problem, they were trying to force the FDA to move forward with its plans — not abandon them altogether.
"It's the FDA's overcautious attitude," said Steven Roach, public health program director for FACT. "If anything we have more evidence now than we did in 1977. And they had enough evidence to proceed back then."
The drugs that were affected by the FDA's decision are among the oldest around. Tetracycline tops the list of most popular antibiotics, with more than 4 million kilograms used in food animals per year, according to 2009 data collected by the FDA. Penicillin comes in fourth, with about 610,000 kilograms of the drug used each year. (Both figures include drugs used on healthy animals as well as to treat those that are sick.)
Both drugs still are widely used by pork producers but in very specific ways, Wagstrom says. For instance, penicillin (usually in combination with other antibiotics) is fed to weanling pigs because it stimulates growth at this early stage in life.
How antibiotics promote growth is not entirely understood. The drugs may affect gut bacteria in a way that permits food nutrients to be better absorbed, or they may suppress low-level disease, according to Dr. H. Morgan Scott, a professor at Kansas State University's College of Veterinary Medicine in Manhattan, Kan. "If they're growing faster, some people would argue they must be healthier."
The FDA has made other moves to restrict antibiotic use in animals. In 2003, the agency began requiring drug companies to do a risk assessment of drugs given to animals as part of the overall approval process. However, those rules don't apply to older drugs like penicillin, Roach said.
The FDA is also developing guidelines for the "judicious use" of antibiotics in livestock. These guidelines, first made public in July 2010, are still in draft form. The agency hasn't set a timeline to finalize them, although it's considered a priority, according to FDA spokeswoman Stephanie Yao.
But those guidelines will only be voluntary, which is why watchdog groups tried to force the FDA to move forward with the decades-old rules about penicillin and tetracycline, Roach said.
The lawsuit brought by the NRDC, FACT and others to force the FDA to take regulatory action against antibiotics in animal feed is ongoing.
Meanwhile, Rep. Louise Slaughter (D-N.Y.) has introduced legislation to restrict the use of medically important antibiotics in agriculture. The Preservation of Antibiotics for Medical Treatment Act would require the FDA to re-review approvals for drugs currently allowed in animal feed. Slaughter re-introduced the bill last March.
-
Kudos to CCP for warnings given regarding Lap Band Surgery some time ago. It's now the beginning of the end (I hope).
http://www.latimes.com/business/la-fi-lap-band-20120208,0,6117596.story
-
"Kudos to CCP for warnings given regarding Lap Band Surgery some time ago."
Thanks JDN.
I don't remember posting on this board about that.
Unfortunately outcomes for lap band are very disappointing. *Most* will gain the weight back and many do have problems later on.
The full bariatric restrictive/absorptive procedures are better. Yet I was recently surprised to find that contrary to expectations patients are not necessarily living a lot longer by what one would think is a life saving procedure. I think it depends on their co - morbid condidtions to start with.
I will try and see if I can find more recent information that I can post here. I don't recall the latest details.
Like the complete turnaround on PSA testing sometimes the longer one studies "outcomes" the more we realize we may not be doing as much good as thought.
That is one of the theoretical concepts behind electronic medical record data. That we will know more about long term effects of what we do and don't do. The jury is out on this. Overall I am not a big fan of it.
Yet the train has left the station like it or not.
-
I received free a copy of the journal. I glanced through a somewhat long article but have not spent the time reading it.
This physician supports the use of it for medical purposes. I am not convinced we need another psychoactive drug out there. OTOH it is out there anyway I guess. Here he is giving a 10 minute chat about it:
http://www.scivee.tv/node/39225
-
Nurse murdering dialysis patients with bleach? Perhaps this should start a crime thread instead of "health".
Divita is a national dialysis chain. Anytime we forget the cruelty of one human to another we can quickly be reminded with stories like these:
http://dfw.cbslocal.com/2012/03/05/texas-nurse-accused-of-killing-patients-with-bleach-ivs/
-
Nurse murdering dialysis patients with bleach? Perhaps this should start a crime thread instead of "health".
Divita is a national dialysis chain. Anytime we forget the cruelty of one human to another we can quickly be reminded with stories like these:
http://dfw.cbslocal.com/2012/03/05/texas-nurse-accused-of-killing-patients-with-bleach-ivs/
Medical personnel, especially doctors are thought to be the worst serial killers.
-
This makes sense to me. I absolutely do not believe antidepressants are not better than placebo. I don't understand the findings of some studies that suggest this. There is NO doubt they are helping some people. It cannot just be placebo. No way. Yet even in this study only one in five benefits (or at least more than placebo) and it appears other modalities may be just as good:
..Study suggests overall benefit from antidepressants
By Genevra Pittman | Reuters – 10 hrs ago....Email
..
....NEW YORK (Reuters Health) - Despite recent debate about how well antidepressants really work in people with only mild or moderate depression, a new analysis of drug studies suggests they may have some benefit across the board.
Researchers found that more patients taking Prozac or Effexor had a substantial improvement in their symptoms than those taking a drug-free placebo pill, regardless of how severe those symptoms were to begin with.
The idea that unless you're very, very ill, you're not going to benefit from treatment does not appear to stand up" when looking closely, said the study's lead author, Robert Gibbons, from the University of Chicago.
Still, not everyone in the studies improved -- on average, about five people had to be treated with one of the drugs for one person to feel better, and the benefits seemed to be diminished among some of the oldest patients.
What's more, one researcher not involved in the study said its findings still don't mean the drugs are any better than non-drug methods of treating depression, such as talk therapy and being more physically active.
For their analysis, Gibbons and his colleagues looked at outcomes for each individual patient in published and unpublished trials testing the effects of six weeks of treatment with antidepressants versus placebo pills. Most of those trials were funded and run by the pharmaceutical companies that manufacture Prozac and Effexor -- Eli Lilly and Wyeth, respectively.
They included 12 studies of Prozac in adults and four each in elderly patients and youth, as well as 21 trials of immediate- or extended-release Effexor in adults. About 9,000 participants were included.
More adults and kids taking Prozac, known generically as fluoxetine, had at least a 50 percent improvement in scores on depression tests after six weeks compared to those assigned to take a placebo pill.
Fifty-five percent of adults on Prozac responded to treatment, compared to 34 percent in the placebo group. In youth, 30 percent on Prozac had significant symptom improvement, compared to just six percent of the comparisons.
The benefits were seen regardless of how severe patients' symptoms were before starting treatment.
However, in the elderly the differences between the treatment and placebo groups were much smaller, and the researchers calculated that 17 older patients would have to be treated with Prozac for one to gain from it.
Clearly the efficacy of antidepressants is age-dependent, (and) largest, most interestingly, in youth, which I don't think would be the mainstream view in psychiatry," Gibbons told Reuters Health.
The findings, he added, raise other questions that need to be followed up (including), what's going on in the elderly?"
Both types of Effexor, or venlafaxine, also seemed to help adults with mild to severe depression, with slightly more patients responding to the immediate-release dose.
Some of the study's authors have testified for or received funding from drug companies, though the report itself was funded by national health agencies.
The researchers said they couldn't be sure there would be similar improvements with other types of antidepressants -- especially given the more limited data in kids and the elderly -- or that the longer-term benefits would be as clear.
One recent study suggested that up to a fifth of patients on the antidepressant Cymbalta (duloxetine) might actually benefit more from placebo pills (see Reuters Health story of December 9, 2011.)
Irving Kirsch, who studies antidepressants and placebos at Harvard Medical School in Boston, said the new report didn't make him more optimistic about the drugs.
If five or more patients need to be treated with an antidepressant for one to substantially improve, most don't get much out of it, he pointed out.
More than 80 percent of the patients are not getting a significant benefit from the drug -- either they're not getting better or they would get the same benefit with placebo," he told Reuters Health.
There are alternative treatments for depression that also produce about the same symptom reduction as the drugs do, but without the risk of side effects," Kirsch added, including psychotherapy and exercise.
Still, Gibbons said that the improvement in symptoms for the average patient wasn't insignificant.
Definitely it doesn't look like antidepressants are placebos," he concluded.
SOURCE: http://bit.ly/AaNJqw Archives of General Psychiatry, online March 5, 2012.
..
-
http://www.youtube.com/watch?v=u8bsCiq6hvM
-
I mention my own notion here that the massive use of antibiotics by the cattle and poultry industry to stimulate faster growth in chickens and cattle with the attendant side effect of dosing us regularly with these antibiotics, which are not neutralized by the act of cooking, may have more than a little to do with this.
======================
http://www.nytimes.com/2012/03/20/health/gut-infections-are-growing-much-more-lethal.html?nl=todaysheadlines&emc=edit_th_20120320
Gastrointestinal infections are killing more and more people in the United States and have become a particular threat to the elderly, according to new data released last week.
Deaths from the infections more than doubled from 1999 to 2007, to more than 17,000 a year from 7,000 a year, the Centers for Disease Control and Prevention reported. Of those who died, 83 percent were over age 65.
Two thirds of the deaths were caused by a bacterium, Clostridium difficile, which people often contract in hospitals and nursing homes, particularly when they have been taking antibiotics. The bacteria have grown increasingly virulent and resistant to treatment in recent years.
But researchers were surprised to discover that the second leading cause of death from this type of illness was the norovirus. It causes a highly contagious infection, sometimes called winter vomiting illness, that can spread rapidly on cruise ships and in prisons, dormitories and hospitals.
“I think there is perhaps a misperception that norovirus causes a mild illness,” said Aron Hall, an epidemiologist at the disease centers. “But this suggests a major problem that requires some attention.”
Both diseases are spread by the fecal-oral route, meaning that people swallow germs found in feces, often spread by people who did not wash their hands after using the toilet.
Problems with C. difficile are not new: Health officials first began warning in 2004 that a more virulent and drug-resistant strain had emerged. It produces high amounts of two potent toxins that can wreak havoc in cells lining the intestine.
But few people anticipated what gains the bacteria would make. Among hospitalized patients, cases rose to 336,000 in 2009 from 139,000 in 2000. Deaths from the infection seem to have leveled off in the past few years, but researchers say they are still far too high and should be dropping, as other hospital-related infections are.
Estimates of cases occurring outside hospitals run as high as three million annually. Overall, C. difficile infections cost $1 billion a year, according to the disease centers.
Two factors typically lead to the infection: taking antibiotics, which make the intestine vulnerable, followed by exposure to the bacteria or their spores in a hospital, clinic or nursing home that has not been properly disinfected. Spores can survive for weeks or maybe even months outside the body, and it takes bleach or other strong disinfectants to kill them.
Many people recover once they stop taking antibiotics, but some become severely ill and require treatment with different antibiotics to get rid of C. difficile. Even then, 20 percent relapse, and some suffer intestinal damage that can be fatal or can require surgery to remove part of the intestine.
In recent years, some people have received fecal transplants, in which stool from a healthy person is placed into the patient’s intestine. The idea is to restore the normal balance of bacteria in the gut, which may include 25,000 to 30,000 different species. There is simply no better way to replace them. Awful as they may sound, the transplants can cure cases that were otherwise intractable.
“The microbes have been at this a lot longer than us,” said Dr. L. Clifford McDonald, a medical epidemiologist at the disease centers. He added, “Our bodies have learned over eons how to keep harmful bacteria out.”
Health officials expressed frustration at a news conference this month, stating that many cases are preventable or at least treatable, and yet death and infection rates have continued at “historically high and unacceptable levels.”
Because nearly all C. difficile infections — 94 percent — come from hospitals or other health care settings, experts say doctors, nurses, other health workers and hospitals should take much of the responsibility for trying to fight them.
A quarter of the infections start in the hospital, and the rest occur in nursing home patients or people recently treated in doctors’ offices or clinics. Patients often carry the germs from one institution to another.
Simple hygiene measures are highly effective, like cleaning surfaces with bleach and wearing gowns and gloves when treating infected people to avoid spreading germs to other patients. One of the disturbing and more disgusting facts about C. difficile is that it is very hard to remove from bare hands: neither soap and water nor alcohol-based hand sanitizers work very well. For health workers, it is much better to wear gloves, to avoid contaminating their hands in the first place, Dr. McDonald said.
He also said that a recent study of hospitals in the United States that set up programs to fight C. difficile found that they were able to lower infection rates by 20 percent in two years. Similar efforts in Britain have cut infection rates by half.
It is also important to use antibiotics only when they are really needed, because people taking them have 7 to 10 times the usual risk of contracting C. difficile while using the drugs and for a month after, and triple the risk for the next two months, according to the disease centers.
For those with serious illnesses that require antibiotics, the risk is unavoidable. But half the antibiotics prescribed in the United States are unnecessary, experts say, so people are being put at risk for no reason.
But why have the bacteria become more virulent? A likely reason, Dr. McDonald said, is that virulence can sometimes be an asset when it comes to evolution. Nice germs finish last, but nasty ones that cause a lot of diarrhea will spread around more, infect more people and beat out the competition — a trait that evolution will tend to favor.
“The strain that is more successful is selected for,” he said.
The finding on norovirus came as a surprise, said Dr. Hall, the C.D.C. epidemiologist, whose report is the first to find that the virus has become the second leading cause of death from gastroenteritis.
The virus causes about 800 deaths a year in the United States, he said, but about 50 percent more in years when new strains emerge.
About 20 million people a year in the United States get sick from norovirus, most often in the winter. It can quickly sweep through a nursing home or dormitory. Just a small dose of the virus, a few particles, is enough to cause illness.
“Someone sick is shedding billions of viruses in every gram of stool,” Dr. Hall said. “One person can expose a lot of people rapidly.”
The incubation period is short, and the virus can persist on surfaces for days or even weeks. Cold and moisture help it last.
Older people are most likely to become severely ill and die from the virus, either from dehydration or aspiration pneumonia, caused by inhaling vomit.
“The second highest death rate is in kids under 5,” Dr. Hall said.
When children die from the infection, the culprit is often dehydration, which can lead to shock and heart problems.
Dr. Hall said that he and his colleagues estimated that 27 children a year die from norovirus, similar to the number killed by another gastrointestinal infection, rotavirus, for which there is now a vaccine.
Researchers are trying to develop a norovirus vaccine, he said. But scientists say vaccines for intestinal infections are among the most difficult to create.
-
A subject upon which I have commented previously. I am sympathetic to govt. action here on the basis of external diseconomies:
By JENNIFER CORBETT DOOREN in Washington and MARK PETERS and IAN BERRY in Chicago
A federal judge ordered the Food and Drug Administration to restart a process that could limit the use of two types of antibiotics in cattle, pigs and poultry, amid concerns such use leads to antibiotic-resistant infections in humans.
In a ruling late Thursday, Judge Theodore Katz in New York said the FDA needed to start the process of no longer allowing penicillin and tetracyclines to be used on livestock for non-medical reasons.
That could wind up materially cutting the amount of antibiotics used in animal feed, addressing a decades-long concern of safety advocates. But the exact outcome remains unclear. Drug makers will be allowed to request a hearing to show that such uses of their products are safe, and any final rule-tightening could get watered down along the way.
In 1977, the FDA concluded that using low doses of penicillin and tetracyclines was not safe, and issued a notice stating it would start the process of withdrawing the approval for use of such drugs for non-medical uses. But it never followed through to stop the practice.
Last year, consumer groups, including the Natural Resources Defense Council, sued the FDA in federal court asking a judge to order the agency to follow through on its 1977 proposal.
In the 1950s, the FDA had approved the use of antibiotics to stimulate growth of cattle, swine and chickens. However, it was later shown that widespread use of antibiotics in livestock can cause the development of drug-resistant bugs that can be transferred from animals to humans.
"For over 35 years, FDA has sat idly on the sidelines largely letting the livestock industry police itself," said Avinash Kar, an attorney at the Natural Resources Defense Council.
"In that time, the overuse of antibiotics in healthy animals has skyrocketed—contributing to the rise of antibiotic-resistant bacteria that endanger human health," he said.
The FDA said it was studying the opinion and considering the appropriate next steps.
Agriculture experts and farmers said many livestock producers have already cut back or eliminated indiscriminate use of antibiotics altogether, and predicted the rule wouldn't change their operations anytime soon.
"A lot of people have the perception that people are using medication without rhyme or reason, and that's not the case," said Lisa Becton, head of swine health information and research for the National Pork Board.
The National Cattlemen's Beef Association, which represents beef producers, said it was disappointed with the court ruling that would require the FDA to use a strict administrative process to regulate antibiotic use.
"Cattle producers work hand-in-hand with veterinarians and animal-health experts each day to implement comprehensive herd-health management plans, which include the judicious use of antibiotics to prevent, control and treat any cattle health issues," the group said.
Leon Sheets, a hog producer, in Ionia, Iowa, said he didn't expect the requirement would change his operations anytime soon. "Antibiotics can be one of those tools" used to manage illness, but farmers already gauge their use in part because of the cost of the drugs, Mr. Sheets said.
Earlier this year, the FDA banned non-medical uses of a class of antibiotics known as cephalosporins, which are sold for human use under brands including Keflex, Ceftin and Cedax, and are used to treat bone, urinary-tract and respiratory infections.
As of April 5, it will become illegal to use the products in healthy animals as a way to help prevent disease, though using them to treat a specific illness will remain legal. Cephalosporins, unlike penicillin and tetracyclines, were never approved by the FDA for non-medical use in animals.
Write to Jennifer Corbett Dooren at jennifer.corbett-dooren@dowjones.com
-
Well the news of Ryan O'Neill and Buffett shows the confilicting facts about prostate cancer> One guy is youngish and has advanced incurable prostate cancer and may well die of it and the other sounds like he is one of those old guys that happens to have it, and from the way it sounds, will die of something else. I read recently 50% of men over 50 could have cancer in their gland and 75% over 80 do. This source is giving lower numbers (over 50% over age 80).
Recently we are told not to do PSA screening as it may be causing more harm than good as a screening test. Yet it sounds like Buffett probably had one done. "Stage 1" is reported. Yet the statistics would suggest that it is far more likely the finding in him, at that age, is incidental and not related to anything else. Yet one wonders if O'Neill was getting the screening tests. Based on the recent "evidence" (which could change next year) probably O'Neill would not even benefitted from the test even if he did have it.
http://www.cancer.gov/cancertopics/screening/understanding-prostate-changes/page3
-
Woof,
Hopeful treatment for Prostate Cancer.
Honeybees Prevents Spread Of Prostate Cancer
By: Jennifer Hong
05/05/2012 08:34 PM ET
Tweet22There’s a lot of exciting news coming from the University of Chicago where researchers found that a compound made in honeybees and hives seems to stop the spread of prostate cancer cells in mice.
The compound, called caffeic acid phenethyl ester or CAPE, is made from propolis, the resin honeybees use to patch holes in their hives. The product has been known and used for centuries as a natural remedy for teeth and skin, as well as a defense against viruses and bacteria.
When the researchers fed CAPE to mice that had early stages of the human form of prostate cancer, it seemed to stop the cancer in its tracks.
“Their tumors simply stopped growing,” said Richard Jones, the study’s author and a cancer researcher at the University of Chicago. “When we stopped feeding the mice CAPE, their tumors returned.”
After six weeks, the tumors in mice eating CAPE were 50 percent smaller than the tumors in mice not getting the compound, whose tumors kept growing unchecked. The CAPE mice also didn’t lose any weight during the treatment, which researchers said indicated that the compound was not overly toxic.
The researchers said the compound didn’t kill the cancer, but it appeared to stop the growth of the cancer cells by masking their ability to use a system of signals to detect nutrition. If cells don’t sense the presence of the food they need, such as glucose, they will stop growing.
The study was only in mice, and the compound has not yet been tested in human cancer patients. But Jones said the cell pathways targeted by CAPE are found in all mammal cells. He said he is hopeful that CAPE will prove useful against cancer in humans, most likely in combination with other available cancer therapies.
P.C.
-
[youtube]http://www.youtube.com/watch?v=c0UDeydlEDM&feature=share[/youtube]
This is a look at the perils of aspertame. Similar videos are conspiracy type, so I can't and won't vouch for the veracity of this video. That said, my doctor told me last week that diet soda drinkers are "deluding themselves about the health benefits."
-
By JENNIFER CORBETT DOOREN
People who suffer from chronic depression throughout their lives are more likely to develop dementia compared with people who aren't depressed, according to a study released Monday.
The study, by California researchers, sheds light on whether depression might cause dementia and Alzheimer's disease, or if it is merely an early sign of memory loss and other problems associated with dementia. Alzheimer's disease is the leading cause of dementia; the second-leading cause is impaired blood supply to the brain, resulting in what is known as vascular dementia.
"It's quite clear depression late in life can be an early sign of Alzheimer's," explained Rachel Whitmer, a study researcher and an investigator at the Kaiser Permanente Northern California Division of Research. "There's a lot of debate whether [depression] is really a risk factor for dementia, or if it just shows up."
Other factors elevate dementia risk.
People with more belly fat in middle age had higher rates of dementia when they reached old age. This held true even for people whose overall body weight was considered normal.
People who smoked in middle age had an increased risk of developing dementia and Alzheimer's disease later on. People who smoked two packs or more daily had more than double the risk.
People with high cholesterol in middle age had an increased risk of developing dementia and Alzheimer's disease in old age
Source: Kaiser Permanente
The findings, published in the May issue of Archives of General Psychiatry, add to the evidence that late-in-life depression is a likely early sign of Alzheimer's disease and suggest that chronic depression appears to increase the risk of developing vascular dementia. Adequate treatment for depression in midlife could cut the risk of developing dementia. The study is the first to examine whether midlife or late-life depression is more likely to lead to either Alzheimer's disease or vascular dementia over the long term.
To look at links between depression and dementia, Dr. Whitmer and other researchers looked at 13,535 long-term Kaiser Permanente members who had enrolled in a larger study in the period from 1964 to 1973 at ages ranging from 40 to 55 years old. Health information, including a survey that asked about depression, was collected at the time.
Researchers looked at whether the same people were depressed late in life, in the period from 1994 to 2000, and then looked at whether they were diagnosed with dementia or Alzheimer's disease in 2003. The participants' average age in 2003 was 81 and 57.9% were women. The study found depression present in 14.1% of subjects in midlife only, in 9.2% in late life only and in 4.2% in both.
Looking at those who later developed dementia, the study found 20.7% of study participants without depression developed dementia, compared with 23.5% of people who reported depression in midlife only and 31.4% of those who were depressed later in life. Among those who were depressed at both mid- and late-life, 31.5% developed dementia.
Researchers then did more analysis to tease out Alzheimer's diagnoses from the broader dementia category. They found people who were depressed in midlife but not late in life had no increased risk of developing Alzheimer's disease or vascular dementia. People who were depressed late in life were more likely to develop Alzheimer's while those depressed at both mid- and late life were three times as likely to develop vascular dementia.
Dr. Whitmer's research focused on people's health and how it affects brain aging. Previous studies she has conducted using Kaiser's database of long-term members, have shown that factors such as smoking, diabetes, high cholesterol and belly fat increase the risk of developing Alzheimer's and other brain diseases. A 2008 study looking at belly fat showed people who had more belly fat during middle age had higher rates of dementia when they reached old age. The finding held true even for people whose overall body weight was considered normal.
Kaiser Permanente Northern California is a large, nonprofit health maintenance organization that provides health services to more than one-quarter of the population in the San Francisco and Oakland, Calif., areas.
Dr. Whitmer's most recent study, conducted with researchers from the University of California in San Francisco, was funded by Kaiser Permanente, the National Institutes of Health and the Brain and Behavior Research Foundation.
Write to Jennifer Corbett Dooren at jennifer.corbett-dooren@dowjones.com
-
http://www.nytimes.com/2012/05/15/science/a-mathematical-challenge-to-obesity.html?_r=1&nl=todaysheadlines&emc=edit_th_20120515
By CLAUDIA DREIFUS
Published: May 14, 2012
Carson C. Chow deploys mathematics to solve the everyday problems of real life. As an investigator at the National Institute of Diabetes and Digestive and Kidney Diseases, he tries to figure out why 1 in 3 Americans are overweight.
We spoke at the recent annual meeting of the American Association for the Advancement of Science, where Dr. Chow, 49, gave a presentation on “Illuminating the Obesity Epidemic With Mathematics,” and then later by telephone; a condensed and edited version of the interviews follows.
You are an M.I.T.-trained mathematician and physicist. How did you come to work on obesity?
In 2004, while on the faculty of the math department at the University of Pittsburgh, I married. My wife is a Johns Hopkins ophthalmologist, and she would not move. So I began looking for work in the Beltway area. Through the grapevine, I heard that the N.I.D.D.K., a branch of the National Institutes of Health, was building up its mathematics laboratory to study obesity. At the time, I knew almost nothing of obesity.
I didn’t even know what a calorie was. I quickly read every scientific paper I could get my hands on.
I could see the facts on the epidemic were quite astounding. Between 1975 and 2005, the average weight of Americans had increased by about 20 pounds. Since the 1970s, the national obesity rate had jumped from around 20 percent to over 30 percent.
The interesting question posed to me when I was hired was, “Why is this happening?”
Why would mathematics have the answer?
Because to do this experimentally would take years. You could find out much more quickly if you did the math.
Now, prior to my coming on staff, the institute had hired a mathematical physiologist, Kevin Hall. Kevin developed a model that could predict how your body composition changed in response to what you ate. He created a math model of a human being and then plugged in all the variables — height, weight, food intake, exercise. The model could predict what a person will weigh, given their body size and what they take in.
However, the model was complicated: hundreds of equations. Kevin and I began working together to boil it down to one simple equation. That’s what applied mathematicians do. We make things simple. Once we had it, the slimmed-down equation proved to be a useful platform for answering a host of questions.
What new information did your equation render?
That the conventional wisdom of 3,500 calories less is what it takes to lose a pound of weight is wrong. The body changes as you lose. Interestingly, we also found that the fatter you get, the easier it is to gain weight. An extra 10 calories a day puts more weight onto an obese person than on a thinner one.
Also, there’s a time constant that’s an important factor in weight loss. That’s because if you reduce your caloric intake, after a while, your body reaches equilibrium. It actually takes about three years for a dieter to reach their new “steady state.” Our model predicts that if you eat 100 calories fewer a day, in three years you will, on average, lose 10 pounds — if you don’t cheat.
Another finding: Huge variations in your daily food intake will not cause variations in weight, as long as your average food intake over a year is about the same. This is because a person’s body will respond slowly to the food intake.
Did you ever solve the question posed to you when you were first hired — what caused the obesity epidemic?
We think so. And it’s something very simple, very obvious, something that few want to hear: The epidemic was caused by the overproduction of food in the United States.
Beginning in the 1970s, there was a change in national agricultural policy. Instead of the government paying farmers not to engage in full production, as was the practice, they were encouraged to grow as much food as they could. At the same time, technological changes and the “green revolution” made our farms much more productive. The price of food plummeted, while the number of calories available to the average American grew by about 1,000 a day.
Well, what do people do when there is extra food around? They eat it! This, of course, is a tremendously controversial idea. However, the model shows that increase in food more than explains the increase in weight.
In the 1950s, when I was growing up, people rarely ate out. Today, Americans dine out — with these large restaurant portions and oil-saturated foods — about five times a week.
Right. Society has changed a lot. With such a huge food supply, food marketing got better and restaurants got cheaper. The low cost of food fueled the growth of the fast-food industry. If food were expensive, you couldn’t have fast food.
People think that the epidemic has to be caused by genetics or that physical activity has gone down. Yet levels of physical activity have not really changed in the past 30 years. As for the genetic argument, yes, there are people who are genetically disposed to obesity, but if they live in societies where there isn’t a lot of food, they don’t get obese. For them, and for us, it’s supply that’s the issue.
Interestingly, we saw that Americans are wasting food at a progressively increasing rate. If Americans were to eat all the food that’s available, we’d be even more obese.
Any practical advice from your number crunching?
One of the things the numbers have shown us is that weight change, up or down, takes a very, very long time. All diets work. But the reaction time is really slow: on the order of a year.
People don’t wait long enough to see what they are going to stabilize at. So if you drop weight and return to your old eating habits, the time it takes to crawl back to your old weight is something like three years. To help people understand this better, we’ve posted an interactive version of our model at bwsimulator.niddk.nih.gov. People can plug in their information and learn how much they’ll need to reduce their intake and increase their activity to lose. It will also give them a rough sense of how much time it will take to reach the goal. Applied mathematics in action!
What can Americans do to stem the obesity epidemic?
One thing I have concluded, and this is just a personal view, is that we should stop marketing food to children. I think childhood obesity is a major problem. And when you’re obese, it’s not like we can suddenly cut your food off and you’ll go back to not being obese. You’ve been programmed to eat more. It’s a hardship to eat less. Michelle Obama’s initiative is helpful. And childhood obesity rates seem to be stabilizing in the developed world, at least. The obesity epidemic may have peaked because of the recession. It’s made food more expensive.
You said earlier that nobody wants to hear your message. Why?
I think the food industry doesn’t want to know it. And ordinary people don’t particularly want to hear this, either. It’s so easy for someone to go out and eat 6,000 calories a day. There’s no magic bullet on this. You simply have to cut calories and be vigilant for the rest of your life.
-
"What can Americans do to stem the obesity epidemic?"
"we should stop marketing food to children"
Good luck with that.
Look we would have to close 95% of the pizze places, Chinese restaurants, fast food joints, diners, restaurants, Chipoltes, KFC stop stocking supermarkets with every conceivable food from around the world, close all the bakeries, carvels on on and on and on.
There is no other way to do it than this or as I think the answer will only come from the pharmacuetical industry some day.
Yes we can promote weight loss, health and speak vegetables and go crazy legislating our diets and behavior.
That will have only marginal benefit and I don't want the "f" government telling me what to eat or not and how much walking I need to do with tax positive and negative reinforcing tax schemes.
That said I just lost 20 more pounds and am as thin as I was in high school.
Why? Because I know what I need to eat and what not to. And after years of working on it I finally figured out what works for me.
Most people don't have a clue. And the government won't help.
And BTW, I do very little exercise.
-
http://www.usatoday.com/news/opinion/forum/story/2012-05-15/women-contraception-abortion-reproductive-rights-doctors/54979766/1
-
Oh my God. Please don't start with a fat tax. There is no end to this crap. This ain't going to work Make 30 million people deal with this to stop 2700 heart attacks a year - even if true is crap. Liberalism is the biggest darn cancer:
Report: 'Fat Tax' Could Curb Nation's Obesity Problem
20 Percent Tax Would Be Placed On Unhealthy Foods
POSTED: 7:27 pm EDT May 17, 2012
UPDATED: 11:47 am EDT May 18, 2012
INDIANAPOLIS -- Health experts have been trying to combat obesity in America for years and have recently suggested a new way to solve the growing problem.
A new study suggests that imposing a fat tax on unhealthy food and drinks could help slim down expanding waistlines.
According to reports, more than 60 percent of Americans are overweight. Under the tax, a $4 cheeseburger would cost an extra 80 cents, RTV6's Stacia Matthews reported.
Some Hoosiers found the proposed fat tax hard to swallow.
"I don't think we should tax people and the way they run their lives,” one man said.
Others said a fat tax is palatable.
"I'd pay 20 percent. It's worth it,” one woman said. "I would eat a lot more healthy just to save more money.”
Researchers said a fat tax could drop obesity rates by 3.5 percent and prevent 2,700 heart-related deaths a year. The study also urged subsidies for healthier foods and veggies to make them more affordable.
Dr. Eric Wright, who heads the Department of Public Health at the Indiana University School of Medicine, said the fat tax falls right in line with other consumer products.
"We've applied tax to alcohol and tobacco and that has definitely shown through very many studies that it actually decreased use. So, the logic has been applied to fatty foods and preliminary evidence in Europe is that it’s very effective,” Wright said.
Researchers said Indiana spends $3.5 billion a year on obesity-related medical costs.
"The reality is, with two-thirds of the population being overweight or obese, that's what's driving up health care costs and you can either choose to pay now, or you can pay later,” Wright said.
Critics of the tax said people who choose to healthier foods should receive tax breaks and incentives. Copyright 2012 by TheIndyChannel.com All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
The following are comments from our users. Opinions expressed are neither created nor endorsed by TheIndyChannel.com. By posting a comment you agree to accept our Terms of Use. Comments are moderated by the community. To report an offensive or otherwise inappropriate comment, click the "Flag" link that appears beneath that comment. Comments that are flagged by a set number of users will be automatically removed.
Use my avatar from...
No avatar
My computer
My Google Profile
My Twitter Account
My FriendFeed Account
My Yahoo! Account
Gravatar email
LoginLogin with:
My Google Profile
My Twitter Account
My FriendFeed Account
My Yahoo! Account
My Blogger Account
My JS-Kit Account
My Haloscan Account
My OpenID
My Websites:
My Site (click to edit)
Login required, click here to beginShareShare with:
This Page
My Google Friends
My Twitter Followers
My FriendFeed Followers
My Yahoo! Friends
This Page
FollowLeave a comment@Controls
Echo 225 ItemsAdmin
Log In
Follow
Moderation
General Settings
Admin Notices
Get this for your site
Echo Blog
Echo on Twitter
Help
– David
PERSONIAL RESPONSIBILITY-whats that-NOT IN AMERICA-its everyones elses fault
Today, 12:50:25 PM– Flag – Like – Reply – Delete – Edit – Moderate HsiaLin Boy
Hey US government, stop trying to play God. You cannot say with a straight face that you "care" about anyones health while you allow alcohol to still be sold. Alcohol kills more people, both the users of and the victimized by..... than any other drug in the world. Just admit you are looking for yet another way to get your hands on peoples money.
Today, 12:50:04 PM– Flag – Like – Reply – Delete – Edit – Moderate Jack
The problem is that they will get used to the additional tax revenue and then not want the money flow to dry up if people stop eating the excessively taxed food items.
Today, 12:49:48 PM– Flag – Like – Reply – Delete – Edit – Moderate Nilo Cantonjos
...and the solution to another problem is imposing more taxes?
What about stop punishing the corporations and start focusing on PERSONAL RESPONSIBILITY?
To liberals... the solution is to always TAX. Kinda stupid if you ask me... but then again, the liberal's mind is so clouded with sin, they can't right. What is right is wrong to them and what is wrong is right to them.
Today, 12:48:38 PM– Flag – Like – Reply – Delete – Edit – Moderate Pat Kelsey
Come on November.
Today, 12:48:26 PM– Flag – Like – Reply – Delete – Edit – Moderate David
the sad thing is-thes so called smart folks-lie to the voters just to get into office-them once thr in they do whatever they want-then when we try to remove them-Senetor HERRIE WORTHLESS REID-they take the money stolen from us to payoff acorn and the union heads to put them bck n office-as a smoker-I DONT PAY THR STUPID TAXES-i save $25/carton by rolling my own-i dont have kids so y shld i pay for that SCHIP tax-heres an idea-IF ANY CITY OR STATES PASSES A FAT TAX,SMOKING TAX OR ANY OTHER STUPID TAX-THEY SHLD JUST MAKE AGAINST THE LAW TO SELL-THAT WLD SOLVE THE PROBLEM
Today, 12:46:31 PM– Flag – Like – Reply – Delete – Edit – Moderate Michael
People are not fat because they over eat or lack activity. Ok some people are. But studies show that the majority of Obese people don't over eat or are super lazy. It is WHAT they eat that causes them to gain weight. And no I am not talking about just fast food, which definitely is an issue. But the fact that anything you buy at the supermarket is in fact bad for you. Yes, anything! unless you are buying all non GMO food, and non fructose corn syrup food. Also, Americans eat way to much meat and dairy.
To tax obese people you are not going to change the problem, just earn money from it. The problem lies in the fact that the organizations that say what a healthy diet is are bought by the big food producers. Change your DIET don't buy processed food, cut back on dairy and meats, and of course exercise more often.
Today, 12:41:36 PM– Flag – Like – Reply – Delete – Edit – Moderate Britt Hall
If they really wanted to curb obesity they would start by limiting the items you can buy with food stamps. We now have more folks using food stamps than ever before and I challenge anyone to go to your grocery store and watch what is being bought with food stamps and then take a look at the size of the people buying it. These folks are buying pure crap called food all on the public dole. Again, don’t take my word on it.. go to your store and see for yourself. But, does anyone think any democrat would even suggest food stamp recipients should be limited in what they can buy with our tax dollars!
Today, 12:37:00 PM– Flag – Like – Reply – Delete – Edit – Moderate James Watson
The time to nip this kind of "thinking" in the bud was when the government started going after smokers. As a smoker, I have watched over the years as voters (many of them obese, junk food eaters) voted to raise my taxes supposedly for cancer research, though it was really just to feed the government beast.
Tell me now why I should come to the aid of junk food eaters?
"First they came for the (fill in the blank), but I remained silent, for I was not a (fill in the blank)...."
Today, 12:36:36 PM– Flag – Like – Reply – Delete – Edit – Moderate David
but if you vote rupublician you will get folks like Mrs.Snow out of Main-The sad thing is thr was a man running for the Presiden of the US who has spent his 35 yrs in congress fighting for the Constution of the United States of American and everyone put him down as a kookie old man-we need 565 Congressman Dr.Ron Pauls in D.C
Today, 12:34:49 PM– Flag – Like – Reply – Delete – Edit – Moderate T N McCoy
This is going to be a tax on the lower income groups, because they are the customers buying these things. Now, Obama is attacking the poor, the rich, the middle class, the US as a whole, and Western civilization. How much more can we take before Revolution occurs?
Today, 12:34:20 PM– Flag – Like – Reply – Delete – Edit – Moderate Jasonn
I am opposed to the NANNY STATE and the feds sticking their noses in my life. Stick to national defense and and infrastructure like highways and leave the rest of everyday living to the folks.
Today, 12:33:48 PM– Flag – Like – Reply – Delete – Edit – Moderate Michelle W
I need a Big Government Mommy and Daddy to shephard me thru life.
The Government is what we the sheeple demand.
Today, 12:32:54 PM– Flag – Like – Reply – Delete – Edit – Moderate H J
here come big brother again. its not enough to impose higher energy costs on all of us to drive our cars, heat and cool our homes etc, its not enough for big brother to limit my water flow in my shower or ability to flush the toilet properly. its not enough that i have to wait a good couple of minutes for my light bulbs to heat up enough to provide some glimmer of light. its not enough that just about everything i do is regulated or taxed by the government. food prices are already sky high and when i want to go get an occaisional cheeseburger, big brother wants to tax me more too? Geezus H. Kryst!!!!!!!!!!
Today, 12:31:38 PM– Flag – Like – Reply – Delete – Edit – Moderate meeee
Maybe we should all stay home and let the Government deliver our groceries
every week and tell us which day to eat certain things.
That way we will be in compliance with the idiotic things they come up with.
Today, 12:31:33 PM– Flag – Like – Reply – Delete – Edit – ModerateMore
Social Networking by Echo
Links We Like
Do you qualify for grants for school?
Return to school with a grant if you qualify. You may be losing up to $21,900 every year you don't go back to school. More Ready for Retirement?
Have a $500K portfolio? Ken Fisher, a 27-year Forbes columnist, has a retirement guide for you! More How to Grow Amazing Eyelashes
This is the best non-prescription eyelash enhancer on the market. More Shocking Discovery for Joint Relief
How you can alleviate joint pain in just 7 days. More Sponsored Links
Scripps TV Station Group ©
2012 The E.W. Scripps Co.Click here for the privacy policy, terms of use.
Microsoft MapPoint Terms of Use
Microsoft Privacy Statement
See All Internet Broadcasting Sites
Site Map
-
CCP; I agree with you we don't need another tax, I deplore tobacco taxes, but as an occasional smoker (cigars only) which is probably more healthy than obesity, I noticed that taxes do play a role in persuading people to quit. Demand is elastic; as the price goes up, less people smoke or they smoke fewer per day. Apply the same theory to fast food, it might work. If my Big Mac cost $10.00 I would think twice (I don't eat fast food) before ordering one. Then again, I am against sin taxes and social engineering.
As a side note, I sometimes get cantankerous in my old age. I was quietly smoking a cigar outside when a fat woman walked by and quite rudely and aggressively said with a sneer, "Do you have to smoke that cigar; don't you know it's bad for your health." I replied, "Do you have to be so fat; don't you know, it's bad for YOUR health." Not to mention my eyes. :-) Needless to say we did not continue the conversation. Frankly, I would be happier if people left each other alone. Let me smoke occasionally in peace outdoors and you can go to MacDonald's on a daily basis. And let's not tax either one of us.
-
"Frankly, I would be happier if people left each other alone. Let me smoke occasionally in peace outdoors and you can go to MacDonald's on a daily basis. And let's not tax either one of us."
I agree completely. Just give me my freedom and leave me alone.
That is why I am a Republican with a trend towards the Tea Party.
-
I don't recall ever seeing anything written about a maximum benefit or limit to exercise before. So for me this is interesting. It was hard to believe that triathalons, extreme endurance sports, etc are not damaging to the body in the long term. Just the wear and tear....:
Interstingly for weight loss/maintenance 60 to 90 minutes a day is recommneded although not at extreme intensities. Her at lest 60 minutes is recommended for children.
****Excess exercise 'hurts the heart' and cause dangerous long-term harm, say scientists
By Jenny Hope
PUBLISHED: 23:39 EST, 3 June 2012 | UPDATED: 23:39 EST, 3 June 2012
Comments (102) Share
Extreme exercise such as marathons may permanently damage the heart and trigger rhythm abnormalities, warn researchers.
They say the safe ‘upper limit’ for heart health is a maximum of an hour a day - after which there is little benefit to the individual.
A review of research evidence by US physicians says intensive training schedules and extreme endurance competitions can cause long-term harm to people’s hearts.
Damage: Excessive endurance exercise can do long-term harm to the cardiovascular system, U.S. scientists say
Activities such as marathons, iron man distance triathlons, and very long distance bicycle races may cause structural changes to the heart and large arteries, leading to lasting injury.
Lead author Dr James O’Keefe, of Saint Luke’s Hospital of Kansas City, said exercise was generally beneficial for health but could tip into becoming harmful when taken to excessive lengths.
More...Why do women keep making passes at me? The eco-warrior aristocrat hailed as the 'new lesbian face of Britain' reveals an intriguing modern trend - illicit advances from married women
'Thank you for saving me': Moment British hostage returned to safety after being kidnapped by Afghan insurgents
He said ‘Physical exercise, though not a drug, possesses many traits of a powerful pharmacologic agent.
A routine of daily physical activity can be highly effective for prevention and treatment of many diseases, including coronary heart disease, hypertension, heart failure, and obesity.
However, as with any pharmacologic agent, a safe upper dose limit potentially exists, beyond which the adverse effects of physical exercise, such as musculoskeletal trauma and cardiovascular stress, may outweigh its benefits.’
Dangers: Too much physical exercise can cause musculoskeletal trauma and cardiovascular stress
A review published in the medical journal Mayo Clinic Proceedings (must credit) looked at studies detailing the mechanisms, pathophysiology, and clinical manifestations of cardiovascular injury from excessive endurance exercise.
Dr O’Keefe and colleagues said research suggests that extreme endurance training can cause transient structural cardiovascular changes and elevations of cardiac biomarkers, all of which return to normal within one week.
But for some individuals, over months and years of repetitive injury, this process can lead to the development of patchy scarring of certain areas of the heart, and abnormal heart rhythms.
In one study, approximately 12 per cent of apparently healthy marathon runners showed evidence for patchy myocardial scarring, and the coronary heart disease event rate during a two-year follow up was significantly higher in marathon runners than in runners not doing marathons.
The review said it had been known that elite-level athletes commonly develop abnormal electrocardiogram readings.
However, studies now show that changes to the heart triggered by excessive exercise can lead to rhythm abnormalities.
Endurance sports such as ultramarathon running or professional cycling have been associated with as much as a five-fold increase in the prevalence of atrial fibrillation, or abnormal heart rhythms.
Chronic excessive sustained exercise may also be associated with other heart problems including artery wall stiffening.
Dr O’Keefe said lifelong vigorous exercisers generally have lower death and disability rates compared with non-exercisers, but it was becoming important to detect intense exercisers whose regime might put them at risk.
The phenomenon has been dubbed Phidippides cardiomyopathy - after the fatal heart damage suffered by the original marathon runner.
Suffering: Massive physical efforts like those delivered by professional cyclist can be harmful, scientists say
The young Greek messenger in 490BC died suddenly after running 175 miles in two days, with the last leg of 26.2 miles from Marathon to Athens.
His death was the first report of a sudden cardiac death of a long distance runner.
Dr O’Keefe stressed the review findings should not undermine the message that physical exercise was good for most people.
He said ‘Physically active people are much healthier than their sedentary counterparts. Exercise is one of the most important things you need to do on a daily basis.
‘But what this paper points out is that a lot of people do not understand that the lion’s share of health benefits accrue at a relatively modest level.
‘Extreme exercise is not really conducive to great cardiovascular health. Beyond 30-60 minutes per day, you reach a point of diminishing returns’ he added.
Government guidelines recommend adults take aerobic exercise five times a week for 30 minutes or more for maximum health benefits.
Children should have at least 60 minutes of moderate to vigorous exercise a day, including taking part in sports, brisk walking and running.
Aerobic exercise is achieved through sports such as jogging, running, cycling, tennis and swimming.
The level of aerobic exertion should be enough to raise the heart rate to 120 beats a minute or higher, which includes a brisk walk and swimming. But taking a stroll or even gardening is also regarded as healthy activity.
Read more: http://www.dailymail.co.uk/health/article-2154267/Excess-exercise-hurts-heart-cause-dangerous-long-term-harm-say-scientists.html#ixzz1wvzb2N9d****
-
Harvard epidemiologist Willet (been around for decades [like me :oops:] - I saw him give a lecture in West Palm Beach around 20 yrs ago) on sweeteners and health. One must remember epidemiology can show a relationshp but that is not necessariy causation and is usually only the first step in studying the relationship of different traits (at least in meidicine). As for my theory that Bloomberg's banning larger sodas is going to do nothing for slowing weight loss - Willet makes a case for Bloomberg here. I admit I had a patient come in just recently and tell me she lost weight and when I asked how - she replied she got rid of the sodas! :-o :|
http://well.blogs.nytimes.com/2012/06/11/which-sweetener-should-you-choose/
-
If Your Teeth Could Talk ...
The Mouth Offers Clues to Disorders and Disease; Dentists Could Play Larger Role in Patient Care
• By MELINDA BECK
The eyes may be the window to the soul, but the mouth provides an even better view of the body as a whole.
Some of the earliest signs of diabetes, cancer, pregnancy, immune disorders, hormone imbalances and drug issues show up in the gums, teeth and tongue—sometimes long before a patient knows anything is wrong.
WSJ 'Personal Journal' Senior Editor Melinda Beck explains that one's teeth and gums hold a lot of details about the body's overall health. Also, don't be fooled by a bright set of pearly whites. Tom Gannam/AP Images for Crest and Oral-B
There's also growing evidence that oral health problems, particularly gum disease, can harm a patient's general health as well, raising the risk of diabetes, heart disease, stroke, pneumonia and pregnancy complications.
"We have lots of data showing a direct correlation between inflammation in the mouth and inflammation in the body," says Anthony Iacopino, director of the International Centre for Oral-Systemic Health, which opened at the University of Manitoba Faculty of Dentistry in Canada in 2008. Recent studies also show that treating gum disease improves circulation, reduces inflammation and can even reduce the need for insulin in people with diabetes.
Such findings are fueling a push for dentists to play a greater role in patients' overall health. Some 20 million Americans—including 6% of children and 9% of adults—saw a dentist but not a doctor in 2008, according to a study in the American Journal of Public Health this month.
"It's an opportunity to tell a patient, 'You know, I'm concerned. I think you really need to see a primary care provider,' so you are moving in the direction of better health," says the study's lead researcher Shiela Strauss, co-director of statistics and data management for New York University's Colleges of Nursing and Dentistry.
George Kivowitz, a restorative dentist with offices in Manhattan and Newtown, Pa., says he has spotted seven cases of cancer in 32 years of practice, as well as cases of bulimia, due to the telltale erosion of enamel on the back of the upper front teeth, and methamphetamine addiction. "We call it 'meth mouth,' " he says. "The outer surface of teeth just rot in a way that's like nothing else."
Some of the most distinctive problems come from uncontrolled diabetes, Dr. Kivowitz adds. "The gum tissue has a glistening, shiny look where it meets the teeth. It bleeds easily and pulls away from the bone—and it's all throughout the mouth."
An estimated six million Americans have diabetes but don't know it—and several studies suggest that dentists could help alert them. A 2009 study from New York University found that 93% of people who have periodontal disease are at risk for diabetes, according to the criteria established by American Diabetes Association.
It's not just that the same lifestyle habits contribute to both gum disease and high blood sugar; the two conditions exacerbate each other, experts say. Inflammation from infected gums makes it more difficult for people with diabetes to control their blood-sugar level, and high blood sugar accelerates tooth decay and gum disease, creating more inflammation.
Diabetes also complicates dental-implant surgery, because it interferes with blood vessel formation and bone growth. "When you put a dental implant in, you rely on the healing process to cement it to the jaw, so you get a higher failure rate with diabetes," says Ed Marcus, a periodontist in Yardley, Pa., who teaches at the University of Pennsylvania and Temple University dental schools.
Dr. Marcus notes that about 50% of periodontal disease is genetic—and even young patients can have significant bone loss if they have an unusually high immune response to a small number of bacteria. Giving such patients a low dose of doxycycline daily can help modify the immune response. "It doesn't really control the bacteria, but it helps reduce the body's reaction," he says.
There's also growing evidence that the link between periodontal disease and cardiovascular problems isn't a coincidence either. Inflammation in the gums raises C-reactive protein, thought to be a culprit in heart disease.
"They've found oral bacteria in the plaques that block arteries. It's moved from a casual relationship to a risk factor," says Mark Wolff, chairman of the Department of Cariology and Comprehensive Care at NYU College of Dentistry.
Bacteria from the mouth can travel through the bloodstream and cause problems elsewhere, which is why people contemplating elective surgery are advised to have any needed dental work performed first.
The American Heart Association no longer recommends that people with mitral valve prolapse (in which heart values close abnormally between beats) routinely take antibiotics before dental procedures, since it's now believed that oral bacteria enter the bloodstream all the time, from routine washing, brushing and chewing food.
But the American Heart Association, the American Medical Association and the American Orthopedic Association all urge people who have had a full joint replacement to take an antibiotic one hour before any dental visit for the rest of their lives to reduce the risk of post-surgical infections. "I have my guidelines taped to the door in my hygienists' room," Dr. Kivowitz says.
Dentists say they also need to stay up to date with all medications, supplements and over-the-counter drugs their patients are taking. Blood thinners can create excess bleeding in the mouth. Bisphosphonates, often prescribed for osteoporosis, can severely weaken jaw bones. Both should be stopped temporarily before oral surgery.
Antihypertensive drugs, calcium-channel blockers and some anti-inflammatory drugs can cause painful ulcerations of the gums. Many medications, from antidepressants to chemotherapy drugs, cause dry mouth, which can cause cavities to skyrocket, since saliva typically acts as a protective coating for teeth. Additional fluoride treatments can help.
Some proactive dentists have glucose monitors for another check on blood-sugar levels if they suspect diabetes. Some also take patients' blood pressure and hold off on invasive procedures if it's extremely high.
The Centers for Disease Control and Prevention recommends that dentists offer HIV testing, because some of the first symptoms appear in the mouth, including fungal infections and lesions. Dentists can do the HIV test with a simple mouth swab and get results in 20 minutes.
Breaking the bad news is often more difficult. "I went into oral surgery because I didn't think I would have to deliver that kind of news to patients," says Clifford Salm, an oral and maxillofacial surgeon in Manhattan who has found leukemia, lymphoma, AIDS and metastatic breast cancer after performing biopsies on suspicious spots. "It can be a difficult conversation," he says, "but most patients are very grateful."
A gleaming, white smile is a sign of a healthy mouth, right? Not necessarily.
"Whiteness and the health of your teeth are totally unrelated," says Mark Wolff, an associate dean at New York University College of Dentistry.
In fact, many dentists worry that people who whiten their teeth may have a false sense of complacency, since their teeth can still be harboring tooth decay and serious gum disease.
Even people who have no cavities can still have inflamed and infected gums. It could be that their saliva is particularly protective of their tooth enamel, while their brushing and flossing habits, needed to keep gum tissues healthy, could be lax.
"I get these patients in their mid-30s who don't have cavities, so they haven't been to a dentist in 10 years. But they have full-blown periodontal disease," says George Kivowitz, a restorative dentist in Manhattan. "They are losing all the supporting structure, and I have to tell them that these gorgeous teeth will fall out of your head if we don't turn this around."
Using whitening products more often than recommended can erode some of the enamel and cause teeth to appear translucent. But whether that actually harms teeth is controversial. "No one has really shown that it's damaging, but no one knows the long-term results," says Dr. Marcus, the periodontist in Yardley, Pa.
Write to Melinda Beck at HealthJournal@wsj.com
-
second post
What’s Inside The Bun?
By WILLIAM NEUMAN
Published: July 1, 2011
If there is no such thing as a healthy hot dog, how do you limit the damage at this weekend’s weenie roast?
Don’t count on the label to help much. Those pricey “natural” and “organic”
hot dogs often contain just as much or more of the cancer-linked
preservatives nitrate and nitrite as that old-fashioned Oscar Mayer wiener.
And almost no one knows it because of arcane federal rules that make the
labels on natural and organic hot dogs, luncheon meats and bacon virtually
impossible to decipher when it comes to preservatives. That includes
products made from beef, pork, turkey and chicken.
“If you actually surveyed consumers going out of their way to buy no-nitrate
products, they’d be very surprised to learn that there’s plenty of nitrates
in there,” said Bruce Aidells, a chef and cookbook author. “It’s very
misleading.” In a role reversal, food manufacturers are now pushing the
federal government for more truthful labeling that would allow them to tell
consumers clearly that some products contain nitrate and nitrite, just from
natural rather than synthetic sources. The current rules bizarrely require
products that derive the preservatives from natural sources to prominently
place the words “Uncured” and “No nitrates or nitrites added” on the label
even though they are cured and do contain the chemicals.
“Nitrite is nitrite and consumers should be aware of what they’re eating,”
said Marji McCullough, director of nutritional epidemiology for the American
Cancer Society, which recommends that people reduce consumption of processed
meats because of studies that link them to colon cancer.
The United States Department of Agriculture says it is aware of the labeling
problem and may take a fresh look. “We feel strongly that labels should help
consumers make informed decisions and we are open to reviewing additional
information to enhance accuracy in labeling,” said a spokesman for the
department. Nitrate and nitrite have been used for centuries to cure meat,
giving products like hot dogs, bacon and ham their characteristic flavor and
color and killing the bacteria that causes botulism. Today, conventional
meat packers typically use a synthesized version known as sodium nitrite.
But companies that label their products natural or organic must use natural
sources of the preservatives. They usually employ celery powder or celery
juice, which are high in nitrate. A bacterial culture is used to convert
that to nitrite. The resulting chemicals are virtually identical to their
synthetic cousins. When the products are packaged, both conventional and
natural products contain residual amounts.
A study published earlier this year in The Journal of Food Protection found
that natural hot dogs had anywhere from one-half to 10 times the amount of
nitrite that conventional hot dogs contained. Natural bacon had from about a
third as much nitrite as a conventional brand to more than twice as much.
The current U.S.D.A. labeling rules require natural products to indicate
there may be naturally occurring nitrate or nitrite, but it often appears in
small print. When combined with the more prominently displayed “No nitrates
or nitrites added” banner, many consumers are left scratching their heads.
“The most consistent feedback we get is, ‘I don’t understand what that
means,’ ” said Linda Boardman, president of Applegate Farms, the leading
brand of natural and organic processed meats. “It’s confusing and it’s not
adding anything to the consumer decision-making process.”
Applegate and other natural companies have proposed alternate wording to the
U.S.D.A. in the past without success. They say they are confident their
products offer enough other benefits — all natural ingredients, meeting the
standards for the humane treatment of animals, for example — that it is best
to be upfront with consumers about the preservatives. Ms. Boardman said
tests showed the amount of nitrite and nitrate in Applegate products was
similar to conventional brands.
Consumer advocates agree the problem does not lie with the meat companies.
“We see the problem lying squarely with U.S.D.A.,” said Urvashi Rangan,
technical policy director of Consumers Union.
Since the 1970s, concerns about the health effects of nitrate and nitrite
have focused on the potential for nitrite to combine with meat protein to
form carcinogenic substances called nitrosamines.
The U.S.D.A. responded by limiting the amount of nitrate and nitrite that
goes into processed meats, and today they contain far less than they did 40
years ago.
But since the health concerns first emerged, scientists have gained more
understanding of the role of nitrate and nitrite in human health and have
discovered the preservatives also have benefits, for example, in the healthy
functioning of the cardiovascular and immune systems.
Some in the meat industry have seized on these discoveries to dismiss as
outdated the link between nitrite in processed meat and cancer. They insist
processed meats are safe.
But many scientists say the evidence of health risks remains persuasive.
While the occasional hot dog or piece of bacon is probably O.K., they point
out that high levels of salt and saturated fat in processed meats also
contribute to health problems.
“What’s very clear is that consuming processed meats is related to higher
risk of diabetes, heart attacks and colon cancer,” said Dr. Walter C.
Willet, chairman of the nutrition department of the Harvard School of Public
Health. “If you tweak the cured meat a little bit like some of these new
products, that’s no guarantee that’s going to make it any better.”
And that weekend weenie roast? George L. Siemon , the chief executive of
Organic Prairie, an organic meat processor, said that when he tried selling
meats with no nitrates from any source, they didn’t taste the same and no
one wanted them.
“We tried the non-anything,” he said. “It just didn’t work for the
customer.”
-
Studying How Body Rhythms Help Diagnose Diseases
By SHIRLEY S. WANG.
In an effort to develop new ways of diagnosing and treating diseases, scientists are increasingly tracking the various patterns by which the body senses and reacts to stimuli.
Such patterns, commonly referred to as body rhythms, are a constant dynamic. A foot senses a crack in the sidewalk and the brain instructs the muscles to compensate so the person doesn't fall down. Within the body, when cells detect too much carbon dioxide, the lungs respond by taking a breath. To get the right response, neurons, or nerve cells, communicate by emitting electrical impulses that are picked up by other neurons.
Researchers are finding that measuring these electrical impulses can reveal the presence of disease. Recent studies have shown that children with autism have significantly different brain-wave patterns than children without the disorder. Other studies have found that brain waves in people with epilepsy behave differently shortly before a seizure.
James Collins, a researcher at Harvard University's Wyss Institute for Biologically Inspired Engineering, in Boston, has been investigating what he calls balance-control rhythms to understand why people are less steady on their feet as they get older and what can be done to correct that.
The growing emphasis on understanding how the body's dynamics change over time contrasts with more common diagnostic techniques, including monitoring chemicals in the body such as blood sugar and cholesterol or looking for abnormalities in brain structures. Such traditional methods may offer only limited information by providing just a snapshot at one point in time. Recent, computer-based analytical tools are also making it easier to sift through the highly complex data captured from body-rhythm monitoring.
Dr. Collins, using sensory floor devices, has been exploring the many little ways that young and old people adjust their body position and weight distribution to maintain balance as they stand or walk. The body is constantly sensing the changing environment and telling us to compensate so that we stay on track and don't topple over. Without this corrective ability, humans would be inherently unstable, "like pencils standing on end," says Dr. Collins, who is also a professor of biomedical engineering at Boston University.
As people age, the mechanisms for sensing the ground under their feet erode, and the body is no longer as good at shifting its weight and correcting a step when it needs to, which is a big reason why the elderly have more difficulty balancing, says Dr. Collins. Poorer balance raises the risk of falling.
Keeping Time
The body's physiological rhythms work on different time scales and often interact with each other. A rhythm that has gone awry can indicate the presence of disease. Here are some examples:
• Circadian rhythm—The body's 24-hour cycle is associated with many important biological functions, including sleep and body weight. Studies in animals also have linked it to fertility.
• Ultradian rhythm—These are cycles that occur multiple times in a day and can involve various parts of the body, including cardiovascular, respiratory and hormonal systems.
• Cellular rhythms—These biochemical rhythms oscillate throughout the day, prompting electrically excitable cells like neurons to activate and rest. Varying calcium levels, for example, can affect cells' physiological responses, including muscle contraction.
Source: WSJ reporting
.Dr. Collins and his colleagues have been experimenting with ways to help older people improve their balance. The solution they have been testing seems counterintuitive: Adding more fluctuations beneath the foot for the body to detect can enhance balance-control rhythms.
When the body has to deal with more random vibrations when someone is standing, it appears to enhance the body's ability to detect the signals that help with balance, according to Dr. Collins's research.
The scientists tested their hypothesis by creating special shoe inserts—gel-like insoles with embedded chips that cause random vibrations that are too subtle to be noticed. The idea is to sensitize people's ability to detect movement so they can better recognize real fluctuations on the ground.
In one study, balance was measured in 12 older people with a mean age of 73 and 15 young people, mean age of 20. When outfitted with the vibrating insoles, the older people's balance improved relative to that of the younger participants. The study was published in the Lancet in 2003.
Dr. Collins says he also has found similar improvements in balance-control rhythms in tests using the vibrating insoles with small numbers of elderly diabetic patients whose disease had led to nerve damage in the feet. That research was published in the Annals of Neurology in 2006.
A shoe-insert prototype is currently in clinical-trial testing, and the research team plans to file for Food and Drug Administration approval as a medical device in coming months, Dr. Collins says.
Researchers also are studying other rhythms in the brain to understand a variety of diseases, including epilepsy, autism, schizophrenia and dementia.
Frank Duffy, director of developmental neurobiology at Boston Children's Hospital, in June published a study online in BMC Medicine showing that kids with autism have distinguishable brain patterns.
Dr. Duffy and colleagues measured electrical brain-wave activity in 430 children with characteristic symptoms of autism, such as social-skill deficits and communication problems, and in 540 other children without apparent autism. The children, who didn't engage in any prescribed activity, each wore a cap with 32 electrodes attached to measure 16 different wave frequencies.
The differences in connectivity between the two groups' brain waves were significant, especially in the region of the brain responsible for language, which could have potential for help with diagnosis. When the researchers used the differences to predict which of the children had an autism diagnosis and which didn't, they were able to do so with 90% accuracy. Although the patterns need further study, Dr. Duffy says the technique appears to establish a physiological benchmark for autism.
Mark Cunningham, a faculty member in neural dynamics at Newcastle University in the U.K., has studied brain rhythms with the aim of predicting seizures in people with epilepsy. In a study published online in Epilepsia in June, Dr. Cunningham and colleagues examined direct electrical activity in patients' brains through electrodes that had previously been implanted for treatment purposes. The researchers noticed one type of wave, known as glissandi, with a unique pattern prior to a seizure. Unlike most brain waves, which move more slowly over time, the glissandi started moving faster. The researchers suggest that glissandi could someday be a target for treating epilepsy.
Write to Shirley S. Wang at shirley.wang@wsj.com
-
My dad died of leukemia, so this is of particular interest to me:
In Treatment for Leukemia, Glimpses of the Future
•
ST. LOUIS — Genetics researchers at Washington University, one of the world’s leading centers for work on the human genome, were devastated. Dr. Lukas Wartman, a young, talented and beloved colleague, had the very cancer he had devoted his career to studying. He was deteriorating fast. No known treatment could save him. And no one, to their knowledge, had ever investigated the complete genetic makeup of a cancer like his.
So one day last July, Dr. Timothy Ley, associate director of the university’s genome institute, summoned his team. Why not throw everything we have at seeing if we can find a rogue gene spurring Dr. Wartman’s cancer, adult acute lymphoblastic leukemia, he asked? “It’s now or never,” he recalled telling them. “We will only get one shot.”
Dr. Ley’s team tried a type of analysis that they had never done before. They fully sequenced the genes of both his cancer cells and healthy cells for comparison, and at the same time analyzed his RNA, a close chemical cousin to DNA, for clues to what his genes were doing.
The researchers on the project put other work aside for weeks, running one of the university’s 26 sequencing machines and supercomputer around the clock. And they found a culprit — a normal gene that was in overdrive, churning out huge amounts of a protein that appeared to be spurring the cancer’s growth.
Even better, there was a promising new drug that might shut down the malfunctioning gene — a drug that had been tested and approved only for advanced kidney cancer. Dr. Wartman became the first person ever to take it for leukemia.
And now, against all odds, his cancer is in remission and has been since last fall.
While no one can say that Dr. Wartman is cured, after facing certain death last fall, he is alive and doing well. Dr. Wartman is a pioneer in a new approach to stopping cancer. What is important, medical researchers say, is the genes that drive a cancer, not the tissue or organ — liver or brain, bone marrow, blood or colon — where the cancer originates.
One woman’s breast cancer may have different genetic drivers from another woman’s and, in fact, may have more in common with prostate cancer in a man or another patient’s lung cancer.
Under this new approach, researchers expect that treatment will be tailored to an individual tumor’s mutations, with drugs, eventually, that hit several key aberrant genes at once. The cocktails of medicines would be analogous to H.I.V. treatment, which uses several different drugs at once to strike the virus in a number of critical areas.
Researchers differ about how soon the method, known as whole genome sequencing, will be generally available and paid for by insurance — estimates range from a few years to a decade or so. But they believe that it has enormous promise, though it has not yet cured anyone.
With a steep drop in the costs of sequencing and an explosion of research on genes, medical experts expect that genetic analyses of cancers will become routine. Just as pathologists do blood cultures to decide which antibiotics will stop a patient’s bacterial infection, so will genome sequencing determine which drugs might stop a cancer.
“Until you know what is driving a patient’s cancer, you really don’t have any chance of getting it right,” Dr. Ley said. “For the past 40 years, we have been sending generals into battle without a map of the battlefield. What we are doing now is building the map.”
Large drug companies and small biotechs are jumping in, starting to test drugs that attack a gene rather than a tumor type.
Leading cancer researchers are starting companies to find genes that might be causing an individual’s cancer to grow, to analyze genetic data and to find and test new drugs directed against these genetic targets. Leading venture capital firms are involved.
For now, whole genome sequencing is in its infancy and dauntingly complex. The gene sequences are only the start — they come in billions of small pieces, like a huge jigsaw puzzle. The arduous job is to figure out which mutations are important, a task that requires skill, experience and instincts.
So far, most who have chosen this path are wealthy and well connected. When Steve Jobs had exhausted other options to combat pancreatic cancer, he consulted doctors who coordinated his genetic sequencing and analysis. It cost him $100,000, according to his biographer. The writer Christopher Hitchens went to the head of the National Institutes of Health, Dr. Francis Collins, who advised him on where to get a genetic analysis of his esophageal cancer.
Harvard Medical School expects eventually to offer whole genome sequencing to help cancer patients identify treatments, said Heidi L. Rehm, who heads the molecular medicine laboratory at Harvard’s Partners Healthcare Center for Personalized Genetic Medicine. But later this year, Partners will take a more modest step, offering whole genome sequencing to patients with a suspected hereditary disorder in hopes of identifying mutations that might be causing the disease.
Whole genome sequencing of the type that Dr. Wartman had, Dr. Rehm added, “is a whole other level of complexity.”
Dr. Wartman was included by his colleagues in a research study, and his genetic analysis was paid for by the university and research grants. Such opportunities are not available to most patients, but Dr. Ley noted that the group had done such an analysis for another patient the year before and that no patients were being neglected because of the urgent work to figure out Dr. Wartman’s cancer.
“The precedent for moving quickly on a sample to make a key decision was already established,” Dr. Ley said.
In Treatment for Leukemia, Glimpses of the Future
•
(Page 2 of 3)
Ethicists ask whether those with money and connections should have options far out of reach for most patients before such treatments become a normal part of medicine. And will people of more limited means be tempted to bankrupt their families in pursuit of a cure at the far edges?
“If we say we need research because this is a new idea, then why is it that rich people can even access it?” asked Wylie Burke, professor and chairwoman of the department of bioethics at the University of Washington. The saving grace, she said, is that the method will become available to all if it works.
A Life in Medicine
It was pure happenstance that landed Dr. Wartman in a university at the forefront of cancer research. He grew up in small-town Indiana, aspiring to be a veterinarian like his grandfather. But in college, he worked summers in hospitals and became fascinated by cancer. He enrolled in medical school at Washington University in St. Louis, where he was drawn to research on genetic changes that occur in cancers of the blood. Dr. Wartman knew then what he wanted to do — become a physician researcher.
Those plans fell apart in the winter of 2002, his last year of medical school, when he went to California to be interviewed for a residency program at Stanford. On the morning of his visit, he was nearly paralyzed by an overwhelming fatigue.
“I could not get out of bed for an interview that was the most important of my life,” Dr. Wartman recalled. Somehow, he forced himself to drive to Palo Alto in a drenching rain. He rallied enough to get through the day.
When he returned to St. Louis, he gave up running, too exhausted for the sport he loved. He started having night sweats.
“I thought it might be mono,” he said. “And I thought I would ride it out.”
But then the long bones in his legs began to hurt. He was having fevers.
He was so young then — only 25 — and had always been so healthy that his only doctor was a pediatrician. So he went to an urgent care center in February 2003. The doctor there thought his symptoms might come from depression, but noticed that his red and white blood cell counts were low. And Lukas Wartman, who had been fascinated by the biology of leukemia, began to suspect he had it.
“I was definitely scared,” he said. “It was so unreal.”
The next day, Mr. Wartman, who was about to graduate from Washington University’s medical school, went back there for more tests. A doctor slid a long needle into his hip bone and drew out marrow for analysis.
“We looked at the slide together,” Dr. Wartman said, recalling that terrible time. “It was packed with leukemia cells. I was in a state of shock.”
Dr. Wartman remained at the university for his residency and treatment: nine months of intensive chemotherapy, followed by 15 months of maintenance chemotherapy. Five years passed when the cancer seemed to be gone. But then it came back. Next came the most risky remedy — intensive chemotherapy to put the cancer into remission followed by a bone-marrow transplant from his younger brother.
Seven months after the transplant, feeling much stronger, he went to a major cancer meeting and sat in on a session on his type of leukemia. The speaker, a renowned researcher, reported that only 4 or 5 percent of those who relapsed survived.
“My stomach turned,” Dr. Wartman said. “I will never forget the shock of hearing that number.”
But his personal gauge of recovery — how far he could run — was encouraging.
By last spring, three years after his transplant, Dr. Wartman was running six to seven miles every other day and feeling good. “I thought maybe I would run a half marathon in the fall.”
Then the cancer came back. He remembered that number, 4 or 5 percent, for patients with one relapse. He had relapsed a second time.
This time, he said, “There is no number.”
His doctors put him on a clinical trial to try to beat the cancer with chemotherapy and hormones. It did not work.
They infused him with his brother’s healthy marrow cells, to no avail.
A Clue in RNA
Dr. Wartman’s doctors realized then that their last best hope for saving him was to use all the genetic know-how and technology at their disposal.
In Treatment for Leukemia, Glimpses of the Future
•
(Page 3 of 3)
After their month of frantic work to beat cancer’s relentless clock, the group, led by Richard Wilson and Elaine Mardis, directors of the university’s genome institute, had the data. It was Aug. 31.
The cancer’s DNA had, as expected, many mutations, but there was nothing to be done about them. There were no drugs to attack them.
But the other analysis, of the cancer’s RNA, was different. There was something there, something unexpected.
The RNA sequencing showed that a normal gene, FLT3, was wildly active in the leukemia cells. Its normal role is to make cells grow and proliferate. An overactive FLT3 gene might be making Dr. Wartman’s cancer cells multiply so quickly.
Even better, there was a drug, sunitinib or Sutent, approved for treating advanced kidney cancer, that inhibits FLT3.
But it costs $330 a day, and Dr. Wartman’s insurance company would not pay for it. He appealed twice to his insurer and lost both times.
He also pleaded with the drug’s maker, Pfizer, to give him the drug under its compassionate use program, explaining that his entire salary was only enough to pay for 7 ½ months of Sutent. But Pfizer turned him down too.
As September went by, Dr. Wartman was getting panicky.
“Every day is a roller coaster,” he said at the time, “and everything is up in the air.”
Desperate to try the drug, he scraped up the money to buy a week’s worth and began taking it on Sept. 16. Within days, his blood counts were looking more normal.
But over dinner at a trendy St. Louis restaurant, he picked at his chicken and said he was afraid to hope.
“Obviously it’s exciting,” he said. “But Sutent could have unanticipated effects on my bone marrow.” Maybe his rising red blood cell counts were just a side effect of the drug. Or maybe they were just a coincidence.
“It’s hard to say if I feel any different,” Dr. Wartman said.
And the cost of the drug nagged at him. If it worked, how long could he afford to keep taking it?
The next day, a nurse at the hospital pharmacy called with what seemed miraculous news: a month’s supply of Sutent was waiting for Dr. Wartman. He did not know at the time, but the doctors in his division had pitched in to buy the drug.
Two weeks later, his bone marrow, which had been full of leukemia cells, was clean, a biopsy showed.
Still, he was nervous. The test involved taking out just a small amount of marrow. Cancer cells could be lurking unseen.
The next test was flow cytometry, which used antibodies to label cancer cells. Again, there were no cancer cells.
But even flow cytometry could be misleading, Dr. Wartman told himself.
Finally, a yet more sensitive test, called FISH, was done. It labels cancer cells with fluorescent pieces of DNA to identify leukemia cells. Once again, there were none.
“I can’t believe it,” his awe-struck physician, Dr. John DiPersio, told him.
Dr. Wartman, alone in his apartment, waited for his partner, Damon Berardi, to come home from work. That evening, Mr. Berardi, a 31-year-old store manager, opened the door with no idea of Dr. Wartman’s momentous news. To his surprise, Dr. Wartman was home early, waiting in the kitchen with champagne and two flutes he had given Mr. Berardi for Christmas. He told Mr. Berardi he should sit down.
“My leukemia is in remission,” he said. The men embraced exultantly, and Dr. Wartman popped open the champagne.
“I felt an overwhelming sense of relief and a renewed vision of our future together,” Mr. Berardi said. “There were no tears at that moment. We had both had cried plenty. This was a moment of hope.”
Hunches and Decisions
Dr. Wartman and his doctors had fateful decisions to make, with nothing but hunches to guide them. Should he keep taking Sutent or have another bone-marrow transplant now that he was in remission again?
In the end, Dr. DiPersio decided Dr. Wartman should have the transplant because without it the cancer might mutate and escape the Sutent.
Meanwhile, Pfizer had decided to give him the drug. Dr. Wartman has no idea why. Perhaps the company was swayed by an impassioned plea from his nurse practitioner, Stephanie Bauer.
Dr. Wartman’s cancer is still gone, for now, but he has struggled with a common complication of bone-marrow transplants, in which the white blood cells of the transplanted marrow attack his cells as though they were foreign. He has had rashes and felt ill. But these complications are gradually lessening, and he is back at work in Dr. Ley’s lab.
His colleagues want to look for the same mutation in the cancer cells of other patients with his cancer. And they would like to start a clinical trial testing Sutent to discover whether the drug can help others with leukemia, or whether the solution they found was unique to Lukas Wartman.
Dr. Wartman himself is left with nagging uncertainties. He knows how lucky he is, but what does the future hold? Can he plan a life? Is he cured?
“It’s a hard feeling to describe,” he said. “I am in uncharted waters.”
Monday: Promise and heartbreak.
-
A Cancer Treatment's Tantalizing Promise Brings Heartbreaking Swings
In the second article of her three-part series, Gina Kolata of The New York Times tells the story of one family’s quest to save the life of a beloved mother and wife, Beth McDaniel, who was fighting a rare form of cancer. Her son Timothy, a molecular biologist, led the drive to get the genes of his mother’s cancer and healthy cells sequenced and analyzed. Scientists identified a gene aberration that led to a unique medical treatment. It seemed to stop the cancer cold, but all too soon the disease came roaring back.
Mrs. McDaniel’s experience offers a sobering look at the challenges of using an approach still very much in its infancy.
Read More:
http://www.nytimes.com/2012/07/09/health/new-frontiers-of-cancer-treatment-bring-breathtaking-swings.html?emc=na
-
Part three
http://www.nytimes.com/2012/07/09/health/new-frontiers-of-cancer-treatment-bring-breathtaking-swings.html?nl=todaysheadlines&emc=edit_th_20120709
-
Simply extraordinary:
A First: Organs Tailor-Made With Body’s Own Cells
STOCKHOLM — Andemariam Beyene sat by the hospital window, the low Arctic sun on his face, and talked about the time he thought he would die.
Two and a half years ago doctors in Iceland, where Mr. Beyene was studying to be an engineer, discovered a golf-ball-size tumor growing into his windpipe. Despite surgery and radiation, it kept growing. In the spring of 2011, when Mr. Beyene came to Sweden to see another doctor, he was practically out of options. “I was almost dead,” he said. “There was suffering. A lot of suffering.”
But the doctor, Paolo Macchiarini, at the Karolinska Institute here, had a radical idea. He wanted to make Mr. Beyene a new windpipe, out of plastic and his own cells.
Implanting such a “bioartificial” organ would be a first-of-its-kind procedure for the field of regenerative medicine, which for decades has been promising a future of ready-made replacement organs — livers, kidneys, even hearts — built in the laboratory.
For the most part that future has remained a science-fiction fantasy. Now, however, researchers like Dr. Macchiarini are building organs with a different approach, using the body’s cells and letting the body itself do most of the work.
“The human body is so beautiful, I’m convinced we must use it in the most proper way,” said Dr. Macchiarini, a surgeon who runs a laboratory that is a leader in the field, also called tissue engineering.
So far, only a few organs have been made and transplanted, and they are relatively simple, hollow ones — like bladders and Mr. Beyene’s windpipe, which was implanted in June 2011. But scientists around the world are using similar techniques with the goal of building more complex organs. At Wake Forest University in North Carolina, for example, where the bladders were developed, researchers are working on kidneys, livers and more. Labs in China and the Netherlands are among many working on blood vessels.
The work of these new body builders is far different from the efforts that produced artificial hearts decades ago. Those devices, which are still used temporarily by some patients awaiting transplants, are sophisticated machines, but in the end they are only that: machines.
Tissue engineers aim to produce something that is more human. They want to make organs with the cells, blood vessels and nerves to become a living, functioning part of the body. Some, like Dr. Macchiarini, want to go even further — to harness the body’s repair mechanisms so that it can remake a damaged organ on its own.
Researchers are making use of advances in knowledge of stem cells, basic cells that can be transformed into types that are specific to tissues like liver or lung. They are learning more about what they call scaffolds, compounds that act like mortar to hold cells in their proper place and that also play a major role in how cells are recruited for tissue repair.
Tissue engineers caution that the work they are doing is experimental and costly, and that the creation of complex organs is still a long way off. But they are increasingly optimistic about the possibilities.
“Over 27 years, I’ve become more convinced that this is doable,” said Dr. Joseph P. Vacanti, a director of the Laboratory for Tissue Engineering and Organ Fabrication at Massachusetts General Hospital and a pioneer in the field.
In Mr. Beyene’s case, an exact copy of his windpipe was made from a porous, fibrous plastic, which was then seeded with stem cells harvested from his bone marrow. After just a day and a half in a bioreactor — a kind of incubator in which the windpipe was spun, rotisserie-style, in a nutrient solution — the implant was stitched into Mr. Beyene, replacing his cancerous windpipe.
It was such a seemingly wild scheme that Mr. Beyene had his doubts when Dr. Macchiarini first proposed it.
“I told him, I prefer to live three years and then die,” he said. “I almost refused. It had only been done in pigs. But he convinced me in a very scientific way.”
Now, 15 months after the operation, Mr. Beyene, 39, who is from Eritrea, is tumor-free and breathing normally. He is back in Iceland with his wife and two small children, including a 1-year-old boy whom he had thought he would never get to know. In Stockholm earlier this year for a follow-up visit, he showed the long vertical scar on his chest and spoke quietly in English, the raspiness of his voice a leftover from radiation therapy.
His strength was improving every day, he said, and he could even run a little.
“Things are good,” Mr. Beyene said. “Life is much better.”
Imitating Nature
To make an organ, it helps to know how nature does it.
That is why Philipp Jungebluth, a researcher in Dr. Macchiarini’s lab, had mounted a heart and a pair of lungs inside a glass jar on a workbench and connected them by tubing to another jar containing a detergent-like liquid. The organs, fresh from a sacrificed rat, had slowly turned pale as the detergent dripped through and out of them, carrying away their living cells. After three days the cells were gone, leaving a glistening mass that retained the basic shape of the organs.
Page 2 of 3)
These were the heart and lungs’ natural scaffolds, or extracellular matrix — intricate three-dimensional webs of fibrous proteins and other compounds that keep the various kinds of cells in their proper positions and help them communicate.
Labs around the world are now experimenting with scaffolds. In some cases the goal is to use the natural scaffolds themselves to build new organs — to take a donor lung, for example, strip all its cells and reseed it with a patient’s own cells. Why not use what nature has perfected, this line of thinking goes, rather than try to replicate it in a synthetic scaffold?
Dr. Macchiarini and his team tried this beginning in 2008, successfully implanting reseeded windpipes from cadavers in about a dozen patients, most of whom are now living normal lives. Because the donor’s own cells are removed, this approach all but eliminates a major problem of transplants: the risk that foreign tissue will be rejected by the recipient. But it does not solve several other problems that may be just as troublesome. A donated windpipe may not be the right size; it has to be stripped of its cells and reseeded while the recipient waits; and the procedure still requires donor organs, which are in short supply.
So for Mr. Beyene, the decision was made to produce a scaffold out of plastic. But all the work with natural windpipes proved useful. “We learned so much, starting from zero,” Dr. Macchiarini said. “We could have never done the artificial transplant without the past experience.”
Made to Order
Mr. Beyene’s synthetic scaffold was fabricated by scientists at University College London, using scans of his natural windpipe as a template. It was an exquisite piece of polymer engineering, tailor-made to fit his chest.
But it was still just a lifeless piece of porous plastic. To become a working organ, the tiny spaces in the plastic needed to be filled with cells that would eventually function together as tissue. Not just any cells would do; Dr. Macchiarini and his team would start with stem cells.
To ensure that the organ would not be rejected, the cells had to come from Mr. Beyene himself, which also bypasses the kind of ethical issues that have arisen over the use of embryonic stem cells. Mr. Beyene’s stem cells were obtained from his bone marrow. The cells were placed in nutrient solution and then dripped by pipette over the scaffold. It was like basting a turkey.
Human stem cells are part of the body’s system for building and repairing itself. They begin as a blank slate, but are able to become specialized cells specific to particular tissues or organs like the windpipe. In recent years, scientists have made great advances in understanding how stem cells can differentiate in this way.
The Stockholm team was hoping that with the help of stem-cell-stimulating drugs, the marrow cells placed on the windpipe would start to become the right kinds of cells on both the inside and outside of the organ. But Dr. Macchiarini does not think the process worked quite as planned. “I’m convinced that the cells we are putting in the bioreactor after two or three days are gone,” he said. But as they die they release chemicals that signal the body to send more stem cells from the bone marrow through the bloodstream to the site, aiding the regenerative process.
Or at least that is what Dr. Macchiarini thinks happened. “We are far away from understanding this process,” he said. “Far, far away.”
‘If It Bleeds, It Lives’
If you cannot cough, you’re dead.
That sums up one of the important functions of the windpipe: keeping bacteria and other particles in the air out of the lungs, where they could cause potentially fatal infections. A normal windpipe is lined with specialized cells, including some that produce mucus that can trap the particles. Coughing then brings the mucus up and out.
Page 3 of 3)
So one test of a tissue-engineered windpipe is whether it contains these specialized cells. In Dr. Macchiarini’s earlier work involving donor windpipes, he had seeded the inside with similar cells taken from the recipient’s nose. But with Mr. Beyene, Dr. Macchiarini was counting on stem cells to differentiate into these other kinds of cells, generating a lining for the windpipe.
In November, five months after the surgery, Mr. Beyene’s windpipe was found to be partly lined with the specialized cells. And in the later follow-up visit, Dr. Macchiarini noted that the lining was still thriving, with no sign of infection. “And he is able to cough,” Dr. Macchiarini said.
If the cells are surviving, that means the windpipe is developing a complex network of tiny blood vessels through the same regenerative process that produced the specialized cells. All tissues must have such a network so that every cell can get oxygen and nutrients. But developing one — or ensuring that one develops — is an enormous challenge for tissue engineers.
“From the beginning, our view was that the principal barrier to this was going to be the blood supply,” said Dr. Vacanti, whose laboratory has long worked on developing a tissue-engineered liver, among other organs.
Mr. Beyene’s doctors had one way to be certain that his windpipe was developing a blood vessel network. As part of their follow-up exam, they purposely injured the internal lining slightly.
“If it bleeds, it lives,” Dr. Macchiarini said.
Mr. Beyene’s windpipe bled.
A Quest Continues
Mr. Beyene hopes to return someday to Eritrea and work as a geothermal engineer. But for now he remains in Iceland, to be close to Stockholm for regular follow-up visits.
The windpipe contains only his own cells, so he does not need to take drugs to suppress his immune system to ward off rejection. But the synthetic scaffold, like any foreign material, caused the body to produce scar tissue, which had to be removed. While that is no longer a problem, Mr. Beyene does not know when, or if, he will be able to return home. “They have to say, ‘Things are perfect; you don’t need any more care,’ ” he said.
“Nobody knows. This is the first case.”
Last November, five months after Mr. Beyene’s surgery, Dr. Macchiarini implanted a bioartificial windpipe in another cancer patient, Christopher Lyles. He used an improved plastic scaffold, made up of even smaller fibers for the cells to be embedded in. Mr. Lyles returned home to Maryland in January but died in March. The family did not release the cause of death, but Dr. Macchiarini said that the implant had been functioning well.
Despite that setback, in June Dr. Macchiarini performed similar operations on two patients in Russia. Both have been discharged from the hospital and are doing well, he said.
Dr. Macchiarini is planning even more operations. But there needs to be a less complex and cumbersome solution, he said, beyond procedures that can cost up to half a million dollars.
Because the need for this kind of work is potentially so enormous, “we cannot pretend that we can reseed with the specific cells outside the body,” he said. Instead, he envisions developing even better scaffolds and implanting them without cells, relying on drugs to stimulate the body to send cells to the site.
His ultimate dream is to eliminate even the synthetic scaffold. Instead, drugs would enable the body to rebuild its own scaffold.
“Don’t touch the patient,” Dr. Macchiarini said. “Just use his body to recreate his own organ. It would be fantastic.”
Monday: Using animal scaffolding to get human tissue growing.
-
By Dana Sullivan Kilroy
October 6, 2012
A fascinating, if disconcerting, fact: More than 100 trillion so-called good bacteria thrive in or on the human body. A sizable chunk of them maintain residence in the human digestive tract. Probiotics, live microorganisms that benefit their human host, are among these beneficial bacteria.
Probiotics are also found in foods and supplements, and when consumed they change how the immune system responds to "bad" bacteria.
"Probiotics seem to enhance the intestinal flora and promote a healthier gut environment," says Jeannie Gazzaniga-Moloo, a registered dietitian in Sacramento and a spokeswoman for the Academy of Nutrition and Dietetics. Scientists don't know exactly how probiotics work, but they may also produce anti-microbial substances that destroy harmful microorganisms and stimulate an immune response.
Even though probiotics-infused foods may seem like a modern phenomenon, the idea that consuming living microorganisms could improve health was introduced more than 100 years ago. That's when Elie Metchnikoff, a Nobel-winning scientist, proposed the idea in his book, "The Prolongation of Life: Optimistic Studies."
"Certain dairy products, especially yogurt, contain probiotics naturally," Gazzaniga-Moloo adds, but more recently probiotics have been added to juice, cereal, cookies and more. There are also dozens of probiotic supplements — capsules, tablets and powders — on the market.
Why are food manufacturers adding bacteria to foods that don't contain them? Some studies suggest that probiotics may help prevent and treat vaginal yeast infections and urinary tract infections, may prevent eczema in children and may reduce the severity and longevity of colds and flu. Other studies have shown definitively that people who are suffering from antibiotic-associated diarrhea benefit from consuming probiotics. Most recently, an analysis that appeared in the May issue of the Journal of the American Medical Assn. found that people who are suffering from diarrhea because they are taking antibiotic medications may reduce the risk of diarrhea by 42% if they consume probiotics. While some advocates claim that probiotics reduce the symptoms of irritable bowel syndrome and Crohn's disease, the evidence doesn't yet bear this out. Nor has the U.S. Food and Drug Administration approved any health claims for probiotics.
"I have clients who swear that once they start eating more foods with probiotics they have less bloating and gastrointestinal discomfort, fewer colds and flu," says Gazzaniga-Maloo.
As we start to stare down cold and flu season, a 2009 study that was published in Pediatrics is worth revisiting. The study, which was funded by a company that makes products with probiotics, compared two groups of kids, 326 total, ages 3 to 5, who drank milk with either Lactobacillus acidophilus or Bifidobacterium animalis or plain milk twice a day. The kids who consumed the probiotics-infused milk ultimately got half as many fevers and fewer runny noses than the kids who drank plain milk. Their symptoms also didn't last as long, they took fewer prescriptions and missed fewer days of school than the kids who drank the plain milk.
health@latimes.com
Copyright © 2012, Los Angeles Times
-
Woof all - here is a blurb I wrote up for my middle son who is helping with a blood drive tomorrow - just a good reminder of the importance of donating blood when you are able.
I would like to ask all of you to please consider giving blood today. Here are a few facts from the Red Cross about blood donation.
Every 2 seconds someone in the US needs blood.
More than 44 thousand blood donations are needed every day.
A single car accident victim can require up to 100 pints of blood.
Different parts of the blood from a single donation may be used to save up to 3 different people.
5) Only 38 percent of the population are eligible to donate blood, which means if you are able to donate, you are really needed.
The average adult has 10 pints of blood of which we take only one.
The entire process from start to finish takes about an hour and fifteen minutes.
Let me ask you this - when is the last time that you could honestly say that you helped save someone’s life? Come donate blood and you can say that TODAY.
Thank you.
C Dr Dog
-
http://www.redorbit.com/news/health/1112723215/breakfast-sandwich-atherosclerosis-103112/
-
An Outcast Among Peers Gains Traction on Alzheimer's Cure
By JEANNE WHALEN
Gareth Phillips for The Wall Street Journal
After years of effort, researcher Dr. Claude Wischik is awaiting the results of new clinical trials that will test his theory on the cause of Alzheimer's.
.Some people collect stamps, others vintage cars. As a young Ph.D. student at Cambridge University in the 1980s, Claude Wischik was on a mission to collect brains.
It wasn't easy. At the time, few organ banks kept entire brains. But Dr. Wischik, an Australian in his early 30s at the time, was attempting to answer a riddle still puzzling the scientific community: What causes Alzheimer's disease? To do that, Dr. Wischik needed to examine brain tissue from Alzheimer's patients soon after death. That meant getting family approvals and enlisting mortuary technicians to extract the brains, he says, "no matter the time of day or night." And it wasn't just a few brains: he collected more than 300 over about a dozen years.
He also embraced an idea that, if he is right, could ultimately spin Alzheimer's research on its heels—and raise new hopes for the roughly 36 million people world-wide afflicted with Alzheimer's or dementia.
Alzheimer's researcher Claude Wischik has long backed a minority view: that a protein in the brain called tau-not plaque-is largely responsible. WSJ's Shirley Wang spoke with Dr. Wischik about his work on a new drug to treat the devastating disease.
.The 63-year-old researcher believes that a protein called tau—which forms twisted fibers known as tangles inside the brain cells of Alzheimer's patients—is largely responsible for driving the disease. It is a theory that goes against much of the scientific community: For 20 years, billions of dollars of pharmaceutical investment has supported a different theory that places chief blame on a different protein, beta amyloid, which forms sticky plaques in the brains of sufferers. But a string of experimental drugs designed to attack beta amyloid have failed recently in clinical trials, including two this summer from Eli Lilly LLY 0.00%& Co. and a partnership involving Pfizer Inc., PFE +0.04%Johnson & Johnson JNJ +0.32%and Elan Corp. DRX.DB +2.30%
After years on the sidelines, Dr. Wischik, who now lives in Scotland, sees this as tau's big moment. The company he co-founded 10 years ago, TauRx Pharmaceuticals Ltd., has developed an experimental Alzheimer's drug that it will begin testing in the coming weeks in two large clinical trials. Slowly, other companies are boosting investment in tau research, too. This summer, Roche Holding AG ROG.VX -0.11%bought the rights to a type of experimental tau drug from Switzerland's closely held AC Immune SA.
History is peppered with examples of scientists who struggled against a prevailing orthodoxy, only to be proved right. In 1854, British doctor John Snow traced a cholera outbreak in London to a contaminated water supply, but his discovery was rejected by other scientists, who believed bad vapors in the air caused the disease. In the 1880s, cholera was finally pegged to bacteria found in contaminated water. In 1982, when two Australian scientists declared that bacteria caused peptic ulcers, conventional wisdom had it that stress and lifestyle were to blame. The scientists won the 2005 Nobel Prize in medicine for their discovery.
It is far from clear whether Dr. Wischik will join their ranks. Although interest in tau is building, opinions about the cause of Alzheimer's remain deeply divided. Some scientists believe an interaction between beta amyloid and tau plays a central role. Others think there are many possible triggers, including some beyond beta amyloid or tau.
Dr. Wischik says he and other tau-focused scientists have been shouted down over the years by what he calls the "amyloid orthodoxy," a hard-charging group of researchers who believed passionately that beta amyloid was the chief cause of the disease. "Science is politics," he says. "And the politics of amyloid won."
Yet Dr. Wischik has also been hampered by inconclusive research. A small clinical trial of TauRx's drug in 2008 produced encouraging, but mixed, results. What's more, plenty of influential scientists still are backing the idea that beta amyloid plays a central role. Although Roche is investing in tau, Richard Scheller, head of drug research at Roche's biotech unit, Genentech, says the company still is a strong believer in beta amyloid. He thinks amyloid drugs need to be tested on Alzheimer's patients much earlier in the disease cycle in order to prove effective; Roche recently announced plans to conduct such a trial.
“Drugs tied to conventional theories on Alzheimer's causes haven't been effective.
”
Meanwhile, scientists Dr. Wischik accuses of wrongly fixating on beta amyloid, such as Harvard neurologist Dennis Selkoe, say the evidence for pursuing amyloid is strong. "Claude I think sees the world somewhat darkly…if we've made our case more potently for [beta amyloid], there is nothing wrong with that," Dr. Selkoe says. He adds that he supports tau research, as well, and believes drugs to attack both beta amyloid and tau will be necessary.
Alzheimer's disease is the leading cause of dementia in the elderly, and according to the World Health Organization, the cost of caring for dementia sufferers totals about $600 billion each year world-wide. The disease was first identified in 1906 by German physician Alois Alzheimer, who studied the brain of a deceased woman who had suffered from dementia and documented the plaques and tangles that riddled the tissue. The following decades brought few advancements in understanding the disease, in part because of the difficulty of studying the human brain, which unlike other tissues cannot be biopsied and examined until after death.
Still, in the 1960s, British scientist Martin Roth and colleagues showed that the degree of clinical dementia was worse for patients with more tangles in the brain. In the 1980s, Dr. Wischik joined Dr. Roth's research group at Cambridge University as a Ph.D student, and was quickly assigned the task of determining what tangles were made of, which launched his brain-collecting mission, and years of examining tissue.
Finally, in 1988, he and colleagues at Cambridge published a paper demonstrating for the first time that the tangles first observed by Alzheimer were made at least in part of the protein tau. Later research identified tau as the main ingredient. Like all of the body's proteins, tau has a normal, helpful function—working inside neurons to help stabilize the fibers that connect nerve cells. But when it misfires, tau can clump together to form harmful tangles that kill brain cells.
Dr. Wischik's discovery was important news in the Alzheimer's field: identifying the makeup of tangles made it possible to start developing ways to stop their formation. But by the early 1990s, tau was overtaken by another protein: beta amyloid.
Signs of Decline
View Interactive
.
.Several pieces of evidence convinced an influential group of scientists that beta amyloid was the primary cause of Alzheimer's. Among these was the discovery of several genetic mutations that all but guaranteed a person would develop a hereditary type of the disease. These mutations also appeared to increase the production or accumulation of beta amyloid in the brain, leading scientists to believe that amyloid deposits were the main cause of the disease.
The so-called "amyloid hypothesis" quickly gripped the field, and attacking the protein became the main strategy for fighting Alzheimer's. Athena Neurosciences, a biotech company whose founders included Harvard's Dr. Selkoe, focused in earnest on developing drugs to attack amyloid. Meanwhile, tau researchers say they found it hard to get research funding or to publish papers in medical journals.
"It was very difficult to have a good publication on tau, because the amyloid cascade was like a dogma," says Luc Buee, a tau-focused researcher at the French National Institute of Health and Medical Research. "For 15 years if you were not working in the amyloid field you were not working on Alzheimer's disease."
Dr. Wischik and his colleagues fought to keep funding from the UK's Medical Research Council for the repository of brain tissue they maintained at Cambridge, he says. The brain bank became an important tool. In the early 1990s, Dr. Wischik and his colleagues compared the postmortem brains of Alzheimer's sufferers against those of people who had died without dementia, to see how their levels of amyloid and tau differed. They found that both healthy brains and Alzheimer's brains could be filled with amyloid plaque, but only Alzheimer's brains contained aggregated tau. What's more, as the levels of aggregated tau in a brain increased, so did the severity of dementia. "We decided that amyloid isn't what is making people demented," Dr. Wischik says.
In the mid-1990s, Dr. Wischik discovered that a drug sometimes used to treat psychosis dissolved tangles in a test tube. He tried to set up a company to develop the drug as a treatment for Alzheimer's, but found that American and British venture capitalists wanted to invest in amyloid projects, not tau.
By 2002, Dr. Wischik scraped together about $5 million from Asian investors with the help of a Singaporean physician who was the father of a classmate of Dr. Wischik's son in Cambridge. TauRx is based in Singapore but conducts most of its research in Aberdeen, Scotland.
As his tau effort launched, early tests of drugs designed to attack amyloid plaques were disappointing. A vaccine developed by Athena Neurosciences failed to improve patients' cognitive function in a trial that ended in 2002.
To better understand these results, a team of British scientists largely unaffiliated with Athena or the failed clinical trial decided to examine the brains of patients who had participated in the study. They waited for the patients to die, and then, after probing the brains, concluded that the vaccine had indeed cleared amyloid plaque but hadn't prevented further neurodegeneration.
Commitment to the amyloid hypothesis persisted, however. Peter Davies, an Alzheimer's researcher at the Feinstein Institute for Medical Research in Manhasset, NY, recalls hearing a researcher at a conference in the early 2000s concede that his amyloid research results "don't fit the hypothesis, but we'll keep going till they do."
"I just sat there with my mouth open," he recalls.
In 2004, TauRx began a clinical trial of its drug, called methylene blue, in 332 Alzheimer's patients. Around the same time, a drug maker called Elan Corp., which had bought Athena Neurosciences, began a trial of an amyloid-targeted drug called bapineuzumab in 234 patients.
A key moment came in 2008, when Dr. Wischik and Elan presented results of their studies at an Alzheimer's conference in Chicago. The Elan drug failed to improve cognition any better than a placebo pill, causing Elan shares to plummet by more than 60% over the next few days.
The TauRx results Dr. Wischik presented were more positive, though not unequivocal. The study showed that, after 50 weeks of treatment, Alzheimer's patients taking a placebo had fallen 7.8 points on a test of cognitive function, while people taking 60 mg of TauRx's drug three times a day had fallen one point—translating into an 87% reduction in the rate of decline for people taking the TauRx drug.
But TauRx didn't publish a full set of data from the trial, causing some skepticism among researchers. (Dr. Wischik says it didn't to protect the company's commercial interests). What's more, a higher, 100-mg dose of the drug didn't produce the same positive effects in patients; Dr. Wischik blames this on the way the 100-mg dose was formulated, and says the company is testing a tweaked version of the drug in its new clinical trials, which will begin enrolling patients late this year.
Meanwhile, drugs designed to attack beta amyloid have continued to disappoint. This summer, a trio of companies that now own the rights to bapineuzumab—Elan, Pfizer and Johnson & Johnson—scrapped development of the drug after it failed to work in two large clinical trials.
Then in August, Eli Lilly & Co. said its experimental medicine targeting beta amyloid, solanezumab, failed to slow the loss of memory or basic skills like bathing and dressing in two trials involving 2,050 patients with mild or moderate Alzheimer's. Just recently, Lilly disclosed that in one of the trials, when moderate patients were stripped away, the drug slowed cognitive decline only in patients with mild forms of the disease. Lilly said it would talk to regulators before deciding what to do next with the experimental drug.
The trial failures have tempered support for the amyloid hypothesis, but there are still fervent believers who say beta amyloid needs to be attacked very early in the disease cycle—perhaps before symptoms begin—for such medicines to work. This spring, the U.S. government said it would help fund a $100 million trial of Roche's amyloid-targeted drug, crenezumab, in 300 people who are genetically predisposed to develop early-onset Alzheimer's but who don't yet have symptoms. Dr. Selkoe, one of the authors of the amyloid hypothesis, says this trial should help provide a "definitive" answer about the theory.
Scientists and investors, meanwhile, are turning more attention to tau. Roche this year said it would pay Switzerland's AC Immune an undisclosed upfront fee for the rights to a new type of tau-targeted drug, and up to CHF400 million in additional payments if any drugs make it to market.
Dr. Buee, the longtime tau researcher in France, says Johnson & Johnson asked him to provide advice on tau last year, and that he's currently discussing a tau research contract with a big pharmaceutical company. (A Johnson & Johnson spokeswoman says the company invited Dr. Buee and other scientists to a meeting to discuss a range of approaches to fighting Alzheimer's.)
With its new clinical trial program under way, TauRx is the first company to test a tau-targeted drug against Alzheimer's in a large human study, known in the industry as a phase 3 trial. With his passionate beliefs, Dr. Wischik admits he may be just as much a zealot about tau as he accuses others of being about beta amyloid. "I may be," he says. "In the end…it's down to the phase 3 trial."
Write to Jeanne Whalen at jeanne.whalen@wsj.com
-
Where Salt Is Lurking on Restaurant Menus
Navigating Around Sodium When Dining Out Takes Inside Information
•
By ALINA DIZIK
American adults eat in restaurants an average of five times a week—which means they probably eat way too much salt. Even fine-dining menus offer little escape from sodium overload.
Starting with the bread and salad and ending with the final plate of tiny cookies, many of restaurants' least salty-seeming options are significant sources of dietary salt.
Some of the tastiest dishes served in restaurants are loaded with salt, often taking health conscious diners by surprise. WSJ contributor Alina Dizik and nutritionist Kristy Lambrou join Lunch Break for a look at which foods are likely to serve up too much salt, and what do do about it. Photo: Ramsay de Give for The Wall Street Journal.
The desire to limit salt isn't just for heart-attack patients. Some 90% of Americans will have to contend with high blood pressure in their lifetimes, so it is important for almost everyone to limit their sodium intake, says Walter Willett, chairman of the department of nutrition at the Harvard School of Public Health.
Yet restaurant diners who read menus closely tend to be looking to avoid fats, not sodium. "The consequence of too many calories is more conspicuous," Dr. Willett says. "The sodium issue is quite invisible until they have a stroke."
Salt is indispensable in restaurant kitchens beyond just how it makes food taste. It extends the shelf life of prepared foods, prevents bitterness in produce and encourages binding in breads, says Joy Dubost, director of nutrition at the National Restaurant Association, a Washington, D.C., industry group. Replacing salt with alternative preparations or seasonings, such as herbs, will almost always end up costing more.
Enlarge Image
CloseRamsay de Give for The Wall Street Journal
Jeremy Bearman, executive chef, with Kristy Lambrou, nutritionist, at Rouge Tomate.
Restaurants often salt raw steaks and chops before browning. And green salads can contain salt, whether added to the leafy greens or present in the dressing, cheese or meat add-ins. Chefs put a little extra vinegar in the dressing to balance out a salty-tasting salad.
"Something may have lots of salt in it but not taste salty," says Amy Chaplin, a New York recipe developer and personal chef preparing vegetarian cuisine.
Even simple cooked vegetables can sneak salt onto the menu, says Kristy Lambrou, a culinary nutritionist who works in the kitchen at Rouge Tomate, a New York restaurant whose menu focuses on healthful eating.
To help vegetables retain flavor, nutrients and color, restaurants blanch them, plunging them briefly into boiling salted water and then an ice-water bath. The salt absorbed will vary.
Cutting Down on Salt
View Interactive
Ramsay de Give for The Wall Street Journal (4)
Bread, luncheon meats, pizza, poultry, soups, burgers, cheese and pasta dishes are some of the most common sources of dietary sodium, according to the Centers for Disease Control and Prevention. Charcuterie and cheese plates are out of the question for diners limiting salt.
Diners also should avoid braised meats and sausages, which also often contain a lot of salt. Skip potatoes when possible, because they are usually prepared with a liberal dose of salt. Ditto soups, gravies, curries and other soupy or saucy dishes, which tend to require more seasoning because the liquid dilutes flavor.
Restaurants "use so much more salt than people realize," says Michael Stebner, brand executive chef at True Food Kitchen, a Scottsdale, Ariz., chain developed by Fox Restaurant Group and Andrew Weil, the author of books on integrative medicine. The chain uses recipes modified to require 25% less added salt.
Many health experts recommend cutting salt by 25% because they contend it won't drastically change the flavor. Chefs, though, say generous salting more than once in the cooking process helps bring out depth of flavor.
Enlarge Image
CloseRamsay de Give for The Wall Street Journal
Fresh Herb Tagliatelle
More Taste, Less Sodium
Chef Jeremy Bearman's Fresh Herb Tagliatelle with Maine Lobster has 690 milligrams of sodium—far less than the 1,600 milligrams or more found in a typical serving of traditional pasta and shrimp in tomato sauce.
• About 60% of the sodium comes from the lobster itself. Colorful vegetables—leek, fennel, broccoli—provide sensory appeal and potassium to balance the lobster's saltiness.
• Housemade pasta is flavored with saffron but not salt, rolled with fresh herbs and cooked in unsalted water.
• Minimally salted pasta sauce begins with unsalted fennel stock. It contains leek purée made with saffron, lobster oil, lemon juice, Espellete pepper powder and a pinch of salt.
• Lobster oil is made by roasting lobster shells with tomato, white wine, chili flake, peppercorns, tarragon, carrot, celery and onion and then steeping them in olive oil.
• A squeeze of fresh lemon adds bright flavor.
Source: Rouge Tomate
"It opens up the pores on your tongue and enables you to taste the food better," says Mr. Stebner, former owner of the San Diego restaurant Region.
Some chefs rely on salt to enhance previously frozen meats or less-than-ripe vegetables, he adds. "Salt is being used to extract more flavor than the food actually has."
Sodium is a major cause of high blood pressure, which can lead to both heart attack and stroke, says Rachel Johnson, spokesperson for the American Heart Association and nutrition professor at the University of Vermont. Hypertension affects one in three Americans.
The average American consumes more than 3,400 milligrams of sodium per day, more than double the American Heart Association's recommended 1,500 mg, which is the equivalent of two-thirds of a teaspoon of table salt.
Restaurant foods are denser in sodium than home-prepared food, the CDC says, and contribute about 25% of sodium in the American diet.
Jeremy Bearman, chef at Rouge Tomate, balances sodium-rich ingredients with potassium-rich ingredients, Ms. Lambrou says. Mussels, which like other seafoods are naturally high in sodium, are often paired with tomatoes.
"One major [heart disease] contributor is not just having a lot of sodium, but also not having enough potassium," Ms. Lambrou says. "Those are two electrolytes that need to be in balance." The restaurant uses coarse salt, because "pinch for pinch" it has less sodium, she adds.
Potassium helps counteract sodium's effects on blood pressure, Dr. Willett says. Most U.S. adults get only about 3,000 mg of potassium a day, far short of the recommended 4,700 mg a day. Dr. Willett says frequent restaurant diners should try to eat more fresh fruits and vegetables, which naturally contain potassium.
Most menus don't offer much transparency when it comes to salt. Opt for simple vegetable and fish preparations with olive oil and lemon, grilled proteins and in-season vegetables, says Ms. Chaplin.
Spicy preparations can be a good lower-sodium alternatives. And drinking wine with the meal will naturally heighten your desire for more savory, salty flavors, Ms. Chaplin adds.
Janet Riccio, 55, a New York advertising executive, says tries to monitor her salt intake because of a genetic disposition to high blood pressure. At business meals, she'll ask the waiter about sodium content before ordering and will usually request sauce on the side.
Beyond that, though, there is only so much vetting she feels comfortable doing, out of consideration for the server and her fellow diners. "I hope I'm doing it in a way that doesn't offend anybody," she says.
Some restaurateurs are wary when diners request low-sodium preparations, because they don't want to send unappetizing food to the dining room.
At Maverick, in San Francisco, Emmanuel Eng, the executive chef, says omitting salt from the chicken liver mousse or the lobster bisque would leave diners unsatisfied. "A dish without salt is not as good as it could be," he says. "We're in the business of pleasing guests."
Diners who call ahead are more likely to find a restaurant willing to accommodate a low-sodium request. Ideally, call a day or two ahead so the chef can set aside unsalted portions. Start with restaurants whose menus emphasize fresh ingredients. "When [they] use fresh products, the restaurants can focus on adding lots of herbs and spices or doing reductions and layering flavors" instead of simply adding salt, says Darcie Ellyne, a Burlingame, Calif., nutrition consultant to chains including Una Mas Mexican Grill and Ruby's Diner.
If arriving unannounced, ask the server for recommendations. Try to be flexible.
When ordering, ask for "no salt where possible," Mr. Eng says. When diners pop in with surprise special dietary requests, "that can severely limit what we can do on the fly," he adds.
-
http://www.scientificamerican.com/article.cfm?id=its-time-to-end-the-war-on-salt
It's Time to End the War on Salt
The zealous drive by politicians to limit our salt intake has little basis in science
By Melinda Wenner Moyer
For decades, policy makers have tried and failed to get Americans to eat less salt. In April 2010 the Institute of Medicine urged the U.S. Food and Drug Administration to regulate the amount of salt that food manufacturers put into products; New York City Mayor Michael Bloomberg has already convinced 16 companies to do so voluntarily. But if the U.S. does conquer salt, what will we gain? Bland french fries, for sure. But a healthy nation? Not necessarily.
This week a meta-analysis of seven studies involving a total of 6,250 subjects in the American Journal of Hypertension found no strong evidence that cutting salt intake reduces the risk for heart attacks, strokes or death in people with normal or high blood pressure. In May European researchers publishing in the Journal of the American Medical Association reported that the less sodium that study subjects excreted in their urine—an excellent measure of prior consumption—the greater their risk was of dying from heart disease. These findings call into question the common wisdom that excess salt is bad for you, but the evidence linking salt to heart disease has always been tenuous.
-
A fair point , , , up to a point.
FWIW, I do better when I watch my salt consumption.
-
Reliability unknown, source suspect:
http://news.yahoo.com/insight-evidence-grows-narcolepsy-gsk-swine-flu-shot-070212916--finance.html
STOCKHOLM (Reuters) - Emelie Olsson is plagued by hallucinations and nightmares. When she wakes up, she's often paralyzed, unable to breathe properly or call for help. During the day she can barely stay awake, and often misses school or having fun with friends. She is only 14, but at times she has wondered if her life is worth living.
Emelie is one of around 800 children in Sweden and elsewhere in Europe who developed narcolepsy, an incurable sleep disorder, after being immunized with the Pandemrix H1N1 swine flu vaccine made by British drugmaker GlaxoSmithKline in 2009.
Finland, Norway, Ireland and France have seen spikes in narcolepsy cases, too, and people familiar with the results of a soon-to-be-published study in Britain have told Reuters it will show a similar pattern in children there.
Their fate, coping with an illness that all but destroys normal life, is developing into what the health official who coordinated Sweden's vaccination campaign calls a "medical tragedy" that will demand rising scientific and medical attention.
Europe's drugs regulator has ruled Pandemrix should no longer be used in people aged under 20. The chief medical officer at GSK's vaccines division, Norman Begg, says his firm views the issue extremely seriously and is "absolutely committed to getting to the bottom of this", but adds there is not yet enough data or evidence to suggest a causal link.
Others - including Emmanuel Mignot, one of the world's leading experts on narcolepsy, who is being funded by GSK to investigate further - agree more research is needed but say the evidence is already clearly pointing in one direction.
"There's no doubt in my mind whatsoever that Pandemrix increased the occurrence of narcolepsy onset in children in some countries - and probably in most countries," says Mignot, a specialist in the sleep disorder at Stanford University in the United States.
30 MILLION RECEIVED PANDEMRIX
In total, the GSK shot was given to more than 30 million people in 47 countries during the 2009-2010 H1N1 swine flu pandemic. Because it contains an adjuvant, or booster, it was not used in the United States because drug regulators there are wary of adjuvanted vaccines.
GSK says 795 people across Europe have reported developing narcolepsy since the vaccine's use began in 2009.
Questions about how the narcolepsy cases are linked to Pandemrix, what the triggers and biological mechanisms might have been, and whether there might be a genetic susceptibility are currently the subject of deep scientific investigation.
But experts on all sides are wary. Rare adverse reactions can swiftly develop into "vaccine scares" that spiral out of proportion and cast what one of Europe's top flu experts calls a "long shadow" over public confidence in vaccines that control potential killers like measles and polio.
"No-one wants to be the next Wakefield," said Mignot, referring to the now discredited British doctor Andrew Wakefield who sparked a decades-long backlash against the measles, mumps and rubella (MMR) shot with false claims of links to autism.
With the narcolepsy studies, there is no suggestion that the findings are the work of one rogue doctor.
Independent teams of scientists have published peer-reviewed studies from Sweden, Finland and Ireland showing the risk of developing narcolepsy after the 2009-2010 immunization campaign was between seven and 13 times higher for children who had Pandemrix than for their unvaccinated peers.
"We really do want to get to the bottom of this. It's not in anyone's interests if there is a safety issue that needs to be addressed," said GSK's Begg.
LIFE CHANGED
Emelie's parents, Charles and Marie Olsson, say she was a top student who loved playing the piano, taking tennis lessons, creating art and having fun with friends. But her life started to change in early 2010, a few months after she had Pandemrix. In the spring of 2010, they noticed she was often tired, needing to sleep when she came home from school.
But it wasn't until May, when she began collapsing at school, that it became clear something serious was happening.
As well as the life-limiting bouts of daytime sleepiness, narcolepsy brings nightmares, hallucinations, sleep paralysis and episodes of cataplexy - when strong emotions trigger a sudden and dramatic loss of muscle strength.
In Emelie's case, having fun is the emotional trigger. "I can't laugh or joke about with my friends any more, because when I do I get cataplexies and collapse," she said in an interview at her home in the Swedish capital.
Narcolepsy is estimated to affect between 200 and 500 people per million and is a lifelong condition. It has no known cure and scientists don't really know what causes it. But they do know patients have a deficit of a brain neurotransmitter called orexin, also known as hypocretin, which regulates wakefulness.
Research has found that some people are born with a variant in a gene known as HLA that means they have low hypocretin, making them more susceptible to narcolepsy. Around 25 percent of Europeans are thought to have this genetic vulnerability.
When results of Emelie's hypocretin test came back in November last year, it showed she had 15 percent of the normal amount, typical of heavy narcolepsy with cataplexy.
The seriousness of her strange new illness has forced her to contemplate life far more than many other young teens: "In the beginning I didn't really want to live any more, but now I have learned to handle things better," she said.
TRIGGERS?
Scientists investigating these cases are looking in detail at Pandemrix's adjuvant, called AS03, for clues.
Some suggest AS03, or maybe its boosting effect, or even the H1N1 flu itself, may have triggered the onset of narcolepsy in those who have the susceptible HLA gene variant.
Angus Nicoll, a flu expert at the European Centre for Disease Prevention and Control (ECDC), says genes may well play a part, but don't tell the whole story.
"Yes, there's a genetic predisposition to this condition, but that alone cannot explain these cases," he said. "There was also something to do with receiving this specific vaccination. Whether it was the vaccine plus the genetic disposition alone or a third factor as well - like another infection - we simply do not know yet."
GSK is funding a study in Canada, where its adjuvanted vaccine Arepanrix, similar to Pandemrix, was used during the 2009-2010 pandemic. The study won't be completed until 2014, and some experts fear it may not shed much light since the vaccines were similar but not precisely the same.
It all leaves this investigation with far more questions than answers, and a lot more research ahead.
WAS IT WORTH IT?
In his glass-topped office building overlooking the Maria Magdalena church in Stockholm, Goran Stiernstedt, a doctor turned public health official, has spent many difficult hours going over what happened in his country during the swine flu pandemic, wondering if things should have been different.
"The big question is was it worth it? And retrospectively I have to say it was not," he told Reuters in an interview.
Being a wealthy country, Sweden was at the front of the queue for pandemic vaccines. It got Pandemrix from GSK almost as soon as it was available, and a nationwide campaign got uptake of the vaccine to 59 percent, meaning around 5 million people got the shot.
Stiernstedt, director for health and social care at the Swedish Association of Local Authorities and Regions, helped coordinate the vaccination campaign across Sweden's 21 regions.
The World Health Organisation (WHO) says the 2009-2010 pandemic killed 18,500 people, although a study last year said that total might be up to 15 times higher.
While estimates vary, Stiernstedt says Sweden's mass vaccination saved between 30 and 60 people from swine flu death. Yet since the pandemic ended, more than 200 cases of narcolepsy have been reported in Sweden.
With hindsight, this risk-benefit balance is unacceptable. "This is a medical tragedy," he said. "Hundreds of young people have had their lives almost destroyed."
PANDEMICS ARE EMERGENCIES
Yet the problem with risk-benefit analyses is that they often look radically different when the world is facing a pandemic with the potential to wipe out millions than they do when it has emerged relatively unscathed from one, like H1N1, which turned out to be much milder than first feared.
David Salisbury, the British government's director of immunization, says "therein lies the risk, and the difficulty, of working in public health" when a viral emergency hits.
"In the event of a severe pandemic, the risk of death is far higher than the risk of narcolepsy," he told Reuters. "If we spent longer developing and testing the vaccine on very large numbers of people and waited to see whether any of them developed narcolepsy, much of the population might be dead."
Pandemrix was authorized by European drug regulators using a so-called "mock-up procedure" that allows a vaccine to be authorized ahead of a possible pandemic using another flu strain. In Pandemrix's case, the substitute was H5N1 bird flu.
When the WHO declared a pandemic, GSK replaced the mock-up's strain with the pandemic-causing H1N1 strain to form Pandemrix.
GSK says the final H1N1 version was tested in trials involving around 3,600 patients, including children, adolescents, adults and the elderly, before it was rolled out.
The ECDC's Nicoll says early warning systems that give a more accurate analysis of a flu strain's threat are the best way to minimize risks of this kind of tragedy happening in future.
Salisbury agrees, and says progress towards a universal flu vaccine - one that wouldn't need last-minute changes made when a new strain emerged - would cuts risks further.
"Ideally, we would have a better vaccine that would work against all strains of influenza and we wouldn't need to worry about this ever again," he said. "But that's a long way off."
With scientists facing years of investigation and research, Emelie just wants to make the best of her life.
She reluctantly accepts that to do so, she needs a cocktail of drugs to try to control the narcolepsy symptoms. The stimulant Ritalin and the sleeping pill Sobril are prescribed for Emelie's daytime sleepiness and night terrors. Then there's Prozac to try to stabilize her and limit her cataplexies.
"That's one of the things that makes me feel most uncomfortable," she explains. "Before I got this condition I didn't take any pills, and now I have to take lots - maybe for the rest of my life. It's not good to take so many medicines, especially when you know they have side effects."
(Reporting by Kate Kelland; Editing by Will Waterman)
-
IMO a good objective summary of the situation. The urologists and radiation oncologists have too much financial stakes to be able to give rational explanations. Don't get me wrong. Their intentions were honorable in trying to combat this disease, but the fact of the matter is that PSA screening leads to a lot of testing, surgery radiation treatment and much anxiety among people who are found to have it. I discus with my male pts. the pros and cons and even give them a website to go to and read if they like and allow them to decide. Some decide against. Some appear incapable of understanding the controversies and usually opt for the test, and a few still want it. Bottom line I try to inform them the best I can and the choice is theirs. One caveat about the family history as one reason for men to do the test. If it is estimated 75% of men over 80 will have prostate cancer (though very few will ever know - unless we do a search and destroy mission) then most men, if they have ancestors who live long enough and get tested they now will have a family history. When I think of family history being relevant it is more important if they have a family member who either died of the disease or was younger when diagnosed. The risks are higher for Blacks for unknown reasons (NO it is not discriminatory or racist).
http://www.mayoclinicproceedings.org/article/S0025-6196(12)01091-9/fulltext
-
I don't know if anyone remembers from the DMG board years ago I pointed out my suspicion that the argument we should get people to stop smoking because they utilize more health care dollars while all the rest of us pay for their medical problems is flawed?
The concept that we will reduce costs in the long run by getting them to quit might be flawed. If these people die at 50 or 60 rather than living to 80 or more the US might save a bundle in social security, Medicare, and long term care costs.
Scott Gottlieb of FDA and (of Gilder's health stock letter fame and FDA guy) takes what I think is a tongue in cheek stance that we should just let the smokers (and obese) simply die. Why should society pay for their health ills keeping them alive?
http://hosted.ap.org/dynamic/stories/U/US_MED_HEALTH_COSTS_REALITY_CHECK?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2013-01-26-10-03-12
-
CCP: "I pointed out my suspicion that the argument we should get people to stop smoking because they utilize more health care dollars while all the rest of us pay for their medical problems is flawed...The concept that we will reduce costs in the long run by getting them to quit might be flawed. If these people die at 50 or 60 rather than living to 80 or more the US might save a bundle in social security, Medicare, and long term care costs."
Doc, you are correct (as usual). Hubert Humphrey III made his mark with the states suing the tobacco companies for these 'costs'. Key point in the trial was the ruling made by the judge that the fact these people died more quickly includes a health care coszt savings, not counting what you point out Social security etc., when they get sick with lung cancer, emphysema etc was inadmissible.
Despicable to use their early death as a cost savings - except for the fact that the lawsuit was all about costs.
A libertarian view (aren't we a libertarian country?) is that it is none of government's business whether you are obese or smoke. Your mother, daughter, spouse, father, son, boss, neighbor or pastor can nag you about that, not the federal government. Now every choice you make affects a public expenditure. Every wet french fry you eat affects our currency relationship with China and the debt burden on children not yet born.
George Orwell could not foresee the number of cameras and the data mining systems that will double check your compliance.
Have you been told yet you to ask your patients about guns in the home yet? It's a health care cost now. The government will need to stop you from exercising your rights, based on false data and unconstitutional powers.
-
Hi Doug,
Yes. The paradox and twisted logic for political correctness. Saying that we should live like vegetarians, walk or bike ride to work, take yoga, avoid sugars, fats, alcohol (except maybe that one red wine at night) sounds wonderful. Some of us may even add a few years to our lives. Yet the reality is that there will be more people living longer on SS and the entitlements share of the pie will expand even more.
OTOH if we can keep older people healthy in a way they can move around and continue to perform cognitively as well as physically and keep them working or volunteering longer they would become a vital store of experience wisdom and contribute to society rather then the opposite. OF course we can't expect this now when it hurts to walk around, memories are not so good and people may have to wear diapers.
"George Orwell could not foresee the number of cameras and the data mining systems that will double check your compliance."
In recent med journals (I forget which one) there are articles from politburo members who are PhDs (nothing against PhDs but just the point that MBAs and PhDs are along with some MDs involved) in something like industrial engineering and work flow engineering. If one is not in health care in the US we probably all have a relative who is who can attest to health care evolving into something more resembling an assembly line. My mind is boggled every day with all the regulatory requirements and the absolute hair splitting of every single step in every single human interaction, function, task, as well as duplicate and triplicate controls. Perhaps for younger people more attune to this view of the world and daily life because of electronic gadgets it is not so rough. For me it is torture. Like "Secret Agent Man" they took away your name and gave you a number.
"Have you been told yet you to ask your patients about guns in the home yet? It's a health care cost now."
The only time I ask anyone that is if I am concerned they are so depressed that they may commit suicide. If they have a gun in the house I am more worried.
Other than that - no. And I will not. None of my damn business.
I don't ask people if they wear their seatbelts either. Enough is enough. I am not their nanny.
I do try to help with cigarettes and weight where I can.
-
CCP Thanks for the nice response.
I'm all for having people's doctor helping them to live longer, a key reason we go there. Governing is different. Defend our shores, plow our streets etc. but not control all our behaviors and choices. Cigarettes under current science seem kind of obvious. Your odds of bad health consequences go way up. I'm fine with the warning label mandates and all kinds of educational efforts.
Problem is the government does not know where to stop. For this board, I point out an obvious future target and hope no one in government reads it: Martial Arts has health risks. And soccer, football, hockey, skiing, skydiving and eating breakfast lunch and dinner - all involve risk taking. A friend just died of snow shoveling (heart attack). Sex for older people they are already saying ask you doctor if that is okay for you, next could be prohibition. We joked that after cigarettes, what's next, french fries and soft drinks? It's not a joke anymore. Give them that power and it becomes their responsibility forever and they won't always get the science right or respect personal choices. (understatement)
- "Have you been told yet you to ask your patients about guns in the home? It's a health care cost now." The only time I ask anyone that is if I am concerned they are so depressed that they may commit suicide.
Pediatricians ask here. I let my daughter field the question, I had one at the time that she didn't know about. The doctor meant no big invasion, it was in the context of kids wearing bike helmets for safety. I just didn't like that it came as a direct question, as part of checklist, making a record on a very private matter he seemed compelled to ask. Maybe I am sensitive but I see a distinction between informing us about safety and creating a very personal record easily breached.
-
Sugar is indeed toxic. It may not be the only problem with the Standard American Diet, but it’s fast becoming clear that it’s the major one.
A study published in the Feb. 27 issue of the journal PLoS One links increased consumption of sugar with increased rates of diabetes by examining the data on sugar availability and the rate of diabetes in 175 countries over the past decade. And after accounting for many other factors, the researchers found that increased sugar in a population’s food supply was linked to higher diabetes rates independent of rates of obesity.
In other words, according to this study, obesity doesn’t cause diabetes: sugar does.
The study demonstrates this with the same level of confidence that linked cigarettes and lung cancer in the 1960s. As Rob Lustig, one of the study’s authors and a pediatric endocrinologist at the University of California, San Francisco, said to me, “You could not enact a real-world study that would be more conclusive than this one.”
The study controlled for poverty, urbanization, aging, obesity and physical activity. It controlled for other foods and total calories. In short, it controlled for everything controllable, and it satisfied the longstanding “Bradford Hill” criteria for what’s called medical inference of causation by linking dose (the more sugar that’s available, the more occurrences of diabetes); duration (if sugar is available longer, the prevalence of diabetes increases); directionality (not only does diabetes increase with more sugar, it decreases with less sugar); and precedence (diabetics don’t start consuming more sugar; people who consume more sugar are more likely to become diabetics).
The key point in the article is this: “Each 150 kilocalories/person/day increase in total calorie availability related to a 0.1 percent rise in diabetes prevalence (not significant), whereas a 150 kilocalories/person/day rise in sugar availability (one 12-ounce can of soft drink) was associated with a 1.1 percent rise in diabetes prevalence.” Thus: for every 12 ounces of sugar-sweetened beverage introduced per person per day into a country’s food system, the rate of diabetes goes up 1 percent. (The study found no significant difference in results between those countries that rely more heavily on high-fructose corn syrup and those that rely primarily on cane sugar.)
This is as good (or bad) as it gets, the closest thing to causation and a smoking gun that we will see. (To prove “scientific” causality you’d have to completely control the diets of thousands of people for decades. It’s as technically impossible as “proving” climate change or football-related head injuries or, for that matter, tobacco-caused cancers.) And just as tobacco companies fought, ignored, lied and obfuscated in the ’60s (and, indeed, through the ’90s), the pushers of sugar will do the same now.
But as Lustig says, “This study is proof enough that sugar is toxic. Now it’s time to do something about it.”
The next steps are obvious, logical, clear and up to the Food and Drug Administration. To fulfill its mission, the agency must respond to this information by re-evaluating the toxicity of sugar, arriving at a daily value — how much added sugar is safe? — and ideally removing fructose (the “sweet” molecule in sugar that causes the damage) from the “generally recognized as safe” list, because that’s what gives the industry license to contaminate our food supply.
On another front, two weeks ago a coalition of scientists and health advocates led by the Center for Science in the Public Interest petitioned the F.D.A. to both set safe limits for sugar consumption and acknowledge that added sugars, rather than lingering on the “safe” list, should be declared unsafe at the levels at which they’re typically consumed. (The F.D.A. has not yet responded to the petition.)
Allow me to summarize a couple of things that the PLoS One study clarifies. Perhaps most important, as a number of scientists have been insisting in recent years, all calories are not created equal. By definition, all calories give off the same amount of energy when burned, but your body treats sugar calories differently, and that difference is damaging.
And as Lustig lucidly wrote in “Fat Chance,” his compelling 2012 book that looked at the causes of our diet-induced health crisis, it’s become clear that obesity itself is not the cause of our dramatic upswing in chronic disease. Rather, it’s metabolic syndrome, which can strike those of “normal” weight as well as those who are obese. Metabolic syndrome is a result of insulin resistance, which appears to be a direct result of consumption of added sugars. This explains why there’s little argument from scientific quarters about the “obesity won’t kill you” studies; technically, they’re correct, because obesity is a marker for metabolic syndrome, not a cause.
The take-away: it isn’t simply overeating that can make you sick; it’s overeating sugar. We finally have the proof we need for a verdict: sugar is toxic.
-
Interesting but is clearly political.
First in medicine we don't view epidemiological findings as "proof". A real scientist would know this. It generally results to a hypothesis that is then later tested in double blind placebo controlled trials that try to avid the bias this author OBVIOUSLY has.
Second. Who the heck is PLoS? It is some sort of scientific "advocacy" group. Sounds like the climate change crowd. The same crowd that would like to regulate our daily lives.
I am not aware that this is any legitimate journal.
Third, I don't see any mention of genetic differences between countries. For example it is well know Latinos and Asians have much higher rates of diabetes even at lower weights. Could it be partly due high rice and maybe sugar intake - yes. But there is likely a genetic component as well.
I would say this study which I have not reviewed, if well done, as claimed, is interesting but nothing more.
Of course, I am sure this pseudoscientist who seems to know how to promote his numbers game as some sort of definitive Earth shattering discovery, would be very pleased to get a couple hundred grand from Axelrod and corp to "study" this further.
I like to call a spade - a spade.
-
Doctors have long assumed that saturated fat and cholesterol in red meat are what raise the risk of heart disease. But a study in the journal Nature Medicine fingers another culprit: carnitine, a compound abundant in red meat that also is sold as a dietary supplement and found in some energy drinks.
Carnitine typically helps the body transport fatty acids into cells to be used as energy. But researchers at the Cleveland Clinic found that in both humans and mice, certain bacteria in the digestive tract convert carnitine to another metabolite, called TMAO, that promotes atherosclerosis, or a thickening of the arteries.
The researchers, led by Stanley Hazen, chief of cellular and molecular medicine at the Cleveland Clinic's Lerner Research Institute, tested the carnitine and TMAO levels of omnivores, vegans and vegetarians, and examined records of 2,595 patients undergoing cardiac evaluations. In patients with high TMAO levels, the more carnitine in their blood, the more likely they were to develop cardiovascular disease, heart attacks, stroke and death.
.Many studies have linked consumption of red and processed meat to cardiovascular disease and some cancers. The Harvard School of Public Health reported last year that among 83,000 nurses and 37,000 male health professionals followed since the 1980s, those who consumed the highest levels of red meat had the highest risk of death during the study, and that one additional serving a day of red meat raised the risk of death by 13%.
The new findings don't mean that red meat is more hazardous than previously thought. But they may help explain the underlying risk of eating red meat, which some researchers have long thought was higher than the saturated fat and cholesterol content alone could explain.
Dr. Hazen speculated that carnitine could be compounding the danger. "Cholesterol is still needed to clog the arteries, but TMAO changes how cholesterol is metabolized—like the dimmer on a light switch," he said. "It may explain why two people can have the same LDL level [a measure of one type of cholesterol], but one develops cardiovascular disease and the other doesn't."
One surprising finding, Dr. Hazen said, was how a long-term diet that includes meat affected the amount of TMAO-producing bacteria in the gut and thus magnified the risk. In the study, when longtime meat-eaters consumed an eight-ounce steak and a carnitine supplement, their bacteria and TMAO levels rose considerably. But when a vegan ate the same combination, he showed no increase in TMAO or bacterial change.
"Vegans basically lose their ability to digest carnitine," said Dr. Hazen.
The study, sponsored by the National Institutes of Health, didn't assess how little red meat people could consume and still have elevated TMAO. Nor did it look at how long someone had to abstain from red meat to end the process. "We know it will be longer than one week, but shorter than one year," Dr. Hazen said.
He and his colleagues have been exploring how altering gut bacteria might influence the risk of heart disease. "In the future, maybe there will be a heart-healthy yogurt, or a drug to block the formation of TMAO," he said.
Consumption of red meat—primarily beef, veal, lamb and pork—has been falling gradually since 1970.
Trade groups for meat producers have questioned the link to cardiovascular disease, saying studies that ask people to recall what they ate over long periods are imprecise.
"Cardiovascular disease…is a complex condition that appears to have a variety of factors associated with it, from genetics to lifestyle," said Betsy Booren, chief scientist at the American Meat Institute Foundation.
As a dietary supplement, carnitine is designated as "generally regarded as safe" by the Food and Drug Administration, but few studies have looked at its long-term safety. A 2006 risk assessment found no adverse effects when subjects consumed 2,000 milligrams a day for six months. (An eight-ounce steak has roughly 200 mg of carnitine.)
Ads for supplements promote carnitine as helping boost energy levels, particularly in endurance sports, and assisting in recovery after intense exercise; some also claim that it helps shed pounds and improve brain function.
Duffy MacKay, vice president for scientific and regulatory affairs at the Council for Responsible Nutrition, a trade group for the supplement and energy-drink industries, called the study "a new, emerging hypothesis," but said the researchers were drawing large conclusions from small studies of mice, bacteria and human biomarkers. "The concept that one component of your diet, or one molecule, is responsible for your health woes is questionable," he said.
Dr. Hazen noted that some energy drinks have more carnitine in a single can than a porterhouse steak. "I worry about what happens in 10, 20 or 30 years of consumption," he said.
He said humans generally have plenty of carnitine in their diet, which also is found in small amounts in nuts, beans, vegetables and fruit, and don't need to take it in supplement form.
-
twenty five years ago hepatitis C wasn't even discovered. We used to call it non-AnonB hepatitis and we used to infer a person was infected from the abnormal liver tests. Since then we have discovered and characterized the virus produced a test to find if a person is infected and developed marginally good albeit getting better treatments. Soon it will be curable or long term controllable like HIV.
http://www.huffingtonpost.com/2013/04/23/hepatitis-c-treatment-cures-abbvie_n_3139989.html
If only we had treatments for the common cold.
-
CCP:
Interesting-- in addition to the health blessing for those with Hep C, it should be a helluva financial blessing for the company developing it :-D
-
Agreed but I am not clear who is the winner(s). I am afraid I have NEVER made money in an health stock. I lost in corixa. I lost with inhaled insulin. Biomira. Pain therapeutics.
I read vivus drug was great for weight loss and almost bought at ten only to chicken out and a few days later it doubled when drug approved.
Gilead sounds good but the train has left the station it seems. I watched Sanofi fall to low 30's after its Plavix patent expired thinking it was a good buy. I was right . It is now in 50s. Of course I didn't buy it. :cry:
-
works on different brain receptors than existing medicines:
http://www.huffingtonpost.com/2013/04/03/suvorexant-side-effects-sleeping-_n_3008709.html#slide=1328563
-
Interesting.
My issue is not falling asleep, but staying asleep. I often awake after 4.5 hours of sleep.
I tried the GABA stuff, but found out it tends to suppress breathing! So much for GABA! :-o
-
"but found out it tends to suppress breathing"
Raises concern for sleep apnea. Please look into this if not already done.
-
My solution was simple. No more of this stuff!
-
"My solution was simple. No more of this stuff!"
Thank goodness. I hope the board continues for another 50 yrs! :))
Sometimes sedatives or hypnotics can unmask or worsen an underlying sleep apnea problem.
-
I am a little surprised Christie had lap band surgery. It is easier and quicker but the success rate is far less than gastric sleeve or Roux - en - Y.
Something like 80% of lap band procedures fail by 5 yrs. I don't even recommend it anymore. I've seen and heard many problems with it.
Yet the fear of a permanent but slightly higher risk procedure usually still has people choosing this.
-
The new bible of mental disorders is filled many myths. It is kind of like the real Bible - whatever one wants to believe:
http://www.psychologytoday.com/blog/dsm5-in-distress/201212/dsm-5-is-guide-not-bible-ignore-its-ten-worst-changes
-
I am only surprised the number is not higher. What the study doesn't address is the prevalence of bias against the obese in the general population. As for med students I have some points from my experience.
1- obesity treatments were not taught at all other the proverbial "diet and exercise" and simply admonishing a patient for not doing more in this regard. I can tell you this never works.
Perhaps obesity treatment is taught better now ; I don't know.
2- obesity treatment are often complicated and are a whole specialty unto itself though not a recognized one by the board of specialties - it should be.
3- obesity is very difficult to treat - very. Indeed the medical treatment is almost always with the realistic hope of some sustained weight loss not huge losses from obese to healthy. I heard one physician who devotes his entire practice say during a lecture, "in my 25 yrs of treating obesity if I have had 2 or 3 patients get from a BMI of 45 (morbid obese - overweight by 100 pounds or more) to a BMI of 25 (top number designated healthy) and keep it off that is a lot".
4- Some experts appear to have thrown in the towel for medical treatment in those patients who are extremely overweight and from the very beginning steer them to bariatric surgery which has a DRAMATICALLY higher success rate.
****Many Medical Students Have Anti-Fat Bias, Study Finds
Healthday 13 hrs ago | By -- Mary Elizabeth Dallas of HealthDay
FRIDAY, May 24 (HealthDay News) -- Two out of five medical students have an unconscious bias against obese people, a new study found.
The study authors, from Wake Forest Baptist Medical Center, noted the anti-fat stigma is a significant barrier to the treatment of obesity. They concluded that teaching medical students to recognize this bias is necessary to improve care for the millions of Americans who are overweight or obese.
"Bias can affect clinical care and the doctor-patient relationship, and even a patient's willingness or desire to go see their physician, so it is crucial that we try to deal with any bias during medical school," study lead author Dr. David Miller, associate professor of internal medicine at Wake Forest Baptist Medical Center, said in a center news release. "Previous research has shown that on average, physicians have a strong anti-fat bias similar to that of the general population. Doctors are more likely to assume that obese individuals won't follow treatment plans, and they [doctors] are less likely to respect obese patients than average weight patients."
The study, which took place over the course of three years, involved more than 300 third-year medical students. Although all of the students attended a medical school in the southeastern United States from 2008 through 2011, they were originally from many different parts of the United States as well as 12 other countries.
Using a computer program called the Weight Implicit Association Test, the researchers were able to measure the participants' unconscious preferences for fat or thin people. The medical students also completed a survey to determine if they were aware of any weight bias they had.
The study revealed that 39 percent of the medical students had a moderate to strong unconscious anti-fat bias. Seventeen percent had a moderate to strong anti-thin bias. The researchers added that less than 25 percent of the students were aware of their biases.
"Because anti-fat stigma is so prevalent and a significant barrier to the treatment of obesity, teaching medical students to recognize and mitigate this bias is crucial to improving the care for the two-thirds of American adults who are now overweight or obese," Miller said. "Medical schools should address weight bias as part of a comprehensive obesity curriculum."
The study was published online May 23 in the Journal of Academic Medicine.****
-
http://www.breitbart.com/Big-Hollywood/2013/06/02/douglas-cancer-oral-sex?utm_source=BreitbartNews&utm_medium=facebook
-
If only....... he put his tongue in a condom......... or he stayed away from those Hollywood harlots....
Seriously, it is thought HPV is rarely the cause of head and neck cancer but for him to blame that when he smoked like a heroin addict for decades is absurd.
The statistical odds it was HPV rather than cigarettes is probably on the order hundred thousand to one. I suppose one could theorize that HPV may have made the toxic effects of the cigarettes even worse but even that is a stretch.
HPV is thought to cause penis cancer, anal cancer, and virtually all cervical cancer.
-
Major Study Examines Meat-Diabetes Link
By JENNIFER CORBETT DOOREN
People who increased their consumption of red meat during a four-year period were more likely to develop Type 2 diabetes in a subsequent four-year period, according to an analysis involving about 150,000 people.
The analysis, led by researchers at the National University of Singapore, took data from three long-running Harvard University studies involving mostly nurses and doctors. The results were published online Monday in JAMA Internal Medicine, a journal of the American Medical Association. The studies were funded by grants from the National Institutes of Health.
While bumping up red-meat intake can raise diabetes risk, some experts suggest eating lean cuts of meat like certain steaks or lamb instead of fattier options like sausage.
While prior studies have also found a link between red-meat consumption and the development of Type 2 diabetes, the new analysis is believed to be the first time researchers have tracked changes in red-meat consumption over time with the risk of developing Type 2 diabetes. Study participants filled out detailed questionnaires about the types of food and drinks they consumed at the beginning of the study and every four years. The analysis looked at some 20 years of data.
Broadly, the study showed that, compared with a group of people who had no change in red-meat intake, increasing red-meat consumption by more than a half-serving per day over a four-year period was associated with a 48% increase in the risk of developing Type 2 diabetes during the next four years.
However, reducing red-meat consumption by the same amount during the same time period didn't cut the risk of diabetes during the next four years. It did reduce the risk by 14% over a longer time period, though.
The changes were independent of other factors such as body weight and overall diet quality.
"Our results confirm the robustness of the association between red meat and [Type 2 diabetes prevention] and add further evidence that limiting red-meat consumption over time confers benefits for…prevention," the study authors wrote. An Pan, an assistant professor at the National University of Singapore's Saw Swee Hock School of Public Health, was the study's lead author.
Other doctors say red meat in and of itself isn't necessarily the trouble.
"It is not the type of protein (or meat) that is the problem; it is the type of fat," said William J. Evans, who is affiliated with both Duke University and GlaxoSmithKline PLC., GSK.LN -0.59% and who wrote a commentary about the study that was also published online in JAMA Internal Medicine. "It's mischaracterizing red meat as high fat," Dr. Evans said in an interview.
He said consumers could choose lean cuts of red meat such as sirloin tips or round steak over high-fat cuts like rib-eye.
Dr. Pan could not be reached for comment Monday.
Similar to general dietary guidelines from the U.S. government, the American Diabetes Association recommends people with diabetes eat lots of vegetables and fruit and choose whole-grain foods including dried beans, as well as eating fish two or three times a week. Lean meats include cuts of beef or pork that end in "loin," such as pork loin and sirloin.
Diabetes affects about 26 million Americans and is characterized by high blood-glucose levels caused by the body's inability to either make or properly use insulin. Type 2 diabetes, the most common form of the disease, is often associated with weight gain and older age. The disease raises the risk of heart attacks and strokes, kidney disease, blindness, amputations and nerve damage. The other type of diabetes, Type 1, is an autoimmune disease and often diagnosed in childhood.
The Centers for Disease Control and Prevention has projected that as many as 1 in 3 U.S. adults could have diabetes by 2050. The disease is currently the seventh leading cause of death in the U.S.
Doctors say that improving diet is important not only for managing diabetes, but for keeping the adult-onset Type 2 at bay for those with the highest risk. The CDC estimates that 35% of U.S. adults age 20 and older—nearly 80 million Americans, by the agency's estimate—are affected with prediabetes, a condition in which people have higher-than-normal blood-glucose levels. People with prediabetes also have a higher risk of developing problems like heart disease and stroke.
Researchers said one of the limitations of the study was that participants were mostly white, educated U.S. adults. Some groups have a higher risk than others for developing Type 2 diabetes, according to the diabetes association, including African-Americans and Hispanics.
The diabetes and red-meat analysis involved data from the Health Professionals Follow-Up Study collected between 1986 and 2006, as well as information from two groups of women in the Nurses' Health studies collected during a similar time period.
-
Is it possible to test for HPV?
-
From CDC:
****Is there a test for HPV?
HPV tests are available to help screen women aged 30 years and older for cervical cancer. These HPV tests are not recommended to screen men, adolescents, or women under the age of 30 years. There is no general HPV test for men or women to check one's overall "HPV status." Also, there is not an approved HPV test to find HPV in the mouth or throat.****
Screening for cervical cancer in women. If the HPV leads to visible warts on genitals, mouth (mostly on HIV people), anal areas the infection is obvious.
There are investigational ways of looking for viral DNA in tissue samples but to my knowledge these are not widely available. Perhaps Michael Douglas paid for this out of pocket. In any case it would only have been of academic interest to him. Treatment for his cancer would not have changed (as far as I know).
If one had warts they could be removed until they don't return. Does this mean a person is cured and virus is eradicated, and protected from long term consequences? To my knowledge the answer is unknown. Could viral remnants still remain that can cause cancer years down the road? Again I am not aware of any definite answers to that.
-
Thank you.
How prevalent is HPV in men? women?
-
CDC estimates 79 million in US:
http://www.cdc.gov/std/stats/STI-Estimates-Fact-Sheet-Feb-2013.pdf
-
Editorial
A Surprisingly Successful HPV Vaccine
By THE EDITORIAL BOARD
Published: June 21, 2013
A vaccine to protect teenage girls against dangerous strains of the human papillomavirus, or HPV, that are a leading cause of cervical cancer has proved to be enormously effective.
A study published Wednesday by the Centers for Disease Control and Prevention found that the prevalence of high-risk strains in teenage girls dropped by half after the vaccine was introduced in 2006, from 7.2 percent in 2006 to 3.6 percent in 2010.
Unfortunately, many parents still resist having their daughters immunized. A study published in March found that 44 percent of parents said in 2010 that they did not intend to vaccinate their daughters, up from 40 percent in 2008.
Some parents fear that vaccination might promote promiscuity (the new study found no sign of that); some see no need to vaccinate girls before they become sexually active, even though vaccination beforehand offers the best protection.
Health officials were surprised at the steep decline in infection rates because only about a third of American teenage girls have received the full course of three doses. In other advanced countries and even in a developing nation like Rwanda, vaccination rates have reached 80 percent or higher. Increasing the vaccination rate to 80 percent in this country could prevent an additional 53,000 cervical cancers and 17,000 deaths among girls now 13 years old and younger over the course of their lives.
Doctors need to recommend, and parents need to accept, a vaccine that can save thousands of lives.
-
Many recommend young men get the vaccine now mainly to curtail spread of some of the carcinogenic HPV subtypes.
I have no idea why any young person would not want to get it unless they plan on being celibate for ever.
-
second post today:
Interesting new enzyme blocker which actually works to alter the metabolism for fat in the body and not simply an appetite suppressant. Company not public but if clinical studies continue to suggest safety and efficacy it will be.
Huge, huge risk. I looked up this class of drugs and they appear to have different and unknown actions in the body.
Our wonderful regulatory government can tax fatty foods, sugary foods, alcohol, pot, cigarettes guild walking and bicycle paths, go after soda makers and force companies to set up fitness plans for their employees all they want. But these kinds of drugs are the future of the treatment of obesity.
http://www.news-medical.net/news/20100628/Data-on-MetAP2-inhibitors-for-treatment-of-obesity-presented-at-ADA-2010.aspx
-
http://www.ted.com/talks/peter_attia_what_if_we_re_wrong_about_diabetes.html?source=facebook#.Uc8BJ3RYnvx.facebook
-
Researchers in Japan have used human stem cells to create tiny human livers like those that arise early in fetal life. When the scientists transplanted the rudimentary livers into mice, the little organs grew, made human liver proteins, and metabolized drugs as human livers do.
Researchers from Japan used human stem cells to create "liver buds," rudimentary livers that, when transplanted into mice, grew and functioned.
They and others caution that these are early days and this is still very much basic research. The liver buds, as they are called, did not turn into complete livers, and the method would have to be scaled up enormously to make enough replacement liver buds to treat a patient. Even then, the investigators say, they expect to replace only 30 percent of a patient’s liver. What they are making is more like a patch than a full liver.
But the promise, in a field that has seen a great deal of dashed hopes, is immense, medical experts said.
“This is a major breakthrough of monumental significance,” said Dr. Hillel Tobias, director of transplantation at the New York University School of Medicine. Dr. Tobias is chairman of the American Liver Foundation’s national medical advisory committee.
“Very impressive,” said Eric Lagasse of the University of Pittsburgh, who studies cell transplantation and liver disease. “It’s novel and very exciting.”
The study was published on Wednesday in the journal Nature.
Although human studies are years away, said Dr. Leonard Zon, director of the stem cell research program at Boston Children’s Hospital, this, to his knowledge, is the first time anyone has used human stem cells, created from human skin cells, to make a functioning solid organ, like a liver, as opposed to bone marrow, a jellylike organ.
Ever since they discovered how to get human stem cells — first from embryos and now, more often, from skin cells — researchers have dreamed of using the cells for replacement tissues and organs. The stem cells can turn into any type of human cell, and so it seemed logical to simply turn them into liver cells, for example, and add them to livers to fill in dead or damaged areas.
But those studies did not succeed. Liver cells did not take up residence in the liver; they did not develop blood supplies or signaling systems. They were not a cure for disease.
Other researchers tried making livers or other organs by growing cells on scaffolds. But that did not work well either. Cells would fall off the scaffolds and die, and the result was never a functioning solid organ.
Researchers have made specialized human cells in petri dishes, but not three-dimensional structures, like a liver.
The investigators, led by Dr. Takanori Takebe of the Yokohama City University Graduate School of Medicine, began with human skin cells, turning them into stem cells. By adding various stimulators and drivers of cell growth, they then turned the stem cells into human liver cells and began trying to make replacement livers.
They say they stumbled upon their solution. When they grew the human liver cells in petri dishes along with blood vessel cells from human umbilical cords and human connective tissue, that mix of cells, to their surprise, spontaneously assembled itself into three-dimensional liver buds, resembling the liver at about five or six weeks of gestation in humans.
Then the researchers transplanted the liver buds into mice, putting them in two places: on the brain and into the abdomen. The brain site allowed them to watch the buds grow. The investigators covered the hole in each animal’s skull with transparent plastic, giving them a direct view of the developing liver buds. The buds grew and developed blood supplies, attaching themselves to the blood vessels of the mice.
The abdominal site allowed them to put more buds in — 12 buds in each of two places in the abdomen, compared with one bud in the brain — which let the investigators ask if the liver buds were functioning like human livers.
They were. They made human liver proteins and also metabolized drugs that human livers — but not mouse livers — metabolize.
The approach makes sense, said Kenneth Zaret, a professor of cellular and developmental biology at the University of Pennsylvania. His research helped establish that blood and connective tissue cells promote dramatic liver growth early in development and help livers establish their own blood supply. On their own, without those other types of cells, liver cells do not develop or form organs.
“They were letting nature do its thing rather than trying to conceive of what the right signals might be,” Dr. Zaret said. But, he said, the mice were studied for only a couple of months. He would like to see what happens over a longer time.
“We don’t know if the cells will grow out of control or will poop out,” Dr. Zaret said.
Even if the liver buds never fulfill their clinical promise, they still could be enormously important for pharmaceutical research, Dr. Zon said. Drugs must be tested to see if they damage the liver, a major site of drug toxicity. Companies do this with liver cells taken from cadavers and grown in petri dishes. But the liver buds could be a big improvement and offer a large supply of rudimentary livers for testing.
“That would be huge,” Dr. Zon said. “It would open up lots of drugs in the pipeline and bring them to the clinic much more quickly.”
Dr. Takebe and his colleagues, though, are more focused on scaling up their process so they can think of trying to take it to the clinic, perhaps to treat babies and children whose livers have failed. Dr. Takebe estimates they would need hundreds of thousands, perhaps millions, of liver buds to replace 30 percent of the liver.
Dr. Tobias, the transplant surgeon, hopes they succeed.
“This is obviously the wave of the future,” he said.
-
Why I Donated My Stool
By MARIE MYUNG-OK LEE
POTH
This spring I saved a friend from a terrible illness, maybe even death. No, I didn’t donate a kidney or a piece of my lung. I did it with my stool.
About 18 months ago, my friend, whom I’ll call Gene to protect his privacy, fell sick with stomach pain, intestinal cramps and copious bloody diarrhea. He had ulcerative colitis, a colon riddled with bleeding ulcers.
His gastroenterologist started him on steroids and anti-inflammatories — standard treatment for these ulcers. He felt better and within a few weeks was able to taper off the steroids, which can be dangerous if used over the long term. But a month later, the bleeding and diarrhea were back. He was in horrible pain that worsened when he ate or drank. He couldn’t sleep at night.
The doctor put him back on the steroids, but this time the symptoms weren’t held in check. For the next excruciating year, my friend went through episodes where he could do nothing but lie writhing in bed in pain. He lost frightening amounts of weight, became anemic from the blood loss and was forced to take medical leave from a job he loved.
According to his doctors, he was left with two options: powerful immunosuppressant drugs (the kind they give people after organ transplants) or a total colectomy (the removal of the colon). The drugs might not be effective, and they raised the risk of lymphoma or fatal infections, while with the surgical option, the tissue left behind could and often did eventually become ulcerated itself.
That’s when Gene started reading about a procedure called fecal microbiota transplant, or F.M.T.
Transplanting the stool from one person into the digestive tract of another seems, well, repulsive, but it also makes sense. The majority of the matter in stool — roughly 60 percent — is bacteria, dead and alive, but mostly alive. While bacteria can make us sick, they also constitute a large part of who we are; the hundreds of trillions of cells in an individual’s microbiome, as this collective is known, outnumber human cells 10 to 1. The bacteria serve many functions, including in metabolism, hormone regulation and the immune system.
Katie Scott
The microbiome of the digestive system is particularly important. At least a thousand strains of bacteria coexist in a healthy human bowel, and beneficial bacteria are involved in vitamin production, digestion and keeping “bad” bacteria in check. Thus, changes to the gut microbiome can precipitate disease. For instance, taking a powerful antibiotic wipes out both good and bad gut flora, which can lead to opportunistic bacteria taking over and causing infection.
Many people who suffer from clostridium difficile, a dangerous strain of bacteria that is becoming epidemic in hospitals and nursing homes, got it this way. The idea behind fecal transfers is that restoring colonies of healthy bacteria can either dilute or crowd out these harmful strains. And it seems to work: in January, The New England Journal of Medicine reported that the first randomized clinical trial of F.M.T.’s for clostridium difficile had been halted because the treatment worked so well that it was unethical to withhold it from the control group.
The causes of ulcerative colitis are more mysterious than those of clostridium difficile (doctors in Gene’s case did not hazard a guess), but there is some speculation that the condition can also be traced to pathogenic bacteria. A small study of children with ulcerative colitis, published this spring in The Journal of Pediatric Gastroenterology and Nutrition, found that 78 percent had a reduction in symptoms within a week of being treated with fecal transfers.
The idea of using stool as medicine is not new. In the 16th century, during the Ming dynasty, fermented fecal concoctions, euphemistically named “yellow soup,” were used for digestive problems. In the 17th century, Christian Franz Paullini, a German physician, compiled a stool recipe book for treating dysentery and other digestive ailments. In the United States, fecal transplants have long been used on sick horses, and in 1958, Dr. Ben Eiseman pioneered the concept in humans, writing about the use of a fecal enema as a last-ditch effort for a patient with clostridium difficile.
Today, around 3,000 F.M.T.’s have been performed worldwide. No significant adverse reactions have been definitively attributed to the procedure (though there have been two F.M.T.’s that may have led to the transmission of the norovirus stomach bug, both of which cleared on their own within days).
CONVINCED that the potential benefits outweighed the risks, Gene decided, early this year, to try F.M.T. However, this turned out to be harder than he’d expected. There are only about 16 centers in the country that even offer the treatment. Gene finally secured an appointment with Dr. Lawrence Brandt, one of the most experienced F.M.T. practitioners, only to find out, just before his visit, that Dr. Brandt was suspending his F.M.T. practice for ulcerative colitis on the advice of the hospital’s lawyers, in order to comply with a new Food and Drug Administration decision. In April, the F.D.A. decided to classify human stool that is used therapeutically as a drug, and thus approved for use only within an F.D.A.-approved clinical study.
Gene tried tracking down other doctors, but found to his frustration that almost all of them had stopped doing F.M.T.’s as a result of the agency’s somewhat ambiguous restrictions. He found one remaining gastroenterologist, R. David Shepard, who had an excellent record of treating ulcerative colitis with fecal transfers and was still doing them. But Dr. Shepard was in Florida, and Gene was now too sick to travel.
Dr. Shepard, however, had a solution: he would help Gene with the mechanics of performing a do-it-yourself F.M.T., something he’d done successfully with a handful of other patients. Gene just had to find a donor.
The donor question was a tricky one. The donor has to be healthy (and will be screened, via stool and blood, for transmissible diseases like H.I.V., as well as for pathogens and parasites); has to avoid any foods the patient might be allergic to; and has to be nearby, as freshness is an issue: the bacteria mix may begin to change once the stool leaves the body.
THIS is where I enter the story. My friends know me as being somewhat evangelical about eating fresh fruits and vegetables. I also eat a lot of naturally fermented vegetables, which contain beneficial bacteria as well as the kind of fiber that nourishes good bacteria in the gut, and I follow a gluten-free diet (Gene had found that his colitis did better off gluten). Finally, I’m regular, which is also important. In the end, it was kind of inevitable that he ask me.
After the initial weirdness of the request wore off, I told him I’d be happy to do it.
The screening took one visit to the lab. The procedure is, of course, messy and odoriferous, but it’s also simplicity itself. Gene’s marching orders were to procure a dedicated blender and sieve, enema tubing and syringe, and lots and lots of newspaper. F.M.T. basically consists of blending stool with saline, straining it, and reintroducing it into the colon via enema.
I delivered my first donation, in Tupperware, and Gene took it into the privacy of his bathroom. I stayed, just in case I was needed, and after about half an hour, he came out and told me, with a look of wonder, that he was feeling better already. Already? We checked with Dr. Shepard, who told us that, indeed, one can feel the effects that quickly.
However, a few hours later, the cramps returned. The good bacteria appeared to be doing something, but hadn’t gained a foothold in Gene’s gut. We would need to keep doing the transfers — first twice a day, then just once a day.
By early May, Gene felt well enough to get on a plane to Dr. Shepard’s center in Florida, where he received a colonoscopic F.M.T. The doctor confirmed that instead of the multiple ulcers Gene once had, there’s only a single small one remaining.
He can’t declare his ulcerative colitis “cured,” because it could still return. However, for now, the diarrhea, bleeding and mental misery are in the past.
Fecal microbiota transplants may cure bacterial infections, and even save lives.
Of course, his experience is only one story, hardly a double-blind clinical trial. And there could be risks we don’t know about: could moving the genetic material of one person to another also transfer unwanted characteristics, like a propensity toward diabetes or cancer? More studies are needed. But at the same time, the F.D.A. needs to fast-track research into this field, though it is neither glamorous nor capable of promising a blockbuster drug payoff for some corporation.
Thankfully, just two weeks ago, the agency announced that it was easing some of the restrictions it imposed in April on the use of F.M.T. for clostridium difficile. But this does not apply to ulcerative colitis. Gene had been lucky to have received one of Dr. Shepard’s last F.M.T.’s.
Gene was also lucky (or desperate enough) to find a donor. Some patients have resorted to Craigslist. There is the possibility of creating synthetic stool, but given that there are thousands of unknown species of bacteria in human stool, there’s no way to know if it would be effective. In an ideal future, a universal screening panel will be put in place so that healthy people can donate their microbiota, the way you can with blood.
The upside for patients would be huge. In a maelstrom of skyrocketing health care costs, think of what we could save, in terms of quality of life and money, with this procedure. Clostridium difficile infections alone kill about 30,000 a year and cost billions of dollars. The prescription drugs for Gene’s ulcerative colitis, let alone the doctor visits and one hospitalization, ran into the tens of thousands of dollars. The F.M.T. was basically the cost of the blender and the enema materials.
Gene gained back much of the weight he’d lost and recently returned to work. He was feeling so good that, last month, he gave a party. He’d kept his illness very private and thus most people hadn’t seen him at his sickest — to them he probably just looked like himself. But I remembered how skeletal and hollow-eyed he looked and the incredible journey he took just to fight his way back to normal. Now, thanks to some doctors who are promoting the curative powers of what we once used to think of as “waste,” Gene has a new medicine, one that’s replenishable and has no co-pay.
As for me, in a normal world, I would prefer not to discuss my stool in a public forum. But seeing my friend restored to health has made me change my attitude. Every morning (like I said, I am very regular), I find myself with a new appreciation for this bacterial world that we share.
Marie Myung-Ok Lee
Marie Myung-Ok Lee teaches writing at Columbia and is working on a novel about health care.
-
interesting research angle into the obesity and diabetes conditions. diabetes @ tends to reverse within a few days after bariatric surgery even before the major weight loss has occurred suggesting the anatomical changes in the proximal gut alter the chemistry via gastrointestinal hormones in a way the change metabolism. This same chemical alterations may lead to drugs that can induce the same changes without the surgery. NGM biopharmaceuticals is private but has entered into agreement with Medimmune:
http://www.biospace.com/news_story.aspx?StoryID=300116
NovoNordiscs victoza used for Type 2 diabetes treatment is known to induce several percent weight loss. At this time it is FDA approved only for diabetes. A dose of 3 mg (vs the 0.6 to 1.8 for diabetes) is being researched for FDA approval for use in obesity. It may cause and ?maintain up to 8% weigh loss. I am not sure if all its mechanisms are known. It delays stomach emptying this making feel full faster and less hungry and is also thought to work directly through the brain as well. I wonder if adding that to the VVUs drug would add additional benefits. Some combinations I have read do not add much if any benefit however.
*Of course for us male and female studs on this board we do not need such help. I am speaking of the millions of couch potatoes who sit at desks all day and commute for hours.*
-
HPV Vaccine Found to Help With Cancers of Throat
By DONALD G. McNEIL Jr.
Published: July 18, 2013
A vaccine that protects women against cervical cancer also appears to protect them against throat cancers caused by oral sex, and presumably would protect men as well, according to a study released Thursday.
Rates of this throat cancer have soared in the past 30 years, particularly among heterosexual middle-aged men. About 70 percent of oropharyngeal cancers are now caused by sexually transmitted viruses, up from 16 percent in the 1980s. The epidemic made headlines last month when the actor Michael Douglas told a British newspaper that his throat cancer had come from performing oral sex.
Oncologists have assumed that the human papillomavirus vaccine, which is used to prevent cervical cancer, would also prevent this other type of cancer, but this was the first study to provide evidence.
“This is a very nice paper,” said Dr. Marshall R. Posner, medical director for head and neck cancer at Mount Sinai Medical Center in New York, who was not involved in the study. “We expected this — that’s why we want everyone to vaccinate both boys and girls. But there’s been no proof.”
The study, supported by the National Cancer Institute, found that Cervarix, made by GlaxoSmithKline, provided 93 percent protection against infection with the two types of human papillomavirus that cause most of the cancers.
“We were surprised at how big the effect was,” said Dr. Rolando Herrero, head of prevention for the World Health Organization’s International Agency for Research on Cancer, and the study’s lead author. “It’s a very powerful vaccine.”
The study was done with 5,840 women in Costa Rica who were ages 18 to 25 and sexually active when it began. Four years after being vaccinated, each gave a mouthwash gargle sample that picked up cells from deep in the throat. Only one woman who had received the vaccine was infected with the viruses HPV 16 or HPV 18, the cancer-causing types; 15 women who had gotten a placebo vaccine were infected.
Dr. Herrero explained some of the study’s limitations: when it began, it was concerned only with cervical cancer, so no men were enrolled. The women were initially tested to make sure they had no cervical infections, but were not tested for throat or anal infections. They gave oral samples only once, so it was not possible to say how many had persistent infections; most people clear HPV infections on their own, so only a tiny fraction lead to cancer. Four years is not long enough to know how many cancers would develop — but finding out for sure would require waiting 20 years or more, and ethical guidelines require that all women in the trial get regular examinations and that any suspicious lesions be destroyed before they turn cancerous. Also, only Cervarix, and not Merck’s similar Gardasil vaccine, was tested.
However, Dr. Herrero said, men would “probably” get the same protection as the women did, because the vaccine produces identical antibody levels in both sexes.
Dr. Posner said the large discrepancy in infection rates between those who got the vaccine and those who got placebo suggested that the data was “very reliable” even though the infections were detected far too early to produce cancers.
“What we don’t know,” he said, “is how long-term the protection is, or if re-vaccination is necessary.”
While cancers caused by smoking or drinking usually occur in the mouth, those caused by oral sex usually occur at the base of the tongue or deep in the folds of tonsillar tissue, and are hard to detect. They are more common among heterosexual men than among women or gay men; experts believe that is because vaginal fluid contains more virus than the surface of the penis.
Dr. Eric J. Moore, a Mayo Clinic surgeon specializing in these cancers, said the study was “very encouraging.”
“But remember,” he added. “It only works if you’re vaccinated prior to contracting the infection. Once you’re 40 and have had multiple sexual partners, it’s not going to help.”
-
http://politicalblindspot.org/scientists-finally-discover-the-function-of-the-human-appendix/
-
Kitten nearly dies from vegan diet
Kellie Cameron •
Moonee Valley Leader•
July 22, 20135:00AM
Lort Smith Vet Leanne Pinfold says cats should be fed a proper diet. She is pictured with Roger, who is well-fed and available for adoption.Source: News Limited
A KITTEN has almost died after its owners fed it a strict vegan diet.
The horrific case at a North Melbourne animal hospital has prompted a warning about the dangers of people "forcing ideologies" on their pets.
Lort Smith Animal Hospital veterinarian Leanne Pinfold said the kitten was brought in this month by its owners, who were believed to be vegan.
She said the kitten's diet of potatoes, rice milk and pasta had caused it to become critically ill.
"It was extremely weak and collapsed when it came in. It was almost non-responsive," Dr Pinfold said.
The kitten was given fluids via a drip, placed on a heat pad and fed meat.
It remained in hospital for three days after which the kitten's owners were given meat to feed their pet at home, she said.
Dr Pinfold said as obligate or true carnivores, cats needed meat to survive.
She said people who wanted a pet that did not eat meat should consider other animals, such as rabbits.
"Concern for animal welfare has to include a biologically-appropriate diet," she said. "You can't force your ideology on the cat.
"Carnivores will seek out meat and your cat is possibly more likely to go hunting and kill local native fauna if you deprive it of meat.''
Dr Pinfold said she had not come across a similar case in her 11 years as a veterinarian.
-
I've posted before how I think it wrong that there are countless sales pitches for so called natural products that "might" cure or treat every illness known to man with almost no legal or regulatory challenge.
http://news.yahoo.com/fda-cracks-down-illegal-diabetes-140142593.html
-
I've posted before how I think it wrong that there are countless sales pitches for so called natural products that "might" cure or treat every illness known to man with almost no legal or regulatory challenge.
http://news.yahoo.com/fda-cracks-down-illegal-diabetes-140142593.html
I'm sure they'll approach their enforcement with the nonpartisan, professional detachment that's become the standard the last few years.
-
GM, I am not sure the FDA is "partisan" but I would agree there likely is corruption there from a money point of view.
There was an article about corrupt research and the FDA in Scientific American a couple of months back. If I can find it I will try to post.
I notice that in between my favorite talk radio shows, mostly on weekends are these endless so called experts (expert con artists if you ask me) hawking there latest natural treatments for all sorts of ubiquitous ills.
Almost all of it is nonsense. Even the "science" they base their claims are is junk and often corrupt.
-
Heart Surgery in India for $1,583 Costs $106,385 in U.S.
By Ketaki Gokhale - Jul 28, 2013 2:30 PM ET Facebook Share Tweet LinkedIn Google +1 66 Comments
Print QUEUEQ
Devi Shetty is obsessed with making heart surgery affordable for millions of Indians. On his office desk are photographs of two of his heroes: Mother Teresa and Mahatma Gandhi.
Shetty is not a public health official motivated by charity. He’s a heart surgeon turned businessman who has started a chain of 21 medical centers around India. By trimming costs with such measures as buying cheaper scrubs and spurning air-conditioning, he has cut the price of artery-clearing coronary bypass surgery to 95,000 rupees ($1,583), half of what it was 20 years ago, and wants to get the price down to $800 within a decade. The same procedure costs $106,385 at Ohio’s Cleveland Clinic, according to data from the U.S. Centers for Medicare & Medicaid Services.
“It shows that costs can be substantially contained,” said Srinath Reddy, president of the Geneva-based World Heart Federation, of Shetty’s approach. “It’s possible to deliver very high quality cardiac care at a relatively low cost.”
Medical experts like Reddy are watching closely, eager to see if Shetty’s driven cost-cutting can point the way for hospitals to boost revenue on a wider scale by making life-saving heart operations more accessible to potentially millions of people in India and other developing countries.
“The current price of everything that you see in health care is predominantly opportunistic pricing and the outcome of inefficiency,” Shetty, 60, said in an interview in his office in Bangalore.
Out-of-Pocket
Cutting costs is especially vital in India, where more than two-thirds of the population lives on less than $2 a day and 86 percent of health care is paid out of pocket by individuals. A recent study by the Public Health Foundation of India and the London School of Hygiene & Tropical Medicine found that in India non-communicable ailments such as heart disease are now more common among the poor than the rich.
One in four people there die of a heart attack and per-capita health spending is less than $60 a year. Yet the country performs only 100,000 to 120,000 heart surgeries each year, well short of the 2 million Shetty estimates are needed. The mortality rate from coronary artery disease among South Asians is two to three times higher than that of Caucasians, according to a study published in 2008 in the journal Vascular Health and Risk Management.
Dietary Patterns
“There has been fast urbanization in India that’s brought with it a change in dietary patterns and lifestyle,” said Usha Shrivastava, head of public health at the National Diabetes, Obesity and Cholesterol Foundation. “It’s leading to this huge jump in cardiovascular disease.”
The average age for a first heart attack in India, Pakistan and other South Asian nations was 53 years, compared with 58.8 years in countries outside the region, according to a study published in 2007 in the Journal of the American Medical Association.
The biggest impediment for heart surgery in India is accessibility. Shetty aims to bridge that by building hospitals outside India’s main cities. He said he plans to add 30,000 beds over the next decade to the 6,000 the hospital chain has currently, and has identified 100 towns with populations of 500,000 to 1 million that have no heart hospital.
A 300-bed, pre-fabricated, single-story hospital in the city of Mysore cost $6 million and took six months for construction company Larsen & Toubro Ltd. to build, Shetty said. Only the hospital’s operating theaters and intensive-care units are air-conditioned, to reduce energy costs.
Changing Procedures
One of the ways in which Shetty is able to keep his prices low is by cutting out unnecessary pre-op testing, he said.
Urine samples that were once routine before surgery were eliminated when it was found that only a handful of cases tested positive for harmful bacteria. The chain uses web-based computer software to run logistics, rather than licensing or building expensive new systems for each hospital.
That might cover the cost of linens here:
****When Shetty couldn’t convince a European manufacturer to bring down the price of its disposable surgical gowns and drapes to a level affordable for his hospitals, he convinced a group of young entrepreneurs in Bangalore to make them so he could buy them 60 percent cheaper.
In the future, Shetty sees costs coming down further as more Asian electronics companies enter the market for CT scanners, MRIs and catheterization labs -- bringing down prices. As India trains more diploma holders in specialties such as anesthesiology, gynecology, ophthalmology and radiology, Narayana will be able to hire from a larger, less expensive talent pool.
One positive unforeseen outcome may be that many of the cost-saving approaches could be duplicated in developed economies, especially in the U.S. under health reform.
“Global health-care costs are rising rapidly and as countries move toward universal health coverage, they will have to face the challenge of providing health care at a fairly affordable cost,” said the World Heart Federation’s Reddy, a New Delhi-based cardiologist who is also president of the Public Health Foundation of India. ****
-
The article does not specify details but I can see the report in the journal. Other organizations have already recommended this. The pulmonary doctors and those who own CT scans are dancing in the streets now. I don't necessarily agree with ding these but this endorsement will definitely give the green light to screening tests:
http://news.yahoo.com/panel-backs-lung-cancer-screening-210228577.html
-
http://well.blogs.nytimes.com/2013/07/29/report-suggests-sweeping-changes-to-cancer-detection-and-treatment/?nl=todaysheadlines&emc=edit_th_20130730&_r=0
-
second post
http://www.nytimes.com/2013/07/30/us/program-compelling-outpatient-treatment-for-mental-illness-is-working-study-says.html?nl=todaysheadlines&emc=edit_th_20130730
-
Education is a good thing.
http://online.wsj.com/article/SB10001424127887323407104579037320321621280.html?mod=WSJ_hps_MIDDLENexttoWhatsNewsFifth
-
http://www.whydontyoutrythis.com/2013/08/10-american-foods-that-are-banned-in-other-countries.html
-
http://www.nytimes.com/2013/09/06/health/gut-bacteria-from-thin-humans-can-slim-mice-down.html?nl=todaysheadlines&emc=edit_th_20130906
-
Industrialization/corporatization of pharmacy - I assume it is the same all over the US. When one walks into one of these chain pharmacies one sees an exasperated staff answering calls, taking orders from the drive thru, filling prescriptions, catering to lines of customers, calling doctors, insurers, kept on hold, etc. I feel sorry for them. (In contrast has anyone ever seen a government agency employee work so hard?) I read this and I can relate:
****On Being a Doctor (in this case a pharmacist)| 3 September 2013
A Day in the Life of a Corporate Retail Pharmacist
David D. Dore, PharmD, PhD
Ann Intern Med. 2013;159(5):366-367. doi:10.7326/0003-4819-159-5-201309030-00014
It was the Tuesday after Memorial Day and my fourth consecutive 13-hour day in the pharmacy. Having just passed the boards, I landed a job as a floating staff pharmacist. It was my first time working at this store and my third store in as many days. I did not know what to expect except that, as usual, I would be the only licensed pharmacist working here today. This fact struck me as a microcosm of my profession's ineffectualness—an ineffectualness resulting from misaligned objectives and poor processes of care, afflicting first pharmacists and, ultimately, patient care.
Today's store was small and old, the mirror against the wall a vestige of the soda fountain of years past. The fibrous carpet, with its familiar gray-square pattern, was the same as that at the two megastores where I worked over the weekend. Familiar, too, was the impending tumult of the day, which was as disruptive to the 20-year veteran pharmacist who managed this store as it was to me.
Arriving at the pharmacy, I entered the alarm code and raised the dusty gate. I prepared the cash register and logged into the ancient computer system, wondering when the pharmacy technician was due to arrive. Fifty new refill requests awaited. I preferred to arrive early for busy shifts, especially on a Tuesday after a holiday, but it was against corporate policy.
I answered the telephone. “Jim, this is Rocco. I need my orange pills and my inhaler,” the caller said.
“Sir, Jim has the day off. I'm filling in for him. Let me see whether I can help you. What is your last name?”
He hung up. I answered a second call. It was the practice nurse from one of the local primary care providers responding to a question left on voicemail the previous evening. Prescriptions with pending problems are conventionally left in plain sight, but I found no note or other evidence of the situation. Perhaps the permanent pharmacists would have known of this issue, though not through any evident record-keeping system. No two systems were alike.
“I'm sorry, but I'l have to call you back,” I said.
She hung up, wasting no time on pleasantries. My anxiety grew.
Standing alone in the pharmacy, I turned my attention to the now 60 prescriptions waiting. I spent the next 10 minutes processing the prescription orders, overriding the many warnings that popped up on the computer screen, thinking of the alarm fatigue that my colleagues at the hospital experience with medical equipment. The whirling of the laser printer drowned out the overhead music.
The first technician arrived 15 minutes late and began counting tablets on a small plastic tray by using a spatula that resembled a butter knife. Meanwhile, I was caught in a proxy battle with an insurance company. They no longer paid for olmesartan. A patient would have to use an alternative drug that her insurance company now preferred.
I called the physician's office to request a substitution, cursing the fact that I could not make the substitution without a physician's approval. After waiting on hold for several minutes, I left a message requesting a prescription for valsartan. I made a note to call the customer, who had not yet learned that her prescription was changing.
The technician was also on the telephone, and four customers arrived at the counter in rapid succession. The first woman tapped her keys on the counter, apparently to ensure that we noticed her. I smiled at her while my anxiety mounted.
After hanging up the telephone, I greeted the woman at the counter. She handed me a prescription for isotretinoin, for which the Food and Drug Administration required a special program for therapeutic risk management. I had to call a telephone-based registry system before filling the prescription.
“I have a new insurance card,” she said, handing me a card that had no information that could be used for billing a pharmacy claim.
“You should have received a separate card for your pharmacy coverage,” I told her. “Do you have it?”
“I didn't get it.”
“I'l call the insurance company,” I said.
“How long will it take?”
“About 30 minutes.”
“But your advertisement says that prescriptions will be filled in 15 minutes or less.”
She was right.
“I'm sorry, but that is not feasible at the moment. I'l finish it as soon as possible,” I said.
She walked away with an angry look. I didn't notice, but that day I had not yet used any knowledge of pharmacotherapy that was the focus of my training.
The next customer was an overweight, out-of-breath woman in her mid-70s named Mrs. da Silva, who arrived with her daughter. Mrs. da Silva was a regular customer who spoke only Portuguese. Translating, the technician told me that Mrs. da Silva was just discharged from the hospital for what I inferred was an acute myocardial infarction. I had no access to her actual diagnosis or medical records. Mrs. Da Silva handed me 12 prescriptions written by the hospital's housestaff.
In subsequent moments, I prioritized the filling of Mrs. da Silva's prescriptions; her pale appearance suggested that she would be better off resting at home than sitting on a bench next to the pharmacy. The chaos of the routine prescription-filling circled just beyond my attention.
As the technician translated, I began counseling Mrs. da Silva on the importance and logistics of taking the medicines. I realized quickly that she learned very little about the medications from her doctors at the hospital, which came as no surprise. During the inpatient rotations of my training, I learned how hectic hospital life could be for medical interns and residents.
Then, a second technician whose arrival I barely noticed interrupted to tell me that I had to take an urgent telephone call from a cursing customer. The caller was a man irate about the copayment for the prescription that his daughter had just picked up. When I returned to the counter, Mrs. da Silva was gone. I contemplated calling her when she arrived home but was interrupted by a beeping noise indicating that a car was at the drive-through pharmacy window.
“She just wanted to go home,” said the technician who had translated.
I do not know why I allowed my conversation with Mrs. da Silva to be interrupted except that a typical day at a corporate pharmacy involves being understaffed and overworked, resulting in the need to address one urgency after another. Technician help is scarce, not because there are too few technicians but because corporate overseers allocate staffing resources.
Moreover, prompt responses are expected in retail, even if I have no influence over the physician's choice of drug or the insurance company's coverage policies. The large corporate pharmacies limit staff in favor of profit and promise convenience instead of health care. I also know that continuity of care after discharge from the hospital is imperfect and that community pharmacists are the most accessible health care providers.
As a community pharmacist, I cannot be expected to be a patient's primary care provider; indeed, physicians must follow their sickest patients closely. However, it seems that improving the patient-centeredness rather than profit-centeredness of pharmacy care would prevent lost opportunities for patient–provider dialogue, such as that with Mrs. da Silva.
Reflecting on the reasons why I went to pharmacy school, I recall that in my precollege years I had simply wanted a future career where I could help people. Although I considered a range of options, the college of pharmacy's recruitment materials touted the effect that one could have after completing the required doctoral-level training. Perhaps in a different practice setting that effect could be realized.
I spent the remainder of the day filling the 400 prescriptions that were waiting for my attention, talking to customers and physicians’ offices on the telephone, and answering routine questions at the counter, all the time being rushed by the incessant flow of work. Yet, when I walked away from Mrs. da Silva, I knew that I had missed the most important opportunity that day to provide real pharmaceutical care.
Several months later, I was back at the same pharmacy working with the same technicians when Mrs. da Silva's daughter came in to tell us that her mother had died. With sad eyes, she told us that it was unexpected, because Mrs. da Silva had made a promising recovery from the first heart attack.
When I opened her pharmacy record to document that she was deceased, I noticed that Mrs. da Silva had never refilled her 12 prescriptions. My heart sank. To this day, I wonder whether Mrs. da Silva died of a diseased heart or a broken pharmacy system.****
-
It's a simple enough request, but for patients and families who feel vulnerable, scared or uncomfortable in a hospital room, the subject can be too intimidating to even bring up with a doctor or nurse: Have you washed your hands?
Hospitals are encouraging patients to be more assertive, amid growing concern about infections that are resistant to antibiotics.
Strict hand hygiene measures are the gold standard for reducing infections associated with health care. Acquired primarily in hospitals but also in nursing homes, outpatient surgery centers and even doctor's offices, they affect more than one million patients and are linked to nearly 100,000 deaths a year, according to the Centers for Disease Control and Prevention.
The CDC aims to engage both patients and caregivers in preventing dangerous hospital infections.
Yet despite years of efforts to educate both clinicians and patients, studies show hospital staff on average comply with hand-washing protocols, including cleansing with soap and water or alcohol-based gels, only about 50% of the time. Two new studies show patients aren't much more comfortable today than a decade ago with the idea of asking doctors and medical staff to lather up.
Hospitals have reduced certain infections over the past four years with measures such as removing unnecessary catheters and washing a patient's skin before surgery with antibacterial soap. Some have lifted hygiene compliance to nearly 100% with strict "wash in, wash out" protocols, and some have designated unidentified staffers to secretly monitor co-workers. Some hospitals link merit increases to compliance and temporarily suspend clinical privileges of doctors who ignore the rules, says Gina Pugliese, vice president of the Safety Institute at hospital purchasing alliance Premier Inc. According to a 2010 study, a disciplinary program at the University of Kentucky Medical Center in Lexington that included suspending doctors' privileges led to improved compliance rates.
More hospitals have turned to electronic sensors, thermal imaging and video cameras to monitor hand hygiene, and some are issuing badges that wirelessly record staffers' use of hand hygiene stations before entering a patient room. Some monitoring systems emphasize patient engagement and sound an electronic alert to remind patients to speak up when a staffer enters the room.
The CDC has provided 16,000 copies of a video, titled "Hand Hygiene Saves Lives," to be shown to patients at admission. In one scenario, a doctor comes into a room and the patient's wife says, "Doctor, I'm embarrassed to even ask you this, but would you mind cleansing your hands before you begin?" The doctor replies, "Oh, I washed them right before I came in the room." The wife says, "If you wouldn't mind, I'd like you to do it again, in front of me."
After patients at 17 hospitals run by Cincinnati-based Catholic Health Partners watched the video, there was a rise in both the proportion of patients asking staffers to wash their hands, and physicians and nurses reporting that they were asked, according to a 2010 study. "Hand hygiene is probably the most important thing health-care workers can do to protect their patients from infection," says John Jernigan, director of the CDC's hospital infection-prevention efforts who appears in the video. When patients speak up, it helps create "a culture of safety," he says.
The nonprofit Association for Professionals in Infection Control and Epidemiology is kicking off a campaign this month including posters mailed to 15,000 hospitals with tips on how patients can take an active role. It suggests asking staff about hand hygiene and requesting that hospital rooms be cleaned if they appear dirty.
"We've been focusing on intensive interventions to improve hand hygiene among health-care workers for decades, yet we've really shown very little progress," says Carol McLay, a Lexington, Ky., infection prevention consultant and chair of the committee that designed the campaign. "We are trying to empower patients and families to speak up and understand their role."
At some hospitals, posters, bedside placards and buttons for staffers say, "Ask me if I've washed my hands." Susan Coffin, a pediatric infectious disease physician at the Children's Hospital of Philadelphia, says while many efforts are made in good faith, they are "insufficient to overcome some of these barriers." She is co-author of a study, published in June in the American Journal of Infection Control, which found that 84% of parents were aware of infection risk yet only 67% would remind a health-care worker to wash their hands, most often because of concern about appearing rude or undermining authority. Yet 92% of parents said if a health-care worker invited reminders, they would be more likely to do so. The hospital is "trying to make it a more active conversation," Dr. Coffin says. Admission packets offer detailed information on hand hygiene and nurses tell families that staffers welcome questions about hand washing.
In a study published in September in the journal Infection Control and Hospital Epidemiology, one-third of patients surveyed at the University of Pittsburgh Medical Center said they observed doctors failing to wash their hands, but nearly two-thirds said nothing to their doctor about hand hygiene. Most didn't believe it was their role to do so and said they felt embarrassed or awkward and worried about reprisal.
Patients are more likely to ask nurses about hand hygiene, says Gregory Bump, associate professor of medicine. "There is something about the white-coat barrier that makes them reluctant to challenge doctors." Physicians may resist assertive patients and seem unreceptive or even hostile to a question about hand washing, he says.
Patients, instead of receiving information about infections and hand washing, would prefer having staffers wear a button or light to indicate whether his or her hands had been washed, the study also found. UPMC is developing a system to measure and track hand-washing compliance, as well as computerized verbal reminders to patients to ask the employee to clean their hands when they enter the room.
Michael Gettes, 50, has been hospitalized several times and says he has never had to remind Dr. Bump, his primary physician, to wash his hands. He has asked other hospital staffers to do so. One doctor reacted negatively. "It put our relationship on a bad footing," Mr. Gettes says. "Yes, you run the risk of upsetting someone who has been taking care of you. But it is my life. If they make a mistake I am impacted or I die."
Gail Ulager, a 72-year-old kidney transplant recipient at UPMC, says she worries about the possibility of infection because she is taking drugs that suppress her immune system to prevent rejection of her new organ. She found a way to give the message to doctors, nurses and even her dentist without seeming disrespectful. "I always tell them that the transplant center insists that everyone washes their hands" she says.
-
Yes I have been asked this before.
I tell patients with infections to wash their hands at home to prevent them from spreading to their families or getting something else.
Try washing your hands at home the next time you have a cold every time you touch your eyes your nose your mouth of blow your nose or cough with your hand over your mouth.
See how easy it is. :|
-
As ridiculous as this sounds, despite millions spent on special antibiotics, this of all things, appears to be the giant advance we have been waiting for.
****Pills made from poop cure serious gut infections
Dr. Thomas Louie, an infectious disease specialist at the University of Calgary, holds a container of stool pills in triple-coated gel capsules in his lab in Calgary, Alberta, Canada on Thursday, Sept. 26, 2013. Half a million Americans get Clostridium difficile, or C-diff, infections each year, and about 14,000 die. A very potent and pricey antibiotic can kill C-diff but also destroys good bacteria that live in the gut, leaving it more susceptible to future infections. Recently, studies have shown that fecal transplants - giving infected people stool from a healthy donor - can restore that balance. (AP Photo/The Canadian Press, Jeff McIntosh)
Associated Press
MARILYNN MARCHIONE 10 hours ago
Hold your nose and don't spit out your coffee: Doctors have found a way to put healthy people's poop into pills that can cure serious gut infections — a less yucky way to do "fecal transplants." Canadian researchers tried this on 27 patients and cured them all after strong antibiotics failed to help.
It's a gross topic but a serious problem. Half a million Americans get Clostridium difficile, or C-diff, infections each year, and about 14,000 die. The germ causes nausea, cramping and diarrhea so bad it is often disabling. A very potent and pricey antibiotic can kill C-diff but also destroys good bacteria that live in the gut, leaving it more susceptible to future infections.
Recently, studies have shown that fecal transplants — giving infected people stool from a healthy donor — can restore that balance. But they're given through expensive, invasive procedures like colonoscopies or throat tubes. Doctors also have tried giving the stool through enemas but the treatment doesn't always take hold.
There even are YouTube videos on how to do a similar treatment at home via an enema. A study in a medical journal of a small number of these "do-it-yourself" cases suggests the approach is safe and effective.
Dr. Thomas Louie, an infectious disease specialist at the University of Calgary, devised a better way — a one-time treatment custom-made for each patient.
Donor stool, usually from a relative, is processed in the lab to take out food and extract the bacteria and clean it. It is packed into triple-coated gel capsules so they won't dissolve until they reach the intestines.
"There's no stool left — just stool bugs. These people are not eating poop," and there are no smelly burps because the contents aren't released until they're well past the stomach, Louie said.
Days before starting the treatment, patients are given an antibiotic to kill the C-diff. On the morning of the treatment, they have an enema so "the new bacteria coming in have a clean slate," Louie said.
It takes 24 to 34 capsules to fit the bacteria needed for a treatment, and patients down them in one sitting. The pills make their way to the colon and seed it with the normal variety of bacteria.
Louie described 27 patients treated this way on Thursday at IDWeek, an infectious diseases conference in San Francisco. All had suffered at least four C-diff infections and relapses, but none had a recurrence after taking the poop pills.
Margaret Corbin, 69, a retired nurse's aide from Calgary, told of the misery of C-diff.
"It lasted for two years. It was horrible. I thought I was dying. I couldn't eat. Every time I ate anything or drank water I was into the bathroom," she said. "I never went anywhere, I stayed home all the time."
. Thomas Louie, right, an infectious disease specialist at the University of Calgary, administers …
With her daughter as the donor, she took pills made by Louie two years ago, and "I've been perfectly fine since," Corbin said.
Dr. Curtis Donskey of the Cleveland Veterans Affairs Medical Center, who has done fecal transplants through colonoscopies, praised the work.
"The approach that Dr. Louie has is completely novel — no one else has done this," he said. "I am optimistic that this type of preparation will make these procedures much easier for patients and for physicians."
The treatment now must be made fresh for each patient so the pills don't start to dissolve at room temperature, because their water content would break down the gel coating. Minnesota doctors are testing freezing stool, which doesn't kill the bacteria, so it could be stored and shipped anywhere a patient needed it.
"You could have a universal donor in Minnesota provide a transplant for someone in Florida. That's where we're heading," Donskey said.
Other researchers are trying to find which bacteria most help fight off C-diff. Those might be grown in a lab dish and given to patients rather than the whole spectrum of bacteria in stool.
Thomas Louie, an infectious disease specialist at the University of Calgary, prepares vials in t …
The hope is "we could administer that as a probiotic in a pill form," Donskey said.
Louie sees potential for the poop pills for other people with out-of-whack gut bacteria, such as hospitalized patients vulnerable to antibiotic-resistant germs.
"This approach, to me, has wide application in medicine," he said. "So it's not just about C-diff."
CDC on C-diff: http://www.cdc.gov/HAI/organisms/cdiff/Cdiff_infect.html*****
___
-
http://news.yahoo.com/ligament-found-human-knee-142502691.html
I don't know how a "new" ligament could be rightfully "just" discovered. With hundreds of thousands, millions of knee surgeries and replacements and MRI etc.
I wonder if the new ligament is simply being re categorized as being separate from the lateral collateral ligament and not perhaps a sporadic separate head of the same ligament.
If I run into any orthopedic guys I'll get their opinion.
-
http://www.alternet.org/doctor-pubic-hair-exists-reason-our-obsession-hairless-genitals-must-end-0
-
You Are What Your Bacteria Eat: The Importance of Feeding Your Microbiome – With Jeff Leach
http://chriskresser.com/you-are-what-your-bacteria-eat-the-importance-of-feeding-your-microbiome-with-jeff-leach
Podcast with a transcript
"We’re more microbe than mammal. That really wasn’t well understood a decade ago, and so the new DNA techniques are allowing that. And what’s really remarkable is that not since Darwin’s concept of natural selection has something had such a profound impact on our understanding of “self.” In our anthropocentric world, we think we’re the center of it all, but at the end of the day, the microbes are actually pulling the levers on a lot of what’s going on when you consider that at the gene level they outnumber us 150 to 300 to 1. We’re born with genes that mom and dad gave us, and we’re pretty much stuck with those, but the genes in our gut – again, the bacteria are called the microbiota, and when you add their genes in as well, that’s our microbiome. Of course, a biome is just an ecosystem, so we have this inner ecosystem. So, depending on how we treat them, they can make life OK or they can make it problematic, and when they get out of balance, it’s now thought that that may be the root or the cause of a lot of disease. The problem is working out causality versus correlation."
-
Very interesting Rachel, an excellent find.
-
:-o
My experience in medical care has brought me to the conclusion that care near the end of life does not have to be akin to an all out war fought to keep a patient alive till their last dying breath. Alternative options such as palliative care or hospice care are ethical, valid, and most importantly humane options for many. The key word is these must remain as OPTIONS that can be chosen, sampled, refused or changed with the knowledge that the decision is never binding. I still am convinced that medical science has as much capacity to reduce costs as well as increase them. Just think how much death and disease will be prevented when we are better at curing a disease like Hepatitis C. How about dementia or obesity? People will live longer and mostly though not always better.
***************Human Exceptionalism
Life and dignity with Wesley J. Smith.
Time to Prevent Elderly From Living Too Long?
By Wesley J. Smith
December 1, 2013 5:03 PM
Bioethicist Founding Father Daniel Callahan has long supported death panel health care rationing based on age. He has now weighed in against spending a lot on research to delay the aging process.
The transhumanists aren’t going to like this! From, “On Dying After Your Time:”
Even if anti-aging research could give us radically longer lives someday, though, should we even be seeking them? Regardless of what science makes possible, or what individual people want, aging is a public issue with social consequences, and these must be thought through.
Regardless of what science makes possible, or what individual people want, aging is a public issue with social consequences, and these must be thought through. Consider how dire the cost projections for Medicare already are. In 2010 more than 40 million Americans were over 65. In 2030 there will be slightly more than 72 million, and in 2050 more than 83 million. The Congressional Budget Office has projected a rise of Medicare expenditures to 5.8 percent of gross domestic product in 2038 from 3.5 percent today, a burden often declared unsustainable.
Contrary to the transhumanist eschatology, Callahan doesn’t believe that extending the length of lives will also mean extending their vitality. I tend to agree. But he doesn’t exactly practice what he preaches:
Modern medicine is very good at keeping elderly people with chronic diseases expensively alive. At 83, I’m a good example. I’m on oxygen at night for emphysema, and three years ago I needed a seven-hour emergency heart operation to save my life. Just 10 percent of the population — mainly the elderly — consumes about 80 percent of health care expenditures, primarily on expensive chronic illnesses and end-of-life costs. Historically, the longer lives that medical advances have given us have run exactly parallel to the increase in chronic illness and the explosion in costs. Can we possibly afford to live even longer — much less radically longer?
Callahan could have refused that expensive treatment. I don’t say he should have, but no one forced him to spend all that (presumably) public money on care.
He does ask a valid question, I think, about the wisdom of pouring resources into radical life-extending research (at least public money). However he also seems to assert that the elderly be somehow prevented from living longer (my emphasis):
We may properly hope that scientific advances help ensure, with ever greater reliability, that young people manage to become old people. We are not, however, obliged to help the old become indefinitely older. Indeed, our duty may be just the reverse: to let death have its day.
What does that mean? Some kind of Logan’s Run scenario?
Callahan isn’t that type. But he should have specified what he meant. As I read him, he seems to be proclaiming some kind of a moral duty of the elderly to die.
Or it could mean refusing efficacious medical care to the elderly that the younger would be able to obtain. In less genteel hands than Callahan’s, it could mean something even more insidious.
My, don’t those clouds on the horizon look dark?**********
-
The Motley Fool
5 Jaw-Dropping Facts About Legal Marijuana
By Brian Orelli | More Articles
November 30, 2013 | Comments (25)
The legal use of marijuana for both medical use and adult recreational use is on the rise. Here are five facts that might just surprise you about the drug.
Source: Chuck Coker, Flickr.
1. Marijuana could be the best-selling legal drug. Ever.
According to ArcView Market Research, the national market for legalized marijuana could hit $10.2 billion in five years. Pfizer's (NYSE: PFE ) Lipitor currently holds the record for prescription drugs at about $13 billion. If ArcView's prediction is correct, it's not hard to see how marijuana could surpass that record in the following year. It's growing from a base of just $1.44 billion this year.
And unlike Pfizer, which saw Lipitor sales crash once generic versions hit the market, there isn't likely to be a cliff that causes sales to drop precipitously, short of having the federal government decide to crack down on state laws. Of course, unlike Lipitor, you can't invest in one company to capture all the revenue.
2. 14 states could join Colorado and Washington legalizing marijuana for recreational use
In fact, that's one of the driving forces behind ArcView's growth prediction. The sentiment has shifted recently; a majority of Americans now favor legalization. If they vote the same way they answer poll questions, it's likely that we'll see many more states where marijuana use is legal in the coming five years.
The driving force for the states is the potential revenue from taxes. They want to get their cut, which they don't get on illegal sales now.
It'll be interesting to watch Colorado and Washington as they try to deal with how to tax what many consider to be a drug to help people -- which are typically not taxed -- compared with a recreational drug, which, like cigarettes and alcohol, are typically highly taxed.
3. The government sends out marijuana cigarettes each month
It's part of a study to see if marijuana could help patients with glaucoma. At its peak, there were 30 patients enrolled in the study, which stopped accepting new participants in 1992. Those still enrolled get sent their prescriptions from a special farm on the University of Mississippi campus that provides the drug for medical research.
4. Only 6% of studies on marijuana investigate its potential benefit.
According to CNN's Sanjay Gupta, the other 94% investigate its potential harm. The problem, as Gupta points out, is that it's very hard to run clinical trials on marijuana use since it's still illegal at the national level. While the University of Mississippi farm can provide the medication legally for studies, it's apparently not that all that easy to acquire medication from it.
Researchers also have to gain approval from the NIH's National Institute on Drug Abuse, which has a mission "to lead the nation in bringing the power of science to bear on drug abuse and addiction." That's not exactly a ringing endorsement for potential benefits of drugs.
5. The receptor that marijuana activates has been an (unsuccessful) drug target
Tetrahydrocannabinol, or THC, one of the active drugs in marijuana, is available as a prescription drug called Marinol, developed by Abbott's drug arm, now called AbbVie (NYSE: ABBV ) , to stimulate appetite and control nausea and vomiting in patients taking chemotherapy. But the drug isn't widely used because it's absorbed by different people at different levels, making it hard to get the right dosage .
Sanofi (NYSE: SNY ) tried to do the opposite and block the receptor, thus controlling appetite. While Sanofi's obesity drug, Acomplia, was fairly good at helping patients shed the pounds, it had psychiatric side effects including depression. The FDA never approved the drug, and Sanofi had to remove it from the market in Europe in 2008.
*************************************
My thoughts: On #1 Best selling drug? Who would grow it and sell it?
On #2 Kind of sad that the driving force for legalization is tax revenue. Just another example how everything is money. I guess one could make similar claims for gambling and prostitution where those are also legal. Alcohol and maybe a sugar tax. The latter suddenly could be labeled a vice.
On #3 I didn't know the government was sponsoring studies on use of marijuana for glaucoma. It can lower intra-orbital pressures but my understanding is the affects were too erratic and there are so many better drugs that the use for this is dubious. I met an eye doctor in Florida who got into trouble with the ATF for testing this. He claimed they ruined his life and his wife eventually committed suicide over it. I only know his side of the story. This was about ten years ago. He was in his seventies.
On # 4 Old drugs do make comebacks. Gupta noted that most studies looked at the harms not the benefits. Remember thalidomide? The drug given to pregnant women in Europe that led to horrible birth defects? Just the mere mention of it afterwards gave everyone the shivers. Now it is a beneficial drug used for other diseases.
On # 5 The Sanofi drug did work to help people lose weight but then a suicide was reported and that was that in the US. I don't know what the experience was in Europe since it was approved there and later taken off their market.
I left the comments from some other readers here:
Help us keep this a respectfully Foolish area! This is a place for our readers to discuss, debate, and learn more about the Foolish investing topic you read about above. Help us keep it clean and safe. If you believe a comment is abusive or otherwise violates our Fool's Rules, please report it via the Report this Comment Report this Comment icon found on every comment.
Report this Comment On December 01, 2013, at 5:25 AM, VikingBear wrote:
Legalize everything.
Let the herd cull itself.
Report this Comment On December 01, 2013, at 8:46 PM, Kalamakuaikalani wrote:
Hard to take your article seriously when you title it "5 Jaw-Dropping Facts ....." & then subtitle number 1: 1. Marijuana could be the best-selling legal drug. Ever. ................... It's not a FACT if marijuana COULD BE. It either is or it isn't & THEN, that would be a FACT.
Report this Comment On December 01, 2013, at 8:53 PM, glenns45 wrote:
Controlled Substance Act of 1971 signed by a President who was forced to resign or be prosecuted. The DEA was created to make sure the right people were selling the Drugs and supporting the NWO. The Feds are the ones who bring in the drugs this is on public record do some research.
Report this Comment On December 01, 2013, at 9:23 PM, towolf2 wrote:
When it smacks somebody upside the chops, then you know what is a fact and what isn't. That's 35 years as a pro grower speaking. Say hey to The Duke for me!!
Report this Comment On December 01, 2013, at 9:26 PM, towolf2 wrote:
Which part am I reading? The educated humorous enriching part, or is this the NASCAR Channel. Caught out again.
Report this Comment On December 01, 2013, at 9:53 PM, oldmutt1949 wrote:
5 other jaw breaking facts about marijuana.
1. It has 424 compounds that turns into over 2000 when lit.
2. Those 2000 compounds release numerous poisons including hydrogen cyanide and carbon monoxide.
3. French Academy of Science using the atomic microscope has shown long term use of marijuana can alter a person DNA ( Science Daily )
4. Total number of people killed in the drug war in Mexico, central and Latin America exceeds the number of U.S. casualties in VIet Nam.
5. A lot of hippies from my generation who smoked this polluted crap are no longer here.
And last but not least their isn't a single study that has confirmed that all the substances in marijuana are safe evident by he emergency rooms a In Denver and other cities kept busy treating kids poisoned by this stuff because their parents are so dumb down they can't provide their children a safe environment.
Report this Comment On December 01, 2013, at 9:59 PM, fixer wrote:
Hemp used to be such a valuable crop that in George Washington's time ,farms we're required to plant a percentage of their fields with hemp.The oil from the seeds was a good lamp oil and the fiber made strong cloth and rope.
Report this Comment On December 01, 2013, at 10:21 PM, southernhippy wrote:
Old mutt is lying his butt off, Just look at old willie Nelson to see the truth, Pot smoking does not affect your age. Off course old mutt is talking about smoking and not one work about eating.
Report this Comment On December 01, 2013, at 10:24 PM, junior wrote:
something else you forgot oldmutt1949, there was talk about leagalizing it in my state. Even if it does become legalized, we were told by the plant manager that if our random pee test revealed any THC we would still loose our job.
This is why I agree with Vikingbear. Let the herd cull itself. The job market may open up so that someday I can find a job where I can afford a pack of store bought cigarrettes
Report this Comment On December 01, 2013, at 10:32 PM, southernhippy wrote:
BTW mutt lets add some other facts to that mix..
Pot smokers tend to be closer to normal weight...
Higher good cholesterol.
Also lets add the fact that smoking pot don't increase you chances of lung or any other cancer. Not to mention and numerous medical uses of MJ among those would be nausea, seizure control, pain management. So when do we decide when the good outweighs the bad? Almost every war on Pot argument has been debunked, when do you see anything other than hate?
BTW us hippies are alive and well living a great and healthy life style, after all it was us hippies who came up with the who vegetarian thing long before anyone else, peace out...
Report this Comment On December 01, 2013, at 10:57 PM, imnxtc2001 wrote:
"evident by he emergency rooms a In Denver and other cities kept busy treating kids poisoned by this stuff" Yeah oldmutt, them hospital rooms are just packed with them pot smoking whippersnappers. Too funny! If you have any time between your naps and your shuffleboarding league, you can take a few minutes to look up that marijuana by itself equals the same amount of emergency room visits as OTC sleep medicine. I will give you the benefit of the doubt, that you may have been mistaken for synthetic marijuana which is extremely dangerous.
Report this Comment On December 01, 2013, at 10:57 PM, OldSkewel wrote:
Oldmutt1949 is NOT lying southernhippy. ANYONE with at least 1/2 a brain knows it is NOT natural OR healthy to take smoke of ANY kind into a healthy set of lungs.
What I find truly ironic is the very same people that use to jump all over big time tobacco companies and the dangers of smoking absolutely sound like hypocrites now touting the oh so many benefits of cannabis which EVERYONE knows the most popular form of use is the SMOKING thereof.
While we're on the subject of cannabis, somebody please remind me, isn't hashish addictive? What, basically; is hashish comprised of...?
As far as the economic impact is concerned, it WOULD make sense to legalize it but that's the ONLY reason and EVEN THEN, the economic benefits would be relatively short term compared to the devastating social and moral impact (especially considering America's children) that would no doubt occur as you just as well can take America's public education school system and pitch it out the window, not that it works that well now but can you imagine what would happen if "chronic" was legalized...?
Report this Comment On December 01, 2013, at 11:08 PM, imnxtc2001 wrote:
Just one more observation while I'm still laughing....I'm not perfect with punctuation or grammar, but someone that doesn't smoke marijuana telling me: "jaw breaking" instead of "jaw dropping"...."their" instead "there"....."he" instead of "the"....."a In" instead of just plain out "in" minus the "a" and capital "I".....Geez, I need to smoke a bowl to even make sense of your comment at all.
Report this Comment On December 01, 2013, at 11:09 PM, southernhippy wrote:
Odds of MJ addiction is the same as gambling, Pot has no chemical addiction. You also have the same chance of becoming a workaholic or any other habit that could be considered a bad or good life choice. Pot has been around for more than 10k years and has not stopped any progression of mankind. BTW CBD's that are found in pot are also anti-cancerous, also naturally lowers blood sugars and even can protect the brain in the event of a heart attack or stroke. BTW we are also talking about Eating the plant, y'all do know it's non-toxic and impossible to overdose on right? Y'all are just looking that that lovely drug free propaganda against a persons right to live as they chose too. BTW one other note, Pot does have 5 natural nero keyways in the brain that can open up nero pathways(hence why there is enhanced sight, smells, and creativity.) Pot is indeed a natural product the human mind knows very well. MJ has been demonized for decades for no real reason other than sobriety, nothing else.
I do agree on one Idea though, kids under 21 should not get access and should be treated like booze and advertising should be the same as tobacco when it comes to kids.
Report this Comment On December 01, 2013, at 11:21 PM, imnxtc2001 wrote:
Old Skewel: Is it natural or healthy to drive a car? But you do it anyways don't you? Your trip to the store tomorrow will produce more pollutants into EVERYBODYS air, than one pot smoker can produce in a year. btw....I don't know if you've been asleep the past 50 years, but kids in school(if they choose to)get pot just as easy now, as they would if it was legal and fell under same laws as tobacco. As far as hash...it is basically the same as marijuana, just made from different parts. And the same studies you got your information that it was addictive, are the same ones that say marijuana is also.
Report this Comment On December 01, 2013, at 11:36 PM, HMull81 wrote:
Let’s get a few things right:
First - the problem with legalizing any previously illegal substance isn’t a morally grounded issue; being that most of these substances are vices are not socially accepted when overly indulged anyway.
Second – look up some history and consider why hemp production was ground to a halt in the first place, I’ll give you a hint……
It wasn’t because pothead hippies were overrunning the world with their outrageous free love and open minded way of living, that didn’t come until the 60s.
It is all economic and taxation that has put at spin on what any generation finds acceptable.
It doesn’t matter if you are for or against the legalization of pot, it matters where it would lead to based off of the revenue gained cause face it, the government has stopped doing for the people a long time ago, and if you are current with what is popular; the Kim and Kanye saga get more press than real issues such as legalizing pot, gun law, government debt, and not to forget my favorite government shut down.
I know that if I quit working when I was a soldier in the U.S. Army there were consequences which usually ended with me in a bad kind of way.
Report this Comment On December 02, 2013, at 12:05 AM, allykat7825 wrote:
This will be the first step in finishing off the Regan inspired War against drugs which has cost so many billions over the years. It put the lotteries to shame when the taxes are added up and make many more people happy. Add cocaine to the list and the cartels are a thing of the past, which should please oldmutt. Oldmutt is probably not as old as I am and despite rumors to the contrary, and what many others might think, I still have my wits about me. .
Report this Comment On December 02, 2013, at 1:03 AM, Sniper2013 wrote:
http://www.youtube.com/watch?v=Kf07aK_5004
Report this Comment On December 02, 2013, at 2:05 AM, uniquelyNzaneSam wrote:
Where oldMutt1949 is investment advice?: anti-pesticidal controls against garden herbivores? Bet on that eliminates most carcinogens' category of compounds. Good alarm oldMutt about marijuana combustion: extreme diarrhea treatment on terminal illness cases will not intrest as much financial and mental risk as combustibles, crack and meth. Expect ascending physical medicine values from home-brewed tea-therapy thereby more versatile prescriptions flavorful hashish gel-capsuled and milligram-tweeked synthetically. Noncombusted eliminates psychological addiction injuring only nervous system like brain damages from psychotropic over-use.
>Behavioral health dermal patches prescribing "thc" will dominate nicotine futures into oblivion. Chemical, money lust, even commercialed availability are not the gateway drugs guaranteeing stupefied economics. Anti-faith religious propaganda misinterpretation-poisoning scorches your love into an emptying black-holes to drain away everyone&thing appreciable. Artificial counterfeits especially joy inducements cannot possibly satisfy longest-term spiritual-nature provisions. Will algebraic naturals ever displace monetary abstracts? Where oldMutt1949 is investment advice?: anti-pesticidal controls against garden herbivores? Bet on that eliminates most carcinogens' category of compounds. Good alarm oldMutt about marijuana combustion: extreme diarrhea treatment on terminal illness cases will not intrest as much financial and mental risk as combustibles, crack and meth. Expect ascending physical medicine values from home-brewed tea-therapy thereby more versatile prescriptions flavorful hashish gel-capsuled and milligram-tweeked synthetically. Noncombusted eliminates psychological addiction injuring only nervous system like brain damages from psychotropic over-use.
>Behavioral health dermal patches prescribing "thc" will dominate nicotine futures into oblivion. Chemical, money lust, even commercialed availability are not the gateway drugs guaranteeing stupefied economics. Anti-faith religious propaganda misinterpretation-poisoning scorches your love into an emptying black-holes to drain away everyone&thing appreciable. Artificial counterfeits especially joy inducements cannot possibly satisfy longest-term spiritual-nature provisions. Will algebraic naturals ever displace monetary abstracts? Someday Where oldMutt1949 is investment advice?: anti-pesticidal controls against garden herbivores? Bet on that eliminates most carcinogens' category of compounds. Good alarm oldMutt about marijuana combustion: extreme diarrhea treatment on terminal illness cases will not intrest as much financial and mental risk as combustibles, crack and meth. Expect ascending physical medicine values from home-brewed tea-therapy thereby more versatile prescriptions flavorful hashish gel-capsuled and milligram-tweeked synthetically. Noncombusted eliminates psychological addiction injuring only nervous system like brain damages from psychotropic over-use.
>Behavioral health dermal patches prescribing "thc" will dominate nicotine futures into oblivion. Chemical, money lust, even commercialed availability are not the gateway drugs guaranteeing stupefied economics. Anti-faith religious propaganda misinterpretation-poisoning scorches your love into an emptying black-holes to drain away everyone&thing appreciable. Artificial counterfeits especially joy inducements cannot possibly satisfy longest-term spiritual-nature provisions. Will algebraic naturals ever displace monetary abstracts? Perhaps after college graduations? How might one economically invest private citizen properties, hide them secure from theft, or accelerate prosperity to make defrauding obsolete?
Report this Comment On December 02, 2013, at 2:50 AM, gareball wrote:
"Only 6% of studies on marijuana investigate its potential benefit.
According to CNN's Sanjay Gupta, the other 94% investigate its potential harm. The problem, as Gupta points out, is that it's very hard to run clinical trials on marijuana use since it's still illegal at the national level. While the University of Mississippi farm can provide the medication legally for studies, it's apparently not that all that easy to acquire medication from it".
If the FDA were to subject ANY drug from Big Pharma to the same skewed testing there wouldn't be a new drug on the market for decades. I'm betting that the drugs 'oldmutt' or 'Old Skewel' take to stay alive would never have passed such rigorous testing, and probably contain more virulent side effects than marijuana ever could.
Step into the 21st century, guys, and realize that it's time to put the idiotic and woefully expensive "war on drugs" to rest. It hasn't, and never will, work.
By the way 'old' fellas.....I'm 64 myself and have been a regular pot user for more than 45 of those years. I'm the picture of good health, thanks to a vegetarian diet, and will probably outlive both of you pot demonizers by a decade, at least. Oh, and 'Old Skewel', hashish IS NOT addictive, it's basically the resin from the marijuana flower and is nothing more than a more potent delivery device for THC. The sum total of what you anti-pot "experts" DON'T know is astounding. Then again, when you rely on anti-pot propaganda for your "facts" you're deliberately being fed a pack of lies designed to keep Big Pharma, the Liquor Lobby, and the 'for profit' prison system in customers for years to come. Try thinking for yourself, for once, and do the research so you'll be armed with REAL facts!
-
Please post in "War on Drugs" thread as well.
TIA.
-
The Motley Fool
5 Jaw-Dropping Facts About Legal Marijuana
I have favored 'de-criminalization' over legalization, a subtle but important difference.
"On #1 Best selling drug? Who would grow it and sell it?" Anyone with a profit motive.
"On #2 Kind of sad that the driving force for legalization is tax revenue. " Agree
"On #3 I didn't know the government was sponsoring studies on use of marijuana for glaucoma. It can lower intra-orbital pressures but my understanding is the affects were too erratic and there are so many better drugs that the use for this is dubious." I believe they can measure and control dosage much better now. (And it's going up at an alarming rate!)
"Hashish IS NOT addictive, it's basically the resin from the marijuana flower and is nothing more than a more potent delivery device for THC." Addictive and habit-forming are synonyms.
"5 other jaw breaking facts about marijuana.
1. It has 424 compounds that turns into over 2000 when lit.
2. Those 2000 compounds release numerous poisons including hydrogen cyanide and carbon monoxide."
They now vaporize - heat only to the temp that releases the drug - and not light it. Releases fewer toxins.
"kids under 21 should not get access and should be treated like booze and advertising should be the same as tobacco when it comes to kids." Agree, but good luck with that when it is available everywhere. See my first point, decriminalize it, not endorse it.
-
What to Consider Before Undergoing a DNA Test
A Columbia University bioethicist discusses medical and ethical issues raised by testing
By Anne Tergesen
Dec. 8, 2013 4:32 p.m. ET
As the price of sequencing a person's entire DNA has tumbled from $1 billion a decade ago to a few thousand dollars today, many adults—and their physicians—are turning to genetic tests to better understand and manage their health.
The process, though, can be problematic. Some people who test, like the actress Angelina Jolie, learn information that can have dramatic consequences for their health and insurability—and that of their relatives.
And the testing business itself is still young and experiencing growing pains. Last month the Food and Drug Administration ordered genetic-testing firm 23andMe Inc. to stop marketing its $99 mail-order kit. The agency warned that false results could prompt consumers to undergo unnecessary health procedures. The company halted all ads for the kit and said it would work with regulators to address their concerns.
To better understand some of the issues people should consider before undergoing genetic tests, we spoke with Robert Klitzman, director of Columbia University's master's of bioethics program and the author of "Am I My Genes? Confronting Fate and Family Secrets in the Age of Genetic Testing." Here are edited excerpts from the conversation:
WSJ: Should the average person get tested?
(Robert Klitzman: 'A key question is what you will do with the information.' Amelia Panico)
DR. KLITZMAN: We still haven't found the genes responsible for most cases of common diseases, including Parkinson's and the inherited forms of most cancers. But tests have been developed for about 2,000 relatively rare genetic diseases, including the hereditary neurologic disorder Huntington's disease and the BRCA1 and BRCA2 gene mutations—the former of which Angelina Jolie tested positive for—which raise the odds of getting breast cancer to about 50% from 12%, on average.
When deciding whether to get tested, a key question is what you will do with the information. It probably makes sense to test if you believe you are at risk for one of the 24 or so treatable conditions with very predictive tests among the 2,000 with available tests. Aside from breast cancer, they include a form of hereditary colon cancer called Lynch syndrome, familial medullary thyroid cancer, and hypertrophic cardiomyopathy, which can cause sudden death. The presence of certain other genes can also help in predicting responses to some medicines.
It is important to keep in mind that testing positive for a mutation doesn't always mean that you will get ill. Nor does testing negative always mean you are safe. For example, with Alzheimer's, those who receive a genetic variant from both parents have around a 50% to 60% chance of developing the disease, but these patients account for only about 10% of those who get Alzheimer's.
WSJ: What kind of genetic test should individuals get?
DR. KLITZMAN: You can be tested for the specific disease you and your doctor are concerned about. Many insurers cover those tests.
You could also have your full genome sequenced for about $8,000. Interpreting it costs several thousand dollars more. The price of testing your whole genome will probably soon be around $1,000.
For about $100, some companies test portions of your DNA. But these tests aren't always accurate, in part because people can have mutations elsewhere. Before testing, consult with a genetic counselor.
WSJ: Do people have an obligation to share the results with relatives?
DR. KLITZMAN: Ethically, I think we owe it to people to give them information that can help them, if we can. But before you blurt out the results, ask your relatives if they want to know, and raise the subject before you get tested.
WSJ: Should you confide in your doctor?
Enlarge Image
DR. KLITZMAN: Some people who test positive for serious diseases hesitate to tell their doctors, because once the information is in their medical charts, an insurance company can access it. A federal law passed in 2008 prevents insurers from using the results of genetic tests to turn people down for most forms of health insurance. But the law doesn't apply to life, long-term-care or disability insurance.
WSJ: What lies ahead?
DR. KLITZMAN: My guess is that in 10 or 20 years, many of us will have our genomes sequenced, and a lot of us will be getting certain information whether we want it or not. My concern is that, in the future, some of these decisions may not be entirely the patient's.
The American College of Medical Genetics and Genomics recently recommended that patients who have all their genes tested get told the results for 56 genes involved with the 24 treatable, serious genetic conditions. But parents would then be told about genes in their children that might have no effect for decades, if ever. All this is a brave new world.
Ms. Tergesen is a staff reporter for The Wall Street Journal in New York. She can be reached at encore@wsj.com.
-
http://www.herpiderp.com/video/1236/the-skin-gun
-
FDA Seeks Stricter Rules on Antibacterial Soaps
Companies Would Have to Prove Their Products Are Safe, Effective
Email
Print
Save ↓ More
15 Comments
Facebook
Twitter
Google+
LinkedIn
smaller
Larger
By
Thomas M. Burton and
Serena Ng
connect
Updated Dec. 16, 2013 6:56 p.m. ET
The FDA is raising safety concerns about antibacterial soaps, which they say are not more effective at preventing illness than plain soap. Tom Burton reports on Lunch Break. Photo: AP.
WASHINGTON—The Food and Drug Administration is challenging the underpinnings of the antibacterial-soap industry by requiring makers to prove that their ingredients are safe and accomplish more than regular hand soaps in fighting bacteria.
The federal agency Monday proposed a rule requiring makers of antibacterial hand soaps and body washes to demonstrate that their products are safe for long-term daily use and are more effective than plain soap and water in preventing illness and spread of infections.
The federal agency acted Monday after some scientists and consumer groups had become skeptical about the advantages of antibacterial soap and after recent studies suggesting that one ingredient—triclosan—could interfere with human hormone activity.
Janet Woodcock, head of the FDA's drug unit, said the extra scrutiny was merited because people are using antibacterial soaps in everyday settings "where the risk of infection is relatively low."
Related
Antibiotics of the Future
Q&A: FDA Weighs In on Antibacterial Soaps
FDA's statement
Two groups representing makers of soaps and detergents protested the move. "We are perplexed that the agency would suggest there is no evidence that antibacterial soaps are beneficial, as industry has long provided data and information about the safety and efficacy of these products," said a joint statement from the American Cleaning Institute and the Personal Care Products Council.
The latter group, whose members include more than 600 companies, has previously highlighted academic studies that found fewer microbes on hands that were washed with antibacterial soap.
Companies sold $5 billion worth of soap, bath and shower products in the U.S. last year, according to market-research firm Mintel Group, whose data also showed that as many as two-thirds of shoppers in this area look for liquid hand soap that is antibacterial.
A spokeswoman for German conglomerate Henkel AG HEN3.XE -0.60% , which owns the Dial brand, said the company is reviewing the FDA's statements, takes the agency's proposal seriously and will work with the agency to provide consumers with safe and effective products. Colgate-Palmolive Co., which owns the Softsoap brand, didn't respond to requests for comment. The brands also make liquid hand soaps without antibacterial properties.
The directive doesn't affect hand sanitizers that don't need water and generally contain alcohol. In fact, the FDA encourages people to use these if soap and water aren't available.
Criticism of the antibacterial soaps centers around three allegations: They may not fight germs any better than regular soaps; their ingredients may have side effects in humans; and they may promote the rise of resistant bacteria.
Andrea Gore, a University of Texas toxicology professor who has studied antibacterial ingredients, hailed the FDA's action, saying there has been an "exponential increase in evidence" about triclosan and its effect on human hormones.
Likewise, Stuart Levy, a microbiologist at the Tufts University School of Medicine, said, "This has been on the agenda for a number of years, and finally we are hearing from the FDA that they are in line with what was recommended by experts to their advisory board several years ago."
Over the decade from 2000 to 2010, several countries in Europe and elsewhere restricted the use of triclosan in consumer products. Reckitt Benckiser RB.LN -1.23% PLC, a British-based consumer-products company known for making Lysol, said it has been phasing out triclosan in all its U.S. products. Currently, it is producing just one containing triclosan, and a spokesman said none of the company's products in the U.S. will contain the ingredient by the end of 2014.
Antibacterial soaps often are sold over the counter at pharmacies and elsewhere. The FDA previously classified them as "generally regarded as safe and effective." But under the proposed rule issued Monday, it is reversing the burden of proof.
Now, manufacturers will have to turn over to the FDA more data on the safety of the soaps and on their effectiveness if they are to stay on the market labeled as "antibacterial soap."
The agency said the new data will need to include evidence from clinical studies demonstrating the soaps' superiority over simple hand-washing with regular soap and water.
The agency said many soaps labeled "antibacterial" or "antimicrobial" contain ingredients mentioned in the proposed rule, such as triclosan and triclocarban. The FDA said some soaps labeled "deodorant" may also contain such substances. The agency said there is some evidence that the substances carry health risks like bacterial resistance and hormonal effects.
After receiving comment and companies' data, the FDA said it expects to make a final decision by September 2016, either banning certain products or allowing them based on new evidence.
"Antimicrobial ingredients proliferated in consumer soaps and washes without ever having to prove their long-term safety or effectiveness," said Sen. Edward Markey (D., Mass.), who has been trying to remove triclosan from the market.
Not all antibacterial soaps contain triclosan. At a Washington, D.C., drugstore display Monday, several soaps described as antibacterial didn't have the ingredient while two did—Dial and the drugstore's brand.
Write to Thomas M. Burton at tom.burton@wsj.com and Serena Ng at
-
Spike in Harm to Liver Is Tied to Dietary Aids
Michael Stravato for The New York Times
http://www.nytimes.com/2013/12/22/us/spike-in-harm-to-liver-is-tied-to-dietary-aids.html?nl=todaysheadlines&emc=edit_th_20131222
Christopher Herrera and his mother, Lordes Gonzalez, at home in Katy, Tex. A green tea extract nearly cost Christopher his liver.
By ANAHAD O’CONNOR
Published: December 21, 2013
When Christopher Herrera, 17, walked into the emergency room at Texas Children’s Hospital one morning last year, his chest, face and eyes were bright yellow — “almost highlighter yellow,” recalled Dr. Shreena S. Patel, the pediatric resident who treated him.
Christopher, a high school student from Katy, Tex., suffered severe liver damage after using a concentrated green tea extract he bought at a nutrition store as a “fat burning” supplement. The damage was so extensive that he was put on the waiting list for a liver transplant.
“It was terrifying,” he said in an interview. “They kept telling me they had the best surgeons, and they were trying to comfort me. But they were saying that I needed a new liver and that my body could reject it.”
New data suggests that his is not an isolated case. Dietary supplements account for nearly 20 percent of drug-related liver injuries that turn up in hospitals, up from 7 percent a decade ago, according to an analysis by a national network of liver specialists. The research included only the most severe cases of liver damage referred to a representative group of hospitals around the country, and the investigators said they were undercounting the actual number of cases.
While many patients recover once they stop taking the supplements and receive treatment, a few require liver transplants or die because of liver failure. Naïve teenagers are not the only consumers at risk, the researchers said. Many are middle-aged women who turn to dietary supplements that promise to burn fat or speed up weight loss.
“It’s really the Wild West,” said Dr. Herbert L. Bonkovsky, the director of the liver, digestive and metabolic disorders laboratory at Carolinas HealthCare System in Charlotte, N.C. “When people buy these dietary supplements, it’s anybody’s guess as to what they’re getting.”
Though doctors were able to save his liver, Christopher can no longer play sports, spend much time outdoors or exert himself, lest he strain the organ. He must make monthly visits to a doctor to assess his liver function.
Americans spend an estimated $32 billion on dietary supplements every year, attracted by unproven claims that various pills and powders will help them lose weight, build muscle and fight off everything from colds to chronic illnesses. About half of Americans use dietary supplements, and most of them take more than one product at a time.
Dr. Victor Navarro, the chairman of the hepatology division at Einstein Healthcare Network in Philadelphia, said that while liver injuries linked to supplements were alarming, he believed that a majority of supplements were generally safe. Most of the liver injuries tracked by a network of medical officials are caused by prescription drugs used to treat things like cancer, diabetes and heart disease, he said.
But the supplement business is largely unregulated. In recent years, critics of the industry have called for measures that would force companies to prove that their products are safe, genuine and made in accordance with strict manufacturing standards before they reach the market.
But a federal law enacted in 1994, the Dietary Supplement Health and Education Act, prevents the Food and Drug Administration from approving or evaluating most supplements before they are sold. Usually the agency must wait until consumers are harmed before officials can remove products from stores. Because the supplement industry operates on the honor system, studies show, the market has been flooded with products that are adulterated, mislabeled or packaged in dosages that have not been studied for safety.
The new research found that many of the products implicated in liver injuries were bodybuilding supplements spiked with unlisted steroids, and herbal pills and powders promising to increase energy and help consumers lose weight.
“There unfortunately are criminals that feel it’s a business opportunity to spike some products and sell them as dietary supplements,” said Duffy MacKay, a spokesman for the Council for Responsible Nutrition, a supplement industry trade group. “It’s the fringe of the industry, but as you can see, it is affecting some consumers.” More popular supplements like vitamins, minerals, probiotics and fish oil had not been linked to “patterns of adverse effects,” he said.
The F.D.A. estimates that 70 percent of dietary supplement companies are not following basic quality control standards that would help prevent adulteration of their products. Of about 55,000 supplements that are sold in the United States, only 170 — about 0.3 percent — have been studied closely enough to determine their common side effects, said Dr. Paul A. Offit, the chief of infectious diseases at the Children’s Hospital of Philadelphia and an expert on dietary supplements.
“When a product is regulated, you know the benefits and the risks and you can make an informed decision about whether or not to take it,” he said. “With supplements, you don’t have efficacy data and you don’t have safety data, so it’s just a black box.”
Since 2008, the F.D.A. has been taking action against companies whose supplements are found to contain prescription drugs and controlled substances, said Daniel Fabricant, the director of the division of dietary supplement programs in the agency’s Center for Food Safety and Applied Nutrition. For example, the agency recently took steps to remove one “fat burning” product from shelves, OxyElite Pro, that was linked to one death and dozens of cases of hepatitis and liver injury in Hawaii and other states.
The new research, presented last month at a conference in Washington, was produced by the Drug-Induced Liver Injury Network, which was established by the National Institutes of Health to track patients who suffer liver damage from certain drugs and alternative medicines. It includes doctors at eight major hospitals throughout the country.
The investigators looked at 845 patients with severe, drug-induced liver damage who were treated at hospitals in the network from 2004 to 2012. It focused only on cases where the investigators ruled out other causes and blamed a drug or a supplement with a high degree of certainty.
When the network began tracking liver injuries in 2004, supplements accounted for 7 percent of the 115 severe cases. But the percentage has steadily risen, reaching 20 percent of the 313 cases recorded from 2010 to 2012.
Those patients included dozens of young men who were sickened by bodybuilding supplements. The patients all fit a similar profile, said Dr. Navarro, an investigator with the network.
“They become very jaundiced for long periods of time,” he said. “They itch really badly, to the point where they can’t sleep. They lose weight. They lose work. I had one patient who was jaundiced for six months.”
Tests showed that a third of the implicated products contained steroids not listed on their labels.
A second trend emerged when Dr. Navarro and his colleagues studied 85 patients with liver injuries linked to herbal pills and powders. Two-thirds were middle-aged women, on average 48 years old, who often used the supplements to lose weight or increase energy. Nearly a dozen of those patients required liver transplants, and three died.
It was not always clear what the underlying causes of injury were in those cases, in part because patients frequently combined multiple supplements and used products with up to 30 ingredients, said Dr. Bonkovsky, an investigator with the network.
But one product that patients used frequently was green tea extract, which contains catechins, a group of potent antioxidants that reputedly increase metabolism. The extracts are often marketed as fat burners, and catechins are often added to weight-loss products and energy boosters. Most green tea pills are highly concentrated, containing many times the amount of catechins found in a single cup of green tea, Dr. Bonkovsky said. In high doses, catechins can be toxic to the liver, he said, and a small percentage of people appear to be particularly susceptible.
But liver injuries attributed to herbal supplements are more likely to be severe and to result in liver transplants, Dr. Navarro said. And unlike prescription drugs, which are tightly regulated, dietary supplements typically carry no information about side effects. Consumers assume they have been studied and tested, Dr. Bonkovsky said. But that is rarely the case. “There is this belief that if something is natural, then it must be safe and it must be good,” he said.
-
This seems amazing!
https://www.facebook.com/DrNajeeb
-
http://www.cdc.gov/flu/weekly/usmap.htm
-
***What Dr. Samadi fails to say is that only 1 in 36 men actually die of it**** Please see yahoo post response to this article included below. Autopsy studies suggest that 75% of men have microscopic prostate cancer in their gland when they died. Proportionately few will even know much less even die of it. Not to say prostate cancer can be ignored - 25 000 die of it every year in the US. So it is very serious. I don't like this guy promoting a procedure he and probably the institution he works with both making a mint from this touting it as the greatest thing since sliced bread. We see this a lot in the medical field. Conflict of interests are Everywhere. And they are not readily reported as pretended by publications like the New England Journal of Medicine. That is not to say there are not very ethical men and women who ARE doing the best they can for humanity and if they can make money from it that is fine. But I am very skeptical this guy is one of them.
******For Prostate Cancer, Radiation Complications May Outweigh Risks
LiveScience.com
By Dr. David Samadi, Lenox Hill Hospital in New York City January 31, 2014 7:36 PM
Dr. David Samadi is the chairman of urology and chief of robotic surgery at Lenox Hill Hospital in New York City and is a board-certified urologist and oncologist specializing in the diagnosis and treatment of urologic diseases, kidney cancer, bladder cancer and prostate cancer. Samadi also specializes in many advanced, minimally invasive treatments for prostate cancer; is one of the few urologic surgeons in the United States trained in oncology, open-, laparoscopic- and robotic-surgery; and was the first surgeon in the nation to successfully perform a robotic surgery redo. He contributed this article to LiveScience's Expert Voices: Op-Ed & Insights.
Radiation for prostate cancer has shown once again that it leads to more complications than surgery. For men with prostate cancer, deciding whether to opt for radiation or surgical removal of the gland can be overwhelming. How does one decide with the risks, such as the unpleasant side-effects of erectile dysfunction and incontinence?
Prostate cancer is the second most common malignancy, second only to skin cancer. Unfortunately, doctors diagnose more than 240,000 men in the United States with the disease every year, which translates into 1 in every 6 men being affected by prostate cancer. A new study published last Thursday in the Lancet Oncology Journal found that "men treated with radiotherapy had fewer minimally invasive urological procedures compared to those who chose surgery." However, over time, "the radiation group had a higher proportion of hospital admissions, rectal or anal procedures, related surgeries and secondary cancers."
Men need to take the time to do their research on how "radiation" really works and what side effects they will have to live with. There are two kinds of radiation, external beam and brachytherapy, which involves radioactive material inside the prostate. We as men have all the control in the world to decide what form of treatment is best for us. Do you just want a quick fix that will sometimes show you upfront results from radiation, but will cause you to suffer from side effects in the long run or would you rather choose robotic prostatectomy with minimal bleeding, 95 percent to 97 percent continence rate, and an overall better quality of life? Put aside the temporary leakage and erectile dysfunction that you may receive from robotic prostatectomy, because a year from your surgery those minimal side effects will dissipate.
The questions I suggest my patients ask themselves are:
Do you want to be admitted to the hospital more frequently?
Do you want to likely bleed from your bladder or rectum?
Do you want to risk a second cancer?
This can be the reality for patients who undergo radiation treatments and how it can decrease your confidence and overall quality of life. In the recent study, radiotherapy complication rates were 2- to 10-times higher than complication rates in men who were treated with robotic prostatectomy. Choosing surgery after radiation makes the surgery more complicated. Radiation destroys the surrounding healthy tissue causing the prostate to be embedded in scar tissue. This makes the surgery more complex than operating on tissue that has not been affected by radiation.
Once the prostate is removed, surgeons like myself monitor the prostate-specific antigen (PSA) levels to ensure that the cancer doesn't come back. If radiotherapy is performed prior to the surgery, the PSA will fluctuate due to radiotherapy and pieces of the prostate that are left behind, confusing that monitoring process.
Following a prostate cancer diagnosis, men are flooded with tons of informationand must try to make sense of the different treatment options — it can make even the most educated patient uncertain. [Prostate Cancer Screening Test May Prevent 17,000 Advanced Cases Yearly]
Do your homework and really look at the outcomes one month to one year to a lifetime from now and ask yourself: "Will I be happy with these results?" As the numbers point to robotic prostatectomy, the decision lies in your hands.*****
___________________________________
A very good reply from someone in the same specialty who has no financial conflict of interests very unlike this Fox news guy who for quite sometime now has lost my respect as not much more than a self serving charlatan:
****This is a very self-serving & misleading piece of pro-surgery propaganda. Full disclosure: I'm a retired urologist who practiced 20 years privately and was also a clinical prof. at the local medical school. The first item is that the DaVinci robot is currently under multiple suits over its design and propensity to cause serious injuries at surgery leading to major complications, reoperations, permanent urinary incontinence, permanent impotence (erectile dysfunction), and death. It is true that radiation therapy (XRT) has a higher incidence of 'radiation proctitis' (inflammation & bleeding of & from the rectal blood vessels)... since surgical prostatectomy, done correctly, doesn't affect the rectum, that's not surprising since radiation is less precise; although brachytherapy ('seeds') has a far lower incidence. It is also important to understand that all urologists have a vested interest in treating prostate cancer aggressively since the advent of effective medical treatment for benign enlargement of the prostate ('BPH') has rendered the prior 'bread & butter' operation for it (TURP) infrequent. What Dr. Samadi does by waving the scare statistic of 1 in 6 men getting prostate cancer (ACP) is to try and create a stampede of fearful men seeking any means of not dying of prostate cancer. What Dr. Samadi fails to say is that only 1 in 36 men actually die of it (Google: What are the key statistics about prostate cancer?) and that dying of ACP is more a function of the aggressiveness of the cancer than of its treatment - that is; men with aggressive prostate cancers die of it more often than men with less aggressive tumors regardless of how early it's detected or how it's treated. Lastly, the vast majority of men's prostate cancers are detected within the last decade or two of their lives and, if followed until evidence of local growth is note, and XRT given then (followed by hormonal therapy for those rare progressions after XRT) most can live very comfortably and without complications of treatment until their other disease processes take them away... and in my book, even if there's evidence of active prostate cancer, that's effectively a 'cure'.
.
Expand Replies (1) Reply
-
Diabetic man eats pizza for decades. He also bikes 30 to 40 miles a day which explains part of it. Years ago there was a study that compared an all you can eat vegetable diet with an all you can eat pizza diet. Those in the former group gained more weight. Why? There is more variety in vegetables than pizza. After a while pizza eaters got sick of eating pizza and wound up eating less calories. Part of the mix of the American obesity epidemic is the variety of foods we have available. Italian one day, donuts the next, Chinese third, Ice cream, Mexican is now rampant and all over the place, Chicken and on and on and on:
https://www.yahoo.com/food/this-guy-has-eaten-pizza-every-day-for-the-last-23-78003722644.html
-
erectile dysfunction - hang out with a Brazilian wandering spider. It also has the most toxic spider venom:
****Brazilian Wandering Spider: Bites & Other Facts
By Jessie Szalay,
Brazilian wandering spider, spiders
The Brazilian wandering spider belongs to the genus Phoneutria, which means “murderess” in Greek. And it’s no wonder why — it’s one of the most venomous spiders on earth. Its bite can be deadly to humans, although antivenom makes death unlikely. The Guinness Book of World Records has named it the world’s Most Venomous Spider in multiple years.
There are eight species of Brazilian wandering spiders, which can all be found in Brazil. Some of the species can also be found throughout Latin America, from Costa Rica to Argentina. These powerful arachnids have been known to hitch rides internationally in banana shipments, for which they’ve been given the nickname “banana spider.”
In 2007, scientists discovered that in addition to intense pain and possible medical complications, the bite of a Brazilian wandering spider also deliver a long, painful erection to human males. The venom boosts nitric oxide, a chemical that increases blood flow. There has since been talk of incorporating the venom into drugs for erectile dysfunction.
-
I have to ask my surgeon friends as usually they get a quick path report back that should have told this trainee it was not the appendix. Or with in
a day. Sometimes surgeons now treat appendicitis with antibiotics alone and do not perform surgery. I am not clear which is best in pregnancy.
There is risk to many antibiotics and pregnancy too.
https://en-maktoob.entertainment.yahoo.com/blogs/parenting/pregnant-woman-dies-horrifying-medical-mixup-200700512.html
-
Scientists alter fat metabolism in animals to prevent most common type of heart disease
Working with mice and rabbits, Johns Hopkins scientists have found a way to block abnormal cholesterol production, transport and breakdown, successfully preventing the development of atherosclerosis, the main cause of heart attacks and strokes and the number-one cause of death among humans. The condition develops when fat builds inside blood vessels over time and renders them stiff, narrowed and hardened, greatly reducing their ability to feed oxygen-rich blood to the heart muscle and the brain.
In a series of experiments, described April 7 in the journal Circulation, the Johns Hopkins team says it identified and halted the action of a single molecular culprit responsible for a range of biological glitches that affect the body's ability to properly use, transport and purge itself of cholesterol—the fatty substance that accumulates inside vessels and fuels heart disease.
The offender, the researchers say, is a fat-and-sugar molecule called glycosphingolipid, or GSL, which resides in the membranes of all cells, and is mostly known for regulating cell growth. Results of the experiments, the scientists say, reveal that this very same molecule also regulates the way the body handles cholesterol.
The Johns Hopkins team used an existing man-made compound called D-PDMP to block the synthesis of the GSL molecule, and by doing so, prevented the development of heart disease in mice and rabbits fed a high-fat, cholesterol-laden diet. The findings reveal that D-PDMP appears to work by interfering with a constellation of genetic pathways that regulate fat metabolism on multiple fronts—from the way cells derive and absorb cholesterol from food, to the way cholesterol is transported to tissues and organs and is then broken down by the liver and excreted from the body.
"Current cholesterol-lowering medications tackle the problem on a single front—either by blocking cholesterol synthesis or by preventing the body from absorbing too much of it," says lead investigator Subroto Chatterjee, Ph.D., a cardio-metabolic expert at the Johns Hopkins Children's Center. "But atherosclerosis is a multi-factorial problem that requires hitting the abnormal cholesterol cycle at many points. By inhibiting the synthesis of GSL, we believe we have achieved exactly that."
Specifically, the experiments showed that treatment with D-PDMP led to:
•a drop in the animals' levels of so-called bad cholesterol or low-density lipoprotein, LDL;
•a drop in oxidized LDL, a particularly virulent form of fat that forms when LDL encounters free radicals. Oxidized LDL easily sticks to the walls of blood vessels, where it ignites inflammation, damaging the vessel walls and promoting the growth of fatty plaque;
•a surge in good cholesterol or high-density lipoprotein, HDL, known to counteract the effects of LDL by mopping it up; and
•a significant drop in triglycerides, another type of plaque-building fat.
The treatment also prevented fatty plaque and calcium deposits from building up inside the animals' vessels. These effects were observed in animals on a daily D-PDMP treatment even though they ate a diet made up of 20 percent triglycerides—the human equivalent of eating a greasy burger for breakfast, lunch and dinner. In addition, the researchers say, D-PDMP appears to precision-target the worst byproducts of aberrant cell growth signaling, such as oxidized LDL and the activity of certain chemicals that fuel vessel inflammation, without altering cell growth itself.
D-PDMP, which is already widely used in basic research to experimentally block and study cell growth and other basic cell functions, is deemed safe in animals, the investigators say. For example, animals in the current study had no side effects even when given D-PDMP doses 10 times higher than the minimum effective dose, the study found. The research team is currently designing a compound drug with D-PDMP, which they soon plan to test in other animals and, eventually, in humans.
Mice used in the experiments were genetically engineered to lack a protein essential in the breakdown of fats and thus were predisposed to atherosclerosis. The researchers fed the animals a high-fat diet over the course of several months, but also gave a third of the animals a low-dose of D-PDMP. They gave a double dose of the same inhibitor to another third and placebo to the rest.
When scientists measured the thickness of the animals' aortas—the body's largest vessel and one that carries blood from the heart to the rest of the body—they found striking differences among the groups. As expected, the aortas of mice that got placebo had grown thicker from the accumulation of fat and calcium deposits inside them. The aortas of mice on low-dose D-PDMP, however, were significantly thinner with little to no obstruction. To the researchers' surprise, Chatterjee says, mice eating high-fat foods and treated with high-dose D-PDMP had nearly pristine arteries free of obstruction, indistinguishable from those of healthy mice.
Next, the researchers measured how well and how fast blood traveled through the animals' blood vessels. Slower blood flow signals clogging of the vessel and is a marker of atherosclerosis. The vessels of mice fed a high-fat diet plus D-PDMP had normal blood flow. Mice receiving a high-fat diet without D-PDMP predictably had compromised blood flow.
When researchers examined cells from the animals' livers—the main site of fat synthesis and breakdown—they noticed marked differences in the expression of several genes that regulate cholesterol metabolism. The activity of these genes is heralded by the levels of enzymes they produce, Chatterjee says. Mice treated with D-PDMP had notably higher levels of two enzymes responsible for maintaining the body's delicate fat homeostasis by regulating the way cells take in and break down cholesterol. Specifically, the scientists say, the inhibitor appeared to stimulate the action and efficacy of a class of protein pumps in the cell responsible for maintaining healthy cholesterol levels by transporting cholesterol in and out of the bloodstream. In addition, mice treated that way had higher levels of lipoprotein lipase, an enzyme responsible for the breakdown of triglycerides. A deficiency in this enzyme causes dangerous buildup of blood triglycerides.
Treatment with a D-PDMP also boosted the activity of an enzyme responsible for purging the body of fats by converting these fats into bile, the fat-dissolving substance secreted by the liver.
In a final set of experiments, researchers compared the effects of treatment with D-PDMP in two groups of healthy rabbits, both fed high-fat diets, with half of them receiving treatment. Rabbits that ate high-fat food alone developed all the classic signs of atherosclerosis—fatty plaque buildup in the arteries and stiff, narrowed blood vessels. Their cholesterol levels shot up 17-fold. By contrast, rabbits treated with D-PDMP never developed atherosclerosis. Their cholesterol levels also remained normal or near-normal.
The World Health Organizations estimates that high cholesterol claims 2.6 million lives worldwide each year. More than 70 million Americans have high cholesterol, according to the U.S. Centers for Disease Control and Prevention. Current cholesterol-lowering drugs, such as statins, do not work in about one-third of people who take them, experts say.
-
VERY interesting!
-
The Questionable Link Between Saturated Fat and Heart Disease
Are butter, cheese and steak really bad for you? The dubious science behind the anti-fat crusade
By Nina Teicholz
May 2, 2014 6:48 p.m. ET
RF Pictures/Corbis
"Saturated fat does not cause heart disease"—or so concluded a big study published in March in the journal Annals of Internal Medicine. How could this be? The very cornerstone of dietary advice for generations has been that the saturated fats in butter, cheese and red meat should be avoided because they clog our arteries. For many diet-conscious Americans, it is simply second nature to opt for chicken over sirloin, canola oil over butter.
The new study's conclusion shouldn't surprise anyone familiar with modern nutritional science, however. The fact is, there has never been solid evidence for the idea that these fats cause disease. We only believe this to be the case because nutrition policy has been derailed over the past half-century by a mixture of personal ambition, bad science, politics and bias.
Our distrust of saturated fat can be traced back to the 1950s, to a man named Ancel Benjamin Keys, a scientist at the University of Minnesota. Dr. Keys was formidably persuasive and, through sheer force of will, rose to the top of the nutrition world—even gracing the cover of Time magazine—for relentlessly championing the idea that saturated fats raise cholesterol and, as a result, cause heart attacks.
This idea fell on receptive ears because, at the time, Americans faced a fast-growing epidemic. Heart disease, a rarity only three decades earlier, had quickly become the nation's No. 1 killer. Even President Dwight D. Eisenhower suffered a heart attack in 1955. Researchers were desperate for answers.
As the director of the largest nutrition study to date, Dr. Keys was in an excellent position to promote his idea. The "Seven Countries" study that he conducted on nearly 13,000 men in the U.S., Japan and Europe ostensibly demonstrated that heart disease wasn't the inevitable result of aging but could be linked to poor nutrition.
Critics have pointed out that Dr. Keys violated several basic scientific norms in his study. For one, he didn't choose countries randomly but instead selected only those likely to prove his beliefs, including Yugoslavia, Finland and Italy. Excluded were France, land of the famously healthy omelet eater, as well as other countries where people consumed a lot of fat yet didn't suffer from high rates of heart disease, such as Switzerland, Sweden and West Germany. The study's star subjects—upon whom much of our current understanding of the Mediterranean diet is based—were peasants from Crete, islanders who tilled their fields well into old age and who appeared to eat very little meat or cheese.
As it turns out, Dr. Keys visited Crete during an unrepresentative period of extreme hardship after World War II. Furthermore, he made the mistake of measuring the islanders' diet partly during Lent, when they were forgoing meat and cheese. Dr. Keys therefore undercounted their consumption of saturated fat. Also, due to problems with the surveys, he ended up relying on data from just a few dozen men—far from the representative sample of 655 that he had initially selected. These flaws weren't revealed until much later, in a 2002 paper by scientists investigating the work on Crete—but by then, the misimpression left by his erroneous data had become international dogma.
In 1961, Dr. Keys sealed saturated fat's fate by landing a position on the nutrition committee of the American Heart Association, whose dietary guidelines are considered the gold standard. Although the committee had originally been skeptical of his hypothesis, it issued, in that year, the country's first-ever guidelines targeting saturated fats. The U.S. Department of Agriculture followed in 1980.
Other studies ensued. A half-dozen large, important trials pitted a diet high in vegetable oil—usually corn or soybean, but not olive oil—against one with more animal fats. But these trials, mainly from the 1970s, also had serious methodological problems. Some didn't control for smoking, for instance, or allowed men to wander in and out of the research group over the course of the experiment. The results were unreliable at best.
But there was no turning back: Too much institutional energy and research money had already been spent trying to prove Dr. Keys's hypothesis. A bias in its favor had grown so strong that the idea just started to seem like common sense. As Harvard nutrition professor Mark Hegsted said in 1977, after successfully persuading the U.S. Senate to recommend Dr. Keys's diet for the entire nation, the question wasn't whether Americans should change their diets, but why not? Important benefits could be expected, he argued. And the risks? "None can be identified," he said.
In fact, even back then, other scientists were warning about the diet's potential unintended consequences. Today, we are dealing with the reality that these have come to pass.
One consequence is that in cutting back on fats, we are now eating a lot more carbohydrates—at least 25% more since the early 1970s. Consumption of saturated fat, meanwhile, has dropped by 11%, according to the best available government data. Translation: Instead of meat, eggs and cheese, we're eating more pasta, grains, fruit and starchy vegetables such as potatoes. Even seemingly healthy low-fat foods, such as yogurt, are stealth carb-delivery systems, since removing the fat often requires the addition of fillers to make up for lost texture—and these are usually carbohydrate-based.
The problem is that carbohydrates break down into glucose, which causes the body to release insulin—a hormone that is fantastically efficient at storing fat. Meanwhile, fructose, the main sugar in fruit, causes the liver to generate triglycerides and other lipids in the blood that are altogether bad news. Excessive carbohydrates lead not only to obesity but also, over time, to Type 2 diabetes and, very likely, heart disease.
The real surprise is that, according to the best science to date, people put themselves at higher risk for these conditions no matter what kind of carbohydrates they eat. Yes, even unrefined carbs. Too much whole-grain oatmeal for breakfast and whole-grain pasta for dinner, with fruit snacks in between, add up to a less healthy diet than one of eggs and bacon, followed by fish. The reality is that fat doesn't make you fat or diabetic. Scientific investigations going back to the 1950s suggest that actually, carbs do.
The second big unintended consequence of our shift away from animal fats is that we're now consuming more vegetable oils. Butter and lard had long been staples of the American pantry until Crisco, introduced in 1911, became the first vegetable-based fat to win wide acceptance in U.S. kitchens. Then came margarines made from vegetable oil and then just plain vegetable oil in bottles.
All of these got a boost from the American Heart Association—which Procter & Gamble, the maker of Crisco oil, coincidentally helped launch as a national organization. In 1948, P&G made the AHA the beneficiary of the popular "Walking Man" radio contest, which the company sponsored. The show raised $1.7 million for the group and transformed it (according to the AHA's official history) from a small, underfunded professional society into the powerhouse that it remains today.
After the AHA advised the public to eat less saturated fat and switch to vegetable oils for a "healthy heart" in 1961, Americans changed their diets. Now these oils represent 7% to 8% of all calories in our diet, up from nearly zero in 1900, the biggest increase in consumption of any type of food over the past century.
This shift seemed like a good idea at the time, but it brought many potential health problems in its wake. In those early clinical trials, people on diets high in vegetable oil were found to suffer higher rates not only of cancer but also of gallstones. And, strikingly, they were more likely to die from violent accidents and suicides. Alarmed by these findings, the National Institutes of Health convened researchers several times in the early 1980s to try to explain these "side effects," but they couldn't. (Experts now speculate that certain psychological problems might be related to changes in brain chemistry caused by diet, such as fatty-acid imbalances or the depletion of cholesterol.)
We've also known since the 1940s that when heated, vegetable oils create oxidation products that, in experiments on animals, lead to cirrhosis of the liver and early death. For these reasons, some midcentury chemists warned against the consumption of these oils, but their concerns were allayed by a chemical fix: Oils could be rendered more stable through a process called hydrogenation, which used a catalyst to turn them from oils into solids.
From the 1950s on, these hardened oils became the backbone of the entire food industry, used in cakes, cookies, chips, breads, frostings, fillings, and frozen and fried food. Unfortunately, hydrogenation also produced trans fats, which since the 1970s have been suspected of interfering with basic cellular functioning and were recently condemned by the Food and Drug Administration for their ability to raise our levels of "bad" LDL cholesterol.
Yet paradoxically, the drive to get rid of trans fats has led some restaurants and food manufacturers to return to using regular liquid oils—with the same long-standing oxidation problems. These dangers are especially acute in restaurant fryers, where the oils are heated to high temperatures over long periods.
The past decade of research on these oxidation products has produced a sizable body of evidence showing their dramatic inflammatory and oxidative effects, which implicates them in heart disease and other illnesses such as Alzheimer's. Other newly discovered potential toxins in vegetable oils, called monochloropropane diols and glycidol esters, are now causing concern among health authorities in Europe.
In short, the track record of vegetable oils is highly worrisome—and not remotely what Americans bargained for when they gave up butter and lard.
Cutting back on saturated fat has had especially harmful consequences for women, who, due to hormonal differences, contract heart disease later in life and in a way that is distinct from men. If anything, high total cholesterol levels in women over 50 were found early on to be associated with longer life. This counterintuitive result was first discovered by the famous Framingham study on heart-disease risk factors in 1971 and has since been confirmed by other research.
Since women under 50 rarely get heart disease, the implication is that women of all ages have been worrying about their cholesterol levels needlessly. Yet the Framingham study's findings on women were omitted from the study's conclusions. And less than a decade later, government health officials pushed their advice about fat and cholesterol on all Americans over age 2—based exclusively on data from middle-aged men.
Sticking to these guidelines has meant ignoring growing evidence that women on diets low in saturated fat actually increase their risk of having a heart attack. The "good" HDL cholesterol drops precipitously for women on this diet (it drops for men too, but less so). The sad irony is that women have been especially rigorous about ramping up on their fruits, vegetables and grains, but they now suffer from higher obesity rates than men, and their death rates from heart disease have reached parity.
Seeing the U.S. population grow sicker and fatter while adhering to official dietary guidelines has put nutrition authorities in an awkward position. Recently, the response of many researchers has been to blame "Big Food" for bombarding Americans with sugar-laden products. No doubt these are bad for us, but it is also fair to say that the food industry has simply been responding to the dietary guidelines issued by the AHA and USDA, which have encouraged high-carbohydrate diets and until quite recently said next to nothing about the need to limit sugar.
Indeed, up until 1999, the AHA was still advising Americans to reach for "soft drinks," and in 2001, the group was still recommending snacks of "gum-drops" and "hard candies made primarily with sugar" to avoid fatty foods.
Our half-century effort to cut back on the consumption of meat, eggs and whole-fat dairy has a tragic quality. More than a billion dollars have been spent trying to prove Ancel Keys's hypothesis, but evidence of its benefits has never been produced. It is time to put the saturated-fat hypothesis to bed and to move on to test other possible culprits for our nation's health woes.
Ms. Teicholz has been researching dietary fat and disease for nearly a decade. Her book, "The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet," will be published by Simon & Schuster on May 13.
-
My 2 cents again. I think E cigarettes are a great idea. A patient told me he uses one without the nicotine and flavored which helps with the "habit" part of smoking:
*******U.S. e-cigarette experiment inspires new medical device
Reuters
By By Toni Clarke 2 hours ago
Electronic cigarette vaporizers Cera and Luna by Thermo-Essence Technologies are pictured in San Carlos
(L-R) Electronic cigarette vaporizers Cera and Luna by Thermo-Essence Technologies are pictured in San …
By Toni Clarke
(Reuters) - When Noah Minskoff's mother died of lung cancer in 2007, e-cigarettes were just entering the U.S. market. Minskoff, who had just started medical school in Utah, wondered whether the devices might have saved his mother's life by helping her quit smoking. Later, he sent some samples to his boyhood friend Nathan Terry, a mechanical engineer, and asked for his opinion.
Terry, who was working in Germany for the French industrial firm Areva, took apart the products to see how they were made. What he found disturbed him: at the heart of the devices were heater wires of unknown quality wrapped around bundles of glass fibers and surrounded by steel wool, silicon, plastic, tape and adhesives.
Wires between the heater, circuit board and batteries were connected with lead solder and also housed in tape and plastic. Everything was close to the heat source, meaning consumers were at risk of inhaling fiber and metal particles as well as toxic fumes from hot plastic and lead.
"There were red flags everywhere," Terry said.
Still, he liked the concept and decided to design a version of his own, avoiding the use of fiberglass, plastic and solder and sourcing his materials entirely in the United States. In 2009 he reunited with Minskoff in California and formed a company, Thermo-Essence Technologies, to sell the product.
At $300 a piece, the e-cigarette serves a niche market, albeit one with a loyal following among medical marijuana patients and smokers looking for a high-end e-cigarette. As many as 30,000 have been sold.
But what began as a quest to develop a better e-smoke has broadened into an ambitious effort to design a new medical device: an inhaler that delivers measured doses of nicotine to help people quit smoking. The technology could also eventually be used as an abuse-resistant delivery device for other drugs, including opioid painkillers.
If successful, the inhaler could become the first new smoking-cessation product to emerge from the e-cigarette field and would compete with products such as GlaxoSmithKline Plc's nicotine gum and Pfizer Inc's antismoking drug, Chantix.
A STARTUP WITH BIOTECH FUNDING
To develop the inhaler, Terry formed a second company, Minusa LLC, which is based in Newtown, Connecticut. Minskoff left Thermo-Essence for family reasons and is not involved in Minusa. Terry himself is leaving Thermo-Essence, which is currently being sold, to concentrate on Minusa.
The new company obtained initial funding from Michael Breede, a commercial real-estate-turned-biotech investor whose father suffered from drug and alcohol addiction and who is eager to see an abuse-resistant painkiller device.
"This is in my wheelhouse," he said. "I think we can put a serious dent in this problem."
When Terry developed his e-cigarette he assumed the U.S. Food and Drug Administration would begin regulating the industry, as it has recently done, proposing a ban on sales to people under the age of 18 and requiring companies to register. Later it could impose product standard and quality controls.
Terry wanted to create a product that would pass any FDA inspection. He used a pure metal wire wrapped around a rod made from magnesia-stabilized zirconia, a highly durable ceramic material. Instead of meshes, tape and plastic he used novel porous ceramics and surgical-grade alloys, and instead of soldering parts together he connected them mechanically, fitting components together like Legos to complete the circuits.
He built on that design to create his drug-delivery device, known as Envi, a single-user, tamper-resistant, metered-dose inhaler.
Envi is about the size of a short cigar and comes with a spare in a case the size of a deck of playing cards.
The nicotine or other drug will come in a sealed cartridge that the patient will insert into the inhaler. To activate the device, the user will have to enter a code. The inhaler will be programed to deliver a certain amount of drug and then turn off.
When the device is returned to the case, which is required after each dose to activate it for the next dose, data on the patient's usage will be downloaded and available to be viewed electronically by the prescribing physician.
"It will only let you take your prescription," Terry said. "It will log your usage and transmit it in real time, and make it easier for the doctor to monitor and interact with the patient."
BUILDING A BETTER INHALER
Terry, 37, who grew up on an organic farm in Ohio to "hippy commune" parents and studied mechanical engineering at the University of Idaho, faces multiple challenges.
Inhalers are typically more expensive to develop than pills, and ensuring patients get the right dose is more complicated.
"I can see a lot of barriers, but the idea is certainly interesting," said Dr. Ben Forbes, a Reader in Pharmaceutics, broadly the equivalent of a U.S. professor, at King's College London who specializes in inhaled medications.
There needs to be a good reason to target a drug to the lungs, Forbes said. Drugs that are inhaled may work faster than pills, so a device that offered quick pain relief in an abuse-resistant form would be "brilliant" if it could be produced economically, he added.
"Changes in inhaler technology have been very incremental over the years, so maybe something like this would have a place."
In the meantime, big tobacco companies are developing alternative nicotine products they hope one day will carry a "modified risk" of harm. Some are dispensed through an inhaler.
Unlike Terry's smoking-cessation device, which he plans to file with the FDA's drug division, these products would be marketed as less risky alternatives to smoking and be processed through the FDA's tobacco division.
However smokers end up using the new products will be the subject of intense research by the FDA.
Terry believes he is creating a product that will survive any market configuration. Minusa has a long way to go, and human trials may be two years off. Eventually he hopes to partner with a big drug company.
"I think we can change how drugs are delivered."
(Reporting by Toni Clarke in Washington; Editing by Michele Gershberg and Prudence Crowther)
-
http://www.newstatesman.com/sci-tech/2014/04/we-need-talk-about-poo-and-how-it-could-save-your-life
-
I frankly am not sure what to make of this except that I am thinking of going out and buying a plate of (without the bread) corn beef, roast beef, and pastrami, and yes tongue!
In general I suggest to patients just to keep the calories down as much as possible. Diets, low fat, low carb, low this low that. Just low calories with some obvious healthy foods with fiber and nutrients like fruits and vegetables.
I included some of the comments posted in response to the article.
******Heart Association’s Junk Science Diet
By Barbara H. Roberts, MD 4 hours ago The Daily Beast
Heart Association’s Junk Science Diet
The dogma that saturated fat causes heart disease is crumbling.
A recent Cambridge University analysis of 76 studies involving more than 650,000 people concluded, “The current evidence does not clearly support guidelines that [recommend]… low consumption of total saturated fats.”
Yet the American Heart Association (AHA), in its most recent dietary guidelines, held fast to the idea that we must all eat low fat diets for optimal heart health. It’s a stance that—at the very best—is controversial, and at worst is dead wrong. As a practicing cardiologist for more than three decades, I agree with the latter—it’s dead wrong.
Why does the AHA cling to recommendations that fly in the face of scientific evidence?
What I discovered was both eye opening and disturbing. The AHA not only ignored all the other risk factors for heart disease, but it appointed someone with ties to Big Food and bizarre scientific beliefs to lead the guideline-writing panel—just the type of thing that undermines the public’s confidence in the medical community.
The AHA guidelines warrant that saturated fat make up no more than 5 to 6 percent of daily calories for adults because this will lower “bad” (LDL) cholesterol. And, for those people who need blood pressure control, the guidelines also suggest lowering sodium (salt) intake to no more than a teaspoon (2,300 mg) daily.
Despite many other known risk factors for heart disease, salt and fat were, astonishingly, the only two considered by the AHA panel writing the guidelines. There are many other recognized risk factors the AHA ignored, including blood sugar level, low “good” (HDL) cholesterol, insulin levels, and body weight—all of these are influenced by diet.
In fact, most people who have heart attacks don’t have elevations in bad cholesterol. They are much more likely to have metabolic syndrome—a condition that puts you at high risk for diabetes and heart disease. Metabolic syndrome is defined when you have three of the following: high triglycerides (blood fats), high blood sugar, high blood pressure, low “good” cholesterol (HDL-C), and a large abdomen measurement (abdominal obesity).
Interestingly enough, blood triglycerides do not go up with eating fat—they go up if you eat a diet high in processed grains, starches, and sugar. Unfortunately for the proponents of high carbohydrate diets, high blood triglycerides are a major risk factor for heart disease. In addition, low fat/high carb diets lower protective “good” cholesterol and raise insulin. These diets are implicated in the development of diabetes, which is a potent risk factor for developing heart disease.
The writers of the 2013 statin guidelines based their recommendations on studies that looked at the reduction in the risk of events like heart attacks in people treated with statins, compared to people on placebo. The AHA dietary guidelines do not cite any diet studies that looked at whether following a specific diet lowered the risk of developing cardiac events—yet they are giving dietary advice. Why?
There might be two plausible reasons. One is the AHA’s moneymaking “Heart Check Program.” The second is the conflict of interest (and curious beliefs) of Robert Eckel—the co-chair of the panel that wrote the guidelines.
The AHA introduced the Heart Check Program in 1995 and it has been quite the moneymaker, as the AHA sells the Heart Check stamp-of-approval to food manufacturers. Food companies shell out between $1,000 and $7,500 to be certified by the Heart Check Program—and then there are yearly renewal fees. The program currently endorses 889 foods as “heart-healthy.”
And the Heart Check Program is not the only way the AHA benefits from Big Food companies. In their annual report for 2012-2013, the AHA lists among its lifetime donors of $1 million or more Conagra, Quaker Oats, and Campbell Soups, among others.
Forty-five percent of these “heart healthy” foods—over 400 of them—are meat; 92 are processed meats—which have been shown to have either neutral or negative effects on heart health.
Even more problematic are the foods containing added sugar. The AHA recommends that women consume less than 6 teaspoons (100 calories) of sugar a day and less than 9 teaspoons (150 calories) for men. Yet there are items that get the nod of approval from the Heart Check program despite being near or at the sugar limit, like Bruce’s Yams Candied Sweet Potatoes and Healthy Choice Salisbury Steak. Indeed, until 2010, the Heart Check imprimatur was stamped on a drink called Chocolate Moose Attack, which contained more sugar per ounce than regular Pepsi.
And until this year, Heart Check approved many foods with trans-fats, which raise bad cholesterol and lower good cholesterol, among other deleterious effects on health, like increasing inflammation and the laying down of calcium in arteries.
Like the dietary guidelines, the AHA Heart Check Program appears to address only the effect of foods on cholesterol level and blood pressure. Meanwhile, since the 1970s, our yearly sugar consumption has skyrocketed along with the incidence of diabetes and obesity.
This brings us to Dr. Robert H. Eckel, the co-chair of the Working Group. He is a consultant for Foodminds, which specializes “in food, beverage, nutrition, health and wellness.” Foodminds works with more than 30 leading food, beverage, and nutrition to offer a “one stop shop of…consulting…to guide food and beverage companies in navigating the complexities around the upcoming FDA Nutrition Facts label overhaul.” In other words, Foodminds is a lobbying firm for “Big Food.”
And then there is this:
Dr. Eckel describes himself as “a scientist and professing six-day creationist and a member of the technical advisory board of the Institute for Creation Research…” Many scientists are religious. This is not to question Dr. Eckel’s religious beliefs, but to question his ability to think scientifically. He believes there is scientific proof that the world was created in six days and that evolution does not exist. This should at least raise eyebrows when the co-chair of an influential panel charged with giving scientifically sound dietary advice has a financial conflict of interest and proselytizes for beliefs that are anti-scientific.
Practice guidelines affect both public policy and medical practice. We should expect professional medical organizations —like the American Heart Association—to examine all the evidence relating to diet and heart disease risk.
The American people should be able to trust that only impartial scientists write guidelines. We should be confident that those experts are not working to advance corporate interests and that they do not espouse beliefs that are well outside the scientific mainstream. An avowed creationist who consults for a food lobby hardly seems an appropriate choice to fulfill these criteria.
READ MORE The Truth About Salt
For the last several decades, the AHA has promoted a low fat high carbohydrate diet as a cornerstone of heart health. It has taken a very public position that saturated fats are a major driver of heart disease risk and the mounting tide of evidence that this is dead wrong must put them it in a very uncomfortable position. And yet a fundamental requirement of science—as opposed to propaganda—is that when evidence that contradicts a hypothesis is replicated over and over again, that hypothesis must be abandoned.
The idea that eating high amounts of saturated fat causes hardening of the arteries—the so-called “diet-heart hypothesis”— deserves to be jettisoned along with other discredited belief systems. Creationism comes to mind. Will the AHA step up to the plate?
The American Heart Association had not returned an inquiry for comment at the time of publishing.
...
.
10 Comments .
Ernesto 1 hour ago
two years ago, I realized that the AHA did NOT need my donation. It seemed to me that most of their donations may come from the food and pharmaceutical industry so, they really don't need either my participation on the heart day walk. Their statistics show that during the past 30 years their guidelines and recommendations are linked to a double fold increase of heart disease in the U.S. And the sad part is that doctors, specifically cardiologists, and health insurances either promote or follow these inept guidelines. Recently, I almost purchase a food brand deli turkey which it showed a heart check on the label. I decided to read the ingredients to find out that the processed meat contained too much sodium and phosphates. Both ingredients are bad for the heart. AFP RELAXNEWS Wednesday, May 7, 2014, 10:39 AM
Phosphates, which are also found in Parmesan, colas and baking soda, may stimulate the production of the hormone FGF23, which puts a strain on the heart and can lead to high blood pressure and cardiovascular disease, researchers said.....
Definitely, the AHA doesn't need my two cents... I don't need their two cents either.
oh well 55 minutes ago
Dr. is correct as she is wrong in her approach. Levels of cholesterol and other lipids are a result for most people higher than normal weight values and excessive intake of fats and sugars. High blood pressures can be influenced by amount of salt intake, however salt in itself is not the only culprit: kidney disease, stress and release of catecholamines contribute to arterial injury as does smoking: the latter being a virtual do not enter area for heart
patients and their families. Exercise to help control weight, increase HDL and help in lowering levels of glucose and stress hormones all contribute to a healthier person who feels better and sees the world in a better light which influences attitude and heart health and brain health as well..
In essence balance is a key for most people but be careful of those heavy meals and overdoing it whether at the gym or the table.....
Have a nice day.
Sandra 2 hours ago
I did a research paper for school a couple of years ago that validates what this article is saying about saturated fats. Not sure why the author finds it necessary to back up her view by bringing Dr. Eckel's belief in creationism as some kind of evidence to back up the idea? There is enough material available on diet and heart disease to prove the point. I don't believe in the 6 day creationism story either, but don't see how it can discount someone as a scientist.
MrHersch11 49 minutes ago
I was rolling right along, agreeing with each of Dr Roberts' points, and then she throws in the creationism thing. That's a whole separate issue, and her use of that issue tends to make you forget all the valid points she made throughout the rest of the article. She'd have been better off making her points about AHA and diet, and then shutting up.
Sam 51 minutes ago
Being stupid is relevant.
Seldom Wrong 20 minutes ago
Sugar and grain based foods do far more damage than meat and dairy. After 60 years of pushing an unhealthy diet, the American Heart Association has succeeded in making us all fat and sick. When are they going to own up to their guilt and change their recommendations? If they keep pushing the same lies, they don't deserve anyone's support.
Candy 1 hour ago
So is this article attacking the diet that the AHA backs up or is it attacking creationism and Dr. Eckel?
Lothar F 39 minutes ago
The AHA, and the AMA as well, have sold us, the public, down the river to big business interests. People need to use common sense and stick to a traditional diet that does not contain any processed or refined foods.
Sam 44 minutes ago
How does a nutball end up in any scientific position?
My clinic recommends one third fat for most diets.
JohnW 1 hour ago
I'm so glad this is finally coming out. Dr. Atkins said this for years. People's health would greatly benefit it they would cut out the cookies and pop.
Lynne 2 hours ago
If true, this is all fairly damning. Shame on the AHA for allowing it.
-
Not sure if this should go into the Technology thread, its kind of both....
I really dig the new technology health \ fitness related technology that is coming.
http://bionicly.com/2014/04/forget-the-iwatch-10-examples-of-next-generation-body-sensors/
I have stuff like the Bodymedia device and I pitched in on another device by Push Strength.
-
Very interesting!
-
Very interesting!
I agree Guro, but with all this data sometimes it seems like you will need help interpreting it to make it useful, some of the info is obvious and then since all this data has the ability of being stored in the cloud here come the security issues.
Which takes us to another thread of Cyber Security. Now that I am working for a hospital in the InfoSec field I have become more aware of things that I just never thought of. I read a few articles where your health information is more valuable than just your credit card. Your health records never really expire and they contain a lot of data about you including your payment methods.
-
Please feel free to post about that in the 4th Amendment and Privacy thread.
-
There is a video and slides at the link.
http://quantifiedself.com/2014/06/max-gotzler-testosterone-diet-experiment/
What did I do?
I explored how diet changes influenced my level of free testosterone. In addition, I observed how changes in testosterone related to my mood, sleep and energy level.
How did I do it?
Over the course of one year, I regularly checked my level of free (active) testosterone in saliva and correlated the results to other data I had collected using apps and tracking devices.
What did I learn?
I learned that eliminating carbs from my diet resulted in lower testosterone and adding carbs together with fat and protein increased testosterone. I also learned that sleep was closely tied to my level of testosterone. After good nights of sleep (usually more than 8 hours), my level was elevated the next morning.
-
Probably all or at least the vast majority of these marketing natural health substances are scams. They all pretty much follow the same format. Some con artist picks up on some lousy or worthless study published in some journal and then turns around to sell some product that will make one feel younger, cure or ease joint pain, help one sleep better, or have the sexual drive of a 14 yo, live longer, feel more energetic, reduce fatigue depression anxiety and all the rest.
The site how they are the only ones who get it pure, or in the correct mixture, or from some rare plant in S America. They try to impress with their PhD or memorizations of some biochemical pathways. I truly suspect some of the University people who actually do these studies are in on the scams. Many are most certainly receiving some kickbacks. Oz maybe doesn't but I am sure some of these people who do studies do.
I am glad we are seeing more public outrage of this. As for Dr. Oz I really know little about him and have never listened to him though a few people have asked me about some things he has said.
****WASHINGTON (AP) — Under pressure from Congress, celebrity doctor Mehmet Oz on Tuesday offered to help "drain the swamp" of unscrupulous marketers using his name to peddle so-called miracle pills and cure-alls to millions of Americans desperate to lose weight.
Oz appeared before the Senate's consumer protection panel and was scolded by Chairman Claire McCaskill, D-Mo., for claims he made about weight-loss aids on his TV show, "The Dr. Oz Show."
Oz, a cardiothoracic surgeon, acknowledged that his language about green coffee and other supplements has been "flowery" and promised to publish a list of specific products he thinks can help America shed pounds and get healthy — beyond eating less and moving more. On his show, he never endorsed specific companies or brands but more generally praised some health supplements as fat busters.
McCaskill took Oz to task for a 2012 show in which he proclaimed that green coffee bean extract was a "magic weight loss cure for every body type."
"I get that you do a lot of good on your show," McCaskill told Oz, but "I don't get why you need to say this stuff because you know it's not true."
Oz insisted he believes in the supplements he talks about on his show as short-term crutches and even has his family try them. He said his job on the show is to be a "cheerleader" for his audience, one who offers hope even if that means looking to alternative healing traditions and any evidence that might support them.
But Oz did agree that there's no long-term miracle pill out there without diet and exercise.
Within weeks of Oz's comments about green coffee — which refers to the unroasted seeds or beans of coffee — a Florida-based operation began marketing a dietary supplement called Pure Green Coffee, with claims that the chlorogenic acid found in the beans could help people lose 17 pounds and cut body fat by 16 percent in 22 weeks.
The company, according to federal regulators, featured footage from "The Dr. Oz Show" to sell its supplement. Oz has no association with the company and received no money from sales.
Last month, the Federal Trade Commission sued the sellers behind Pure Green Coffee and accused them of making bogus claims and deceiving consumers.
The weight-loss industry is an area where consumers are particularly vulnerable to fraud, Mary Koelbel Engle, an associate director at the FTC, testified at the Senate hearing. She said the agency conducted a consumer survey in 2011 and found that more consumers were victims of fraudulent weight-loss products than of any of the other specific frauds covered in the survey.
Oz stressed during the hearing that he has never endorsed specific health supplements or received money from the sale of supplements. Nor has he allowed his image to be used in ads for supplements, he said.
"If you see my name, face or show in any type of ad, email or other circumstance," Oz testified, "it's illegal" — and not anything he has endorsed. He hasn't allowed his name to be associated with specific brands, he said, because of ethical concerns he has about doctors making endorsements of health products.
Sen. Richard Blumenthal, D-Conn., asked Oz if he would be willing to create a master list of brands he feels work, instead of suggesting that a general supplement may work for weight loss and then leaving consumers to poke around on the Internet in hopes of finding something.
"I've been actively looking at that," said Oz. "With your suggestion and support, I think I'm going to do it and I think it'll do a lot to drain the swamp that we've created around this area."
Copyright 2014 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.****
-
Yahoo news mention of yak meat this morning so I look up the ingredients. It is very low in fat, has omega 3, low sodium, very low calories, no carbs. Now the question, does it taste good?
http://aboutyaks.com/health.html
-
Federal Appeals Court Deals Setback to Health Care Law
In a ruling that could upend President Obama’s health care law, a federal appeals court ruled Tuesday that the government could not subsidize premiums for people in three dozen states that use the federal insurance exchange. The 2-to-1 ruling could cut off financial assistance for more than 4.5 million people who were found eligible for subsidized insurance in the federal exchange, or marketplace.
Under the Affordable Care Act, the court said, subsidies are available only to people who obtained insurance through exchanges established by states.
The law “does not authorize the Internal Revenue Service to provide tax credits for insurance purchased on federal exchanges,” said the ruling, by a three-judge panel of the United States Court of Appeals for the District of Columbia Circuit. The law, it said, “plainly makes subsidies available only on exchanges established by states.”
READ MORE »
http://www.nytimes.com/2014/07/23/us/court-rules-against-obamacare-exchange-subsidies.html?emc=edit_na_20140722
-
I agree this is outrageous that this guy uses pictures of a patient to promote himself. How dare him!
That said who the heck would have had any clue who this woman was? Now we all know who she is.
http://www.thesmokinggun.com/documents/doctor-sued-over-cocaine-nose-photos-687321
-
I've heard this is the most expensive hospital in the country. One of the guys who bought the hospital at basement rates, who used to be with Blackstone got his Wall Street buddies to finance fixing the place up and embarked on an out of network strategy and then resold it for something like a 40 million profit. The health care mogul as he was called in a news article now has a mansion in the Hamptons. So this poor guy gets stuck with a 9K bill.
I have a patient who told me he went to this hospital which is much farther from here than several others to have a procedure done via a limousine. In this way the patient got in his mind "first class treatment". The bill is usually multiples of what it would otherwise cost. I explained this abuse to the patient. His response: "but it didn't cost me anything". I asked him doesn't this dishonest game playing while using you as the pawn bother you? His response, was again "it didn't cost me a thing".
So there you have it. I replied, but it costs everyone else a bundle to finance this. What do you think happens to everyone's insurance rates with this going on? No response from him. No concern.
*********Hospital ER Charges $9,000 to Bandage Cut Finger
Money Talks News
By Krystal Steinmetz 8 hours ago
A New Jersey teacher was stunned when he received a $9,000 bill after his cut finger was bandaged in a hospital emergency room. Baer Hanusz-Rajkowski cut his finger with the claw end of a hammer. After waiting a few days to see if it would heal on its own, Hanusz-Rajkowski decided to go to the emergency room at Bayonne Medical Center in New Jersey, according to NBC New York. It was determined (without X-rays) that his finger didn’t need stitches. So Hanusz-Rajkowski left with a bandaged middle finger. NBC New York said he was surprised to get this in the mail:
Hanusz-Rajkowski got hit with an $8,200 bill for the emergency room visit. On top of that, Bayonne Medical Center charged $180 for a tetanus shot, $242 for sterile supplies, and $8 for some antibacterial ointment in addition to hundreds of dollars for the services of the nurse practitioner.
That $9,000 bill left Hanusz-Rajkowski speechless. From NBC:
“I got a Band-Aid and a tetanus shot. How could it be $9,000? This is crazy,” Hanusz-Rajkowski said. “If I severed a limb, I’d carry it to the next emergency room in the next city before I go back to this place.”
Why was the bill so high? The answer isn’t clear. It’s more of a he said, she said. Carepoint Health bought Bayonne Medical Center about six years ago, making it a for-profit business, NBC said. Dr. Mark Spektor, president and CEO of the medical center, said the big bill is the fault of Hanusz-Rajkowski’s insurance company, United Healthcare, which no longer has an in-network pricing contract with the hospital. Spektor said United doesn’t offer fair reimbursement rates. According to NBC, Mary McElrath-Jones, spokeswoman for United Healthcare, disagrees with Spektor. “United Healthcare is deeply concerned about hospitals establishing an out-of-network strategy to hike the rate they charge for emergency room services, often surprising patients,” she said. Regardless of whether there’s an in-network price deal, New Jersey law demands that insurers cover the costs of ER visits, NBC said. United Healthcare ended up paying $6,640 on the bill. After the story hit the news, the hospital wrote off Hanusz-Rajkowski’s portion of the bill. Some people are calling for a price cap on ER procedures, NBC reported. Spektor said that would put the hospital, which was once on the brink of bankruptcy and is now profitable again, at risk.
“Insurance companies in the state of New Jersey particularly have had record profits last year. Billions of dollars in profits while hospitals are struggling and closing. That is the real story,” Spektor said.
What do you think of Hanusz-Rajkowski’s hospital bill? Do you think you’ve been massively overcharged at a hospital? Share your comments below or on our Facebook page.
This article was originally published on MoneyTalksNews.com as 'Hospital ER Charges $9,000 to Bandage Cut Finger'.
-
Please post that at http://dogbrothers.com/phpBB2/index.php?topic=1411.0
-
http://phenomena.nationalgeographic.com/2014/08/06/the-quantified-microbiome-self/
-
http://www.nytimes.com/2014/09/02/world/europe/parents-who-took-ill-son-abroad-fight-order-to-return-to-britain.html?emc=edit_th_20140902&nl=todaysheadlines&nlid=49641193
-
http://www.psmag.com/navigation/health-and-behavior/truth-wont-admit-drinking-healthy-87891/
-
http://www.nytimes.com/2014/12/22/business/pharmacy-deal-heralds-changed-landscape-for-hepatitis-drugs.html?emc=edit_th_20141222&nl=todaysheadlines&nlid=49641193
AbbVie Deal Heralds Changed Landscape for Hepatitis Drugs
By ANDREW POLLACKDEC. 22, 2014
Photo
AbbVie’s Viekira Pak was approved Friday by federal regulators for the treatment of hepatitis C. A typical course costs $83,319. Credit AbbVie Inc
In a sign that price competition may take hold for hepatitis C drugs, the nation’s largest manager of prescriptions will require all patients to use AbbVie’s newly approved treatment rather than two widely used medicines from its rival Gilead Sciences.
The pharmacy benefit manager, Express Scripts, said it had negotiated a significant discount from AbbVie in exchange for making the drugmaker’s treatment, Viekira Pak, the exclusive option for 25 million people. Express Scripts also said it would allow all people with hepatitis C to be treated with AbbVie’s drug, not only those with more serious liver damage.
“We really believe we want all patients treated,” Dr. Steve Miller, the chief medical officer of Express Scripts, said in an interview Sunday. He said that AbbVie had made that affordable by offering “a significant discount.”
Continue reading the main story
Related Coverage
Hepatitis C Treatment Wins Approval, but Price Relief May Be LimitedDEC. 19, 2014
Gilead’s drugs have set a new standard, curing the vast majority of patients in only 12 weeks with few side effects. But their prices have ignited an outcry. One drug, Sovaldi, has a list price of $84,000 for a typical 12-week course of therapy, or $1,000 per daily pill. The newer Harvoni costs $94,500 for 12 weeks.
Gilead says the prices reflect the value the drugs bring to patients and the health care system. But some health plans, state Medicaid programs and prison systems say the drugs are busting their budgets. Many have been limiting treatment to only the sickest patients. Congress has investigated the prices, and Philadelphia’s transit authority sued Gilead this month, saying its “price-gouging” violated antitrust laws.
Express Scripts has been one of the loudest complainers, with Dr. Miller even calling himself the “chief whining officer.” He has threatened to boycott Gilead’s drugs once alternatives were available and now seems to be doing just that.
Initial hopes that AbbVie would compete on price seemed to be dashed Friday, when Viekira Pak won approval from the Food and Drug Administration. AbbVie set the price at $83,319 for the typical 12-week course, not a huge discount to Harvoni.
But list prices are not the entire story. Health plans and pharmacy benefit managers negotiate discounts in exchange for a better positioning on the formulary, the list of approved drugs. Express Scripts’ announcement suggests AbbVie is being more aggressive behind the scenes than it is with its list price.
The discounts will help hold down health care costs for employers that use Express Scripts but patients will probably not notice an immediate cost difference, such as lower co-payments.
Preferred position on the formulary typically means the preferred drug must be tried first, or has a lower co-payment.
But recently pharmacy benefit managers have been trying a more powerful weapon to increase their bargaining leverage — refusing to pay at all for the less preferred drug. Express Scripts’ national preferred formulary, which is used by many employers and covers 25 million people, will exclude about 70 drugs next year, including Harvoni, Sovaldi and another new hepatitis C drug, Johnson & Johnson’s Olysio.
Continue reading the main story Continue reading the main story
Continue reading the main story
Gilead, in a statement, said it had “been negotiating in good faith with Express Scripts and other payers” and hoped to continue to have discussions “that focus on the best interests of patients with hepatitis C.” A company spokeswoman declined to say what fraction of Gilead’s hepatitis C sales were covered by Express Scripts.
Doctors who treat hepatitis C cheered the fact that all patients would be treated, regardless of the severity of their disease.
“It’s going to expedite treatment for patients,” said Dr. Rena Fox, a hepatitis specialist at the University of California, San Francisco. “It certainly avoids putting doctors in a very uncomfortable position of having to say yes to some patients and no to other patients.” Dr. Fox said that any differences between AbbVie’s and Gilead’s drugs were minor, so there was no problem in excluding Gilead’s drugs.
But Dr. Eugene Schiff, director of the center for liver diseases at the University of Miami, disagreed. He said Harvoni was one pill once a day while AbbVie’s drug required four pills, three in the morning and one in the afternoon. And many patients getting Viekira also have to take ribavirin, an older drug that can have serious side effects.
“To say that it’s exclusively this drug is not right,” Dr. Schiff said.
Harvoni and Viekira Pak are approved only for so-called genotype 1 hepatitis C, which accounts for about 70 percent of cases in the United States. Express Scripts said it would still pay for Sovaldi when used to treat other genotypes. And patients already taking Sovaldi or Harvoni can continue.
Dr. Miller would not disclose the discounts AbbVie is providing but said it would significantly narrow the gap between prices charged in the United States and Western Europe. Sovaldi has been selling for $50,000 to $70,000 in some European countries.
AbbVie also agreed not to charge twice as much when patients needed to take 24 weeks of Viekira Pak instead of 12. And Express Scripts will distribute the drug exclusively through its own specialty pharmacy, so it will make money on distribution.
In addition to giving AbbVie exclusivity and agreeing to treat all patients, Express Scripts also said it would allow doctors other than liver specialists and infectious disease specialists to prescribe Viekira, further widening the market.
AbbVie declined to comment.
-
http://www.israelvideonetwork.com/new-israeli-cancer-vaccine-triggers-response-in-90-of-cancer-types/?omhide=true&utm_source=MadMimi&utm_medium=email&utm_content=Breaking+News+Video%3A+New+Israeli+Cancer+Vaccine+Triggers+Response+In+90_+Of+Cancer+Types&utm_campaign=20150103_m123838382_1%2F03+Breaking+News+Video%3A+New+Israeli+Cancer+Vaccine+Triggers+Response+In+90_+Of+Cancer+Types&utm_term=New+Israeli+Cancer+Vaccine+Triggers+Effective+Response
-
Gilead Strikes Hepatitis Drug Deal With CVS Health
By ANDREW POLLACKJAN. 5, 2015
NYT
Gilead Sciences struck back on Monday against its rival AbbVie in a budding marketing war over costly hepatitis C drugs, winning exclusive access to many patients whose prescriptions are managed by CVS Health.
CVS Health, the nation’s second-largest pharmacy benefits manager, said that it would make Gilead’s drugs, Harvoni and Sovaldi, the exclusive option for patients on its commercial drug list, as well as for patients it manages on health care exchanges, Medicare Part D and Medicaid.
The decision partly counteracts a decision made last month by Express Scripts, the largest pharmacy benefit manager, to make AbbVie’s Viekira Pak the exclusive option for most patients in its main commercial plan covering 25 million people.
AbbVie earned that position by offering what Express Scripts characterized as a significant discount below Viekira’s list price of $83,319 for a typical 12-week course of treatment.
Express Scripts’ move caused a steep drop in Gilead’s shares and in many other biotech stocks because it suggested that pharmacy benefit managers were becoming more willing to limit patient options to procure discounts from drug companies, limiting the ability of drug manufacturers to charge high prices.
But on Monday, after CVS’s decision was announced, Gilead’s shares rose 2 percent to $96.79 while AbbVie’s shares fell nearly 2 percent to $64.68.
Geoffrey C. Porges, biotechnology analyst at Sanford C. Bernstein & Company, said that once Gilead was excluded by Express Scripts, it had a strong incentive to strike a deal with CVS “in order to ensure a reasonable level of access and also to avoid overblown negative perceptions of poor access.”
Gilead ignited protests by pricing Sovaldi, its first drug for hepatitis C, at $84,000 for a 12-week course of treatment, or $1,000 per daily pill. Gilead’s newer Harvoni has a list price of $94,500 for the 12 weeks of treatment, or $1,125 per daily pill.
While doctors have hailed both drugs as breakthroughs, some health plans, state Medicaid programs and prison systems said they could not afford to treat everyone at those prices. More than three million people in the United States are infected with the hepatitis C virus, which gradually destroys the liver.
The hope was that when AbbVie won approval for Viekira Pak in December, competition would drive down prices. That appears to be happening, though to what extent is not known because pharmacy benefit managers do not reveal how much of a discount they are getting.
CVS said in a statement that it goal “was to create the lowest net-cost solution for the entire population of patients” with hepatitis C. CVS’s decision was first reported by The Wall Street Journal.
-
http://www.scientificamerican.com/article/like-valium-and-oxycontin-without-the-side-effects-video/
-
Michael Douglas head and neck cancer he claims was caused by HPV. I didn't believe it since he is a long time smoker. I was not aware of the latest data suggesting these cancers (Jamie Diamond) are from HPV. This article suggests it is the # 16 strain. The HPV vaccine recommended to all females now males age 9 to 26 should be protective:
http://oralcancerfoundation.org/hpv/
I cannot imagine why anyone would not want the vaccine for their children.
-
If a person is overweight they should do their best to lose excess weight. If they are not and their cholesterol is high than a statin drug for those at higher risk. I rarely advise low cholesterol fat diets otherwise. Some still will do that. Exercise is always good. But I have thought this was long overrated and mostly agree with this "new" recommendation:
New guidelines expected to downplay importance of lowering cholesterol
Posted 8:05 AM, February 17, 2015, by PIX11 Report
(PIX11/CNN) – In a step that would reverse decades of thinking, a dietary guidelines panel suggests that consumers don’t need to worry about how much cholesterol is in their food.
“Cholesterol is not considered a nutrient of concern for overconsumption,” the 40-page report notes.
What nutrients are of concern, according to the panel? Vitamin D, calcium, potassium, fiber and iron – all of which are severely lacking from Americans’ diets. And sodium and saturated fat, which make up too much of Americans’ diets.
The draft was issued in December. The Dietary Guidelines Advisory Committee must send its final recommendation to the Department of Health and Human Services and the U.S. Department of Agriculture before they get the final approval.
The American Heart Association classifies cholesterol in two ways: “good” and “bad.” It says too much of one type of cholesterol or not enough of another can put you at risk for coronary heart disease, heart attack or stroke.
The agency recommends all adults age 20 or older have their cholesterol checked every four to six years.
-
http://www.forbes.com/sites/arleneweintraub/2015/02/24/brain-altering-devices-may-supplant-drugs-and-pharma-is-ok-with-that/
-
http://www.forbes.com/sites/sallypipes/2015/03/23/obamacare-at-five-years-old-a-disappointment/
contrast this:
http://aspe.hhs.gov/health/reports/2015/uninsured_change/ib_uninsured_change.pdf
-
In Yiddish we call this disease meshugganosis. I had two people over the years who were convinced beyond comprehension that fibers were coming out of their skin. They would come into the office and insist that what appeared to be a fiber possibly from a carpet or upholstery of some sort on their hand or finger actually was growing out of their skin. They would go from doctor to doctor insisting this.
I would give them the benefit of the doubt and send to infectious disease or skin specialists etc. Nothing was ever confirmed.
I don't know if Joni Mitchell (who I never listened to growing up) did too much LSD or what:
http://news.yahoo.com/joni-mitchells-mysterious-skin-disease-causes-morgellons-203447248.html
-
Perhaps readers will recall a private held company called Theranos that I posted is a big threat to present entrenched lab companies like Quest and LabCorp. Well this is LabCorps response:
http://www.msn.com/en-us/money/companies/the-doctor-is-out-labcorp-to-let-consumers-order-own-tests/ar-AAblxGC
-
http://www.popsci.com/science/article/2010-05/new-technique-uses-bodys-stem-cells-regenerate-teeth
-
http://www.theatlantic.com/health/archive/2015/05/when-the-last-patient-dies/394163/
-
http://www.delish.com/food/a43162/kale-poison-thallium/
-
Some of my colleagues I have spoken with also throw up their hands when they hear this back and forth controversy. Even the experts can't seem to agree. Which the hell is it?
http://health.usnews.com/health-news/articles/2016-02-01/new-blood-pressure-guidelines-a-danger-to-patients-study
-
This would be a dream come true for those with type 1 diabetes:
https://news.yahoo.com/cure-diabetes-moving-closer-toward-130633800.html
-
https://www.yahoo.com/news/syphilis-outbreak-plaguing-las-vegas-013800618.html
-
Forwarded to me by someone who follows these things:
http://perfecthealthdiet.com/2011/06/blood-lipids-and-infectious-disease-part-i/
-
Do this at your own risk. To me it sounds like another con job. Strange brew that can only be obtained from some exotic jungle and cures every possible emotional ailment known to man. Even migraines. I suppose seizure claims are next.
I only know like all the other gimmicks is that it is making some people money:
http://www.wsj.com/articles/is-perus-psychedelic-potion-a-cure-or-a-curse-1461944415
BTW, PTSD is being over diagnosed as is ADHD.
-
Though there may well be exploitation, IMHO it may not be all BS. There are Native Americans of the American southwest/Mexican northwest who have psychedelic induced religious experiences.
-
Peyote yes. It was used by some when I was in college.
Didn't seem to help Tony Soprano. Just kidding.
It is possible there may be a real therapeutic effect but the reports are anecdotal and some of these things IMHO also seem to have some sort of placebo effect.
I just don't know. Look at all the massive expenditures the drug companies make to research risk rewards of psychoactive drugs and then compare that to reports of people swearing by the life altering benefits of this unstudied drug on the human mind.
-
Wow. Lets keep our fingers crossed:
http://arstechnica.com/science/2016/05/scientists-find-cure-for-type-2-diabetes-in-rodents-dont-know-how-it-works/
-
Wow. Lets keep our fingers crossed:
http://arstechnica.com/science/2016/05/scientists-find-cure-for-type-2-diabetes-in-rodents-dont-know-how-it-works/
I didn't know Type 2 Diabetes in rats was a major issue. :wink:
Let's hope our speedy, streamlined, patient health oriented FDA makes this available to humans as well!
-
https://www.youtube.com/watch?v=z0O_VYcsIk8
[youtube]https://www.youtube.com/watch?v=z0O_VYcsIk8[/youtube]
:-D
-
"I didn't know Type 2 Diabetes in rats was a major issue. wink
Let's hope our speedy, streamlined, patient health oriented FDA makes this available to humans as well!"
I propose we test the application in liberals and progressives to see if it works in humans as well as rats. :wink:
-
Don't know much about the technology yet or the company or the stock but if this is true this could be a big advance. I should check with some of my oncologist friends:
https://www.yahoo.com/finance/news/worlds-richest-doctor-wants-revolutionize-141948699.html
-
http://www.latimes.com/local/lanow/la-me-ln-possible-ebola-hollywood-20160606-snap-story.html
:-D
-
https://www.conservativereview.com/commentary/2016/08/telemedicine-the-21st-centurys-answer-to-long-wait-times
-
Has merit; especially with the dramatic increase in recent decades in information available to patients to prepare them for interactions with their doctors.
-
I notice the main culprits in its' spread are noticeably not mentioned but this is the WP after all:
https://www.washingtonpost.com/news/to-your-health/wp/2016/09/21/threat-of-untreatable-gonorrhea-is-increasing-new-data-show/
older forms of treatment:
http://www.antimicrobe.org/h04c.files/history/Gonorrhea.asp
-
:-o :-o :-o
Please post here as well.
http://dogbrothers.com/phpBB2/index.php?topic=1148.100
This forum's interest in this issue is longstanding.
-
http://nymag.com/scienceofus/2016/08/is-elysium-healths-basis-the-fountain-of-youth.html?utm_source=facebookNYMag&utm_medium=cpc&utm_campaign=2%25LaLJune2016AllNFAutobidNYMag&utm_content=Paid+Content&GA=attribution
-
This was on reason why Katherine would never get an insulin pump:
https://www.yahoo.com/finance/news/exclusive-j-j-warns-diabetic-123046807.html
-
The Surgeon General recently came out with a rather critical summary of E cigs requesting more or less they start being treated like regular cigarettes.
https://e-cigarettes.surgeongeneral.gov/documents/2016_SGR_Exec_Summ_508.pdf
Here is one response to the Surgeon General's opinion report:
https://www.aei.org/publication/dear-surgeon-general-and-public-health-agencies-anti-vaping-polices-are-bad-for-public-health/
As a doctor I think E cigarettes are good if used as intended! As a *temporary* means for people to wean off of tobacco products. But for how long does one substitute one for the other?
I suppose if one "vapes" for many years instead of smoking or chewing tobacco that is still great progress because we know the E cigarettes are not nearly as dangerous as tobacco cigarettes.
So in these regards I am for it.
But the Surgeon General's report brings to my attention something I was not thinking of:
Youth taking up E cigarettes instead of tobacco products.
I am definitely NOT for that. Why in the world would I want children taking up nicotine addiction even if it is from an overall health perspective far less dangerous? It is still nicotine addiction.
This is NOt what I had in mind when I was thinking about E cigarettes and patients ask me about them. I will have to adjust my position on them.
Sure if one cannot quit cigarettes by any other means then go ahead and vape . At least you will not likely have the exponential risk of dying of cancer or heart disease prematurely.
On the other hand I am totally against children taking this up to be cool or for social acceptance .
-
Suppose this should happen to a bacteria that is as easily spread as bubonic plague -
https://www.cdc.gov/mmwr/volumes/66/wr/mm6601a7.htm?s_cid=mm6601a7_e
-
http://www.sciencealert.com/new-alzheimer-s-treatment-fully-restores-memory-function
-
very interesting concept.
whether it really works and is safe will take a decade to find out. Lets hope....
-
http://nypost.com/2017/04/28/drinking-coffee-basically-keeps-you-alive/
Yes!
-
I usually recommended naproxen (aleve) when I prescribe a nonsteroidal medicine for pain. First it is twice a day vs 3 times a day like ibuprofen (motrin) and it is the only one of that class that is NOT assoicated with heart attacks:
https://www.thesun.co.uk/living/3520232/taking-ibuprofen-to-treat-pain-increases-your-risk-of-heart-attack-after-just-one-week/
PS aleve can still cause bleeding ulcers and injure kidneys and raise blood pressure so talk to your doctor 0)) :wink:
-
I drink an energy drink daily . The caffeine content is 160 mg caffeine. A single starbucks coffee can have close to that. This is equivalent to about 2 cups of normal coffee. Not excessive. Back in the 90's when thinking about opening a coffee bar I recall reading a book on the health effects of caffeine and it reviewed all the research up to that time. There was no evidence of any danger to up to about 2 cups a day or It think about 200 mg / day. The main risk to more then that is not dropping dead but withdrawal symptoms like headaches and fatigue, maybe mood swings, and insomnia.
There was some danger to the older way of making or brewing coffee that was last still done in some Scandinavian countries (then at least - maybe no longer) where they would drink unfiltered coffee and thus one would also consume unsaturated fats. (from what I recall)
This young fellow who passed away drank a lot of caffeine in a short amount of time. He must have had some cardiac predisposition that made him sensitive to the affects . The other question I would have would be about the unknown about other ingredients in the energy drinks. Such as taurine. The last I read about it was that there is little information about the health effects of that in larger quantities:
https://www.yahoo.com/beauty/teen-dies-drinking-much-coffee-soda-energy-drink-010804115.html
-
For the sake of of context , in over 30 yrs in medicine I have never seen an article that explains how to care for diabetics during Jewish fasting holidays of during Christmas or Easter:
http://www.mdedge.com/ccjm/article/136661/diabetes/diabetes-control-during-ramadan-fasting
-
For the sake of of context , in over 30 yrs in medicine I have never seen an article that explains how to care for diabetics during Jewish fasting holidays of during Christmas or Easter:
http://www.mdedge.com/ccjm/article/136661/diabetes/diabetes-control-during-ramadan-fasting
"A diabetic patient who develops signs or symptoms of hypoglycemia during Ramadan fasting should break the fast to avoid serious complications."
If we can ease the rules of Islam, maybe we can also relax the call to kill all infidels.
-
For the sake of of context , in over 30 yrs in medicine I have never seen an article that explains how to care for diabetics during Jewish fasting holidays of during Christmas or Easter:
http://www.mdedge.com/ccjm/article/136661/diabetes/diabetes-control-during-ramadan-fasting
"A diabetic patient who develops signs or symptoms of hypoglycemia during Ramadan fasting should break the fast to avoid serious complications."
If we can ease the rules of Islam, maybe we can also relax the call to kill all infidels.
Yes, getting muslims to value human life above religion. That would be nice.
Don't hold your breath.
-
to worry about......
I've read that some scientists have been able to come up with genetic engineered means by which they could wipe mosquitos off the face of the Earth. Of course that may not be all good. I am not sure I would mind if they could do the same for the plague of ticks . Do ticks serve any good purpose?
************Another Tick-Borne Disease In NJ — With Potentially Strange Side Effects************
Another tick-borne disease has spread to New Jersey, and it may produce some strange side effects that could impact the way people eat.
By Tom Davis (Patch Staff) - May 18, 2017 10:50 am ET
ShareTweetGoogle PlusRedditEmailComments2
Another Tick-Borne Disease In NJ — With Potentially Strange Side Effects
A tick that produces a rash similar to that of Lyme disease has spread to New Jersey, and it may produce some strange side effects that could impact your diet.
The lone star tick produces southern tick-associated rash illness, or STARI, that can lead to fatigue, fever, headache, muscle and joint pains, according to the Centers for Disease Control and Prevention.
But there's another potential symptom that you may not have expected: an allergic reaction to red meat.
Thomas Platts-Mills, the director of the University of Virginia School of Medicine’s allergy division, told nj.com that research shows that people who have been bitten by the tick have suffered a meat allergy called alpha-gal.
"If you're allergic to shrimp, well, most people don't eat shrimp every day. So if you have a reaction to shrimp, you know it. People come in and tell us they're allergic to shrimp, and they're usually right," Platts-Mills told nj.com.
The publication cited one victim, Jerry Dotoli of Ocean County, who had gone to Florida for the winter and was beset by frequent hives accompanied by a ferocious itching "four times worse than poison ivy." Dotoli got a blood test and was told he had become allergic to meat, pork and dairy, with the possible culprit being a lone star tick.
The N.J. Department of Health says it does not keep statistics on how many people have been bitten by the lone star tick because the rash too closely resembles Lyme disease. But the Freehold Health Department estimates that up to 9 percent of the state's tick-bite cases involve the lone star.***********
-
Whoa , , ,
-
Drowning is almost always a deceptively quiet event.
No. 2 cause of accidental death in children, ages 15 and under
“Except in rare circumstances, drowning people are physiologically unable to call out for help. The respiratory system was designed for breathing. Speech is the secondary or overlaid function. Breathing must be fulfilled before speech occurs.
Drowning people’s mouths alternately sink below and reappear above the surface of the water. The mouths of drowning people are not above the surface of the water long enough for them to exhale, inhale, and call out for help. When the drowning people’s mouths are above the surface, they exhale and inhale quickly as their mouths start to sink below the surface of the water.
Drowning people cannot wave for help. Nature instinctively forces them to extend their arms laterally and press down on the water’s surface. Pressing down on the surface of the water permits drowning people to leverage their bodies so they can lift their mouths out of the water to breathe.
Throughout the Instinctive Drowning Response, drowning people cannot voluntarily control their arm movements. Physiologically, drowning people who are struggling on the surface of the water cannot stop drowning and perform voluntary movements such as waving for help, moving toward a rescuer, or reaching out for a piece of rescue equipment.
From beginning to end of the Instinctive Drowning Response people’s bodies remain upright in the water, with no evidence of a supporting kick. Unless rescued by a trained lifeguard, these drowning people can only struggle on the surface of the water from 20 to 60 seconds before submersion occurs."
http://www.slate.com/articles/health_and_science/family/2013/06/rescuing_drowning_children_how_to_know_when_someone_is_in_trouble_in_the.html
-
The World Health Organization's cancer agency says a common weedkiller is "probably carcinogenic." The scientist leading that review knew of fresh data showing no cancer link - but he never mentioned it and the agency did not take it into account.
http://www.reuters.com/investigates/special-report/glyphosate-cancer-data/
http://www.powerlineblog.com/archives/2017/06/another-left-wing-science-scandal.php
-
If works this could be the real deal:
http://www.news-medical.net/news/20170630/SCT-scientists-develop-Neo-Islet-technology-for-treating-insulin-dependent-diabetes.aspx
-
http://www.dailymail.co.uk/news/article-3602846/Pictured-Melbourne-university-lecturer-34-died-altitude-sickness-Mount-Everest-taking-climb-husband-prove-vegans-anything.html
Pictured: Vegan lecturer, 34, who attempted to climb Mount Everest to prove 'vegans can do anything'... only to die from altitude sickness
Read more: http://www.dailymail.co.uk/news/article-3602846/Pictured-Melbourne-university-lecturer-34-died-altitude-sickness-Mount-Everest-taking-climb-husband-prove-vegans-anything.html
-
http://www.jordantimes.com/news/region/egypt-once-top-hepotitis-c-sufferer-draws-cure-seekers
-
interesting article
but the drug itself is not described which is very curious.
I don't suppose it is a pirated copy of a drug in US that costs many thousands of dollar here.
-
Flu season has started so you or your loved ones may want to get the flu vaccine if haven't yet.
-
In my opinion air travel from this country should be banned unless passengers are screened ala ebola
This is MORE contagious then Ebola because it is airborne though it can be cured with antibiotics if given soon enough and before the patient dies:
http://www.dailymail.co.uk/health/article-5043497/Deadly-airborne-plague-cases-rocket-40.html
-
https://www.dailystar.co.uk/news/latest-news/660006/black-death-plague-madagascar-get-worse-antibiotics
IN this article that keeps posting on Drudge it calls plague a virus
It is not . It is a bacteria
From what I have read it is not resistant to the standard antibiotics - at least yet
In pre antibiotic history most died since there were no antibiotics but now less would live if treated early or prophylactically
That said it is extremely contagious especially in the lung for of disease
and could kill untold numbers of people due to the rapidity of spread
And of course resistance could develop at any time
-
https://mail.yahoo.com/d/folders/1/messages/ABbxbcJupuTfWuCHmA1SKOi5QRc
-
https://mail.yahoo.com/d/folders/1/messages/ABbxbcJupuTfWuCHmA1SKOi5QRc
Pls doublcheck the link.
All stories I find searching the title refer to 'synthetic pot', whatever that is.
-
https://www.newyorker.com/magazine/2018/05/14/the-promise-of-vaping-and-the-rise-of-juul?mbid=nl_Daily%20050718&CNDID=50142053&spMailingID=13459185&spUserID=MjAxODUyNTc2OTUwS0&spJobID=1400626123&spReportId=MTQwMDYyNjEyMwS2
-
being reported more in the US
this has previously been a South American disease :
https://www.businessinsider.com/chagas-disease-spreading-and-causing-heart-problems-2018-8?yptr=yahoo
I don't suppose the people walking in here from S of the border are possibly bringing this with them and making the prevalence rates skyrocket.
PS to my knowledge there is no cure .
-
https://www.foxbusiness.com/features/magic-mushrooms-to-treat-depression-this-peter-thiel-backed-startup-just-got-fda-okay-to-begin-trials
-
https://neurosciencenews.com/probiotic-health-questioned-9818/
https://neurosciencenews.com/probiotics-brain-fog-bloating-9659/
-
Is this some sort of joke:
https://www.yahoo.com/lifestyle/suzanne-somers-diagnosed-breast-cancer-believe-happened-sex-symbol-120128943.html
-
Very interesting!
http://nautil.us//issue/30/identity/how-the-western-diet-has-derailed-our-evolution?utm_source=Nautilus&utm_campaign=4ce4a84e17-EMAIL_CAMPAIGN_2018_11_16_11_07&utm_medium=email&utm_term=0_dc96ec7a9d-4ce4a84e17-61805061
-
https://www.nytimes.com/2019/01/04/opinion/marijuana-pot-health-risks-legalization.html?rref=collection%2Fsectioncollection%2Fopinion
Opinion, What Advocates of Legalizing Pot Don’t Want You to Know
"large studies in peer-reviewed journals showing that marijuana increases the risk of psychosis and schizophrenia"
-
https://imprimis.hillsdale.edu/marijuana-mental-illness-violence/
-
https://imprimis.hillsdale.edu/marijuana-mental-illness-violence/
Very well researched and constructed article, does a nice job of presenting the best real data mathematically and let you draw your own cause and effect conclusions.
Typical user does not turn to violence. Typical user does not have a psychotic break. Very few do but three times as likely for something a vulnerable teenager is not told is alarming:
"Teenagers who smoke marijuana regularly are about three times as likely to develop schizophrenia, the most devastating psychotic disorder."
Most users don't turn from pot to hard and deadly drugs, but three times as likely is a significant correlation:
"people who used cannabis in 2001 were almost three times as likely to use opiates three years later, even after adjusting for other potential risks."
...
"In the 1970s, the last time this many Americans used cannabis, most marijuana contained less than two percent THC. Today, marijuana routinely contains 20 to 25 percent THC"
More than 10 times stronger now than some may remember - and it was a plenty psychoactive drug then.
"The first four states to legalize marijuana for recreational use were Colorado and Washington in 2014 and Alaska and Oregon in 2015. Combined, those four states had about 450 murders and 30,300 aggravated assaults in 2013. Last year, they had almost 620 murders and 38,000 aggravated assaults—an increase of 37 percent for murders and 25 percent for aggravated assaults, far greater than the national increase, even after accounting for differences in population growth."
I'm not as convinced on this. They adjust for population growth but perhaps not for the demographics of the population, young males moving in for the novelty, coolness, culture of legalization. The increases were not in retiring couples, families with children, etc.
The crime rate is up in oil boom areas too, not from the oil but from the demographic that moves there:
https://billingsgazette.com/news/state-and-regional/crime-and-courts/north-dakota-s-crime-rate-sees-biggest-spike-of-the/article_6d4a48d7-137a-5583-adf4-8e56ad90ddef.html
-
The potency of today's mj creates a lot of 911 calls, meaning a police/fire/ems response and a trip to the ER. Not cheap, and we get to fund that.
https://imprimis.hillsdale.edu/marijuana-mental-illness-violence/
Very well researched and constructed article, does a nice job of presenting the best real data mathematically and let you draw your own cause and effect conclusions.
Typical user does not turn to violence. Typical user does not have a psychotic break. Very few do but three times as likely for something a vulnerable teenager is not told is alarming:
"Teenagers who smoke marijuana regularly are about three times as likely to develop schizophrenia, the most devastating psychotic disorder."
Most users don't turn from pot to hard and deadly drugs, but three times as likely is a significant correlation:
"people who used cannabis in 2001 were almost three times as likely to use opiates three years later, even after adjusting for other potential risks."
...
"In the 1970s, the last time this many Americans used cannabis, most marijuana contained less than two percent THC. Today, marijuana routinely contains 20 to 25 percent THC"
More than 10 times stronger now than some may remember - and it was a plenty psychoactive drug then.
"The first four states to legalize marijuana for recreational use were Colorado and Washington in 2014 and Alaska and Oregon in 2015. Combined, those four states had about 450 murders and 30,300 aggravated assaults in 2013. Last year, they had almost 620 murders and 38,000 aggravated assaults—an increase of 37 percent for murders and 25 percent for aggravated assaults, far greater than the national increase, even after accounting for differences in population growth."
I'm not as convinced on this. They adjust for population growth but perhaps not for the demographics of the population, young males moving in for the novelty, coolness, culture of legalization. The increases were not in retiring couples, families with children, etc.
The crime rate is up in oil boom areas too, not from the oil but from the demographic that moves there:
https://billingsgazette.com/news/state-and-regional/crime-and-courts/north-dakota-s-crime-rate-sees-biggest-spike-of-the/article_6d4a48d7-137a-5583-adf4-8e56ad90ddef.html
-
quote author=G M:
"The potency of today's mj creates a lot of 911 calls, meaning a police/fire/ems response and a trip to the ER. Not cheap, and we get to fund that."
Right.
The switch to edibles, thought to be a more healthy choice, completely screws up dosage. Packages of legal edibles are marked in numbers that make no sense to most users. The edibles out of the package are not labeled. A person might knowingly or unknowingly eat a whole package of cookies when the dosage they should have had was zero for a teenager or maybe a quarter of a cookie for a responsible adult. Not many drugs are literally distributed as candy. The delay to take effect also tempts people to take more than a light, recreational dosage.
I have long preferred decriminalization to legalization, recognizing that small personal use is a choice of vice for a responsible adult, a mostly victimless sin usually deserving little of no punishment or record if not occurring in conjunction with a crime or accident. But sponsorship and promotion by society without facts and warnings is creating its own problems.
Information and misinformation in Colorado is mostly distributed by young, enthusiastic salespeople in the 'dispensaries', high on the job, with an interest in selling the product and filling their own tip jar.
-
"The switch to edibles, thought to be a more healthy choice, completely screws up dosage. Packages of legal edibles are marked in numbers that make no sense to most users. The edibles out of the package are not labeled. A person might knowingly or unknowingly eat a whole package of cookies when the dosage they should have had was zero for a teenager or maybe a quarter of a cookie for a responsible adult. Not many drugs are literally distributed as candy. The delay to take effect also tempts people to take more than a light, recreational dosage."
THIS.
-
I was wondering if this got covered on the forum:
https://www.jpost.com/HEALTH-SCIENCE/A-cure-for-cancer-Israeli-scientists-say-they-think-they-found-one-578939
-
Hi Doug,
I read about the Israeli company's claims , and
while no expert on cancer research thought if it is too good to be true ....
I found this reaction to the announcement just now:
https://sciencebasedmedicine.org/is-an-israeli-company-about-to-cure-cancer/
Overall this may well turn out to a new approach to treatment but it could not possibly be something that could prove to work and be safe for a long time.
Sounds like this company is looking for investors.
(I wish it were true)
-
on new drug
from 400 babies :
https://www.newsmax.com/health/health-news/us-med-fda-most/2019/05/24/id/917499/
-
so buyers don't have to pay tax.
uh oh . this will make the tax and spend crats to go nuts. less money to pay off all the pension debts:
https://pjmedia.com/trending/legal-marijuana-a-boon-to-illegal-cartels/
-
so buyers don't have to pay tax.
uh oh . this will make the tax and spend crats to go nuts. less money to pay off all the pension debts:
https://pjmedia.com/trending/legal-marijuana-a-boon-to-illegal-cartels/
City Journal notes that it's not just mom and pop scofflaws that are problematic:
Legal-pot states are attracting international criminal cartels. Mexican drug gangs have smuggled illegals into Colorado to set up growing operations, former U.S. prosecutor Bob Troyer wrote last September, explaining why his office was stepping up enforcement. Rather than smuggle pot from Mexico, the cartels grow it in Colorado and smuggle it elsewhere—spurring violence. In 2017, seven homicides in Denver were directly connected to marijuana growers. “I would love to be able to shift some of my resources away from marijuana to other things,” Denver lieutenant Andrew Howard said last year. “But right now, the violence is marijuana or marijuana-related.”
**I was told this was IMPOSSIBLE!
-
I played this in college 40 + yrs ago:
https://www.youtube.com/watch?v=EXvyNKaFkaU
These guys make it look easy.
-
As a boy my step father took me to the City Athletic Club for squash and this.
-
Good article in Jama but I can't post due to blocking as subscription
I don't subscribe to the journal but for some reason they always send it to me for free
Bottom line is PBMA production is very environmentally sound.
Due to being produced in a lab and production center not need cows
saves on deforestation making way for grasslands , methane gas from cow flatulence , cow waste products from contaminating water, less energy usage to produce, cheaper and not having to raise animals just to slaughter. Efforts are underway to produce similar products that taste like pork and chicken and fish.
At this time some of the protein is soy or from peas.
What is NOT know is are the products healthier , less healthy , or neutral to real animal protein.
There are additives which may not be healthy.
IF one looks at the total calories in PBMA from what I have seen from the ingredient label on the some of the products is the total calories is about the same of maybe a bit less .
I tried Beyond Meat sausages and was pleasantly surprised . To me they do taste "real"
Ate a hamburger last night and it was good though not quite as close to real beef to me .
I would buy both products again .
Not al all like "veggie" burgers which to me are very distasteful.
Bottom line,
environmentally sound but health wise unclear at this time.
And as is true with nearly every single publication in any medical journal . - MORE study is needed!
-
https://bigthink.com/devil-in-the-data/alzheimers-is-type-3-diabetes?utm_medium=Social&utm_source=Facebook#Echobox=1576960381
-
The Korea Institute of Science and Technology announced that a collaborative research team led by Dr. Kwan Hyi Lee from the Biomaterials Research Center and Professor In Gab Jeong from Asan Medical Center have developed a technique for diagnosing prostate cancer from urine within only twenty minutes with almost 100% accuracy. The research team developed this technique by introducing a smart AI analysis method to an electrical-signal-based ultra-sensitive biosensor. As a noninvasive method, a diagnostic test utilizing urine is convenient for patients and does not need invasive biopsy, thereby diagnosing cancer without side effects.
https://pubs.acs.org/doi/10.1021/acsnano.0c06946
-
Far out.
-
Smoking’s Long Decline Is Over (partly due to lockdowns)
Wall Street Journal ^ | January 28, 2021 | Jennifer Maloney
The decades long decline in U.S. cigarette sales halted last year as people in lockdown lit up more frequently and health concerns around e-cigarettes caused some vapers to switch back to cigarettes. Before the pandemic, U.S. cigarette unit sales had been falling at an accelerating rate, hitting 5.5% in 2019, as smokers quit or switched to alternatives like e-cigarettes. The pandemic put the brakes on that slide. In 2020, the U.S. cigarette industry’s unit sales were flat compared to the previous year, according to data released Thursday by Marlboro maker Altria Group Inc. People had more opportunities to smoke
-
Smoking’s Long Decline Is Over (partly due to lockdowns)
Wall Street Journal ^ | January 28, 2021 | Jennifer Maloney
The decades long decline in U.S. cigarette sales halted last year as people in lockdown lit up more frequently and health concerns around e-cigarettes caused some vapers to switch back to cigarettes. Before the pandemic, U.S. cigarette unit sales had been falling at an accelerating rate, hitting 5.5% in 2019, as smokers quit or switched to alternatives like e-cigarettes. The pandemic put the brakes on that slide. In 2020, the U.S. cigarette industry’s unit sales were flat compared to the previous year, according to data released Thursday by Marlboro maker Altria Group Inc. People had more opportunities to smoke
More lockdown damage, cancer screenings plummeted:
https://fee.org/articles/cancer-screenings-plummeted-in-2020-the-results-are-grim/
-
https://www.yahoo.com/news/western-pa-doctors-saying-controversial-100400824.html
every single advisory committee member voted against approving this drug
yet the FDA approved
something fishy in Denmark?
lot of money involved
we need a real Alzheimer's drug(s) that work
apparently this one does not (unless more time is needed to show a benefit)
like all those that went down before it.
-
https://www.nbcnews.com/science/environment/monarch-butterflies-are-wiped-combat-veterans-are-trying-rcna2200
-
https://www.nature.com/articles/d41586-021-00187-9
-
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5789927/
I knew Ibuprofen was poison but I didn't know this link.
-
Whoa!!!
-
https://nypost.com/2022/01/06/mike-pompeos-weight-loss-story-down-90-pounds-in-6-months/
seeing Newt on Laura last night , he appeared thinner too
wonder if they hit the weights together? :-D
-
Huge fan of Pompeo. Very glad to see this!
-
https://bigthink.com/health/neanderthal-dna/#Echobox=1641479022
-
https://interestingengineering.com/metal-lungs-boost-mammals-respiratory-efficiency-by-300?fbclid=IwAR3ZIsTELnhS5x9nGR5ubyu4hXVQ-6owAjMRM-0-n_G0rQqW-gZhHqTMQdY
-
I am not against heavy set people being encouraged to exercise
but this does not seem logical :
https://www.womenshealthmag.com/fitness/a39382727/lizzo-bikini-instagram-photos/
-
https://www.studyfinds.org/medical-marijuana-addiction/
-
https://blog.cordblood.com/2022/02/a-woman-appears-cured-of-hiv-following-a-stem-cell-transplant-using-cord-blood/?mtag=NEWS&utm_source=marketo&utm_medium=email&utm_campaign=042022-client-newsletter&mkt_tok=NTg5LVhGSC01NTcAAAGDpXPO717vWFTAjE_PjqZ1WDC_u5VNSLCfI5mxENP-8FRsZ19QKm4SIiHBVe38jhU1XXwBA2Wh3pphd91EsFFfTV3J2e6awhSoB6_c32ZAzx8
-
https://www.theepochtimes.com/cancer-trial-using-monoclonal-antibody-finds-remission-in-every-patient-report_4514295.html?utm_source=News&utm_campaign=breaking-2022-06-06-1&utm_medium=email&est=rDSagU%2BTq4nsLnNihmKVl0XzfwDHm7653%2B9O5F2BgCtTtclmQRinja59ns9DKx6WIIZx
-
https://www.theepochtimes.com/universal-cancer_4530249.html?utm_source=Health&utm_campaign=health-2022-06-14&utm_medium=email&est=ilWSPdw1nJf13l%2BwW2%2FbfqH6CTCq5vjwx9C7YU3Q8zxYz6J0EYtMK3E1FYwbTAAynPjO
Did Scientists Stumble Upon a Universal Cancer Treatment Innate to the Human Body?
BY HEALTH 1+1 TIMEJUNE 13, 2022 PRINT
Conventional cancer treatments, such as chemotherapy and radiation therapy, come with the drawback where they might also suppress or weaken our immune system by lowering the number of white blood cells and other immune system cells.
Immunotherapy is a relatively new type of cancer treatment that seeks to strengthen our immune system to fight cancer. But it is only effective in treating certain types of cancer.
Over two years ago, researchers in the UK accidentally discovered a type of immune cell that appears to have the power to detect and kill many kinds of cancer cells—at least all the cancers the team had tested. This discovery makes the outlook of finding a universal treatment for cancer ever more promising.
T Cells: The ‘Trained Assassins’ in Our Immune System
Before going into the discovery, we should first introduce an important immune cell.
As an important part of the immune system, T-cells are a type of white blood cell that originate in the bone marrow and mature in the thymus. They travel to different parts of the body to hunt down foreign substances deemed harmful to the body.
Professor Gillian Griffiths from the Cambridge Institute for Medical Research describes T cells as “trained assassins that are sent on their deadly missions by the immune system. There are billions of them in our blood, each engaged in a ferocious and unrelenting battle to keep us healthy. Once a T cell has found its target, it binds to it and releases its toxic cargo.”
How do T cells find their targets?
On the surface of a T cell is a type of protein called a receptor. When the T cells travel around in the body, the receptors sniff the surface of other cells looking for clues that might signal an abnormality or a foreign invasion. There are many different types of T cell receptors, each has a specific target. Take the cancer-targeting receptors, for example: they can sniff out proteins or other molecules (antigens) that are found only on cancer cells.
Following this method, the scientists have found ways to produce specific receptors that target different kinds of cancer. The “CAR T cell therapy” is the latest cutting-edge cancer treatment using this method, which we will go into detail about.
This is what we currently know about T cells, but there seems to be more to the T cell that we have yet to understand.
Epoch Times Photo
The Discovery of a Ubiquitous T-cell
Researchers at Cardiff University in the UK have discovered a special type of T cell that can kill many different types of cancer cells. Their paper was published in Natural Immunology in January 2020.
The Cardiff researchers were originally looking for a kind of T cell that can kill a bunch of bacteria. They happened to use cancer cells as the hosts of the bacteria, since cancer cells can be easily infected with different bacteria.
To their astonishment, they discovered a special type of T cell that not only killed the bacteria (as expected), but also killed ALL the cancer cells–with or without bacteria inside them–used in the experiment.
This discovery sparked their curiosity–is this new hope for universal cure for cancer?
Then they tested other types of cancer in mice who were given human cancers. Lung cancer, colon cancer, bone cancer, breast cancer, blood cancer, skin cancer–all cancer cells used by the researchers were killed by this one type of T cell. What was even more surprising is that this T-cell left the normal cells untouched.
Take melanoma as an example:
Epoch Times Photo
The ‘Smoking Gun’ Protein–MR1
Established research tells us that T cells are highly specialized in detecting a certain type of protein on the surface of a cell.
How can this new T cell detect so many different types of cancer cells? Perhaps there is one “smoking gun” antigen that is common among many different cancer cells?
To test this hypothesis, the Cardiff researchers deleted the proteins from the surface of cancer cells one at a time (using CRISPR-Cas 9 gene editing). If the T cell stops working after a protein is deleted, then that protein is the smoking gun.
They did find a protein called MR1. However, MR1 is found on all cells, not just cancerous cells. So, the scientists do not know exactly what information inside MR1 that enables the new T cell to differentiate cancer cells from normal cells.
In their own words, the Cardiff researchers wrote, the receptor “does not recognize MR1 by known mechanisms.”
More research is underway to determine the communication mechanism between MR1 protein and the receptor on the new T cell.
Engineering T Cells to Treat Cancer: CAR T Cell Therapy
The CAR T-cell therapy strengthens a cancer patient’s immune system by adding a lab-produced receptor to the patient’s T cells. This lab-made receptor, called Chimeric Antigen Receptor (CAR), can sniff out the specific type of cancer cells in the patient. In other words, the CARs can recognize and bind to the specific antigens on the surface of cancer cells.
CARs don’t exist naturally, but once they are infused back into the patient’s body, they can continue to multiply in the patient’s blood.
Since 2017, six CAR T-cell therapies have been approved for the treatment of certain blood cancers by the Food and Drug Administration.
Because the CARs must be produced in the lab tailored to each patient, cost is a huge factor. The recently approved CAR T-cell therapy is more than $450,000.
Professor Awen Gallimore, Co-Director of Systems Immunity Research Institute at Cardiff University, told EurekAlert.org in January 2020, “If this transformative new finding holds up, it will lay the foundation for a ‘universal’ T-cell medicine, mitigating against the tremendous costs associated with the identification, generation and manufacture of personalized T-cells.”
The Epoch Times reached out to researchers at Cardiff University.
Health 1+1 is the most authoritative Chinese medical and health information platform overseas. Every Tuesday to Saturday from 9:00 am to 10:00 am EST on TV and online, the program covers the latest on the coronavirus, prevention, treatment, scientific research and policy, as well as cancer, chronic illness, emotional and spiritual health, immunity, health insurance, and other aspects to provide people with reliable and considerate care and help. Online: EpochTimes.com/Health TV: NTDTV.com/live
-
Big Pharma Wants to Put an End to Vitamins and Supplements
BY JOSEPH MERCOLA TIMEJULY 19, 2022 PRINT
The pharmaceutical industry wants nothing more than to put an end to one of its biggest competitors – vitamins and supplements. They’ve been trying for years to do it, but now they’re pulling out the stops to make it happen. Take action now to safeguard your access to supplements.
STORY AT-A-GLANCE
One of the latest attempts to thwart your ability to access nutritional supplements comes in the form of draft legislation that would require premarket approval for dietary supplements. In short, it would require supplements — which are food — to undergo the same approval process as drugs
In the past, the drug industry and the U.S. Food and Drug Administration has tried to ban certain supplements, including vitamin B6 and N-acetylcysteine (NAC), by reclassifying them as new drugs
Another strategy the drug industry has been using to gain a monopoly over the supplement industry is to buy up supplement brands. Just 14 mega corporations — many of them drug companies — now own more than 100 of the most popular supplement brands on the market
This monopoly over the supplement industry gives drug companies enormous regulatory influence, and that’s a way by which they could eliminate independent supplement makers who can’t afford to put their products through the drug approval process. Indeed, it seems that’s what the Durbin-Braun premarket approval proposal is trying to accomplish
Take action to protect widespread access to dietary supplements. Contact your Senators and urge them to oppose the Dietary Supplement Listing Act of 2022, and its inclusion in the FDA Safety Landmark Advancements Act
In the video above Alexis Baden-Mayer, political director for the Organic Consumers Association (OCA), interviews Gretchen DuBeau, the executive and legal director for the Alliance for Natural Health, who in addition to being a lawyer also has a master’s degree in applied healing arts, talk about Big Pharma’s efforts to eliminate one of its greatest competitors, namely nutritional supplements.
One of the latest attempts to thwart your ability to access nutritional supplements comes in the form of draft legislation that would require premarket approval for dietary supplements. In short, it would require supplements to undergo the same approval process as drugs.
The Durbin-Braun Premarket Approval Proposal
A discussion draft of the legislation was released by the United States Senate Health, Education, Labor, and Pensions Committee (HELP) in mid-May 2022. As reported by Vitamin Retailer:1
“On May 17 [2022], the United States Senate Health, Education, Labor, and Pensions Committee (HELP) released a discussion draft of its legislation to reauthorize FDA user fees for drugs, biologics and medical devices package, which includes the controversial and divisive Durbin-Braun premarket approval concept and more that would be damaging to the industry, according to the Natural Products Association (NPA).2
‘The NPA is significantly concerned with Chair Murray and Republican Leader Burr who failed to reject the radical and dangerous legislation from Senators Durbin and Braun that would require premarket approval for dietary supplements and weaken key privacy protections of the Bioterrorism Act, which protects the dietary supplement supply chain,’ said Daniel Fabricant, Ph.D. president and CEO of the NPA.
‘Last time I checked, dietary supplements are not drugs, biologics or medical devices, so why Congress or anyone supporting nongermane legislation that will only add costs to consumers who are doing all they can to stay healthy is extremely troubling.
Groups who [sic] have supported this legislation, have stated there are protections for technical disagreements with the FDA like those with hemp, CBD, NAC, and several other products. However, if this legislation were to pass, it is abundantly clear these products would be eliminated from the market.'”
For years, the drug industry, with the U.S. Food and Drug Administration’s support, has tried to get nutritional supplements off the market. One of the most often used tactics has been to try to reclassify them as drugs.
Usually, they would target specific nutrients that stood in their way of profits, but legislation such as the Durbin-Braun premarket proposal would allow the drug industry to monopolize the market in one fell swoop.
Big Pharma Tried to Ban Vitamin B6
The fight over vitamin B6 (pyroxidine) is one example of how Big Pharma tried to eliminate a natural substance that stood in the way of a drug patent. In 2007, Medicure Pharma submitted a citizen’s petition to the FDA in which it argued that any dietary supplement containing pyridoxal 5′-phosphate — vitamin B6 — were “adulterated” under the Federal Food, Drug and Cosmetic Act, article 402(f).3
In essence, Medicure wanted all vitamin B6 products banned, because they undermined the company’s incentive to continue development of it’s drug version of B6.
Medicure had gotten wise to vitamin B6’s effectiveness against ischemia (inadequate blood flow), and decided to make a drug out of it by simply renaming the vitamin “MC-1.” They entered it into the drug bank and then argued that B6 supplements contained “their” MC-1. The drug bank even admits the renamed vitamin B6, i.e., MC-1, is:4
“… a biologically active natural product which can be regarded as a chemical entity that has been evolutionarily selected and validated for binding to particular protein domains.”
The main reason why drug companies engage in this kind of sleight of hand is because once a substance is classified as a drug, you can jack up the price by 1,000% over the supplement’s typical retail.5
FDA Cracking Down on NAC
Perhaps the most recent example of the FDA trying to shut down easy access to nutritional supplements was its 2020 attack on N-acetylcysteine (NAC). NAC has been a widely-used dietary supplement for six decades, yet the FDA suddenly decided to crack down on it in late July 2020 — right after it was discovered how useful it was for the prevention and treatment of COVID-19.6
According to the FDA, NAC was excluded from the definition of a dietary supplement because it had been approved as a new drug in 1963.7 But if that was the case, why did they wait until 2020 to take action?
As reported by NPI at the time,8 there were more than 1,170 NAC-containing products in the National Institutes of Health’s Dietary Supplement Label Database when the FDA started sending out warning letters9 to companies that marketed NAC as a remedy for hangovers.
Members of the Council for Responsible Nutrition also worried the FDA might start to target NAC more widely. So far, that hasn’t happened, but Amazon immediately stopped selling all NAC products after those warning letters went out, whether the sellers marketed it as a hangover remedy or not.
Also, the selection of “hangover” for those warning letters seemed arbitrary at best. The fact is that several scientists had called attention to NAC’s benefits against COVID, and shortly afterward, the FDA came up with this ridiculous excuse to limit the availability of it. It just smacked of conflict of interest.
Another Way Big Pharma Is Seeking to Take Over
Another strategy the drug industry has been using to gain a monopoly over the supplement industry is by simply buying up supplement brands. Nestlé Health Science, for example, has acquired Garden of Life, Vital Proteins, Nuun, Pure Encapsulations, Wobenzym, Douglas Laboratories, Persona Nutrition, Genestra, Orthica, Minami, AOV, Klean Athlete and Bountiful.10
Bountiful, in turn, owns brands like Solgar, Osteo Bi-Flex, Puritan’s Pride, Ester-C and Sundown, all of which are now under Nestlé’s control. The Bountiful brands alone generated net sales of $1.87 billion in the 12 months ending March 31, 2021, so the $5.75 billion agreement to acquire a majority stake, signed in August 2021, didn’t necessarily burn a big hole in Nestlé’s pocket. According to J.P. Morgan analyst Celine Pannuti, quoted by Natural Products Insider:11
“Through the acquisition of The Bountiful Co., Nestlé can build a ‘leading position’ in the ‘fragmented category’ for vitamins, minerals and supplements, which ‘has delivered the highest and most consistent growth in consumer health care over the past 10 years.'”
The ‘Free Market Competition’ Lie
In all, a mere 14 mega corporations — many of them drug companies — now own more than 100 of the most popular supplement brands on the market. The graphic below is from Neal Smoller, PharmD, the holistic pharmacist’s website.12
It doesn’t show the ownership of all available brands, but it gives you an idea of just how small the ownership circle has become. As noted by Smoller, many competing brands are even owned by the same corporation, rendering the notion of free market competition null and void.
-
https://www.theepochtimes.com/chemical-imbalance-theory-of-depression-hugely-profitable-and-its-not-even-true_4653254.html?utm_source=Health&utm_campaign=health-2022-08-17&utm_medium=email&est=w7GBxlvxqzU%2FI0eNECTtx7MDnGSD6No%2FGSpi8g8j8edDSI14oE2TU88L9X9j80TriP%2Bv
-
A Ubiquitous ‘Forever Toxin’ Can Cause Liver Cancer—4 Ways to Avoid It
BY FLORA ZHAO AND HEALTH 1+1 TIMEAUGUST 28, 2022 PRINT
A ubiquitous substance that can cause liver cancer can be found in water, food wraps, shampoo, and non-stick pans. It is the toxin known as “forever chemicals”—per- and poly-fluoroalkyl substances (PFAS).
Not long ago, the U.S. Environmental Protection Agency (EPA) reduced the recommended standard limits for perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS)—members of PFAS—in drinking water by more than a thousandfold. Its 2016 health advisories for PFOA and PFOS were both 70 parts per trillion (or 70 ppt), and the recently updated health advisories for PFOA and PFOS are 0.004 ppt and 0.02 ppt, respectively.
An increasing number of studies show that PFAS are very toxic. The latest research in August 2022 further discovered that such substances can cause liver cancer.
The PFAS are a group of man-made organofluorine chemical compounds that contain multiple fluorine atoms attached to an alkyl chain to form stable strong carbon-fluorine bonds. This structure has high thermal and chemical stability, making these substances incredibly hard to break down both in body and in the environment.
PFAS substances break down very slowly and accumulate continuously in the environment, humans, and animals. PFAS are among the most environmentally persistent substances among organic chemicals, and they are thus called “forever chemicals.”
PauseUnmute
Fullscreen
PFAS were invented in the late 1930s and have been in widespread use since the 1940s due to their unique properties of hydrophobicity and oleophobicity. PFAS can enter the human body through food and drinks, breathing, and skin contact. They are found throughout the body, accumulating mainly in the kidneys, liver, and blood. As some of them are readily absorbed by the body and cannot always be filtered by the kidneys, they eventually accumulate in organs such as the liver.
People are worried about the impact of PFAS on the human body, and researchers have also conducted many animal experiments. However, it is not easy to study the toxicity and effects of such substances on the human body due to its long term nature.
Nevertheless, a breakthrough has been made in the studies: American scientists published an epoch-making study in the Journal of Hepatology in August 2022, which is the first practical proof that PFAS substances can cause hepatocellular carcinoma (HCC) in humans.
HCC is a primary liver cancer, accounting for 75 percent to 85 percent of all cases. With a five year survival rate of less than 20 percent, it is one of the deadliest cancers.
Scientists have identified 50 people with HCC from among 200,000 U.S. residents. They obtained the blood samples of these people before they were diagnosed with liver cancer. The results showed that several PFAS substances were prevalent in their blood. Ultimately, the researchers focused on PFOS.
Epoch Times Photo
They found that the top 10 percent of people with the highest levels of PFOS in their blood were associated with a 4.5 fold increased risk of HCC over those with low levels of PFOS in their blood.
The researchers further found that PFOS affected the normal function of the liver by altering the metabolism of four substances in the liver, including glucose, a bile acid, an amino acid, and a keto acid.
In addition, PFAS substances may cause cardiovascular diseases, thyroid problems, immune system problems, liver damage, and kidney and prostate cancers.
Common Sources of PFAS
The EPA has currently identified more than 8,000 types of PFAS compounds. Aside from the non-stick cookware coating that everyone knows, PFAS are everywhere around us:
Drinking water
Fish and livestock exposed to PFAS
Food packaging (grease-resistant paper, food containers/wrappers)
Personal care products (certain shampoos, dental floss, and cosmetics)
Household products (waterproof and stain-resistant carpets, waterproof clothing, non-stick cookware, cleaning products, paints, varnishes, and sealants)
Scientists have tested 2,094 serum samples collected from the general U.S. population older than 12 years of age to assess exposure to a dozen types of PFAS. Four types of PFAS were detected in the blood of at least 98 percent of the people, among which PFOS (99.9 percent) and PFOA (99.7 percent) were the most common.
Epoch Times Photo
PFOA and PFOS are the two most widely used PFAS substances. In recent years, these two substances have been replaced by other PFAS substances in the United States: GenX as a replacement for PFOA, and perfluorobutane sulfonate (PFBS) as a replacement for PFOS. However, the EPA acknowledges that GenX can affect the liver, kidneys, immune system, and has developmental effects, and it is also linked to cancer; and that PFBS can affect the health of the thyroid, reproductive system, and kidneys and people’s development.
4 Ways to Avoid PFAS
Although PFAS substances are pervasive around us and in the environment, we can adjust certain lifestyles and habits to minimize our exposure to these substances.
Replace non-stick cookware with stainless steel cookware
PFAS substances in non-stick cookware can be transferred to food during the cooking process. Scientists tested this with salted tomato paste and found that PFOS and PFAS substances in non-stick cookware are gradually transferred into food.
You can replace non-stick cookware with stainless steel cookware. If you are worried that the food might stick to the stainless steel cookware while cooking, you can pour a little oil, heat the cookware, let it cool naturally, and then put it aside. Then when you start cooking, add oil into the cookware, and this can prevent food from sticking to it.
Epoch Times Photo
If using non-stick cookware, pay attention to the following to reduce the amount of PFAS and other toxic substances in your food:
Do not heat empty cookware. Cook on medium-low heat. Turn on the ventilation fan or open the windows when cooking on high heat.
Avoid using utensils that can scratch the surface of the cookware.
Do not use abrasive cleaning products.
Replace the cookware if they become damaged or worn.
Replace potentially health-threatening carpets in your home
Some oil- and stain-resistant carpets contain PFAS.
Modern people spend 90 percent of their time at home or in other indoor environments. A study published in Environmental Science and Technology Letters shows that the concentrations of volatile PFAS in indoor air, carpets, and dust are closely related to one another, indicating that carpets and dust are major sources of these substances in air.
Rainer Lohmann, the study’s co-author and a professor of oceanography at the University of Rhode Island, said that PFAS-treated carpets are an important exposure pathway and can be replaced with PFAS-free carpet.
Cook your own food
A wide variety of food packaging can contain PFAS. The best solution is to buy raw food and cook at home.
Researchers have found that people who regularly ate at home had significantly lower levels of PFAS in their body. For every 100 kcal of food eaten at home, the concentrations of PFAS substances would be decreased by 0.5 percent. In contrast, people who ate a lot of fast food or frequently ate at restaurants tended to have higher PFAS serum levels.
This means that foods from fast food and other restaurants contain more PFAS, as foods in these places are more likely to have been in contact with PFAS-containing food packaging.
Be careful when buying waterproofing and antifouling clothes
In outdoor clothes and protective workwear, water- and oil-resistant materials that contain PFAS substances are usually used. These garments gradually degrade and release these substances during their use and washing.
-
above CD article concerning
but lets try to regulate
and not start in with the endless law suits
the trillion dollar funds with endless TV commercials
if you have hepatocellular carcinoma
or anything related we can make you (and us rich) stuff
so every alcoholic person with fatty liver and viral induced cirrhosis can now get rich
because we can argue 100% of people exposed and there fore there is a theoretical risk
it was from this.
-
"but lets try to regulate and not start in with the endless law suits"
I like that the article focuses on what we can do for ourselves.
-
ET
‘Vaccine Hesitancy’ Is 1 of WHO’s Top 10 Global Threats—but Flu Shot Data Tells a Different Story
By Dr. Sean Lin and Health 1+1 October 12, 2022 Updated: October 14, 2022biggersmaller Print
In 2019, the World Health Organization (WHO) proposed 10 threats to global health, such as air pollution, non-communicable diseases, global influenza pandemic, Ebola and other high-threat pathogens, weak primary health care, and HIV. Among them, vaccine hesitancy was also mentioned, which many people might find surprising.
The elevation of this issue to a global health threat is a rather political approach. From this perspective, it should not be acceptable to the public. Just as consumers evaluate the quality of the products they purchase, people want to know the vaccines they are getting are good in quality and effective. If a vaccine is proven to be effective while there are minimal side effects, most people wouldn’t hesitate to get vaccinated.
Furthermore, vaccination is just one of the preventive measures aimed at protecting the vaccine recipients against certain diseases. And vaccine’s protection effects depend on the functional immune system in the vaccinated people’s bodies. There are many other ways to achieve the same outcomes, such as boosting the individuals’ innate immunity. Also, for some diseases, there are effective medications to cure the patients, alleviate their symptoms, or prevent critical illness.
The term “vaccine hesitancy” is not scientific per se. Rather, it is a political term. In fact, it has become a label that can be used to attack people. In many cases, people who are described as “vaccine hesitant” are also labeled as “anti-science.” This is irrational and shouldn’t be promoted, especially by such an authoritative international health organization as the WHO. This is because the qualities of different vaccines vary greatly. Labeling people “vaccine hesitant” is a practice to violate their right to self-determination. Therefore, people should question whether there are political operations or interest groups behind the campaigns to attack people for “vaccine hesitancy.”
One such example is the WHO’s promotion of the human papillomavirus (HPV) vaccine, in the name of eliminating cervical cancer on a global scale. However, prior to the development of cervical cancer, there are already pre-cancerous cells in many females, which can be caused by various internal mechanisms of the human body. Vaccination alone cannot prevent the development of all cervical cancer cases. Therefore, the WHO’s proposal to eliminate cervical cancer through HPV vaccination is unscientific and sounds like a marketing campaign for the vaccine products. The HPV vaccines would reduce the occurrence of cervical cancer, but cannot eliminate it.
Flu Vaccines Have Varying Effects on the Immune Responses of Different Age Groups
Currently, the most commonly used production method of influenza vaccines is the egg-based approach, in which flu viruses grow and replicate themselves. They are then isolated, purified, and inactivated, before being added to the formulation to produce vaccines. Although cost-effective, this method is prone to mutations, which can lower the vaccines’ effectiveness and cause potential problems, such as weakening the vaccine recipients’ immune system.
Epoch Times Photo
When implementing flu vaccines, the more responses from T cells and B cells, the better. From the graph below, we can see that among children aged 5 to 9, in terms of T-cell response stimulation, inactivated flu vaccines are less effective than live attenuated influenza vaccines (LAIVs) (pdf).
Epoch Times Photo
Furthermore, vaccines are not a panacea that works for everyone or every age group. This graph shows the changes in the T cells of children and adults after their immunization with one dose of LAIV. We can see that although the same type of flu vaccines were administered, in terms of T cell response, the vaccines are more effective in children aged 5 to 9 years than in adults. In addition, different vaccine platforms also have different effects on vaccine recipients.
Therefore, we can conclude that these flu vaccines have varying effects on different age groups. The same vaccines may not have the same protection for everyone, as individual factors such as age, gender, body mass index (BMI), and response to vaccines are also involved, and they may vary greatly among different populations. So, when designing vaccination policies, there should be some adjustment for different age groups. This also further illustrates our points earlier that people should have the self-determination for vaccinations based on their own individual factors, such as the age factor here.
New Generation of Flu Vaccines Will Also Have Mutations and Challenges
Although LAIVs are more effective than inactivated flu vaccines when providing protection, they are not as widely promoted as inactivated vaccines, due to their side effects. Therefore, the next generation vaccines are expected to have better stimulation of T cell responses through new technologies, such as the DNA recombinant technology. One example of a next generation flu vaccine is Wyeth/IL-15/5Flu, which is a T cell-activating vaccine based on the H5N1 flu strain and produced by the pharmaceutical company Wyeth.
However, this T cell-activating vaccine induces a higher incidence and degree of mutation on the influenza A virus genome. That is, even if the virus strains used in the production of the vaccine are not grown from eggs, there will still be mutations at important hemagglutinin-receptor binding sites. For example, in the flu virus strain used in Wyeth/IL-15/5Flu vaccine production, it was found that the mutation at position 34 (involved in receptor binding) in HA protein is 10 times higher than virus strains used for inactivated vaccines.
For instance, when producing these new vaccines, once the mutation-prone virus hemagglutinin’s head domain is removed, its hemagglutinin (HA) stem region, which has a relatively low mutation frequency, will now mutate more. And beneficial adaptation mutations on the polymerase basic 2 (PB2) gene/protein can occur, as the virus adapts to the new production method and environment. As breakthroughs are produced, the stem, which was previously not prone to mutations, would also mutate.
In addition to the mutations brought about by the immune environment, the vaccine companies would also deliberately select the fast-growing strains of influenza virus. This is because for high volume virus production, the choice of virus strains with higher reproduction efficiency is also important. So, it is necessary for vaccine companies to select strains that reproduce fast, in order to grow more viruses with fewer resources.
During this virus strain screening process, mutations concerning gene segments such as the viral enzymes PB1 and PB2 are introduced, and this changes the strains’ replication capability. Also, many of the new generation vaccines are in Vero cells, which are a lineage of monkey kidney epithelial cells and the most popular cell lineage for manufacturing human vaccines. However, Vero cells are not human cells. The virus still needs to adapt to a different host when using Vero cells.
The Impact of Annual Vaccination on the Human Immune System and the Flu Virus
In the 1970s, T.W. Hoskins and colleagues observed a phenomenon in a British boarding school for the first time. That is, flu vaccination in prior influenza seasons can reduce the effectiveness of the vaccine in the current season. This phenomenon, known as the “Hoskins effect,” has also been identified by some other studies.
Although academics have been exploring the “Hoskins effect” for decades and scratching their heads over this phenomenon, the general public is not aware of this issue.
Many people believe that the benefits of flu vaccination outweigh its drawbacks. This is why they are promoting the implementation of flu vaccines. Although there have always been questions about the effectiveness of flu vaccines, there haven’t been any large-scale studies on this issue so far.
Currently, the Centers for Disease Control and Prevention (CDC) recommends people over the age of 6 months to receive seasonal flu vaccines. However, what are the impact of annual flu vaccination on our immunity?
According to the journal Frontiers in Immunology, a human cohort vaccine study has been conducted since the 2016-2017 flu season with adult (over the age of 18) and teenage (12 to 18 years old) participants, who are vaccinated annually against the seasonal flu. Every flu season, the subjects’ sera samples and personal information are collected and analyzed at the University of Georgia.
Epoch Times Photo
Their immune responses to repeated annual influenza vaccination is tested by hemagglutination Inhibition (HAI) composite scores. The participants are enrolled in early September every year, without having received the seasonal flu vaccine. In the teenage participant group, during the 2017-2018 flu season, the hemagglutination inhibition was relatively adequate. However, the inhibition came down in the following flu season. The same phenomenon took place in the adult group, as well.
It can be interpreted that at the beginning of the 2017-2018 flu season, the participants were not vaccinated, and the flu vaccine later provided them with useful protection. However, in the subsequent 2018-2019 flu season, with repeated flu vaccination, the protection offered by the vaccine actually decreased. It has also been observed that the vaccine had become less and less effective among the repeatedly vaccinated participants.
Overall, the HAI composite scores declined significantly from one flu season to the next in teenagers, but somehow remained steady in adult participants. In addition, a comparison of the mean HAI composite scores of prior vaccinated teens and those newly enrolled in the 2018-2019 flu season implies that repeated annual vaccination resulted in reduced immune responses.
Therefore, repeated vaccination strains are associated with reduced boosting of immune responses and thus protection.
The annual flu vaccine contains four different virus strains. It was discovered that if the virus is the same, to very similar year to year, the decline in immune response would be more obvious if the vaccine had been given continuously year to year. In addition, if there is a change in the choice of virus strains between seasons, the vaccine’s protection effect would be better. This may be because the immune system has been fatigued by the repeated vaccination.
The immune system may use the immunological memory based on the previous vaccination when a second slightly different vaccine is administered, leaving the immune system stuck with its first immune responses and unable to generate more effective responses to the second vaccination. However, as flu viral strains change from year to year, the antigens in the vaccine are also adjusted. There has been no tracking of the immune fatigue associated with a particular strain of virus. And the specific mechanism of this phenomenon has not been studied in particular detail.
Epoch Times Photo
In addition, repeated vaccination also forces the virus to undergo mutation, as it guides the virus to develop in a certain direction, as it screens the virus strains. This is called immune escape.
During the natural evolution process, pathogens experience random mutations that change their antigens. Therefore, the vaccine loses its effectiveness against the mutated pathogens. Nevertheless, during the vaccine-driven evolution process, after the vaccine is administered, certain pathogens die, and the surviving ones replicate themselves. After several rounds of repeated vaccination, the surviving pathogens would have gone through several rounds of screening, and the vaccine then has less effect on them. And eventually, vaccine-escape mutants will be screened out.
Epoch Times Photo
Vaccine escape does not just occur for flu vaccines. There are many examples for other bacteria vaccines. Lessons were not rare.
For example, Bordetella pertussis is the bacterium causing pertussis (whooping cough). As the design of the vaccine against Bordetella pertussis was targeting one of its surface-associated proteins called pertactin, through self-screening, more and more pertactin-negative bacterial isolates were replicating themselves more than the other ones.
This immune escape phenomenon may explain the fact that since the 2009-2010 flu season, the effectiveness of the flu vaccines has been below 50 percent most years.
Do Flu Shots Reduce the Rate of Severe Illness?
Many people get the annual flu jabs, because they believe that they can prevent severe illness. However, the results of a Japanese study may disappoint. This study, published in the journal Vaccine in 2014, shows that flu vaccination doesn’t reduce the risk of subsequent hospitalization or prevent severe illness.
Epoch Times Photo
As shown in the table, within 14 days of flu infection, around 40 percent of people who had previously been vaccinated with the flu vaccine were infected with the flu virus. And the percentage of cases in which the individuals got vaccinated and became hospitalized was 9 percent, while this figure was 4 percent for the hospitalized patients who were unvaccinated. Therefore, the flu vaccine doesn’t always reduce disease severity or prevent critical illness as the general public believes, a belief driven by the annual flu vaccination campaigns.
Epoch Times Photo
The CDC also conducted a study on flu-caused critical illness among a vaccinated population recently. The patients with life-threatening illness included those who used invasive ventilation, vasopressor, dialysis, and cardiopulmonary resuscitation.
According to this study, the flu vaccine was effective in 75 percent of the cases with life-threatening illness and in 57 percent of the cases with non-life-threatening illness.
However, this study is not very rigorous, as its sample size is very small. More importantly, the factor of underlying medical conditions was not included in the evaluation of the patients’ disease severity, as many of them already had respiratory, cardiovascular, and/or neurological conditions prior to flu infection. The data of disease severity was not stratified based on different types and degrees of underlying medical conditions. The data shown in this paper only pointed out how many people, whether vaccinated or not, have underlying medical conditions. Therefore, this study is very biased and it draws more conclusions than its data can suggest.
So, in summary, objective evaluation of vaccine efficacy and safety are critical to provide unbiased information to the public. And international organizations or health regulators should avoid politicizing the people who carefully evaluate of their choice of vaccinations. “Vaccine Hesitancy” is a political label that should be abandoned by health agencies and international organizations like WHO.
-
False information syndrome has really hurt public health and confidence.
First they tell us w can't be trusted with real data or contrary opinions, then they find people have no trust - even in good data.
-
Yup.
-
Antibiotics Linked to Fatal Heart Condition
HEALTH VIEWPOINTS
Joseph Mercola
JOSEPH MERCOLA
Oct 19 2022
(David Gallaher/Shutterstock)
(David Gallaher/Shutterstock)
This antibiotic contributes to rising problems with antibiotic-resistant bacteria, kidney stones and psychotic episodes; data demonstrates it increases your risk of a fatal heart condition. I’ll share how to avoid this risk.
STORY AT-A-GLANCE
Fluoroquinolones, long associated with Achilles tendonitis and rupture, have been demonstrated to increase your risk of aortic dissection (a tear in the wall of the major artery, allowing blood to flow between the layers) or aortic rupture, which can lead to death
Even though “black-box” warnings are now attached to them, fluoroquinolones are still often prescribed for upper respiratory infections or urinary tract infections
Antibiotic use can trigger a permanent change in your gut microbiome, which accounts for nearly 80% of your immune system function, so it is important to use antibiotics only when absolutely necessary
You may reduce your risk of bacterial and viral infections by supporting your immune system through simple lifestyle measures, such as quality sleep, fermented foods, regular exercise and optimizing your vitamin D level
Research shows your body’s microbiome has nearly 39 trillion bacteria.[[1] During early years, your family, dietary intake and environmental exposure contribute to the variety in your microbiome, influencing your lifelong health. Everyday activities such as brushing your teeth, eating, kissing someone or handling a family pet also affect your microbiome.
This composition may be as distinct to you as a fingerprint and plays an enormous role in disease prevention, and influences the function of your skin, lungs, breast and liver.[2] Harmful bacteria can trigger illness and disease, which is frequently treated with antibiotics. Of the 10 most commonly prescribed, two are from the antibiotic class of fluoroquinolones.[3]
The Food and Drug Administration (FDA) first added a boxed warning to fluoroquinolones in 2008, due to the increased risk for tendinitis and tendon rupture.[4] Boxed warnings, also referred to as black box warnings, appear on prescription drug labels designed to call attention to serious or life-threatening risks.[5]
An additional warning was added in 2011 for those suffering from myasthenia gravis, and updates were included in 2013 describing irreversible peripheral neuropathy.[6] In 2018, the FDA warned fluoroquinolone antibiotics may increase the occurrence of ruptures or tears in the aorta.[7] And, in January 2022, the FDA decided:[8]
“We have determined that fluoroquinolones should be reserved for use in patients with no other treatment options for acute bacterial sinusitis, or ABS, acute bacterial exacerbation of chronic bronchitis (ABECB), and uncomplicated UTI because the risks generally outweighs the benefits.
For some serious bacterial infections the benefits of fluoroquinolones outweigh the risks, and it is appropriate for them to remain available as a therapeutic option.”
Yet, despite these warnings, researchers found in April 2022 that fluoroquinolones are still among the most-prescribed antibiotics around the world.[9] They concluded that some health care workers may have an “unsatisfactory knowledge” of the safety profiles and risks of these drugs, and that more education on adverse reactions to fluoroquinolones may be needed.
FDA Warning Links Fluoroquinolones With Aortic Damage
The aorta is the main artery in your body supplying oxygenated blood to your circulatory system. The artery comes from the left side of your heart and runs down the front of your backbone. The review by the FDA found fluoroquinolone antibiotics increase the risk of tears in the aorta, also called aortic dissections, or ruptures of an aortic aneurysm, leading to excessive bleeding and death.
The findings occurred when antibiotics were given by mouth or through an injection. This led the FDA to caution against the use of fluoroquinolone antibiotics in those at risk, unless there are no other treatment options available.
Specifically, the antibiotic should not be used in those who are at risk for, or have a current, aortic aneurysm, such as those suffering peripheral atherosclerotic vascular disease, hypertension and specific genetic conditions such as Ehlers-Danlos syndrome or Marfan syndrome.[10]
Findings were pulled from four published observational studies, which taken together demonstrated a consistent association between aortic dissection or rupture and fluoroquinolone use. The underlying mechanism could not be determined from those studies.
Some of the commonly used fluoroquinolones include ciprofloxacin (Cipro), levofloxacin (Levaquin), gemifloxacin (Factive) and moxifloxacin (Avelox). These are prescribed to treat upper respiratory and urinary tract infections. In a statement, the FDA warns:[11]
“Fluoroquinolones should not be used in patients at increased risk unless there are no other treatment options available.
Health care professionals should avoid prescribing fluoroquinolone antibiotics to patients who have an aortic aneurysm or are at risk for an aortic aneurysm, such as patients with peripheral atherosclerotic vascular diseases, hypertension, certain genetic conditions such as Marfan syndrome and Ehlers-Danlos syndrome, and elderly patients.”
Upper Respiratory Infections Are Often Viral
Viruses commonly trigger upper respiratory infections (URIs) with symptoms of runny nose, cough, low grade fever, sore throat and difficulty sleeping. URIs represent the most common acute illness in the outpatient setting, often related to the common cold, which is typically a mild, self-limited inflammation of the mucous membranes in the airways.[12]
Bacterial illness may follow a viral illness as a secondary infection, and commonly includes symptoms persisting longer than 14 days with a fever higher than one might typically expect from a virus. Oftentimes, the fever gets worse a few days into the illness rather than improving.[13]
Unfortunately, one of the more common reasons fluoroquinolones are prescribed is for upper respiratory infections, ordinarily triggered by a virus. According to the U.S. Centers for Disease Control and Prevention (CDC),[14] the highest number of community antibiotic prescriptions are written in the southeastern states.
Fluoroquinolones ranked No. 4 in the highest number of prescriptions written per 1,000 people in the CDC’s outpatient antibiotic prescription index in 2016. Because providers were still opting for fluroquinolones more than they should for respiratory infections such as pneumonia, the CDC reported in 2021 that an expert panel had recommended the use of these drugs for this purpose be lowered by 90%.[15]
Bacterial and viral infections are dissimilar in important respects related to the organism’s structure and the way they respond to medications. Although both are too small to be seen with the naked eye, the largest virus is actually smaller than the smallest bacteria.[16] Unlike the more complex bacteria, viruses cannot survive without a host and only reproduce by attaching themselves to other cells. Also, unlike bacteria, most viruses are specific in the cells they attack.
The differences in the structure and complexity of the organism have an impact on the type of medication that may be effective against it. Viral infections are not affected by antibiotics such as fluoroquinolones. In fact, using antibiotics for viral infections only contributes to the rising number of antibiotic-resistant infections.
Fluoroquinolones Linked to Multiple Health Concerns
Fluoroquinolone antibiotics have been associated with Achilles tendon ruptures and damage for over a decade. Other severe adverse events, such as retinal detachments as well as aortic aneurysms, may also be associated with other systems requiring collagen formation.[17] This may also explain, at least in part, how the drug increases your risk of aortic rupture or dissection, as collagen[18] lines your arteries and veins to allow for stretch as the heart pumps blood.[19]
Subsequently, in July 2022 the FDA mandated another warning, “alerting physicians to the increased risk of tendonitis and tendon rupture associated with their use.”[20] According to Dr. Renata Albrecht, who heads the FDA’s Division of Special Pathogen and Transplant Products, “Achilles’ ruptures associated with fluoroquinolones are three to four times more frequent than ruptures among people not taking these drugs.[21]
So, if you are taking these antibiotics, you should seek immediate medical care if you experience soreness or inflammation in muscles or tendons. You should also not exercise while your joints are affected.
The drugs are also powerful iron chelating agents that may trigger epigenetic changes through the loss of agents requiring iron as a cofactor. As noted in one study, this may also explain the classic renal toxicity associated with the antibiotics:[22]
“At sub-millimolar concentrations, these antibiotics inhibited jumonji domain histone demethylases, TET DNA demethylases and collagen prolyl 4-hydroxylases, leading to accumulation of methylated histones and DNA and inhibition of proline hydroxylation in collagen, respectively. These effects may explain fluoroquinolone-induced nephrotoxicity and tendinopathy.”
A recent study[23] has linked the use of fluoroquinolones to the rising number of children and adults affected by kidney stones. The odds of stones increased 1.5 times with the use of fluoroquinolones and exposure within 3 to 12 months was associated with greater risk. It appeared children and adolescents were particularly susceptible.
Reactions can be bodywide, impacting your central nervous system and musculoskeletal, visual and renal systems, sometimes simultaneously. Among the serious reactions reported are:[24]
Memory impairment
Delirium
Agitation
Disorientation
Retinal detachment[25]
Hearing loss and/or tinnitus[26]
Disturbance in attention
Kidney stones
Kidney failure[27]
Hypoglycemia leading to coma
Aortic rupture or dissection
Tendon rupture or dissection
More Psychiatric Side Effects Than You Might Imagine
Researchers recommend further study to understand the pathogenesis caused by antibiotics in order to treat antibiotic-associated diseases through the mitigation of the intestinal environment — restoring it to its original state.[28]
Further research has demonstrated an imbalance in gut microbiome caused by antibiotics can negatively affect health in a number of ways and for long periods of time.[29] If your physician prescribes one of these dangerous antibiotics, ask to use another one. It would be unusual a fluoroquinolone would be the only antibiotic that could be used to treat your infection.
Remember, these dangerous antibiotics should be used as a last resort only. If it is necessary, be sure to carefully read the package insert and all the warnings, and seek medical attention the moment you notice a side effect.
The late Dr. David Flockhart, who served as professor of medicine and chief of clinical pharmacology at Indiana University School of Medicine, and who before his death was considered one of the leading experts in fluoroquinolone side effects, said in 2012 that “as many as one-third of patients taking a fluoroquinolone will experience some sort of psychiatric side effect.”[30]
But the thing is, Flockhart had tried to call attention to these drugs over 10 years earlier, in 2001, when he decried Ciprio specifically, as he tried to stress just how dangerous fluoroquinolones are:[31]
“Cipro is basically a big gun whose benefits outweigh its risks in certain circumstances. But the bigger the gun you use, the more damage you can expect as collateral.”
Antibiotics Trigger Permanent Changes to Your Gut Microbiome
The health of your gut microbiome is a game changer. It has become increasingly apparent in recent years that the composition of your gut microbiome plays an enormous role in your health and disease prevention. Cancer and many other health conditions have been traced back to the influence of gut microbes, including obesity, depression, Parkinson’s and allergies, just to name a few.
Since your gut is the main residence of your immune system,[32] disrupting your gut microbiome automatically disrupt your immune function, which can have far-reaching consequences. One way antibiotics can promote disease is by creating an oxygen-rich environment in your intestines, favoring the growth of pathogenic bacteria.
Beneficial microbes grow in an anaerobic (no oxygen) environment, while pathogenic bacteria need oxygen to survive.[33] Data suggest even one course of antibiotics can negatively alter your microbiome for up to one year, which is why it’s crucial to use antibiotics only when it is absolutely necessary.[34]
However, Dr. Martin Blaser with the Langone Medical Center at New York University argues the impact of antibiotics on gut bacteria may be permanent. In an editorial in Nature he writes:[35]
“Early evidence from my lab and others hint that, sometimes, our friendly flora never fully recover. These long-term changes to the beneficial bacteria within people’s bodies may even increase our susceptibility to infections and disease.
Overuse of antibiotics could be fueling the dramatic increase in conditions such as obesity, Type 1 diabetes, inflammatory bowel disease, allergies and asthma, which have more than doubled in many populations.”
Support Your Health and Your Gut
The stronger your immune system, the less chance any microbe will have of gaining a foothold in your body. Below are some basic strategies for supporting your immune system and preventing illness.
Optimize your diet — Avoid foods that tax your immune system, such as trans fats, fried foods, processed foods, sugars and grains. Seek to reduce your net carbohydrate (sugar, grains, fructose) and protein intake, replacing them with high-quality healthy fats.
Balance your gut flora — One of the best ways to support your gut is by incorporating naturally fermented foods into your diet, working up to 4 to 6 ounces per day. You may take a high-quality probiotic supplement, but fermented foods tend to offer the greatest benefit.
Exercise regularly — Exercise improves the circulation of immune cells in your blood, creating a more efficient system at locating and eliminating pathogens in your body. Make sure your fitness plan incorporates weight training, high-intensity exercises, stretching and core work.
Get plenty of restorative sleep — Research shows sleep deprivation has the same effect on your immune system as physical stress or disease, which is why you may feel ill after a sleepless night.
Reduce stress — High levels of stress hormones can diminish your immunity, so be sure you’re implementing some sort of stress management. Meditation, prayer, yoga and Emotional Freedom Techniques (EFT) are all excellent strategies for managing stress, but you’ll have to find what works best for you.
Optimize vitamin D levels — Studies show inadequate vitamin D can increase your risk for MRSA and other infections. Your best source of vitamin D is through sensible sun exposure. Monitor your vitamin D level to confirm they’re in a therapeutic range of 60 to 80 ng/mL. If you can’t get UV exposure, consider taking an oral vitamin D3 supplement, in conjunction with magnesium and vitamin K2 (MK-7).
In addition to the lifestyle measures listed above, there are natural agents that are naturally antibacterial, including the following:
Vitamin C — Vitamin C’s role in preventing and treating infectious disease is well established. Intravenous vitamin C is an option, but if you don’t have access to a practitioner who can administer it, liposomal vitamin C is the most potent oral form. For more information on vitamin C, listen to my interview with Dr. Ronald Hunninghake (hyperlinked above), an internationally recognized vitamin C expert.
Garlic — Garlic is a powerful antibacterial, antiviral and antifungal. It can stimulate your immune system, help wounds heal and kill antibiotic-resistant bacteria. For highest potency, the garlic should be eaten fresh and raw (chopped or smashed.)
Olive leaf extract — In vitro studies show olive leaf extract is effective against Klebsiella, a gram-negative bacteria, inhibiting its replication, in addition to being toxic to other pathogenic microbes.
Manuka honey — Manuka honey, made from the flowers and pollen of the Manuka bush, has been shown to be more effective than antibiotics in the treatment of serious, hard-to-heal skin infections. Clinical trials have found Manuka honey can effectively eradicate more than 250 clinical strains of bacteria, including resistant varieties such as MRSA.
Tea tree oil — Tea tree oil is a natural antiseptic proven to kill many bacterial strains.[36]
Colloidal silver — Colloidal silver has been regarded as an effective natural antibiotic for centuries, and recent research shows it can even help eradicate antibiotic-resistant pathogens. If you are interested in this treatment, make sure you read the latest guidelines for safe usage of colloidal silver as there are risks with using it improperly.
Originally published Sep 30 2022, on Mercola.com
References
[1] American Microbiome Institute, January 20, 2016
[2] Institute of Science for Society February 26, 2014
[3] Drugs.com, Antibiotics Guide
[4] Food and Drug Administration, July 26, 2016
[5] Food and Drug Administration, A Guide to Drug Safety Terms at the FDA
[6] Food and Drug Administration, July 26, 2016
[7] Food and Drug Administration, December 20, 2018
[8] FDA. FDA Updates Warnings for Oral and Injectable Fluroquinolone Antibiotics Due to Disabling Side Effects. January 19, 2022
[9] Frontiers in Medicine. April 29, 2022
[10] Food and Drug Administration, December 20, 2018
[11] NBC News, December 20, 2018
[12] Medscape, Upper Respiratory Tract Infection
[13] Duke Health, October 1, 2013
[14] Centers for Disease Control and Prevention, Outpatient Antibiotic Prescriptions — United States, 2016
[15] CDC. 2021 Update on Antibiotic Use in the United States. 2021
[16] Mayo Clinic. Bacterial vs. Viral Infections: How Do They Differ?
[17] BMJ Open, 2015; 5(11)
[18] Collagen, G.A. Holzapfel, P 285
[19] Collagen Complete, Did You Know That the Walls of Your Blood Vessels are Lined With Collagen and Elastin?
[20] ABC News. FDA Mandates Black Box Warning for Some Antibiotics. July 9, 2022
[21] ABC News. FDA Mandates Black Box Warning for Some Antibiotics. July 9, 2022
[22] Journal of Biological Chemistry, 2015;290(36):22287
[23] Renal and Urology News, May 15, 2018, Kidney Stones Linked to Oral Antibiotics
[24] MPR, July 10, 2018
[25] JAMA, 2012;307(13)
[26] Ther Adv Drug Saf. 2018 Apr; 9(4): 219–221
[27] Drug Safety, 2000;22(6):479
[28] Yonsei Medical Journal, 2018;59(1):4
[29] Frontiers in Microbiology, 2015;6:1543
[30] Forbes, Antibiotic Alert: The Drug the Doctor Ordered Could Cause Deadly Side Effects,” September 30, 2012
[31] UCLA Department of Epidemiology, “Drug of Choice Has a Downside,” October 29, 2001
[32] Hopkinsmedicine.org, November 2015
[33] Cell Host & Microbe 2016;19(4):443
[34] Cell Host & Microbe 2016;19(4):443
[35] Wired, August 26, 2011
[36] Journal of Hospital Infection, 2004;56(4):28
-
Statins Double Diabetes Rates
Your risk of diabetes may even triple with long-term use.
HEALTH VIEWPOINTS
Joseph Mercola
Joseph Mercola
Oct 29 2022
biggersmaller
The data also indicated that individuals taking statin medications had a 6.5% increased risk of high blood sugar as measured by hemoglobin A1c values. (Proxima Studio/Shutterstock)
The data also indicated that individuals taking statin medications had a 6.5% increased risk of high blood sugar as measured by hemoglobin A1c values. (Proxima Studio/Shutterstock)
Cholesterol lowering medications have a long history of side effects and adverse events. Research finds your risk of diabetes may double, or even triple, with long-term use. Lower your risk of cardiovascular events without using medications.
STORY AT-A-GLANCE
While past research has indicated statins increase your risk of diabetes, data demonstrate they double your risk of Type 2 diabetes, and when taken for more than two years may even triple your risk
Statins work by blocking a liver enzyme your body uses to make cholesterol; blocking this enzyme triggers a depletion of CoQ10 and vitamin K2, both necessary for heart health and the prevention of some cancers. Your body makes cholesterol as it is necessary for the production of hormones and cell walls, and to produce substances to digest food
While the relative risk reduction of a cardiovascular event with statin medications is between 20% and 25%, the absolute risk, or the actual difference in rates of coronary death is 2.3%
Additional risks associated with statin medications include neurodegenerative diseases, musculoskeletal disorders, cataracts and heart disease; consider using natural approaches to improve your cardiovascular health
Statins are a type of medication prescribed to lower cholesterol levels. They work by blocking an enzyme in the liver your body uses to make cholesterol.1 Although vilified for many years as causing heart attacks and stroke,2 your body makes cholesterol as it is needed to produce hormones, build cell membranes and produce substances used to digest food.3
Cholesterol is found in foods from animals, such as dairy products and meats.4 Your body makes the fatty substance cholesterol, but it cannot travel in the bloodstream alone.5 The body encases small particles of cholesterol inside protein particles that are able to mix easily with the blood. These are called lipoproteins and they’re responsible for transporting cholesterol.6
One of the main types of lipoproteins is high-density lipoprotein (HDL), sometimes called the “good” cholesterol as its job is to collect cholesterol and deliver it to your liver where it’s removed.7
Low density lipoprotein (LDL) and very low-density lipoprotein (VLDL) are often referred to as “bad.”8 It’s important to remember that only 20% of the cholesterol in your body is acquired from the food you eat, while the rest is made by your body.9
Prescriptions for statins are written to reduce the levels of cholesterol made by the body.10 However, since your body is so complex, changing one factor often results in unintended events, sometimes called side effects or adverse reactions.11 As suggested by one study, one adverse reaction from statin drugs may be doubling your risk of Type 2 diabetes.12
Risk of Diabetes Doubles With Cholesterol Medication
Past studies have demonstrated that statins increase the risk of diabetes.13 A new study led by a graduate researcher at The Ohio State University14 explored this link in research published in Diabetes Metabolism Research and Reviews. The study was a retrospective evaluation of medical records using employees and spouses from a private insurance plan.
Yearly biometric screening, health surveys, medical claims and pharmacy data were gathered from 2011 through 2014.15 Individuals who had indications for statin use, or who had a previous cardiovascular event, were enrolled. Adults who had Type 2 diabetes before the study or who acquired it in the first 90 days were excluded.
Records were classified as belonging to a statin user if they had two or more prescriptions filled, but individuals using statins before January 2011 or within the first 90 days of enrollment in the insurance were excluded. Data were collected from 755 individuals using statins and 3,928 who were not.16
After accounting for factors such as age, gender, ethnicity, education and body mass index, the researchers found those who used statins during the study were two times as likely to be diagnosed with diabetes than those who did not take statin medications.17
Interestingly, individuals who used statin drugs longer than two years experienced an increased risk of more than three times as likely to get the disease.18 The data also indicated that individuals taking statin medications had a 6.5% increased risk of high blood sugar as measured by hemoglobin A1c values.
The hemoglobin A1c blood test is an average level of blood sugar measuring the past 60 to 90 days.19 The test measures how much sugar is bound to hemoglobin on red blood cells. Since red blood cells live for up to 90 days, the test is an average of your blood glucose level during this time.
Take One Medicine for the Side Effects of Another
In 2012, the FDA20 approved changes to labels on statin medications to provide information on adverse events, including reports of increased blood sugar and higher A1c testing. Other side effects listed on the label included cognitive effects such as memory loss and confusion.
While there had been reports of rare but serious liver conditions in those taking statin medications,21 in the same announcement, the FDA22 removed the need for routine monitoring of liver enzymes and recommended they should be performed before starting therapy and then as clinically necessary. Since severe injury was rare, they concluded routine monitoring would not be effective.
The NHS, National Health Services from England, recommends23 statins should not be used in those with severe liver disease since they affect your liver and are “more likely to cause serious problems if you already have a severely damaged liver.”
In 2014,24 one team of researchers discovered adding Glyburide to a statin regimen suppressed the immune response they believed was responsible for the development of Type 2 diabetes. The team led by Jonathan Schertzer, Ph.D., from McMaster University, believed this finding may lead to a next generation of statins. As reported in a press release:25
“Recently, an increased risk of diabetes has been added to the warning label for statin use. This was perplexing to us because if you are improving your metabolic profile with statins you should actually be decreasing the incidence of diabetes with these drugs, yet, the opposite happened.
We found that statins activated a very specific immune response, which stopped insulin from doing its job properly. So we connected the dots and found that combining statins with another drug on top of it, Glyburide, suppressed this side effect.”
In other words, to offset a significant adverse event from one drug, the team recommended the addition of a second drug, which comes with an additional list of side effects including vasculitis, hyponatremia (low blood sodium associated with confusion, seizures and muscle weakness),26 alopecia and liver damage.27
One journalist for Diabetes.co.uk commented on this turn of events, saying: “However, as glyburide stimulates insulin production, using a type 2 diabetes drug to prevent type 2 diabetes seems a peculiar treatment.”28
Statins Trigger High Number of Side Effects
Statin medications deplete your body of coenzyme Q10 (CoQ10), which may account for some of the devastating long-term results. It was strongly suggested29 the FDA add a black box warning to statin medications to advise patients and physicians about this, but in 2014 the FDA decided against it.30
The reduction in CoQ10 may be responsible for an increased risk of acute heart failure31 and atherosclerosis, as reported in a 2015 scientific investigation.32 The study addressed physiological mechanisms in the reduction of CoQ10, including the inhibition of the synthesis of vitamin K2 necessary to protect against arterial calcification.
A reduction in vitamin K2 may contribute to osteoporosis,33 heart disease,34 brain disease35 and inappropriate calcification.36 Statins have also been associated with an increased risk of neurodegenerative diseases,37 cataracts,38 cancer.39,40 and musculoskeletal disorders.41
In one study,42 a research team evaluated the use of statins in patients with terminal illnesses who had a high likelihood of dying within one year. They found those who stopped taking statins had a mean survival of 39 more days than those who continued to take statins — 229 days without statins and 190 days with statins.
Although the FDA calls liver complications rare, one physician’s43 search of MedWatch, the FDA’s Adverse Event Reporting Program, found 5,405 individuals reporting hepatitis or liver function abnormalities associated with just two statin medications between 2006 and 2013.
Effectiveness of Statins Lower Than Publicized
How effective a medication may or may not be is expressed as relative risk or absolute risk.44 If the type of risk is not identified it may be difficult to determine whether taking action would affect you.
For instance, if a medication under investigation to prevent prostate cancer enrolls 200 men and splits them into two equal groups, one is likely to receive a placebo and the other is likely to receive the experimental drug. In the placebo group, two men may develop prostate cancer; in the treatment group, perhaps only one man develops it. When compared, the researchers find there’s a 50% reduction in relative risk.
Relative risk is determined by comparing the number between two groups. One man developed it in the treatment group and two in the control group. Since one is half of 2, there’s a 50% reduction in the development of the disease. The absolute risk is far smaller.
The risk of developing prostate cancer in the control group was 2%, since two out of 100 developed prostate cancer, but in the treatment group it was 1%. This means there’s a 1% absolute risk of developing prostate cancer with the medication as compared to 2%. Your absolute risk is not 50% less but rather just 1% less when taking the medication.
Knowing the difference between relative risk and absolute risk is necessary when balancing the benefits of statin medications against the side effects and adverse events. If you are in a position of needing to decide to use statin medications, it’s important to note the relative reduction in risk of a major cardiac event while using statins was between 20% and 25%.
In the case of having to decide whether the potential benefits of statins are worth the known risks, for example, it’s important to consider a report from 2016. In an Expert Analysis article, it was noted that a meta-analysis45 of 27 randomized trials revealed that “[F]or every ~40mg/dL LDL-C reduction with statin therapy, the relative risk of major adverse events is reduced by ~20-25%, and all-cause mortality is reduced by 10%.”
While another study found a similar relative risk, the actual difference in rates of coronary death in the population was 9% in the placebo group and 6.7% in those who were treated with statins.46
Researchers therefore found the difference between the treated and untreated groups was a mere 2.3% and not the inflated relative risk of 28%. They wrote that while the reduction in relative risk appears impressive to some readers, this form of data presentation is misleading.47
Simple Strategies to Normalize Your Cholesterol Levels
Before becoming concerned about your cholesterol levels, it’s important to evaluate whether you really need a statin drug to reduce your risk of a cardiovascular event. Updated guidelines published by the American Heart Association and the American College of Cardiology are based on a personalized risk assessment.48
However, the U.S. Department of Health and Human Services critically evaluates those with cholesterol levels over 200 milligrams per deciliter.49 I believe this total cholesterol measurement has little benefit in evaluating your risk for heart disease unless the number is over 300.
In some instances, high cholesterol may indicate a problem, provided it’s your LDL or triglycerides and you have low HDL. A better evaluation of your risk of heart disease are these two ratios in combination with other lifestyle factors, such as your iron level and diet.
HDL/Cholesterol ratio — Divide your HDL level by your cholesterol. This ratio should ideally be above 24%.
Triglyceride/HDL ratio — Divide your triglyceride level by your HDL. This ratio should ideally be below 2. Data demonstrate a ratio greater than four is a powerful predictor of coronary artery disease.50
You have control over your health and may protect your heart and lower your risk of heart disease by following suggestions affecting your lifestyle and exposure to environmental toxins.
Originally published October 27, 2022 on Mercola.com
Sources and References
1 Medical News Today, July 17, 2017
2 Harvard Health Publishing, Cholesterol
3, 4, 7, 8 Medline Plus, Cholesterol
5, 6, 9 Harvard Health Publishing, February 2017
10 American Heart Association, Cholesterol Medications
11 Food and Drug Administration, July 19, 2018
12, 15, 16 Diabetes Metabolism Research and Reviews, May 24, 2019; doi:10.1002/dmrr.3189
13 Journal of Pharmacology and Pharmacotherapeutics, 2014;5(3):181
14, 17, 18 Medical News Today, June 26, 2019
19 CDC. All About Your A1C
20, 22 Food and Drug Administration, January 19, 2016
21 Hepatology, 2014;60(2):679
23 NHS, Statins, Considerations
24 Diabetes, 2014;63(11)
25 EurekAlert! June 11, 2014
26 MayoClinic, Hyponatremia
27 Drugs.com, Glyburide Side Effects
28 Diabetes.co.uk, June 23, 2015
29 Holistic Primary Care, October 15, 2002
30 Lawyers and Settlements, January 16, 2015
31 BMJ Open Heart, 2015;2:e000326 doi:10.1136/openhrt-2015-000326
32 Expert Review of Clinical Pharmacology, 2015;8(2)
33 Journal of Nutrition and Metabolism, 2017;2017:6254836
34 Current Nutrition Reports, 2017;6(3):197
35 Frontiers in Neurology, 2019;10:239
36 Integrative Medicine, 2015;14(1):34
37 Movement Disorders 2015; doi.org/10.1002/mds.26152
38 JAMA Ophthalmology 2013;131(11):1427
39 The Prostate. 2011;71(16):1818
40 Cancer Epidemiology Biomarkers Prev. 2013;22(9):1529
41 JAMA Internal Medicine 2013;173(14):1318
42 JAMA Internal Medicine, 2015;175(5):691
43 Journal of American Physicians and Surgeons, Adverse Effects of Statin Drugs: A Physician Patient’s Perspective
44 Institute for Work & Health. Absolute and Relative Risk. November 2006
45 American College of Cardiology, 2016; Summarizing the Current State and Evidence on Efficacy and Safety of Statin Therapy
46, 47 BMJ, 2017;358:j4171
48 American Heart Association, November 10, 2018
49 National Cholesterol Education Program, High Blood Cholesterol What You Need to Know
50 Clinics, 2008;63(4)
-
thank you for the article
I recall reading about this some yrs back
and literally forgot all about it.
Not sure what to do with the information
since statins are so beneficial in lowering vascular events.
I am thinking doctors will think twice about using statins in people at risk for diabetes
who are not yet diagnosed with diabetes
the definition of which is somewhat arbitrary actually.
-
Thank you.
-
Endocrinologist Forecasts More Hormone-Related Diseases as Spike Proteins Found to Deplete Endocrine ‘Reserves’
SPIKE PROTEIN
Marina Zhang
Marina Zhang
Nov 1 2022
biggersmaller
Rendering of SARS-CoV-2 spike proteins binding to ACE2 receptors. (Shutterstock)
Rendering of SARS-CoV-2 spike proteins binding to ACE2 receptors. (Shutterstock)
0:00
19:16
1
Dr. Flavio Cadegiani, a Brazilian endocrinologist, suspects that the worst has yet to come for spike protein-induced diseases in the endocrine system.
The endocrine system, colloquially known as the hormone system, is critical for our health. It regulates growth and development, mood, metabolism, reproduction, immunity, and functions of other organs through the secretion of hormones.
Hormones are one of the three biggest messengers in the body. Compared to the two other messengers—neurotransmitters and cytokines—hormones are slower in responding, and have systemic functions across the body rather than localized actions.
While cells can usually respond to neurotransmitters in milliseconds and cytokines in minutes to hours, cells that respond to hormones can take hours or even weeks.
Since hormones can have slow and systemic actions, a dysfunctional or damaged endocrine system will generally be slow in its symptom onset and recovery.
Studies have shown that spike proteins from COVID-19 infection and the vaccines can damage endocrine glands, including pituitary, thyroid, and adrenal glands, as well as reproductive organs, and many more.
Cadegiani raised a concern that the slower onset of endocrine pathologies may pose difficulties in diagnosis and treatment.
Depletion of Hormonal Reserves
Endocrine pathologies can take longer to become apparent because endocrine glands have “reserves,” according to Cadegiani.
“What we’re going to see in the future [for endocrine diseases] is a little bit different from the other fields, because glands have reserves and the decrease of the reserve will not be clinically seen right now, but it may be in the future,” said Cadegiani at a Front Line COVID-19 Critical Care Alliance (FLCCC) conference in Kissimmee, Florida.
Therefore, affected individuals may show no symptoms until their reserves have been depleted.
Cadegiani said that most of his concerns for the future are speculative and based his own clinical observations. But since the pandemic and the administration of COVID-19 vaccines began, there have been increasing reports that implicate endocrine pathologies.
Endocrine,Glands,Of,Human,Body,For,Male,And,Female,Including
(udaix/Shutterstock)
Hormonal Axis and Systemic Dysfunction
Hormones regulate the entire body, so once the reserved are depleted and underlying endocrine pathologies are unmasked, there may be cases of systemic dysregulations.
Endocrine glands control the function of many organs across the body, and each endocrine organ is also connected through a feedback loop, also known as a hormonal axis.
At the top of this chain is the hypothalamus, which is a diamond structure in the brain and acts as a master switchboard. It sends messages to the pituitary glands, a small, oval structure tucked behind the nose.
The pituitary gland is colloquially known as the master gland; it regulates other endocrine organs, together with the hypothalamus forming hormonal axes.
The pituitary gland is part of the hypothalamic-pituitary-gonadal (HPG) axis which regulates the reproductive organs including the ovaries and the testes. In females, it is responsible for regulating the release of ovarian hormones as part of the menstrual cycle, and in males the axis regulates spermatogenesis.
The hypothalamic-pituitary-adrenal (HPA) axis is a neuroendocrine axis that mediates the adrenal glands, an organ that produce hormones that trigger the fight or flight response. The fight or flight process is a stress response that occurs in response to harmful threats, and can reduce metabolism, suppress immune, as well as activate the sympathetic nervous system.
Another major axis is the hypothalamic-pituitary-thyroid (HPT) axis. This regulates the thyroids and the hormones it secretes. Thyroid hormones are essential for biological functions of growth, regulation of the cardiovascular system, bone replacement, liver function, and metabolism.
How Spike Proteins Target the Endocrine System
The spike protein is the most toxic part of the SARS-CoV-2 virus. Studies on people with long COVID and post-vaccine symptoms often detected spike protein presence months or even a year after the exposure.
Spike protein particularly favors tissues and organs that express ACE2 and CD147 receptors. Many endocrine glands display ACE2 receptors, including the pancreas, thyroid, testes, ovaries, adrenal glands, and the pituitary gland, making the endocrine system particularly vulnerable to SARS-CoV-2.
The key driver behind spike protein-induced disease is inflammation.
Upon entering cells, spike protein can activate pro-inflammatory pathways by inducing DNA damage, inhibiting DNA repair, causing stress to the cell’s mitochondria, which is critical for cell energy production, and many more. All of this lead to cellular stress, injury, and possible cell death.
When many cells are affected, it can cause problems in tissues and organs, affecting individual endocrine glands and the system.
Spike proteins also inhibit autophagy, the cellular “recycling system,” thereby preventing the cells from clearing the toxic protein out, leading to prolonged damage.
Read More
Natural Ways to Increase Autophagy and Detox Spike Proteins After COVID Infection, Vaccination
Spike proteins may also contribute to autoimmunity. Since it shares many similarities with common human tissues and proteins—known as “molecular mimicry”—it has the potential to cause immune cells to mount an attack against its own cells and organs, leading to endocrine damage.
Several studies have reported on endocrine pathologies following COVID-19, though data on the exact damage is still emerging.
Epoch Times Photo
(ttsz/iStock)
Pituitary Glands
As the master gland of the endocrine system, the pituitary gland secretes many hormones, including ones that regulate other endocrine glands:
Adrenocorticotrophic hormone (ACTH) targets the adrenal glands and is responsible for producing cortisol, which stimulates the stress response
Thyroid-stimulating hormone (TSH) regulates the thyroid
Growth hormone (GH) is responsible for growth and metabolism
Melanocyte-stimulating hormone (MSH) boosts the production of melanin when exposed to UV rays and increases appetite
Anti-diuretic hormone (ADH) is responsible for retaining water and producing less urine
Luteinizing hormone (LH) follicle-stimulating hormone (FSH), prolactin (PRL) are important for reproduction
Oxytocin plays a role in childbirth, metabolism, and happiness
Studies in cell culture have shown that the spike protein is able to suppress the production of LH and FSH in pituitary cells, with unknown long term consequences in humans.
ACTH deficiencies have been observed following mRNA vaccination in Japan, with the person affected found to have a shrunken pituitary gland.
Cadegiani said that pathologies in the pituitary are difficult to diagnose; they are often masked by other conditions, therefore there is little literature on pituitary pathology presentation after COVID-19 vaccinations.
Epoch Times Photo
The adrenals are a pair of glands shaped like Napoleon’s hat that lie just above the kidneys. (ttsz /iStock)
Adrenal Glands
There is published literature with data that may be used as evidence to suggest spike protein injury at the adrenal glands.
The adrenal glands, located above the kidneys, produce hormones responsible for the stress response. This includes adrenaline, cortisol, and aldosterone. The release of these three hormones are critical for maintaining energy and other needs during stressful situations.
Studies on COVID-19 have shown that the adrenal glands are major sites of SARS-CoV-2 mRNA accumulation and spike protein production.
The glands are also likely to be involved in post-vaccine myocarditis events that are often seen in young males. Cadegiani reasons that this type of myocarditis may be a sign of adrenal dysfunction.
Cadegiani authored a peer-reviewed study on post-vaccine myocarditis and concluded catecholamines are a main trigger for these events. Catecholamines are a group of neurohormones and includes dopamine, noradrenaline, and adrenaline.
While dopamine mostly acts within the nervous system, both adrenaline and noradrenaline play important roles in stress responses.
Adrenaline activates the fight or flight stress response and the noradrenaline supports the response by increasing heart rate, breaking down fats, and increasing blood sugar levels.
Intense and prolonged exercise trigger the fight or flight response, which is why catecholamines are usually elevated in athletes. Males in particular tend to have higher levels of catecholamine. Testosterone is also suspected to play a role in the higher incidence of myocarditis following vaccination.
Stress responses increase blood pressure, stronger heart contraction, and when chronic, can increase the risk of cardiac events.
Cadegiani linked catecholamines with myocarditis by analyzing autopsy reports in two teenage boys who died three to four days after mRNA vaccination from myocarditis events. Their heart damage was different from normal myocarditis pathology, with clear similarities with stress-induced cardiomyopathy; Cadegiani observed clear characteristics of catecholamine-induced myocarditis.
He hypothesized that vaccines triggered a hyper-catecholaminergic state by elevating levels of adrenaline, causing hyperactivation of adrenaline.
Studies on mRNA vaccinated athletes also found that after exercise, those who were vaccinated had higher heart rates and noradrenaline levels than those who were not vaccinated.
Dysfunctions in the adrenal glands are likely to lead to adrenal insufficiency.
Cadegiani hypothesized adrenal insufficiency–a condition that the adrenal glands become unable to produce enough hormones–to be a possible consequence of spike protein injury.
There is already a report of adrenal insufficiency following infection; in the case of long COVID where there are spike protein remnants, it is likely that the damage will be prolonged, possibly leading to chronic damage.
In the case of vaccines, a report evaluating spike protein production after COVID-19 mRNA vaccination found that the adrenal glands were one of the highest spike protein-producing tissues, and the spike protein production in these glands increased with time.
Current research has also shown that complications from thrombocytopenia as a post-vaccine symptom have led to adrenal hemorrhage and adrenal insufficiency.
Epoch Times Photo
The thyroid is a butterfly-shaped gland located in the the neck just above the collarbone. It secretes hormones that regulate many body functions including metabolism and cell growth. (Shutterstock)
Thyroid
The thyroid is a butterfly-shaped gland located over the throat. It has a lot of functions, primarily regulating growth and metabolism.
It makes two hormones, thyroxine and triiodothyronine. Deficiencies in triiodothyronine results in hypothyroidism, characterized by a large thyroid; over secretion of it can cause hyperthyroidism.
The thyroid also plays roles in regulating the immune system. COVID-19 infection is often a sign of underlying thyroid problems, and damage from infection can exacerbate thyroid problems, creating a negative cycle.
An autopsy study on 15 people deceased from COVID-19 found that 13 of them had viral RNA and proteins in their thyroid tissues. ACE2 receptors, previously thought to be not presented on the thyroid, were also detected, indicating a possible route for SARS-CoV-2 infection.
Though the research shows that thyroids can be implicated in infection, thyroiditis, which is inflammation of the thyroids, have currently only been reported in relation with the COVID-19 vaccine.
A study from Turkey stated that the COVID-19 vaccine can induce thyroiditis. The study evaluated 15 patients who developed thyroiditis following vaccination.
Four of the patients also developed Grave’s disease, which is an autoimmune disease and a complication of hyperthyroidism. Hashimoto’s disease, another thyroid autoimmune condition, has also been reported following vaccinations.
It is possible that spike proteins produced from vaccinations may attack the thyroid cells by binding to ACE2 receptors. However, looking at the high reports of autoimmune diseases, Cadegiani suspects that the pathogenesis of thyroid dysfunction is likely autoimmune. The spike protein has also demonstrated its autoimmune capacity due to high incidences of “molecular mimicry.”
Pancreas
The pancreas produces glucagon and insulin, two important hormones that regulate our blood sugar levels. Dysregulation of blood sugar levels are an indication of pancreatic dysfunction and may lead to complications such as diabetes.
Spike protein both from the vaccine and the virus have shown a potential to disturb glucose metabolism.
There have been reports of a sudden onset of type 1 diabetes, which is a form of autoimmune disease where the body attacks its own pancreatic beta cells.
A study evaluating EudraVigilance safety surveillance reports have also found reports of dysregulation of blood glucose with transient worsening of hyperglycemia reported after vaccinations.
Chronic hyperglycemia, meaning high blood sugar, is usually a sign of dysfunction in the pancreatic beta cells.
Therefore Cadegiani proposed that there could be a loss or malfunction of pancreatic beta cells as studies have shown that the spike protein is able to directly affect and damage these beta cells, likely resulting in their death.
Epoch Times Photo
Health of sperm relates to overall body health, Australian research has found. ( koya979/Adobe Stock)
Reproductive Organs
The harms of COVID-19 on male reproductive organs are well established.
A study from Thailand showed that in 153 sexually active men, around 64.7 percent experienced erectile dysfunction during COVID-19 infection, with 50 percent persisting in these symptoms three months after recovery.
Erectile dysfunction has been established in research to be due to dysfunctions of the endothelial cells, and the spike protein impairs endothelial cells.
Studies linking COVID-19 and erectile dysfunction have largely blamed it on the virus’s interaction with ACE2 receptors displayed on the surface of endothelial cells. Endothelial cells are abundant in ACE2 receptors, making it one of the most targeted in COVID-19 infections.
A study evaluating adenovirus DNA vaccines showed that cells exposed to the vaccines also produced spike proteins that could interact and bind with ACE2 receptors, suggestive of equal endothelial damage.
Since the vaccine rolled out in 2021, the CDC data reported 193 cases of erectile dysfunction following COVID-19 vaccination.
An Israeli study on sperm donations have also noticed a reduction by 15 percent in sperm concentration and 22 percent in motile sperm count following COVID-19 mRNA vaccination.
The authors confirmed in a later response (pdf) that the people tested had no underlying health conditions, and therefore the reduction could not be due to any underlying health conditions that were existent prior to the vaccination.
Though sperm count gradually made a recovery after 145 days, sperm concentration and motility did not return to pre-vaccination levels, with unknown long-term effects.
Concerns of reproductive problems have also been reported in women, most particularly after vaccinations rather than after infection.
Studies showed that men are generally at a higher risk of severe outcomes and deaths from COVID-19 infections; however, women seem to be at a higher risk of vaccine injury.
VAERS data showed that over 60 percent of adverse event reports came from women, indicating that women are more vulnerable to post-vaccine symptoms.
Dr. Paul Marik, critical care expert, also observed that women were at a greater risk of presenting with post-vaccines symptoms in the clinic.
During the pandemic, many women reported menstrual abnormalities following vaccination. A study on Middle Eastern women found almost 70 percent of them reporting menstrual irregularities after vaccination.
A study funded by the National Institute of Health found a “temporary increase in menstrual cycle length” linked to the COVID-19 vaccination.
A study published on the website titled My Cycle Story reported over 290 women who have experienced decidual cast shedding after the COVID vaccines rolled out, even though less than 40 such cases have been documented over the past 109 years. This also indicated that many of the reproductive symptoms women were suffering from may be vaccine related, rather than related to COVID infections.
Cadegiani predicted greater adverse events in pregnancies for the coming future.
He cited a study that concluded “no association” between COVID-19 vaccines and fertility. The data however showed that unvaccinated women had a higher rate of pregnancy than the vaccinated, both for clinical and biochemical pregnancy.
The authors of the paper reviewed 10 studies and found that unvaccinated women have a clinical and biochemical pregnancy rate of 47 and 60 percent respectively, while the COVID vaccinated had a rate of 45 and 51 percent.
Cadegiani predicts more cases of endocrinopathologies as a result of spike injuries in the future.
“Endocrine diseases progress slowly and then only clinically appears in the severe states,” said Cadegiani. “So it’s not possible to tell this [anytime] beforehand.”
-
https://www.newsmax.com/newsfront/cdc-opioids/2022/11/03/id/1094784/
thought nothing stated about securing the border :((
-
Backing up what Tucker Carlson has repeatedly said:
https://pubmed.ncbi.nlm.nih.gov/28981654/
-
Backing up what Tucker Carlson has repeatedly said:
https://pubmed.ncbi.nlm.nih.gov/28981654/
(https://i0.wp.com/www.powerlineblog.com/ed-assets/2022/12/download-6-2.jpg?ssl=1)
-
https://www.newsmax.com/health/health-news/alzheimers-eisai-biogen/2023/01/06/id/1103373/
https://www.nature.com/articles/d41586-023-00030-3
if I recall the advisory 3 panel members resigned after the FDA ignored their 8 to 1 decision to not recommend approval
something rotten at FDA ?
-
https://www.theepochtimes.com/mkt_app/health/evidence-of-serious-adverse-events-in-what-is-believed-to-be-one-of-the-most-effective-vaccines_4972564.html?utm_source=Morningbrief&src_src=Morningbrief&utm_campaign=mb-2023-01-16&src_cmp=mb-2023-01-16&utm_medium=email&est=DWqiO7fVOHJXirnGJmw1gXoAMCt23Co8vgUv%2FfD0HT6bvDMsr3VICeItcuZmAqO2Wd3T
-
https://www.propublica.org/article/what-to-know-about-cellphone-radiation?utm_source=sailthru&utm_medium=email&utm_campaign=majorinvestigations&utm_content=river
-
Sidebar comments can be seen at:
https://www.theepochtimes.com/health/cardiologist-speaks-truth-about-cholesterol-and-statins_5088422.html?utm_source=Health&src_src=Health&utm_campaign=health-2023-03-02&src_cmp=health-2023-03-02&utm_medium=email&est=FdpVeNEsvLjsglLANm5E4fsHjv7sGssvdeiGV%2F6jFCbVDmDtjQ9zvir8wUfFUGOSHg9J
Cardiologist Speaks Truth About Cholesterol and Statins
FEATUREDHEART HEALTH
Thomas E. Levy
Feb 28 2023
Is elevated cholesterol really a problem? In a word, absolutely! However, beyond that assertion, there is a lot about cholesterol that is little known or completely misunderstood. Elevated cholesterol levels feed the growth of obstructive plaques in the coronary arteries, and the higher the cholesterol levels, generally, the more rapid the growth of the plaques.
Very elevated cholesterol levels clearly increase the chances of having a heart attack as long as they are up, with the highest levels having the highest risks. So, significantly elevated cholesterol levels (280 mg/dL or greater) must be avoided at all costs.
Obviously, I want to get my cholesterol as low as possible, right?
Here’s Where It Gets Just a Little Complicated About Cholesterol Levels
Cholesterol levels rise because they are one of the body’s natural defense mechanisms against various toxins. The higher the toxin presence, the higher the cholesterol goes to help block/neutralize the increased oxidative stress from those toxins. So, more heart disease is aggravated as the cholesterol levels rise.
But … you don’t want to lower the cholesterol levels without lowering the toxin presence as well. Otherwise, you’ll just have more un-neutralized toxins in the blood and in the body, causing increased oxidative stress and damage wherever they go.
Then What Do I Do if My Cholesterol Levels Are Elevated?
What needs to be done is to identify your toxin sources, eliminate them, and take an antioxidant protocol that will neutralize the toxins’ pro-oxidant effects. If this is done effectively, cholesterol levels will normalize all by themselves, without the need to use anti-cholesterol drugs such as statins.
Isn’t it good to take a statin drug just to make sure that my cholesterol stays nice and low? Not really. When just the elevated cholesterol level is treated with a statin and no attempt is made to lower toxin exposure and/or to neutralize existing toxins with antioxidants such as vitamin C, your chances of cancer dramatically rise.
The lower your cholesterol levels go without addressing the underlying toxin presence, the greater your chances of cancer. Period.
Furthermore, in a 2013 study, it has been shown that long-term statin use is associated with increased risks of two different types of breast cancer, completely consistent with the long-established link between cancer and low cholesterol. Multiple earlier studies have conclusively shown that cancer risk increases as cholesterol decreases, whether from drugs or severe dietary cholesterol restriction.
So, What Is a Good Cholesterol Level, Anyway?
As a general guideline, when new toxin exposures have been properly addressed, and “normal” daily toxin exposures are all that remain, most adults will end up with a “normal” cholesterol level between 160 and 220 mg/dL. You never want a cholesterol level to chronically stay below 150 mg/dL.
The low cholesterol levels resulting from very strict vegetarian diets are probably the biggest downside of such a way of eating. Nathan Pritikin, the father of the largely vegetarian Pritikin diet, had been diagnosed with heart disease at the age of 41. His cholesterol was over 300 mg/dL.
After following his own diet, he eventually lowered his cholesterol to 120 mg/dL. However, he ultimately ended up with two different kinds of leukemia, and he finally committed suicide many years later.
At autopsy, he had achieved his goal of having notably healthy and clean coronary arteries. So, cholesterol definitely accelerates heart disease, and lowering cholesterol does help to resolve heart disease. However, the answer to elevated cholesterol levels is not to solely lower it with drugs and leave endogenous toxins unaddressed.
So, Statins Should Never Be Taken?
Yes and no. If your cholesterol is above 300 mg/dL and you refuse to address your toxins, such as the proper removal of root canal-treated teeth, you will probably live longer taking a statin and getting your cholesterol back into the mid-200 range.
But the toxins will still be doing their work, and your chances of contracting and aggravating any of a wide variety of conditions, including cancer, will be increased. And be prepared to deal with the many possible side effects of statins, including, but not limited to, muscle pain and damage, liver damage, digestive problems, rashes, increased blood sugar that could lead to diabetes, and a variety of neurological problems, including memory loss and confusion.
And What Do I Do If I Don’t Want to Take Statins?
Dental toxicity needs to be addressed, as well as digestive toxicity. High doses of vitamin C, in regular and liposome-encapsulated forms, should be taken on a daily basis, along with as wide a variety of other quality antioxidant supplements as can reasonably be afforded.
Republished from NaturalHealth365
Sources for this article include:
NIH.gov
NIH.gov
NIH.gov
NIH.gov
-
https://www.breitbart.com/politics/2023/03/02/dianne-feinstein-hospitalization-leaves-senate-democrats-without-outright-majority/
typically not something person gets hospitalized for
unless it is in multiple locations, involvement of the eye, or severe pain,
or if they live alone , elderly and cannot care for themselves
-
https://reason.com/2023/03/10/the-end-of-obesity/
-
all day long people call in for infections
and all day long we have to try to limit antibiotics
it is by far the hardest thing we do
this is why:
https://www.nbcnews.com/health/health-news/-arrived-post-antibiotic-era-warns-new-drugs-deadly-superbugs-rcna76601
not clear from the article is whether any of the investigational antibiotics oral for outpatient use ( I doubt it) or just the more expensive Intravenous forms for hospitalized patient infections.
-
From the bottom of the totem pole, I find myself wondering about the role of antibiotics in the food chain in this.
-
https://www.technologyreview.com/2023/03/07/1069475/forget-designer-babies-heres-how-crispr-is-really-changing-lives/?utm_source=Facebook&utm_medium=tr_social&utm_campaign=businessreportvol2&fbclid=IwAR3lyr3GYWrBo1xtSGUcKQiv0a_uc-ZovXDoPQx1HxnxxZe24P6rp0BoDbM
-
https://www.popsci.com/health/infertility-world-health-organization-study/
-
Killing Bacteria with Antimicrobials and Antibiotics May Be Shortsighted, According to New Science About the Microbiome (Part 1)
Cultivating Our Gut Microbiome to Stifle Disease Series
Amy Denney
Apr 3 2023
We might be on the verge of a new medical paradigm if what scientists are discovering about the microbiome ever makes it into the doctor’s office.
In this series, “Cultivating Our Gut Microbiome to Stifle Disease,” we’ll share how the latest developments on this medical frontier are transforming our approaches to illness and offering new strategies to heal and prevent disease.
Modern medicine has progressed in large part by waging war against germs—snuffing out microscopic disease-causing creatures before they kill us.
The 19th-century discovery that microorganisms are the cause of infectious disease—the leading cause of death at the time—led scientists to the consensus that “germs” posed a great danger to humanity, a stance that’s been woven into policy and ideology to this day. Public health advancements in the 20th century proved that controlling infectious outbreaks extended life expectancy and reduced infant and maternal deaths.
It was an era heralded for great medical achievements.
Death rates rapidly declined—even before the introduction of penicillin and vaccines—as public sanitation and better hygiene in hospitals transformed public health. Mass antibiotic production came in the 1940s, initially for wounded soldiers, then exploded into the public sphere. These new antimicrobial weapons cured millions of infections and saved many lives. However, antibiotics also came with consequences that are squeezing today’s health care on two sides: superbug infections and a rise in all diseases.
Good, Bad, and Usually Ugly
The microbial world is diverse. While it’s true that some microbes cause disease, saying that all of them are killers would be like calling all dogs killers because of a few.
Researchers have learned that thinking of microbes as pathogenic, or disease-causing, is profoundly incorrect. In fact, the microbial world encompasses bacteria, viruses, and fungi that largely promote health. Human beings host a vast microbial community, or microbiome, which forms a kind of detached organ with interactions that keep us alive. These tiny creatures may not be cute, but they are essential.
“[There is] a consortium of organisms in us and on us and around us. There are trillions of them,” Dr. Neil Stollman told fellow physicians at a recent Malibu Microbiome Meeting. “When we lose bugs, we are at risk of other bugs hurting us. They are intimately involved in our immune system development. And we help them. We provide a home for them and nutrients.”
Stollman is chairman of gastroenterology at Alta Bates Summit Medical Center in Oakland, California and past chairman of the American College of Gastroenterology.
Bugs Everywhere
Everyone has an individually unique microbiome, as well as distinct microbiomes in different areas of their bodies. We have microbes, for instance, on our skin and in our mouths, lungs, nasal passages, urinary tract, and especially in our gastrointestinal tract, and some of those microbes indeed are associated with illness. One database offers 5,677 associations between 1,781 microbes and 542 human diseases across more than 20 sites on the body.
Not surprisingly, the gastrointestinal tract was associated with 37 percent of those disease associations, with the oral cavity next at less than 10 percent. However, that doesn’t mean researchers understand this realm all that thoroughly. Dr. Sabine Hazan said more than 95 percent of microbes are still a mystery. A gastroenterologist and researcher, she presented microbiome discoveries from the past four years at the Malibu Microbiome Meeting.
“We have no idea what their names are and what they do, and possibly, they could be the culprit of a disease,” Hazan said. That also means researchers don’t know the precise synergistic roles those microbes play in the body that keep us alive and healthy. This collection of microbes, or flora, remains largely a mystery though it is an area of intense interest to researchers.
Tiny Organisms With Big Jobs
Microbiome studies tend to focus heavily on the gut, where our microbes configure the majority of our immune system. High levels of certain beneficial bacteria help us mount a robust response to invading viruses, for example. We know now that a diversity of flora is protective against disease.
Other processes that happen in the gut are critical to life, including metabolism, hormonal regulation, and neurological function. Various microbes throughout the gut set off a chain of signals to cells that are involved in hormone release and metabolic processes such as insulin sensitivity, appetite, and fat storage. Metabolic disorders such as insulin resistance and diseases of the heart and circulatory system, as well as endocrine disorders that affect organs that rely on hormones, all lean on the microbiome.
Acceptance of the notion that the gut and mental health are connected has ebbed and flowed for decades, but metabolic processes instigated by bacteria can affect both the permeability of the gut lining and flip on inflammatory pathways. Both of these can affect mental health, as well as a plethora of other conditions and physiological systems, and now have wide acknowledgment.
Undoing a History of Hygiene
Historically, even as recently as the COVID-19 outbreak, medicine has been obsessed with pathogenic microbes, while commensal (helpful) bacteria haven’t gotten credit for the grunt work they do to keep us alive and healthy.
The problem is historical, in some sense. It goes back to our earliest concepts of the microbial world, when doctors including Ignaz Semmelweis hypothesized in the 1840s that physicians and medical students were transmitting “death particles” from autopsy rooms where they started their workday to clinics where they delivered babies for the remainder of the day.
That gave rise to the practice of routine hand-washing, with immediate and observable effects. But by the time we learned that many microbes played beneficial roles, there were already massive industries built around the war against microbes. Food processing, chemically treated crops, and overreliance on pharmaceuticals destroyed massive volumes of health-sustaining microbes.
One result of this assault is the seemingly unending dilemma of deadly superbugs that have become resistant to antibiotics. Allergies, asthma, autoimmune disorders, and inflammatory bowel diseases have all been linked to the oversterilization of our microbial environment. Killing microbes is a multibillion-dollar industry.
“Clearly, there are those who will want to defend the past and even the status quo. That is to be expected,” Dr. David Perlmutter, neurologist and fellow of the American College of Nutrition, wrote in his book “Brain Maker.” “I believe it is far more important to break the bonds of these constraints and recognize that our most exciting and respected science is offering us an incredible opportunity to regain our health through the force wielded by the microbiome.”
Medicine’s Philosophical Shift
Medicine is confronted with a crossroads: keep on the current anti-microbial path or reset our medical paradigm around the reality that our various microbiomes help sustain us while also fighting off infection and disease.
Many of the rapidly growing diseases we’re contending with today—such as autism and autoimmune disorders—have now been linked to microbiome health. A combination of lifestyle factors—from foods that feed the wrong microbes, to routine chemical exposures, and unnecessary antibiotics—have undoubtedly taken a toll on our symbiotic microbes and health, Hazan said.
“Have we in essence killed our microbiome? Could it be maybe we’re overdoing it?” she asked.
Concepts that include precision health and personalized nutrition hinge on a broad understanding of the gut microbiome, a race that has spurred investment in new companies with promises that have far outpaced the available research.
Scientists at the Malibu Microbiome Meeting shared absurd claims of products that insinuate one single probiotic can reverse specific diseases.
“To simply believe you’re going to take one pill of one particular bacteria and it’s going to solve your problem and provide some beautiful homeostasis to your microbial ecosystem is absurdly simplistic and is absolutely not true,” Stollman said.
And yet, there are also miraculous case studies indicating incredible promise. Trials are underway, at rapid rates. In fact, more than 80 percent of microbiome research has occurred since 2017, according to Stollman.
“There’s a real mania about the biome. I think the mania is also based not as much on ‘can we improve our health?’ but rather ‘can we diagnose an illness, and treat an illness?’” he said.
The challenge ahead is significant. Beyond fixing outdated medical protocols, like indiscriminate antibiotic use, there is the staggering volume of microbes and microbial interactions that need to be understood. Considering that our cells perform impossible complex chemistry at a scale and intricacy beyond anything modern science can match, imagine the additional complexity of trillions of microorganisms doing something similar.
In the next article:
Microbiome science may be new, but researchers have made undeniable connections between various bacteria and specific diseases. The truth of Hippocrates’s statement that “all disease begins in the gut” is starting to be recognized by today’s scientists.
Amy Denney is a health reporter for The Epoch Times. Amy has a master’s degree in public affairs reporting from the University of Illinois Springfield and has won several awards for investigative and health reporting. She covers the microbiome, new treatments, and integrative wellness.
-
I have people tell me all the time tell me they are taking "good bacteria " for this or that reason.
But do any of these things work ?
just to find the latest update I found only these 2 benefits :
mild improvement in IBS constipation type with bacillus coagulans
and to prevent second bout of C diff with saccharomyces boulardii after antibiotics
so far are only know good study supported benefits of good bacteria
researchers must be having lots of fun trying to figure out the benefits / harms done by 50 trillion bacteria in our guts
then compound that with different amounts combinations in people all with different genetics - well you can get the picture
of how formidable this is.
-
I take this:
https://www.rgarden.com/inner_garden_flora.html
and this:
https://www.rgarden.com/l_salivarius.html
whenever I get gassy/bloated and in short order my digestion improves and I feel better.
-
Big pharma controls medical research with obvious conflicts of interests
resulting in crazy rise in prescription prices
Something I have posted about in past:
https://imprimis.hillsdale.edu/americas-broken-health-care-diagnosis-and-prescription/
recently I posted about the lack of transparency on drug pricing among the middle. men such as pharmacy benefits managers
Author points out the pharma industry also seems make their research less transparent.
not good for the nation as a whole that is going broke ....
-
Imprimis does very good work!
-
https://townhall.com/tipsheet/katiepavlich/2023/04/19/the-data-breach-at-the-consumer-protection-bureau-was-worse-than-we-previously-known-n2622163
I just finished my umpteenth course and protecting health data
literally just this afternoon telling us how we can go to jail , be fined , terminated from employment and any company one works with be sued and have their reputation damaged
then I read the above
I am willing to bet since this is government at fault there will be no one held accountable
what a joke
-
https://en.wikipedia.org/wiki/OK_gesture#/media/File:LG_WHISEN_%EC%86%90%EC%97%B0%EC%9E%AC_%EC%A7%80%EB%A9%B4_%EA%B4%91%EA%B3%A0_%EC%B4%AC%EC%98%81_%EC%82%AC%EC%A7%84_(30)_hand_only.jpg
I have hard time looking at her image and not thinking something is wrong when I see what surgery has produced .
yeah she asked for this and is "happy"
blah blah blah
-
https://en.wikipedia.org/wiki/OK_gesture#/media/File:LG_WHISEN_%EC%86%90%EC%97%B0%EC%9E%AC_%EC%A7%80%EB%A9%B4_%EA%B4%91%EA%B3%A0_%EC%B4%AC%EC%98%81_%EC%82%AC%EC%A7%84_(30)_hand_only.jpg
I have hard time looking at her image and not thinking something is wrong when I see what surgery has produced .
yeah she asked for this and is "happy"
blah blah blah
You might have something else you wanted to post.
-
ET
Study of Popular Drinks Found 95 Percent Contained Plasticizers
HEALTH & SAFETY
Jessie Zhang, Reporter
May 10 2023
Study of Popular Drinks Found 95 Percent Contained Plasticizers
Spanish researchers have found in a study of 75 drink samples that nearly all contained plasticizers—chemical coatings that give plastics their bendy and soft form—and the more sugar, the more plasticizer it had.
Plasticizers are polymer materials added to plastics for desired flexibility and durability, with bisphenol A, also known as BPA, and phthalates being the most commonly used.
They are also used in daily items such as food storage containers, canned foods, and some toiletries.
However, excessive amounts of plasticizer in food can cause serious damage to the liver, kidneys, and reproductive system.
It has also been linked to causing miscarriages, birth deformities, and even cancer.
Published in Environment International, the researchers analyzed water, cola, juices, wine, and hot drink samples and found that regardless of the packaging, added sugar was found to make the most significance.
“Our results show that more than 95 percent of the beverages have at least one of the 19 plasticizers that we analysed, which shows the ubiquity of these compounds and our exposure to them in our day-to-day lives,” Julio Fernández Arribas explained.
Fernández Arribas is the first author of the study and a researcher from the Institute of Environmental Assessment and Water Research (IDAEA) of the Spanish National Research Council.
They detected the highest levels of contamination in sugary soft drinks and juices with added sugars, with averages of 2,876 nanograms per litre and 2,965 ng/L, respectively.
The lowest levels of contamination were found in bottled water (2.7 ng/L) and coffee (24 ng/L), followed by wine, sugar-free soft drinks, tea, and juices without added sugars.
Barcelona’s tap water had significantly higher levels than bottled water, with 40.9 ng/L and 2.7 ng/L of plasticizer, respectively, which the researchers said is due mainly to the chemicals that may come from the plastic water pipes Spain uses.
Epoch Times Photo
The more sugar, the more contaminated by plasticizers. (Shutterstock)
“One of the most striking results was to observe that sugary beverages had higher levels of plasticizers, especially due to the presence of 2-ethylhexyldiphenyl phosphate (EHDPP),” IDAEA researcher and main author of the study, Ethel Eljarrat, said.
EHDPP is related to an increase in the risk of suffering from some types of cancer, such as breast and uterine cancer.
Surprisingly, packaging type—glass, plastic, or can—wasn’t critical in determining the plasticizer levels in drinks.
They found that plastic coating on metal caps of glass bottles releases eight separate compounds into the drinks, and in the case of one brand of juice, the glass bottle contained ten times higher plasticizer levels than the other packages.
Top Sugary Beverages
Sugar-sweetened beverages are prevalent in Australia, especially among young adult males, foreshadowing continued population weight gain and high burdens of chronic disease.
A population study of 3,430 adults found that almost half of Australian adults had consumed a drink that was high in sugar in the past week.
Consumption of fruit juices was the most prevalent at nearly 40 percent, followed by soda at 29 percent, artificially-sweetened soda at 18 percent, sports drinks at eight percent, and energy drinks at four percent.
In line with previous research from the U.S., the UK, and Norway, higher soda consumption was linked with males, younger age, socio-economic disadvantage, frequent takeaway food consumption, obesity, and a diagnosis of heart disease or depression.
Additionally, the levels of plasticizers in Australian food are generally low, according to Food Standards Australia & New Zealand’s (FSANZ) latest survey.
They analysed seven phthalate, adipate, and citrate plasticisers that may be used in food packaging materials.
“Estimated dietary exposure for Australian consumers was below internationally recognised Health-Based Guidance Values, and no appreciable health risks have been identified for the Australian population,” FSANZ said.
-
https://www.theepochtimes.com/health/inhaled-microplastics-could-affect-sex-hormones_5257598.html?utm_source=Health&src_src=Health&utm_campaign=health-2023-05-15&src_cmp=health-2023-05-15&utm_medium=email&est=QFUu10nE4Do4mIgHT02diRbPkllLBufRJL7C5ynaMOA3LSWqC3CotX8OECsrH1%2FscRWF
Inhaled Microplastics Could Affect Sex Hormones
Irina Antonova
May 11 2023
Inhaled Microplastics Could Affect Sex Hormones
Microplastics may be more dangerous than first thought after a new study demonstrated that the substances were not only dangerous as chemicals but could also produce a hormone-disrupting effect when inhaled.
For humans, disruptions to sex hormones can impact the body’s fertility and metabolism, which researchers argue could be behind the recently declining fertility and increasing obesity rates around the globe.
Additionally, inhalation of such plastic chemicals can also generate pulmonary inflammation, as well as cardiovascular dysfunction and systematic inflammation.
MNPs can be found both in indoor and outdoor environments making it hard for humans to avoid them.
The trial, which was undertaken by the Rutgers laboratory, showed that MNPs (microscale and nanoscale particles) of the known plastic polyamide—also known as nylon—can produce endocrine-disrupting effects when inhaled by female rats in laboratory conditions, using concentrations that are experienced by humans.
“This is one of the first studies to show endocrine disrupting effects from a plastic particle itself, not based on exposure to the plasticizing chemical,” explained Phoebe Stapleton, PhD, assistant professor at the Rutgers Ernest Mario School of Pharmacy and senior author of the study, in an interview for Rutgers Research.
“Previous research has focused almost exclusively on chemical additives,” Stapleton clarified.
The Study
Scientists noted that if they were to “assess the toxicological consequences of a single inhalation exposure,” they would need an innovative method of study to create airborne microplastics.
To this end, they used a very fine food-grade nylon powder (their MNPs model), which they placed on a rubber pad on top of a bass speaker so that the bass pulse dispersed the nylon in the air for the rats to breathe. They then assessed the toxicological effect of a single 24-hour exposure to MNPs by the female rats and estimated the pulmonary deposits of MNPs and their impact on the lungs, cardiovascular, systematic and endocrine systems.
“Previous studies have injected animals with the particles being studied or fed them to them. We figured out how to aerosolize the MNP to be inhaled just as we breathe it in real life. We expect many labs to use this method for experiments going forward as it better mimics actual exposure,” Stapleton said.
The researchers found that the inhaled particles deposited throughout the rats’ lungs, but this did not lead to significant lung inflammation.
What they did see, though, was an impairment of the animal’s cardiovascular function and that the levels of the reproductive hormone 17 beta-estradiol had decreased.
They explain that the latter was due to the fact that polyamide has a high affinity with estrogenic compounds, which can act as an endocrine disruptor in biological settings.
The main concern of the scientists is that the MNPs have similar effects on humans, and though it is not new that plastics can be harmful to us, the fact that those most microscopic particles are now in the air and we are breathing them is new and worrisome.
“Unfortunately, there’s very little that people can do to reduce exposure at the moment. You can be aware of your flooring, wear natural fibres and avoid storing food in plastic containers, but invisibly small plastic particles are likely in nearly every breath we take,” Stapleton said.
The authors conclude their paper with the hope that more knowledge on the issue will be helpful, “The pervasive nature of MNPs and their adverse effects as presented in this study highlight the need for better understanding of MNP toxicities to support consumer choice, regulatory policy, and environmental remediation.”
What are MNPs?
Microscale (microplastics) and nanoscale (nanoplastics) particles (MNPs) refer to tiny plastic fragments that are less than 5 millimetres and less than one micrometre in size, respectively.
They are a type of plastic pollution that is increasingly becoming a concern due to their widespread presence in the environment.
Microplastics are generally formed through the breakdown of larger plastic items, such as bottles, bags, and packaging materials, as well as from the degradation of synthetic fibres used in textiles.
Nanoplastics, on the other hand, can be intentionally manufactured at the nanoscale or result from the further degradation of microplastics.
These particles are pervasive in various environmental compartments, including oceans, rivers, lakes, soils, and even the air.
They have been found in diverse ecosystems, from the deep sea to the Arctic, and have been detected in numerous organisms, including marine life, birds, and even humans.
The presence of microplastics and nanoplastics raises concerns due to their potential adverse effects on ecosystems and human health.
Marine animals may ingest these particles, leading to physical harm, inflammation, and disruption of their digestive systems.
Additionally, microplastics can act as carriers for toxic substances, such as persistent organic pollutants and heavy metals, which may accumulate in the food chain.
Although research on the impacts of nanoplastics is still in its early stages, there are concerns about their increased mobility, potential for cellular uptake, and interactions with biological systems, as the small size of nanoplastics could enable them to cross cellular barriers and have a more significant impact on organisms.
Efforts are being made to reduce plastic pollution at its source and develop sustainable alternatives.
Additionally, research is ongoing to better understand the environmental fate, behaviour, and impacts of microplastics and nanoplastics, as well as to develop effective detection and monitoring methods.
-
https://www.theepochtimes.com/health/toxic-chemicals-used-to-make-plastics-found-in-many-otc-medications_5307867.html?utm_source=Health&src_src=Health&utm_campaign=health-2023-06-07&src_cmp=health-2023-06-07&utm_medium=email&est=jkDrLYJMIKRtrpDgkvjiERak0Pro6gbWeNmaP038xknLU%2FI5dZDiJZAGTWX%2F%2FApVXrrU
-
second
https://www.theepochtimes.com/health/health-expert-says-most-dangerous-food-is-not-red-meat_5312271.html?utm_source=Health&src_src=Health&utm_campaign=health-2023-06-07&src_cmp=health-2023-06-07&utm_medium=email&est=TB%2BlU6GQ0xYPI7QV8b3DvMYUjCHTP1cLbOcXtY1B8dMzRLjpll65I9d7II%2BjpdCbLlsP
-
https://www.wsj.com/articles/otc-birth-control-pill-4c180a93
the day after pill is already otc
funny how these things always are announced by WSJ.........
-
https://www.theepochtimes.com/health/research-finds-safer-way-to-detect-colon-polyps-5372452?utm_source=Health&src_src=Health&utm_campaign=health-2023-07-25&src_cmp=health-2023-07-25&utm_medium=email
-
very interesting
the study of the microbiome is very interesting
yet so far, so poorly understood
-
In my very layman amateur way I have been following this over time and whenever I feel bloated or other digestive unease I take:
https://www.rgarden.com/inner_garden_flora.html
https://www.rgarden.com/l_salivarius.html
I get the argument that doing so is "unnatural" but I think of it rather as a matter of counteracting the unnatural presence of anti-biotics in our food supply.
Regardless, my empirical experience is quite positive.
-
https://www.theepochtimes.com/mkt_app/health/antibiotics-linked-to-increased-risk-of-kidney-stones-5426967?utm_source=Bright&src_src=Bright&utm_campaign=bright-2023-08-04&src_cmp=bright-2023-08-04&utm_medium=email&est=%2BEazwypJo%2BGU8Fog9vL9QLihUwrGDcnHBZ0W0ttOaW62fhx1UDZAmyGXj%2BWZ72IHt%2F%2Fe
-
https://www.theepochtimes.com/mkt_app/health/statins-the-lesser-known-dangers-and-a-good-alternative-5450083?utm_source=Health&src_src=Health&utm_campaign=health-2023-08-15&src_cmp=health-2023-08-15&utm_medium=email&est=SV6u0ek0pLx406JY1vPEnFB4tx7HWGEjp7FQdheOoSGJuVrHo32ZRb%2BcwAoJPRWOwxnS
Statins: The Lesser-Known Dangers, and a Good Alternative
FEATUREDDRUGS & TREATMENTS
Vance Voetberg
Vance Voetberg
Aug 12 2023
biggersmaller
(joel bubble ben/Shutterstock)
(joel bubble ben/Shutterstock)
0:00
5:52
1
For decades, statins—the most common cholesterol-lowering medications—have been recognized as a lifesaver for those with heart disease. While statins have revolutionized heart health in a positive way, some studies highlight the lesser-known concerns of the medication: energy-sapping, increased diabetes risk, and, for many people, muscle pain.
The Puzzling Link Between Statins and Insulin Resistance
A recent systematic review of 11 epidemiological studies with nearly 47 million participants found associations between statin use and decreased insulin sensitivity, as well as insulin resistance—both significant factors for developing Type 2 diabetes. Additionally, statins were found to reduce glycemic control and elevate fasting glucose levels.
Experts are uncertain about the precise mechanism through which statins might impact insulin resistance, considering their advantages, such as lowering inflammation, decreasing oxidative stress, and enhancing endothelial function—all of which actually improve insulin sensitivity rather than diminish it.
A 2021 study published in the journal Arteriosclerosis, Thrombosis, and Vascular Biology also found that statins can increase the risk of Type 2 diabetes, but how was unclear. In weighing the potential risks of statins, however, most researchers and health care professionals still believe them to be more beneficial than harmful.
“It is generally viewed that the strengths of lower cholesterol by a lot outweigh a modest increase in insulin resistance,” Michael Snyder, a genetics professor and chair of the Genetics Department at Stanford University School of Medicine, told The Epoch Times.
But the double-sided nature of statins remains unclear to researchers, added Dr. Snyder, who has coauthored multiple studies investigating the correlation between statin usage and insulin intolerance.
Lifestyle factors like obesity also play a major role in insulin resistance. Insulin resistance is often associated with high body weight, which individuals can reduce to potentially offset statins’ effects, Dr. Snyder said.
Why Do Statins Drain Energy?
Fatigue and muscle pain seem to be common with statin use. A study of over 350 statin users found that 93 percent reported muscle pain and fatigue, while 85 percent reported weakness.
“This is of no surprise because of the well-documented effects that statins have on Coenzyme Q-10 (CoQ10), which is a primary cofactor for mitochondrial function,” Dr. Node Smith, a board-certified naturopathic physician, told The Epoch Times. Mitochondria create energy for the entire body at the cellular level. Therefore, in practical terms, statins can deplete the body’s cellular energy by depleting CoQ10, he added.
A letter to the editor published in the British Journal of Clinical Pharmacology noted that people taking statins who also supplemented with CoQ10 were less likely to experience chronic fatigue.
Dr. Smith said many of his patients who have taken statins long-term have reported experiencing persistent muscle pain, weakness, fatigue, and brain fog. “Some of these patients are avid athletes and simply are confused why they can no longer work out,” he added. “If I see this presentation in someone on a statin medication, I will almost always assume the statin is at least a contributing factor and discuss with the patient its removal and replacement with another therapy.”
Your Health Matters
Ads By logo
img-responsive
Diabetes Is Not From Sweets! Meet The Number One Enemy
Healthy Blood Sugar
img-responsive
Doctor: Your Hair Will Grow Like Crazy (Try This Tonight)
Regrow Hair Formula
Is Vitamin B3 an Alternative to Statins?
Statins are commonly used alongside niacin (vitamin B3), recommended for over 40 years to prevent heart disease due to the vitamin’s positive impact on lipid levels.
Niacin is the most common and effective treatment that replaces statins, according to Dr. Smith. “Of all the pharmaceutical medications I’ve helped people get off of, statins are the easiest, least concerning, and patients typically have the best results with—because it is not uncommon for them to feel almost instantly better.”
Niacin decreases LDL cholesterol, which can build up plaque in arteries when levels are too high. It also increases HDL cholesterol, which absorbs other forms of cholesterol in the bloodstream and carries it back to the liver for removal, according to a clinical trial of over 300 people. Additionally, niacin lowers triglycerides, a type of fat in the blood.
Optimized niacin therapy costs patients $15 to 30 per month and is worth trying before statins, Dr. Smith added.
Studies have found that combining niacin and statins may outperform statins alone. Dr. Smith has observed similar results in his practice, although some studies suggest otherwise.
Niacin fell out of favor due to the side effect of niacin flushing, which produces a slight prickly heat sensation for about 30 minutes and can be quite concerning and uncomfortable for some people, he said.
About 15 years ago, wax-coated niacin tablets were developed. They allow high doses of niacin to be delivered while reducing flushing for most people, according to Dr. Smith. Side-effect management methods like taking niacin with food or baking soda can also help.
However, Dr. Smith cautioned that people with familial hypercholesterolemia, a genetic disorder, may need more aggressive therapies, potentially including statins.
-
"Niacin fell out of favor due to the side effect of niacin flushing, which produces a slight prickly heat sensation for about 30 minutes and can be quite concerning and uncomfortable for some people, he said"
not true .
niacin fell out of favor because it was not found to reduce cardiovascular events.
Almost never used today
interesting too that Niacin can also increase glucose
and muscle pain and gout and liver
For a while I was taking max dose naicin 2 grams 3 x per day
my good cholesterol went up and my bad down
the flushing was tolerable
aspirin was used in attempt to reduce flushing though I don't remember if it helped or not.
I oversaw a study with a niacin aspirin mix in 1990.
in the end studies revealed that while niacin a B class vitamin did have benefits on cholesterol numbers this did not translate to lower heart attacks or strokes
-
Her assertion that fat adds to the effects of high glycemic carbs is contrary to my understanding see e.g. Barry Sears "Enter the Zone":
Doctors Reveal a ‘Main Culprit’ for Heart Disease
FEATUREDHEART DISEASE
Marina Zhang
Marina Zhang
Aug 15 2023
High blood cholesterol has been a central focus in cardiovascular disease for decades. However, doctors are now challenging this emphasis, proposing that this may have caused health practitioners to overlook a critical culprit: insulin resistance.
Why Insulin Resistance Is a Cause for Concern
Dr. Robert DuBroff, a cardiologist and professor from the University of New Mexico, had a patient who suffered multiple cardiovascular events. The patient underwent coronary artery bypass three times and had been treated aggressively with statin medications, but his cardiovascular events continued.
Dr. DuBroff noticed that his patient’s blood sugar was borderline prediabetic and that he was overweight. However, none of these risk factors was addressed by previous doctors. Once these factors were addressed, the patient stopped having additional problems.
Insulin resistance is the leading cause of Type 2 diabetes and an indicator of metabolic health. One study found that over 80 percent of Americans were metabolically unhealthy, with nearly half prediabetic.
Type 2 diabetics face at least a twofold risk of developing cardiovascular disease, and most die from cardiovascular events. However, this is often missed in the literature, professor Ian Givens, specializing in nutrition at the University of Reading, told The Epoch Times.
“The certification of death says cardiovascular disease; doesn’t say diabetes, which is technically true because that is what they’ve eventually died from,” clarified Mr. Givens. However, this perspective overlooks crucial information: It was diabetes that led the person to die from heart disease.
What Is Insulin Resistance?
Insulin, a hormone released into the bloodstream when blood sugar rises after a meal or sugary consumption, directs the body’s fat, liver, and muscle cells to absorb the blood sugar, restoring normal blood levels.
Insulin resistance occurs when the body’s cells no longer respond to insulin.
Consequently, the brain signals pancreatic beta cells, responsible for insulin production, to secrete more insulin to help.
Over time, the body’s insulin resistance intensifies, ultimately causing beta cells to deteriorate and die off. Then, blood sugar gets out of control.
Insulin Resistance and Heart Disease
In an article published in The Pharmaceutical Journal, the official journal of the Royal Pharmaceutical Society, renowned Drs. Aseem Malhotra and Robert Lustig wrote that insulin resistance is the “main culprit” of heart disease.
Healthy Blood Sugar
Insulin resistance contributes to all of the major heart disease risk factors.
Atherosclerosis
Atherosclerosis involves the development of plaques within blood vessels and eventual cardiovascular events such as heart attacks.
Insulin resistance results in chronically elevated insulin levels in the body, which promotes chronic inflammation. This impairs blood vessel linings and fosters plaque creation. Additionally, inflammation heightens platelet activation, increasing vulnerability to blood clotting.
High insulin also contributes to dyslipidemia—an imbalance in blood lipids, or fats. Dyslipidemia manifests as high blood triglycerides, low HDL cholesterol, and high LDL cholesterol levels, with insulin influencing all three components.
As a storage hormone, insulin tells the liver to package ingested calories into triglycerides to be distributed across the body for storage, elevating blood triglyceride levels.
Insulin suppresses HDL particle formation, reducing the “good” HDL cholesterol. When insulin levels increase, proteins that break down HDL particles also increase, which can cause an increased clearance of HDL particles from the blood.
“The HDL particle’s job is to bring lipids from the body back to the liver,” where they will “be recycled,” explained Mr. Bikman, who has a doctorate in bioenergetics and is a cell biology and physiology professor specializing in metabolic disease and the pathological effects of insulin at Brigham Young University. “But the insulin doesn’t want energy to be returning.”
Insulin also promotes the generation of atherogenic, small, dense LDL particles instead of the more harmless, larger buoyant ones.
Hypertension
Insulin increases heart rate and blood pressure. One way it does this is by activating the sympathetic nervous system.
The sympathetic nervous system is responsible for activating the fight-or-flight response, usually activated during periods of stress. But insulin can trigger a similar reaction. During the fight-or-flight response, adrenaline and cortisol are released into the bloodstream, blood pressure rises, and the heart beats faster.
Apart from acting as a hormone for storage, insulin also promotes growth, which can cause the inner lining of the blood vessels to thicken, increasing blood pressure.
Obesity
Elevated insulin levels lead to the storage of consumed sugar as fat instead of promoting its immediate consumption for energy, explained nephrologist and metabolic expert Dr. Jason Fung. This is also why meals high in carbohydrates, triggering insulin spikes, often induce hunger more quickly.
Preventing Insulin Resistance
1. Reduce Refined and Starchy Carbohydrate Consumption
Insulin is uniquely sensitive to glucose, so cutting down on sugary and starchy foods can prevent spikes in blood glucose and insulin levels. Any food that’s sweet, crunchy, or comes in packaging is usually high in carbohydrates, according to Mr. Bikman.
Complex carbohydrates such as vegetables, legumes, and low-glucose fruits primarily consist of dietary fiber and have a minimal impact on blood sugar levels and insulin resistance.
Consuming fat and simple carbohydrates together is worse than consuming only carbohydrates or only fat. Although fat is calorically dense, fat by itself does not trigger insulin. However, in the presence of sugar or starches, insulin levels rise and stay up longer, Mr. Bikman said. Studies show that foods that combine sugar and fat increase cravings, stimulating overeating.
2. Practice Fasting, Chew Thoroughly
During fasts, no food is ingested, meaning there is no rise in blood sugar or insulin.
Fasting promotes the breakdown of fat in fat cells for energy and improves insulin sensitivity, according to a 2021 review.
According to Mr. Bikman, insulin resistance usually first starts in the fat cells.
Fat cells are the body’s primary storage sites of calories, including sugar, acting as the energy warehouse.
Fat cells can also expand up to 20 times their original diameter to accommodate more energy. However, “when fat cells get too big,” Mr. Bikman explained, insulin wants the fat cell to continue growing, but the cell has reached maximum dimension. “They become insulin resistant.”
Breaking down fat in these fat stores frees up room in the warehouse, thereby improving insulin sensitivity.
Chewing food thoroughly also helps.
Eating too quickly can result in swift spikes in blood glucose, triggering a robust insulin response. It is also linked with poorer satiety, making the person more likely to snack after the meal.
3. Sleep, Build Muscle
Adequate sleep prevents stress and inflammation, which contribute to elevated blood glucose levels and insulin resistance.
Muscles are the primary consumers of glucose, utilizing up to 80 percent of ingested glucose daily. If an individual maintains their previous sugar intake while their muscle mass decreases, excess sugar cannot be entirely burned and gets stored as fat.
Resistance training is the most effective exercise for increasing muscle mass. These exercises stimulate the release of testosterone and growth hormones, facilitating muscle development and boosting metabolic rates.
RELATED TOPICS
insulin resistanceheart diseasesugar
Marina Zhang
Marina Zhang
Marina Zhang is a health writer for The Epoch Times, based in New York. She mainly covers stories on COVID-19 and the healthcare system and has a bachelors in biomedicine from The University of Melbourne. Contact her at marina.zhang@epochtimes.com.
-
good article
every extra pound of muscle added increases basal metabolic rate ~ 50 Kcal per day
I recently got back into weights - ***4530.592*** grams in each arm !!! :))
[ 10 pounds - :(( ]
-
https://www.theepochtimes.com/mkt_app/health/2-strange-ways-medicine-is-manipulating-the-microbiome-5468145?utm_source=Health&src_src=Health&utm_campaign=health-2023-08-23&src_cmp=health-2023-08-23&utm_medium=email&est=3kyXF84Vo3QZ1NEZ8QSm7vqfP%2B%2F9DzGKA3qBfpzKZdt%2BIIakbYWsHP%2BuFElngeFMV2lf
-
https://www.yahoo.com/finance/news/biden-administration-targets-drugs-from-jj-merck-for-controversial-medicare-price-negotiations-114618490.html
I believe this is a good thing towards "saving" Medicare.
Not sure what the overall effect will be. Will the pharmas then simply increase the prices of private insurance costs to make up for this?
I am not privy to the price elasticity but would lowering the price thus increase overall sales and be a wash in the end for the pharmas.
What will it mean for pharmacy benefits managers?
-
https://www.theepochtimes.com/health/gut-microbiome-may-be-key-in-treating-lyme-disease-5475521?utm_source=Health&src_src=Health&utm_campaign=health-2023-09-07&src_cmp=health-2023-09-07&utm_medium=email&est=u7jfNlqlwUDPCt2Y83eKWgD5KQDlK8EG2J%2FkEY9VtrjnKZ%2Fk%2BXfEZm1yPOToPzsiFYBT
-
one clear reason Medicare must be able to negotiate lower drug prices
is the obvious fact Medicare will soon be bankrupt
the newer drugs are much better then older drugs
but the costs are very high.
We need to negotiate
for the future of Medicare
that and Social Security are the big drivers of debt .
alternative is we see the debt continue to increase and HHS and SSA go bust .
I know not "free market"
but a big provider like Medicare NOT negotiate is NOT free market either.
as hospitals continue to merge buy up all the local health care delivery
and insurers continue to grow and negotiate advantage plans through Medicrare,
then Medicare should also negotiate with big pharma
I think this will help people get better drugs and reduce costs
though I admit I am not sure about this supposition
-
A Gut Microbe That Heals the Gut Is Dying Off
L. reuteri is fading from the microbiome even as we discover more of its benefits
One bacteria that can reverse gut problems is going extinct.
A Gut Microbe That Heals the Gut Is Dying Off
Not many people have L. reuteri bacteria in their gut anymore, which might explain the rise in small intestinal bacterial infections. (Shutterstock)
Amy Denney
By Amy Denney
9/9/2023
Updated:
9/12/2023
Print
X 1
0:00
12:39
Donna Schwenk’s kitchen is overflowing with bacteria—something that comes as no surprise after more than two decades of culturing food for healing, first as a personal mission to heal her baby and now for her business.
Still, she was a bit reluctant to try out a new bacteria. Afterall, her health was in tip-top shape, and her business, Cultured Food Life, was growing. Author of three bestselling books and podcast host, Ms. Schwenk had her hands full with her courses teaching others the ins and outs of how to make their own fermentation labs at home.
She reluctantly began culturing yogurt with a new bacterial strain—Limosilactobacillus (formerly Lactobacillus) reuteri at the encouragement of Dr. William Davis, a cardiologist and author of several books including “Super Gut.” Dr. Davis also asked her to eat it daily for a year.
RELATED STORIES
Causes and Alternative Treatments for SIBO
6/9/2023
Causes and Alternative Treatments for SIBO
Rising Gut Dysbiosis Rates Point to How Nature's Microbiome Impacts Our Own
10/21/2022
Rising Gut Dysbiosis Rates Point to How Nature's Microbiome Impacts Our Own
“It blew my mind. I thought I was really smart. I thought I knew everything,” she said. “They use L. reuteri to clean fermentation vats because it’s so strong."
Ms. Schwenk said the human gut is also a fermentation vat or sorts since it nurtures the growth of many different bacteria, some of which may also need to be cleaned out. That's where L. reuteri comes in.
"It will kill all the other [microbes] that don't belong there, and it will thrive. That’s why it’s working so well for people, because in that upper gastro area, without L. reuteri, you start having problems if you get other bacteria in there.”
Advertisement - Story continues below
Ms. Schwenk began offering it to friends, including one who had chronic diarrhea and couldn’t leave the house. Relief from pain and embarrassment came in just a few days. Other testimonies included improved energy and mental health, less muscle fatigue, easier breathing, appetite suppression, and more.
A single bacterial species can have widespread effects in the gut by altering the entire community microbes in the human microbiome—the total collection of bacteria, viruses, and fungi.
In the case of L. reuteri, it inhibits the growth of pathogenic species while remodeling the biome, benefits host immunity, and decreases the translocation of bacteria out of the gastrointestinal tract into the bloodstream or lymphatic system—believed to be a root cause of autoimmune disease.
L. Reuteri’s Origins
Discovered in 1962, L. reuteri colonizes human gastrointestinal tracts and can withstand a wide range of pH environments, making it a rare beneficial bacteria that can proliferate in the small intestine. Typically, bacterial overgrowth in the small intestine can lead to digestive problems, but not with L. reuteri. Back when it was discovered, L. reuteri was found in about 30 percent to 40 percent of the population. A Science Daily article in 2010 said its presence had shrunk to 10 percent to 20 percent by then. Dr. Davis and others claim its level is now at 4 percent.
Advertisement - Story continues below
Like many other bacteria that are disappearing from the human microbiome, L. reuteri’s extinction is connected to antibiotic overuse, glyphosate, emulsifiers in processed food, and stomach acid blockers. Dr. Davis told The Epoch Times that L. reuteri is quite susceptible to death by antibiotics.
“Even though reuteri is ubiquitous in mammals and in indigenous human population like New Guinea or in the Brazilian rainforest, almost nobody in the modern world has reuteri anymore because we’ve all killed it,” he said.
It’s believed that L. reuteri is conferred to infants from breastfeeding mothers. Samples of breast milk from different regions in a 2008 study in Microbial Ecology in Health and Disease illustrate the differences between the bacterial makeup of breastmilk by country. Breastfeeding translates to greater protection against childhood diseases such as asthma and obesity.
About half of the mothers from Japan and Sweden had L. reuteri. Mothers in South Africa, Israel, and Denmark had very low or undetectable levels. Urban and rural living did not appear to play a significant role, though the authors speculated that diet could be a factor. The Japanese diet, for instance, is high in functional, probiotic, and fermented foods.
A Stanford University study comparing diets high in fiber to those high in fermented foods lends credibility to the idea that eating foods rich in probiotics diversifies gut bacteria. Those randomly assigned to fermented food diets for 10 weeks more quickly expanded their microbiomes and also displayed decreases in molecular signs of inflammation associated with disease, according to the results published in 2021 in Cell.
L. Reuteri and Gut Infections
L. reuteri appears to have a bi-directional relationship between gut health and disease. Several studies show that L. reuteri’s antimicrobial properties are nature’s version of an antibiotic—capable of protecting the body from gut infections.
There are various strains of L. reuteri that undergo a metabolic process which produces lactic acid, acetic acid, ethanol, and/or reutericyclin. These metabolites have proven effective against pathogens including Escherichia coli, Clostridium difficile, Salmonella, and Helicobacter pylori (H. pylori), according to a 2018 Frontiers Microbiology review article.
H. pylori infections are a major cause of chronic gastritis and peptic ulcers, in addition to a risk factor for gastrointestinal (GI) cancers. L. reuteri supplementation is particularly effective at decreasing the bacterial load of H. pylori when both are competing for food and resources. Some studies have shown L. reuteri has the potential to completely eradicate H. pylori.
A Frontiers Immunology review article published in August explains L. reuteri’s mechanism of action like this: the microbe is able to resist the acidic environment of the small intestine and adhere to intestinal epithelial cells where it begins to regulate intestinal flora, enhance the mucosal barrier, regulate immune cells, improve antioxidant activity, and regulate the immune system of the host.
L. reuteri has been successfully used in GI diseases like colic, which can affect as many as 20 percent of newborns, and diarrhea. One way this pathogenic antagonist does this is by secreting exopolysaccharide, which is able to form mucus that tightens junctions in the intestinal mucosal barrier and begins healing GI damage.
L. reuteri bacteria have the ability to produce mucus that helps intestinal barrier form tight junctions that can better keep pathogens and toxins from entering the blood stream.
L. reuteri bacteria have the ability to produce mucus that helps intestinal barrier form tight junctions that can better keep pathogens and toxins from entering the blood stream.
The Rise of SIBO
It’s a logical theory that L. reuteri’s disappearance is linked to small intestinal bacterial overgrowth (SIBO), which makes its reintroduction to the GI tract a compelling alternative to harsh prescription antibiotics for the condition.
SIBO is the presence of excessive bacteria in the small intestine that cause symptoms like abdominal pain, bloating, diarrhea, and sometimes malabsorption. Stomach acid and peristalsis (contractions that move food through the digestive tract) are protective mechanisms designed to protect the small intestine against excessive bacterial growth. Most non-specific gastrointestinal complaints are now considered to be SIBO.
“The SIBO gets pushed back by this microbe. There’s a variety of ways to gauge that, including if you test,” Dr. Davis said.
Besides breath tests that measure the amount of hydrogen or methane that you breathe out, inflammatory markers, blood pressure, body mass index, triglycerides, and symptoms related to inflammatory bowel disease have been associated with SIBO and impacted by L. reuteri, according to Dr. Davis.
Diseases Associated with L. Reuteri
Weak intestinal barriers—sometimes called “leaky gut”—have been implicated in a number of diseases, particularly autoimmune diseases. According to the 2018 review, many studies have shown that L. reuteri induces anti-inflammatory regulatory T cells, or Treg cells, which play a role in preventing autoimmunity, suppressing cytokine storms, and limiting chronic inflammatory diseases.
This makes L. reuteri a good candidate for disease prevention, as well as symptom management. “Indeed, the therapeutic potential of various L. reuteri strains has been studied in diverse diseases and the results are promising in many cases,” the study said. “The safety and tolerance of L. reuteri has been proven by the numerous clinical studies.”
Among some interesting studies:
Colon Cancer: Low levels of L. reuteri and reuterin levels are linked with colon cancer, according to research published in Cell in 2022. The study found L. reuteri was protective against tumor formation in the colon, with L. reuteri and reuterin levels reduced in mice and humans with colon cancer. In mice, both the bacteria and its metabolite were found to decrease tumor growth and prolong survival.
Obesity and depression: One L. reuteri strain was shown in a 2023 Frontiers in Pharmacology study to alleviate depressive-like behaviors and obesity co-morbidities in mice. They experienced improved blood lipids and insulin resistance. The bacteria also reduced liver inflammation, tightened intestinal junctions, and alleviated dysbiosis, or the overall imbalance of gut microbes.
Constipation: Use of L. reuteri for symptoms of gas, abdominal pain, bloating, and incomplete defecation led to better outcomes over a placebo in a double blind trial published in 2017 in Beneficial Microbes.
Proceed with Caution
While this microbe is very promising, there are some caveats. First, there are many different strains of L. reuteri that appear to have specific applications.
Also, as the 2023 review article warned, host genetics, and epigenetics—particularly diet— appear to diversify immune responses. Other issues of concern are dosing, how well studies are designed with subjects and controls, the length of intervention, and the synergistic effect of multiple strains, which could be beneficial but potentially damaging.
“[M]ixed strains might get out of control due to the inconsistent reproduction speed of each strain, thus disturbing the balance and hindering the control of microecology,” according to the review.
Weak strains were a concern for Dr. Davis, which is why he cultured the bacteria in yogurt using a supplement dose intended for newborns (the only one available when he began his investigations). Using flow cytometry, he was able to ferment and multiply the dose from 100 million to 300 billion.
Compared to other yogurts, it’s a bit harder to culture—requiring a sustained temperature of 100 degrees for 36 hours—and it appears that permanent gut colonization is unlikely so it would have to be maintained through diet, Dr. Davis said. The microbe is getting a lot of attention, however, with 21 studies in 2005 growing more than 200 last year in the PubMed database.
“So far every observation made in mice is proving true in humans, seen anecdotally and in clinical trials,” Dr. Davis said. “In other words, a lot of the modern phenomenon, we’re seeing recede by recolonizing the upper intestine with reuteri.”
The only people who should be cautious with L. reuteri—or take reduced doses—are pregnant or menstruating women and children, he said. That's because when women go into labor, their oxytocin levels surge. Another way L. reuteri is believed to work is by increasing production of oxytocin, the so-called “love” hormone that facilitates bonding, though the mechanism of action is not well understood.
-
https://www.theepochtimes.com/health/astounding-feats-of-the-brain-in-your-gut-5354708?utm_source=Health&src_src=Health&utm_campaign=health-2023-09-13&src_cmp=health-2023-09-13&utm_medium=email&est=E11g2fu24tiQT4kjx1zIAhyZdpWlNLtGwH6YfYLRJsFNhbWLvex5lYI4DFEYTTHO2vhA
-
https://www.theepochtimes.com/health/the-growing-threat-doctors-and-patients-are-creating-5491895?utm_source=Health&src_src=Health&utm_campaign=health-2023-09-19&src_cmp=health-2023-09-19&utm_medium=email&est=zsMHgNeyYE6LV754uWGX47uyYrHMiCqu1QVvq94%2FFGi4WYkaVL9TgR%2BKvPSoTG9uxW4R
-
thanks for the article
CD
I am careful when I read that such and such % of antibiotics prescribed are not needed
because "need" is not clear cut
Need is determined by academic types and epidemiologists who look at trends
Where I worked we were being compared to peers (on how often we were prescribing antibiotics) with the goal of cutting back
At some point the company even tied bonuses to keeping rates down.
I explained to them that is never a good idea - clouding physicians best judgement with financial gain in withholding medicines.
I also explained that if our bonuses were tied to keeping rates low then doctors will begin to game the coding documenting game by coding other diagnosis that are not really included in the "data"
For example if a person is diagnosed with "sinus infection" and coded that way the bean counters will match all visits of "sinus" diagnoses to the number prescribed antibiotics
if the % is too high doctor will not get bonus
Well as I explained to them doctors will, with bonus in mind then code the visit for other diagnoses not included in the calculation to avoid having too many sinus and antibiotic prescription visits.
I saw this back the in the mid to late 90's when I did in hospital Medicare chart reviews.
OTOH it is very very hard to refuse an antibiotic to a patient who "knows " they need one , though doing so has become easier in recent yrs
due to education of patients
Some patients learn to game the system too . Telling us signs and symptoms and exaggerating how long they are sick in order to better meet antibiotic necessity guidelines.
The "game " is played on both sides.
After the above events came true as expected they stopped tying bonuses to how many antibiotic prescribed
As far as the need for antibiotics for root canals I honestly know little about that since I am not a dentist.
Probably not needed but may be safer to give if patient has serious other medical co morbid conditions putting them at higher risk for infection or serious infection.
Funny thing about *data*
On one hand the "gold standard" is always based on population data .
If there is no measured benefit or the risk to benefit is negative on populations we should generally speaking not treat an individual this way.
Recently Fauci when confronted on cable that the best most recent study of population data seemed to demonstrate mask wearing is a waste of time for corona prevention.
His response was quite telling about his dishonest nature.
He stated well that may be true for populations but when looking at individuals it may beneift some.
Odd , suddenly populations studies which we all go by , he tried to debunk.
He is truly a self serving scum bag .
-
Thank you for thoughtful comments.
-
For gay, bi men who can't keep their peckers in their pants:
https://www.breitbart.com/news/us-health-officials-propose-using-a-cheap-antibiotic-as-a-morning-after-pill-against-stds/
I thought we were reducing antibiotic use to reduce emergence of resistance
once again gay sex can't be controlled .
-
very interesting:
https://www.breitbart.com/politics/2023/10/05/pharmacy-benefit-managers-the-big-insurance-con-that-drives-up-your-drug-prices-and-their-profits/
-
https://www.msn.com/en-us/news/us/invasive-apple-snails-pose-threat-to-dog-s-nervous-systems-vets-warn/ar-AA1hKjdR?ocid=msedgntphdr&cvid=685037ec13f4430fac1c77ce2172575a&ei=10
-
https://www.theepochtimes.com/health/breakthrough-study-finds-probiotics-can-reduce-mental-health-symptoms-5505146?utm_source=Bright&src_src=Bright&utm_campaign=bright-2023-10-09&src_cmp=bright-2023-10-09&utm_medium=email&cta_utm_source=Bright&est=m6Uw8ojLelOoRoz0trvVZflq6XpboHdh0FJrR5oK1jbr8G3D1eb1V9y4q2oppL8C8iqq
-
https://www.insidehook.com/wellness/how-to-get-better-grip-strength
-
A physical therapist who does hand therapy once told me the strongest measurement of hand grip she got was from a plumber.
I am sure she never tested a climber's grip
what the elite ones can do is truly amazing
-
https://www.the-sun.com/news/9330004/
Around where I am Walgreens then CVS are the two busiest and often the most annoying drug stores to do business with.
Even as a doctor I have had to wait over 10 minutes to get someone on the phone to call in a prescription.
I always felt sorry for the pharmacists who answered calls, walk ins, the drive thrus, and fill the orders answer questions, run around looking at the location of what they needed from the stocks, all while trying to be pleasant and not make any mistakes.
I thought corporate abused them frankly.
-
A physical therapist who does hand therapy once told me the strongest measurement of hand grip she got was from a plumber.
I am sure she never tested a climber's grip
what the elite ones can do is truly amazing
The first art I studied was Judo, which does a lot of hand training so you can better grip a gi and such and thus better throw your opponent. With no pancreas any longer I’m a diabetic, while chemo caused neuropathy, which diabetes can make worse. The net effect is I hang out w/ various specialists, including a neurologist who measures my grip strength among other things. Judo it seems has stuck w/ me as I’m told my grip is off the charts.
-
Far out.
Any tendency to elbwo pain?
-
Elbow pain seems to be one I’ve avoided so far. Among other indignities that have come my way as I’m closer to my 7th decade than my 5th is arthritis, which leaves most joints complaining about something or other. Somehow my elbows have escaped notice, touch wood.
-
Mark Felix - the Grenadian strong man:
https://www.youtube.com/watch?v=eICtcsd0TvY
Climber vs the Beast (world's strongest man) in grip competition
guess who wins:
https://www.bing.com/videos/riverview/relatedvideo?q=climber+competes+with+worlds+strongest+man+in+grip&mid=AE9C8AB4177093CD22E9AE9C8AB4177093CD22E9&FORM=VIRE
I remember how my father would tell me his father could bend quarters with his hands after many yrs of shovelling coal for Esso.
Then in the 80's or 90s I saw a clip of man on TV show *ripping* a quarter in half with fingers/hands ! :-o
-
Still cannot find the video but I found this:
https://www.rollitup.org/t/my-uncle-could-rip-coins-with-his-fingers.1048492/
I believe the poster claiming his uncle could do this as I do remember (thank God not senile yet :wink:)
seeing it on some "believe it or not" like show.
Could not remember name of show but did remember the feat.
It had to be this:
'That's Incredible' early 80s, I guess 1982 the year he cites.
The video of the episode is not posted apparently.
Episodes showing Tiger Woods golfing like pro at age 5 and Karate expert knocking arrows shot at him out of the air can be found.
-
https://www.theepochtimes.com/health/the-potential-impact-of-microplastics-on-major-organs-including-the-brain-what-science-says-5499861?utm_source=Goodevening&src_src=Goodevening&utm_campaign=gv-2023-10-22&src_cmp=gv-2023-10-22&utm_medium=email&cta_utm_source=Goodevening&est=APIaabV%2B%2FrHWizpapE8%2FJ4UxOoAF5QxL1eF6%2FfYCuM6Z66XxUJfsjJ9T7n1Z9EB%2FdVcO
-
EXCLUSIVE: Moderna has halted a trial of a new mRNA vaccine for young people after a suspected myocarditis case
The case, which occurred in a Phase 1 trial of Moderna's jab for the Epstein-Barr virus, will only add to the concerns around mRNA biotechnology and heart issues, particularly myocarditis.
ALEX BERENSON
NOV 17
READ IN APP
Investigators for Moderna today halted an early-stage clinical trial for its mRNA Epstein-Barr virus vaccine in adolescents after a participant in the trial developed a suspected case of myocarditis.
The case “necessitates an immediate suspension of all dosing for ALL adolescents,” an investigator at the company that is supervising the trial for Moderna wrote, adding, “Please confirm understanding and receipt of this urgent communication.”
The trial subjects should continue to be monitored for safety, the investigator wrote. About 150 adolescents are in the trial, along with 272 people aged 18-30.
A person not employed by Moderna, which makes the Spikevax Covid vaccine, provided the email to Unreported Truths.
Moderna did not disclose the trial halt, which occurred before stock markets opened for trading Thursday, to investors. Moderna stock is down about 85 percent from its highs in 2021, as sales of Spikevax lag, but it remains among the most valuable biotechnology companies, with a $30 billion market value.
—
(All Dosing Must Pause Immediately! A partial subject line from the email sent halting the trial. Note the email time stamp - before Moderna stock opened for trading Thursday.)
—
The Epstein-Barr virus, which causes mononucleosis, is one of Moderna’s leading candidates for new vaccines. The company has told investors it could reach billions of dollars in sales a year.
But the trial halt raises questions for Moderna and mRNA jabs that go far beyond the Epstein-Barr vaccine - officially called mRNA-1189 - alone.
The vaccine uses essentially the same design as Moderna’s Covid shot. Both jabs include a strand of modified mRNA surrounded by a tiny fat globule called a “lipid nanoparticle,” or LNP.
—
READ IN APP
Investigators for Moderna today halted an early-stage clinical trial for its mRNA Epstein-Barr virus vaccine in adolescents after a participant in the trial developed a suspected case of myocarditis.
The case “necessitates an immediate suspension of all dosing for ALL adolescents,” an investigator at the company that is supervising the trial for Moderna wrote, adding, “Please confirm understanding and receipt of this urgent communication.”
The trial subjects should continue to be monitored for safety, the investigator wrote. About 150 adolescents are in the trial, along with 272 people aged 18-30.
A person not employed by Moderna, which makes the Spikevax Covid vaccine, provided the email to Unreported Truths.
Moderna did not disclose the trial halt, which occurred before stock markets opened for trading Thursday, to investors. Moderna stock is down about 85 percent from its highs in 2021, as sales of Spikevax lag, but it remains among the most valuable biotechnology companies, with a $30 billion market value.
—
(All Dosing Must Pause Immediately! A partial subject line from the email sent halting the trial. Note the email time stamp - before Moderna stock opened for trading Thursday.)
—
The Epstein-Barr virus, which causes mononucleosis, is one of Moderna’s leading candidates for new vaccines. The company has told investors it could reach billions of dollars in sales a year.
But the trial halt raises questions for Moderna and mRNA jabs that go far beyond the Epstein-Barr vaccine - officially called mRNA-1189 - alone.
The vaccine uses essentially the same design as Moderna’s Covid shot. Both jabs include a strand of modified mRNA surrounded by a tiny fat globule called a “lipid nanoparticle,” or LNP.
—
-
Nicanos and the "flute girl"
https://www.wondersandmarvels.com/2012/02/fear-of-flute-girls.html
here is an audio of instrument that made Nicanos anxious:
https://www.youtube.com/watch?v=aI7YwJ1jBhY
-
Magic Pills Are Coming
Wearable ultrasound machines and other inventions could reduce medical costs.
Andy Kessler
By
Andy Kessler
Follow
Nov. 26, 2023 4:43 pm ET
At healthcare conferences, someone always asks, “What if there was a magic pill?” One that could cure major diseases. What would the healthcare industry look like? Some emergency rooms and hospitals but less doctors and spending? Inevitably, the discussion ends with, “But, of course, there is no magic pill.” So we spend, spend, spend on healthcare, from $1.4 trillion in 2000 in the U.S. to more than $4.3 trillion—18% of the economy—in 2021.
Could there be magic cures? History shows plenty of wonder drugs and treatments. Aspirin reduces inflammation. Penicillin and other antibiotics fight infections. Insulin treats diabetes. Stents unblock arteries. These treat but don’t cure diseases. Plus, two-thirds of American adults are overweight or obese, which puts them at greater risk for many chronic diseases such as heart disease and stroke. According to the National Institutes of Health, “86% of health care costs are attributable to chronic disease.”
By now you’ve heard about glucagon-like peptides (GLP-1). Drugs that mimic these hormones, like Novo Nordisk’s Ozempic and Wegovy and Eli Lilly’s Mounjaro, seem to treat diabetes by lowering blood-sugar levels. They also promote weight loss and lower the risk of heart disease. What can’t GLP-1s do?
A friend of mine with diabetes started taking Mounjaro and now, because of shortages, takes Ozempic. He lost 70 pounds, got his A1C levels back to normal and told me, “I’m simply not hungry anymore. It’s not even like I’m full. I used to throw back a whole pizza and a gallon of milk. Now a slice and a bottle of water is more than enough. The food I used to crave has no interest for me.” Amazing. Goldman Sachs Research expects this to be a $100 billion market by 2030. It could save multiples of that in healthcare costs. Patients take these drugs via injectable pens. Pills are coming—dare I say magic pills?
Here’s another magic cure: Israeli company Insightec, backed by Koch Industries, has made a helmet with 1,020 acoustic sources that when placed on a shaved head can focus ultrasound signals to specific spots in the brain. For patients with tremors, including some with Parkinson’s disease, the system uses magnetic resonance, similar to an MRI, to guide “focused ultrasound” to a specific spot in the brain, which it heats to 113 degrees Fahrenheit. This creates a lesion, which miraculously eliminates tremors with a less than 1% chance of side effects.
Insightec CEO Dr. Maurice R. Ferré tells me the company’s “incisionless brain surgery” is in 200 medical centers. Its devices have been used to perform 20,000 procedures that cost $18,000 to $20,000, replacing $60,000 electrode-implanting brain surgery. He adds that the company has 35 ongoing trials investigating focused ultrasound for things like depression, obsessive-compulsive disorder, Alzheimer’s, and even neurodegenerative diseases like ALS.
One trial caught my eye. The Rockefeller Neuroscience Institute at West Virginia University has been running trials on curing opioid and substance abuse. After putting the ultrasound helmet on a patient, researchers apply triggers for drug use, via images on virtual-reality glasses and scents, to look for areas where the brain “lights up.” Instead of heat, the focused ultrasound uses neuromodulation to excite the appropriate tissue.
Yes, it sounds right out of “A Clockwork Orange”—but it works! I heard of one patient, a longtime opioid user, who said he hasn’t had a craving for drugs in years. A study published in September in Frontiers in Psychology says the procedure “acutely reduced substance craving,” even 90 days later. Sounds similar to GLP-1s and food cravings. So far, 12 people have had the procedure and Dr. Ferré says “there has been no relapse or recurrence of cravings.” A brave new world indeed.
There are other promising technologies. Crispr gene therapy can fix gene mutations for Duchenne muscular dystrophy and coming soon are one-off treatments for sickle-cell anemia. Even cancer treatment is changing rapidly. I paid $950 for the Galleri blood test from Grail, a subsidiary of Illumina. Using AI, it looks for patterns in your blood that can identify over 50 different cancers, even at a very early stage. My tests came back negative. Whew.
And if it found cancer? The same mRNA that quickly turned out Covid vaccines from BioNTech and Moderna is being used to fight cancer, including hard-to-detect pancreatic cancer. Wouldn’t that be a magic pill? Find cancer with a blood sample and take the appropriate mRNA pill before cancer requires expensive hospital care.
For other ailments? Medical chatbots are already here. Type symptoms into an AI large language model and out pops a diagnosis. Google claims its Med-PaLM 2 scores 86.5% accuracy on United States Medical License Exam-style questions. I doubt chatbots will ever be 100% accurate, but they will help augment doctors. And, according to JAMA Internal Medicine, patients think chatbots are more empathetic than doctors 80% of the time anyway.
Technology is changing medicine. Maybe there is a magic pill after all.
-
GLP 1 analogs or mimetics
appear to have another benefit other then diabetes or weight control:
https://www.yahoo.com/gma/woman-says-ozempic-helped-her-184738459.html
This would be huge if pans out.
I am keeping my eye on the what seems like serious side effect of gastroparesis reported on wegovy .
Not clear how common this is at this point but sounds rare.
I used to tell people who asked if the drug they are on is causing there symptoms , nah , not reported.
With experience I now say not typically or reported but I have learned that one can never be 100 % sure the person has some unique genetic make up or along with other factors makes them idiosyncratically
sensitive to a drug or chemical that is well tolerated by virtually everyone else.
Over the years people will say something like they had so and so side effect after taking a drug such as tylenol , then they stop it they get better and then retry it another time and same odd side effect recurs
fulfilling the Koch postulate and making it very likely they simply for whatever reason have some unusual but real negative reaction to the drug.
Never say never with regards to drugs and people I now say to myself.
" Listen to the patient"
they are not crazy.
-
"" Listen to the patient. HeShe is not crazy."
This is very pithy.
-
well I was speaking of side effect reports
I don't know about he/she gender choice at the spur of the moment stuff. :-o
-
" Listen to the patient"
they are not crazy.
"" Listen to the patient. HeShe is not crazy."
"I don't know about he/she gender choice at the spur of the moment stuff."
My use of "HeShe" was intended to correct humorously the incongruity of a singular "patient" with the plural pronoun "they".
-
The DNA is wrong:
https://www.msn.com/en-us/news/us/lawsuit-ex-harvard-doctor-accused-of-inseminating-woman-with-his-own-sperm-without-permission/ar-AA1lsN5i
Sickening.
-
https://www.theepochtimes.com/health/long-term-use-of-statins-linked-to-heart-disease-studies-5532644?utm_source=Bright&src_src=Bright&utm_campaign=bright-2023-12-23&src_cmp=bright-2023-12-23&utm_medium=email&est=ZamNjqspSZm1oA%2BibcRCrLOFFp%2FxU%2BNi4nRwYMSVbojIdBAJfbECRbMtQcpj3xXHdh4L
-
interesting
but I would note the author I would bet has interest in Coenzyme Q 10 which long ago was thought to help in heart failure but this has not been born out in later studies.
However, I am always open for more / new information
-
Oh.
I have been taking it for years now.
-
it was promoted to help prevent muscle pain for those taking statin drugs.
of course that would be too easy a fix ( :cry:); it usually is not that simple though wish it is.
and later evidence suggested it did not work.
That is all I know.
-
https://www.yahoo.com/entertainment/kelly-clarkson-explains-she-dropped-153053567.html
oh come on
we know she is on a GLP-1 drug
so is Trump.
so obvious ....
-
What is a GLP-1 drug?
-
glucagon like peptide agonist or mimetics
Wegovy Mounjaro
semaglutide
lilarglutide
tirzepatide
and a few others
of the weight loss drugs we keep hearing about
does not Trump look leaner recently?
anyone think he goes to the Mar a Lago fitness center more to achieve that?
-
https://www.theepochtimes.com/health/aspirin-inhibits-metastatic-cancer-spread-reducing-mortality-by-21-percent-study-5552949?utm_source=Healthtop5&src_src=Healthtop5&utm_campaign=htop5-2024-01-07&src_cmp=htop5-2024-01-07&utm_medium=email&est=%2FsCGZLcLWqHqwX78%2Fxf%2FyxekT7jPyC2c9SrRIb1yNnZkAU%2FY3H5lhSZSpGD87bquFUHR
-
second
https://www.theepochtimes.com/epochtv/whats-the-avocado-effect-on-inflammation-blood-pressure-and-brain-aging-any-avocado-side-effects-5555721?utm_source=Healthtop5&src_src=Healthtop5&utm_campaign=htop5-2024-01-07&src_cmp=htop5-2024-01-07&utm_medium=email&est=qGSrXFcFhOoRrAR9oKfrXTbBC5E0yvOqL%2FZUKTOuSdUi2zhRK76OJRAeNP0jZXii%2BRyS
-
https://www.theepochtimes.com/health/we-must-be-very-cautious-with-genetic-medicines-dutch-molecular-biologist-warns-5555711?utm_source=Health&src_src=Health&utm_campaign=health-2024-01-08&src_cmp=health-2024-01-08&utm_medium=email&est=iDq5GHg3WpkZHvj3cCmBtcrpmEywnXz3Wbbq0MjZRJZ3T1rX1dk7ou3gR0JBoQxzTrPR
-
https://www.theepochtimes.com/health/the-silent-epidemic-eating-away-americans-minds-5560857?utm_source=Health&src_src=Health&utm_campaign=health-2024-01-17&src_cmp=health-2024-01-17&utm_medium=email&est=uPxJc%2BinZ5rkAqvqEVB8t28aeFnnqkS%2FN9cEDj7mmjXeYZsB3ZceTV%2FrrrBaH%2F2JMKk4
-
https://www.msn.com/en-us/health/other/at-93-he-s-as-fit-as-a-40-year-old-his-body-offers-lessons-on-aging/ar-AA1n3CkD
-
I saw this.
Remarkable.
Even more amazing he did not begin working out till he was in his 70s.
I am thinking luck, genetics play a huge role here.
Living into the 90s would be fine with me only if I can function and think like this.
If my destiny is to be in a nursing home drooling in a wheelchair staring into space then it ain't worth it.
-
retracts 6 research papers and seeks to correct "dozens more"
https://www.msn.com/en-us/health/other/harvard-cancer-hospital-retractions-prove-academic-rot-runs-bone-deep/ar-BB1h8U7L?ocid=msedgntp&pc=DCTS&cvid=cd77274a01c74bea81d4bc5cffc08be9&ei=19
oh just an oversight..... :wink:
watch the data!
-
https://www.theepochtimes.com/health/high-good-cholesterol-linked-to-increased-dementia-risk-5566136?utm_source=Health&src_src=Health&utm_campaign=health-2024-01-24&src_cmp=health-2024-01-24&utm_medium=email&est=FPLoMlQjgSKw6tR1GoRO55eoCqWAKwfepyhAYdKr%2F82EwVBavYl7vNesQtKrz9YxCArB
-
Harvard Scientist Stunned: Oreos Surpass Statins in Lowering His Cholesterol
In a very specific experiment, Oreo cookies were shown to outperform traditional cholesterol medication in lowering cholesterol.
Harvard Scientist Stunned: Oreos Surpass Statins in Lowering His Cholesterol
Shutterstock/Anusorn Nakdee
Sheramy Tsai
By Sheramy Tsai
1/22/2024
Updated:
1/23/2024
Print
X 1
0:00
Nicholas Norwitz, a Harvard medical student who holds a doctorate in metabolism and nutrition from the University of Oxford, has explored uncharted territory in cholesterol management through an innovative experiment.
Central to his study is an ambitious goal—to validate the Lipid Energy Model—a theory poised to transform our comprehension of human metabolism, especially in terms of fat or “lipid” metabolism. He investigates the contrasting impacts of Oreo cookies and statins on cholesterol levels.
Within the esteemed environments of Harvard and Oxford, the 28-year-old researcher faces the daunting challenge of being a “little fish with a big idea.” He aims to make a substantial scientific contribution while operating without the backing of multimillion-dollar grants.
Story continues below advertisement
Your Health Matters
Ads By logo
img-responsive
#1 Nutrient You Need After 50 For Swollen Feet
Native Path
img-responsive
This #1 Mushroom Acts As Turbo-Shot For Your Immune System
Trumeta Reds
“Everyone knows the feeling of being so engrossed by a question that it occupies your mind. What do you do when that question challenges everything you’ve been taught? For me, that’s the essence of this experiment,” he told The Epoch Times, highlighting the motivation driving his research.
Understanding Cholesterol
Cholesterol is a term that often ignites passionate debates in health care. Viewed by many as a primary factor in heart disease, it is also acknowledged as an essential component critical for bodily functions.
Central to this discussion is LDL-C, or low-density lipoprotein cholesterol, commonly labeled as “bad” cholesterol. LDL is not cholesterol itself, but its transporter. LDL particles are like a delivery truck circulating fat fuel and cellular building blocks throughout the body.
Traditionally, medical professionals have linked an excess of LDL “trucks” to arterial plaque accumulation, elevating heart attack and stroke risks. Given that nearly 94 million U.S. adults suffer from high cholesterol, its prevalence is undeniable.
RELATED STORIES
Long-Term Use of Statins Linked to Heart Disease: Studies
12/14/2023
Long-Term Use of Statins Linked to Heart Disease: Studies
Re: ‘Statins: The Lesser-Known Dangers, and a Good Alternative’ by Vance Voetberg, Published in the Aug. 23–29 Edition
11/8/2023
Re: ‘Statins: The Lesser-Known Dangers, and a Good Alternative’ by Vance Voetberg, Published in the Aug. 23–29 Edition
In the American Medical Association (AMA) series, “What Doctors Wish Patients Knew,” Kate Kirley, a family physician and AMA director of chronic disease prevention, debunks a prevalent cholesterol myth, “The amount of cholesterol that you eat, doesn’t actually impact your own cholesterol very much,” she explains. Dr. Kirley underlines that the body’s cholesterol production is mostly separate from dietary cholesterol, countering a common misconception.
The battle against high LDL-C has long been fought with statins—drugs that cut down cholesterol production in the liver. As of 2021, the global statins market was estimated at around $15 billion and is expected to reach $22 billion by 2032.
Oreos vs. Statins in LMHR Cholesterol Management
Imagine lowering your cholesterol with Oreos instead of medication. This was the core of Mr. Norwitz’s experiment. He investigated whether incorporating Oreo cookies into his low-carb, ketogenic diet could decrease LDL-C levels, comparing this to the effects of conventional statin drugs.
His study illuminates the “lean mass hyper-responder” phenomenon, a condition observed in specific individuals on low-carb diets who experience a dramatic escalation in cholesterol levels, with LDL-C occasionally reaching 500–600 mg/dl. This rise is often accompanied by elevated high-density lipoprotein (HDL) cholesterol and diminished triglycerides.
Dr. William Cromwell, a seasoned lipidologist, elaborates on this unique dietary group to The Epoch Times, stating, “This case study adds to our understanding of an atypical group of people—lean individuals who have a substantial increase in LDL cholesterol on a ketogenic/very low-carb diet. The combination of very high LDL-C, high HDL cholesterol, and low triglycerides has been called the ‘lean mass hyper-responder’ (LMHR) phenotype.” These traits craft a distinctive lipid profile that, while rare in the general population, is relatively prevalent among lean individuals on low-carb diets.
The rationale for this phenotype originates from the Lipid Energy Model (LEM). This model proposes that reduced carbohydrate intake changes the way fats are processed, which may influence cholesterol levels in those otherwise metabolically healthy.
For lean people, cutting down on carbs means their bodies use more fat for energy. This change primarily happens in the liver, which sends out more very-low-density lipoprotein (VLDL), a type of particle that carries fats in our blood. Once these VLDL particles deliver their fat cargo, they become LDL-C (the so-called “bad” cholesterol) and HDL-C (the “good” cholesterol). This process explains why LDL-C and HDL-C levels can rise while triglycerides (another type of fat) drop in these individuals.
Story continues below advertisement
AD
Mr. Norwitz explained, “Based on the lipid energy model, adding back carbs and repleting the store of glycogen in the liver should bring LDL-C back down in a lean-mass hyper-responder.” His study suggests that the carbohydrate source, whether bananas, potatoes, or even Oreo cookies, can substantially decrease LDL cholesterol.
The Experiment
In this dietary trial, Mr. Norwitz adhered to his typical ketogenic diet, low in carbohydrates (20 grams per day). Subsequently, he introduced a unique variable—eating 12 Oreo cookies daily for 16 days, adding 100 grams of carbohydrates. During this phase, he maintained ketosis with ketone supplements, ruling out ketosis as a factor for any increase in his LDL-C.
Mr. Norwitz ate 12 Oreo cookies daily for 16 days. (Shutterstock)
Mr. Norwitz ate 12 Oreo cookies daily for 16 days. (Shutterstock)
After a three-month break, or “washout,” to reset his weight and health markers to their original state, he embarked on the second phase of the experiment. This time, he took 20 mg of rosuvastatin daily for six weeks, a statin drug used for lowering cholesterol, all while sticking to his ketogenic diet.
The results were striking. Initially, Mr. Norwitz’s LDL-C level was 384 mg/dl. After the Oreo supplementation, it plummeted to 111 mg/dl, marking a 71 percent reduction. After the break, LDL-C levels rose to 421 mg/dl but were only reduced to 284 mg/dl—a 32.5 percent reduction—on statin therapy.
“The results in this case study are consistent with changes expected from the LEM and demonstrate the potential for substantial and rapid LDL cholesterol lowering by increasing dietary carbohydrates in selected individuals,” Dr. Cromwell explained.
“This study is helpful for lean individuals who experience a significant increase in LDL cholesterol on a ketogenic/low-carb diet,” Dr. Cromwell asserts. “For such people, diet modification (increasing carbohydrates) rather than medications should be considered as the first line of treatment if LDL lowering is needed.”
The study is meant to be a head-turner. New research reveals that low body mass index—not saturated fat—is a key factor in the sharp rise of LDL cholesterol for those on low-carb diets. This insight, supported by top-level evidence, challenges previous beliefs and points to leaner body mass—rather than dietary fat—as the primary driver behind the “lean mass hyper-responder” phenomenon.
Unproven Hypothesis: Constraints of the Oreo Experiment
While Mr. Norwitz’s experiment has garnered interest, acknowledging its limitations is vital. The study reflects the singular experience of Mr. Norwitz, who is uniquely categorized as a lean mass hyper-responder. The results of his experiment can’t be broadly applied to the general population.
“This was a metabolic demonstration. I sincerely hope nobody takes this to mean Oreos are good for heart health,” Mr. Norwitz explained. “Nevertheless, the experiment raises an uncomfortable implicit question about the consequences … and I love uncomfortable questions in science.”
The core concept of Mr. Norwitz’s study, the Lipid Energy Model, is an evolving model yet to gain full scientific consensus. It sheds light on how low-carb diets may influence cholesterol levels in particular instances like LMHRs but does not account for all variables influencing LDL cholesterol across different diets and populations. “It’s not meant to be all-encompassing,” explains Mr. Norwitz. “No models are complete, but some are useful.”
The hope, however, is that Mr. Norwitz’s approach will turn heads and inspire further research. By spotlighting the LMHR phenotype and the complex dynamics of human lipid metabolism, this study may pave the way for more detailed investigations. Such research could lead to a better understanding of dietary impacts on health, potentially transforming personalized nutrition and medical treatment.
Curiosity in Medicine: Challenging the Status Quo
The pursuit of knowledge in academic medicine frequently encounters significant hurdles, notably in securing funding. Many studies are backed by the pharmaceutical and food industries, which can sometimes lead to a conflict of interest, especially when research might contradict their agendas. For independent researchers, finding support for unconventional research can be a daunting task.
“I think funding is the greatest hurdle in conducting this type of research,” states Dr. Cromwell.
Mr. Norwitz’s unique study stands as a deliberate attempt to spotlight his idea around the Lipid Energy Model. He emphasizes that the use of Oreo cookies in his study is not an endorsement of them as a health food or a cholesterol-lowering strategy for the general public. Instead, his experiment with Oreos serves as a creative method to highlight and generate interest in his ongoing research.
“I’m in an environment surrounded by the world’s top experts. How could I see something they don’t? How can I pursue this question without the established academic muscle or the funding to make a large-scale experiment happen?” Mr. Norwitz’s questions highlight the challenges faced by researchers with innovative ideas but limited resources.
Story continues below advertisement
AD
This experiment is more than just a scientific inquiry—it’s a call to ignite curiosity within the medical field. Mr. Norwitz aims to bring attention to a model that could revolutionize our understanding of cholesterol management for the general population. “What I want people to walk away with is a feeling of curiosity,” he says. “One of the greatest pleasures in life is when reality defies your expectations, and you’re like an infant seeing the world anew.”
In an arena frequently influenced by industry-sponsored studies, Mr. Norwitz’s research underscores the value of independent investigation and the role of curiosity in propelling medical science forward. His efforts highlight the necessity for varied sources of research funding, promoting an expansive examination of concepts that may profoundly impact public health.
-
https://www.theepochtimes.com/health/the-essential-guide-to-prostate-cancer-symptoms-causes-treatments-and-natural-approaches-5571278?utm_source=Bright&src_src=Bright&utm_campaign=bright-2024-01-31&src_cmp=bright-2024-01-31&utm_medium=email&est=sgJo1%2BcfnlKcxtCqbEufBJ0G0ojDEJ41MpxbSJUWfgRH0ndBKwn6Y3m1BtFgjOQB%2FO7A
-
as I read is being reported:
https://thehill.com/opinion/technology/4437988-why-did-nih-abruptly-halt-research-on-the-harms-of-cell-phone-radiation/
and not covid vaccines :roll: :roll: :roll:
-
:-o :-o :-o
-
Simple Solution for High Blood Pressure–Why Isn’t Everyone on Board?
While enriching salt with potassium could improve widespread hypertension, the recommendations continue to spark medical community debates.
Simple Solution for High Blood Pressure–Why Isn’t Everyone on Board?
(fizkes/Shutterstock)
Sheramy Tsai
By Sheramy Tsai
2/1/2024
Updated:
2/1/2024
Print
X 1
0:00
Amid prevalent high-sodium diets and widespread hypertension, international experts propose a straightforward solution: incorporating potassium into everyday table salt.
This method involves replacing part of sodium chloride in regular salt with potassium chloride. Experts believe it could significantly impact blood pressure control while maintaining familiar taste.
While there’s advocacy for integrating potassium-enriched salt into global hypertension guidelines, the recommendations continue to spark medical community debates.
The Silent Epidemic of High Blood Pressure
The United States faces a critical high blood pressure crisis, with a 2023 American Heart Association report indicating that it affects half of Americans 20 and over. Far more than just high medical readings, high blood pressure severely damages arteries and precedes heart disease, stroke, and other serious health problems.
Story continues below advertisement
Your Health Matters
Ads By logo
img-responsive
This #1 Mushroom Acts As Turbo-Shot For Your Immune System
Trumeta Reds
img-responsive
Leaky Bladder? Drink Daily for Stronger Bladder Muscles
Native Path
This issue’s global magnitude is similarly distressing. Dr. Tom Frieden, president and chief executive officer of Resolve to Save Lives, emphasized in a press release that hypertension cases have doubled in 30 years to roughly 1.3 billion. “High blood pressure kills more than ten million people every year—almost 20 people every minute,” he said. “Twenty percent of these deaths can be linked to a single culprit: eating too much salt.”
These statistics highlight the need for practical solutions to address this escalating health threat. The international struggle against the surge of hypertension-related issues increasingly centers on dietary elements—notably the widespread high salt consumption—as critical areas of focus in the global health battle.
Sodium and Potassium: Key Players in Blood Pressure Regulation
The delicate balance between sodium and potassium is crucial in managing blood pressure. Each cell in the human body relies on these minerals for proper functioning, with their interplay being vital for overall health.
Professor Alta Schutte, a hypertension management expert, explains this crucial relationship. “Practically every human cell needs both sodium and potassium to maintain normal cell function. When sodium is pumped out of the cell, potassium is pumped into the cell,” she told the Epoch Times. “An imbalance in potassium will, therefore, have adverse health consequences.”
RELATED STORIES
Why Your Sodium-to-Potassium Ratio Is Important
8/8/2023
Why Your Sodium-to-Potassium Ratio Is Important
High Sodium Levels Linked to Increased Biological Aging, Drinking Enough Water May Help
1/9/2023
High Sodium Levels Linked to Increased Biological Aging, Drinking Enough Water May Help
Dr. Bruce Neal, a UK-trained physician and executive director at The George Institute, Australia, expands on this. “Humans evolved on diets that had about 0.5 grams of sodium and about 10 grams of potassium per day. Current diets contain about ten times as much sodium and one-third the quantity of potassium,” he told The Epoch Times.
The balance between these minerals is frequently disrupted in modern, highly processed diets, leading to higher blood pressure. Excessive sodium causes water retention, raising blood volume and arterial pressure. Conversely, potassium counteracts sodium’s effects and eases blood vessels, thereby reducing blood pressure.
The Global Push for Potassium-Enriched Salt
Research in the journal Hypertension reveals a notable discrepancy in global hypertension treatment standards. Analysis of 32 international guidelines showed a concerning inconsistency: all advise lowering sodium intake, yet few suggest boosting potassium levels or explicitly recommend potassium-enriched salt.
Dr. Neal emphasizes the practical benefits of potassium-enriched salt. “Reducing sodium and supplementing potassium both lower blood pressure. Potassium-enriched salt does the two together,” he notes. He acknowledges the challenges in cutting back on regular salt, which involves altering cooking, seasoning, and shopping habits.“Potassium-enriched salt looks, behaves, and tastes just like regular salt. And people can make the switch much more easily,” he asserts.
Ms. Schutte expands on this, stating, “Key challenges are that the general public, governments, and health care providers are not aware of this ‘easy’ solution that could have profound population health benefits.” She also addresses the difficulty in sourcing potassium and the limited availability of salt substitutes in economically disadvantaged regions.
The research highlights the struggle to reduce dietary sodium and boost potassium consumption, hampered by ingrained consumer habits and food industry resistance. Ms. Schutte stresses the importance of recent evidence and clinical trials backing salt substitutes, underscoring the necessity for guideline committees to consider these findings.
The authors propose revising blood pressure management guidelines to endorse potassium-enriched salt (approximately 75 percent sodium chloride and 25 percent potassium chloride) for those with hypertension, barring individuals with advanced kidney issues or those on potassium-related drugs. This recommendation also extends to the general populace, assuming no adverse effects on those with potentially unrecognized advanced kidney disease.
Story continues below advertisement
AD
These recommendations follow a recent U.S. Food and Drug Administration (FDA) proposal advocating a shift from traditional to lower-sodium salt alternatives. “By providing manufacturers another tool to decrease sodium in food production, we aim to lower Americans’ risk of conditions such as hypertension, which is intrinsically linked to heart disease and stroke,” stated FDA Commissioner Dr. Robert M. Califf in a press release.
The momentum for potassium-enriched salt substitutes is pulling manufacturers into the dialogue. Ms. Schutte reports that The George Institute for Global Health has initiated talks with manufacturers about the significance of producing and integrating salt substitutes in foods, also addressing production barriers. “For some of the major companies, this is a priority, but it will take more global effort to push this agenda forward,” she stated.
“A global switch to using potassium-enriched salt would immediately lower average global blood pressures, and blood pressure is the single biggest cause of premature death worldwide,” asserts Dr. Neal. He references a study he led, suggesting this change could avert nearly a million strokes and heart attacks each year.
The Risk of Potassium Overload in Vulnerable Populations
The proposition of adding potassium to table salt has its critics. Central to the debate is the safety of this method, especially for those with kidney disease.
Dr. Stephen Fadam, MD, a nephrologist and chair of the American Association of Kidney Patients (AAKP) medical advisory board, underscores kidney patients’ distinct challenges. “Patients with kidney disease, and especially diabetics, may have an impaired ability to secrete potassium, and this is further complicated by some of the medications that are recommended,” he explains in an email to the Epoch Times.
Dr. Fadam emphasizes the necessity of customizing dietary advice for kidney patients and advocates for detailed dialogues among nephrologists, renal dietitians, and patients. He advises, “This study needs to be taken in the context of what is best for kidney patients, and further discussions involving kidney doctors, renal dietitians, and patients should occur before the FDA considers this research as evidence for potential regulatory action,” emphasizing the need for a cautious approach in translating this research into practice.
Paul Conway, chair of Policy and Global Affairs for the AAKP and a kidney transplant recipient, criticizes the study for neglecting key concerns. Speaking to The Epoch Times, he remarks that the researchers “missed an important opportunity to raise awareness about the overall lack of kidney disease screening and how many people likely suffer from undiagnosed disease.”
Mr. Conway urges the FDA to engage with the kidney community before endorsing such salt alternatives, highlighting the need to protect kidney patients and taxpayers from potential health policy oversights.
Dr. Stephen P. Juraschek, a primary care physician specializing in heart disease epidemiology, responded to concerns about potassium-enriched salt substitutes. “The level of replacement in potassium-enriched salt is modest and unlikely to cause hyperkalemia in most adults,” he told The Epoch Times. He acknowledges, however, the critical need for consistent health monitoring in individuals with kidney disease or on hypertension medications.
Dr. Juraschek also pointed out that the study referenced by Dr. Neal didn’t indicate a significant hyperkalemia risk from potassium replacement, implying that the health advantages could surpass the risks for most individuals.
Beyond Salt: Addressing the Root Causes of Hypertension
The debate also extends to the broader issue of addressing hypertension’s root causes. Critics argue that focusing on modifying salt composition might be a superficial solution, diverting attention from more fundamental problems associated with modern lifestyles.
James DiNicolantonio, a cardiovascular research scientist and author of “The Salt Fix,” shared his reservations about salt substitutes with the Epoch Times. “When it comes to high blood pressure, the two best things people can do is eat whole, nutritious foods and exercise.” He argued that in this context, increased salt intake is often necessary.
Mr. DiNicolantonio identified salt retention as the core issue, usually resulting from excessive refined carbohydrates and sugar intake. He advised, “The goal should be to limit the refined carbohydrates so people can eat a normal salt intake,” highlighting its importance for various bodily functions, including exercise performance and energy levels.
Additionally, Mr. DiNicolantonio remarked that a diet abundant in whole foods naturally boosts potassium levels, possibly rendering the addition of potassium to salt redundant. Such foods include avocados, spinach, potatoes, squash, and certain beans.
Indeed, health experts believe that about 80 percent of chronic diseases could be prevented by changes in diet and lifestyle. This figure indicates that interventions ought to be more holistic, addressing not only salt intake but also the broader lifestyle and dietary factors influencing hypertension.
The discussion raises questions about the role of processed foods in modern diets. Adding another mineral to such foods could be perceived as a mere band-aid over a larger issue—the pervasive consumption of these foods themselves.
Story continues below advertisement
AD
Dr. Juraschek highlights the combined impact of diet and lifestyle modifications. He explains, “The DASH-Sodium trial demonstrated that sodium reduction independently lowered blood pressure regardless of the overall healthy dietary pattern. The effects of combining a healthy diet (the DASH diet) with sodium reduction were even greater. Both of these strategies are important and synergistic for blood pressure reduction, and one should not replace the other.”
Dr. Juraschek recommends a combined approach, suggesting that policy changes favoring potassium-enriched salt in food preparation and as a table option could greatly benefit public health, alongside a continued emphasis on promoting healthy lifestyles. His viewpoint contributes to the broader discussion, underscoring the need for a multi-pronged strategy to address hypertension, which merges dietary advancements with essential lifestyle modifications.
-
interesting thought
exchanging potassium for sodium would be dangerous for those with moderate to severe kidney disease.
underperforming kidneys results in the body being unable to excrete excess K+.
one can by "salt substitute" in the stores
it is a misnomer in a way because it is not salt substitute but sodium substitute with potassium salt.
If I recall I tried it once, and was to me at least, not as good.
Back in 1986 we had a patient in the hospital who had diabetes and moderate to severe kidney disease. Elevated potassium is always a concern because one can drop dead from it.
We noticed his potassium kept going up and could not figure out why. Finally, someone realized he used salt substitute on his hospital food brought in by relative. We advised him to stop and his K+ went down.
2 yr later I had a morning report in a different teaching program where all the residents and some professors would discuss cases for teaching purposes.
The case one day was a patient who had elevated K+ and no one could figure out why.
I rose my hand and asked if patient was taking salt substitute especially since he had renal disease this could well be the culprit . Many scoffed and the resident presenting the case rolled his eyes and basically said this was ridiculous (maybe embarrassed he did not think of it)
Someone turned to an attending nephrologist who said that indeed this can be a REAL problem and they do see it.
Another attending, a really great rheumatologist admitted he did not know that and was impressed with my bringing it up.
I had my 30 seconds of fame and ego stroking.
The presenting resident of course ignored it. Why he couldn't just say 'great idea', and I will have to look into it as possible cause could only be explained by his ego.
-
Good follow up to my post-- thank you.
-
This may bear watching:
A One-and-Done Injection to Slow Aging? New Study in Mice Opens the Possibility
Singularity Hub / by Shelly Fan / February 05, 2024 at 04:32PM
A preventative anti-aging therapy seems like wishful thinking.
Yet a new study led by Dr. Corina Amor Vegas at Cold Spring Harbor Laboratory describes a treatment that brings the dream to life—at least for mice. Given a single injection in young adulthood, they aged more slowly compared to their peers.
By the equivalent of roughly 65 years of age in humans, the mice were slimmer, could better regulate blood sugar and insulin levels, and had lower inflammation and a more youthful metabolic profile. They even kept up their love for running, whereas untreated seniors turned into couch potatoes.
The shot is made up of CAR (chimeric antigen receptor) T cells. These cells are genetically engineered from the body’s T cells—a type of immune cell adept at hunting down particular targets in the body.
CAR T cells first shot to fame as a revolutionary therapy for previously untreatable blood cancers. They’re now close to tackling other medical problems, such as autoimmune disorders, asthma, liver and kidney diseases, and even HIV.
The new study took a page out of CAR T’s cancer-fighting playbook. But instead of targeting cancer cells, they engineered them to hunt down and destroy senescent cells, a type of cell linked to age-related health problems. Often dubbed “zombie cells,” they accumulate with age and pump out a toxic chemical brew that damages surrounding tissues. Zombie cells have been in the crosshairs of longevity researchers and investors alike. Drugs that destroy the cells called senolytics are now a multi-billion-dollar industry.
The new treatment, called senolytic CAR T, also turned back the clock when given to elderly mice. Like humans, the risk of diabetes increases with age in mice. By clearing out zombie cells in multiple organs, the mice could handle sugar rushes without a hitch. Their metabolism improved, and they began jumping around and running like much younger mice.
“If we give it to aged mice, they rejuvenate. If we give it to young mice, they age slower. No other therapy right now can do this,” said Amor Vegas in a press release.
The Walking Dead
Zombie cells aren’t always evil.
They start out as regular cells. As damage to their DNA and internal structures accumulates over time, the body “locks” the cells into a special state called senescence. When young, this process helps prevent cells from turning cancerous by limiting their ability to divide. Although still living, the cells can no longer perform their usual jobs. Instead, they release a complex cocktail of chemicals that alerts the body’s immune system—including T cells—to clear them out. Like spring cleaning, this helps keep the body functioning normally.
With age, however, zombie cells linger. They amp up inflammation, leading to age-related diseases such as cancer, tissue scarring, and blood vessel and heart conditions. Senolytics—drugs that destroy these cells—improve these conditions and increase life span in mice.
But like a pill of Advil, senolytics don’t last long inside the body. To keep zombie cells at bay, repeated doses are likely necessary.
A Perfect Match
Here’s where CAR T cells come in. Back in 2020, Amor Vegas and colleagues designed a “living” senolytic T cell that tracks down and kills zombie cells.
All cells are dotted with protein “beacons” that stick out from their surfaces. Different cell types have unique assortments of these proteins. The team found a protein “beacon” on zombie cells called uPAR. The protein normally occurs at low levels in most organs, but it ramps up in zombie cells, making it a perfect target for senolytic CAR T cells.
In a test, the therapy eliminated senescent cells in mouse models with liver and lung cancers. But surprisingly, the team also found that young mice receiving the treatment had better liver health and metabolism—both of which contribute to age-related diseases.
Can a similar treatment also extend health during aging?
A Living Anti-Aging Drug
The team first injected senolytic CAR T cells into elderly mice aged the equivalent of roughly 65 human years old. Within 20 days, they had lower numbers of zombie cells throughout their bodies, particularly in their livers, fatty tissues, and pancreases. Inflammation levels caused by zombie cells went down, and the mice’s immune profiles reversed to a more youthful state.
In both mice and humans, metabolism tends to go haywire with age. Our ability to handle sugars and insulin decreases, which can lead to diabetes.
With senolytic CAR T therapy, the elderly mice could regulate their blood sugar levels far better than non-treated peers. They also had lower baseline insulin levels after fasting, which rapidly increased when given a sugary treat—a sign of a healthy metabolism.
A potentially dangerous side effect of CAR T is an overzealous immune response. Although the team saw signs of the side effect in young animals at high doses, lowering the amount of the therapy was safe and effective in elderly mice.
Young and Beautiful
Chemical senolytics only last a few hours inside the body. Practically, this means they may need to be consistently taken to keep zombie cells at bay.
CAR T cells, on the other hand, have a far longer lifespan, which can last over 10 years after an initial infusion inside the body. They also “train” the immune system to learn about a new threat—in this case, senescent cells.
“T cells have the ability to develop memory and persist in your body for really long periods, which is very different from a chemical drug,” said Amor Vegas. “With CAR T cells, you have the potential of getting this one treatment, and then that’s it.”
To test how long senolytic CAR T cells can persist in the body, the team infused them into young adult mice and monitored their health as they aged. The engineered cells were dormant until senescent cells began to build up, then they reactivated and readily wiped out the zombie cells.
With just a single shot, the mice aged gracefully. They had lower blood sugar levels, better insulin responses, and were more physically active well into old age.
But mice aren’t people. Their life spans are far shorter than ours. The effects of senolytic CAR T cells may not last as long in our bodies, potentially requiring multiple doses. The treatment can also be dangerous, sometimes triggering a violent immune response that damages organs. Then there’s the cost factor. CAR T therapies are out of reach for most people—a single dose is priced at hundreds of thousands of dollars for cancer treatments.
Despite these problems, the team is cautiously moving forward.
“With CAR T cells, you have the potential of getting this one treatment, and then that’s it,” said Amor Vegas. For chronic age-related diseases, that’s a potential life-changer. “Think about patients who need treatment multiple times per day versus you get an infusion, and then you’re good to go for multiple years.”
Image Credit: Senescent cells (blue) in healthy pancreatic tissue samples from an old mouse treated with CAR T cells as a pup / Cold Spring Harbor Laboratory
https://singularityhub.com/2024/02/05/a-one-and-done-injection-to-slow-aging-new-study-in-mice-opens-the-possibility/
-
Erectile dysfunction drugs lower the incidence of Alzheimer’s?
https://www.forbes.com/sites/ariannajohnson/2024/02/07/erectile-dysfunction-drugs-like-viagra-may-reduce-alzheimers-risk-study-finds/?sh=662e5e753c96
-
https://www.sciencenews.org/article/new-device-sense-temperature-prosthetic-hand-touch
-
https://www.gentlecure.com/
-
https://phys.org/news/2024-02-important-molecular-pathway-aging.html?fbclid=IwAR0OHb_t0-w6Ra7ESDOo4-oBSm2QUqirb2ZlxYDX2UBFdEpWsUC3pl_bCb0
-
Used to have a neighbor that raised reptiles and non-venomous snakes, with her boyfriend in the next county over raising venomous snakes as it was legal at that time to own them there. I’d make shipping containers for them, with the one for venomous snakes having some very specific requirements.
As that may be, the boyfriend disappeared for a while; turns out he was bit by one of his snakes and was hospitalized. Turns out moreover, that if you get bit and don’t receive anti-venom you develop antibodies to the venom you can then turn around and make big bucks by selling your blood to turn into anti-venom. Guess this gent’s blood was good for harvesting 3 or 4 types of specific antibodies, I’ll let you imagine why.
Anyhoo, looks like this may well put an end to that sort of side income:
https://www.sciencealert.com/a-universal-antivenom-for-snake-bites-is-closer-than-ever-to-reality
-
https://www.theepochtimes.com/health/alteration-of-gut-microbiota-affects-the-severity-and-complications-of-covid-19-post-5594202?utm_source=Health&src_src=Health&utm_campaign=health-2024-03-09&src_cmp=health-2024-03-09&utm_medium=email&est=AAAAAAAAAAAAAAAAYvAqcwcVzc7PzLYPrHFRB710wA0AIj31kx5JTWZu9FddhEg4S8RP
-
https://finance.yahoo.com/news/alphabet-introduces-ai-company-drug-130235414.html
understanding the 3 D shape of proteins will greatly reduce the trial and error guesswork we now use for drug discovery.
however, even AI will be dwarfed by the promise of quantum computing to be able to due billions of calculations at the same time vs. one after the other.
-
I wonder if the recipient will prove to be an apt truffle hunter once he recovers?
Man Gets Pig Kidney Transplant
NeuroLogica Blog / by Steven Novella / Mar 25, 2024 at 8:00 AM
On March 16 surgeons transplanted a kidney taken from a pig into a human recipient, Rick Slayman. So far the transplant is a success, but of course the real test will be how well the kidney functions and for how long. This is the first time such a transplant has been done into a living donor – previous experimental pig transplants were done on brain dead patients.
This approach to essentially “growing organs” for transplant into humans, in my opinion, has the most potential. There are currently over 100 thousand people on the US transplant waiting list, and many of them will die while waiting. There are not enough organs to go around. If we could somehow manufacture organs, especially ones that have a low risk of immune rejection, that would be a huge medical breakthrough. Currently there are several options.
One is to essentially construct a new organ. Attempts are already underway to 3D print organs from stem cells, which can be taken from the intended recipient. This requires a “scaffold” which is connective tissue taken from an organ where the cells have been stripped off. So you still need, for example, a donor heart. You then strip that heart of cells, 3D print new heart cells onto what’s left to create a new heart. This is tricky technology, and I am not confident it will even work.
Another option is to grow the organs ex-vivo – grow them in a tank of some kind from stem cells taken from the intended recipient. The advantage here is that the organ can potentially be a perfect new organ, entirely human, and with the genetics of the recipient, so no issues with rejection. The main limitation is that it takes time. Considering, however, that people often spend years on the transplant wait list, this could still be an option for some. The problem here is that we don’t currently have the technology to do this.
Similar to this approach is to grow a human organ inside an animal – essentially using the animal as the “tank” in which to grow the organ. The host animal can then provide nutrition and oxygen, and a suitable environment. This would require that the animal will not reject the organ, which would mean treating with drugs or engineering animals hosts that are humanized or whose immune systems cannot mount a rejection.
The most futuristic and also ethically complex approach would be to clone an entire person in order to use them as an organ donor. This would not have to be like “The Island” movie in which the cloned future donors were living people kept in a controlled environment, unaware of their ultimate fate. Anencephalic humans (without brains) could be cloned and grown, and just kept as meat bags. There are two big disadvantages here. The first is that the clones would likely need to be kept alive for years before the organs would be mature enough to be used. How would that work? Would a recipient need to wait 10 years before they could get their donor organ, or would there be clone banks where clones were kept in case they were needed in the future? These seem like cost-prohibitive options, except for the super wealthy.
One potential solution would be to genetically engineer universal donors, whose organs could potentially be transplanted into any human recipient. Or perhaps there would need to be a finite number of donors, say for each blood type. When someone needs an organ they get the next one off the rack. Still, this seems like an expensive option.
The other main limitation of the clone approach is the ethical considerations. I doubt keeping banks of living donor clones will be morally acceptable to society, at least not anytime soon.
This leaves us with what I think is by far the best option – genetically engineering animals to be human organ donors. Pigs are good candidates because the size and shape of their organs are a good match. We just need to engineer them so their immune systems use human proteins instead of pig proteins. We can remove any of the proteins that are most likely to trigger rejection. This also means giving the pigs a human immune system. The pigs are therefore both humanized and altered so as not to trigger rejection. Slayman will still need to take anti-rejection drugs, but it is easy to imagine that as this technology incrementally improves eventually we will get to a population of pigs optimized for human organ donation. The advantages of this approach over all other approaches are simply massive, which leads me to predict that this approach is the one that will win out for the foreseeable future.
One potential ethical objection is from raising domestic animals for the purpose of being slaughtered, which some animal rights activists object to. But of course, we already do this for food. At least for now, this is ethically acceptable to most people. Slaughtering a pig not just for food but to save the lives of potentially 5-7 people is not a hard sell ethically. This approach could also be a huge money saver for the healthcare system.
I am therefore very happy to see this technology proceed, and I wish the best for Slayman, both for him personally and for the potential of this technology to save many lives.
The post Man Gets Pig Kidney Transplant first appeared on NeuroLogica Blog.
https://theness.com/neurologicablog/man-gets-pig-kidney-transplant/
-
https://www.theepochtimes.com/health/fluoroquinolone-alert-the-common-medication-that-could-lead-to-irreversible-health-conditions-5586004?utm_source=Bright&src_src=Bright&utm_campaign=bright-2024-03-31&src_cmp=bright-2024-03-31&utm_medium=email&est=AAAAAAAAAAAAAAAAYvAqcwcVzc7PzLYPrHFRB710wA0AIj31kx5JTWZu9FddhEg4S8RP
-
quinolones
very interesting
I remember when they first came out in late 90's
They were wonder drugs covering all types of bacteria almost as well as IV antibiotics.
besides tendon problems
I saw two patients that had what appeared to be irreversible nerve damage
one in the hands and feet and one in lower extremities
One of the patients was so terrified he refused ANY antibiotics
-
https://www.hippocraticai.com/video
very weird
:-o