Health – Page 11 – artdiamondblog.com

The Cholera and Bubonic Plague Vaccination Campaigns of Waldemar Haffkine Count as Evidence of “the Benevolence of British Medical Imperialism”

(p. C7) “In the end, all history is natural history,” writes Simon Schama in “Foreign Bodies: Pandemics, Vaccines and the Health of Nations.” The author, a wide-ranging historian and an engaging television host, reconciles the weight of medical detail with the light-footed pleasures of narrative discovery. His book profiles some of the unsung miracle workers of modern vaccination, and offers a subtle rumination on borders political and biological.

. . .

Inoculation, Mr. Schama writes, became a “serious big business” in commercial England, despite the inoculators’ inability to understand how (p. C8) it worked, and despite Tory suspicions that the procedure meant “new-fangled,” possibly Jewish, interference in the divine plan. In 1764, the Italian medical professor Angelo Gatti published an impassioned defense of inoculation that demolished humoral theory. Mr. Schama calls Gatti an “unsung visionary of the Enlightenment.” His work was a boon to public health, though his findings met resistance in France, where the prerevolutionary medical establishment was more concerned with protecting its authority.

. . .

(p. C8) Mr. Schama alights on the story of Waldemar Haffkine, the Odessa-born Jew who created vaccines against cholera and bubonic plague. In 1892, Haffkine inoculated himself against cholera with the vaccine he had developed at the Institut Pasteur in Paris. He went on to inoculate thousands of Indians, and so effectively that his campaigns served as, in Mr. Schama’s words, “an advertisement for the benevolence of British medical imperialism.”

. . .

The author notes the contrast between the facts of Haffkine’s achievements and the response of the British establishment, with its modern echoes of the medieval fantasy that Jews were “demonic instigators of mass death.” Yet Mr. Schama’s skepticism of authority only extends so far. It would have been instructive to learn why, when Covid-19 appeared, the WHO concurred with Voltaire that the Chinese were “the wisest and best governed people in the world” and advised liberal democracies to emulate China’s lockdowns.

Haffkine’s colleague Ernest Hanbury Hankin once wrote an essay called “The Mental Limitations of the Expert.” Mr. Schama’s conclusion shows the limitations of our expert class, which appears not to understand the breach of public trust caused by the politicization of Covid policy and the suppression of public debate. You do not have to be “far right” to distrust mandatory mRNA vaccination. As Mr. Schama shows, the health of the body politic depends on scientific inquiry.

For the full review, see:

Dominic Green. “Protecting the Body Politic.” The Wall Street Journal (Saturday, Sept. 23, 2023): C7-C8.

(Note: ellipses added.)

(Note: the online version of the review has the date September 22, 2023, and has the title “‘Foreign Bodies’ Review: Migrant Microbes, Human Borders.”)

The book under review is:

Schama, Simon. Foreign Bodies: Pandemics, Vaccines, and the Health of Nations. New York: Ecco Press, 2023.

Neuroscientists Confirm Folk Medicine Claims of Lavender’s Healing Powers

(p. D2) Lavender has purported healing powers for reducing stress and anxiety. But are these effects more than just folk medicine?

Yes, said Hideki Kashiwadani, a physiologist and neuroscientist at Kagoshima University in Japan — at least in mice.

. . .

In a study published Tuesday [Oct. 23, 2018 [sic]] in the journal Frontiers in Behavioral Neuroscience, he and his colleagues found that sniffing linalool, an alcohol component of lavender odor, was kind of like popping a Valium. It worked on the same parts of a mouse’s brain, but without all the dizzying side effects.

. . .

Their findings add to a growing body of research demonstrating anxiety-reducing qualities of lavender odors and suggest a new mechanism for how they work in the body.

For the full story see:

JoAnna Klein. “Purple Reigns: Folk Wisdom Hails Lavender’s Powers. Now Researchers Are Pinning Down Why.” The New York Times (Tuesday, October 30, 2018 [sic]): D2.

(Note: ellipses and bracketed date added.)

(Note: the online version of the story has the date Oct. 23, 2018 [sic], and has the title “Lavender’s Soothing Scent Could Be More Than Just Folk Medicine.” Where there is a small difference in wording between the versions, the passages quoted above follow the online version.)

The article co-authored by Kashiwadani and mentioned above is:

Harada, Hiroki, Hideki Kashiwadani, Yuichi Kanmura, and Tomoyuki Kuwaki. “Linalool Odor-Induced Anxiolytic Effects in Mice.” Frontiers in Behavioral Neuroscience 12 (Oct. 23, 2018).

Elephants Have Backup or “Resurrected” Copies of Cancer-Killing Genes

(p. D3) Elephants ought to get a lot of cancer. They’re huge animals, weighing as much as eight tons. It takes a lot of cells to make up that much elephant.

All of those cells arose from a single fertilized egg, and each time a cell divides, there’s a chance that it will gain a mutation — one that may lead to cancer.

Strangely, however, elephants aren’t more prone to cancer than smaller animals. Some research even suggests they get less cancer than humans do.

On Tuesday [Aug. 14, 2018 [sic]], a team of researchers reported what may be a partial solution to that mystery: Elephants protect themselves with a unique gene that aggressively kills off cells whose DNA has been damaged.

Somewhere in the course of evolution, the gene had become dormant. But somehow it was resurrected, a bit of zombie DNA that has proved particularly useful.

Vincent J. Lynch, an evolutionary biologist at the University of Chicago and a co-author of the paper, published in Cell Reports, said that understanding how elephants fight cancer may provide inspiration for developing new drugs.

. . .

In 2015, Dr. Lynch and his colleagues discovered that elephants have evolved unusual p53 genes. While we only have one copy of the gene, elephants have 20 copies. Researchers at the University of Utah independently made the same discovery.

. . .

Dr. Lynch and his colleagues continued their search for cancer-fighting genes, and they soon encountered another one, called LIF6, that only elephants seem to possess.

In response to DNA damage, p53 proteins in elephants switch on LIF6. The cell makes LIF6 proteins, which then wreak havoc.

Dr. Lynch’s experiments indicate that LIF6 proteins make their way to the cell’s tiny fuel-generating factories, called mitochondria.

The proteins pry open holes in the mitochondria, allowing molecules to pour out. The molecules from mitochondria are toxic, causing the cell to die.

. . .

After the ancestors of elephants evolved ten LIF genes, however, something remarkable happened: One of these dead genes came back to life. That gene is LIF6.

Somewhere in the course of elephant evolution, a cellular mutation inserted a genetic switch next to LIF6, enabling the gene to be activated by p53. The resurrected gene now made a protein that could do something new: attack mitochondria and kill damaged cells.

For the full commentary see:

Carl Zimmer. “MATTER; A Resurrected Cancer Fighter.” The New York Times (Tuesday, August 21, 2018 [sic]): D3.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the commentary has the date Aug. 14, 2018 [sic], and has the title “MATTER; The ‘Zombie Gene’ That May Protect Elephants From Cancer.” Where there is a small difference in wording between the versions, the passages quoted above follow the online version.)

The paper published in Cell Reports and mentioned above is:

Vazquez, Juan Manuel, Michael Sulak, Sravanthi Chigurupati, and Vincent J. Lynch. “A Zombie LIF Gene in Elephants Is Upregulated by TP53 to Induce Apoptosis in Response to DNA Damage.” Cell Reports 24 (2018): 1765–76.

Patients Know Their Condition and Should Be Listened to by Physicians

The article quoted below gives evidence that on average the patients of female physicians have slightly better health outcomes than the patients of male physicians, and speculates that the reason is that on average, female physicians are somewhat better at listening than are male physicians. The article does not highlight an important implication of this speculation: that what the patient is saying is worth listening to, i.e., it has merit, often providing true and useful knowledge about their own condition. Patients actually know something. If so, this goes against the popular views that physicians should be paternalistic, and that the only actionable source of health knowledge is a randomized double-blind clinical trial.

(p. D4) Whether your doctor is male or female could be a matter of life or death, a new study suggests. The study, of more than 580,000 heart patients admitted over two decades to emergency rooms in Florida, found that mortality rates for both women and men were lower when the treating physician was female. And women who were treated by male doctors were the least likely to survive.

Earlier research supports the findings. In 2016, a Harvard study of more than 1.5 million hospitalized Medicare patients found that when patients were treated by female physicians, they were less likely to die or be readmitted to the hospital over a 30-day period than those cared for by male doctors. The difference in mortality was slight — about half a percentage point — but when applied to the entire Medicare population, it translates to 32,000 fewer deaths.

Other studies have also found meaningful differences in how women and men practice medicine. Researchers at Johns Hopkins Bloomberg School of Public Health analyzed a number of studies that focused on how doctors communicate. They found that female primary care doctors simply spent more time listening to patients than did their male colleagues. But listening comes with a cost. Doctors who were women spent, on average, two extra minutes, or about 10 percent more time per visit, creating scheduling delays and putting them an hour or more behind their male colleagues by the end of the day.

Dr. Nieca Goldberg, a cardiologist whose book “Women Are Not Small Men” helped start a national conversation about heart disease in women, said the research should not be used to disparage male doctors, but should instead empower patients to find doctors who listen.

. . .

Edna Haber, a retired mortgage company owner who lives in Westchester County in New York, said she has had wonderful male and female doctors, but her worst experiences have all involved male doctors. . . .

Recently she decided to see Dr. Goldberg to discuss heart palpitations and feeling lightheaded. But a series of medical tests during the office visit found that her heart was normal. “I do believe that had I been with a male doctor, I think he just would have put his arm around me and said, ‘Listen, go home, relax, meditate, maybe take a tranquilizer,’ and that would have been the end of it.”

But Dr. Goldberg knew the patient had been concerned enough to see a doctor, so she suggested that she wear a heart monitor for a few days. Several days later, the technicians monitoring the feed noticed a pattern that ultimately showed Ms. Haber needed a pacemaker.

“She paid attention and treated me as if I was credible,” said Ms. Haber. “I wish all the women I know could understand how important it is to have a doctor who pays attention to them, whatever part of the body they are looking at. I think a lot of women are getting short shrift.”

For the full story see:

Tara Parker-Pope. “Should You Choose a Female Doctor?” The New York Times (Tuesday, August 21, 2018 [sic]): D4.

(Note: ellipses added.)

(Note: the online version of the story has the date Aug. 14, 2018 [sic], and has the same title as the print version.)

The “new” study mentioned above is:

Greenwood, Brad N., Seth Carnahanb, and Laura Huang. “Patient–Physician Gender Concordance and Increased Mortality among Female Heart Attack Patients.” PNAS 115, no. 34 (Aug. 21, 2018): 8569–74.

Buy Health Supplements Certified by “a Trusted Third Party” Like U.S. Pharmacopeia (USP)

According to a Consumer Reports article, “USP is a nonprofit organization that sets what CR experts say are the most widely accepted standards for supplements.” Note that with the services of private organizations such as USP, attentive consumers can be safe without the heavy hand of government regulators.

(p. D6) . . . most supplements have not been rigorously tested for safety or effectiveness, said Dr. JoAnn Manson, a professor of medicine at Harvard Medical School.

. . .

But, she said, there are some instances where taking a supplement may improve your health. Here are some of the main ones.

If a blood test reveals that your body is low in a particular vitamin or mineral, such as vitamin D or iron, supplements can be “essential” in correcting that deficiency, said Dr. Pieter Cohen, an internist at Cambridge Health Alliance in Somerville, Mass.

. . .

Most older adults usually get enough nutrition from their food. But as you age, your requirements for some nutrients increase while your ability to absorb them and your appetite can diminish, so your doctor may recommend a supplement. Older adults may have trouble absorbing vitamin B12, for example. And you may need a calcium and vitamin D supplement if you’re at risk for bone loss, Dr. Manson said.

. . .

Several recent trials have also found that multivitamins may improve memory and slow cognitive decline in older adults, though more research is needed, Dr. Manson said.

And there’s some evidence that taking a supplement that contains vitamins C and E, zinc, copper, lutein and zeaxanthin (called an AREDS supplement) can slow vision loss for those with age-related macular degeneration, Dr. Manson said.

. . .

If you do purchase supplements, look for a certification seal from a trusted third party organization such as the U.S. Pharmacopeia or NSF, which confirm that the products contain the ingredients listed on the label.

For the full story see:

Alice Callahan. “Ask Well: Are Any Supplements Proven To Benefit Health?.” The New York Times (Tuesday, November 7, 2023 [sic]): D6.

(Note: ellipses added.)

(Note: the online version of the story has the date Oct. 31, 2023, and has the title “Ask Well: Should I Be Taking Supplements?” Where there is a difference in wording between the versions, the passages quoted above follow the online version.)

Fauci’s Office Rejected Protocol for a Voluntary COVID Human Challenge Trial That Could Have Tested Therapies and Vaccines Faster

(p. 2) . . . the first Covid-19 human challenge study [was] just completed in Britain, where young, healthy and unvaccinated volunteers were infected with the coronavirus that causes Covid while researchers carefully monitored how their bodies responded.

. . ., there were those who decried deliberately infecting or “challenging” healthy volunteers with disease-causing pathogens. It violates the medical principle of “do no harm.” The trade-off is a unique opportunity to discover the causes, transmission and progression of an illness, as well as the ability to more rapidly test the effectiveness of proposed treatments.

. . .

Dr. [Matthew] Memoli [the director of the Laboratory of Infectious Diseases Clinical Studies Unit at the National Institute of Allergy and Infectious Diseases] has conducted numerous influenza challenge studies, and he prepared a protocol for a Covid challenge trial that the National Institute of Allergy and Infectious Diseases rejected last year because it was felt that not enough was known about the virus and that there were no effective rescue therapies, according to a statement from the office of the director, Dr. Anthony Fauci.

The consortium formed to run Britain’s Covid challenge trial, which included scientists who trained at the Common Cold Unit, had access to the British National Health Service’s robust, real-time data on Covid hospitalizations and deaths. The researchers designing the study said they felt confident that there was little risk to the healthy unvaccinated 18-to-30-year-old volunteers they recruited for the trial. There were no severe adverse events in the 36 people who participated, and they will continue to be monitored over the next year.

The aim of the study was to identify the lowest amount of virus to safely and reliably infect someone, so researchers can later easily test the efficacy of vaccines or antivirals on future challenge trial volunteers.

. . .

Dr. Fauci’s office said the institute has no plans to fund Covid-19 human challenge trials in the future. Many bioethicists support that decision. “We don’t ask people to sacrifice themselves for the good of society,” said Jeffrey Kahn, director of the Johns Hopkins Berman Institute of Bioethics. “In the U.S., we are very much about protecting individual rights and individual life and health and liberty, while in more communal societies it’s about the greater good.”

But Josh Morrison, a co-founder of 1Day Sooner, which advocates on behalf of more than 40,000 would-be human challenge volunteers, argues it should be his and other people’s right to take risks for the greater good. “Most people aren’t going to want to be in a Covid challenge study, and that’s totally fine, but they shouldn’t project their own choices on other people,” he said.

. . .

As one participant in Britain’s Covid human challenge trial put it: “You know the phrase ‘one interesting fact about yourself’ that strikes terror into everyone? That’s now solved forever. I did something that made a difference.”

For the full commentary, see:

Kate Murphy. “Are Human Challenge Trials Ethical?” The New York Times, SundayReview Section (Sunday, October 17, 2021 [sic]): 2.

(Note: ellipses, and bracketed words, added.)

(Note: the online version of the commentary has the date Oct. 14, 2021 [sic], and has the title “Britain Infected Volunteers With the Coronavirus. Why Won’t the U.S.?”)

The “Rules of Desperation Oncology” Allow Oncologists to Throw Dying Patients a Hail Mary Immunotherapy Drug

(p. D1) Dr. Oliver Sartor has a provocative question for patients who are running out of time.

Most are dying of prostate cancer. They have tried every standard treatment, to no avail. New immunotherapy drugs, which can work miracles against a few types of cancer, are not known to work for this kind.

Still, Dr. Sartor, assistant dean for oncology at Tulane Medical School, asks a diplomatic version of this: Do you want to try an immunotherapy drug before you die?

The chance such a drug will help is vanishingly small — but not zero. “Under rules of desperation oncology, you engage in a different kind of oncology than the rational guideline thought,” Dr. Sartor said.

The promise of immunotherapy has drawn cancer specialists into a conundrum. When the drugs work, a cancer may seem to melt away overnight. But little is known about which patients might benefit, and from which drugs.

Some oncologists choose not to mention immunotherapy to dying patients, arguing that scientists first must gather rigorous evidence about the benefits and pitfalls, and that treating patients experimentally outside a clinical trial is perilous business.

But others, like Dr. Sartor, are offering the drugs to some terminal patients as a roll of the dice. If the patient is dying and there’s a remote chance the drug will help, then why not?

. . .

(p. D6) . . . there is Clark Gordin, 67, who lives in Ocean Springs, Miss. He had metastatic prostate cancer, “a bad deck of cards,” he said in an interview.

Dr. Sartor tried conventional treatments, but they didn’t work for Mr. Gordin. Finally, the doctor suggested immunotherapy.

Mr. Gordin’s insurer refused. But then the lab that had analyzed his tumor discovered it had made a mistake.

There was a chance Mr. Gordin might respond to immunotherapy, because he had a rare mutation. So his insurer agreed to pay.

Immediately after taking the drugs, Mr. Gordin’s PSA level — an indicator of the cancer’s presence — went down to nearly zero.

“Makes my heart nearly stop every time I think about it,” Dr. Sartor said. “Life sometimes hangs on a thin thread.”

For the full story see:

Gina Kolata. “A Life’s One Last Chance.” The New York Times (Tuesday, May 1, 2018 [sic]): D1 & D6.

(Note: ellipses added.)

(Note: the online version of the story has the date April 26, 2018 [sic], and has the title “‘Desperation Oncology’: When Patients Are Dying, Some Cancer Doctors Turn to Immunotherapy.”)

Dogs Can Alert Owners to Epileptic or Diabetic Emergencies

(p. B1) Rosebud is a service dog trained at a nonprofit called Canine Partners for Life in Cochraneville, Pa. The dog can detect when Ms. Vible will have a seizure about 15 minutes before it happens. She lets Ms. Vible know with a whine or a bark and then lies down with her owner until the seizure is over.

Seizure-alert dogs are part of a growing class of service animals that can detect warning signs of epileptic seizures and diabetic emergencies and identify other medical conditions. Demand has surged, according to trainers and training centers—some of which now have long wait lists—as recent scientific studies have started to confirm the dogs’ efficacy in helping their owners.

. . .

Their acute sense of smell helps the dogs detect low and high blood-sugar levels and epileptic seizures before they happen. Researchers haven’t yet identified the specific compounds that the dogs are smelling. But once the dogs recognize the smell, they are trained to respond with a specific action such as barking or pawing at their owners. Depending on the owner’s state and the animal’s training, some dogs also might alert another adult, bring a juice box or press a button that sends a phone text to a caregiver.

The University of Bristol in England this year produced a study of dogs’ ability to detect hypoglycemia, which occurs when a diabetic’s blood sugar drops dangerously. If left untreated, this can lead to unconsciousness or death. In assessing the effectiveness of 27 glycemia-alert dogs, the Bristol study found that the dogs alerted their owners to 83% of hypoglycemic episodes in more than 4,000 hypo- and hyperglycemic episodes.

The findings of another study released this year showed promise for people suffering from epilepsy. Researchers from the University of Rennes in Normandy, France, presented dogs with samples of breath and sweat odors obtained from epileptic patients having seizures, not having seizures and exercising (to determine whether the dogs were just detecting sweat). All of the dogs succeeded in identifying the epileptic-seizure-odor sample, and the dogs spent about 23 seconds investigating the seizure smell, compared with about five seconds spent on the other samples.

The lead researcher of the study, Amelie Catala, a Ph.D. candidate at the University of Rennes, says the research could help in the development of electronic noses, devices that can detect and analyze odors and flavors.

“If there is an organic compound related to these diseases that we can detect and identify, it could help develop electronic noses,” she says.

Medical-alert dogs are being trained by for-profit and nonprofit centers, by individual trainers and at times by individual pet owners themselves. In addition to those skills already mentioned, some have been trained to warn patients about abnormal heart rhythms, and to detect allergens. Dogs also have been trained to help identify certain cancers in laboratory settings.

For the full story, see:

Aili McConnon. “Dogs That Can Read Warning Signs Progress Before Explosion.” The Wall Street Journal (Monday, Sept. 16, 2019 [sic]): R9.

(Note: ellipsis added.)

(Note: the online version of the story has the date Sept. 12, 2019 [sic], and has the title “A Growing Role for Medical-Alert Dogs.” The last four paragraphs quoted above appear in the online, but not in the print, version of the article.)

The University of Bristol academic paper mentioned above is:

Rooney, Nicola J., Claire M. Guest, Lydia C. M. Swanson, and Steve V. Morant. “How Effective Are Trained Dogs at Alerting Their Owners to Changes in Blood Glycaemic Levels?: Variations in Performance of Glycaemia Alert Dogs.” PLOS ONE 14, no. 1 (2019): e0210092.

The University of Rennes academic paper mentioned above is:

Catala, Amélie, Marine Grandgeorge, Jean-Luc Schaff, Hugo Cousillas, Martine Hausberger, and Jennifer Cattet. “Dogs Demonstrate the Existence of an Epileptic Seizure Odour in Humans.” Scientific Reports 9, no. 1 (2019): article #4103.

Allowing the Sale of Hearing Aids Over-the-Counter (O.T.C.) Results in “Increased Innovation and Lower Prices”

(p. D3) A year ago, the Food and Drug Administration announced new regulations allowing the sale of over-the-counter hearing aids and setting standards for their safety and effectiveness.

. . .

Some background: In 2020, the influential Lancet Commission on Dementia Prevention, Intervention and Care identified hearing loss as the greatest potentially modifiable risk factor for dementia.

Previous studies had demonstrated a link between hearing loss and cognitive decline, said Dr. Frank Lin, an otolaryngologist and epidemiologist at Johns Hopkins and lead author of the new research.

“What remained unanswered was, If we treat hearing loss, does it actually reduce cognitive loss?” he said. The ACHIEVE study (for Aging and Cognitive Health Evaluation in Elders) showed that, at least for a particular group of older adults, it could.

. . .

A small study recently published in JAMA Otolaryngology found that patients who were given a commercially available, self-fitting hearing aid in a clinical trial could, after six weeks, hear as well as patients fitted with the same device by audiologists.

. . .

The United States is the first country to develop a regulated O.T.C. hearing aid market, and “the tech companies and the retailers are still experimenting,” Dr. Lin pointed out. He predicts increased innovation and lower prices ahead.

For the full commentary, see:

Paula Span. “THE NEW OLD AGE; A Challenging Over-the-Counter Market for Hearing Aids.” The New York Times (Tuesday, October 31, 2023): D3.

(Note: ellipses added.)

(Note: the online version of the commentary has the date Oct. 30, 2023, and has the title “THE NEW OLD AGE; Hearing Aids Are More Affordable, and Perhaps More Needed, Than Ever.”)

The “small study” mentioned above is:

De Sousa, Karina C., Vinaya Manchaiah, David R. Moore, Marien A. Graham, and De Wet Swanepoel. “Effectiveness of an over-the-Counter Self-Fitting Hearing Aid Compared with an Audiologist-Fitted Hearing Aid: A Randomized Clinical Trial.” JAMA Otolaryngology–Head & Neck Surgery 149, no. 6 (2023): 522-30.

Surgeons Often Excise Useful Appendix Even When Antibiotics Would Have Cured–“Surgeons Who Don’t Operate Miss Out on a Hefty Fee”

(p. D7) The appendix is a finger-shaped pouch attached to the large intestine (colon), usually on the lower right side of the abdomen. Long considered a vestigial organ with no known function, many people, young and old, have theirs removed in the course of another operation.

However, there are now indications that the appendix serves as a repository of healthy bacteria that can replenish the gut after an extreme attack of diarrhea. People who have had appendectomies, for example, are more likely to experience recurrent infections with the bacterium Clostridium difficile, a debilitating intestinal infection that causes severe, difficult-to-treat diarrhea.

. . .

Acute appendicitis is the nation’s most common surgical emergency. . . . Some 300,000 people in the United States undergo an appendectomy each year, but sometimes, the appendix turns out not to have been inflamed, meaning the operation was not necessary.

The results of several recent studies suggest that patients with uncomplicated appendicitis should not be rushed into surgery and instead should be offered the option of a trial of antibiotics.

In a controlled study among 540 adult patients, 72.7 percent of 257 patients randomly assigned to take antibiotics in lieu of an operation did not require subsequent surgery a year later, and those who did need surgery had no bad effects from the delay.

In another nonrandomized study of 3,236 patients who were not operated on initially, the nonsurgical treatment failed to cure the appendicitis in 5.9 percent of cases, and the inflammation recurred in 4.4 percent.

Some patients may choose an operation so they won’t have to worry about developing another attack of appendicitis, but if they aren’t told they have a choice, they can hardly make one.

Writing in JAMA [in February 2016] . . ., Dr. Dana A. Telem, a surgeon at Stony Brook University Medical Center, noted that “the notion of nonoperative treatment of appendicitis has not been well-received by the majority of the surgical community.” This is hardly surprising, because doctors, like many of us, are creatures of habit, and surgeons who don’t operate miss out on a hefty fee.

For the full story see:

JANE E. BRODY. “PERSONAL HEALTH; A Choice for Treating Appendicitis.” The New York Times (Tuesday, March 22, 2016 [sic]): D7.

(Note: ellipses, and bracketed words, added.)

(Note: the online version of the story has the date March 21, 2016 [sic], and has the title “PERSONAL HEALTH; A New View of Appendicitis.”)

The controlled randomized study mentioned above is:

Salminen, Paulina, Hannu Paajanen, Tero Rautio, Pia Nordström, Markku Aarnio, Tuomo Rantanen, Risto Tuominen, Saija Hurme, Johanna Virtanen, Jukka-Pekka Mecklin, Juhani Sand, Airi Jartti, Irina Rinta-Kiikka, and Juha M. Grönroos. “Antibiotic Therapy Vs Appendectomy for Treatment of Uncomplicated Acute Appendicitis: The Appac Randomized Clinical Trial.” JAMA 313, no. 23 (2015): 2340-48.

The nonrandomized study mentioned above is:

McCutcheon, Brandom A., David C. Chang, Logan P. Marcus, Tazo Inui, Abraham Noorbakhsh, Craig Schallhorn, Ralitza Parina, Francesca R. Salazar, and Mark A. Talamini. “Long-Term Outcomes of Patients with Nonsurgically Managed Uncomplicated Appendicitis.” Journal of the American College of Surgeons 218, no. 5 (May 2014): 905-13.

Mandated Fukushima Evacuations Killed 1,600; Radiation Killed 0

Berkeley scientist Noah Whiteman’s Most Delicious Poison argues that often chemicals that are therapeutic at low doses are poisons at high doses. The commentary quoted below provides evidence that what Whiteman argues is true of many chemicals, is also true of radiation.

(p. D3) This spring [2015], four years after the nuclear accident at Fukushima, a small group of scientists met in Tokyo to evaluate the deadly aftermath.

No one has been killed or sickened by the radiation — a point confirmed last month by the International Atomic Energy Agency. Even among Fukushima workers, the number of additional cancer cases in coming years is expected to be so low as to be undetectable, a blip impossible to discern against the statistical background noise.

But about 1,600 people died from the stress of the evacuation — one that some scientists believe was not justified by the relatively moderate radiation levels at the Japanese nuclear plant.

. . .

“The government basically panicked,” said Dr. Mohan Doss, a medical physicist who spoke at the Tokyo meeting, when I called him at his office at Fox Chase Cancer Center in Philadelphia. “When you evacuate a hospital intensive care unit, you cannot take patients to a high school and expect them to survive.”

Among other victims were residents of nursing homes. And there were the suicides. “It was the fear of radiation that ended up killing people,” he said.

Most of the fallout was swept out to sea by easterly winds, and the rest was dispersed and diluted over the land. Had the evacuees stayed home, their cumulative exposure over four years, in the most intensely radioactive locations, would have been about 70 millisieverts — roughly comparable to receiving a high-resolution whole-body diagnostic scan each year. But those hot spots were anomalies.

By Dr. Doss’s calculations, most residents would have received much less, about 4 millisieverts a year. The average annual exposure from the natural background radiation of the earth is 2.4 millisieverts.

How the added effect of the fallout would have compared with that of the evacuation depends on the validity of the “linear no-threshold model,” which assumes that any amount of radiation, no matter how small, causes some harm.

Dr. Doss is among scientists who question that supposition, one built into the world’s radiation standards. Below a certain threshold, they argue, low doses are harmless and possibly even beneficial — a long-debated phenomenon called radiation hormesis.

. . .

Life evolved in a mildly radioactive environment, and some laboratory experiments and animal studies indicate that low exposures unleash protective antioxidants and stimulate the immune system, conceivably protecting against cancers of all kinds.

. . .

. . ., a study of radon by a Johns Hopkins scientist suggested that people living with higher concentrations of the radioactive gas had correspondingly lower rates of lung cancer. If so, then homeowners investing in radon mitigation to meet federal safety standards may be slightly increasing their cancer risk. These and similar findings have also been disputed.

. . .

There is more here at stake than agonizing over irreversible acts, like the evacuation of Fukushima. Fear of radiation, even when diluted to homeopathic portions, compels people to forgo lifesaving diagnostic tests and radiotherapies.

We’re bad at balancing risks, we humans, and we live in a world of continual uncertainty. Trying to avoid the horrors we imagine, we risk creating ones that are real.