Latest News from Swine Influenza News

Why scientific medicine just can't win in testimonials [Respectful Insolence]

Tue, 23 Jun 2009 09:00:00 EDT

Over the last month or so, I've written numerous posts about Daniel Hauser. Danny, as you recall, is the 13-year-old Minnesota boy who was diagnosed with Hodgkin's lymphoma back in February, underwent one round of chemotherapy for it, and then decided that he wanted to pursue quackery instead of more chemotherapy. His mother supported his decision and justified it by appealing to a faux Native American religion known as Nemenhah, which is, in reality, nothing more than an excuse for its originator, a wannabe who named himself Chief Cloudpiler, to sell quackery under the guise of "Native American" medicine. Ultimately, his mother Colleen Hauser's and his refusal to undergo chemotherapy led to child protective services reporting the family. Legal hearings ensued, and the judge ordered the Hausers to make sure that Daniel underwent appropriate therapy for his cancer. Unfortunately, Daniel's mother took him on the lam from the law. Fortunately, they were only gone a couple of days before Colleen turned herself (and Danny) in to the law. When last we met Daniel, a friend was reporting that he had undergone chemotherapy and that his tumors were shrinking, a good sign.

Over the weekend, CNN weighed in, confirming that Daniel is indeed doing well. However, the story also happened to be one of the rare instances where I've seen in the mainstream press where a concept that I've emphasized since the very beginning of this blog was illustrated so well: Namely that, when an alt-med believer undergoes both standard, science-based therapy and an "alternative medicine," he always attributes any improvement to the woo, not the standard therapy. Always. Unfortunately, the story was far too credulous and did not point this principle out. Just look at how the report begins:

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Influenza season, part 2 [Effect Measure]

Tue, 23 Jun 2009 07:55:07 EDT

CDC has another snapshot of what the flu surveillance system is seeing up through week 23 (ending June 13). It shows still circulating in many communities at a time when most seasonal flu is normally at a very low level. Indeed of the 2765 specimens tested in CDC's network of 150 laboratories, virtually all of the roughly 40% were influenza A (seasonal influenza B has all but disappeared). Not all the flu A viruses were or could be subtyped, but of those that were or could be, 98% were novel H1N1. IN other words, there's lots of flu around, but essentially none are the seasonal strains of last winter. They are almost all pandemic H1N1. Here is a bar chart of positive specimens by week:

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Third-trimester abortions [Greg Laden's Blog]

Mon, 22 Jun 2009 23:47:16 EDT

In light of the recent assassination, by a member of a right wing Christian anti-abortion cabal, of a physician who specialized in late term abortions, it may be worth having a look this medical phenomenon.

Well, my blog colleague Monado contacted me a week ago or so and we discussed this, and I felt that she should write up what she had, since she had done some research. I would then hope that my readers who are interested in this will go and have a look at her post.

The bottom line is that third trimester abortions are done for a diverse set of reasons, and a lot of what is said in the public debate is not accurate.

Have a look at "What causes third-trimester abortions?" at Science Notes.

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The world's most annotated man [Genetic Future]

Mon, 22 Jun 2009 20:56:39 EDT

Author David Ewing Duncan now officially has the most annotated genome of any human being; but given that the vast majority of those annotations are wrong and the remainder only weakly predictive, he's also a powerful illustration of how far we still have to go before the era of personal genomics comes to fruition.

Duncan isn't the person with the largest portion of his genome sequenced (Craig Venter, Jim Watson and Seong-Jin Kim are the named individuals currently competing for that honour), but he has so far cast his net the most widely in examining the potential functional information within his DNA. His 5,321 current associations come courtesy of SNPedia, a public database of genetic associations maintained by Michael Cariaso.

The majority of those associations, unfortunately, are pure noise - the detritus left behind by the noxious wave of false positives that was the era of the candidate gene association study. Of the relative minority that are likely to be genuine, most are common variants with very small effects on disease risk and thus extremely limited predictive value. Wading through the sheer mass of loosely annotated data in Duncan's SNPedia report provides sharp insight into the challenges of navigating large-scale genetic data.

It's clear that consumers will need tremendous guidance in that navigation - but it's still unclear exactly who will be the best at providing that guidance. The medical establishment certainly wants you to think that they are the only qualified providers, but upstart private personal genomics companies like 23andMe are giving clinicians a run for their money, and crowd-sourced efforts such as SNPedia remain a wild card.

In the meantime, Duncan isn't resting on his laurels - he says he plans to have his entire genome sequenced "soon" as part of a broader process of self-exploration. It's worth keeping an eye on Duncan as the model of an extremely enthusiastic early adopter of personal genomic technologies - the obstacles to understanding his genetic information will soon be things that the rest of us need to wrestle with as well.

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What's wrong with Steve Jobs, revisited [Respectful Insolence]

Mon, 22 Jun 2009 10:00:00 EDT

It's no secret that, when it comes to computers, my preferred axe has been the Apple Macintosh. Indeed, back in the 1983-1984 school year I was in college living in a house with five other guys, and one of my roommates was a a total Apple geek. He had, as one might expect, an Apple IIe, and I immediately decided that, when it came to computers, I definitely liked the Apple product better than the IBM PC that my other roommate had. Of course, at the time I was nowhere well off enough to be able to afford either, but these two roommates were both computer science majors. They had to have a computer; and both somehow came up with the cash. (Back in those days PCs cost several thousand dollars.) In any case, my first experience with the Macintosh dated back to the original Macintosh, delivered to my Apple-loving roommate through a student discount plan in the early part of 1984. I immediately fell in love with the machine.

I realize that my younger readers will have a hard time believing this, but it's true and it wasn't at all uncommon in the 1980s. I didn't own a computer for about eight years after that, including through medical school and the first two years of graduate school. Instead, I had to rely on computer lab machines and, later, the machine's in my Ph.D. thesis advisor's laboratory, which, fortunately, was a Macintosh. The first computer I ever bought for myself was a Mac LC; I could barely scrape together the cash. Now that I'm incredibly fortunate enough (especially in this economy) to have a good income, I have a MacBook Pro and a Mac Pro at home; my wife has a MacBook; and I have multiple Macs in my lab, all relatively new, even though our IT department is about as Mac hostile as it can be without simply banning Macs and requiring Windows XP boxes. Fortunately, that is changing, thanks to my insistence and that of two other faculty who prefer Macs. Finally, Mac geek that I am, I even bought an iPhone 3 GS on the day it was released. (Yes, I like it. A lot.)

All of which is a revisitation (or, depending on your point of view, a regurgitation) of why I care about Apple and why what happens to Steve Jobs interests me. Last year, when Steve Jobs was looking gaunt and various reports were coming out about his health, full of dire speculation about what was wrong with him, I wrote a post about what I suspected to be going on. Basically, Jobs had had a neuroendocrine tumor of the pancreas, for which he had undergone a pancreaticoduodenectomy (colloquially known as the Whipple procedure) in 2004. As I pointed out at the time, Jobs had been incredibly lucky in that the mass discovered growing in the head of his pancreas turned out not to be a run-of-the-mill pancreatic cancer (adenocarcinoma of the pancreas), which has an absolutely dismal five year survival. (Patrick Swayze has metastatic adenocarcinoma of the pancreas and has thus far beaten the odds by surviving more than a year since his diagnosis.) Rather, it turned out to be a rare type of tumor known as a neuroendocrine tumor, which, in contrast to pancreatic cancer, is eminently curable with surgery. A year ago, I speculated that the reason for Steve Jobs' gaunt appearance was a complication from his Whipple operation, specifically the dumping syndrome. When earlier this year Steve Jobs took a leave of absence from Apple for a few monthsi due to an "endocrine disorder," I was, quite frankly, flummoxed. I couldn't reconcile the reports with my previous speculation.

If a story in the Wall Street Journal is correct, it would appear that I was pretty darned wrong. Indeed, if this story is correct, it would appear that Steve Jobs underwent a liver transplant:

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Serious Mandate for National Health [The Corpus Callosum]

Mon, 22 Jun 2009 09:24:37 EDT

It was the second-most-blogged article on the NYT when I got up this morning; now, it is the first-most-blogged. It is the article that reports on a survey that shows 72% support for a government-run health insurance program. The program would be similar to Medicare, but would be available to persons under 65 and not on Social Security Disability.

In Poll, Wide Support for Government-Run Health
By KEVIN SACK and MARJORIE CONNELLY
Published: June 20, 2009

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If you smell, here's a remedy [Effect Measure]

Mon, 22 Jun 2009 07:44:49 EDT

If you don't want to smell, the FDA has a recommendation: use an over-the-counter cold remedy that contains an intranasal zinc solution. You won't smell. Possibly ever again:

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CRISP is dead to me; Long live... [DrugMonkey]

Sun, 21 Jun 2009 16:29:35 EDT

RePORTER!!

This is so much better.

h/t: writedit

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Nobel laureate Paul Nurse on his family story [Genetic Future]

Sun, 21 Jun 2009 10:58:15 EDT

This is slightly unusual subject matter for this blog, but I found this presentation by 2001 Nobel Prize winner Paul Nurse absolutely fascinating. It's an account of his slow unravelling of his family background, told to an audience at the World Science Festival in New York last week.

The full video is beneath the fold:

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Is Electroacupuncture an Effective Treatment for Hypertension? [On Becoming a Domestic and Laboratory Goddess]

Sun, 21 Jun 2009 01:42:05 EDT

There are a couple of fantastic boy bloggers here at ScienceBlogs who write about the marketing of unvalidated alternative therapies to patients (a practice they call "woo"). I agree with them that is completely unethical to market a therapy (or, non-therapy) using claims that have not been scientifically tested and peer reviewed. That said, is there any value to treatments we traditionally think of as "alternative?" Do they have a place in traditional medicine, provided they are subjected to the same rigorous scrutiny as traditional therapies?

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Making influenza fun! SNEEZE! [erv]

Sat, 20 Jun 2009 12:15:16 EDT

No idea what this website is (Routes?), but they have some fun science themed (loosely science based) Flash games, like SNEEZE!

They also have 'DNA Hero'-- Guitar Hero with ACTG sequences, and 'Ginger Dawn'-- increase the frequency of that recessive gene, baby! LOL! And it looks like there are a few more games in the works... gonna have to investigate this site more.

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Finishing up Homeopathy Awareness Week: It's not just homeopathy, it's quantum homeopathy! [Respectful Insolence]

Sat, 20 Jun 2009 12:00:00 EDT

Homeopathy Awareness Week is almost over, alas. I hope I've done a good job at making my readers even more "aware" of just how silly the principles of homeopathy are. To finish up, I thought I'd repost a bit of "classic insolence" from three years ago, because it's dedicated to one of the most amazing homeopathic woo-meisters I've ever seen: Lionel Milgrom. It was also the very first post I ever did for Your Friday Dose of Woo.

Enjoy!

While thinking about ways to make the blog better, I wondered if I should emulate some of my colleagues, many of whom have regular features every week, often on Friday. And, since I usually get a little less serious on Fridays anyway (and, because traffic seems to fall off 50% or more anyway regardless of what I post, on the weekends, too), it seemed like a good idea. But I couldn't think of something that ties together the common themes of this blog, yet maintains a suitably Friday-blogging light-hearted feel to it. And then I came across this article:

L. R. Milgrom (2006). Towards a New Model of the Homeopathic Process Based on Quantum Field Theory. Forsch Komplementärmed 2006;13:174-183.

(Forsch Komplementärmed, apparently, means Research in Complementary Medicine, the journal's English title.)

Oh, joy! I had my idea: Your Friday Dose of Woo! (And what better way to start off the long 4th of July weekend here in the states than with a bit of woo?) Not only did I have my idea, but I had my first topic. Just a look at the abstract will tell you why:

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Severe cases in swine flu: lack of clinical details [Effect Measure]

Sat, 20 Jun 2009 08:06:36 EDT

Two elite flu reporters, Helen Branswell (Canadian Press) and Declan Butler (Nature), both noted yesterday the dearth of clinic information on the serious and fatal swine flu cases. First Butler:

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Nature: blogging conference presentations won't break embargo [Genetic Future]

Fri, 19 Jun 2009 20:37:37 EDT

One of the major reasons for concern from presenters and conference organisers about the notion of conference bloggers is that having unpublished work discussed online may violate the embargo policies of journals and damage their chances of publication.

We now have clarification of this issue from one major journal. Nature has an editorial that continues its recent theme of encouraging scientists to engage in the blogosphere, and also includes this important statement:

At the same time, however, our cardinal rule has always been to promote scientific communication. We have therefore never sought to prevent scientists from presenting their work at conferences, or from depositing first drafts of submitted papers on preprint servers. So Nature journalists or those from any other publication should hear results presented at a meeting, or find them on a preprint server, the findings are fair game for coverage -- even if that coverage is ahead of the paper's publication. This is not considered a breaking of Nature's embargo. Nor is it a violation if scientists respond to journalists' queries in ensuring that the facts are correct -- so long as they don't actively promote media coverage.

Sounds good to me, and I hope to see similar clarification from other journals in the near future.

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Free genome scans - but what's the business model? [Genetic Future]

Fri, 19 Jun 2009 20:31:28 EDT

Misha Angrist points me to the launch of TruGenetics, which basically looks like just another genome scan company with a unique gimmick: they're giving 10,000 scans away free.

What's the business model here? The registration page provides some hints:

Your questionnaire responses and genetic information will be used for genetic research. One of the main goals of TruGenetics™ is to develop a unique research database for conducting genetic studies. Your decision to use TruGenetics'™ services indicates that you are willing to contribute your questionnaire responses and genetic information to the TruGenetics™ research database. [...] TruGenetics™ may conduct this research, or may partner with another organization, including non-profit and commercial entities, to conduct research. TruGenetics™ may charge a fee for conducting research using this database.

[...]

You will not benefit directly from contributing your information to the research database. However, important discoveries might be made through this research, and this might significantly help other people. If these discoveries are validated and accepted by the scientific community, we will provide you with this information as it pertains to your genes. This research may also lead to the development of a commercial product. You will not receive any payments if this occurs.

Looks to me as though the business model here is pretty much the same as 23andMe's fundamental strategy - recruit customers, get them to provide both genetic and phenotypic data, look for novel associations and then (the tricky step) figure out a way to monetise said associations by selling them on to pharma or biotech companies. The only difference is that TruGenetics is willing to absorb more of a loss than 23andMe in developing that potentially saleable resource.

Ten thousand individuals is enough to power a reasonable genome-wide association study (GWAS) for one complex trait, or 2-5 moderately-powered GWAS for much more simple traits (e.g. drug response). Ideally, customers would be recruited on the basis of falling into specific phenotype categories (e.g. disease cohorts and healthy controls), so it will be interesting to see if customers have to fill in their phenotype survey before they are given any guarantee of receiving a free scan.

The big question is what genetic markers you could possibly find with 10,000 people that won't be scooped up by academic GWAS consortiums before you can finish your analysis and submit your patent applications. You'd need to target a phenotype that was sufficiently medically relevant to be worth selling, but simultaneously sufficiently obscure to not be the target of massive GWAS already in the pipeline.

Alternatively, perhaps the company is most interested in recruiting perfectly healthy individuals from specific populations to serve as a shared control group for disease-specific GWAS being performed by other groups; this could potentially be a fairly valuable resource. I'm speculating pretty wildly now, so I'll leave it there.

I've signed up, but I'll need to hear more details from the company before I commit to handing over my genetic and medical details. I'll let you all know when I do.

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Chriopractic, quackery, and moral bankruptcy [White Coat Underground]

Fri, 19 Jun 2009 14:33:10 EDT

I've been a bit remiss in my coverage of the Simon Singh case, reviewed in detail by Phil Plait, among others. As many of my readers already know, respected science writer Simon Singh is being sued for libel in England by the British Chiroquacktic Association (BCA) because he described some of their treatments as "bogus". Despite the fact that he underplayed his hand, he is still getting his legal ass whooped over in the motherland, thanks to their idiotic libel laws.

Be that as it may, the BCA wasn't complaining about Singh being wrong, but about him being mean. You see, "bogus" seemed to imply not just that they were a bunch a stupid twits, but that they were dishonest stupid twits, and that's just too naughty.

But as stupid twits often will, they are no longer able to hold back. They are now insisting on showing off just how stupid, twittish, and wrong they really are. In a response to L'affaire Singh, the BCA has posted a broadsheet defending their particular type of prescientific quackery.

(As an aside, I would like to remind my readers about my thoughts on "quackery from ignorance". Just because a quack believes in what they do does not exculpate them from the wrong they are doing. They have taken on a special responsibility, a grave responsibility to people in pain, and to honor this, they must be extra vigilant, sort of like real doctors. Ignorance is not a viable excuse for bad medicine.)

Anyway, since the arrogance of ignorance has trumped common sense, let's take a look at what the BCA is offering us.

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Mental Illness - a personal perspective. [Good Math, Bad Math]

Fri, 19 Jun 2009 12:25:36 EDT

This is an edited repost of something I wrote nearly three years ago. You can see the original post and comments here.

Over at Dr. Isis's blog, there's a post answering a reader's question about whether to tell her postdoc advisor about her troubles with clinical depression. I agree with Isis's advice - without knowing the advisor really well, you can't be sure of how they'll react. If the postdoc had become ill due to something like a diabetic episode, where the change in schedule and environment caused by taking a new job messed up the PDs control of their blood sugar - well, there wouldn't be an issue. The PD would be able tell their advisor they had a medical issue without worrying too much about repercussions. But mental illness is different: the fact is that there is a very strong stigma attached to mental illness, which makes it different from other illnesses.

This is something that's very important to me. I have people very close to me who have dealt with profound mental illness, and I've seen them suffer from the effects of the stigma associated with it. And I am mentally ill myself: I have clinical depression.

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Your Friday Dose of Woo: What's better than homeopathic plutonium? Homeopathic antimatter, of course! [Respectful Insolence]

Fri, 19 Jun 2009 11:00:00 EDT

With Homeopathy Awareness Week rapidly approaching its end, I wondered just what I could do to bring further "awareness" of just how bogus and full of woo the concepts of homeopathy are. True, discussing homeopathic plutonium as a remedy and how homeopaths did "provings" of it the other day was fun, but surely there's more. What other homeopathic "remedies" (quotes used due to a complaint about my having actually used the term "remedy" to describe homeopathy, given that any true homeopathic remedy is diluted so much that there's nothing left but water (or alcohol, if that is what the diluent used was) have homeopaths tried to dilute and succuss into nonexistence in order to "prove"?

How about homeopathic antimatter, as a reader pointed out to me?

Yes, it's really been done. Well, given that the claim is that someone took positronium and did a homeopathic proving on it, I'm guessing that homeopathic positronium is as "real" as homoepathic plutonium (actually, almost certainly much less so, given that, as improbable as it is, it's still possible for a homeopath to have gotten his hands on some plutonium to dilute and success). Let's take a look at the claim. It is supposedly the overview of some of the themes that arose from the proving of Positronium by students at The School of Homœopathy in the early months of 1998."

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Swine flu in health care workers: a first look [Effect Measure]

Fri, 19 Jun 2009 07:52:39 EDT

Swine flu infection of health care workers (or as CDC refers to them, health care personnel or HCP) was of interest early in the pre-pandemic phase for at last two reasons. One was the obvious goal of estimating the risk to front line workers and devising best practices for their protection. Another was the belief, reinforced by the SARS outbreak in 2003, that spread to HCP was an early warning that the virus was easily transmissible from person to person. SARS is a disease where patients are most infectious in the later stages when they are extremely ill, and HCP were among the hardest hit groups. Most flu is transmitted in the community, but the SARS model still seems appropriate for flu viruses like H5N1 ("bird flu") where transmission is rare. Any report that a health care worker has been infected from a bird flu patient is viewed with alarm, possibly suggesting that the probability of transmission has increased. And bird flu was the template upon which pandemic planning was based. So within a few weeks of the outbreak (the first case of novel H1N1 was diagnosed in mid-April), CDC asked state health departments to report any cases of novel H1N1 among HCP. Yesterday they reported the first results in CDC's Morbidity and Mortality Weekly Reports (MMWR):

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Support the Hayre Fellowship, Combat Animal Rights Extremism [DrugMonkey]

Thu, 18 Jun 2009 16:15:24 EDT

You may have been following with some interest the statements made by an apparent biomedical science blogger, Dr. J., regarding the unacceptability of the use of cats in biomedical research. The post and subsequent comments from Dr. J follow a familiar track- the arbitrary personal standard (poorly defined), ignorance or intentional misrepresentation of the conduct of research and threats of violence against animal researchers. The only news here, I suppose, is that it is coming from someone who is engaged in some sort of biomedical research which, of course, relies directly and indirectly on the use of animals including vertebrates. (It is worth reading the comment thread because there are nice descriptions of why certain species are preferred for vision research over others.) If you would like additional discussion, see posts from Drs. Isis and Stemwedel.

A Voice of Lunacy From Within the Scientific Community

Non-rational lines, empathy, and animal research

[ This might be a good time to click on over and sign the Pro-Test petition in support of the responsible, well-regulated conduct of animal research, if you have not already done so. It has gone over 9,000 signatures recently but we must keep going. If the UK can gain 20,000 signatures on a similar petition, the US at 5 times the population should target 100,000. ]

I have little specific to add to the current discussion about Dr. J.'s blog comments because the usual misrepresentations about the conduct of feline research are too fuzzy to address meaningfully. It does, however, give me the opportunity to remind you about the Michael D. Hayre Fellowship:

The Americans for Medical Progress/Michael D. Hayre Fellowship in Public Outreach, established in 2008, promotes peer education about animal research among students and young adults aged 18-30. Named in memory of Michael D. Hayre, DVM, ACLAM, the Fellowship provides support for peer outreach and education projects in the United States.
The first AMP/Hayre Fellow was Tom Holder, a recent graduate of Oxford University and a leader of the U.K. research support group Pro-Test. Tom toured the U.S. in 2008, speaking to students and others on campuses and at biomedical research facilities. Tom's work as a Hayre Fellow included the creation of Speaking of Research, an outreach and advocacy website and online network.

Although the deadline for this year's applicants has just passed, be sure to pass this around to any trainees you think might be looking to go into a science-policy or science-communication direction.

I also ask you to consider making a small donation to continue funding this program and, dare we hope, expand it. Education on the value and reality of animal research continues to be the key. As we have discussed here and around the blogosphere, much of the anti-animal research ground game depends on the misrepresentation of reality. Misrepresentation of the value of the scientific findings, misrepresentation of the current alternatives and misrepresentation of the regulatory and oversight conditions of the research. In my view, the first Hayre Fellow, Tom Holder has done a magnificent job in promoting outreach and awareness*...but it is only a relative drop in the bucket. We can do better.

__
*are you on Twitter? Are you following @RaisingVoices, @uclaresearcher and @medicalprogress?

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The rise and fall of zinc as a cure for the common cold. [erv]

Thu, 18 Jun 2009 14:30:15 EDT

Zincs connected to the common cold isnt as wooie as you all might be thinking after this weeks Zicamscepade (cough, sniffle). Though Zicam was marketed as a 'homeopathic' remedy, zinc-->common cold connection wasnt established by some naked sweaty white guy pretending he is a Native American deciding that Ayurvedic law dictates 'colds' require a 'hot' metal like zinc to neutralize viral chi.

Zinc-->common cold was discovered by boring 'science' a long time ago. In 1974, Korant et al tested a ton of metals ions at lots of different concentrations to see if they had any effect on cold virus replication-- cadmium, calcium, cobalt, copper, magnesium, manganese, mercury, molybdenum, nickle, and zinc.

Zinc is the only one that worked. Turns out it interferes with the cleavage of an essential polyprotein (like how HIV-1 gp160 gets cleaved into gp120 and gp41), interfering with cold virus replication. YAY!

Well, all those experiments were in tissue culture. Know how we kill HIV-1 in tissue culture? Bleach. Tissue culture victories arent always real-world victories.

In 1984, a clinical trial involving zinc salt lozenges showed promise, but later analyses demonstrated that zinc salts did not provide therapeutic concentrations of zinc, so if zinc was 'working', it wasnt by the mechanism proposed in 1974.

Around 2000, scientists started publishing the results of their new idea: Maybe the zinc ions are binding to the receptors on the outside of the viruses, preventing them from binding to our receptors, limiting infection? Well, the cold virus replicates in your nose/respiratory tract, so why not just put zinc gel/spray up your nose? Like putting EGCG in condoms, put the drug where the action is.

Some of the nose-zinc trials worked, some didnt-- the scientific community was still working out the kinks... too late. Zicam blew through the door in 1999, and was marketed straight to the public. None of that hoity-toity lab learnin for THEM!

Charles Hensley and his colleagues at Gel Tech thought the solution was as plain as, well, the nose on your face. Why not skip the mouth and spritz the zinc directly into the old proboscis? They developed a gel that can do just that and tried it out on 104 volunteers. The results of this study, having been withdrawn once, will probably never be published in a scientific journal. Because Zicam is marketed as a homeopathic remedy, however, the Food and Drug Administration doesn't require it to undergo rigorous testing.

At this point, the only fair thing to say about Zicam is that its benefits are still not proved. Maybe if I'm desperate, I'll try it next time I get a telltale tickle in my throat. In the meantime, I hope to sidestep the problem by following the advice of Dr. Jack Gwaltney of the University of Virginia School of Medicine, a top cold researcher. "Wash your hands a lot with soap and water," he says, because cold viruses like to linger there. Don't put your fingers in your eyes or nose, as they give easy access to the nasal passages.

Fast forward to 2006.

Results: Coronal sections of the rat ONe and corresponding olfactory bulbs showed consistent cellular and tissue damage of increasing severity that correlated with the duration of treatment with the zinc compound when compared with the control group animals.

Conclusion: The results of this analysis indicate that the repeated oral administration of such zinc-containing compounds have neurotoxic effects on the ONe and to the mitral cells in the olfactory bulbs of treated rats. These findings point toward the need for increased investigation into the potential deleterious effects of zinc-containing compounds to humans as well.

Aaaaand here we are in 2009.

The agency says that since 1999, it has received more than 130 reports of loss of smell associated with Zicam Cold Remedy Nasal Gel; Zicam Cold Remedy Nasal Swabs; and Zicam Cold Remedy Swabs, kids size. The products have been linked to long-lasting or permanent loss of smell called anosmia. In some cases, the loss of smell occurred after the first dose.

So there you have it. The rise and fall of zinc as a cure for the common cold. Decades of work by real scientists has been tarnished in an instant by some money grubbing 'homeopathic' businessmen. Zinc didnt deserve to die like this.

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Silence is the Enemy: Singing those uncomfortable stories [Sciencewomen]

Thu, 18 Jun 2009 12:04:28 EDT

Have you ever bought an album and discovered a song so dark, so sad that it makes you physically uncomfortable to listen to it? What do you do then? Can you stand to hear it or do you skip the track in favor of something a little lighter?

For me, the songs that twist my stomach in knots are the ones with stories of domestic violence, child abuse, or rape. And when I find one of those songs, I force myself not to delete it from my playlists and I pay attention when my iTunes shuffle pops it up. The singers recorded those songs for a reason - to tell us that terrible things are happening around us even when we don't want to admit it. They are reminding us that Silence is the Enemy.

Below the fold, I've embedded the you-tube videos of four gut wrenching songs from some of my favorite artists. They tell stories of domestic violence, child abuse, rape, and murder. They are not happy songs to listen to, but they are important. If you are up for it, please click through and listen to the stories. Then think about what you can do break the silence.

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Universal coverage, comparative effectiveness, and the muddying of the healthcare debate [Neuron Culture]

Thu, 18 Jun 2009 11:43:23 EDT

A key component of health-care reform -- and saving our ass from going bankrupt and sick from spending too much on lousy treatments -- is establishing comparative effectiveness measures, otherwise known as "actually knowing WTF works and what doesn't."

This idea terrifies companies who don't want such objective measures. It also generates a lot of fear, partly via confusing or intentionally frightening arguments. Yet making sure we don't pay for stuff that doesn't work is key to reform -- a point made in this Times op-ed from libertarian economist Tyler Cohen, keeper of the blog Marginal Revolution.

Cohen argues that the main problem is, as he puts it,

the financial incentives for doctors and medical institutions to recommend more procedures, whether or not they are effective.

These were discussed vividly in Atul Gawande's recent New Yorker piece, and they are clearly a part of the problem. I think Cohen lets industry off a bit too easily when he says that drug-company profits aren't really part of the problem, for expenditures on drugs that either do little good or do little better than far less expensive drugs are costing us many billions as well; over the last two decades, for instance, we've spent scads of money on modern antipsychotics that cost 20 times as much as the drugs they replaced -- and only recently gathered enough data to show they work no better than the old ones.

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We need an Antiques Roadshow for Wunderkammer! [bioephemera]

Thu, 18 Jun 2009 11:00:00 EDT

Joanna of Morbid Anatomy is on a quest to locate private collections of medical oddities. She's already sussed out fourteen such hidden wunderkammern and photographed their treasures, but she wants to find more:

"Who are these private collectors, and what sort of treasures do they possess? How might their methods of displaying collections differ from institutional approaches? Are we reaching a historical moment similar to the pre-museum era of private cabinets, in which the most interesting artifacts are now in private rather than public hands?"

It's a really interesting question. Wunderkammern were not originally institutional - these cabinets were in private hands, and their organizational philosophies emerged from the idiosyncratic worldviews of their owners and/or curators. Today, such collections could easily die with their owners - broken up and auctioned off, or simply thrown out as rubbish. The beauty and value of taxidermic specimens, vintage gas masks, bottled fetuses and prosthetic limbs are not readily apparent to everyone! And it's unlikely that a steampunk version of Antiques Roadshow would have a large American audience (alas). So if you own or know of a collection that fits the bill, please contact Joanna, so she can document it for the public and posterity. (Owners can remain anonymous if they choose.)

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The BPA cabal's toxic memo [Effect Measure]

Thu, 18 Jun 2009 07:52:42 EDT

We were among the first to bring you the full text of the leaked minutes of the secret meeting of the bisphenol-A (BPA) cabal at a posh private club in Washington, DC on May 28. It turns out those minutes may be almost as toxic to the cabal as their endocrine disrupting chemical is to humans. I guess I am exaggerating. It would have to pretty toxic for that. But it is at least producing some unpleasant fall out (see also here). You may remember one element (besides describing as the "holy grail" finding a “pregnant young mother who would be willing to speak around the country about the benefits of BPA”) was the plan to put pressure on legislators in two key states considering BPA bans, California and Connecticut. This got the attention of the Connecticut Attorney General (h/t DO):

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Who knew? There are actual medicines in those "homeopathic" remedies [Respectful Insolence]

Thu, 18 Jun 2009 01:00:13 EDT

Will wonders never cease? A recent story about how "homeopathic" Zicam managed to slide through a loophole in which the FDA doesn't require evidence of efficacy or safety for medicines labeled as homeopathic has been percolating through the blogosphere based on a recent warning that the FDA issued. It turns out that the zinc in Zicam can mess up your sense of smell, causing a loss of the sense called anosmia. Steve Novella has already done an excellent job of discussing the issues involved with this loophole, which is big enough to pilot the proverbial Death Star through.

However, a followup story on the AP shows that the problem is likely more widespread than Zicam:

CAMBRIDGE, Mass. - The unsettling little secret of Zicam Cold Remedy finally spilled out this week. Though widely sold for years as a drug for colds, it was never tested by federal regulators for safety like other drugs. And that was perfectly legal -- until scores of consumers lost their sense of smell. One little word on Zicam's label explains all this: "homeopathic."
Zicam and hundreds of other homeopathic remedies -- highly diluted drugs made from natural ingredients -- are legally sold as treatments with explicit claims of medical benefit. Yet they don't require federal checks for safety, effectiveness or even the right ingredients.

They're somewhat similar to dietary supplements, which use many of the same natural ingredients and also aren't federally tested for safety or benefit.

Many scientists view homeopathic remedies as modern snake oil -- ineffective but mostly harmless because the drugs in them are present in such tiny amounts.

But an Associated Press analysis of the Food and Drug Administration's side effect reports found that more than 800 homeopathic ingredients were potentially implicated in health problems last year. Complaints ranged from vomiting to attempted suicide.

The reason, it turns out, is because these "homeopathic" remedies have actual--gasp!--medicine in them:

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Abs & back [Gene Expression]

Wed, 17 Jun 2009 23:16:22 EDT

Is Your Ab Workout Hurting Your Back?:

Instead, he suggests, a core exercise program should emphasize all of the major muscles that girdle the spine, including but not concentrating on the abs. Side plank (lie on your side and raise your upper body) and the "bird dog" (in which, from all fours, you raise an alternate arm and leg) exercise the important muscles embedded along the back and sides of the core. As for the abdominals, no sit-ups, McGill said; they place devastating loads on the disks. An approved crunch begins with you lying down, one knee bent, and hands positioned beneath your lower back for support. "Do not hollow your stomach or press your back against the floor," McGill says. Gently lift your head and shoulders, hold briefly and relax back down. These three exercises, done regularly, McGill said, can provide well-rounded, thorough core stability. And they avoid the pitfalls of the all-abs core routine. "I see too many people," McGill told me with a sigh, "who have six-pack abs and a ruined back."

I know some readers are fitness buffs. Thoughts?

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On Being a Nurse - a guest post [A Blog Around The Clock]

Wed, 17 Jun 2009 17:47:34 EDT

My name is not Catharine. My name is "Nurse!" Not "Nurse?" Or "Nurse." But "Nurse!" Sometimes "Nuuurrrrsssse!!!!" That is what I'm called by the patients (if they can talk), their families, the doctors, social workers, dietitians, respiratory therapists, chaplains, visitors, physical therapists, everybody calls me "Nurse!" I'd sooner be called c*nt, b*tch, f*ckface or wh*re because calling me "Nurse!" amounts to a Master calling a slave. And slave I am.

In my job I am not allowed to curse under my breath, disagree, look serious or speak my mind. I am not allowed to be anything less than warm, friendly and accommodating. Male nurses, of which there are many in critical care, are not held to the same standards. As long as they are knowledgeable and skillful, they are considered "good" nurses. Female nurses, no matter how knowledgeable and skillful, still have to do a lot of ass-kissing to be considered "good" nurses.

According to the hospital, nothing is more important than "customer service." Never mind that I am not selling anything, that I am working with patients, not "customers." I am servicing. Above all, I must service the whims and fancies of the patients (yes, people really do ask me to fluff their pillow), their families (an empty plastic pitcher is thrust in my face along with the command "ice!"), the doctors (no example needed), my manager, and to a lesser extent, my coworkers. In this age of consumer medicine, "servicing" has become more important than providing the actual nursing care for which I studied, was trained and practice according to the highest possible standards and latest research.

Despite the pretense of the "team" approach in our ICU, my opinion doesn't mean much. A few Attendings will ask if there are any "nursing issues," but not many. Nevertheless, because I want the best for my patients, I often "cover" for physicians. I say nothing when an intern presents my idea as his/her own during rounds. I order important labs and x-rays when the medical team "forgets." I spend an extraordinary amount of time explaining a patient's diagnosis, reviewing the plan of care and answering questions honestly and in a way that the family can understand, which often allows the time a physician spends with the family to be more efficient.

I have too many fingers to count the number of times in the last ten years a physician has thanked me for my efforts.

I had to laugh the day an intern was in the room with a patient who started to code (hadn't I been warning him for hours that this was going to happen?!) and the doctor desperately called out, "I need a nurse!" It wasn't about the tasks that needed to be done. This young fellow had no idea how to run a code. But that's how it is in a teaching hospital.

Nurses get no respect. It always hurts to see a patient's family, who has been rude and demanding and condescending to me for hours, bow and scrape and fall apart with gratitude when a doctor enters the room. Don't get me wrong. I have enormous respect for physicians. I am stunned by the intelligence, commitment, compassion and the huge amount of responsibility that doctors bring to the table. But a nurse is always, well, just a nurse. Somehow it is easy to forget that the person who keeps the patient clean, dry and comfortable, the person who makes sure that labs and other diagnostics are done, the person who administers the necessary medications and treatments, the person who manages the continuous dialysis, keeps an eye on the ventilator, collects and records the data, does the wound care, cleans up the shit, blood and vomit, educates and addresses the emotional needs of the patient/family, has the greatest risk of exposure, uses her knowledge and judgment to do exactly what needs to be done at exactly the right time, must stomp her feet in order to get the resident to listen when a problem is developing, in short, the person who keeps the patient alive minute by minute, is just a nurse. And when the time comes, it is the nurse who makes damn sure that the patient dies with as much comfort and dignity as possible.

Nursing is not highly valued as a profession. Nursing (especially critical care) demands a broad knowledge base, advanced technical skills and a great deal of judgment. It seems that we are suffering from a collective historical hangover from the days when nursing was unskilled "women's work." Plumbers make more money and nobody dies if they have a bad day. And I admit nurses are better off in the US than in most other countries. When my mother-in-law tells her friends in Serbia that I am a nurse, she might as well be telling them that I am a street sweeper. Let's face it: How many of you are hoping your kid will grow up to become a nurse?

In fact, with the exception of Halloween night in 1971, I never wanted to be a nurse. I was going to get my PhD in Philosophy. But then it hit me that I had a family to support and that changed everything.

As it turns out, becoming a nurse is one of the best decisions that I have ever made. I can't imagine any other job that would give me the same opportunity for meaningful, authentic human contact. I have provided comfort. I have eased suffering. I have protected the vulnerable. I have grieved with families. I have met needs that are real and immediate. I work tirelessly to keep people alive. I am a staunch patient advocate. I have seen many die but I have also saved a few lives. This work happens in a place much deeper than class, race, gender, sexuality, etc. Being a nurse has taught me more about being a human being than a PhD in Philosophy ever could.

So, yes, I am in many ways a slave. Many see nursing as nothing more than following physician orders (and be "caring" while you're at it!). I work in an ocean of blood, shit and tears that the average person just can't imagine. My work is hard (mentally, physically and emotionally) and in general, I do not recommend it. But at the end of my fourteen hour day, when I come home cursing and complaining, barely able to take another step, I know that I have done something meaningful, something real. And that, somehow, makes it worth it.

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The (Illusory) Rise and Fall of the "Depression Gene" [Neuron Culture]

Wed, 17 Jun 2009 12:01:55 EDT

Big psych news of the day is that a big JAMA study debunked the "depression gene" -- that is, this big new study (by Risch et alia, in JAMA, today) found that, contrary to a famous earlier big study (Caspi et alia, in Science, 2003), the short ("bad") form of a particular gene called 5-HTT does NOT make a person more vulnerable to depression. Or, to flip it:: Caspi 2003 had found that having a short version of 5-HTT, which affects processing of serotonin, put someone at more risk of depression if they experienced (as adults) repeated stressful life events. Risch 2009, crunching data from a bunch of studies (including Caspi 2003) to ask the same question -- Does the short version of 5-HTT make you more vulnerable to depression if you suffer stressful events as an adult? -- found the answer was No.

The headlines are predictable enough, "Sad News for Depression Gene" being perhaps the funnest.

But wait. Not quite so fast. Has an empire crumbled here? A hypothesis evaporated?

You need only look at this briefly, I think, to see that the question addressed by both papers is fairly limited, and does not, crucially, cover variations in how early life experiences might amplify any risk conferred by the short 5-HTT allele. (Caspi & Moffitt clearly did not include such events in theirs, and in fact took measures, such as removing from analysis anyone who suffered depression before age 21, that would be likely to exclude some people who suffered particularly rough early years.. And unless I missed something in reading the Risch paper, it too makes no effort to look at early experience in particular -- and, since it pulled Caspi's data from Caspia, would reflect the same possible filtering out of such early-onset depression cases.)

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Self-refilling bowls: An idea whose time should never come [Cognitive Daily]

Wed, 17 Jun 2009 11:48:51 EDT

[Originally posted in April 2007]

One "trick" dieters often use is to put their food on a smaller plate. The idea is to fool yourself into thinking you're eating more food than you really are. But doesn't our stomach tell us how full we are?

Actually, it doesn't. Brian Wansink has devoted his career to studying how perception of food intake relates to actual eating behavior. Together with James Painter and Jill North, he's come up with a dramatic demonstration of how wrong our stomachs can be.

Volunteers were recruited to participate in a soup-only lunch in a room adjoining the school cafeteria. They filled out a form asking about color preferences, then were seated a table with four different-colored bowls. The colors were just a distraction: the real purpose of the study was to see how much people would eat when their soup bowls refilled automatically.

Two of the participants ate from self-refilling bowls; the other two had their bowls refilled by a server. Everyone was encouraged to eat as much as they wanted. The self-refilling bowls involved a fair bit of cooking technology -- plastic tubes connected a soup pot next to the table to the underside of each bowl. The refill rate of the bowls was adjusted so that the bowls could be filled completely in 20 minutes -- the duration of the study. Technically the bowls could be nearly empty by the end of the session, but each bowl held 18 ounces of soup, so this would have required consuming over a quart of soup!

Despite the fact that everyone's bowls were refilled, the people eating from self-refilling bowls ate 73 percent more soup. Even more surprising is that they didn't feel any different from people who ate from manually-refilled bowls:

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The things Sci has seen... [Neurotopia]

Wed, 17 Jun 2009 10:54:26 EDT

Sci has learned something important today: Mini-moos SUCK. I know my regular brand of coffee. I know it in all its dark, rich, spicy deliciousness. But today, it tastes like...like...I don't know how it's possible for a creamer to make expensive, fair trade, delicious awesome into watery stuff you could buy from the 7-11.

I want my REAL creamer back. Call me old-fashioned, but...

The other thing you should know is that the animal research debate has resurfaced. It's going on at Dr. Isis' and at Dr. Free-Ride's, both of whom can talk about this much better than I can.

All I can say is this:

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AMA Slides Into Irrelevancy [The Corpus Callosum]

Wed, 17 Jun 2009 10:01:59 EDT

When I first heard about the American Medical Association (AMA) opposing Obama's health care reform, I was troubled. I almost wrote a post about it, but by the time I got home, I found that others had beaten me to it. Revere, for example, appears to have written before work, posting at 6:46AM. That's dedication.

But it the interim, I've come up with a different angle. Part of it comes from an article on Medpage Today (free registration):

AMA: Obama Faces Tough Audience at the 'House of Medicine'
By Emily P. Walker, Washington Correspondent, MedPage Today
Published: June 14, 2009

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Homeopathic plutonium? Now there's a hot time in the old town tonight! [Respectful Insolence]

Wed, 17 Jun 2009 10:00:00 EDT

In keeping with Homeopathy Awareness Week (which still runs until June 21), I can't resist commenting on this gem of a story that was sent to me the other day. I mean, we're talking super duper heaving shopping in the very heart of London. It turns out that the Helios Homeopathy Shop right in Covent Garden will fix you up with homeopathic plutonium if you need it:

Dr Fiona Barclay, a chemist at RGB Research in west London, made this discovery. Her company specialises in selling collections of the periodic table elements (with the exception of those elements that are illegal or are so very short-lived - a few seconds or less - that they invite frustration). Some elements are easy to purchase: carbon, sulphur, iron. For others, one can turn to eBay, where arsenic, uranium (in the form of uranium-tipped missiles), and other elements of ill repute are commonly on offer.
But plutonium proved hard to find ... until Barclay turned to Google, which directed her to the Helios shop. She explains what happened next:

"I went to Covent Garden and went into the shop and said, 'Please, may I have some plutonium.' And the lady behind the counter said, 'I shall fetch the chemist.'

"The chemist was duly fetched, and I said, 'I'd really like a sample of plutonium.' She asked, 'And how strong would you like it, madam?'

Now there's customer service! When told to jump, smile and ask how high! Of course, there's one catch:

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They Shoot Horses, Don't They? [Living the Scientific Life (Scientist, Interrupted)]

Wed, 17 Jun 2009 08:59:53 EDT

tags: Shawn Johnson, gymnastics, sports, humor, satire, Onion News, streaming video

Gymnast Shawn Johnson euthanized after breaking leg. After gym doctors confirmed the her injuries were career-ending, Johnson's trainers said there was no reason to keep her alive. [2:28]

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Swine flu and travel insurance [Effect Measure]

Wed, 17 Jun 2009 07:28:53 EDT

I've been getting questions about whether it is safe to send sons and daughters to travel to places where there might be a lot of swine flu about. Many are from people in North America whose children are due to travel to Asia or Africa. The irony is that it is North America which is where most of the cases are, but that will undoubtedly change. And the real fear, I think, is what happens if someone gets really sick far from home, possible somewhere where the medical care is sub-optimal. That's not just a swine flu concern. Those of us who travel often take out medical travel insurance that covers costs of cancelation, medical care while traveling or even air ambulance back home. So is this a good idea considering the fact that there is now an official pandemic with swine flu? The answer seems to be . . . Read the Fine Print:

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Thread made of crab shell and polyester can stitch together broken nerves [SciencePunk]

Wed, 17 Jun 2009 07:03:03 EDT

Researchers at the University of Washington have woven together chitosan and polyester to create a new material that can help to repair severed nerves. Chitosan, found in the shells of crabs and shrimp, was mixed with an industrial polyester; the hybrid fibre combines the biologically favourable qualities of the natural material with the mechanical strength of the synthetic polymer.

"A nerve guide requires very strict conditions. It needs to be biocompatible, stable in solution, resistant to collapse and also pliable, so that surgeons can suture it to the nerve," said lead author Miqin Zhang, a professor of material science and engineering, "This turns out to be very difficult."

When a peripheral nerve (such as one in a finger) is severed, nerve endings continue to grow. But to repair the nerve surgeons must join the two fragments together. In the past, surgeons used to bridge large gaps with a difficult nerve graft. Current surgical practice is to attach tiny tubes, called nerve guides, that channel the two fragments toward each other.

Left: a closeup of chitosan and polyester fibers woven at the nanometer scale. Centre: a nerve cell growing on the resulting mesh, which has a texture similar to the body's fibrous connective tissue. Right: a cross-section of the synthetic nerve guide. Arrows point to nerve cells that have attached to the inner and outer surfaces of the tube.

Today's commercial nerve guides are made from collagen, a structural protein derived from animal cells. But collagen is expensive, and the protein tends to trigger an immune response. By contrast, chitosan is cheap, biodegradable, and does not trigger an immune reaction. Combining that with polycaprolactone - a strong, water-repellent, biodegradable material already used in sutures, resulted in a material 8 times stronger than collagen.

Zhang envisions the new material finding uses in a broad range of biomedical applications, including heart grafts, tendons, ligament, cartilage, muscle repair and more. This new material doesn't appear to have a name though. Any suggestions?

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The Onion says: Vaccine rejectors put kids at risk [Respectful Insolence]

Wed, 17 Jun 2009 01:00:00 EDT

When it comes to antivaccinationists, The Onion, as for most things, nails it.

Don't vaccinate not because science shows no link between vaccines and autism but rather because, you know, Jenny McCarthy has some really convincing anecdotes.

When antivaccine loons are the butt of jokes on The Onion saying that they're endangering children, they should beware. Few things cut as deep as an Onion parody.

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The Music of the Heart [bioephemera]

Tue, 16 Jun 2009 21:20:05 EDT

A beautiful anatomical ad campaign for the Zurich orchestra, via fubiz via Notcot.

Of particular interest I think is this comment on the thread at fubiz, from kmaz: "Music, and overall classical music, plays on emotion, not on the nervous system. instead of putting the music emotion above all, it takes it down heavily and awkwardly, to tie it with simple physic reactions." Really? "Plays on emotion, not on the nervous system"? Pardon me, but to a neurobiologist, that dichotomy is nonsensical. Our emotions and our nervous systems are inextricably entwined. Further, the complex physics and biology that make our emotional response to music possible only make the power of music and art more amazing, not less. Kudos to the Zurich orchestra for appreciating that.

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Steroids, bodybuilding, and anti-aging-- what a tangled web wooers weave [erv]

Tue, 16 Jun 2009 21:15:03 EDT

The latest edition of 'Life Extension' as once again provided me with a bounty of lols. For instance, did you know that "For the past fourteen years, the gerontological establishment has sought to persecute anti-aging physicians, anti-aging health practitioners, and the American Academy of Anti-Aging Medicine (A4M; www.worldhealth.net) itself, simply because they defy the prevailing model of disease-based, drug-oriented medicine"? The assaults have even included "mocking the anti-aging medical movement and its physician leaders."

Well, if theres one thing I will never, NEVER stand for, its MOCKING!

*fumes with rage*

Heres the deal, theres a whole troupe of crazies we havent dealt with much on SciBlogs yet-- The anti-aging crowd. Orac recently mentioned them a bit in response to Oprah-woo:

The article starts with the example of Suzanne Somers, whom I've mentioned before because of her belief that alternative medicine cured her of her breast cancer:
...in her books she says that she also starts each day by giving herself injections of human growth hormone, vitamin B12 and vitamin B complex...

You see, young folks have lots of human growth hormone. Older folks dont. That means if you give older folks HGH, they feel like younger folks!... Right?

Unfortunately, however, what Ms Somers (and anti-aging HGH peddlers) is doing is quite illegal. US Federal Statute 21 USC 333:

...prohibits knowingly distributing, or possessing with the intent to distribute, HGH for any use in humans other than the treatment of a disease or other recognized medical condition...

PubMed 'geriatric hgh', three hits. 'Gerontology hgh', three hits. Theres not enough science behind anti-aging HGH for it to be a 'recognized medical condition'. Prescribing HGH for anti-aging is illegal.

Not that this stops True Believer anti-aging physicians. They still prescribe it 'off label', or compare normal adult HGH levels to childrens levels, which are much higher, thus normal adult becomes low, and YAY! YOU NEED HGH!

But these stupid 'laws' are just being used to persecute anti-aging physicians:

Under the influence of the misinformation campaign contrived by the gerontological elite, US Federal Statute 21 USC Sec. 333(e) "enables a witch-hunt of [anti-aging] physicians who judiciously administer hGH therapy," when instead the statute was intended to prohibit trafficking of performance enhancing substances by non-physicians, prior to the existence of the anti-aging medical movement.

But heres where things get funny! Its cheaper for bodybuilders/power-lifters to get their drugs from Mexico, but there is a way to get legal anabolic drugs in the US. Go to an anti-aging physician, and get them to prescribe them for you. But they cant prescribe them for anti-aging. So they just run a blood test and when your rigged testosterone test comes back 'low', you get your legal HGH for anti-aging... which you are really using for bodybuilding.

ROFL!!! Oh, what a tangled web the wooers weave!

Whats even funnier (at least to me), is that anti-aging HGH is BS, but I see absolutely no reason why anabolic steroids are illegal for athletes, or just people who want to put on some muscle. Why can *I* can choose to ask a physician for invasive, potentially deadly medical procedures to make my boobs bigger, but a man who wants to take anabolic steroids to improve his looks, cant?

I mean what happens when I get sick of my breast implants? What if theyre too big? What if the doc totally Tara Reid botches them? More surgery or a life of pain and embarrassment.

What happens if I guy isnt pleased with the results of his cycle of steroids? What if he decides the side effects arent worth it? He just has to stop using steroids. The effects of anabolic steroids are reversible.

Witch hunting is going the wrong way there, Prof. Dr. Zs.-Nagy.

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The PharmacoScientific Creation of Well-Being [Neuron Culture]

Tue, 16 Jun 2009 20:25:03 EDT

Neuroskeptic offers an elegant unpeeling of a study seeming specifically designed to find a marketing-friendly distinction for a drug -- Abilify -- otherwise undistinguished.

Suppose you were a drug company, and you've invented a new drug. It's OK, but it's no better than the competition. How do you convince people to buy it?
You need a selling point - something that sets your product apart. Fortunately, with drugs, you have plenty of options. You could look into the pharmacology - the chemistry of how your drug works in the body - and find something unique there. Then, all you need to do is to spin a nice story to explain how the pharmacological properties of your drug make it brilliant.

On an entirely unrelated note, aripiprazole (Abilify) is an antipsychotic marketed in the US by Bristol Meyers-Squibb. A Cochrane meta-analysis finds that it's about as good as any other antipsychotic in terms of efficacy and side effects. As good, but no better. However, uniquely, aripiprazole is a D2 receptor partial agonist. Other antipsychotics work by blocking D2 receptors in the brain, switching them off (full antagonism). Aripiprazole also blocks D2 receptors, but it activates them slightly in the process (partial agonism).

Is that a good thing? A paper just published says yes - The relationship between subjective well-being and dopamine D2 receptors in patients treated with a dopamine partial agonist and full antagonist antipsychotics. The research in question was funded, by the way, by Bristol Meyers-Squibb. Let's see if it holds up.

Some clean and clear-eyed writing follows, in which Neuroskeptic educates us about dopamine receptors even while exposing a cleverness of study design -- the study manages , absurdly but "not unreasonably," to find a possible lift in well-being without any measured correlations -- that comes close to provoking wonder.

"I leave it to the reader to evaluate this claim," Neuroskeptic concludes, "and to consider how likely we are to progress in our understanding of the brain when so much of the research is funded by organisations with a direct financial interest in certain theories."

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Location, location, location: ethical considerations in where to run a clinical trial. [Adventures in Ethics and Science]

Tue, 16 Jun 2009 20:24:43 EDT

A day later than promised, let's kick off our discussion of "Research Rashomon: Lessons from the Cameroon Pre-exposure Prophylaxis Trial Site" (PDF). The case study concerns a clinical trial of whether tenofovir, an antiretroviral drug, could prevent HIV infection. Before it was halted in the face of concerns raised by activists and the media, the particular clinical trial discussed in this case was conducted in Cameroon. Indeed, one of the big questions the activists raised about the trial was whether it was ethical to site it in Cameroon.

From the case study:

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Francis Collins "upbeat" about impact of common disease genetics [Genetic Future]

Tue, 16 Jun 2009 20:21:46 EDT

Emily Singer has been doing a great job of covering the consumer genetics beat over at Technology Review; her most recent piece draws on a recent presentation by former head of the National Human Genome Research Institute Francis Collins.

Collins caused a bit of a stir during his presentation (at last week's Consumer Genetics Show in Boston) by announcing that he had signed up for several personal genomics services under a false name. His conclusions:

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Biology of Genomes meeting report [Genetic Future]

Tue, 16 Jun 2009 18:51:44 EDT

Regular readers will be aware that my last attempt to report on the presentations at last month's Cold Spring Harbor Laboratory Biology of Genomes meeting resulted in some controversy, as well as some fruitful (if sometimes heated) discussion on the topic of conference blogging.

My next attempt will likely prove less divisive: I was kindly invited to write a meeting report by the journal Genome Medicine, and the full text of the article is now available free online. Given the brevity of the article and the scope of the journal I've focused my coverage on the presentations most relevant to medical genetics, meaning that I had to leave out some of the very interesting talks on non-human genomics - but hopefully I've covered the broad themes of the meeting that are of most interest to readers of this blog, or at least those of you who missed my posts the first time around.

Finally, for the curious: yes, I did seek and receive written permission from all of the presenters mentioned in the report to discuss their work, following CSHL's policy. Since there is near-complete overlap between my blog coverage and the material in the article I feel rather reassured that my own internal presentation blogging policy at the time - focus on the big picture, and steer clear of the details most likely to be regarded as sensitive by presenters - did generally fit with the views of presenters on what was suitable for online consumption.

Subscribe to Genetic Future.

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Sports Doping via Elective Surgery [DrugMonkey]

Tue, 16 Jun 2009 17:59:53 EDT

BikeMonkey Guest PostProfessional sports continues to suffer from doping scandal. Although it is understood that preparation for the highest levels of competition involves considerably more than "training", most sports have enacted rules to distinguish allowable training/preparation aids from "cheating". This is by no means new. Nor is it over, the cycling world is poised for the now-traditional pre-Tour revelations of doping which will re-shuffle the lineup on July 4th.

But rules violations are in some ways uninteresting. There are rules to sport and if you break them you are penalized. Within that context, the nature of cheating and the ethical concepts of fair play are operationalized. Boring.

More interesting is to consider the essentially arbitrary distinctions that create the rules in the first place. Take Lance Armstrong. Winner of a record number of Tours de France, dominant rider and all around cycling icon. Did I mention he was making a come-back at his ripe old age and after a several year layoff? Great stuff.

And this was all possible only because he decided to have cancer.

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Does anyone even read disclaimers? [Genetic Future]

Tue, 16 Jun 2009 17:27:35 EDT

I've stumbled rather late across a very promising new blog on the experience of a consumer genomics customer, Fantastic Voyage. The blog is primarily written by Grant Wood, the senior IT strategist for a clinical genetics institute in Salt Lake City; the premise of the blog is that Wood will discuss his own experience of consumer genetic testing (via a 23andMe genome scan), while receiving input from two advisors: Marc Williams, a medical geneticist, and Janet Williams, a genetic counsellor.

In the two posts so far the highlights have been the insights from Marc Williams. For instance, on his shifting attitude towards direct-to-consumer genetic testing:

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Mind Bogglingly Stupid Logic About the Drug War from Kristoff [DrugMonkey]

Tue, 16 Jun 2009 16:47:33 EDT

Nicholas Kristoff of the NYT has an Op-Ed Column up which questions the Drug War. When it comes to asking about the cost of incarceration and interdiction, I have no bloggable opinion. As my readers know, I don't really delve into policy issues on this front.

My main problem is when Kristoff trots out the usual dismissal of the public health costs of de-criminalization and, in particular, resorts to an argument which is so disconnected from any logical reality it is laughable. Or it would be, if I couldn't see otherwise intelligent people nodding along in agreement.

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Quick dip: Fish hatchery mischief; health-care-reform sabotage; wiki science; and maple seeds [Neuron Culture]

Tue, 16 Jun 2009 16:05:38 EDT

SciAm ponders evidence that fish hatcheries are watering down the trout and salmon gene pool.

Matt Yglesias looks at one of many lies being told by those opposing health-care reform — confirming Salon's prediction that the opponents of reform are not going to play nice. See also The American Prospect on How Big Pharma Intends to Kill the Public Option. I should add this campaign is having an effect: On the radio this morning I heard NPR Steve Insky vigorously press the "public plan as trojan horse" attack on Kathleen Sibelius; I can only hope he'll as vigorously ask people such as Mitt Romney what exactly is wrong with offering more attractive insurance options to the almost 75 million people who are un- or under-insured.

And if somehow you missed it, do see Carl Zimmer's fine post on Swine Flu Science: First Wiki, Then Publish and Brandon Keim's fascinating look at how Maple Seeds Ride Self-Generated Tornadoes.

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Guinea Worm Disease [Greg Laden's Blog]

Tue, 16 Jun 2009 15:28:34 EDT

Here is the Guinea Worm Movie, and for more information and additional links, click here.

Minor Africa Story hidden below the fold.

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Bad Advice for Pregnant Women [Greg Laden's Blog]

Tue, 16 Jun 2009 12:35:17 EDT

People like to help pregnant women. On buses it is routine to give up one's seat for a pregnant woman. In Boston, drivers try less hard to run over pregnant women in crosswalks. And so on. But sometimes good intentions can lead to bad advice.

First, I'd like to point out that there is reasonably good evidence that obesity has negative health effects, and obesity in relationship to pregnancy is probably worse. So women who are planning on getting pregnant should probably trim down a bit if they need to. Also, exercise is good for many many reasons, so women who are planning on getting pregnant should look at their own exercise and activity routines and see if some adjustment can be made in those areas. And certainly, activity levels and patterns of diet and fat storage are all related, so in making these considerations do remember that this is all an interconnected complex whole.

And then, if you do actually get pregnant, don't listen to anyone.

Or at least, think about the advice you are getting when people are yammering at you.

In particular, cast off and ignore the following pieces of advice that you will receive again and again and again:

1) Forget about healthy eating, just shove whatever food is in front of you into your mouth, preferably focusing on saturated fats; and

2) Stop all forms of exercise for the next several months as your brood develops inside you.

Now, you might be thinking "I've never heard anyone say those things to a pregnant woman" but if you are thinking that, then you are just not listening. You hear it all the time. Maybe not in exactly those words, but this is what people are telling the pregnant women.

You, the pregnant woman, are NOT eating for two. You are one person, you weigh somehwere between 90 and 160 pounds (leaving lots of room for variation) and for the first third of your pregnancy, the unit of additional biomass that you are also eating for will reach a whopping two pounds or so. So for your first trimester you need to increase your intake by about one percent to make up the difference. In the last trimester, you'll have a lot more extra tissue that you are feeding via your blood supply, but still, imagine a 7 pound baby and add 7 pounds overhead (because for some reason we never weigh the placenta as part of the baby, even though it is, and there's the expanded uterus) and you get 14 pounds. Maybe, maybe, the additional tissue that you are feeding will be about 8-15 percent.

If you were eating for two you'd be eating 200% of your normal diet, and to do that in terms of calories, you are going to have to eat a LOT of fatty foods because there is just not enough time in the day to double your caloric intake by eating leaves and other low-quality "diet" food.

In terms of activity levels, I would say that a pregnant woman should start, by the end of the first trimester, to avoid activities in which you have an elevated risk of injury. Motorcycle racing, water skiing, that sort of thing. This is because of the significant added medical complications of combining trauma with pregnancy. Later, activity levels will also have to be modulated in certain ways because of balance issues, and the simple fact that certain activities could damage the offspring directly. So no fencing or boxing.

But activity levels need to be maintained just to keep healthy for a reasonable amount of time, adjusting as needed for all those common issues that happen late in pregnancy.

In other words, when it comes to activity levels and types, as well as diet, follow the advice of:

Mainstream books and possibly web sites
Your doctor and/or
Your certified midwife

Ignore the advice of

Everybody else that you know, especially
Anyone who has had a baby but not in the last five years or more; and especially especially
Anyone who has not had a baby

.... when they tell you to sit quietly on the couch and eat ice cream for six months. As much as that sounds like it might be fun.

And take your prenatal/pregnancy vitamins, of course.

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Juxtaposition #8 [bioephemera]

Tue, 16 Jun 2009 10:38:44 EDT

Der Mensch als Industriepalast (Man as Industrial Palace)
Fritz Kahn, 1926

Pintura/Anatomias, Sintonizando
Fernando Vicente, 2000

The suddenly blogospherically ubiquitous pinup-artist turned anatomical illustrator Fernando Vicente is clearly influenced by German artist Fritz Kahn. If this is your cup of tea, you'll probably also like "An Iconography of the Industrial Body: Fritz Kahn, Popular Medical Illustration and the Visual Rhetoric of Modernity," a talk by Michael Sappol of the National Library of Medicine, curator of Dream Anatomy and author of A Traffic of Dead Bodies: Anatomy and Embodied Social Identity in Nineteenth-Century America:

Influenced by Dada, neue Sachlichkeit, surrealism, futurism, Bauhaus, constructivism, Art Deco, neo-classicism, comic strips, photomontage, and advertising graphics, Kahn, and the artists working under his direction, visually explained how the human body works, based on the findings of modern biological science. At the same time, the images refer back to the chaos, violence, impasses, pleasures, dreams, and technological and sociocultural ambitions of early and mid-20th-century Germany. Kahn deployed a visual vocabulary of modernism to figure industrial modernity within the body and the body within industrial modernity. The result was a corpus of images and tropes which imagined a new body for the modern age.

Sappol speaks this Friday, June 19th, at 7:30 PM in the Observatory in Brooklyn, NY.

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