Health – Page 92 – artdiamondblog.com

“Powerful Pressure for Scientists to Conform”

Source of book image: online version of the WSJ review quoted and cited below.

(p. A13) In “Hyping Health Risks,” Geoffrey Kabat, an epidemiologist himself, shows how activists, regulators and scientists distort or magnify minuscule environmental risks. He duly notes the accomplishments of epidemiology, such as uncovering the risks of tobacco smoking and the dangers of exposure to vinyl chloride and asbestos. And he acknowledges that industry has attempted to manipulate science. But he is concerned about a less reported problem: “The highly charged climate surrounding environmental health risks can create powerful pressure for scientists to conform and to fall into line with a particular position.”

Mr. Kabat looks at four claims — those trying to link cancer to man-made chemicals, electromagnetic fields and radon and to link cancer and heart disease to passive smoking. In each, he finds more bias than biology — until further research, years later, corrects exaggeration or error.
. . .
I know whereof Mr. Kabat speaks. In 1992, as the producer of a PBS program, I interviewed an epidemiologist who was on the EPA’s passive-smoking scientific advisory board. He admitted to me that the EPA had put its thumb on the evidentiary scales to come to its conclusion. He had lent his name to this process because, he said, he wanted “to remain relevant to the policy process.” Naturally, he didn’t want to appear on TV contradicting the EPA.

For the full review, see:
RONALD BAILEY. “Bookshelf; Scared Senseless.” The Wall Street Journal (Mon., AUGUST 11, 2008): A13.
(Note: ellipsis added.)
(Note: the first paragraph quoted above has slightly different wording in the online version than the print version; the second paragraph quoted is the same in both.)

The book under review is:
Kabat, Geoffrey C. Hyping Health Risks: Environmental Hazards in Daily Life and the Science of Epidemiology. New York: Columbia University Press, 2008.

Feds Protect Us from Freshly Baked Cookies

“Schools like Omaha’s Masters Elementary, which held a recent holiday bake sale, count on the profits from selling cupcakes, caramel corn and other goodies to raise money for field trips and other activities.” Source of caption and photo: online version of the Omaha World-Herald article quoted and cited below.

(p. 1A) A business club at Millard West High School peddles freshly baked cookies, raking in $15,000 annually to help send students to national conferences.

At Omaha’s Masters Elementary, cupcakes, fudge and other bake-sale treats raise $500 for field trips, rain jackets for the safety patrol and playground equipment.

But the federal government could slam the brakes on those brownies and lower the boom on the lemon bars.
A child nutrition bill passed recently by Congress gives a federal agency the power to limit the frequency of school bake sales and other school-sponsored fundraisers that sell unhealthy food.
To some, the bake sale provision makes about as much sense as leaving the marshmallows out of Rice Krispies treats.
It maybe makes sense for the federal government to monitor the quality of ground beef, eggs and milk sold in grocery stores. But caramel corn and snicker doodles whipped up by parents for school bake sales?
“Aren’t there more important (p. 2A) things for them to be worried about?” Sandy Hatcher, president of Masters’ parent organization, said of the federal government.

For the full story, see:
MICHAEL O’CONNOR. “Putting the brakes on bake sales; New federal rules on frequency during school day may affect fundraising.” Omaha World-Herald (Sun., December 12, 2010): 1A-2A.

Cuban Government Gets Billions by “Exporting” Doctors; Some Defect

“Dr. Felix Ramírez in Gambia in 2008.” Source of caption and photo: online version of the WSJ article quoted and cited below.

(p. A1) Felix Ramírez slipped into an Internet cafe in the West African nation of The Gambia, scoured the Web for contact information for U.S. diplomats, then phoned the U.S. embassy in Banjul, the capital.

He told the receptionist he was an American tourist who had lost his passport, and asked to speak to the visa section. As he waited to be connected, he practiced his script: “I am a Cuban doctor looking to go to America. When can we meet?”
Dr. Ramírez says he was told to go to a crowded Banjul supermarket and to look for a blond woman in a green dress–an American consular official. They circled one another a few times, then began to talk.
That furtive meeting in September 2008 began a journey for the 37-year-old surgeon that ended in May 2009 in Miami, where he became a legal refugee with a shot at citizenship.
Dr. Ramírez is part of a wave of Cubans who have defected to the U.S. since 2006 under the little-known Cuban Medical Professional Parole immigration program, which allows Cuban doctors and some other health workers who are serving their government overseas to enter the U.S. immediately as refugees. Data released to The Wall Street Journal under the Freedom of Information Act shows that, through Dec. 16, 1,574 CMPP visas have been issued by U.S. consulates in 65 countries.
Cuba has been sending medical “brigades” to foreign countries since 1973, helping it to win friends abroad, to back “revolutionary” regimes in places like Ethiopia, Angola and Nicaragua, and perhaps most importantly, to earn hard currency. Communist Party newspaper Granma reported in June that Cuba had 37,041 doctors and other health workers in (p. A12) 77 countries. Estimates of what Cuba earns from its medical teams–revenue that Cuba’s central bank counts as “exports of services”–vary widely, running to as much as $8 billion a year. Many Cubans complain that the brigades have undermined Cuba’s ability to maintain a high standard of health care at home.

For the full story, see:
JOEL MILLMAN. “New Prize in Cold War: Cuban Doctors.” The Wall Street Journal (Sat., JANUARY 15, 2011): A1 & A12.

Source of graph: online version of the WSJ article quoted and cited above.

Higher Cancer Rates Due More to Longer Life Spans than to Modern Life Styles

“DIAGNOSIS. Evidence of tumors in the skull of a male skeleton exhumed from an early medieval cemetery in Slovakia. Often thought of as a modern disease, cancer has always been with us.” Source of caption and photo: online version of the NYT article quoted and cited below.

(p. D1) When they excavated a Scythian burial mound in the Russian region of Tuva about 10 years ago, archaeologists literally struck gold. Crouched on the floor of a dark inner chamber were two skeletons, a man and a woman, surrounded by royal garb from 27 centuries ago: headdresses and capes adorned with gold horses, panthers and other sacred beasts.

But for paleopathologists — scholars of ancient disease — the richest treasure was the abundance of tumors that had riddled almost every bone of the man’s body. The diagnosis: the oldest known case of metastasizing prostate cancer.
The prostate itself had disintegrated long ago. But malignant cells from the gland had migrated according to a familiar pattern and left identifiable scars. Proteins extracted from the bone tested positive for PSA, prostate specific antigen.
Often thought of as a modern disease, cancer has always been with us.
. . .
(p. D7) . . . , Tony Waldron, a paleopathologist at University College London, analyzed British mortality reports from 1901 to 1905 — a period late enough to ensure reasonably good records and early enough to avoid skewing the data with, for example, the spike in lung cancer caused in later decades by the popularity of cigarettes.
Taking into account variations in life span and the likelihood that different malignancies will spread to bone, he estimated that in an “archaeological assemblage” one might expect cancer in less than 2 percent of male skeletons and 4 to 7 percent of female skeletons.
Andreas G. Nerlich and colleagues in Munich tried out the prediction on 905 skeletons from two ancient Egyptian necropolises. With the help of X-rays and CT scans they diagnosed five cancers — right in line with Dr. Waldron’s expectations. And as his statistics predicted, 13 cancers were found among 2,547 remains buried in an ossuary in southern Germany between A.D. 1400 and 1800.
For both groups, the authors wrote, malignant tumors “were not significantly fewer than expected” when compared with early-20th-century England. They concluded that “the current rise in tumor frequencies in present populations is much more related to the higher life expectancy than primary environmental or genetic factors.”
. . .
“Cancer is an inevitability the moment you create complex multicellular organisms and give the individual cells the license to proliferate,” said Dr. Weinberg of the Whitehead Institute. “It is simply a consequence of increasing entropy, increasing disorder.”
He was not being fatalistic. Over the ages bodies have evolved formidable barriers to keep rebellious cells in line. Quitting smoking, losing weight, eating healthier diets and taking other preventive measures can stave off cancer for decades. Until we die of something else.
“If we lived long enough,” Dr. Weinberg observed, “sooner or later we all would get cancer.”

For the full story, see:
GEORGE JOHNSON. “Unearthing Prehistoric Tumors, and Debate.” The New York Times (Tues., December 28, 2010): D1 & D7.
(Note: ellipses added.)
(Note: the online version of the article is dated December 27, 2010.)

Modern Lifestyles May Not Be Cause of Heart Disease

“MODERN MEETS ANCIENT. CT scans of some Egyptian mummies, like the one being done on this priest, reveal signs of atherosclerosis.” Source of caption and photo: online version of the NYT article quoted and cited below.

(p. D6) . . . a team of cardiologists used CT scanning on mummies in the Egyptian National Museum of Antiquities in Cairo to identify atherosclerosis — a buildup of cholesterol, inflammation and scar tissue in the walls of the arteries, a problem that can lead to heart attack and stroke.

The cardiologists were able to identify the disease in some mummies because atherosclerotic tissue often develops calcification, which is visible as bright spots on a CT image. The finding that some mummies had hardened arteries raises questions about the common wisdom that factors in modern life, including stress, high-fat diets, smoking and sedentary routines, play an essential role in the development of cardiovascular disease, the researchers said.
“It tells us that we have to look beyond lifestyles and diet for the cause and progression of this disease,” said Dr. Randall C. Thompson, a cardiologist at St. Luke’s Mid America Heart Institute in Kansas City, Mo., and part of the team of cardiovascular imaging specialists who traveled to Cairo last year. “To a certain extent, getting the disease is part of the human condition.”

For the full story, see:
NATASHA SINGER. “Artery Disease in Some Very Old Patients.” The New York Times (Tues., November 24, 2009): D6.
(Note: ellipsis added.)
(Note: the online version of the review has the date November 23, 2009.)

Government Mandates Insurers Pay for $4,300 Tests on Potential Donors Recruited by $60,000 a Week “Flirtatious Models”

(p. A16) BOSTON — On its face, it seemed reasonable enough: a bone marrow registry sending recruiters to malls, ballparks and other busy sites to enlist potential donors.

But the recruiters were actually flirtatious models in heels, short skirts and lab coats, law enforcement officials say, asking passers-by for DNA swabs without mentioning the price of the seemingly simple procedure. And the registry, Caitlin Raymond International, was paying up to $60,000 a week for the models while billing insurance companies up to $4,300 per test.
. . .
The registry is a nonprofit subsidiary of UMass Memorial Medical Center in Worcester, . . .
. . .
James T. Boffetti, the state’s senior assistant attorney general, said the registry had hired models based on their photographs and had given them “explicit instructions” to wear heels and short skirts.
. . .
New Hampshire passed a law in 2006 requiring insurers to pay for tissue-typing tests for potential bone marrow donors.

For the full story, see:
ABBY GOODNOUGH. “Flirty Models Were Hired in Bid to Find Bone Marrow.” The New York Times (Fri., December 17, 2010): A16.
(Note: ellipses added.)
(Note: the online version of the article is dated December 16, 2010.)

Under Health Care ‘Reform’ the Total Cost of Health Care Will “Go through the Roof!”

“Jonathan Bush, nephew of one former president and cousin of another, built a small medical practice into a national enterprise with nearly 1,200 employees.” Source of caption and photo: online version of the NYT article quoted and cited below.

(p. B10) In the world of health care innovation, the founder and chief executive of Athenahealth has an outsize name. In part, that’s because his name is Jonathan Bush, and he is the nephew of one former president and the cousin of another. But it’s also because his company has mastered the intricacies of the doctor-insurer relationship and become a player in the emerging medical records industry.

Based in Watertown, Mass., Athenahealth offers a suite of administrative services for medical practices. It collects payments from insurers and patients, and it manages electronic health records and patient communication systems. All of this is done remotely through the Internet — or “in the cloud,” as Mr. Bush puts it. Doctors don’t have to install or manage software or pay licensing fees; instead, Athenahealth keeps a percentage of the revenue.
. . .
Q. What’s going on in the health care industry to deliver that kind of growth to you?
A. We are a disruptive technology. We are the only cloud-based service in an industry segment full of sclerotic, enormous, personality-free corporations that have been in business making 90 percent margins doing nothing for decades and decades.
Q. What keeps other companies from building cloud-based systems?
A. For software companies, the biggest barrier to entry is that they give up their business model. Those companies would get hammered on Wall Street if they started selling a service that they have to deliver at a loss for five years. In terms of new entrants, there are two things that we’ve done that would take a good decade to replicate. One, we’ve built out the health care Internet. We’ve been building connections into insurance companies and laboratories and hospital medical records for years and years and years.
And the other barrier to entry is that rules engine. Every time a doctor anywhere in the country gets a claim denied, we have analysts ask the Five Whys. When we get to root cause, we write a new rule into Athenanet and from that day on, no other doctor gets that particular denial from that particular insurance company ever again. We now know of 40 million ways that a doctor can have a claim denied in the United States. The average practice has to rework about 35 percent of their claims, and we only have to rework about 5 percent of ours.
Q. What’s the prognosis for bill collecting under health care reform?
A. Well, there’s going to be new connectors and a whole series of new insurance products that will be managed by the states’ health insurance commissioners. And the law provides for every state to do all of these its own way, so they will have their own rules and regulations, and each state will do it differently. That sounds like springtime in Complexity Land.
Q. What do you think will happen to the total cost of health care under reform?
A. Oh, it’s going to go through the roof! It’s widely accepted that this is not a cost-reform bill — it’s an access bill. It’s in fact a cost-expansion bill.

For the full story, see:

ROBB MANDELBAUM. “Views of Health Care Economics From a C.E.O. Named Bush.” The New York Times (Thurs., September 9, 2010): B10.
(Note: ellipsis added.)
(Note: the online version of the article has the date September 8, 2010.)

Neurosurgeons Treating Dogs is Mutually Beneficial to Dogs and Humans

(p. D3) An operation commonly performed to remove brain tumors from the pituitary glands of humans is now available to dogs, thanks to a collaboration between a neurosurgeon and some veterinarians in Los Angeles. And that is turning out to be good for humans.

So far, nine dogs and one cat that otherwise would have died have been treated successfully.
. . .
What Dr. Mamelak has gained from teaching the procedure to veterinarians is access to tissue samples from the treated dogs. That’s significant because Cushing’s afflicts only one in a million humans, making it a difficult disease to study. By contrast, it afflicts about 100,000 dogs a year in the United States. The canine tissue samples are enabling him and his colleagues to develop drugs to one day treat Cushing’s disease in both humans and dogs.
“We have a full loop,” he said. “We’re using a human procedure in animals, and using their tissue to study the disease.”

For the full story, see:
SINDYA N. BHANOO. “Observatory; They Fetch, They Roll Over, They Aid Tumor Research.” The New York Times, Science Times Section (Tues., October 26, 2010): D3.
(Note: ellipsIs added.)
(Note: the online version of the article is dated October 22 (sic), 2010.)

Feds Chastise Us for Being Fat AND Urge Us to Eat More Cheese Pizzas

“A government-created industry group worked with Domino’s Pizza to bolster sales by increasing the cheese on pies.” Source of caption and photo: online version of the NYT article quoted and cited below.

(p. 1) Domino’s Pizza was hurting early last year. Domestic sales had fallen, and a survey of big pizza chain customers left the company tied for the worst tasting pies.

Then help arrived from an organization called Dairy Management. It teamed up with Domino’s to develop a new line of pizzas with 40 percent more cheese, and proceeded to devise and pay for a $12 million marketing campaign.
Consumers devoured the cheesier pizza, and sales soared by double digits. “This partnership is clearly working,” Brandon Solano, the Domino’s vice president for brand innovation, said in a statement to The New York Times.
But as healthy as this pizza has been for Domino’s, one slice contains as much as two-thirds of a day’s maximum recommended amount of saturated fat, which has been linked to heart disease and is high in calories.
And Dairy Management, which has made cheese its cause, is not a private business consultant. It is a marketing creation of the United States Department of Agriculture — the same agency at the center of a federal anti-obesity drive that discourages over-consumption of some of the very foods Dairy Management is vigorously promoting.
. . .
When Michelle Obama implored restaurateurs in September to help fight obesity, she cited the proliferation of cheeseburgers and macaroni and cheese. “I (p. 23) want to challenge every restaurant to offer healthy menu options,” she told the National Restaurant Association’s annual meeting.
But in a series of confidential agreements approved by agriculture secretaries in both the Bush and Obama administrations, Dairy Management has worked with restaurants to expand their menus with cheese-laden products.

For the full story, see:
MICHAEL MOSS. “While Warning About Fat, U.S. Pushes Cheese Sales.” The New York Times, First Section (Sun., November 7, 2010): 1 & 23.
(Note: the online version of the story is dated November 6, 2010.)
(Note: ellipsis added.)

Source of graphic: online version of the NYT article quoted and cited above.

Being Bilingual Increases “Cognitive Reserve”

Source of graph: online version of the WSJ article quoted and cited below.

At first glance the graph and the text quoted below seem inconsistent on whether bilingualism delays the onset of dementia. The text says no, the graph says yes. On closer reading, the text is referring to the “physical signs of deterioration” while the graph is referring to “visible symptoms.”

(p. D1) A lifetime of speaking two or more languages appears to pay off in old age, with recent research showing the symptoms of dementia can be delayed by an average of four years in bilingual people.

Multilingualism doesn’t delay the onset of dementia–the brains of people who speak multiple languages still show physical signs of deterioration–but the process of speaking two or more languages appears to enable people to develop skills to better cope with the early symptoms of memory-robbing diseases, including Alzheimer’s.
Scientists for years studied children and found that fluently speaking more than one language takes a lot of mental work. Compared with people who speak only one language, bilingual children and young adults have slightly smaller vocabularies and are slower performing certain verbal tasks, such as naming lists of animals or fruits.
But over time, regularly speaking more than one language appears to strengthen skills that boost the brain’s so-called cognitive reserve, a capacity to work even when stressed or damaged. This build-up of cognitive reserve appears to help bilingual people as they age.

For the full story, see:
SHIRLEY S. WANG. “Building a More Resilient Brain.” The Wall Street Journal (Tues., OCTOBER 12, 2010): D1 & D2.

Paleolithic Humans Ate Carbohydrates

(p. D4) LONDON (Reuters) — Starch grains found on 30,000-year-old grinding stones suggest that prehistoric humans may have dined on an early form of flatbread, contrary to their popular image as primarily meat eaters.

The findings, published in The Proceedings of the National Academy of Sciences journal on Monday, indicate that Paleolithic Europeans ground down plant roots similar to potatoes to make flour, which was later whisked into dough.
“It’s like a flatbread, like a pancake with just water and flour,” said Laura Longo, a researcher on the team, from the Italian Institute of Prehistory and Early History.
. . .
The findings may . . . upset fans of the so-called Paleolithic diet, which follows earlier research that assumes early humans ate a meat-centered diet.

For the full story, see:
REUTERS. “Paleolithic Humans Had Bread Along With Their Meat.” The New York Times (Tues., October 19, 2010): D4.
(Note: ellipses added.)
(Note: the online version of the article is dated October 18, 2010.)