Vol. 211 April 15, 2019 A Modest Proposal To Eradicate Measles In The U.S.

April 15, 2019

Measles was declared “eradicated” in 2000. Since then we have had unexpected U.S. measles outbreaks in 2014 and presently we are breaking all records for new cases (78 cases just this very week). In 2014 there were 667 cases of measles in Amish country of Ohio. Since January 1, 2019 the U.S. has had 465 cases in 19 states.

For those of us who are used to hearing big numbers every day—size of the national debt, baseball player salaries, number of immigrants pounding on our door, etc.—these numbers don’t sound very compelling. BUT, measles is a preventable disease. One measles vaccine shot protects the recipient 93% of the time. When you add the second shot years later the individual’s protection goes to 97%. 

 Measles, the most infectious disease we know, can cause debilitating encephalitis (brain swelling), pneumonia, and, very rarely in the U.S., death in both infants and adults. Madagascar is not so lucky. Because of its poverty Madagascar has a vaccination rate of only 58% despite the population’s desire for vaccination. They had 1200 deaths in the115,000 who got measles last year. Europe had 41,000 measles cases in 2018. A community vaccination rate of 90-95% is necessary for effective “herd immunity” in which the vaccinated keep the un-vaccinated safe just be reducing their chances of exposure.

You are not likely to be exposed to a case of Madagascar measles, but if you happen to be in the Williamsburg section of Brooklyn, or Rockland County, NY, or  Portland, Washington, or near Sacremento, California, you may be exposed. These four hot spots of current measles outbreak apparently share an unintended consequence of easy-access global travel.  Unvaccinated Orthodox Jews returning from the September annual Hasidic Pilgrimage from Israel to Uman, Ukraine unexpectedly brought measles back to their unvaccinated, ultra-orthodox Jewish U.S. communities.

There is no aversion to vaccination in the Bible, the Quran, or even Sanskrit texts. It is speculated that these communities have low measles vaccination rates because of “anxiety about science”, “concern about risks of new technology”, and, especially in Soviet emigres, “distrust of the government”. 

In 1896 a Jewish man in Britain refused vaccination contending that it was against his religion. The prosecutor, also Jewish, asked the opinion of the Chief Rabbi of Britain who answered, “Hogwash.” The London court agreed.

Anti-vaxxers don’t respond to facts, They reject scientific data. They are apparently immune to dreaded stories about sick, dying children but appear to believe dreaded stories of assumed vaccine reactions. The mayor of New York City has declared a public health emergency and wants to fine any Williamsburg orthodox Jew who refuse the measles vaccine $1000. He has threatened to even close non-compliant Yeshivas. Rockland County tried to bar unvaccinated persons from public places including . . . gasp, . . . malls! A judge with a cooler head put that on hold.

After reading about the British 1896 court case a modest proposal just sprang out of my head: We should sue an anti-vaxxer, the parent of an unvaccinated child, for civil damages!

It has been recently and repeatedly affirmed that one way to get things done in America, to effect change, is to sue somebody—your spouse, your neighbor, the police, the National Enquirer, the President, whomever. 

So, all we have to do is wait until an unvaccinated child with measles exposes a vaccinated child. Since we know that the measles vaccine is not truly 100%  effective, the vaccinated child has a small chance (probably 3% – 7%) of getting measles. If the vaccinated child now with measles develops the more common complication of pneumonia, or the rare one of encephalitis, or the even rarer one of death, his or her parents could sue the unvaccinated child’s parents for all present and future medical bills, loss of school days, future loss of income due to brain damage, loss of companionship, and other compelling emotional stresses dear to personal injury lawyers. If encephalitis were the complication, the huge jury award would be enough to get the attention of even the most adamant anti-vaxxers. They would learn that their stance is not just a risk to society; it could be a large monetary risk to them personally.

References:
1. “A Modest Proposal”, Jonathan Swift, 1729 

Advertisements

Vol. 210 April 1, 2019 Alzheimer’s: There’s an App For That.

April 1, 2019
This image has an empty alt attribute; its file name is hub-thumbnail-2015-e1519515150729.jpeg

Dr. Atul Gawande, CEO of Haven, the new healthcare-innovation company formed by Amazon, Warren Buffet, and J.P. Morgan, has announced that their first “new model of care” is an app for patients with Alzheimer’s. The app’s name is “FIGAWI”, after that ancient Indian tribe that gets lost in the fog almost every Memorial Day weekend on Cape Cod.

The app will provide a number of programs meeting the anticipated needs of Alzeihmer’s patients including:

WMC – Where’s My Car?
When exiting a store and realizing that you forgot where you parked the car, you just have to say WMC? . . . or WTFMC!?, depending on your sense of frustration and degree of patience.
1. The app will immediately access your state’s RMV Dept. database to collect your car’s make, year, and color,
2. then it will scan your credit card charges to find in which near-by store you had just made a purchase. (If you are near a complex of stores or in a mall, you can speak the name of the store into your phone, or if you have been in multiple stores, the program will search your credit card database for the last 10 store charges in order to identify the relevant parking lot.),
3. then it will get a Google satellite picture of the parking lot nearest to you and place a pin on it marking your car’s location.
4. If your phone’s GPS fails to record you moving toward the car within 3 minutes, the app will activate your car’s horn and flashing head lights to aid in its detection.
5 . If you fail to reach your car to turn off the alarm warning system within 12 minutes, the app will call either your emergency contact person in your contact list or 911, depending on your position (vertical or horizontal) as indicated by your phone’s orientation.
6. As an added bonus, if you open and start your car within 15 minutes, the app will show you any current outstanding parking tickets and remind you about the date and amount of your next car loan payment.

WT – Who’s That?
When meeting a person who you know, but can’t remember his or her name, you just have to say WT? or WTFT!?, depending on your sense of urgency. The app will immediately:
1. take a picture of the person approaching you,
2. compare it to pictures of your friends and families stored in your contacts and photo library (If you do not have a picture of that person in your contacts or photo library, the program will access Facebook, Instagram, WhatsApp, the RMV, your local police database, TSA, and the FBI in sequence to seek a match using built-in face recognition software.).
3. The matched name will appear on your phone’s screen along with the date you last saw them, the person’s nickname, spouse’s name (if any), and names of all their children listed by decreasing birth dates.
4. If facial recognition can’t find a match, the phone screen will light up with the following message, “Say hi and take a picture of this person. Ask the person how to spell his or her name so ‘I can get it right for my contact list’, then say, ‘So glad to see you ______________(insert name)’.”

WDISIT – What Day Is it?
The app immediately calls up and displays your calendar, highlights the day and time , and lists the last two places you were in and for how long, as well as where you are expected next.

WIG – Where Am I Going?
Not quite ready for prime time; still under development. Unfortunately our AI program for reading minds currently works only for people who have indwelling brain electrodes or cochlear implant devices masquerading as same.

WAIH – Why Am I Here?
As in “Why did I come into this room?” – (see above WIG) But this function is currently operational based on scans of your house’s floor plan in your town’s Assessor’s Office which is integrated with the time of day, day of the week, and the next two days of appointments on your calendar.

HDIGT – How Do I Get There?
Just say ‘How do I get there?” or “How the f… do I get there?” (almost a shout). The app will discern your different voice volume and tones. If your voice volume threshold exceeds “almost a shout”, the app screen will immediately flash “CALM YOURSELF, and repeat the request please.”
If the volume threshold is exceeded on the repeated request, the screen will show, “OK, TAKE A DEEP BREATH AND COUNT TO 10 — the number of all your fingers, and try again please.”
Please note that this App is separate from Siri, Alexa, and Google so you may choose one of over a dozen app voices which will respond in kind to your sense of urgency and voice volume on a scale of 1 to 10, just like pain.
Once you have respectfully gained the app’s attention, merely say the name of the place you wish to go: as “Super Stop and Shop”, “”Post Office”, “Doctor Smith’s office”, or “The Dump” (also recognized as the “Transfer Station” or “Recycling Center”).
If you can’t remember a specific name, you can say “where I usually buy groceries”, “where I go to Yoga classes”, “nearest liquor store”, or “where I ate Thanksgiving dinner last year”, and the app will bring up the relevant map and directions after scanning your contact list, your most frequent credit card charges, and both yours and national holiday calendars for the past 5 years.
You can also ask the App to give directions with ONLY right hand turns for your safety, if you wish. Of course, “Take me home” will work without any other directions every time and every where.

These seamless cyber connections are all included in the basic FIGAWI App package. Confidential personal notes about your family members and friends can be included at an additional price in the advanced package, as long as you agree to Facebook’s, Amazon’s, Apple’s, Yelp’s and Google’s privacy policies. The app is available in Russian as well as the usual English, Spanish, Hip Hop, and Rap.

Future upgrades of the App will include integration with car ignition breath analyzer devices, if appropriate (the app can scan court data bases and local newspaper “police blotters” for judgements and allegations). The emerging 5G network will also allow this App to connect with other existing helpful apps like: Find my phone, Find my keys, alerts for CD maturing dates, due dates for oil changes and tire rotations, automatic “I’ve fallen and I can’t get up” calls, time to take your pill alerts, “Did I leave the toaster (iron, radio, thermostat ) on?”, etc. Eventually the App will integrate with self-driving cars, so you can find it after it parks itself in the parking lot.

The password for the App is “No Password” or “I Can’t Remember S**t!” whichever the user feels is most appropriate. The App will accept either one depending on the note of frustration and volume of your voice.

One does not actually have to have the diagnosis of Alzeihmer’s (easily confirmed or ruled out by a scan of your primary physician’s EMR) to get this app. The differences between Alzeihmer’s and cognitive impairment of old age is subtle enough to confuse our current AI program, . . . and some physicians.

The FIGAWI App is available to anyone over 65. Despite AARP’s active lobbying we are not offering it to people just over 55.

I was going to list the website where you can order the app, and its price, but I can’t remember either.

HAPPY APRIL FOOLS DAY.


Vol. 209 March 15, 2019, Jargon Update

March 15, 2019

Jargon: “special words or expressions that are used by a particular profession or group and are difficult for others to understand.”

PIV
“Penis In Vagina” intercourse.  Researchers into the sexual activities of people over 65 yo. are using this term to more accurately define a specific sexual act . . .  because they are documenting a wide variety of sexual practices without penile insertion in this age group.

Elderly” is OUT
This term is currently way out of favor. Few “older adults” want to be considered elderly. “Seniors” is acceptable, even though it implies that those under 65 are “juniors”. It may be the association of that word with “discount” that keeps it current. “Perennials”, suggested as a response to the “millennials”, has the connotation that one has to be replanted every spring so it’s failing to stick. “Olders”, “gerontos”, and “third-agers” are distant possibilities. “Older adults” has been adopted by the American Geriatric Society. The American Association of Retired Persons began referring to itself simply as AARP in the late 1990’s . . . about the time it started sending membership invitations to 50 year olds. The Boston Commission on Affairs of the Elderly just changed its name to the Age Strong Commission. (The best candidate for “Best New Politically Correct Term of the Year” award.)

GM/GF
Genetically engineered wheat that contains far less gluten for gluten-free bread that tastes and feels more like real bread has been created using CRISPR gene modifying technology. When it does reach the marketplace it will undoubtedly cause a real purchasing dilemma for a select group of tree huggers.

“Organic”, “natural”, “healthy”
All still remain relatively undefined by the U.S.  Department of Agricultural so any company can put those labels on almost any food. The USDA and the National Organic Standards Board have opposite opinions on the “organic-ness” of carrageenan, a seaweed derived thickening agent. The USDA Organic label does indicate no synthetic pesticides and fertilizers, no genetically modified crops, no chemical processing aids, and no artificial ingredients. A proposed Food Labeling Modernization Act hopes to set uniform, definitive standards in the U.S.

Computer vision
A growing domain of artificial intelligence using “deep learning”, a “type of machine learning that uses multilayered neural networks whose hierarchical computational design is partly inspired by a biologic neuron’s structure.” (1) (Took the words right out of my mouth.) Computer vision can analyze medical images like pictures of skin lesions as well as the work flow in operating rooms or the progression of patient mobility in the ICU.

Moral injury
This is a substitute term for “burn out” in describing what is happening to our physicians.  “The increasingly complex web of medical providers’ highly conflicted allegiances. . . results in the moral injury . . . of not being able to provide high-quality care and healing in the context of health care. . . . Electronic health records track productivity and business metrics, but significantly reduce face-to-face interactions.” (2)

Cisgender
Having a gender identity that is aligned with one’s sex assigned at birth. The opposite of transgender. . . usually, but some transgender persons identify with both genders or neither! (on to the next jargon item.)

Nonbinary
Identifying as neither male or female, having multiple gender identities, or having none; “a more expansive concept of gender.”

Sexual orientation
“Who you go to bed with. Gender is who you go to bed as.”

High-end lobster
Offered by a Maine seafood restaurant that pumped marijuana smoke through the tank water to sedate lobsters before throwing them into the pot. The practice was stopped by order of the state Department of Health for “dispensing of marijuana without a license.”

Standing desks are OUT
A deeper look into the 2015 research of the health benefits of standing vs. sitting while working at a desk indicates that there is little actual health benefit to standing. “Workers should not fool themselves into thinking that standing is a form of exercise.”

Pasture-raised chicken
“Cage-free” chickens may still be raised in packed buildings with no outside access. “Free-range” chickens have outside access but there is no government standard for amount of available space. “Organic” chickens are cage-free, are fed only organic feed, and have outdoor access, but it may be just a small concrete porch. “Pasture-raised” chicken require 108 square feet per bird of outdoor space to earn that label as well as the “Certified Humane” label. (3)

Geroscience
This emerging field of scientific research of longevity hopes to gain the Federal Drug Administration’s attention for reviewing drugs to retard the aging process, which recognizes aging as a natural process (outside their purview) not as a disease (within their jurisdiction for review of new drugs).  A newly formed Boston-based Academy for Health and Lifespan Research will lobby various governments world-wide to support development of drugs and other age-slowing therapies.

“Safe-school officer”
Former combat veterans wearing body armor while carrying a 9mm Glock handgun and a sawed-off automatic rifle hired to roam the halls of the Manatee School for the Arts in Palmetto, Florida. The principal hired the combat veterans because “I don’t want this to be the first time they’ve had someone shooting at them.”

References:
1. NEJM 378;14 April 5, 2018
2. Drs. Talbot and Dean, Boston Globe 8/15/18
3. Consumer Reports On Health, February 2019


Vol. 208 February 15, 2019 Sex, Love, and Attachment . . .

February 15, 2019

. . .  an appropriate headline for the day after Valentine’s Day, don’t you think?

All three “drives” or urges, sex, love, and attachment, arise from the same part of the brain according to Helen Fisher, neuroscientist and anthropologist, author of The Anatomy of Love. She states that these three brain neuropathways interconnect and interact to produce together the feeling of romantic love. This occurs in the most primal part of our brain which also generates feelings of hunger and thirst. The three pathways can operate independently, obviously one can have sex without love or attachment, but all three have to be working together to produce “romantic love”; think about the lyrics, “Will you still love me tomorrow?” (presumably during a night of sex).

That same part of the brain is the source of dopamine, the neurochemical stimulant associated with our “craving and reward” mechanisms.  Dopamine causes release of endorphins, neurochemical messengers,  and oxytocin, a hormone, both of which are opiate-like. Oxytocin, sometimes called the “love drug”, is released when a mother nurses her infant which promotes their strong attachment, and so is also called the”bonding drug”.  Interestingly, just petting and cuddling your dog has been shown to cause oxytocin release.  The most potent release of oxytocin is associated with orgasm. Dopamine and other “feel good” neurochemicals are known to make the decision-making parts of the brain less active; think of “Love is blind” or “Madly in love” or somebody texting a picture of their genitalia.

In the 1970’s two graduate student psychologists, married to each other, started experimenting with a program to try to promote “personal closeness” in a non-romantic relationship between two strangers. They found that a series of 48 escalating, self-revealing questions that random pairings of people asked of each other, followed by staring silently into each others’ eyes for four minutes, produced “friendships” of strangers that lasted for months in 35% of the pairings. This procedure became known as the Arons Protocol, named after its two developers. (1)

In 2015 the writer of a love column, Mandy Len Carton, decided to try the Arons Protocol, now pared down to 36 questions in three sets, on one of her dates. She promptly fell in love, and described the experience in her Modern Love column, “To Fall in Love With Anyone, Do This”, her most widely read column according to the NY Times.

There are 2500 social network “dating websites” in the U.S. alone. Most ask questions of subscribers in hopes of identifying common compatibilities that will make “a good match”. One of the first sites, eHarmony launched in 2000, boasts that its 150 questions (pared down from the original 450) were scientifically developed by a clinical psychologist to ensure a better “match” of personalities and values; a better match would lead to more “attachment” and long-lasting romantic love. Tinder, not so much.

Most agree that romantic love is not simply something we can talk ourselves into, or game ourselves into, and that it can also occur very quickly as in  “love at first sight”.  Much research shows that many factors, perhaps even including unknown, unidentified pheromones are involved in generating that feeling of love. Deep down most of us don’t want to believe that the mystery of human love can be explained by genetic maps and certain chemical levels in the brain or blood. Alfred Einstein, when asked if he ever thought of trying to have “the perfect child”  with Marilyn Monroe said, “I would be afraid that the child might have my looks and her brains.” Einstein might have had the last word on the relationship between science and love when he said, “Gravity is not responsible for people falling in love.”

Using some of the suggested “attraction” elements for the development of love: Imagine a six-foot, wide-shouldered, licorice-sucking man wearing a lavender sweater over a 2-day old T-shirt driving a Lotus through busy city traffic picking up a hitchhiking, ovulating blonde with a very symmetrical face, eating a doughnut above her C cup bra, and carrying a bouquet of spicy flowers  . . . sounds like a movie . . . wait . . . it IS a movie . . . they already made it . . . but, Julia Roberts is taller than Richard Gere!

Or better yet, imagine using the Aron Protocol to reduce our current society’s polarization. Why not set up Aron Protocol meetings of couples for police and black community members, white and black college students, capitalists and socialists, or even Trump supporters and Trump opponents! Arthur Aron has said, “We never designed [the Aron Protocol] for use in the real world . . . but people are looking for ways to be close to others.” (2)

References: 
1. Aron, A., Melinat, E., Aron, E. N., Vallone, R. D., & Bator, R. J. (1997). The experimental generation of interpersonal closeness: A procedure and some preliminary findingsPersonality and Social Psychology Bulletin, 23(4), 363-377.

2. “The Science of Love,” Linda Rodriguez McRobbie. Boston Globe, Feb. 10, 2019, K1


Vol. 207 February 1, 2019 Things That Threaten

February 1, 2019

With our President and our own intelligence agencies currently in public disagreement about our greatest threats (Southern border migrants {Tweets} VS China, Russia, and North Korea {“Worldwide Threat Assessment”} ), it seems an appropriate time to list again some of the things that might threaten us from a medical point of view.  I last did this on February 1, 2010.

Repeats from 2010:

Watching TV – increase chance of a cardiac death by 18%, increase chance of obesity in children by 5%. 

Tanning Booths – Increase chance of malignant melanoma by 75%; 20 minutes in the booth equals 5 hours in the sun.

Cell phone use in cars – Increase risk of accident by 400%

Toys – 13,663 head injuries in children from toys seen in an ER in 2005; 251,000 toy injuries seen in ERs in 2018; 41% (102,910) were injuries of face or head.

Sleep apnea in truck drivers – Sleep apnea increases the chance of a driving accident by about 100%; 17% of truck drivers have sleep apnea

Brain cancer from cell phones– no evidence for it in 2010; “maybe” in 2019; very heavy users over 10 years in Sweden had an increased incidence of acoustic neuroma (non-cancerous growth on hearing nerve).

Contaminated herbal supplements – more studies continue to find supplements with incorrectly labeled ingredients and/or unlabeled contaminants. Most of these supplements are for sexual enhancements, body building, or weight loss.  

Vaping of nicotine products – “Unknown risks” noted in August 1, 2009; Still unknown over the long term, but of more concern because of the alarming explosion of use by junior high students and 21% of twelfth-graders.( an increase of 1.3 million teens just since 2017) (NEJM 2018 Dec 17)

New threats:

Gun Violence – I am surprised that this wasn’t in my 2010 list since it seems like we have been talking about this threat for years, but it was before the Sandy Hook and Stoneman Douglas school massacres . Wikipedia has a handy list of 122 world-wide school massacres by country, dates, number killed, etc. Do you remember what the auto industry said in the past regarding proposed laws requiring seat belts? – “Cars don’t kill people; people kill people.” I don’t either. Someone must have made that up to make a point. Check my two previous blogs (2015 and 2018) for the comparison of “the frog sitting in the gradually heating up water” with our pace of achieving gun safety. (“By Degrees”, Markerelli.com)

Climate Change – Extreme weather events and raging wildfires in California have caused some to label climate change as a “Health Emergency”. Accompanying an article describing the stress on emergency medical care resources and the significant contribution to air pollution caused by the California wildfires, a lead editorial in the New England Journal of Medicine stated: “Climate change is already adversely affecting human health and health systems, and projected climate change is expected to alter the geographic range and burden of a variety of climate-sensitive health outcomes and to affect the functioning of public health and health care systems.”  

Large Gathering in Any Public Place – During a break in the interminable Boston TV coverage of the Patriots prior to Super Bowl LIII one channel showed a segment on the security planned for the Mercedes Benz Stadium in Atlanta. It was impressive; ten miles of fencing, prohibition of drones, helicopter fly-overs, fully-armed policemen, and more-fully-armed soldiers (always shown walking in pairs). Nothing new to us since September 11th. Just another reminder, but now at least we realize it is not actually foreign “terrorists” that have caused the most havoc in our country.

Enough about threats. Any good news?

Salt-free diet not necessary for heart failure patients- A review of 9 studies showed “a paucity of evidence supporting low-sodium diets for patients with heart failure”. The recommended first step is to “… retreat from an unbridled and potentially harmful insistence on rigorous sodium restriction” in these patients. (JAMA Internal Med 2018 Dec; 178)

Vitamin D supplements of no benefit to preventing cancer or cardiovascular disease –A study of 25,800 participants over 50 years old followed for 5 years showed that daily 2000 IU of Vitamin D “did not keep the doctor away” compared to placebo. This is good news for people spending money on vitamin D supplements for this purpose. (NEJM January 3, 2019:380;1)

Omega-3 Fatty Acids (“fish oil”) of no benefit in preventing cardiovascular disease – Ditto  (JAMA Cardiology March 2018; 3)

Stand-up desks at work reduces sitting times – See “Watching TV” above, but unfortunately there are no studies that standing does anything but improve psychological well being of the worker with some work-related benefits.  When arising from the sitting position, the authors recommended doing some physical activity. Standing alone is not any healthier. (BMJ 2018 Oct10:363)


Vol. 206 January 15, 2019 Updates on 2018 Blogs

January 15, 2019

Causes of Deaths of U.S. Children in 2016
Firearms-related deaths are #2, just behind motor vehicle crashes.  60 % of the three thousand plus firearms-related deaths were homicides. 35% were suicides. Both motor vehicle and firearms-related deaths percentages have increased every year since 2013. The ratio of causes of firearms-related deaths of adults (over 20 yo.) was the opposite: 62% suicide and 37% homicide. Cancer was #3 at 9% of all children deaths both years.

Continued resistance to gun safety reform legislation has been called “another example of U.S. public health intervention being cast as an attack on individual liberty.”

Driver safety being the other example, of course.

Benefits of Aspirin in Elderly or Diabetics
Three studies published in the New England Journal of Medicine this October showed that daily low dose aspirin provided no benefit to the elderly against all types of deaths, cancer-related deaths, dementia, physical disability, or cardiovascular events. They did reveal an increase in non-fatal significant bleeding events. 3% of those taking the aspirin suffered such an event compared to 2% taking the placebo.

A fourth study published in the same issue appeared to show that low dose aspirin reduced the incidence of non-cardiac vascular events in adults (all ages) with diabetes. The percentages of adverse bleeding events (mostly gastrointestinal) was again 1% higher in those taking the aspirin. In contrast to other studies the use of aspirin did not reduce the incidence of gastrointestinal cancer.

Immigrant Children in Detention
The latest independent estimate of children held in 9 U.S. centers is 15,000. The Department of Home Security does not publish statistics, and, in fact, is not too sure itself how many they have. There have been two instances when Home Security could not account for 1400-1500 children. Most of the children are held in large centers with up to a thousand children. The length of stay has been from 104 to 240 days. Currently nearly 300 are children whose parents have already been deported, so that their eventual disposition is up for grabs. 

The recent deaths of two Guatemalan children in detention (one 7 yo. and the other 8 yo.) remain under investigation, but in reading between the lines I suspect that they were caused by flu-like illnesses in dehydrated, malnourished, and tired kids, i.e. eminently preventable deaths.

More About the Southern Border Immigrants
The number of people arrested trying to illegally cross the Mexican border has been decreasing each year since 2005 (President Bush) and is now at the lowest point since 1971. The number of “people in families” arrested monthly during the same period has increased 2.5X from under 10,000 to 25,172 this November. Hence, one reason for the recent development of an “humanitarian crisis”. The number of arrests of “unaccompanied children” has remained the same at about 5,000 per month

The Mexican border is the primary entry point for cocaine, heroin, and methamphetamine which is mostly carried by trucks through official border crossings.

Texas is the only state that has statistics on crimes by immigrants (the federal agencies have none). In 2015 the relative rates of crimes per 100,000 residents in Texas analyzed by the Cato Institute were:

All Crime – (3307 per 100,000 persons) – 
           54 % native born
           27% undocumented immigrants
          18%  legal immigrants

Larceny – (403 per 100,000 persons)
           66% native born
           15% undocumented immigrants
           18% legal immigrant

Sex crime – (64 per 100,000 persons)
            45% native born
            41% undocumented immigrants
            14% legal immigrants

Probiotics for Diarrhea/Effects on Your Microbiome
Two recent very large studies in children showed that twice daily doses of a certain probiotic did NOT shorten the duration of diarrhea or reduce the number of bowel movements per day. This is yet another study showing no real benefit from probiotics, but believers point out that maybe they were using the “wrong” probiotic. 

In other probiotic news: In contrast, another recent study suggests that probiotics can change a person’s own gut microbiome in such a way to make the person’s gut microbiome LESS protective against illnesses.

The Microbiome and Obesity
A study of multi-generational Southeast Asian immigrants showed that soon after arrival in the U.S. the diversity of their gut microbiome began to decrease to the level resembling the less-varied microbiome of European Americans. “Just living in the U.S. reduced their microbiome diversity by 15%.” At the same time their obesity rate spiked!  Previous studies indicated that the more diverse gut microbiome in people in less developed countries protected them from developing metabolic diseases like diabetes.

We Are All Getting Heavier
In the U.S. both the average man and the average woman gained 24 pounds from 1960 to 2002.
By 2016 men had gained an average of 8 pounds more; women 7 pounds.
Both white and black men increased an inch in waist size. White woman increased their waist size by 2 inches; black women reduced theirs by an inch.
The average American man is now 5 feet 9 inches, weighs 198 pounds, and has a 40 inch waist. The average American woman is 5 feet 4 inches, weighs 171 pounds, and has a 39 inch waist. Both have a BMI near or at 30, the “high end of overweight.”
These results are from actual measurements because “ people tend to overreport their height and underreport their weight.”

Editorial note: Our local YMCA “free sign-up day” on January 1 was mobbed. On January 6 the men’s locker room was quite crowded. Overheard from the next cubicle: “Just wait 3 weeks. There’ll be plenty of room again.”
Update in the near future.


Vol. 205 January 1, 2019 Hemp, MJ, THC, and CBD . . . Wha.a.a.a?

December 31, 2018

Hub thumbnail 2015

Hemp and marijuana are both cannabis plants. 

But they are not the same.

There are 80 different cannabinoid compounds in cannabis plants. THC and CBD are the largest in volume. Both hemp and MJ have THC (the chemical that gives you the high) and CBD (the chemical that does not); but in vastly different amounts.  Hemp products have only 0.3% THC.  Marijuana contains from 5% to 30% THC. The CBD in MJ actually regulates (moderates) the effect of THC, produces no euphoria, and is non-addictive.

The Kentucky Supreme Court decided years ago that marijuana and hemp were the same. Woody Harrelson in 1996 was charged with “illegal possession of marijuana” in Kentucky when he announced that he had “planted 4 hemp seeds.” Four years later a Lee County jury acquitted him of that charge. The jury knew that marijuana and hemp were not the same. Hemp has about 25,000 different manufacturing uses and was one of Kentucky’s leading crops until the Marijuana Tax Act of 1937 shut down production. 

Both MJ and hemp are touted to help treat medical illnesses. Some studies show that CBD may be effective in selected medical illness. Our medical knowledge about CBD’s ability to “enhance wellness” is about at the same stage as our scientific understanding of probiotics. Neither seems to do any harm, but there are few studies that indicate they provide any real benefit.

The few studies of medical marijuana have used THC in pill form. Most promoters of medical marijuana believe that the whole marijuana product has to be smoked or ingested to get any benefit. Nobody smokes marijuana for its CBD. Interestingly, marijuana does NOT treat glaucoma. It turns out that the early studies suggesting that were too small and not controlled enough to support that conclusion.

Medical marijuana is now legal in 33 states and D.C.. Hemp products have been legal in all 50 states for some years.

It is the “hemp-derived” CBD oil that is legal and available on Amazon, at Target, or at your local gift and wellness store as one of 150 “wellness” CBD products derived from hemp. Any “marijuana-derived” CBD product carries all the baggage of current marijuana laws. Hence, a good deal of confusion.

Screen Shot 2018-12-31 at 10.27.25 AM

“Hemp-derived” CBD was a $591 million(M) dollar business in the U.S. this year. With the 2018 Federal Farm Act (spear headed by Mitch McConnell, R- Ky) that lifts decades-long U.S. prohibition of hemp cultivation on January 1, 2019 (today), the U.S. hemp industry is predicted to grow to $22 billion(B) by 2022.

The largest marijuana-producing company in Canada is salivating (Hey, remember that the U.S. Supreme Court has ruled that corporations are persons, so why can’t they salivate?) about going into the distribution of hemp-derived CBD-infused “sports” beverages in the U.S.  Vogue magazine calls CBD wellness products one of the top 10 trends in 2018.

Because of severe federal restrictions on research on marijuana there is little reliable scientific data about its medical benefits.  What few studies there are or not always clear about what is actually being tested; THC, CBD, or the other 80 cannabinoids. So there is ample room for scientific and public discussion about the relative medical benefits of THC, CBD, hemp seeds, hemp oil, or other compounds in marijuana and hemp. The lack of real data about relative benefits and risks will continue to allow proponents of one product to shill louder than the others for the consumer’s dollar.

It is helpful to remember that this lack of knowledge about marijuana is such that a physician can NOT write an actual  prescription for it. A physician’s prescription for any medication has to designate the medication’s name, dose, form, and instructions for frequency and duration of use. There is no data to allow the physician to know how to do that for marijuana. Selective physicians can only certify a person as eligible for medical marijuana use. The “patient”  then takes the certificate (not a prescription) to the marijuana store and buys the type, the form, and the dose of the substance he or she chooses.  How does the user know what to buy? By word of mouth, advice from the store keeper, and good old trial and error. Hardly deserves the term “medical use”, does it?


%d bloggers like this: