Vol. 83 February 1, 2013 Antioxidants: Miracle or Myth?

February 1, 2013

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“The hallowed notion that oxidative damage causes aging
and that vitamins might preserve our youth is now in doubt”
-M. W. Moyer, Scientific American February 2013

It was not just a humble roundworm that got us into this debate. it was a MUTANT roundworm, a worm commonly used for the study of aging.

Since the 1960’s the dominant theory of aging blamed a rising level of free radicals. Free radicals are highly reactive organic molecules produced in our bodies by oxidation. We all know that oxidation is “bad” because we learned in high school that it is oxidation that turns steel into rust. Free radicals cause “rust” in our body by mangling other cells, proteins, and even DNA. Therefore, an antioxidant that reduces free radicals will slow cell “mangling”, destruction, and aging. Having lots of antioxidants around should retard our aging process. “Drink red wine and take vitamin E.”  More than half of Americans believe in this theory and take considerable amounts of antioxidants like Vitamin E, Vitamin C,  and beta carotene (carrot juice). (JAMA 2007)

MIRACLE: “These high powered, super antioxidants fight dangerous free radicals, the source of oxidative stress and a leading cause of premature aging. CALL NOW to Receive Your FREE 30-Day Bonus Supply!” (Cape Cod Times ad January 20, 2013, E4)

This super antioxidant is an organic chemical called oligmeric proanthrocyanide, or OPC. It is found in grape seeds and certain pine bark. This particular brand of OPC’s touted by Dr. Fred Vaginini includes some other organic chemicals found in grape skins (hence the benefits of red wine) and other botanicals. It is called OPC Factor (TM);  $59.95 for a month’s supply ($35.99 on Amazon). The “landmark, double blinded research study by the prestigious National Institutes of Health” cited to support the ad’s claims was actually a small study by an NIH grantee in Philadelphia to measure changes in energy levels in 25 adult men who took OPC. The 2006 study  results were posted in 2008 as inconclusive.

In the 1990’s genetic science advanced to the point that worm and mice genes could be manipulated to block antioxidant production resulting in very high levels of free radicals. Much to the surprise of the scientists running the experiments those worms and mice with the highest levels of free radicals lived the LONGEST.

Exercise increases free radicals, but exercise is beneficial. A 2009 study of humans who exercised revealed that the ones that did NOT pop a lot of vitamins to lower their free radical levels  were physiologically healthier than those who did!   A 2010 study of mice bred to overproduce a specific “super” free radical actually lived 32% longer than the others. Free radicals rise as one ages, but it may be a result of aging and not the cause. I remember the classic graph showing the number of lung cancer deaths increasing as the number of refrigerators (or  indoor bathrooms) increased in the U.S. during the early phase of that debate.

MYTH: A 2007 systematic review of 68 clinical trials concluded that antioxidants do not reduce the risk of death. When the analysis is restricted to only the most vigorous, double-blinded studies certain antioxidants were linked to a 5% INCREASED risk of death. The American Heart Association and the American Diabetes Association now advise “that people should not take antioxidant supplements except to treat a diagnosed vitamin deficiency”.

“The literature is providing growing evidence that these supplements- in particular at high doses -do not necessarily have the beneficial effects that they have been thought to…We’ve become acutely aware of potential downsides.” -D. Albanes, Senior Investigator, National Cancer Institute

References:
“The Myth of Antioxidants”, Scientific American, Febuary 2013, 64-66, Melinda W. Moyer


Vol. 79 December 1, 2012 Ten Medical Christmas Gifts for Your Enemies

December 1, 2012


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“I once bought my kids a set of batteries for Christmas with a note on it saying, toys not included.” ~Bernard Manning

1. A Gift Certificate for a CT Scan
This is what inspired my slightly twisted view of Christmas giving. Several Christmas’s ago a new private, for-profit imaging center in our town advertised gift certificates for a CT scan to “give to a friend or loved one”. This marketing ploy implied that it was the kind of gift that showed that “you really cared”. Many local physicians considered it as a good gift, not for your friend, but for your enemy.

Besides the considerable exposure to radiation, at least 30% of CT scans performed have an unexpected “finding”; a shadow or bright spot where none is supposed to exist, an organ or other structure that is bigger or smaller than expected, etc. If the radiologist reading the CT scan is particularly compulsive, aggressive, or extraordinarily risk-averse, that “finding” may be called an “abnormality”. Abnormalities need further work-up that usually involves more radiation, use of intravenous and/or oral contrast medium, more aggressive procedures like inserting scopes into various body orifices, and even needle or open biopsy of one of your favorite organs.

Physicians often call these findings, “ditzels“.  Since about one out of three people getting a CT scan will have one or two ditzels that prompt a new cascade of diagnostic testing, this is a perfect gift for an enemy. CT scans are a superb diagnostic tool for people who are sick, but they are so sensitive that they are not so great as a screening tool. If you should ever be told that you have a “finding” on your CT scan, just ask the doctor if it is really significant or is just a “ditzel.”

2. A screening mammogram
 The current controversy surrounding the mammogram as a screening test for breast cancer makes this a perfect gift for that passive-aggressive Ex whose impenetrable ambivalence was so vexing. Data about the number of “false positive” or equivocal results in mammograms that generate lots of repeat imaging, more expensive imaging technology, consultation referrals, biopsies, and even “unnecessary” surgery and chemotherapy has reordered the risk/benefit ratio of screening mammograms. Different scientific groups have different guidelines for when (women can be too young or too old) and how often (annual, every three years, once?) women should get one. Several studies indicate that mammogram screening has not improved the survival rate of women with breast cancer at all. A side effect of the drive for early diagnosis is that “if you look really hard , you find forms that are ultimately never going to bother the patient” (1)

3. A Prostate Specific Antigen (PSA) blood test
This is a very suitable response from the woman who gets a mammogram gift from her despised Ex. This very popular test has lost its initial considerably positive blush as more and more data appeared that the PSA has had no real impact on reducing the death rate from prostate cancer (spoiler alert: deaths from prostate cancer itself are so few that most studies try to focus on “quality of life” measures.). The PSA’s simple number can prompt a lot of unnecessary specialist consultations, biopsies, and even aggressive surgery.

Besides raising your Ex’s anxiety while awaiting the results, an “abnormally high result” suggests the presence of cancer. This usually causes your Ex to enjoy a series of awkward digital (by finger, that is) rectal exams and even multiple long needle biopsies. The biopsy needles are inserted just below his scrotum as he lies flat on his back with his feet up in stirrups (“sweet justice” you might say if you have happened to bear any of his children.)

Of interest to you as his Ex, an abnormally high PSA may also be caused by an ejaculation within the previous two weeks. About 7% of men who do get biopsied (an office procedure) have to be hospitalized within 30 days for post-biopsy complications.  “The overall balance of benefits and harms results in moderate certainty that PSA-based screening…has no net benefit“.

4. A motorcycle for the one you really hate.
About 4,500 people died in motorcycle crashes last year. That is 1 in 7 of people killed on the nation’s roads annually. This is double the death rate in 1997 while car fatalities decreased by 5% last year.  If you are in a motorcycle crash you are 30 times more likely to die than people in car crashes. Of course, if you gift him a helmet he could drop his chances of death by a third. In case he or she doesn’t get the point, include a certificate granting him or her amnesty for NOT wearing a helmet in the 19 states that require it by law.  (2)

5. A year’s supply of vitamins and other supplements
This is the perfect gift for that annoying vegetarian marathoner friend who won’t stop badgering you to eat healthier and get more exercise. The initial response of gratitude at your surprising thoughtfulness and respect for his life style may fade as he reads the fine print or comes across select issues of Consumers Report. Multiple studies in peer-reviewed medical journals have found no decrease in cardiovascular disease, cancer incidence, or death for any reason among multivitamin users. In a study of over 35,000 men the incidence of prostate cancer was  elevated by 17% in those who took Vitamin E supplements. Supplemental calcium (a 1 gram pill per day) with or without any supplemental vitamin D increased the risk of both heart attack and stroke.

Stocking stuffers for those who don’t want to make a big committment, and two holiday tips:
1. gift certificate for 6 sessions in a tanning booth. (for every 4 visits the risk of skin cancer increased by 15%) (Cancer Research Oct. 2011)
2. gift certificate for an MRI for back pain. (2/3 of asymptomatic people showed “serious disk problems” on their MRI) (NEJM 1994)
3. a bumper sticker that says, “Give your kid a motorcycle for his LAST birthday”.
4. a supply of statins (anticholesterol medication) to anyone over 70 yo. (a high cholesterol may decrease heart attacks in the elderly)
5. a chest x-ray to screen for lung cancer (no benefit) (JAMA Oct.26,2011)
6.. forget the cell phone – it won’t cause brain cancer.
7. But remember, if you leave milk and cookies out for Santa Claus make sure they are lactose-free and gluten-free…and FORGET about peanuts. You don’t want a swollen, wheezing Santa Claus with diarrhea stuck in your chimney Christmas morning.

References:
1. Ann Int Med April 3, 2012 , “Overdiagnosis of Breast Cancer” (Bos Globe,G.Welch, MD A11)
2. Cape Cod Times, Nov. 30, 2012, reporting on a recent GAO Report stating that the 2010  societal costs of motorcycles crashes was $16 billion.
3. Choosing Wisely: Tests to Avoid – http://choosingwisely.org/?page_id=13
4. “Surprising Dangers of Vitamins and Supplements”, Consumer Reports Sept.2012


Vol. 63 March 28, 2012 “Low Back Pain…Oh, NO!”

March 28, 2012

All I said was, “My back pain is a little worse”, in response to the casual “how are ya?”

Suddenly I was engulfed in four other back pain stories. Just try it yourself at the next cocktail party, political rally, or “wherever three or more are gathered”. At least 80% of us Americans have back pain at sometime in our life. Almost 30% of us have it at the same time. (1)

About three years ago I decided to actually do something about mine when I found that I couldn’t complete the short walk from Fenway Park to the MBTA station with my grandson. I suspected that my back pain and stiff, wooden-like, sore thighs were side effects from Lipitor. I stopped taking it, but after no improvement in a month, I went to my primary care doctor. He quickly sent me to a neurosurgeon, passing “lumbar MRI for $1300.”

The neurosurgeon said he could fix my gait by straightening out the “rubber band tangle of spinal nerves” of spinal stenosis by chipping away a little of my backbone. After surgery on L4 and L5 (just in case you are taking detailed notes) my thigh muscles were no longer stiff, wooden, and sore after 100 yards of walking. But, I still had a funny walk, and my low back pain remained. I walked funny because I couldn’t get up on my toes, and my balance was off. The neurosurgeon sent me back to the neurologist saying “I fixed him above the knees, but have no idea what is going on below them.”

The neurologist performed his medieval-torture test called an electromyogram (involves sticking needles into muscles and shocking them with electrical pulses), and sagely announced that I had “diabetic neuropathy”. As diplomatically as I could, I told him that I didn’t have diabetes.  I also blurted out, “ …and I don’t know where the stolen microfilm is hidden.” Several tubes of blood later, the neurologist had ruled out all but two diagnoses, “a peculiar gait” (thanks, but I already knew that) and CIDP (“Chronic Inflammatory Demyelinating Polyneuropathy” or “Chronic Idiopathic Demyelinating Polyneuropathy”). “Idiopathic” is the cover term for “I don’t know”. I am repeatedly impressed by how well we physicians can cover up our ignorance of causation with such lofty sounding terms.

At least CIDP was a diagnosis that had a treatment. Three months after starting monthly intravenous infusions of gamma globulin, I ended up in the hospital in the middle of the night with a pulmonary embolism, a “known but unusual” side effect of the infusions. So I went off the gamma globulin and onto coumadin for a year. I still walked funny and had back pain. By this time my neurologist had joined my children in recommending physical therapy and more exercise, but my children had since moved on to recommending Pilates, Yoga, and meditation.

“I’m an American. Just give me a pill” was my plea to my rheumotologist. He had struggled over 20 years to place me in the correct category of arthritis diagnoses. Whichever one of my three “revolving” diagnoses was the correct one; it had caused both hips to need replacement 10 years before my back pain started. Replacement resolved the hip pain, but one leg ended up an inch shorter than the other.

Many of my friends assumed that my funny walk was from my hips. I grew weary of repeatedly trying to explain things while standing in a bathing suit on the dock, sot that summer I started handing out this card.
.                                 “Yes, I walk funny. My hips are fine. I have some back pain.
.                                   My spinal stenosis was fixed in April. The muscles in my
.                                   lower legs and feet have grown weak because of a rare nerve
.                                   condition, a peripheral neuropathy. No, I am not diabetic.
.                                                         Thank you for caring.”
The card was not entirely true. I have discovered since then that peripheral neuropathy is NOT a rare condition at my age.

My rheumotologist did not think that my back pain had anything to do with my underlying arthritis, whatever that was. He suggested I go back to see the neurosurgeon. Much to my surprise the neurosurgeon said that my repeat MRI looked great, and “he couldn’t see anything else to operate on.” He also said, “You probably should get more exercise.”

Desperate for relief I then turned to Pilates and Yoga, much to the amazement (and joy) of my daughters. Pilates aims to strengthen your core while Yoga seeks to relax it. Both use poses and exercises that mimicked those of physical therapy and the self-help back exercise book one of those afore-mentioned cocktail-party-story-tellers recommended. (2) My flexibility and general well-being improved, but I still woke up with a stiff, sore back that usually resolved by my second cup of coffee, only to return in the evening after walking and standing for the day.

My best friend asked, “So, is this what you are going to settle for for the rest of your life?” By chance, I had my annual exam with my primary care physician the next day. I entered the office determined to get relief. He read my lumbar spine MRI report out loud to me. It sounded like a fly over of the Bad Lands or the Grand Canyon. He followed with, “You are not on anything for degenerative arthritis. What has worked in the past?” Restraining myself from punching him in the mouth for calling me a degenerate (back pain can make people cranky) I responded that my rheumotologist had tried several different ones in the distant past and that Indocin helped the most. “Well, let’s try 50mg. a day and see how that goes.”

Two days later I woke up without back pain.   Thank God, I’m an American!

References:
1. Arch Intern Med. 2009 Feb 9;169(3):251-8. The rising prevalence of chronic low back pain. Freburger JK
2. The Egoscue Method of Health through Motion, Pete Egoscue, HarperCollins 1992.


Vol.45 May 15, 2011 Surprising Medical Fun Facts

May 15, 2011

“Scientists constantly change their minds.
Science is not about immutable laws but provisional
explanationsthat get revised when a better one comes along.
Scientists’ readiness to change their beliefs to align with data
is a source of great strength, not weakness.”
– Daniel Willingham, Prof. of Psychology, Univ. of Virginia
in Scientific American May 2011


Does cranberry juice prevent bladder infections?
NO,
 according to a study of 155 healthy college women in Michigan (the state that produces the most cranberries) who drank two glasses a day of cranberry juice for 6 months after having a bladder infection. The cranberry juice swillers had a recurrence rate of 19% which was lower than the expected recurrence rate of 30%, BUT the control group that drank two glasses a day of a cranberry-like placebo also had a lower than expected recurrence rate at 15%. (1) The study was done to find out if proanthocyanidin, the suspected preventative ingredient in cranberry juice, really worked. The problem is that “tiny little berry that continues to defy science” contains over 200 active substances and several organic acids.Proanthocyanide apparently is not THE one.


Walk fast and carry a big stick .
A study of 35,000 community-dwelling adults with a mean age of 74 showed that life expectancy increased about 12% for each 4 inches per second faster one could walk. A threshold for “higher risk of early mortality” is suggested as “being unable to walk 20 feet in 10 seconds”. (2) In a separate study of 2900 community-dwelling Australian men, 40% of those who were 70-74 years old  reported being sexually active.  43% of those reported having sex less than desired. (3)

The umpires refused to be tested.
Dr. Daniel Laby, a Harvard Professor of Ophthalmology and eye doctor to the Red Sox, reports that the average baseball player’s vision is 20-12. That means they can see at 20 feet what we can’t see until its 12 feet away. The normal standard is 20-20, of course, and the very best a human eye can see is 20-8. He states that seeing the seams on the moving ball is one of the key factors in successful hitting. Dr. Laby offered Major League Baseball the same service for the umpires.  MLB did not respond. (4)

Are they sleeping on the job?
31% of employed Americans take a nap every day, but 39% of UNemployed Americans do too. (5)

Is drinking during pregnancy bad for the baby?
Children born to light drinkers (1-2 drinks a week) were less likely than children born to abstainers to have behavioral problems at 5 years of age and more likely to have higher vocabulary and picture similarity scores. (6)

What about drinking if you are diabetic?
According to “Healthy Eating for Type 2 Diabetes” published by Harvard Medical School, drinking alcohol reduces the risk of diabetes by up to 43%.  It also states that drinking coffee reduces the risk of diabetes by 42%. It does NOT endorse the newly popular Red Bull and vodka cocktails. (7) It does go on to say that losing 10% of your weight is really the best way to reduce your risk of diabetes.

Fishing is more dangerous than being a fireman or policeman.
The U.S. Department of Labor 2009 statistics of fatal occupational injuries per 100,000 full-time workers showed a rate of 200 for “fishers and related fishing workers” and a rate of 13.1 for police and 4.4 for firemen. Non-fatal injuries or illnesses per 10,000 civilian workers that resulted in lost days of work averaged about 117. The police rate of 676 and the firemen’s rate of 512 were soundly topped by the bus driver’s rate of 892. (8)

What’s the cure for the common cold?
Echinacea ain’t it. (9)  Zinc might be. Use of zinc lozenges within the first 24 hours of symptoms reduced the duration of cold symptoms from 7 to 4 days and reduced coughing from 5 to 2 days. (10) BUT, different zinc remedies contain different dosages and different forms of zinc, and too much zinc by nasal inhaler can blunt your taste sense. 200 mg or more of Vitamin C daily will reduce cold symptoms in smokers or seniors, but it won’t prevent colds. (11)

My two favorite cold cures are:
The British cure – Take a cold shower, immediately go outside while still wet, and run around the house without any clothes on. You will probably get pneumonia and “any damn fool doctor can cure pneumonia.”
The Scottish cure – You need a four poster bed, a hat, and a bottle of scotch. Put the hat on the Southeast  corner post of the bed, sit on the bed, and sip scotch until you see two hats. Even if you are not cured, you won’t care.

Another cause of autism?
Researchers in California studied more than 300 preschool children with autism and found that their mothers were much more likely to live near a freeway, and just freeways not other major roads, when pregnant than 260 preschool children without autism. (12) The California real estate market has been hit hard enough without implicating every house within 300 meters of a freeway.

You’re not still worried about bad effects from H1N1 flu shots are you?
A study of nearly 90 MILLION doses of H1N1 vaccine given in China in 2009-2010 were associated with 11 cases of Guillain-Barre Syndrome (GBS, ascending nerve paralysis). That is a rate of 0.1 per million doses which is lower than the normally occurring or “background rate” in China. (13)

Kids getting dirty may reduce later asthma and eczema.
Two studies in Europe showed that kids living on farms developed less asthma and had less eczema than kids living in a city. The kids on the farms were exposed to more bacteria and fungus and to many more types of those two “germs” than the city kids, and that exposure could explain the difference in the asthma rates. (14)

Unintended consequences of the “hot stuff”.
In a study of a 2008 epidemic of food-borne illnesses involving 1500 people in 14 states, 30 out of 35 restaurants (86%) of the associated restaurants were Mexican restaurants. Common ingredients included jalapeno peppers, serrano peppers, and raw tomatoes. Believe it or not, the CDC researchers were able to trace back the peppers through Texas distributors  to just two farms in Mexico. (15)

Some cars are greener than people.
Researchers in physiology at the University of Milan, Italy found that four men jogging produced MORE carbon dioxide emissions than a hybrid car driving them the same distance. (16)

References:
1. Clin Infect Dis 2011 Jan 1; 52:23
2.JAMA 2011  Jan 5;305:50
3. Jour Watch Gen Med vol. 31 Feb. 1, 2011 p. 26
4. Boston Globe Jan. 22, 2010
5.Harpers Index September 2009 p. 13
6. J Epidemiol Community Health 2010 Oct 5
7. AARP Bulletin Nov. 2009 p.14
8. http://www.marketwatch.com, Ruth Mantell, Feb 2011
9. Ann Intern Med 2010 Dec 21;153:769
10. Jour Inf Dis March 2008, Meenu Singh, MD
11. Consumer Reports on Health March 2011 p.4
12. Environ Health Perspect 2010 Dec 13
13. NEJM 364;7 Feb 17, 2011
14. NEJM 364;8 Feb 24, 2011
15. NEJM 364;10 Mar. 10,2011
16. Scientific American May 2011 p.18



Vol. 39 February 15, 2011 Ten Really Fun Facts

February 11, 2011

Satchel Page’s advice for living a long time was right. “Don’t look back. Something may be gaining on you.”

There is a significant association between gait speed and 10-year survival for participants older than 75. If a person can’t walk 20 feet in 10 seconds the risk for early mortality is high. (1)

Grandma was  wrong about cranberry juice.

311 college-aged women drank cranberry juice or a placebo twice a day for six months after being treated for a urinary tract infection (UTI). Recurrence rates of UTIs were the same in both groups. In fact, the women who drank the cranberry juice had twice as many recurrences with E. Coli, the bacteria that cranberry juice is supposed to be most effective against. (2) Cranberry juice contains over 200 active compounds, so “the little berry that defies” science will continue to do so for a while.

Grandpa is still going strong down under.

31% of 2800 Australian men aged 75-95 reported having sex at least once in the past 12 months and 43% reported having sex “less often than desired.”  “A lack of a partner” was cited as the reason by 21%. (3)

French men drink the Irish under the table … and into the ground!

91% of French men surveyed consumed alcohol once weekly while only 61% of Irish men did so. Average DAILY alcohol consumption in French men was 33 grams while Irish men consumed only 22 grams daily. In 10 years of follow-up the Irish men had TWICE the number of adverse coronary events (heart attack or death due to cardiac disease) than the French. You might say that the Irish are just poor losers…or perhaps that wine is better for your heart than beer and whiskey. (4)

Some Super Bowl losses are more permanent than others.

The 1980 Los Angles Ram Super Bowl loss was associated with a 15% increase of cardiac deaths in Los Angeles in the 14 days after the game. The increase was highest in women and those over age 65. In 1984 the Los Angles Raiders won the Super Bowl and cardiac deaths dropped by 1% (5)

Sometimes “progress” can be relative.

The odds of getting killed in an automobile accident in New York City today is about the same as getting killed in a horse accident in 1900 (about 1 in 20,000 – 25,000) (6)

Baseball players CAN see better than umpires.

“On average, a baseball players’ vision is 20/12 which means a baseball player can see from 20 feet what a normal person can see at 12 feet. Normal vision is 20/20, of course. The best the human eye can see is 20/8, so 20/12 is halfway to the best human vision possible.” Major League Baseball did not respond to an offer to evaluate umpires’ vision. (7)

It’s about the same ON or OFF the job.

Percentage of unemployed Americans who take a nap each day: 39%     Percentage of employed Americans who do: 31% (8)

Sperm and the Proton Channel.

“A recent study directly measured whole-cell electrical activities in human sperm using patch-clamp methods and found that the proton channel HV1, which is sensitive to both the membrane potential and the pH gradient, is the predominant mechanism used by sperm to achieve intracellular alkalinization which is necessary for motility and interaction with the egg coat.” (9) I can’t find either the Proton Channel or HV1 on my TV. I wonder if the Australian grandpas get it?

But what about Rock and Roll?

“Adolescents who were enrolled in a school-based drug prevention program were less likely to engage in unprotected sex or sex with multiple partners 7 years later.” (10)

References:

1. JAMA 2011 Jan 5; 305:50, Studenski
2. Clin Inf Dis 2011 Jan 1; 52:23, Barbosa-Cesnik
3.Gen Med Jour Watch, vol. 31, 5,  p.26
4. BMJ 2010 nov 23; 341:c6077, Ruidavets
5. Clin Card, Feb. 2011; 34;2 102-107, Kloner
6. Harper’s Index, Dec. 2010, p.11 and 68
7. Interview with Dr. Daniel Laby, opthalmologist to the Red Sox, Boston Globe G, Feb. 22, 2010, p.3
8. Harper’s Index, Aug 2009, p.13 and 63
9. New Eng J Med 362:20, May 2010 p.1935
10. J Adolesc Health  2009 Aug; 45:111, Ellickson


Vol. 33 November 15, 2010 More Things That Threaten or Kill…or NOT

November 16, 2010

“When good things go bad,
and vice versa.”

 

CELL PHONES DON’T CAUSE CANCER- (1)
Despite ample scientific evidence to the contrary much buzz continues about cell phone usage causing brain cancer. Why is that ? A recent review in Scientific American magazine points out how hard it is to prove a negative. I am reminded about the story of the English farmer spreading purple dust over his fields last year. When asked why he did that he replied “To keep the lions away”.  The questioner pointed out that there had been no lions in England for at least four centuries. “Works pretty well doesn’t it,” was the proud rejoinder.

A $24 million study (2) of 12,000 regular cell phone users, half of whom already had brain cancer, found no correlation between cell phone use and the two most common brain tumors. A recent article in Skeptic magazine stated that the non-correlation was because,  as my oldest son the engineer often says to me, “It’s just physics.” X-rays and gamma rays can cause cancer because their radiation energy can disrupt chemical bonds inside cells, about 480 kilojoules per mole (it’s just a physics energy term). A cell phone generates radiation of less than 0.001 kilojoules per mole. Whatever kilojoules per mole are, it is clear that cell phones don’t generate very much of them; no where near enough to disrupt chemical bonds. The article’s author notes that probably the only way to hurt someone’s brain with a cell phone is to throw it at his/her head. I would add that since HPV (a virus) is associated with cervical cancer and is more apt to be present in sexually active women, I guess you could cause cancer with a cell phone by sexting!

ALCOHOL EVERY DAY KEEPS THE DOCTOR AWAY (3)
Italian researchers (God bless those guys) have shown that two or three alcoholic drinks a day reduces heart attacks or strokes by 25% in men who have already undergone cardiac by-pass surgery. Brigham and Women’s Hospital researchers found that women who consume two to four drinks daily in mid-life may have better health at age 70 than those who didn’t imbibe.

At last the definition of “too much to drink” has been quantified. For decades the definition of “drinking too much” was “drinking more than your doctor”. Now moderate drinking has been defined as one drink a day for women and two drinks a day for men. “One drink” is a shot and half of liquor, or 5 oz. of wine, or a 12 oz. glass of beer. One of the reasons that people drink too much is that they are unaware of how much they are becoming “addicted”. Recent data from a Boston Medical Center study (4) suggests that just by having people complete a questionnaire of a dozen questions they become aware that maybe they have an addiction. Fully a third of those “screening positive” on the self-administered questionnaire were voluntarily abstaining from alcohol and drugs six months later.

Of course, if you leave the country your alcohol problem may get worse. What? The alcohol consumption of college kids twenty-one or older DOUBLED their alcohol intake when studying abroad. For those under twenty-one, their alcohol consumption actually TRIPLED.(5) Hopefully that means that they went from one beer a day to three which doesn’t sound as bad somehow.

NATURAL FOODS AND HERBS ARE ORGANIC, BUT CAN BE HARMFUL
Of 40 herbal supplements tested by the federal Government Accounting Office 37 contained trace levels of at least one hazardous compound. Presence of steroids and other active pharmaceuticals were also found. The FDA has been “regulating” dietary supplements since 1994, but this new report from the GAO suggests how loose that regulation of a $14.8 billion industry (2007) is. Even pure supplements can cause more trouble than expected. Review of  nine clinical trials involving 118,000 people using Vitamin E revealed that those taking Vitamin E had a 22% higher risk 0f hemorrhagic strokes. (6)

EVEN DRUMMING CAN BE DANGEROUS…AND NOT TO JUST YOUR EARS
A 24-year-old woman came into MGH with belly pain and shock and spent 61 days in the hospital with the diagnosis of intestinal anthrax. As you might imagine, the state health department (two actually) and the CDC were soon joined by the FBI in pinning down the source of the anthrax. It turned out that she had recently participated in a drumming event in New Hampshire. Cultures from the site and two of the animal skin drums grew out anthrax. Presumably drumming of the anthrax-contaminated hides produced an aerosol of anthrax particles which she swallowed. (7)

References:
1.Scientific American, October 2010, p.98, Michael Shermer
2. Internat Jour of Epidemiology, “Brain tumor Risk in Relation to Mobile Telephone Use”
3. Am Heart Assoc conference, reported in Boston Globe, Nov 15, 2010
4. MASBIRT, reported in Boston Globe , Nov. 15, 2010
5
.Findings, Harper’s Magazine, December 2010, p.84
6. Scientific American, August 2010, p. 24
7. New Eng Jour Med, August 19, 2010, p. 766


Vol. 31 October 15, 2010 Medical Astrology

October 15, 2010

The gravitational influence of the obstetrician is
much greater [on the baby]
than the gravitational influence of Mars.

- Carl Sagan, On the Pseudoscience of Astrology, 2008

The birth of my sixth grandchild on October 10, 2010 ( time of birth was 10:18 so he just missed a perfect “pentafecta”, 10:10-10/10/10) caused me to notice all the hoopla about 10/10/10 and to do a bit of web surfing among astrology and numerology sites. I was disappointed that I didn’t find anything too exciting or illuminating. One of the more popular sites (according to Google) noted that one of three things could happen on 10/10/10:  1) something really good, 2) nothing, or 3) something really bad, and that #2 was the most likely.

I did discover, believe it or not, a site devoted to Medical Astrology or “Iatromathematics” that, among other things, postulated that Carl Sagan’s death in 1996 was predicted by the alignment of the planets in 1994.

Number of E-cigarette distributors recently cited by the FDA for false health claims and for delivering liquid pharmaceuticals not yet approved in the U.S.: 5  (1)

Types of liquid drugs delivered by E-cigarettes: erectile dysfunction and weight loss

  • I guess that is the kind of cigarette you should light up BEFORE having sex.

Whatever happened to the swine flu epidemic and that H1N1 vaccine we heard so much about? (2)

  • Among 483,276 recipients of the vaccine in one study there were NO cases of Guillain-Barre Syndrome (GBS) and NO deaths.
  • Another study showed that receiving the H1N1 (swine flu) vaccine increased the chance of getting GBS by 0.7/100,000 person-years which is tiny and IDENTICAL to the rate of the usual seasonal flu vaccine.
  • Number of 10 patients with swine flu admitted to a Michigan ICU for ventilator support who were obese: 9 (3)
  • Number of the same 10 who were extremely obese: 7

Funny Graphs - How bad they thought it would be How bad it was

Per cent of people in the U.S. with antibody levels high enough to protect them from getting mumps:  90%

Per cent of immune people necessary to provide “herd immunity” (the protection of unimmunized people) :  92%  (4)

Per cent increase in risk of seizures in 400,000 children within 3 days after a diptheria-tetanus immunization:  ZERO (5)

References:
1. Pediatric News, Clinical Rounds, September 2010, p.42
2. Adriana Weinberg, MD, Report given at 2010 Pediatric Infectious Disease Conference, Pediatric News, September 2010, p.11
3. http://www.cdc.gov/mmwr July 7, 2009
4. J Infect Dis 2010 Sept 1; 202:667
5. Pediatrics 2010 Aug; 126:263


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