August 2009 Archives
From Marcia Angell MD. It's not just the right-wing crazies who oppose health reform. In addition, there are many sane Americans who worry about committing a trillion dollars to it. They have a point. We already spend more than twice as much per person on health care as other advanced countries, and our costs are rising faster. How much is enough? Read the whlw post. Dr Angell is a past editor of the NEJM.
The AP reports that six cases of childhood lead poisoning "in Maine last year came from an unusual source -- lead dust tracked into the family car." Officials from the CDC and the Maine Department of Health and Human Services said that the cases were "the first ever attributed to lead dust on childhood safety seats. The car seats themselves weren't the source; the inside of family cars were contaminated through a parent's workplace." The CDC explained that children's parents, who worked in paint removal or metals recycling, did not change and shower before going home, and so tracked lead dust into their cars and onto children's car seats. Then, "Kids chew on the sides of those seats ... Or they put a cookie down" on the seat and then eat it, Mary Jean Brown, chief of the CDC's Lead Poisoning Prevention Branch said. "Maine officials said they now include checks of cars and child safety seats in their lead investigations."
ABC World News reports, "Protection against the swine flu is going to be delayed for millions of Americans. Federal officials now say that only about a third of the swine flu vaccine the country is counting on will be available by mid-October. That's when the mass vaccination campaign is scheduled to begin." Comment: It is not surprising that politically dominated decisions about medial subjects rarely pan out as intended. The usual rush to judgment was made without adequate scientific input, or else such input was ignored, the most likely event. At the same time we must not let ourselves be diverted from ensuring that children get all the recommended current immunizations.
The September 2009 issue of The American Journal of Clinical Nutrition reports the results of 3 human studies designed to better delineate the relation between animal foods and breast cancer risk. "These studies highlight two very important points," said American Society for Nutrition Spokesperson Shelley McGuire, PhD. "First we all need to remember that there are really no such things as 'bad' foods. Second, observational studies that show associations between diet and health need to be considered with a proverbial grain of salt. These studies clearly provide additional and strong evidence that consumption of meat and dairy products by women does not, by itself, increase breast cancer risk. Further, moderate and mindful consumption of these foods can be very important in attaining optimal nutrition for most women who often do not consume sufficient iron and calcium."
Harvard scientists, alongside researchers at Massachusetts General Hospital and the Dana-Farber Cancer Institute, "analyzed data from two large ongoing studies, the Nurses' Health Study and the Health Professionals Follow-up Study." In total, they looked at data on "nearly 1,300 people with colorectal cancer who'd been followed for an average of 12 years. All the patients in the study had surgery for colon cancer and many also had chemotherapy." The editor-in-chief of the Journal of Clinical Oncology, Daniel G. Haller, MD, of the University of Pennsylvania Cancer Center, says that "they (the data) are not persuasive because, as observational studies, they do not rise to the level needed to change guidelines," Comment: This will lead to the newest fad in use of aspirin which has many side effects, including spontaneous bleeding.
The Los Angeles Times reports, "If people would just do four things -- engage in regular physical activity, eat a healthy diet, not smoke, and avoid becoming obese -- they could slash their risk of diabetes, heart attack, stroke or cancer by 80 percent," CDC researchers found. "But less than 10 percent of the 23,153 people in the multiyear study -- published in Monday's Archives of Internal Medicine -- actually lived their lives this way." Further participants "who followed all four lifestyle factors had a 78 percent lower risk of developing a chronic disease than those with no healthy factors.” Comment: Ts is not much different to the Alameda Study on lifestyles published 35 years ago by Anne Somers et al, where they pinpointed nine behaviors, that if followed ensured 11 years extra quality life. Unfortunately the knowledge about behaviors has not translated into change, Behavioral Medicine, like Economics, is a “Dismal Science” The major problem is that most people do not want some government agency to tell them how to live. Further just as with other addiction than food, such as tobacco and alcohol, long term change is rare...
An editorial in this week’s Lancet lets the air out of the organic food movement. There is little evidence that the nutritional value of ‘organic’ products is better than food raised by other means, but If one wants to buy organic food, do so because it might be fresher and taste better, contain less chemical residues, and is kinder to farmed animals. You have to decide if the price is worth the meal.
The decision to stop the standard treatment of flu patients with Tamiflu was due to its side effects, according to Professor Jaap van Dissel of the Leiden University Medical Centre. Giving Tamiflu to 200 otherwise healthy flu patients will only protect 1 patient from complications, but meanwhile 20 to 30 people will experience serious side effects. Comment: This looks like a science based decision rather than the political one made in the U.S.A. Also the Europeans are not so easily stampeded into mass action.
Studies from this recent HANES survey shows unexpectedly high blood lead levels among Medicaid eligible children . Comment: I wonder why anyone should be surprised. Most children eligible for Medicaid live in old housing, often with multiple layers of lead paint in the home. The current approach of using children as canaries and deleading homes only after children are poisoned has continued for more than forty years despite evidence that rental housing laws ( Portsmouth, VA and Ypsilanti, Michigan) can ensure that no children ae allowed to live in such dangerous homes. It is high time that communities enforce safe housing for children rather than treating them after brain damage has occurred which will stunt their future development! Perhaps realtors should not be allowed to run for local political offices.
Scientists in Singapore, the Netherlands and France report that they have developed a novel immunization method that will induce fast and effective protection in humans against the life-threatening malaria parasite, Plasmodium falciparum, which infects 350 to 500 million people world-wide and kills over one million people each year. [Protection against a Malaria Challenge by Sporozoite Inoculation. The New England Journal of Medicine, 361;5, July 30, 2009] Comment. While I hope this vaccine proves better than previous ones we must also wonder how the countries that use the vaccine will deal with the famine that may result from the increased population.
I note that the WHO Today is giving daily counts of H1N1 flu deaths WORLDWIDE, currently in the hundreds! However they give no data for comparison of death and disability during regular flu seasons which are in the hundreds of thousands if not millions. Neither do they compare these with the millions of deaths each year from heart disease, cancer and stroke, which are often amenable to actions by individuals.
