Hearing loss is a life-altering disability that needs to be addressed to help improve quality of life. (Joern Pollex/Getty Images)

Hearing loss is easy to ignore because there are no visible cues that push it to the “Things to Do Today” list. Many people who suffer from hearing loss are unaware that they are missing so much. Others think that they are getting by well enough and that the degree of loss is not that bad.

What people don’t know is that any amount of hearing loss can be a direct link to negative outcomes, such as loss of income, loss of a job, loss of a relationship, reduced mental health, depression, and a lower quality of life.

Many people avoid getting the help they need to hear the world around them because they don’t understand the negative impact that hearing loss has on their life and their future.

If you recognize that a loved one is ignoring this problem, it may take a good deal of dedication on your part to encourage treatment. By following the six-point plan listed below, you’ll have an easier time empowering the one you love to make a change.

Lead With Compassion

It is unfortunate that today’s society views hearing loss with shame and links it to aging. While impaired hearing can make people appear older and will cause the brain to begin improperly processing the surrounding world, hearing loss is simply a result of the body having some trouble.

People often get sick, have pain, have difficulty seeing or moving. The longer a person lives, the more physical ailments they must conquer. Hearing loss is no different.

Once hearing loss begins, the brain is given less information than when the ears were working properly. Over time, this can lead to frustration and isolation.

Treat loved ones who are experiencing hearing loss the same way you would if they had the flu. Be sympathetic and cater to their needs. Don’t react with anger or frustration.

Rely on a Hearing-Care Provider

Unless you have an audiometer in your home and are trained to perform a hearing exam, refrain from telling loved ones that they can’t hear, are deaf, or need a hearing aid. Encourage them to seek out measurable results from a professional.

Point Out What the Person Is Missing

The hearing-impaired person does not know what he is missing, but you do. For example, you may be at a social function where someone greets your loved one from afar, but he or she is unaware of being addressed and so has no response.

If you heard it, the other should have too. When you are alone, express concern and list the things that you saw him or her miss during the evening.

Keep in mind that the person suffering from hearing loss truly believes that people are mumbling. They are missing important components of speech (t, s, f, v, sh, for example), and this leads them to make excuses for why they don’t hear: “There was too much background noise,” or “That person was walking away from me when they were talking.”

Don’t Repeat. Write It Down

If your loved one refuses to acknowledge that something may be wrong, you must stop repeating what you say. Having speakers repeat perpetuates a habit that may go completely unnoticed to someone suffering hearing loss.

Instead of repeating yourself or talking louder, write down what you said and hand it to the person. At first people may be angry and defensive, but if you can keep it up (while still having compassion), they will begin to notice how many times they are asking you to repeat.

Do not buy in to their excuses and do not stop communicating with them. Doing so would encourage an inclination to withdraw from life.

Express Your Desire to Communicate

Our need to communicate with others is as basic as our need for nourishment. We feel validated and loved when we are listened to. On the other hand, if we feel ignored and shut out, we begin feeling angry and resentful.

When a loved one does not hear you completely, it is natural to feel frustrated and to respond with anger and accusations; however, this will only cause the person to deny the problem and blame the outside world, further complicating your communication ability and the intimacy of your relationship.

Instead, find a good time to sit down and express your need to be heard, explain how much you love to communicate with the person and that you feel like something is getting in the way of this important part of your relationship. Suggest having your hearing tested together.

Develop Safety Measures

If a loved one is at home alone or drives alone and is unwilling to seek help for hearing loss, you need to be very firm in demanding positive measures to keep the person safe when you’re not there.

Security alarms with motion detectors inside or outside of the house and an extra-loud telephone ring are useful safety measures.

You must also discuss safety when driving. Hearing loss causes the brain to react more slowly to the input it receives, and that slowed reaction time could be the difference between arriving home safely or getting into an accident.

Hearing-impaired people could become “addicted” to not hearing the world around them. Change will be hard, but ultimately their quality of life will be better, and as they age, they will benefit from having quality relationships, rather than becoming isolated and depressed.

Melissa Kay Rodriguez, BC-HIS, is the author of “Hear Your Life: Inspiring Stories and Honest Advice for Overcoming Hearing Loss.” www.hearwithmelissa.com.

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Hip replacement is a common surgery that comes with many benefits and as well as some major risks. (Photos.com)

When does a doctor fully realize the nature of a disease? Sir William Osler, distinguished professor of medicine at McGill, Johns Hopkins, and Oxford University, remarked that a doctor only fully understands a disease when he has suffered from it himself.

Having just recovered from a hip replacement operation, I couldn’t agree more with Osler. So what did I learn and what did I fear?

W. C. Fields, the comedian, when asked what he wanted inscribed on his tombstone, replied, “I’d rather be in Philadelphia.” I felt the same way as I was wheeled into the operating room. But at least I had the satisfaction of knowing I had first used every medical therapy I knew to prevent this from happening.

Nine months earlier, while on a trip to Israel with other journalists, I fell and injured my knee and hip. I tried to convince myself I was suffering from post-traumatic arthritis and that tincture of time along with laser therapy and other medication would cure me. It didn’t, and pain finally forced me to the operating table.

As a surgeon, what worried me about the procedure? The truth is, not very much. In fact, the easiest aspect of the surgery was the surgery itself. Since I had a spinal anesthetic and the anesthetist agreed to my request of no sedation, I was awake during the procedure.

What might be upsetting for some patients was the buzzing of the saw that removed the upper part of my femur along with the arthritic ball-shaped acetabulum. This part would be replaced by the hip prosthesis. But I knew that in all probability, nothing would go awry during the removal of this large segment of thighbone.

My adrenaline went on high alert, however, when I heard the surgeon’s hammer pounding the hip prosthesis into the inner part of the remaining bone. I was aware that, although hammering is needed to drive the hip prosthesis into the femur, too much pressure could fracture the bone—not a good complication.

The adrenaline stimulus dropped when the hammering stopped. Most of my time on the table was spent watching the hands of the operating room clock tick off the minutes.

The operation and recovery period have confirmed what I’ve always reported about hip replacements. Years ago as a medical student, I witnessed the first hip replacement performed at the Massachusetts General hospital. It was major surgery then and it still is.

Today, due to the thousands of such operations done every year in North America, most patients believe that exchanging bone anatomy for a spare part is not a big deal. But don’t rush to the operating room. Be grateful that surgery is there when you need it. Just make sure you require it. You never know when you might get more than you bargained for.

For instance, several years ago, Dr. Justin de Beer, an orthopedic surgeon at McMaster University in Hamilton, Ontario, reported disturbing news to the Canadian Orthopedic Association. A worrying number of hip and knee replacement patients suffered heart attacks following the operation.
The majority of these attacks occurred within three to five days of the surgery.

Moreover, 29 percent of patients had no previous history of heart disease. This is not surprising since many patients undergoing hip replacements are not kids, are often obese, and suffer from diabetes. Besides, it’s impossible to remove a large part of the upper leg bone without subjecting the body to major physiological shock.

Development of surgical wound infection is another major concern today.
Hospitals have become hot beds for antibiotic-resistant infections. Every year, about 200,000 Canadians develop life-threatening infections in the hospital, and 12,000 die. The most vicious infection is caused by Clostridium difficile, which can cause up to 40 bowel movements a day.

Luckily, I escaped these potential complications. But I haven’t yet escaped the tedious daily exercises to strengthen muscles surrounding the hip replacement. It’s a daily reminder that it would have been more fun to be in Philadelphia!

See the website www.docgiff.com. For comments, email info@docgiff.com

A young boy with cerebral palsy and autism takes a 30-minute ride on a horse at the Horses and the Handicapped of South Florida facility. He is supported to ride on his back and stomach to strengthen his diaphragm, which helps him speak better, and to strengthen his abdominal muscles. The horse therapy also helps him focus longer and recognize his surroundings. (Tom Ervin/Getty Images)

“Do you know there’s financial help for your child?” I recently asked a friend.

Like many new parents, he and his wife had expected a healthy child. But fate ordained otherwise. Now, several years later, they are struggling with the medical, financial, and emotional burdens of caring for a child with cerebral palsy, a lifetime disability.

Unfortunately, many families are unaware of the new government project providing financial security for all disabled Canadians.

Cerebral palsy is one of the most common congenital disorders of childhood. In Canada and the U.S., there are more than 500,000 children and adults who suffer from this tragic problem.

The way cerebral palsy affects children varies. Some children suffer involuntary and uncontrolled movements, or a loss of balance and depth perception. This makes simple tasks such as standing still difficult.

Others have learning problems and difficulty controlling bladder and bowel functions.

To know what causes most cases of cerebral palsy, you would need the Wisdom of Solomon.

But it’s believed that some cases result from trauma to the brain during labour and delivery, and some are due to infection, uterine maternal problems, or other unknown factors that interfere with normal brain development.

Fortunately cerebral palsy does not get worse over time.

Premature babies, newborns who weigh 3.3 pounds (about 1.5 kilograms), and other low-weight infants such as twins and triplets are more prone to cerebral palsy than babies carried to full term.

But brain damage can also occur in early infancy. For instance, the shaken-baby syndrome, bacterial meningitis, malnutrition, or a car accident without proper seatbelt security can result in cerebral palsy.

Obvious symptoms of cerebral palsy are easy to diagnose. But in some cases diagnosis is incomplete until doctors see a developmental delay that falls outside the normal range, such as reaching for toys at four months or sitting up by eight months.

You also need Solomon’s judgment when trying to prevent cerebral palsy. There are too many unknown factors associated with this disability.

I’ll gladly pay for the new legislation that is helping children and adults with disability.

The type of care cerebral palsy children require is dependent on the extent of the disability. Some may need help for visual impairment or blindness, hearing loss, speech therapy, and sleep disorders. Others may require surgery for dislocated hips or scoliosis, a curvature of the spine commonly associated with this disease.

But I’m sure only the parents, facing the daily task of caring for any disabled child, know the full extent of the problem. Their untold hours of labour take a physical and an emotional toll, not only on the parents but on the whole family.

Don Cherry established the Rose Cherry Home for Kids several years ago to help relieve the burden of parents. Now known as the Darling Home for Kids, it cares for cerebral palsy and other disabled children.

Registered Disability Savings Plan

Like many, I hate to see my taxes wasted. But I’ll gladly pay for the new legislation that is helping children and adults with disability.

But Canadians may not receive the benefit unless my friend and other parents become aware of what’s called the Registered Disability Savings Plan (RDSP).

If you are a Canadian resident under age 60 and eligible for the Disability Tax Credit, you qualify for the RDSP. Parents and guardians simply open an RDSP account for their disabled family member.

The lifetime contribution limit is $200,000 that will grow tax-deferred in the plan. Through the Canada Disability Savings Grant, the government will deposit matching grants into your RDSP to help you save, with a grant limit of $70,000 over your lifetime.

Since July 2011, proceeds from a deceased parent’s or grandparent’s Registered Retirement Savings Plan, Registered Retirement Income Fund, and Registered Pension Plan may be rolled over tax-deferred into a RDSP.

My friend is looking into this RDSP and so should others. Not often is the government 100 percent right. But in this case it is!

Dr. Gifford-Jones is a medical journalist with a private medical practice in Toronto. His website is DocGiff.com. He may be contacted at Info@docgiff.com.

A pediatrician gives an HPV vaccination to a 13-year-old girl in her office at the Miller School of Medicine on Sept. 21, 2011, in Miami, Florida. According to some medical professionals, at least 45 tests and procedures routinely performed on patients across a range of fields are often unnecessary and may in fact be harmful. (Joe Raedle/Getty Images)

At least 45 tests and procedures routinely performed on patients across a range of fields are often unnecessary and may in fact be harmful, a group of leading medical organizations in the United States said Wednesday.

“Many of the things that are routinely done are things that patients have come to expect and doctors have routinely ordered,” said Dr. Christine Cassel, president and CEO of the American Board of Internal Medicine (ABIM). “These are not things that should never be done, but they are things that are often overused.”

The tests include brain-imaging scans, which are often given unnecessarily after fainting or headaches, CT scans or antibiotics for chronic sinusitis, and routine cancer screening tests when there are no signs or symptoms of cancer.

Nine specialty physicians groups have compiled a list in their respective fields, titled “Five Things Physicians and Patients Should Question.” They say this is an endeavor to reduce costs and unnecessary harm while encouraging a deeper conversation between patients and physicians.

The lists were compiled in a report released by the nine groups in conjunction with the Consumers Union, and the AMIB Foundation, at the National Press Club in Washington, D.C., Wednesday, April 4.

The initiative is part of the ABIM Foundation’s Choosing Wisely Program, which lists on its website the 45 routine tests and procedures in question.

“We support the goal of the Choosing Wisely campaign and hope that it will lead to better shared decision making between patients and their physicians and, ultimately, a reduction in unnecessary or harmful medical procedures,” said Dr. Steven Weinberger from the American College of Physicians.

Dr. Christine Cassel, president and CEO of the American Board of Internal Medicine, speaks at the National Press Club in Washington, D.C., on April 4. Shar Adams/The Epoch Times

The group includes the American colleges of cardiology, physicians, and radiology; the American societies of clinical oncology, nephrology, and nuclear cardiology; and the American Academy of Family Physicians.

The American Academy of Family Physicians includes imaging for low back pain within the first six weeks as questionable. Low back pain is the fifth most common reason for all physician visits but “imaging of the lower spine before six weeks does not improve outcomes,” the organization says.

Pap smears in women younger than 21 years are also questioned. Adolescent abnormalities can be harmless and regress, the organization says, while Pap smears can lead to unnecessary anxiety, additional testing, and cost.

James Guest, president and CEO of Consumer Reports, the Consumers Union publication, welcomed the list saying not only will it lead to easier access to information and increase discussions between doctors and patients, but it will also reduce the harmful effects of overtreatment—particularly from X-rays, MRI (magnetic resonance imaging), and CAT scans.

Guest pointed to false positives in unnecessary testing, which can then result in more unnecessary tests.

“There is no real justification in the first place, so it becomes likes a snowballing effect that, I think, needs to be avoided,” he told The Epoch Times.

“I am certainly hearing more and more doctors saying we need to be patient oriented, ‘the patient comes first’ and I think often they don’t quite realize what that is, but that is beginning to change,” he said.

Next…Financial incentives a concern

Women in their 20s should be encouraged to have at least one test of ovarian reserve if they are considering having a family in the future. (Photos.com)

Janice is a 32-year-old woman who had irregular menstrual periods for six months and then saw her periods stop completely.

She felt otherwise well. She saw her doctor, who tested her hormone levels and reported back that she was menopausal—she had run out of eggs!

Janice is not alone in this scenario. Premature menopause occurs in approximately 1 percent of women; however, the reserve of the ovary, that is, the number of eggs it has left, may prematurely begin to decrease rapidly in a much higher percentage of women.

In women over the age of 35, the ovarian reserve begins to decrease exponentially compared to women who are younger. A decrease in the ovarian reserve means there are fewer eggs to grow and mature, and therefore fertility may decrease.

Women are born with a certain number of eggs. Unlike men, who continue to make sperm throughout most of their lifetime, women are unable to make more eggs than the 2 million that they are born with.

If a woman has tests that reflect low ovarian reserve and does not yet have children, she should be encouraged to consider having a family.

Each month, through a process called attrition, women lose eggs—hundreds each month. By the time of menopause, at an average age of 51, the ovary has completely run out of eggs.

Smokers, women with a family history of premature menopause, and women with autoimmune diseases may all be at risk of premature menopause.

Unfortunately, we are unable to prevent this process.

Tests for Egg Quantity

There are three tests currently available to measure the ovarian reserve.

One is an ultrasound, done at the beginning of a menstrual cycle (day 2 or 3), that counts the preantral follicles—small follicles less than 1 centimetre in size that hold the immature eggs—in the ovary. A number greater than five is a good prognostic for reserve.

The second is a blood test for the level of FSH, or follicle-stimulating hormone, done on day 2 or 3 of the cycle, when estrogen level is at the lowest.

Lower estrogen means a higher FSH level is needed to stimulate the follicles and enable the egg inside each follicle to grow and mature. A low ovarian reserve also means more FSH is needed to stimulate egg maturation. A high FSH level, over 15, is a poor prognostic sign for ovarian reserve, indicating a low reserve.

The newest test available is for the level of AMH, or antimullerian hormone, a hormone produced by the ovarian follicles. This blood test can be done on any day of a menstrual cycle. A low AMH level is a poor prognostic sign indicating low ovarian reserve.

This test is not readily available from labs and is done mainly in fertility clinics, and it is currently not covered by provincial health plans such as Ontario Health Insurance (OHIP).

Having a Family

If a woman has tests that reflect low ovarian reserve and does not yet have children, she should be encouraged to consider having a family. Women seeking fertility assistance who test for low reserve are often counselled to be more aggressive with their treatment.

Sadly, science still cannot make more eggs, change the destiny of the eggs women have, or predict what will happen to women as they age.

Women in their 20s should be encouraged to have at least one test of ovarian reserve if they are considering having a family in the future.

Dr. Fay Weisberg is a gynecology and infertility specialist with an active private practice and is Chair of Continuing Medical Education and Professional Development, Department of Obstetrics and Gynecology, University of Toronto. Her website is www.firststepsfertility.ca.

Of 4,336 people on Ambien in the BMJ study, there were 265 deaths compared with 295 deaths among 23,671 people not on Ambien. (Tim Boyle/Getty Images)

As the industrialized world increasingly relies on sleeping pills, new information suggests they may not be as safe as previously thought.

Drugs like Ambien, Lunesta, and Sonata; older drugs like Valium and barbiturates; and even sedative antihistamines all correlate with a threefold increase in the hazard of death, say researchers in the Feb. 27, 2012, issue of the British Medical Journal (BMJ).

Some of the mortality stemmed from a “significant elevation of incident cancer,” say the researchers. Research subjects did not have pre-existing disease.

Sleeping pills have never been Big Pharma’s finest hour. In the 1960s, barbiturates were immortalized by Marilyn Monroe’s death and by the 1967 movie Valley of the Dolls.

In 1993, the sleeping pill Halcion was banned in the United Kingdom and other countries for causing amnesia, paranoia, depression, hallucinations, and violence in users. Travelers would find themselves on the other side of the Atlantic Ocean and not remember boarding a plane.

In 2001, a similar pill, Dalmane, was said to “increase the risk of an injurious accident more than five times normal,” at an FDA/National Transportation Safety Board hearing.

There were more transportation risks. Who in the United States can forget former Rhode Island representative Patrick Kennedy driving to Capitol Hill in 2006 to “vote” at 2:45 a.m. while on Ambien and other drugs and crashing his car?

Law-enforcement officials reported that traffic accidents increased when Ambien became popular. Some drivers were not even aware that police officers were arresting them.

The FDA soon issued warnings about such apparent sleeping pill blackouts.

Of 4,336 people on Ambien in the BMJ study, there were 265 deaths compared with 295 deaths among 23,671 people not on Ambien.

Sleeping pills like Ambien, Lunesta, Sonata, and Rozerem only decrease get-to-sleep time by 18 minutes, according to a major government study. Nonetheless, they have been a gold mine for Big Pharma since direct-to-consumer (DTC) advertising.

Everyone sleeps or watches TV when they can’t sleep. In FDA documents, Rozerem worked no better than a placebo, but its sales shot up 60 percent thanks to DTC advertising, reported the New York Times.

To grow the insomnia market, pharma has rolled out subcategories as it did with different kinds of depression. You could have chronic, acute, transient, initial, or delayed-onset insomnia.

You could also have middle-of-the-night, early-morning, or menopausal insomnia, or even non-restful sleep. But if further research confirms the BMJ findings, enduring the minutes before you

You can always watch the TV commercials for sleeping pills.

Martha Rosenberg is a health reporter and author who lives in Chicago.

A doctor considers the pros and cons of alcohol consumption and believes that there is a place for drinking alcohol in moderation. (Cat Rooney/The Epoch Times)

What do I do when I arrive home after seeing patients all day? I have a predinner drink with my wife. This week, I hope I can still do it.

But on March 22, I’m scheduled for a hip replacement. So today, a column dealing with alcohol is appropriate. I wonder if my surgeon will recall Sir William Osler’s wise remark.

A report in the Journal of the American Medical Association on March 14 claims alcohol causes cancer. The prestigious Nurses’ Health Study followed 106,000 women for more than 25 years. This study revealed that women who routinely consume three to six drinks a week are 15 percent more likely to develop breast cancer than nondrinkers, regardless of the type of alcohol.

For women having six to nine drinks a week, the risk is 20 percent, and the risk jumps to 50 percent for those who partake of more than 19 drinks a week.

But how accurate is this immense study? The first thing to remember is that there are three kinds of lies: “lies, damned lies, and statistics”!

For instance, at first glance, a 15 percent increased risk of cancer for women drinking three to six drinks a week appears to be a fair-size danger. But at age 50, the average woman has a 2.4 percent chance (1 in 42) of developing breast cancer in the next 10 years.

An increase of 15 percent increases the risk to 2.8 percent (1 in 37). Stated another way, among 1,000 women, age 50, light drinking may cause an extra 3 or 4 cases of breast cancer during the next 10 years.

While any increase in deaths from cancer cannot be taken lightly, you have to consider the other side of the coin. Later in life, far more women will die of heart attacks than breast cancer. And several studies show that both women and men who drink moderately live longer than teetotalers or those who drink excessively. I say amen to that.

Does the consumption of alcohol also increase the risk of malignancy in men? Reports from the National Institute of Health (NIH) in the United States show that alcohol increases the risk of oral, stomach, colon, pancreas, liver, and prostate cancer.

What women and men decide about alcohol when faced with these facts is a personal decision. And if you’ve never touched alcohol, don’t start now.

I’ve believed for years that alcohol in moderation is the best medicine ever devised for mankind. Consider the tens of millions who, over the centuries, have died from drinking water!

Consider also the thousands who every year die from prescription drugs. This doesn’t happen to moderate drinkers. So I’ve always believed that, in medical practice, there is a place for the relaxing effects of an alcoholic drink.

Years ago, I shocked nurses when I wrote a postoperative order that allowed surgical patients, who normally enjoyed a predinner scotch and soda, to have one, but only if they wanted one, on the evening of the second postoperative day. This practice had a huge effect on their psyches and convinced patients they were not going to die.

The benefit is not just psychological. Alcohol increases the good cholesterol and relaxes blood vessels. It also keeps platelets slippery so they’re less likely to form a blood clot in the legs. Platelets are tiny particles in the blood associated with the clotting process. It is a disastrous complication if a clot travels to the lungs and causes death.

Enjoy your drink, always in moderation, whether thinking about cancer or other problems. There are many more-serious risks than having a cocktail before dinner, including popping pills that may be useless.

Maybe my surgeon will recall Sir William Osler’s remark: “Alcohol is for the elderly what milk is for the young.” And he knows I’m a long way past 16!

Dr. Gifford-Jones is a medical journalist with a private medical practice in Toronto. His website is DocGiff.com. He may be contacted at Info@docgiff.com.

OxyContin, a powerful painkiller, manufactured to relieve the pain of seriously ill people, is being used by some addicts to achieve a high similar to a heroin rush. Its popularity among abusers of the drug has resulted in a string of pharmacy robberies nationwide. (Darren McCollester/Getty Images)

What will happen to the 200,000 or more Canadian OxyContin addicts now that this opioid narcotic is no longer available? For years, these people have embarked on a willful act of self-destruction.

Those who are rallying to help OxyContin addicts are making a series of illogical errors. Purdue Pharma, makers of OxyContin, also made a blunder. It spent needless money producing OxyNEO, an opioid version of OxyContin that resists crushing or liquefying, so addicts can’t snort or inject it.

Toronto made the same illogical move when it spent millions building a protective fence to prevent people from jumping off the Bloor Street aqueduct. Now they jump in front of speeding subway trains. OxyContin addicts will similarly resort to other addictive drugs, such as heroin and hydromorphone.

Just how sick are OxyContin addicts? I have no personal experience in treating addicts. But Theodore Dalrymple, a British prison doctor and psychiatrist, has looked after addicts for years. In his book “Romancing Opiates,” he writes that heroin is not as highly addictive as is claimed, and withdrawal from this drug is not medically serious.

He adds that a useless bureaucracy has been established to deal with addicts. I say amen to that.

Dalrymple has observed addicts laughing and talking in his waiting area. But once inside his consulting room, they appear to be in extremis. And when he takes them to task for this sudden change of health, they admit they were blagging.

I think Dalrymple is right. Years ago when I was researching heroin in England, I saw cancer patients on huge doses of heroin. But if there was a remission of the cancer, they could be quickly weaned off this painkiller.

I realize there are hard-core addicts who will never be weaned off drugs. But our irresponsibly permissive approach to others seeking a high has resulted in a bureaucracy costing millions of dollars. And it’s not working. How could it be? Over 200,000 are prescription addicts; tens of thousands are using illegal drugs; and in some communities, half of the people are addicted to medication.

Years ago in this column, I predicted this would happen if we did not follow Singapore’s law—the death sentence to those who brought heroin into the country. Now our lenient attitude to drug pushers has resulted in an over-medicated, drug-addicted society.

Now that we have the problem, what can be done about it? I will bet my last dollar that a huge number of those taking illegal drugs and OxyContin are being treated with the wrong prescription.

They don’t need more doctors, social workers, or politicians handing out more money for methadone facilities and injection sites. What they require is a tough sergeant major stationed in northern Canada. His orders would be simple: “Up at 6 a.m. and start chopping wood.” It would result in a speedy cure.

If this country were bursting with dollars and could provide care to everyone, I wouldn’t care how addicts were treated. But we’re not wallowing in dollars.

Hippocrates, the father of medicine, preached that punishment was a form of medicine. I agree, and a good start for OxyContin addicts would be course 101 in chopping wood.

What do you think?

Dr. Gifford-Jones is a medical journalist with a private medical practice in Toronto. His website is DocGiff.com. He may be contacted at Info@docgiff.com.

Older people with even mild hearing loss are three times more likely to fall than older people with normal hearing. (Uwe Zucchi/AFP/Getty Images)

Researchers have found an intriguing link between the risk of falling and hearing loss.

Among aging populations, falls are a major health hazard. A stumble that might lead to just a painful bruise in a younger person can result in a broken hip, disability, and even death in older adults.

Researchers analyzed data from an ongoing U.S. health study, called the National Health and Nutrition Examination Survey (NHANES).

Lead author Frank Lin, of Johns Hopkins University, said he and his colleague, Luigi Ferrucci of the National Institute on Aging, compared measurements of hearing loss in adults age 40-69 with participants’ response to questions about any recent falls they might have had.

“And what we found is that someone’s hearing ability is directly related to their chances of having falls in the past year,” Lin said.

“For someone with just even a mild hearing loss compared to normal hearing, they basically had about a three-fold increased chance of having falls over the past year.”

Lin’s study found a strong association, not cause-and-effect.

But why might hearing loss contribute to falling?

He says there are several possibilities. Poor hearing could make people less aware of the environment around them.

Or it may be linked to another function of the ear, specifically the inner ear, which isn’t used just for hearing.

“It actually helps you maintain balance; so it provides balance information to the brain.

Lin’s findings, published in the Archives of Internal Medicine, confirm several previous studies that have probed the link between hearing loss and falls.

—VOA News

EPOCH TIMES: How prevalent is the use of antibiotics for illnesses that they are not necessarily designed to treat?

HSE: Numerous studies have shown that half of all antibiotic prescriptions may not be appropriate, e.g. incorrect choice of antibiotic, incorrect dose/duration, or prescription of an antibiotic for infections where they are likely to be ineffective.

EPOCH TIMES: How can patients be causing the problem if they need a prescription to get antibiotics?

HSE: Numerous studies have shown that there is a high level of misunderstanding about the role of antibiotics in treating common infections among patients and the general public. This, in turn, can lead to a demand for, or expectation of, an antibiotic prescription by people attending their GP. As a result, studies have shown that prescriber education alone (mainly GP) does not produce a sustained reduction in inappropriate antibiotic use: patient and public education is needed as well. Data from other countries show that for many conditions (particularly upper respiratory infections, or coughs & colds), antibiotics are prescribed when they are not needed in up to 50 per cent of patients. We know that public expectation and pressure can influence prescribing decisions, and that public education has been shown to be an essential component in reducing inappropriate antibiotic use. 

A Europe-wide survey, which included Ireland, showed that members of the public often mistakenly believe that antibiotics can hasten recovery from upper respiratory tract infections and prevent more serious illness. Such misconceptions were lower in countries that have succeeded in maintaining low levels of inappropriate antibiotic use. Surveys have shown that nearly half of the adults that go to their doctor expect an antibiotic once they get there. In the US, between a third and half of parents with children presenting with mild respiratory symptoms said that they expected an antibiotic for a cough or cold.

Belgium has run a successful public education campaign, starting in 2004, mainly targeting antibiotic use for respiratory tract infections during the winter months. The campaign utilises television, radio and print advertising, leaflets, posters and a dedicated website. Analysis of the campaign’s impact has shown that the television advertising component has the greatest impact, with 79 per cent of those who were aware of the campaign citing the television advertisements. The campaign was associated with a 36 per cent reduction in community antibiotic consumption, with an associated reduction in the level of resistance among strains of pneumococcus. The campaign delivered approximately 4 million euro savings in direct drug acquisition costs to the Belgian health system, compared to an annual campaign budget of 400,000 euro.

Public expectation and pressure can influence prescribing decisions…

In France, a national public education campaign was run for six months each year (autumn/winter) from 2002 to 2007. The key message of the campaign was that “antibiotics are not automatic”, and was delivered through a combination of humorous television and radio advertisements, print leaflets and press releases. Post-marketing surveillance demonstrated a significant improvement in public knowledge about antibiotic resistance and the importance of only using antibiotics when they are needed. The campaign resulted in a 23.4 per cent decrease in community antibiotic use (34 per cent for children under 15). During the same time period, there was a 29 per cent reduction in the level of penicillin resistance among strains of S. Pneumonia. The campaign had an annual budget of 4 million euro, but delivered a cost saving of 850 million euro to the French health system.

The current HSE information campaign theme is to stress that ‘Antibiotics are wasted on colds and flu,’ and includes an updated information leaflet for patients on antibiotics, a ‘no prescription for antibiotics’ prescription pad, a dedicated antibiotic section on the HSE website, and a radio ad.

EPOCH TIMES: Are GP’s over-prescribing or prescribing for incorrect use?

HSE: A major component of the joint Royal College of Physicians of Ireland (RCPI) and HSE healthcare-associated infection (HCAI) clinical care programme will be prevention of HCAI and antibiotic stewardship. The GP prescribing guidelines, which are evidence-based, have recently been updated and widely disseminated to a variety of primary care settings. Guidelines are important as they help standardise prescribing and ensure that each patient receives the correct drug as per the latest international evidence. In addition, they help GPs choose narrow-spectrum rather than broad-spectrum antibiotics, which may help prevent antibiotic resistance development. The RCPI clinical advisory group as part of its HCAI strategy is working with GPs and the HSE to develop surveillance in primary care to ensure that there is information on antibiotic resistance trends available to GPs for common infections, e.g. urinary tract infections.

EPOCH TIMES: What else is the HSE doing to raise awareness of the issue?

HSE: We are tackling antimicrobial resistance by reducing unnecessary antibiotic use. We do this by educating and changing the behaviour of prescribers and patients via antibiotic stewardship and public education. We also have systems in place to track emerging trends (i.e., surveillance such as EARS-net and antibiotic consumption surveillance). This ensures that we keep antibiotics for when we need them, reducing bacterial ability to develop resistance. It also means we can save money for both the health system and the patient. 

EPOCH TIMES: What savings, both financially and health-wise, can be made by the correct use of antibiotics?

HSE: Antibiotic use peaks every winter, during cold and flu season. That should make sense, but it doesn’t – colds and flu are caused by viruses, and are not killed by antibiotics. Using antibiotics for illnesses like these when they are not needed is a waste of money, drives antibiotic resistance, can have adverse effects on patients, and has a long term cost to our society and our future. Antibiotic resistance represents a global public health threat, and is associated with increased illness, death and financial cost related to infections. If left unchecked, rising antibiotic resistance threatens to undo many of the medical advances of the past 50 years.

- to ensure our patients get the best care (i.e., that a patient that needs an antibiotic gets the correct one, and also that if somebody does not need an antibiotic, e.g. for a cold or flu, that they take rest, fluids and eat well, consider an over-the-counter remedy to help symptoms such as aches and pains, but don’t get an antibiotic for this indication)
- because taking an antibiotic when it is not needed runs the risk of side effects from the antibiotic
- because with increasing use of antibiotics, some bacteria which cause infection build up resistance, and as a result, antibiotics are less effective (known as ‘antibiotic resistance’).

EPOCH TIMES: Many thanks for the information.

HSE: Thank you

Fertility varies among populations and declines with age in both men and women, but the effects of age are more important in women than in men. (Photos.com)

Infertility is defined as failure to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.

Early consultation is advised for couples who have a known medical problem that may decrease fertility. Similarly, for women who are over the age of 35, seeking medical care earlier is warranted.

Below are some common myths and misconceptions about fertility:

Age and Fertility

Fertility varies among populations and declines with age in both men and women, but the effects of age are more important in women than in men.

Women’s fertility decreases starting at age 35, and in men it decreases starting at the age of 50.

Frequency of Intercourse

Many couples believe that their chance of conceiving is higher if they “store up” the sperm.

This is not true. Abstinence of more than five days may negatively affect sperm, whereas keeping to two-day intervals for intercourse is best.

Evidence suggests that engaging in intercourse daily or every second day during the time of ovulation leads to greatest success.

Fertility Window

Women can only conceive around the time of ovulation, which is the small window of time when the egg is released from the ovary. This process typically occurs once a month for women with regular menstrual periods.

As such, there is a four-to-six-day window of opportunity to achieve pregnancy immediately before, during, and after ovulation.

If a woman does not have a regular menstrual cycle, predicting this window may be much more difficult. Using ovulation kits may improve prediction of the timing of these fertile days.

Sexual Practices

It is a myth that lying flat after intercourse or with the hips on a pillow following male ejaculation improves pregnancy rates. Sperm travel immediately through the cervical mucus into the tubes within seconds of ejaculation.

Infertility affects about 10–15 percent of couples.

Sexual position also plays no role in fertility success, as long as the sperm is ejaculated into the vagina. Furthermore, failure of a woman to achieve orgasm does not decrease the chances of becoming pregnant.

If lubricants are required for sexual intercourse, products such as astroglide and K-Y Jelly may inhibit sperm motility. Pre-Seed has no impact on sperm movement.

Diet

Women who are either very thin or obese have decreased fertility rates, as ovulation may not occur in both of these cases.

There is no evidence that vegetarian diets, elimination of caffeine, or herbal remedies increase fertility rates. Women who are attempting pregnancy should take a folic acid supplement of at least 400 micrograms daily.

Drinking more than 5 cups of caffeine per day can decrease the rate of fertility and increase the risk of miscarriage; however, moderate consumption of 1 cup to 2 cups a day has no effect.

Smoking

Smoking has a substantial negative effect on pregnancy rates. Smoking affects egg quality, estrogen levels, sperm and egg motility in the Fallopian tubes, as well as sperm function. Women who smoke have a higher chance of miscarriage.

It is important that both partners are evaluated so that treatment and hopefully a successful pregnancy can be attained.

Dr. Fay Weisberg is a gynecology and infertility specialist with an active private practice and is Chair of Continuing Medical Education and Professional Development, Department of Obstetrics and Gynecology, University of Toronto. Her website is www.firststepsfertility.ca.

An advertisement for beef steaks is displayed at Marina Meats on January 31. Antibiotics may be in your food without your knowledge. (Justin Sullivan/Getty Images)

In 2008, the FDA announced that “evidence that extra-label use of these drugs [cephalosporins] in food-producing animals will likely cause an adverse event in humans and, as such, presents a risk to the public health,” and called for their prohibition. Notice the FDA says “will likely cause,” not “could likely cause” and “presents a risk” not “could present a risk”?

But by the time hearings were held two months later and lobbyists had worked their magic, the “Cephalosporin Order of Prohibition” had somehow become a “Hearing to Review the Advances in Animal Health Within the Livestock Industry.”

At the hearings, the American Veterinary Medical Association (AVMA), the Animal Health Institute, a Big Pharma trade group, and the egg, chicken, turkey, milk, pork, and cattle industries complained that they could not farm without antibiotics because more feed would be required, and the animals would get sick from being immobilized over their own manure.

“To raise turkeys without antibiotics would increase the incidence of illness in turkey flocks,” said the National Turkey Federation’s Michael Rybolt, Ph.D. Antibiotics “reduce the level of potentially harmful bacteria, which result in infections and sickness,” said the National Milk Producers Federation’s Robert D. Byrne, Ph.D.

Antibiotics decrease the amount of land needed to raise animals and provide a lower priced “wholesome” product for the public, said one farm operator after another. One even claimed that manure is reduced because animals eat less.

While most agriculture reps at the hearings defended the use of antibiotics for “treatment, prevention, and control of disease,” the AVMA’s Christine Hoang, D.V.M., actually went so far as to call the less feed that antibiotics make possible a “health-promoting” effect and a “therapeutic use.” Maybe she meant health and therapy for the bottom line.

After the hearings, W. Ron DeHaven, D.V.M., who was the USDA’s top vet before leaving for industry and helming the AVMA, penned a rambling, almost incoherent 18-page letter with 62 footnotes to the FDA.

The letter went something like this: Cephalosporin-resistant “human pathogens” aren’t increasing, and even if they are, they’re not affecting human health, and even if they’re affecting human health, how do you know it’s from the livestock drugs, and even if it’s from the livestock drugs, the FDA has no legal authority to ban cephalosporin.

The letter plays on terrorism fears by calling a cephalosporin ban a “food security issue” affecting “the number of animals available for the food supply.” It also plays on humanitarian sentiments by claiming a ban would impede veterinarians’ ability “to relieve the pain and suffering of animals” as if cephalosporins are painkillers and other drugs aren’t available. (And as if antibiotics are given for animals’ welfare instead of revenue welfare!)

Nowhere in the letter is there mention of the reason Big Meat won’t let go of antibiotics: The industry is able to raise thousands of animals in crowded conditions that would otherwise kill them and for prices as artificial as the drugs they are raised on.

Big Pharma’s invasion into farming is probably the biggest reason for the demise of family farms, which are no longer able to compete on price. Less than a month after the letter was sent, on Nov. 25, the FDA quietly revoked the prohibition. Good hire, AVMA!

Of course, the revolving door between government and Big Pharma lobbying has a distinguished tradition from Louisiana representative-turned-lobbyist Billy Tauzin, who presided over the Pharmaceutical Research and Manufacturers of America (PhRMA) until 2010, to former CDC Director Julie Gerberding, M.D., who prepared the country for flu outbreaks before turning up as head of Merck vaccines when she left the government.

The Antibiotics You May Be Eating Without Knowing It (Part 1)

This is the second part of a two-part series.

Martha Rosenberg is a health reporter and author who lives in Chicago.

In the 1990s, meth use in Oregon grew rapidly, and after years of government efforts to curb the drug’s availability, state officials were faced with an ever-worsening epidemic. With Oregon law enforcement reporting several hundred meth lab busts annually, in the mid-2000s state lawmakers devised a strategy to restrict the ingredients needed to manufacture the drug.

A pharmacist stocks cold medicines at a pharmacy in Milwaukie, Oreg., in this file photo. (Craig Mitchelldyer/Getty Images)

Unlike many other dangerous illegal drugs, the makings for meth come from common household chemicals. Pseudoephedrine—a primary component in meth production—is also the same ingredient found in over-the-counter cold and allergy medications (such as Sudafed, Claritin D, and others). In 2005 Oregon lawmakers sought to curtail the state’s rampant meth production by making pseudoephedrine products available only by prescription.

While restrictions may be a burden to Oregon’s cold and allergy sufferers, it’s been hard to argue with the significant downturn the state has seen in home-based meth production. According to the state narcotics enforcement, between 2005 and 2010 the number of state lab seizures dropped by 97 percent.

As lab busts fell, authorities applauded the measure, but some still weren’t convinced. Using U.S. Drug Enforcement Agency data from the past few years, the Portland-based Cascade Policy Institute set out to determine whether the mandate was actually as successful as the numbers suggested.

Analysts examined Oregon meth trends and compared them to what was happening in similar states, as well as to trends nationwide. They found that while the number of state meth lab incidents did indeed fall, it had little to do with the prescription requirement, a law that wasn’t enforced until September 2006.

“Ninety percent of that happened before the law took effect,” said Steve Buckstein, a senior policy analyst at Cascade Policy Institute, an Oregon-based think tank that specializes in analysis of state and local issues. “And if you compare the rest of the nation with Oregon, you really can’t tell much difference.”

Buckstein says that about the same time Oregon implemented their prescription mandate, a law at the federal level put cold medication behind the counter across the country, a step that Oregon had already taken in 2004.

“Figure one in our report pretty much says it all,” said Buckstein, referring to a chart of three lines tracing a similar path. “Of all three west coast states, Oregon was the only one that made pseudoephedrine a prescription drug, but all three states had tremendous drops in meth lab incidents from 2004 to 2006. And they continued to go down after that.”

According to the Cascade study, the prescription requirement for pseudoephedrine had no more of an impact on the reduction of meth lab incidents than other measures adopted in neighboring states. Buckstein says all the prescription law did was inconvenience the legitimate buyers of cold and allergy medicine.

“It’s punishing the wrong people, and is actually causing harm to the average consumer,” said Buckstein. “The person who used to be able to go into the drug store and get Sudafed now has to get a prescription. If they don’t do that they may stay home from work with a bad cold, they lose a day’s wages, and their employer loses productivity.”

Oregon was first in prescription only tactics, but other states have since been intrigued by its apparent success. Mississippi and Missouri passed similar laws in 2010, but Buckstein warns other regions not to go down the same road.

“We want this study to tell Oregonians that we tried it, but it didn’t achieve its goal so we’re going to end that experiment,” said Buckstein. “Other states shouldn’t follow our lead.”

Cascade had doubts about the prescription strategy from the beginning, and published two papers detailing their concerns in 2005. Buckstein credits what he calls the Iron Law of Prohibition for the prediction.

“We didn’t know where it would come from, but we knew that somebody would provide the supply if the demand was there. That’s just economics,” said Buckstein. “By making it illegal to do one way, you’re just opening it up to do it another way.”

Although meth production has fallen in Oregon, authorities say the drug is still widely available across the state, and the product is now stronger than ever. Buckstein explains that when the home-based meth cooks went down, enterprising Mexican super labs took over. As a result, the drug is now made in huge quantities, in very sophisticated laboratories, and in much greater purity and concentration than was seen with local manufacturers.

It may be some time before Oregon lawmakers consider the Cascade analysis—the state’s legislative session will end next week and attention is currently focused on balancing the budget. But Buckstein expects the study will have an impact. He says it raises fundamental questions about the law’s effectiveness, and directly challenges whether a mandate that affects everyone is really warranted.

“We hope to have the Legislature look at it when the session ends in 2013 or sooner,” he said. “The data seems pretty clear.”

Superbugs may now be contaminating all of our pork regardless of whether the animals were raised with or without antibiotics. (Joern Pollex/Getty Images)

So far, 2012 is bringing bad news for people who don’t want antibiotics in their food.

Antibiotics are routinely given to factory-farm livestock to make them gain weight with less feed and keep them from getting sick in confined spaces. But the daily dosing, while it lowers feed needs, lowers drug effectiveness and produces antibiotic-resistant bacteria, also known as superbugs.

In January, researchers found 230 out of 395 pork cuts bought in U.S. stores were contaminated with a superbug called MRSA (methicillin-resistant Staphylococcus aureus). Worse, there were “no statistically significant differences” between “conventionally raised swine and swine raised without antibiotics,” reported the researchers. However, this “finding … contrasts with a prior study from the Netherlands examining both conventional and ‘biologic’ meat products.”

Why would meat labeled “raised without antibiotics” be as full of superbugs as conventional and factory-farmed meat? Meat can be contaminated with MRSA at the farm by slaughterhouse workers who carry MRSA or by other meat if processing equipment is not “cleaned out between runs of certified organic and non-certified organic meats,” say the researchers.

A 2009 study of swine workers in Iowa and Illinois found that almost half carried MRSA.

In December, the FDA scrapped its three-decade-long effort to regulate the use of the popular human antibiotics penicillin and tetracycline in livestock. While the FDA says in the announcement that it “remains concerned about the issue of antimicrobial resistance,” it also says, “contested, formal withdrawal proceedings” consume too much of its time and money.

For example, withdrawing nitrofurans from livestock use took 20 years; DES (diethylstilbestrol) took seven years; and enrofloxacin took five years and cost $3.3 million, says the agency.

Cynics might have seen the concession to Big Meat coming when a report from a USDA-contracted researcher who asserted that MRSA killed more Americans per year than AIDS “disappeared” from the National Agricultural Library website last summer with no explanation, says reporter Tom Philpott. MRSA is a dangerous form of staph bacteria that has become resistant to some antibiotics.

 Why would meat labeled ‘raised without antibiotics’ be as full of superbugs as conventional and factory-farmed meat?

Of course, MRSA is only one antibiotic-resistant germ. Clinicians also worry about vancomycin-resistant enterococci (VRE); Clostridium difficile, a serious intestinal bug that is developing resistance; and resistant Acinetobacter baumannii, which affected U.S. troops in Iraq.

Days after the USDA announcement, there was another concession. The FDA issued new, watered-down rules on the use of cephalosporins in livestock (a different type of antibiotic) after Big Meat muscled down the FDA’s original order to prohibit cephalosporins in 2008—an order that also disappeared with little explanation.

Cephalosporins are antibiotics like Cefzil and Keflex used for pneumonia, strep throat, salmonella, and skin and urinary tract infections in humans and one type of antibiotic that Clostridium difficile is developing resistance to. Over a million human salmonella infections occur in the United States per year, resulting in 16,000 hospitalizations and nearly 600 deaths, reported the Harford Advocate.

The Antibiotics You May Be Eating Without Knowing It (PART 2)

This is the first of a two-part series. Next week: More evidence food-producing animals can cause adverse effects in humans.

Martha Rosenberg is a health reporter and author who lives in Chicago.

In the United States, anti-cholesterol drugs account for 255 million prescriptions a year, and about nine million people are taking Lipitor. (Paul J. Richards/AFP/Getty Images)

Is it getting easier for patients to make the right health decision today compared to 50 years ago? It should be, considering the huge advances in medical knowledge since that time.

But unless you’re blessed with the wisdom of Solomon, these advances may merely help you exchange one disease for another. As one wise sage remarked, “Life would be easier if there were no ‘buts.’”

For instance, a study reported in the Annals of Internal Medicine has depressing news for those taking cholesterol-lowering drugs (CLDs).

For seven years, researchers studied thousands of middle-aged and older women who were taking CLDs. Their discovery? Compared to those who were not taking this medication, they were 50 percent more likely to develop diabetes. This is hardly what one would call a therapeutic home run.

Another huge CLD study followed 150,000 women in their 50s, 60s, and 70s for seven years. This group was 48 percent more likely to develop diabetes than those not on this medication. Other earlier studies showed that men on CLDs were 12 percent more prone to develop this disease.

No one at the moment knows why CLDs are linked to the development of diabetes. But we’ve known for years that these drugs can cause liver, muscle, and kidney problems. So it’s not surprising that these drugs can also have an adverse effect on sugar metabolism.

Researchers concluded that although patients faced an increased risk of diabetes when taking CLDs, the benefits far outweighed this risk. This is particularly true for people who have existing heart disease or have had a previous stroke. But I think one could debate this point.

The history of CLDs shows several other situations where patients exchange one devil for another. For instance, a major study called Prosper revealed that those taking CLDs had 22 fewer deaths from cardiovascular disease, but this was offset by an increase of 24 deaths from cancer. Hardly a good exchange!

In still other studies, high blood cholesterol was proven to be associated with increased risk of heart disease, but a low cholesterol level showed a greater risk of death from non-cardiac causes such as violent death, mental problems, liver and kidney disease, strokes, and some cancers.

It has also been shown that low cholesterol, after 50 years of age, is associated with increased risk of death. At the University of Denmark, a report stated that about 15 percent of those on CLDs over this age suffer nerve damage.

The most notable case involved Dr. Duane Graveline, a physician and a superbly trained and conditioned U.S. astronaut. He reported that during a routine NASA checkup, doctors discovered he had an elevated blood cholesterol level and prescribed Lipitor.

Graveline arrived home several months later and did not recognize his family. He was diagnosed with a disease called transient global amnesia (TGA). On stopping Lipitor, his memory returned to normal.

NASA physicians refused to believe his mental problem was due to Lipitor. But they agreed to reduce the dose of this drug by half. After Graveline started taking Lipitor again, TGA recurred.

Dr. Annette Draeger, a researcher at the University of Switzerland, took muscle biopsies from 44 patients on CLDs who were complaining of muscle pain. Fifty-seven percent of these biopsies showed significant muscle damage.

It’s not my intention to propose tossing away CLDs. Ninety-nine percent of physicians are convinced that these drugs are the be-all-and-end-all to prevent and treat cardiovascular problems. But I’m not convinced. And I do stress to patients and readers that I’m not related to the Almighty and could be 100 percent wrong.

I like to have an open mind on new medical advances but not so open that my brain falls out. My brain tells me that something must be wrong when you have to accept the increased risk of diabetes and so many other potential problems when taking CLDs.

Today we could prevent 90 percent of Type 2 diabetes simply by not being obese.

Dr. Gifford-Jones is a medical journalist with a private medical practice in Toronto. His website is DocGiff.com. He may be contacted at Info@docgiff.com.

The use of celebrities in drug advertisements raises all sorts of questions. It is important to know that they are hired to endorse a drug. (Mike Theiler/National Osteoporosis Foundation via Getty Images)

Women are in such danger of osteoporosis they need regular bone scans. That was conventional medical wisdom since the first lucrative bone drug surfaced over a decade ago. 

But an article in the Jan. 19 issue of New England Journal of Medicine concluded: “Osteoporosis would develop in less than 10 percent of older, postmenopausal women during rescreening intervals of approximately 15 years for women with normal bone density or mild osteopenia. …”

In 1994, a year before the introduction of Fosamax, Merck’s blockbuster bone drug, was approved, Merck began marketing the dangers of osteoporosis “far beyond ailing old ladies.” 

It hired researcher Jeremy Allen to whip up osteopenia fears to sell bone drugs by planting bone-scan machines in medical offices across the country, says National Public Radio. Allen created the Bone Measurement Institute to establish osteopenia, the “risk of osteoporosis,” as a health epidemic. 

The scheme worked. By 1999, there were 10,000 bone-scan machines in medical offices, according to the Associated Press, when there had been only 750 before the bone drugs hit the market. The diagnosis of osteopenia increased seven-fold.

Allen’s company also pushed through the Bone Mass Measurement Act, which made bone scans Medicare-reimbursable. The legislation was written by Rep. Constance A. Morella (R-Md.), who appeared with HHS Secretary Donna Shalala in 1998 at a rally kicking off free bone-density screenings to be offered in 100 U.S. cities. 

The publicly funded bone scans were so lucrative to drug companies that when their Medicare reimbursement became threatened, an article appeared in the Cleveland Clinic Journal of Medicine exhorting readers to “lobby your legislators.”

The above article, “Managing Osteoporosis: Challenges and Strategies,” says that without Medicare reimbursement, patients are “likely to be harmed by limited access to DXA testing [bone scans] because of fewer instruments in operation and greater distances to travel to reach them,” and outpatient facilities would incur “financial losses.”

While osteoporosis is a real disease, osteopenia was never meant to be “a disease in itself to be treated,” says Dartmouth Medical School professor Anna Tosteson, M.D., who attended the 1992 World Health Organization meeting in Rome where the term was first invented. The scientists in the room were simply tired and agreed on a definition of the term because they wanted to adjourn for the night, she told NPR.

The bone density units, called T scores, used to define osteopenia are equally fallacious, wrote reporter Susan Kelleher in the Seattle Times: They had “boundaries so broad they include more than half of all women over 50.”

If bone drugs like Fosamax, Boniva, and Actonel (called bisphosphonates) weren’t harmful, the bone-scan con would simply be a case of overmedicating women, ripping off patients and taxpayers, and raising insurance costs. 

But bisphosphonates have been reported to greatly increase the risk of esophageal cancer and osteonecrosis of the jaw—jawbone death. Some dentists will not work on women who take them. Bisphosphonates are also linked to irregular heartbeats and intractable pain, according to medical journals and FDA warnings.

Bone drugs do not prevent fractures—their intended purpose! By suppressing bone remodeling, they are supposed to stop bone loss. But since the bone is not being renewed, it becomes brittle and ossified and fractures easily. 

The thigh bones of patients on bisphosphonates have “simply snapped while they were walking or standing,” after “weeks or months of unexplained aching,” reported the New York Times in an article called “Drugs to Build Bones May Weaken Them.” Medical journals and patients on the website askapatient.com have been reporting the fractures for years.

At the 2010 American Academy of Orthopaedic Surgeons annual meeting in New Orleans, doctors were actually shown the qualitative differences in bisphosphonate-treated bone and could see how the bone had degraded over four years of treatment. Half the doctors at one presentation said they had seen patients with bisphosphonate-compromised bone, reported the Los Angeles Times.

It should be embarrassing to the medical establishment and Medicare administrators that the drug industry and its paid celebrities drove the mania for the bone scans, osteopenia, and bone drugs. 

Here’s how “Today” host Meredith Vieira helped: “When I became menopausal, my doctor recommended I get a bone-mineral-density test. I had never even heard of it, to be quite honest. I thought, I’m in great health, great shape. I have no symptoms. Why do I need this? 

“To illustrate how ignorant I was when I had the test done, I asked where I could change, and the nurse told me I didn’t need to take off my clothes. They did a test on my heel, hip, and spine, which only took a matter of five minutes. And it was totally painless. It’s so simple to do,” she told USA Today. 

It should be even more embarrassing that the con only surfaced when the biggest bone-drug patents expired, so the drug companies don’t even care—because the big bucks are behind them.

This is the last of a three-part series.

Martha Rosenberg is a health reporter and author who lives in Chicago. 

New research suggests massage acts on the cellular level in the same way as many pain medications. (Bryn Lennon/Getty Images)

Massage not only feels good, it does good. It is a regular feature of locker rooms, to soothe the overworked muscles of athletes, and physical therapy sessions, to help patients recover from injuries.

Now, a new study suggests that massage may work on the cellular level in a manner similar to pain-relieving medications such as aspirin and other anti-inflammatory drugs.

Mark Tarnopolsky, a professor of paediatric medicine at McMaster University in Ontario, Canada, led a study that tried to pinpoint the biological mechanism that gives massage its healing property.

“People have a lot of ideas about what massage does and doesn’t do. And many of them were revolving around reduction in pain, and yet very few studies have actually been done to investigate this at the molecular and cellular level.”

Tarnopolsky’s team conducted a study involving 11 young men who exercised to the point of exhaustion on stationary bikes.

The men underwent muscle biopsies in each leg prior to jumping on the bikes, and each participant had one leg—chosen at random—massaged after exercise.

Muscle biopsies—small tissue samples—were taken from each leg 10 minutes after the massage therapy, and again, two-and-a-half hours later during the recovery period.

Researchers did a genetic analysis of each of the tissue samples.

“What we did is we looked at whatever genes were influenced by exercise in a different way in the massaged versus the non-massaged leg,” Tarnopolsky says. “And what came out of that were two different pathways.”

In the muscle tissue of the massaged leg, researchers found a decrease in inflammatory cytokines, or proteins, and an increase in mitochondria, the energy-producing units in cells, compared to tissue from the unmassaged leg.

Inflammation is an indicator of tissue damage, while mitochondrial production is a sign of tissue recovery.

The researchers say the findings suggest that massage acts on the cellular level in the same way as many pain medications, which are known to have some serious side effects.

They believe that massage may be an effective and safer alternative that could be used in routine medical practice.

A package of 'Lyrica' pharmaceutic, the first drug to be approved for fibromyalgia. (Andreas Rentz/Getty Images)

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a serious and dangerous disease. But so are pharma’s immune-suppressing biologic drugs like Remicade, Enbrel, and Humira, which are pushed for treating it. While RA attacks the body’s tissues, leading to inflammation of the joints, surrounding tissues, and organs, immune suppressors can invite cancers, lethal infections, and activate TB.

In 2008, the FDA announced that 45 people on Humira, Enbrel, Remicade, and Cimzia died from fungal diseases. The FDA also investigated Humira’s links to lymphoma, leukemia, and melanoma in children.

This year, the FDA warned that the drugs can cause “a rare cancer of white blood cells” in young people, and the Journal of the American Medical Association (JAMA) warned of “potentially fatal Legionella and Listeria infections” from the use of these drugs.

This year, the FDA warned that the drugs can cause “a rare cancer of white blood cells” in young people.

Immune suppressing drugs are also hazardous to the pocketbook. One injection of Remicade costs up to $2,500; one month of Enbrel costs $1,500; and a year on Humira costs up to $20,000.

Previously, RA was diagnosed from the presence of rheumatoid factor in the blood and inflammation. Thanks to pharma’s supply-driven marketing, stiffness and pain are all that are required for the diagnosis today. (Athletes and people born before 1970—the line forms to the left!)

In addition to diagnostic wiggle room and a catchy name, RA has other blockbuster-disease requirements. It will “only get worse” if untreated, says WebMD, and it is often “misdiagnosed” and under-reported, says Abbott’s Heather Mason because “people often don’t know what they have for a while.”

It’s so serious a disease, it costs over $20,000 a year to treat but so subtle you may not know you have it? RA sounds like a blockbuster.

Fibromyalgia

Another under-reported disease is fibromyalgia, characterized by widespread, unexplained bodily pain. Fibromyalgia is “almost a textbook definition of an unmet medical need,” says Ian Read of Pfizer, which makes the first drug to be approved for fibromyalgia, the seizure pill Lyrica.

Pfizer gave nonprofit groups $2.1 million in 2008 to “educate” doctors about fibromyalgia and financed PSAs (pharma service announcements) depicting sufferers describing their symptoms without mentioning a drug. Lyrica now makes $3 billion a year.

Still, Lyrica has to fight Cymbalta, the first antidepressant to be approved for fibromyalgia. Eli Lilly prepositioned Cymbalta for the physical “pain” of depression in a campaign called “Depression Hurts” before the fibromyalgia approval. Treatment of a fibromyalgia patient with either Lyrica or Cymbalta hovers around $10,000, medical journals say.

Pharma and Wall Street may be happy with fibromyalgia drugs, but patients are not. On Askapatient.com, the drug-rating website, patients on Cymbalta report chills, jaw problems, electrical “pings” in their brains, and eye problems. This year, four patients reported the urge to kill themselves, a frequently reported side effect of Cymbalta.

Lyrica users on Askapatient.com report memory loss, confusion, extreme weight gain, hair loss, impaired driving, disorientation, twitching, and worse. Some patients take both drugs.

This is the second of a three-part series. Next week: sleep disorders

This story first appeared on Alternet.org.

Martha Rosenberg is a health reporter and author who lives in Chicago.

If the blood pressure readings from a patient’s two arms differ by 15 or more, it could indicate a narrowing of arteries to the legs, decreased blood flow to the brain, heart disease, and a 70 percent increased risk of dying from either heart attack or stroke, a recent study found. (Sean Gallup/Getty Images)

Doctors generally check their patients’ blood pressure during office visits, but a new study says many are not doing it the right way—and that by doing it incorrectly, the doctors could be putting their patients’ lives at risk.

Cardiologist Oscar Garfein takes blood pressure readings from both of his patients’ arms. That technique saved the life of one of his patients.

“I found that in one arm, it was very, very low, and in the other one, it was normal,” says Garfein. “And it helped me arrive at a diagnosis of a potentially lethal condition.”

Garfein’s routine is supported by a new study showing that different readings in the right and left arms could be a sign of heart disease or blood vessel problems.

If the two readings of systolic blood pressure—the pressure of blood in arteries when the heart is contracting—differ by 15 or more, it could indicate a narrowing of arteries to the legs, decreased blood flow to the brain, heart disease, and a 70 percent increased risk of dying from either heart attack or stroke.

“You want to search for the risk factors that are associated with this,” says Garfein, “such as high blood pressure or cigarette smoking or high cholesterol, and treat them very aggressively.”

Many cardiologists routinely check blood pressure in both arms, but the practice is much less common on a routine doctor’s visit.

This study, published in The Lancet, confirms a double reading could flag an underlying vascular problem in someone who otherwise seems to be healthy.

“All it takes is about a minute and you can find something that really, most of the time, points to the fact that this patient has established vascular disease,” says Garfein.

ADHD is such a highly diagnosed disorder among young people that there is even a camp that was created for it: Center for Attention and Related Disorders. (Brendan Smialowski/Getty Images)

It used to be joked that a consultant is someone who borrows your watch to tell you what time it is. These days, the opportunist is Big Pharma, which raises your insurance premiums and taxes while providing you “low-priced” drugs that you paid for.

How did pharma get a third of the United States to take antidepressants, statins, and purple pills [Nexium]? By selling the diseases of depression, high cholesterol, and gastroesophageal reflux disease, or GERD!

Supply-driven marketing, also known as “have drug, need disease and patients,” not only turns the nation into pill-popping hypochondriacs, it distracts from pharma’s drought of real drugs for real medical problems.

Of course not all diseases are Wall Street pleasers. To be a true blockbuster disease, a condition must meet certain criteria:

• Really exist but have huge diagnostic wiggle room and no clear-cut test
• Be potentially serious with silent symptoms said to only get worse if untreated
• Be under-recognized, under-reported, and with barriers to treatment
• Explain hitherto vague health problems a patient has had
• Have a catchy name—ED, ADHD, RLS, Low T, or IBS—and instant medical identity
• Need an expensive new drug that has no generic equivalent

Here are some potential blockbuster diseases Pharma hopes you get in 2012.

Adult ADHD

Everyday problems labeled as depression sailed pharma through the last two decades. You weren’t sad, mad, scared, confused, remorseful, grieving, or even exploited. You were depressed, and there was a pill for that.

But depression peaked just like the Atkins diet and the macarena. Luckily there is adult ADHD, which has doubled in women 45 to 65 and tripled in men and women 20 to 44, according to the Wall Street Journal.

Like depression, adult ADHD is a catchall category. “Is It ADHD or Menopause?” asks an article in ADDitude, a magazine devoted exclusively to ADHD. “ADD and Alzheimer’s: Are These Diseases Related?” asks another article in the same magazine.

“I’m Depressed. Could it be ADHD?” says an ad in Psychiatric News, showing a pretty but pouting young woman. “Adults with ADHD were nearly two times more likely to have been divorced,” says another ad, called “Broken Promises,” in the same publication, exhorting doctors to “screen for ADHD.”

Adults with ADHD are often, “less responsible, reliable, resourceful, goal-oriented, and self-confident and they find it difficult to define, set, and pursue meaningful internal goals,” says an article co-written by Harvard child psychiatrist Joseph Biederman, M.D., who is credited with putting “pediatric bipolar disorder” on the map.

They “show tendencies to being self-absorbed, intolerant, critical, unhelpful, and opportunistic,” and “tend to be inconsiderate of other people’s rights or feelings,” says the article, describing most people’s brother-in-laws.

Adults with ADHD will have trouble keeping a job and get worse without treatment says WebMD, tapping into the second requirement of a blockbuster disease—symptoms that worsen without pills.

“Adults with ADHD may have difficulty following directions, remembering information, concentrating, organizing tasks, or completing work within time limits,” says WebMD, whose original partner was Eli Lilly. “If these difficulties are not managed appropriately, they can cause associated behavioral, emotional, social, vocational, and academic problems.”

How did pharma get 5 million kids and now maybe their parents on ADHD meds? Ads on a 26-by-20-foot screen in Times Square ask, “Can’t focus? Can’t sit still? Could you or your child have ADHD?”

Convincing adults they aren’t sleep deficient or bored but have ADHD is only half the battle. Pharma also has to convince kids who grew up diagnosed as having ADHD not to quit their meds, says Mike Cola of Shire, which makes the ADHD drugs Intuniv, Adderall XR, Vyvanse, and the Daytrana patch.

“We know that we lose a significant number of patients in the late teen years, early 20s as they kind of fall out of the system based on the fact that they no longer go to a pediatrician,” Cola says.

A Shire ad in Northwestern University’s student paper this year takes the issue head-on: “I remember being the kid with ADHD. Truth is, I still have it,” says the headline splashed across a photo of Adam Levine, the lead singer of Maroon 5. “It’s your ADHD. Own it” is the tagline.

Of course, pushing speed on college kids (or anyone for that matter) isn’t too hard. Why else do meth dealers say, “First taste free”? But pharma is so eager to retain its pediatric ADHD market, it has funded for-credit courses for doctors like “Identifying, Diagnosing, and Managing ADHD in College Students,” and “ADHD in College: Seeking and Receiving Care During the Transition From Child to Adult.”

To make sure no one thinks ADHD is a made-up disease, WebMD shows color-enhanced PET scans of the brains of a normal person and an ADHD sufferer (flanked by an ad for Vyvanse). But it is doubtful the scans are really different, says psychiatrist Phillip Sinaikin, M.D., author of Psychiatryland. And even if they are, it still proves nothing.

“The crux of the matter is that there is simply no definitive understanding of how neuronal activity is related to subjective consciousness, the age-old unsolved body-mind relationship,” Sinaikin told AlterNet.

“We have not advanced beyond phrenology and this article in WebMD is simply the worst kind of manipulation by the drug industry to sell their overpriced products, in this case a desperate effort by Shire to maintain a market share when Adderall goes generic.”

This article first appeared on Alternet.org.

Martha Rosenberg is a health reporter and author who lives in Chicago.

This is the first part of a three-part series. Next week: Part 2.

A new study found that people who engage in mentally stimulating activities over a lifetime, such as reading, writing, and playing games, have lower levels of a protein in the brain associated with Alzheimer’s disease. (Photos.com)

People who engage in mentally stimulating activities over a lifetime have lower levels of a protein in the brain associated with Alzheimer’s disease, a new study finds.

That supports other research which suggests reading, writing, and playing games may lower the risk of dementia.

Researchers worked with a group of 65 older-adult volunteers with no symptoms of Alzheimer’s disease.

The more cognitively active you can be over the course of your lifespan, the better.

—Susan Landau, research scientist

They answered questions about how often they engaged in stimulating mental activities throughout their lifetimes.

They also got positron emission tomography (PET) brain scans which can identify beta-amyloid deposits. Those deposits are found in the brains of people who have Alzheimer’s.

University of California–Berkeley research scientist Susan Landau says the study showed a link between the quantity of deposits and the lifetime level of brain stimulation.

“People who were the most cognitively active throughout their life, they had the least amyloid in their brains,” she says.

“Based on this association between greater cognitive activity and less amyloid, we think that these people will go on to have a reduced risk of Alzheimer’s disease.”

Keep in mind that the people in this study, many of them in their 70s and 80s, did not show any symptoms of Alzheimer’s. Scientists are still trying to understand the connection between beta-amyloid deposits in the brain and dementia.

Aging and a family history of Alzheimer’s are both considered risk factors, but those are factors we can’t control.

And even if your brain hasn’t been particularly active up until now, Landau says it’s not too late to start ratcheting up your mental activities.

“I think that cognitive stimulation is probably beneficial at any age. But, what our findings from this study show, is that the more cognitively active you can be over the course of your lifespan, the better.”

This work may help the researchers better understand the relationship between stimulating mental activities, beta-amyloid deposits, and dementia.

A researcher was found to have falsified data concerning his research into the antioxidant resveratrol, which is found in red wine and red grapes. (Cat Rooney/The Epoch Times)

The Los Angeles Times reported online on Jan. 12 that a University of Connecticut researcher was found to have falsified data concerning his research into the antioxidant resveratrol, which is found in red wine and red grapes.

This week the British Medical Journal (BMJ) reports that a doctor and flu vaccine researcher based at Leicester University in the U.K. has been suspended for a range of misdemeanors, including forging colleagues’ signatures and recruiting himself into a study under a disguised name.

It would be comforting to think of these events as isolated incidences in the scientific community. However, according to news published in the BMJ on Jan. 12, scientific misconduct is “worryingly prevalent,” at least in the U.K.

The BMJ sent out a questionnaire to more than 9,000 researchers and reviewers asking if they had knowledge of colleagues “inappropriately adjusting, excluding, altering, or fabricating data” for the purpose of publication.

Of those who responded, 13 percent admitted they had such knowledge. Six percent admitted they were aware of misconduct within their own institutions, which remained insufficiently investigated.

On Jan. 12, the Committee on Publication Ethics (COPE) held a summit to address the problem of research misconduct in the U.K.

Referring to the BMJ survey, the chair of COPE, Dr. Elizabeth Wager, is quoted as saying, “This survey chimes with our experience from COPE where we see many cases of institutions not cooperating with journals and failing to investigate research misconduct properly.”

In an editorial published on Jan. 4 in the BMJ, Dr. Wager and the BMJ’s editor Fiona Godlee wrote: “There are enough known or emerging cases to suggest that the U.K.’s apparent shortage of publicly investigated examples has more to do with a closed, competitive, and fearful academic culture than with Britain’s researchers being uniquely honest.”

My feeling is if the culture wasn’t so “closed, competitive, and fearful,” we’d probably see that misconduct is even more prevalent than the recent BMJ survey suggests. And that’s a problem because we really do need to rely on the integrity of research findings in making truly informed decisions about health and the management of disease.

Personally, I’m delighted that institutions such as the BMJ and COPE are shining a light onto this issue and thinking about how we might curb research misconduct.

Dr. John Briffa is a London-based physician and author with an interest in nutrition and natural medicine. His website is DrBriffa.com.

Some doctors think that SIDS has to do with a vitamin D deficiency. (Amal Chen/The Epoch Times)

The BBC in the U.K. has had a recent blitz on stories relating to vitamin D, particularly vitamin D deficiency in children and its potential to cause rickets (with the characteristic weakened, deformed bones prone to fracture). Moreover, some doctors are suspicious that vitamin D deficiency may be an underlying factor in sudden infant death syndrome (SIDS).

A program regarding this problem was aired on BBC Radio 4’s “Today” program on Jan. 26 HERE: There are comments from individuals that leave one with the impression that many health professionals are unaware of the issue of vitamin D deficiency in children.

A lawyer who represented parents who were wrongly accused of killing their child tells of how a senior radiologist at Great Ormond Street Hospital (generally regarding as the U.K.’s best children’s hospital) failed to recognize rickets or the importance of vitamin D. The child was posthumously diagnosed with rickets.

This program features Dr. Marta Cohen (from Sheffield Children’s Hospital), who has discovered vitamin D deficiency in 75 percent of children who had died of SIDS. This does not mean that the vitamin D deficiency caused any of these deaths.

Nevertheless, there are ways in which vitamin D deficiency might cause death, and it’s clearly valid for vitamin D deficiency to be considered in children who appear to have suffered abuse or have died suddenly.

On Jan. 6, the BBC featured pediatrician Dr. Benjamin Jacobs, who is seeing increasing numbers of children with rickets where he works at the Royal National Orthopedic Hospital in the U.K.

Dr. Jacobs makes the point that doctors are often failing to recognize and treat rickets appropriately. Dr. Jacobs is quoted as saying: “There are many other children who have less severe problems—muscle weakness, delay in walking, bone pains—and research indicates that in many parts of the country the majority of children have a low level of vitamin D.

It’s obviously not a good thing that so many children may be suffering from compromised health and possibly lose their lives as a result of vitamin D deficiency. It’s good that this issue is getting mainstream attention and that some dedicated individuals are doing what they can to raise awareness of this issue.

Dr. John Briffa is a London, U.K.-based physician and author with an interest in nutrition and natural medicine. His website is DrBriffa.com.

A new study found increases in about 20 different antibiotic-resistance genes in pigs that were fed low doses of antibiotics. (Stuart Franklin/Getty Images)

Pigs given low doses of antibiotics had more E. coli in their guts, and that bacteria showed an increased resistance to antibiotics, according to new research.

The study confirms that the routine practice of feeding antibiotics to food animals increases drug resistance in the bacteria living in those animals.

Experts say [feeding antibiotics to food animals] is helping spawn new types of antibiotic-resistant disease organisms, fueling a global public health crisis.

The practice is common at large livestock operations worldwide. But experts say it is helping spawn new types of antibiotic-resistant disease organisms, fueling a global public health crisis.

California executive Tom Dukes had a close call with one such superbug. He got painful stomach cramps a couple of years ago. His doctor said it was a serious intestinal condition called diverticulitis and prescribed antibiotics.

“Started those on Monday morning and by Tuesday night, I really felt like a million bucks,” he says.

But a few months later, Dukes got the symptoms again. Again, he got antibiotics

Drug Failure

This time, though, they did not work. He wound up in the emergency room, in incredible pain.

“I’d never encountered anything like this before,” Dukes says. “Out of all the sports injuries and broken arms and things like that, that all paled in comparison.”

Drug-resistant E. coli bacteria were escaping into his abdomen through a tear in his colon. Emergency surgery removed a 20-centimeter section.

Doctors had only one type of drug left that would kill the germs. That saved his life.

Dukes is a self-described workout fanatic who spends a couple hours a day in the gym. So how does an otherwise-healthy person get a life-threatening superbug?

“Although we’ll never know for sure exactly, it seems that the probable cause was basically from eating tainted meat,” he says.

Healthy Animals Versus Sick People

Animals raised for meat-at-large livestock operations around the world are commonly given antibiotics to prevent disease and to help them grow bigger with less feed. In the United States, more antibiotics are used for healthy animals than for sick people.

It’s a controversial practice. In a new study, U.S. Department of Agriculture researcher Thad Stanton and colleagues looked at bacteria coming out of pigs fed some of those antibiotics.

They saw “increases in about 20 different antibiotic-resistance genes,” he says, including genes for resistance to one type of antibiotic that was not even fed to the pigs.  

“We also saw increases in E. coli populations, which were unexpected,” he says.

Stanton notes that most E. coli are harmless, but some do cause disease. And even the harmless ones can pass resistance genes to their not-so-harmless cousins.

Long-Running Debate

This study, in the Proceedings of the National Academy of Sciences, is just the latest round in a debate that stretches back four decades. It has been known for at least that long that feeding livestock antibiotics generates resistance.

But Liz Wagstrom, chief veterinarian for the National Pork Producers Council says, “The bottom line is, what does that mean for either animal health or public health?”

Wagstrom doubts there is much impact at all. She says controls are in place at every step of the journey, from farm to slaughterhouse to market, to keep bacteria out of the food supply.

“The potential adverse effects of that bacteria being resistant are just very, very small. Close to zero.”

‘Extremely Concerning’

Not so, says Jim Johnson, an infectious disease doctor at the University of Minnesota and an expert with the Infectious Diseases Society of America.

Over his 25-year career in medicine, he has watched one drug after another fall to antibiotic resistance.

“The resistance that’s showing up in the E. coli that are coming in on meat products from antibiotic-fed farm animals is extremely concerning,” he says

U.S. regulators recently restricted the use in livestock of one vital group of antibiotics and are recommending other limits. Critics say much tighter controls are needed.

Control Issues

But the threats are even greater in the developing world, where regulations and enforcement are weaker, says Bernard Vallat, head of the World Organization for Animal Health, OIE.

“More than 100 countries have no appropriate legislation to implement control on those products,” he says. In those countries, “there is no control on importation, no control on registration, no control on distribution and use.”

And Vallat says resistant bacteria can travel anywhere in a globalized world.

Experts note that livestock are far from the only source of resistant bacteria. Use and misuse of antibiotics in people is at least as big a problem—perhaps more so.

“I kinda live every day knowing it’s still there,” he says. “And if it ever gets out again, that they may not have anything to combat it this time.”

It’s a fear that’s growing for patients and doctors around the world.

A daughter comforts her father who is grieving. New research finds the risk of having a heart attack is 21 times higher in the day following the loss of a loved one, compared to other times. (Photos.com)

The risk of heart attack goes way up in the hours and days after the death of a loved one, according to new research.

Researchers surveyed almost 2,000 heart attack survivors and asked whether someone close to them had died in the six months before their heart attack.

“We found that the risk of having a heart attack was 21 times higher in the day following the loss of a loved one, compared to other times,” said Elizabeth Mostofsky of Beth Israel Deaconess Medical Center in Boston, who led the study.

“And that risk remained elevated during subsequent days and weeks.”

According to Mostofsky, previous research looked at the risk of dying from any cause over a year or more after the death of a spouse or a child, not including other close family and friends, and her team focused on data from the days immediately after getting the news.

She said several things could explain why the intense feelings after the death of a loved one could trigger a heart attack.

People should be making sure that the bereaved person is taking care of himself or herself.

— Elizabeth Mostofsky, Researcher

“Grief causes feelings of depression, anger, and anxiety, and several studies have shown that these emotions can cause increased heart rate, higher blood pressure, and blood clotting,” she said.

“And those, in turn, can increase the chances of having a heart attack.”

Mostofsky said the key message of her study is that the family and friends of people who are grieving for a loved one, especially one who has died in recent days, should be aware of the increased risk of heart attack.

“People should be making sure that the bereaved person is taking care of himself or herself, including taking their regular medications, because they are at that heightened level of vulnerability at this time in their life.”

How much did you learn from this column last year? It’s always the hope of a medical journalist that at least some medical topics didn’t go in one ear and out the other. Let’s see how many of these questions you can get right.

1. The millimeter wave machine, used in the United States, is a safe human body scanner for airport security. But fliers should refuse to have their bodies exposed to “backscatter” devices and demand that they have a body pat-down instead.

2. Brushing the teeth using plain white bar soap is not the total answer to avoiding dental plaque.

3. Children playing with laser swords can cause serious damage to their eyes, leaving them with permanent blind spots in their vision.

4. Having a CT scan subjects patients to the same amount of radiation as 500 chest X-rays.

5. Campbell Soup in the United States decreased the amount of salt in its soup by 32 percent and saw profits slump as a result.

6. Increasing the amount of sugar in the diet increases blood cholesterol.

7. Animals make their own vitamin C. Humans don’t make their own vitamin C, which makes them more vulnerable to coronary attack.

8. The number of North Americans with advanced kidney disease requiring renal dialysis has doubled in the last 10 years. One of the main reasons for this increase is the number of people who take pain pills, particularly nonsteroidal anti-inflammatory drugs, which must be excreted by the kidneys.

9. Sarcopenia begins in the late 30s and increases at the rate of 1 percent per year. By age 80, many people have lost 30 to 50 percent of their muscle mass and are so weak they cannot get off a toilet seat.

10. In the past, patients who had a hernia were told to have an operation to prevent intestinal obstruction. Now surgeons know that it’s not necessary to repair all hernias.

11. The prime time to have an operation is on Tuesday morning at 8:00 a.m.

12. The inventor of the PSA test for prostate cancer says he wishes he had never invented the test because it has been misused by doctors and caused needless harm to patients.

13. Magnesium is needed so the electrical system of the heart is able to function properly. A deficiency of magnesium can cause an irregular heartbeat called atrial fibrillation.

14. Vitamin K2 helps fight the nation’s No. 1 killer, cardiovascular disease. It places calcium where it belongs, in bones and teeth, and keeps it out of arteries, where it can cause trouble.

All answers to the above are true.

Dr. Gifford-Jones is a medical journalist with a private medical practice in Toronto. His website is DocGiff.com. He may be contacted at Info@docgiff.com.

Morgan DePalma, 7, does push-ups during a program for overweight adolescents and children on Nov. 20, 2010, in Aurora, Colorado. The American Cancer Society annual report says that fewer Americans are dying of cancer, but doctors are seeing more patients with cancers linked to obesity, including pancreatic and kidney cancers. (John Moore/Getty Images)

The American Cancer Society says in its annual report that fewer Americans are dying of cancer, but doctors are seeing more patients with cancers linked to obesity, including pancreatic and kidney cancers.

And while breast cancer patients are living longer, the risks of developing this type of tumor are rising along with the growing rates of obesity.

For many people, a cancer diagnosis is no longer a death sentence.

Former U.S. presidential candidate Herman Cain was diagnosed six years ago with stage-four colon cancer. Tumors had already spread to his liver.

Cain was given a 30 percent chance of survival. But after having surgery and undergoing chemotherapy, Cain says his cancer went into remission.

The American Cancer Society’s annual report shows that death rates from cancer in the U.S. have continued to fall. Between 2004 and 2008, cancer death rates for men went down nearly 2 percent a year; for women they declined about 1.5 percent each year.

Over a longer period of time, from 1990 through 2008, cancer death rates plunged almost 23 percent for men and just over 15 percent for women. That translates to a million lives saved.

But doctors are reporting more cases of esophageal, pancreatic, liver, and kidney cancer. Obesity is a risk factor for these types of cancers and for breast cancer as well. It’s also a risk factor for a number of chronic diseases, including Type 2 diabetes.

Most of my focus has been on diet, because the bang for your buck for changing your diet is really profound.

— Dr. Dariush Mozaffarian

“Most of my focus has been on diet, because the bang for your buck for changing your diet is really profound,” Mozaffarian noted.

And Dr. Mozafarrian believes that, just as growing numbers of Americans have quit their smoking habits, they can beat the obesity trap and avoid the cancers and other diseases that result.

“We’ve had huge success in this country with smoking,” added Mozaffarian. “We’ve gone from about 55 percent smokers to 25 percent smokers in about 40 years.”

For close to 50 years, the U.S. government has adopted policies to discourage people from taking up smoking and to encourage smokers to quit. The policies include education campaigns, high taxes on tobacco product sales, and laws against selling tobacco to anyone under the age of 18.

The new Cancer Society report says the resulting drop in lung cancer deaths accounts for almost 40 percent of the decline in overall cancer deaths.

Dr. Mozaffarian says public health officials should use the anti-smoking campaign as a model to get people at risk of obesity to improve their diets.

And the result, he predicts, will be a decline in the number of obesity-related deaths.

I got a press release today from the consumer advocacy group Which? informing me, “Misleading health claims to be banned at last.”

Apparently, European Union member states today voted to adopt a list of scientifically proven health claims that can be made about food and drink products.

In primary prevention (in essentially healthy individuals) statins do not reduce risk of death.

• Reduced consumption of saturated fat contributes to the maintenance of normal blood cholesterol levels.
• Plant sterols and plant stanols contribute to the maintenance of normal blood cholesterol.

Cholesterol levels are widely recognized as a marker for heart disease, and so the logic goes that reducing cholesterol levels will help prevent this condition. In this case, cholesterol is being used as a “surrogate marker.” The assumption is that a positive change in surrogate-marker levels will translate into benefits for health.

Are these claims true?

Taking dietary steps to reduce cholesterol has not been shown to reduce the risk of heart disease or overall risk of death. If this practice does not have benefits for health or extend life, why bother? Eating less saturated fat and swallowing stanols and sterols can reduce cholesterol all they like, but none of it has proven benefits for health.

A PR representative of the Unilever-made Flora Proactiv products said:
“We absolutely agree that simply lowering cholesterol without making wider positive changes to one’s diet and lifestyle will not make a significant positive health impact.”

I take this as admission of the general uselessness of cholesterol reduction on health.

It may be hard for some to make sense that taking dietary steps to reduce cholesterol is not broadly beneficial to health. However, we should not be too surprised when we consider that we have plenty of similar experiences regarding pharmaceutical drugs. For example:
• Drugs called resins reduce cholesterol but do not reduce overall risk of death
• The drug ezetimibe reduces cholesterol but has never been shown to benefit health
• Drugs called fibrates improve the ratio of good and bad cholesterol but don’t reduce overall mortality
• Hormone replacement therapy improves the ratio of good and bad cholesterol but doesn’t reduce overall mortality and increases the risk of cardiovascular disease.

The situation with statin drugs is somewhat nuanced. In primary prevention (in essentially healthy individuals) statins do not reduce risk of death.

In secondary prevention (those who have already had a heart attack or a stroke), they do, but the fact remains that even in high-risk individuals, the great majority of people who take statins do not benefit from them at all.

There is reason to believe that the little benefit statins have is not as a result of their cholesterol-reducing action, but due to other effects, including anti-inflammatory and blood-thinning actions.

Dr. John Briffa is a London-based physician and author with an interest in nutrition and natural medicine. His website is DrBriffa.com.

Barry J. Marshall of Australia received the joint Nobel Prize for Medicine on Dec. 10, 2005, in Stockholm, Sweden. He proved that bacterial infection was the cause of peptic ulcers. (Pascal Le Segretain/Getty Images)

For centuries, infection has been a major killer. Then several years ago, it appeared that antibiotics had largely eradicated this menace. 

But unexpectedly the AIDS virus struck with a vengeance. Now scientists are linking infection to peptic ulcers, heart attack, and cancer. So how can you protect yourself and your family from these serious illnesses?

In 1984, an Australian physician, Barry Marshall, decided to prove that his theory of infection was right. He drank a bacteria-laced concoction to show that it was bacteria, not stress, that caused peptic ulcers. Subsequent studies confirmed that most ulcers are infected with a bacterium called H. pylori.

But here’s a problem. About half the people over 60 years of age have H. pylori in their stomachs. But only about 5 to 20 percent suffer from ulcers. In fact, it’s believed that H. pylori may even decrease stomach acid and help to ease heartburn in some cases. It’s obvious that treating everyone who has H. pylori is not a prudent move.

We also know that there are other causes of ulcers. Patients taking non-steroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin cause about 25 percent of ulcer cases.

So what do doctors do? Patients with ulcer symptoms such as pain that is eased by eating and recurs several hours later or during the night should be tested for H. pylori.

Some doctors routinely use endoscopy, in which a lighted instrument is inserted down the throat to examine the stomach and upper part of the small bowel. If an ulcer is present, a combination of antibiotics is prescribed to eliminate H. pylori.

Can H. pylori trigger cancer? Since H. pylori is so common, and stomach cancer rare, it’s not a major cause. But researchers believe that by causing chronic irritation to the stomach’s lining, it may on occasion trigger malignancy. It therefore makes sense that patients with a family history of stomach cancer should be tested for H. pylori.

Other cancers are linked to infection. For instance, cancer of the liver has increased in recent years due to infection with the hepatitis B virus. It occurs in people who have multiple sexual partners or who inject illegal drugs.

Today it’s believed that cervical cancer is due to the human papilloma virus. It’s an extremely common infection, but only a tiny fraction of women who carry the virus develop cancer.

The best protection is the annual Pap smear. If the smear shows abnormal changes, a microscopic examination and biopsy of the cervix can be done to rule out precancerous disease.

For years, it’s been believed that heart attack results from clogged arteries due to atherosclerosis. Now cardiologists have found that narrowed, clogged vessels are often inflamed, which contributes to coronary attack and strokes.

Doctors are uncertain whether infection causes the inflammation. But they can monitor the degree of infection by a test called C-reactive protein (CRP). If you have a family history of early heart disease, increased cholesterol, diabetes, or hypertension, it makes sense to have this test done.

Dr. Gifford-Jones is a medical journalist with a private medical practice in Toronto. His website is DocGiff.com.

A mammogram is a special type of X-ray of the breasts, which is used to detect tumors as part of a regular cancer prevention medical check-up. However, a growing body of research on mammograms and breast cancer prevention is making it clear that mammograms are not the answer.

Several years ago, a friend asked if I’d talk to a women’s organization about breast cancer and how mammography could detect malignancy in its early stages.

But when I gave her a short version of what I intended to say, she remarked, “But they would not like to hear that!” That was the end of the talk. So what do women not want to hear?

Anytime I’ve questioned the use of mammography, it’s been like damning motherhood and apple pie. Now, a blue-ribbon panel of experts reports that women under 50 years of age should not have mammograms and that postmenopausal women should submit to this procedure only every two or three years, rather than annually.

The blunt fact is that if mammography had been a drug, it would have been removed from the market long ago due to its ineffectiveness.

For instance, Dr. Peter Goetzsche, a leading Danish researcher, claims that there is no convincing evidence that annual mammograms decrease the risk of death from breast cancer. To reach this conclusion, Goetzsche and his colleagues analyzed international studies on half a million women.

But how could a procedure that costs $0.5 billion every year in Canada be such a loser? There’s an easy explanation.

We could wipe out cancer of the cervix if all women had a Pap smear at regular intervals. That is because this test is a cellular diagnosis. It obtains cervical mucous and is able to detect precancerous cells years before they cause a malignancy. But mammography is a lump diagnosis. For screening, there’s no way to obtain cells from breast tissue.

For years, it’s been stretching the truth to tell women that mammography results in early diagnosis of breast cancer. How could it, when it takes about six or more years for cancer to be large enough to be detected by mammography? This provides time for malignant cells to metastasize.

Another untruth is the number of women’s lives saved by mammography. The cruel truth is that whatever way you slice the cake, the decrease in the number of cancer deaths is modest.

Experts agree that 2,000 women must be screened for 10 years to get one benefit! One can always argue that saving one life is worthwhile. But wouldn’t it be better to use the funds saved from 20,000 inefficient mammograms to find a more efficient way to either diagnose or prevent breast cancer?

Another misconception is the failure to inform women of the negative aspects of mammograms. One study showed that women who had regular mammograms over a 10-year period had a 49 percent chance of requiring breast biopsy during that time because of a suspicious mammogram. These are odds worse than those in Las Vegas.

I’ve all too often witnessed the profound anxiety of a woman whose report requires a second mammogram due to a suspicious area. The wait for the report and apprehension of a breast biopsy to determine whether a malignancy is present causes undue anxiety. Often this scenario is the result of overdiagnosis.

On the other hand, when a mammogram is reported normal, it provides a woman with a false sense of security. But is she secure? For instance, in women 40 to 49 years of age, mammography misses 30 percent of malignancies.

Proponents of mammography also tend to gloss over the radiation risk of this procedure. I’m not a radiation expert, but I’ve talked to international experts who believe that excessive radiation may cause malignant change. The problem is not just the regular mammogram but also the extra ones that are needed to recheck a suspicious lesion.

If there’s one thing in life that I hate, it’s hypocrisy, and there’s been plenty of this given to women regarding mammography. These new guidelines are at least a step in the right direction.

Nevertheless, it’s my prediction that women’s groups and those with vested interests in mammography will not give up this sacred cow without a fight. And tens of thousands of women will continue to have mammograms.

Dr. Gifford-Jones is a medical journalist with a private medical practice in Toronto. His website is DocGiff.com. He may be contacted at Info@docgiff.com.

Creativity leads people to be more "morally flexible," where they are tempted to bend the rules in their favor, according to recent research. (Photos.com)

It seems for the past few years, the news has been filled with stories of people who cheat: bankers bilking investors out of millions of dollars, politicians who cheat on their wives and constituents.

The cheaters were always smart, creative people—who got caught. This prompted several psychological researchers to examine the relationship between cheating and creativity.

Francesca Gino, a behavioral economist who teaches at Harvard Business School, uses ideas from psychology to study how people make economic choices.

Gino finds the behavior of many notable cheaters fascinating, and it got her wondering why so many creative people seem to take the low road.

“Interestingly, there are actually a lot of examples in the literature, novels, movies, comic books about this idea of the evil genius, but really no empirical evidence for this relationship,” she says.

So Gino spent several years testing volunteers to see how creative they were. Then, she put them in situations where they could profit from cheating—where just bending the rules a little bit put a few extra dollars in their pockets.

That does not necessarily mean getting money out of cheating, but it could also be getting other types of pleasures or utilities.

—Francesca Gino, Harvard Behavioral Economist

But where cheating really matters is in the workplace. And in a competitive, global economy, innovation and creativity are particularly prized.

After studying people at work, Gino found that fostering creativity in workers also opens up opportunities for that moral flexibility where people are tempted to bend the rules in their favor.

“We think that the creativity really helps people resolve this conflict between something that is more longer-term, which is the idea of being good and moral and then, something that is more short-term and that is the idea of advancing your own self-interest,” Gino says.

“And that does not necessarily mean getting money out of cheating, but it could also be getting other types of pleasures or utilities.”

Such as cheating on your spouse.

In short, Gino says her study is a warning that creativity has a dark side.

A nurse takes a patient's blood pressure. Developing hypertension in middle age increases a person’s risk of heart attack or stroke later in life, according to a new study. (Photos.com)

A new study indicates people who develop high blood pressure during middle age have a higher risk of heart attack, stroke, or related medical problems later in life.

It’s pretty well established that having high blood pressure, or hypertension, puts you at higher risk of cardiovascular disease. But in this study, the researchers wanted to examine the effect of a change in blood pressure in early middle age—age 40 to 55 or so.

“People who develop hypertension during that time period actually have a higher lifetime risk for cardiovascular disease, as opposed to people who maintain a normal blood pressure during middle age,” says Norrina Allen, of the Northwestern University School of Medicine in Chicago, who led the study.

Her study included data from tens of thousands of participants. Their blood pressure readings were tracked over a period of years. The participants were then followed as they aged to see if they had a heart attack, stroke, or other cardiovascular event.

Allen says an increase in blood pressure put people at considerably higher risk.

It’s important that early in life, starting around age 30 or 40, that we really focus on maintaining a healthy lifestyle, keeping our blood pressure within a normal range.

—Norrina Allen, Northwestern University School of Medicine, Chicago

And people in the study whose blood pressure went down during middle age had a lower risk of cardiovascular disease.

Allen says the study suggests strategies for improving your odds of avoiding heart attack, stroke, and the like.

“It’s important that early in life, starting around age 30 or 40, that we really focus on maintaining a healthy lifestyle, keeping our blood pressure within a normal range, and that will ultimately result in reducing our risk for cardiovascular disease down the road.”

In a study published on Nov. 16, the European Heart Journal concluded, “Aspirin was ineffective or even harmful in the majority of patients.” (Photos.com)

Aspirin is perhaps best-known for its painkilling properties. But another of its actions is to inhibit the ability of platelets to stick together.

 When platelets clump together, clots are formed. Aspirin partially inhibits clot formation. Small blood clots called thrombi are essentially responsible for the blocking off of arteries that can cause heart attacks and strokes. For this reason, many individuals are advised to take aspirin regularly to help prevent these cardiovascular events.

However, there has recently been some challenge to the conventional wisdom on aspirin. There has been growing awareness that many people need to be treated with aspirin for one person to benefit.

The ardor that the medical profession once had for aspirin has cooled recently.

Further dampening of the enthusiasm is likely to come as a result of a recent study that looked at the impact of aspirin on women. It was published online on Nov. 16 in the European Heart Journal.

The women in this study were essentially healthy in that they had no history of heart attack or stroke. In medicine, prevention in this type of person is described as primary prevention.

The researchers found some benefit for women over the age of 65. However, in this group (generally deemed to be at elevated risk), it was calculated that 50 women would have be treated with aspirin for 10 years to prevent one cardiovascular event (that is, a heart attack or a stroke). In other words, 49 people would take aspirin for 10 years with no benefit at all.

For younger women, overall benefits were even less likely. The authors of this study concluded: “Aspirin was ineffective or even harmful in the majority of patients.” These findings are in keeping with contemporary research on aspirin, so we should not be too surprised by them.

I had a sense of déjà vu while reading about this study. It brought back to mind the evidence base regarding the effectiveness of cholesterol-reducing statins. Here’s some things we know about the effectiveness of these drugs:

• In primary prevention, statins do not reduce the risk of death, according to research published in the Archives of Internal Medicine in June 2010.
• In predominantly primary prevention, in women of any age, there is no reduced risk of cardiovascular events with statin treatment from research published in The Lancet in March 2007.
• This is also true for men aged 70 or over from the same research in The Lancet (above).
• In high-risk men aged 30 to 69 years, about 50 patients need to be treated for five years to prevent one cardiovascular event—also from the same research in The Lancet.

And this is before we even start to factor in potential side effects such as liver damage, muscle pain and weakness, and kidney failure.

What is it about preventive medicine that makes it so utterly useless at prevention? One problem is that it almost certainly fails to address the true underlying causes of illness. Heart disease and strokes are not the result of deficiencies of either aspirin or statins.

Increasing levels of these substances may be valuable in disease prevention. Also, as these substances are innate to the body (which aspirin and statins are not), the potential for adverse effects is much smaller.

Dr. John Briffa is a London-based physician and author with an interest in nutrition and natural medicine. His website is DrBriffa.com.

Getting vaccinated can be traumatic, and unfortunately, isn’t necessarily going to prevent the flu. (Christopher Furlong/Getty Images)

The way we are encouraged to get vaccinated against flu, we might imagine this practice is a fail-safe way to avoid the condition. But we’d be wrong.

As I wrote recently in “‘Roll up’ for the Flu Vaccine?,” flu vaccination is a lot less effective than we have been led to believe. Plus, many individuals need to be vaccinated for one person to benefit. In other words, the vast majority of people who are vaccinated against flu will not benefit.

Last week, I wrote about an example of how flu vaccination can be reported in a way that puts it in a very positive light and fails to draw our attention to the fact that this practice is generally quite ineffective. This week I came across another article that made me think again about the wisdom of flu vaccination.

It concerned the supposed flu pandemic of 2009. The virus responsible was of the H1N1 type and was colloquially referred to as swine flu. Back in 1918, a similar flu strain caused an estimated 675,000 deaths in the United States. In 2009, the epidemic killed around 14,000 people—less than in some regular flu seasons. Why was the 2009 virus so benign?

There is evidence published online on Nov. 10 in the journal Clinical Infectious Diseases that catching a previous flu infection might have helped contain the H1N1 virus.

Researchers in America assessed about 500 people during 2009 and 2010. The individuals were tested for the presence of antibodies to H1N1 viruses in their blood. These were individuals who had not been vaccinated, meaning the antibodies must have come from natural contact and from infection with the flu virus.

In those without antibodies, 33 percent of individuals succumbed to the H1N1 virus. In those with antibodies, however, only 18 percent succumbed to the H1N1 virus.

In other words, previous natural exposure to an H1N1 virus appeared to afford significant protection against infection with the particularly virulent H1N1 virus of 2009. And the authors of the study speculate that previous exposure may well have contributed to the relative mildness of that pandemic.

Dr. John Briffa is a London-based physician and author with an interest in nutrition and natural medicine. His website is DrBriffa.com.

Lately, many of the emails I’ve received have been from men. Why? Because a panel of U.S. experts recently reported that healthy men should say no to the Prostate-Specific Antigen (PSA) test that diagnoses prostate cancer.

To many, this is like damning motherhood and apple pie since thousands of men routinely get this test every year.

Several cancer specialists in Canada have openly criticized this report. They argue that the PSA test, although not perfect, does save lives.

But the U.S. panel claims it has no significant effect on the number of deaths and often the end result is serious complications from treatment. So who is right?

This is like asking how many angels can dance on the head of a pin. None of us knows the answer. And no one knows the definitive answer to the dilemma of prostate cancer.

So what do we know for sure about the PSA test?

What worries the U.S. panel is that having an increased PSA level sets in motion a series of events that often cause more harm than good.

But the test is not specific for cancer, as three out of four men with increased PSA levels do not have malignancy. Rather, PSA elevation is due to either an enlargement of the gland, inflammation, or infection.

There’s even debate about the level at which the PSA is able to detect prostate cancer.

The accepted level has been 4.1. But several years ago, a report in the New England Journal of Medicine claimed that this value misses 15 percent of prostate malignancies.

Then a study at the University of Texas showed that 6.6 percent of men with a PSA level of 0.5 had prostate cancer! It appears that no level is totally safe.

What worries the U.S. panel is that having an increased PSA level sets in motion a series of events that often cause more harm than good.

For instance, to determine if a cancer is present, several biopsies of the prostate gland must be done. And if cancer is discovered, should it always be treated?

Like Graying Hair

Evidence of prostate cancer is like graying hair. Autopsies show that by age 70, about 50 percent of men have microscopic cancer in the gland. If it’s a slow-growing cancer, it may take 15 years to cause death.

In the meantime, death may occur from other causes. As the late Dr. Willet Whitmore, a world authority on prostate cancer, remarked: “Growing older is invariably fatal, cancer of the prostate only sometimes.”

Here is the great dilemma: The PSA test saves a few lives, but it can also result in severe complications from surgery or other therapies.

For instance, the New England Journal of Medicine reported a European study that followed 162,000 men for 10 years. Of those who did not have the test, 326 died. But of those given the test, 214 still died.

A difference of 112 deaths out of 162,000 men isn’t terribly impressive.

So here is the great dilemma: The PSA test saves a few lives, but it can also result in severe complications from surgery or other therapies.

Being a medical journalist makes me more aware of this fact than others, as I receive considerable feedback from readers.

Many have said that if they had known they’d be in diapers the rest of their life or impotent, they would never have agreed to the treatment. So in some cases, particularly with elderly men, it’s better to live with the devil you know than the one you’ve never met.

I also believe complications are underreported. A patient with urinary incontinence is much more aware of the annoyance than the surgeon who performs the operation.

So one needs the Wisdom of Solomon, which I don’t have, to know whether it’s prudent to have surgery or other therapies if prostate cancer is diagnosed.

Dr. Gifford-Jones is a medical journalist with a private medical practice in Toronto. His website is DocGiff.com. He may be contacted at Info@docgiff.com.

How did Abbott Laboratories’ Humira become an $8 billion-a-year drug, capable of anchoring an entirely new drug company as Abbott splits in two?

How did it become a blockbuster even though such drugs (which are called TNF blockers and include Remicade, Enbrel, and Cimzia) are linked to TB, rare cancers, and lethal infections like histoplasmosis?

How did it become a blockbuster even though Humira is only approved for the rare conditions of rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis in adults, Crohn’s disease, psoriatic arthritis, and chronic plaque psoriasis?

Humira became a blockbuster the same way all expensive, dangerous drugs become blockbusters: an easy-touch FDA, bought doctors and doctor groups, PR firms to establish diseases as “public health threats,” and massive direct-to-consumer advertising!

The FDA approved Humira, the first TNF blocker to use human cells, not mice or hamster cells, three months early, in 2002, and its Arthritis Advisory Committee announced the following year that TNF blockers are not—repeat “not”—necessarily linked to lymphoma.

Abbott enlisted the public relations giant Edelman to “educate” doctors about the exciting new drug and to team with the Arthritis Foundation. It also enlisted the health care advertising heavy, Harrison and Star, which created an “up close and personal” campaign for Humira that “any doc can vibe with.”

And Abbott gave out free samples of Humira to seniors in 2003 while it lobbied Congress to get the drug’s $15,000- to $25,000-a-year costs on the Medicare dole. It wasn’t even Halloween. (PS—it worked!)

It inserted Humira ads for Crohn’s disease in Chicago college and weekly newspapers and ran “educational” online radio shows about how to live with Crohn’s even though the disease affects only 1 percent of the population. It also runs “Hate psoriasis. Love clearer skin,” ads in high-budget magazines as if Humira is a beauty cream instead of an immune suppressor.

In fact, Abbott advertised Humira so widely that pharmaceutical reporters asked why, since the general public can neither afford the drug, nor does it need it. “Rheumatoid arthritis is a market where people often don’t know what they have for a while,” and it is often “misdiagnosed,” said Heather Mason, Abbott Vice President of Specialty Operations, in classic disease-selling pharma language.

When pharma sells a disease to justify a drug, the disease is always “under-recognized,” with “barriers” and “stigmas” preventing treatment and with under-recognized social costs and “burdens.”

Sure, Humira is expensive, Joel M. Kremer, M.D., an Abbott consultant, told The New York Times in 2008, but there are unrecognized social burdens.

“Inadequately treated rheumatoid arthritis typically leads to multiple joint replacements, lost productivity, lost tax revenue and a greatly diminished quality of life, as well as an increased risk of life-threatening infections and cardiovascular disease,” Kremer said. “You have to consider what it costs to fix a bridge against what it will cost when the bridge collapses.”

In Reviews in Gastroenterological Disorders in 2007, Abbott consultant Stephen Hanauer, M.D., echoed the cheaper-to-treat argument. Humira treatment reduces “overall costs” and enhances “patients’ quality of life,” he said.

But is it really cheaper to give patients Humira when they could use less-expensive and less-dangerous drugs that don’t suppress the immune system?

The Cochrane Collaboration, an international, not-for-profit drug review organization says of drugs like Humira (also called biologics): “Overall, in the short term biologics were associated with significantly higher rates of total adverse events, withdrawals due to adverse events and TB reactivation.” The report stresses, “There is an urgent need for more research regarding the long-term safety of biologics and the comparative safety of different biologics.”

In 2008, the FDA announced that 45 people died from fungal diseases from taking Humira, Enbrel, Remicade, and Cimzia—20 percent of those who got sick! People who lived near the Ohio and Mississippi river valleys were especially at risk.

The same year, the FDA investigated Humira for 30 reports of childhood cancer and its links to lymphoma, leukemia, and melanoma in children—yes, lymphoma.

This year, the FDA warned that Humira can cause “a rare cancer of white blood cells” in young people, and five patients died during Humira trials in Italy. In the Oct. 5 JAMA, an article warns that “potentially fatal Legionella and Listeria infections are the latest opportunistic infections to be added to the boxed warning for medications that block tumor necrosis factor (TNF),” such as Humira.

The FDA’s Adverse Events Reporting System discloses 80 cases of Legionella and 14 deaths, and 26 cases of Listeria and 7 deaths in people on TNF blockers. Other articles this year link drugs like Humira to heart problems.

Still, Humira’s spin machine is humming as Abbott prepares to found an entire company on the blockbuster drug. An investigator with the Italian trials called the deaths “bad luck” and not necessarily Humira-related. (Trials were not stopped.)

An avalanche of pharma-planted articles dispute the heart findings. And Abbott is seeking approvals to market Humira for ulcerative colitis and pediatric Crohn’s disease. Projections say that Humira and a similar drug will “drive nearly two-thirds of the growth in the ulcerative colitis market in the United States.”

Maybe there will be free samples.

Martha Rosenberg is a health reporter and author who lives in Chicago.

Boxes of Zicam cold remedy sit in the storeroom of a drugstore after the company chose to remove the product from its stores following an FDA warning to consumers about using the product, June 17, 2009, in Chicago, Illinois. (Scott Olson/Getty Images)

Who decides whether a drug is licensed and remains licensed should problems turn up later?

The answer is organizations such as the Food and Drug Administration (FDA) in the United States and its European counterpart, the European Medicines Agency (EMA). These bodies act in our interests to protect us against worthless or hazardous pharmaceutical agents, among other things. That’s the theory, anyway.

Both of these organizations have come under repeated criticism for apparently working harder to protect the interests of pharmaceutical companies than our own. Recently, I was reading a piece published in the Journal of the American Medical Association (in August) that highlighted some worrisome examples.

Earlier this year in May, for example, researchers based in Denmark wrote in the British Medical Journal how its request for unpublished data on two weight-loss drugs from the EMA was anything but straightforward. One of these drugs (rimonabant) has subsequently been withdrawn when it was discovered it could cause severe adverse effects on depression and suicidal thoughts.

The other drug (orlistat) has been claimed by the consumer advocacy group Public Citizen to be of limited effectiveness and also potentially hazardous. The EMA refused to release clinical trial data on these drugs, arguing that to do so would undermine commercial interests. It eventually yielded the data only when compelled to do so by the European ombudsman.

Because of the seeming cozy relationship that the EMA has with pharmaceutical companies, the European Parliament has refused to sign off on the agency’s accounts and has ordered a special investigation of the EMA over its funding sources and hiring practices.

The FDA has not been immune to criticism either. The JAMA piece recounts a sorry tale concerning the drug valdecoxib. This drug was licensed in 2001, but the manufacturer asked the FDA to withhold data on it. The FDA argued that such data was a trade secret.

Public Citizen finally forced the data out of the FDA by initiating legal action and discovered that valdecoxib could cause serious adverse effects—including death. The drug was subsequently withdrawn.

According to Dr. Steven Nissen, chair of the department of cardiovascular medicine at the Cleveland Clinic, “The FDA is now somewhat more transparent, but it’s not transparent enough. For reasons I can’t understand, it still keeps information secret.”

Dr. John Briffa is a London-based physician and author with an interest in nutrition and natural medicine. His website is DrBriffa.com.

Cancer Treatment Centers of America runs several hospitals and clinics—including the one above in Goodyear, Ariz.—which provide integrative care for cancer patients. A large number of patients come from out of state.(Courtesy of Cancer Treatment Centers of America)

LOS ANGELES—For the wealthy, integrative medicine (also known as “complementary and alternative medicine” or CAM) for cancer treatment has been available for decades in Asia, the Caribbean, and Europe. For most Americans, however, the costs of travel and lodging are prohibitive.

Whereas Western medicine focuses on treating the illness, an integrative approach to health care focuses on treating the whole person, using naturopathic medicine, acupuncture, nutrition, massage, chiropractic, hypnotherapy, and mind-body therapies.

In the U.S., integrative cancer treatment has not been readily available until recent years because various state laws have limited cancer treatments to traditional medical approaches in hospital and clinical settings.

A major obstacle to integrative cancer treatment has been that trained medical practitioners in various alternative modalities are not licensed to practice under the state medical system.

Changing Times

When patients seeking alternative cancer treatment abroad started reporting positive results, word spread around, and the number of people seeking complementary and alternative treatments increased.

In California, where integrative treatment for cancer is currently not allowed, patients are traveling out of state and bearing the financial burden to find the treatment they seek. States bordering California—Nevada and Arizona—and elsewhere where integrative treatment is allowed, are seeing an increasing number of Californians.

“Two-thirds of our patients come from other states,” said Dr. Timothy Birdsall, vice president of Integrative Medicine and chief medical information officer at Cancer Treatment Centers of America. CTCA runs several hospitals and clinics that offer integrative treatment of cancer across the United States, including in Seattle, Wash., and Goodyear, Ariz.

According to Dr. Birdsall, a study CTCA conducted found that “a large number [of patients] were using complementary treatments already. However, the patients weren’t telling their primary physician they were doing so.”

There is a risk when patients do not tell their physician about the alternative types of treatments they are using.

“Even though each of the complementary treatments has its place in treating a cancer patient, under certain circumstances, some of these other treatments, for example, large doses of vitamins in one case, negated the chemotherapy,” Birdsall said.

Medical Brain Drain

Patients aren’t the only ones looking beyond state borders. Frustrated physicians are as well. Dr. Len Saputo, who specializes in internal medicine and is a founder of Health Medicine Center, an integrative medicine center located in Walnut Creek, Calif., says medical brain drain is occurring.

“Many California physicians have been frustrated, and some have even relocated to more-user-friendly states because under California Public Health law, it is a felony to use CAM treatments for cancer even when mainstream therapies have failed, have been abandoned, and patients [have been] sent home to die,” Dr. Saputo said.

Advocacy Efforts

More states continue to approve integrated cancer treatment. However, despite a long tradition of cutting-edge research in many disciplines, California has moved more slowly.

California Citizens for Health Freedom (CCHF), an advocacy group and watchdog, has been actively focused on making integrative medicine accessible to Californians. It presented the bill to license naturopaths and presented a successful bill in 2004 to legalize non-cancer medical integrative treatment.

The bill is also meant to protect physicians and naturopathic doctors who want to use integrative medicine to treat cancer. Currently, they are limited to using chemotherapy, radiation, or surgery, or they risk losing their medical license, according to CCHF.

This year, CCHF proposed a bill to allow integrative treatment for cancer patients. CCHF President Frank Cuny said: “Californians deserve a more compassionate treatment environment that meets their needs as a whole person.

“This will also make it possible for Californians in our current economy to get this treatment in California, without having to travel to other states. Doctors will also have more treatment options, not available previously.”

Interest in complementary and alternative medicine at the federal level started about 20 years ago. The National Institutes of Health (NIH) established a Complementary and Alternative Medicine section as early as 1992 and established the National Center for Complementary and Alternative Medicine in October 1998.

For those 65 and over, Dr. Briffa points to a Lancet Infectious Diseases study that found a lack of evidence that flu vaccines offer protection. (James Gathany)

I walked past my local doctor’s office recently. Outside, they’re flying a banner that reads something like “Roll up! Roll up—for your Flu Vaccine!”

Flu vaccination seems to be pushed increasingly hard, especially for “at risk” individuals such as the over-65s. Generally, we’re given the impression that having a flu jab will almost assure protection from flu over the coming months. However, new evidence suggests we’d be wide of the mark here.

Research published online on Oct. 26 in the medical journal The Lancet Infectious Diseases finds that the most commonly used flu vaccine there (known as the trivalent vaccine) is, overall, 59 percent effective. The authors of this study concede that this is significantly lower than the effectiveness figures commonly quoted by authorities.

But let’s see what an effectiveness of 59 percent actually means. Let’s say we round up 100 people who have had the flu and have not been immunized. If all of these individuals had been immunized, though, 41 would have got the flu.

This may still seem like a reasonable result until you start to consider that of all the people who get flu jabs, only a small percentage were destined to get flu anyway.

What this means is that the vast majority of people who get the flu shot will not benefit from it one iota. That’s not necessarily a reason not to have it. But it is something that I believe should be made plain to people before they “roll up! roll up!”

And here’s another thing that came out of the research: For certain sections of the community, there really is not good evidence for the effectiveness of flu vaccine, and that includes the over-65s.

Here’s an excerpt from the abstract of the study: “Influenza vaccines can provide moderate protection against virologically confirmed influenza, but such protection is greatly reduced or absent in some seasons. Evidence for protection in adults aged 65 years or older is lacking.”

About this time last year, I had a conversation with my parents about flu vaccination. Both my parents are retired doctors but traditionally took different views on this practice: My dad was dead against it, while my mom dutifully attended for her annual flu shot as requested.

My mom found she would get a persistent cough after her flu shot (possibly coincidence, but perhaps not), and when we discussed the likelihood of her benefiting in real terms she decided to forgo it last year.

Next time I see my mom, I’m going to be telling her about the fact that we have no good evidence that flu vaccination benefits individuals in her age group, and I’ll communicate these latest findings on the effectiveness of flu vaccination too.

Dr. John Briffa is a London-based physician and author with an interest in nutrition and natural medicine. His website is DrBriffa.com.

(Martha Rosenberg)

There was a day when it seemed like everyone was on antidepressant “happy pills” like Prozac, Paxil, and Zoloft. But then the pendulum began to swing.

Patients objected to the weight gain, the feelings of not being themselves, the sexual side effects, and the withdrawal symptoms. There were even reports and warnings about suicide and other “neuropsychiatric” effects.

Now, WebMD, the gigantic, pro-pill website whose original partner was Eli Lilly, is doing damage control for SSRI antidepressants. New articles urge patients not to panic or quit taking their pills just because of things they read.

Don’t believe all the hooey about antidepressants turning you into a “zombie,” ruining your sex life, or costing too much, says an article called “Fears and Facts About Antidepressants,” on WebMD.

And don’t be impatient! “If the first antidepressant medication doesn’t help, the second or third often will. Most people eventually find one that works for them.”

Don’t listen to all that suicide talk either! “Switching to a different antidepressant may help,” say the damage-control articles.

Is your fear of becoming a drug lifer keeping you from antidepressants, asks another WebMD article called “What’s Stopping You From Seeing a Doctor About Depression?” “If you do need a medication, it most likely won’t be for life,” says the article. Just until the patent runs out?

Do you think you can ignore your depression, and it will go away? “Waiting for depression to simply pass can be harmful,” because “depression that goes untreated may become more severe,” say the WebMD articles—thus rewriting medical practice itself since depression has never been a progressive disease but is actually self-limiting.

The important thing, say the articles, is never to stop your meds. “Stopping medication abruptly may … cause depression to return,” and can cause side effects, say the articles.

Even worse is “prescription abandonment”—people discovering what a drug costs and leaving it at the pharmacy or quitting drugs because of their effects. Doing so costs pharma lots of money! Pharma even has programs now that send Big Brother nurses to people’s homes, through their pharmacies, to make sure people are taking their meds.

One antidepressant with a big PR problem is Eli Lilly’s Cymbalta. It’s linked to the deaths of Traci Johnson, a healthy 19-year-old who hung herself on the Lilly campus during clinical trials in 2004, and Carol Anne Gotbaum—daughter-in-law of former New York City Public Advocate Betsy Gotbaum—who died in police custody at Phoenix’s Sky Harbor airport in 2007.

Cymbalta is noted in the scientific literature for producing suicidal side effects in people with no mental health history. A 37-year-old man described in the Journal of Clinical Psychopharmacology as having a stable marriage and employment and no history of mental problems tried to kill himself with carbon monoxide two months after taking Cymbalta for back pain. A 63-year-old man, also with no mental health history, became suicidal on the drug after two weeks.

“There is an emergence of suicidality in apparently non-suicidal patients after starting or increasing duloxetine [Cymbalta],” reads an article in Clinical Practice and Epidemiology in Mental Health.

But now, Cymbalta is being promoted as a pain drug of choice as if it’s not a repurposed antidepressant with antidepressant side effects. Last year, it was approved for chronic musculoskeletal pain, including discomfort from osteoarthritis and chronic lower back pain, and it was already approved for fibromyalgia and diabetic nerve pain.

A Cymbalta ad in October’s New England Journal of Medicine says: “Today a non-NSAID [non-steroidal anti-inflammatory drug] non-narcotic, once daily analgesic FDA approved for three indications across four different chronic pain conditions can be found in one med.” Sounds as safe as Vioxx.

Martha Rosenberg is a health reporter and author who lives in Chicago.

Photos demonstrating reversal of arteriosclerosis. (Courtesy of Sydney J. Bush)

Most people have no idea of the struggle that is going on behind the scenes for control of the health and sickness market. Health care is one of the most lucrative businesses—THE most wealth-generating business in the world.

The reason the pharmaceutical industry is so dangerous is that wealth is concentrated in the hands of a few pharmaceutical companies.

Marcia Angell, M.D., former chief editor of the New England Journal of Medicine, pointed out that the combined profits of the top 10 pharmaceutical companies in the Fortune 500 list of the world’s most profitable companies exceeded the combined profits of the remaining 490 companies!

Imagine a policy-making meeting of the CEOs of those 10 companies. How much do they really care for our health? A story that anyone can verify in a few seconds on the Internet is that Merck, manufacturer of a well-known cholesterol-lowering drug, a statin, learned in the 1980s that statins present a problem: They reduce the heart muscle’s production of coenzyme Q10. Described by some as the “spark plug of the heart,” coenzyme Q10 helps to initiate the heartbeat.

The FDA approved of a heart medicine that has the power to eventually stop the heart.

Realizing the danger, Merck obtained a patent for a combined statin and coenzyme Q10 tablet. End of problem? No. It was never manufactured.

Instead, scurvy was relabeled as vitamin C deficiency, a far less-alarming name. So although probably over 80 percent of us die directly or indirectly from scurvy, in one year, the medical journals only allowed the use of the word 14 times.

Doctors used to wait for people to become ill. Since the World War II, it seems that pharmacy has been seeking ways to hasten the process. “Codex Alimentarius” [see TheEpochTimes.com/n2/health/codex-alimentarius-54120.html] is the full-frontal attack on vitamins that cost pharmacy dearly due to people’s improved health. You will soon have to go to your doctor for a prescription to allow you to buy vitamins.

I thought that if, by measuring changes in the eyes, I detected diseases before others, I would be congratulated. Not so—at least not by the medical profession.

I surprised people by explaining how the pharmaceutical industry could market a statin drug to prevent heart disease when the drug would eventually kill patients by inhibiting the heart muscle’s production of coenzyme Q10.

Recently, the U.K. General Optical Council has taken up much of my time that would have been dedicated to my research in order to answer its allegations.

In 2010, I retired from contact lenses to save people from heart disease. I studied retinal-artery photographs and found what vitamins stopped disease and dissolved blockages.

On Dec. 2, 2009, I lectured to the British Medical Association, concluding, “Optometry has bypassed the bypass and made coronary cardiology ‘kidology.’” (Bypasses are surgery for scurvy instead of vitamin C.)

I was not supposed to make that discovery!

The following is a transcript from my hearing before the General Optical Council. My answers are in brackets:

The Council alleges that in relation to you, Sydney Joseph Bush (registered optometrist):
1. During the period 2008–2010, in the course of practicing as an optometrist:
(i) You held yourself out as practicing “Nutritional preventive CardioRetinometry” and/or able to diagnose and manage coronary heart disease; [Dr. Bush: Yes]
(ii) You held yourself out as being able to “Cure heart disease,” “Prevent coronary thrombosis,” and provide “Real heart attack prevention”; [Dr. Bush: Yes]
(iii) You stated that ‘CardioRetinometry shows heart blockages in retinal arteries dissolving away under our control with our vitamins and supplements”; [Dr. Bush: Yes—exactly, as in the heart!]
(iv) You claimed to be “a new kind of optometrist” providing “a new doctor relationship”; [Dr. Bush: Yes—I was the first.]
(v) You recommended that patients suffering from cardiovascular problems should be treated with vitamin C and/or other forms of nutrition; [Dr. Bush: Yes]
(vi) You encouraged discontinuing the role of statins as treatment for patients in reducing the risk of ischemic heart disease. [Dr. Bush: Not to any named patient, (not) countermanding physicians’ prescriptions.]
2. (i) Each of your actions under paragraphs 1(i), (ii), (iii), (iv), (v), and (vi) above was knowingly outside your professional qualification as a registered optometrist and/or was likely to bring the profession of optometry into disrepute. [Dr. Bush: I wasn’t qualified to make the discovery?]
(ii) Each of your actions under paragraph 2(v) and (vi) above did not comply with the evidential standard for the management of cardiovascular disease as set out by leading professional and health service bodies, such as the National Institute for Health and Clinical Excellence and the Joint British Societies’ cardiovascular risk advice. [Dr. Bush: I succeeded! They failed for 50 years!]
(iii) Each of your actions under paragraphs 2(i), (ii), (iii), (iv), (v), and (vi) above was potentially contrary to the health and safety of patients. [Dr. Bush:
Two hundred written testimonials from happy patients say the opposite!]
And by virtue of the matters set out above your fitness to practice is impaired by reason of misconduct.

In July 2008, the U.K.’s National Health Service refused me a new contract as an optometrist unless I stopped informing patients that arteriosclerosis is reversible.

Dr. Bush practices optometry in the U.K. His website is LifeExtensionOptometry.org An interview of Dr. Bush can be seen here: Humber.TV/shows/CardioRetinometry-eyes-the-window-to-your-heart

A new study finds a link between [synthetic] vitamin E—a popular dietary supplement—and an increased risk of prostate cancer.

In 2001, scientists launched the Selenium and Vitamin E Cancer Prevention Trial (SELECT), to test the widely held belief that the two supplements might help or prevent disease. Analysis from studies on skin and lung cancers had suggested that the mineral supplement selenium or vitamin E might reduce the risk of prostate cancer.

The study enrolled 35,000 healthy men, 50 years or older, at 400 sites in the United States, Canada, and Puerto Rico. Eric Klein of the Cleveland Clinic says the $122 million dollar trial ended in 2008 when it became clear that it would not produce the 25 percent cancer reduction it was designed to show.

“We did notice however at the time the original study was closed that men who were taking [synthetic] vitamin E alone were trending toward having a higher risk of prostate cancer.”

Updated findings, reported in the Journal of the American Medical Association, show no benefit for men who took the 400 International units of [synthetic] vitamin E a day and more importantly, a real risk, says co-author and National Cancer Institute prostate cancer expert Howard Parnes. “At this time the data show a 17 percent increase in prostate cancer, which is statistically significant for the [synthetic] vitamin E alone.”

“There just doesn’t seem to be a reason to be taking [synthetic] vitamin E if you are a man over 55 or 60.”

Klein adds that the study underscores the importance of large-scale, population-based, randomized trials to accurately measure the benefit or harm of micronutrients such as diet supplements.

Note: The SELECT trial employed dl-alpha-tocopherol, a synthetic form of vitamin E derived from petroleum. It did not test natural vitamin E, d-alpha-tocopherol.

A picture and flowers adorn the sidewalk outside the home of Steve Jobs on Oct. 6, 2011, in Palo Alto, Calif. (Kevork Djansezian/Getty Images)

Apple co-founder Steve Jobs died at the age of 56 followed a seven-year battle with a rare form of pancreatic cancer—the fourth leading cause of cancer-related deaths in the United States.

The disease is hard to treat because it is difficult to diagnose. The pancreas is embedded deep in the abdomen, and often symptoms of cancer become evident at a very late, advanced stage of the disease. 


In 2004, Jobs announced he had undergone surgery for pancreatic cancer—a mild and rare form of the disease called an islet-cell neuroendocrine tumor.

That form makes up about 5 percent of all of pancreatic cancers. It affects the cells that produce hormones that control blood sugar levels. The more deadly and common form appears in the exocrine cells of the pancreas that produce digestive enzymes.

The pancreas is a 6-inch-long gland tucked behind the stomach and below the liver. Pancreatic cancer can be hard to diagnose since the early stages have no visible symptoms.

“Neuroendocrine tumor, when it’s detected early, … is curable with surgery alone,” explained Dr. Khaled el-Shami, a cancer specialist at George Washington University Medical Center, in Washington. “And when it is advanced, meaning that it has spread from the pancreas to the liver, typically, or other organs—[then] this is [an] incurable disease.”

In 2009, five years after his cancer surgery, Jobs received a liver transplant.

“About five months ago, I had a liver transplant. So I now have the liver of a mid-20s person,” Jobs said.

Dr. el-Shami says a liver transplant is an aggressive way of dealing with cancer, but it’s no magic bullet.

“It’s a balance between removing a big chunk of cancer in the liver and the risk of having a weakened immune system, which can encourage not only the original cancer to come back but also the emergence of other cancers,” the doctor explained.

While he never treated Steve Jobs and does not know the details of his case, Dr. Matthew Walsh, chairman of general surgery at Cleveland Clinic, says Steve’s cancer was never likely to be cured.

“Having gone through all the treatment, most patients might think that they are cured of the cancer. When it comes back, there is still a great uncertainty [about] what the length of your life will be,” Walsh said.

“It tends to be a disease that does come back—does spread—does take your strength away. …” He said it can produce “all the cancer-associated symptoms and people still die from this type of cancer.”

Few details of Steve’s health have ever been made public, but experts speculate that his cancer may have been a case of late diagnosis.

Flu shot promotion is in full swing. But should you have a flu shot? (Louise McCoy/The Epoch Times)

There is so much written that is dead wrong about this year’s flu vaccine. Here are some facts:

This year’s flu vaccine is the same as last year’s vaccine. If you are healthy and got the vaccine last year, you probably still have antibodies against all three strains.

The antigen used for the 2009 Swine Flu vaccine was an H1N1 hemagglutinen. It was used as a single antigen vaccine in 2009 but was included as one of the three hemagglutinin antigens in 2010 and 2011. In 2009, in some countries, a novel adjuvant was added to the antigen (either MF59 [Novartis] or ASO3 [Glaxo]) to increase the immune response.

For example, in the United States, which used no adjuvant, the 2010 and 2011 flu vaccines contain the 2009 swine flu vaccine, plus two more antigens. Therefore, claims that this year the vaccine is entirely different are misleading.

In countries like Ireland and England, which used the ASO3 adjuvant in 2009, the current flu vaccine differs from 2009 because it has no ASO3. But it does have the same hemagglutinin adjuvant.

Narcolepsy cases have occurred after both adjuvanted and unadjuvanted swine flu vaccines were given.

How effective is the vaccine? Although 70 to 90 percent of recipients develop antibodies, the amount of flu that is prevented is questionable. Remember that studies from Hong Kong and Canada found that if you got flu vaccine in 2008, you were about twice as likely to become ill with a swine flu infection the next year.

The effectiveness of the vaccine varies from year to year, but it is not very high and never over 70 percent for the young and healthy. It is hard to show any efficacy in the aged.

Was narcolepsy the only serious adverse reaction to swine flu vaccine? It’s unlikely.

You may have seen headlines that swine flu vaccine does not cause Guillain-Barre syndrome. However, it seems it does cause Guillain-Barre syndrome after all.

The full text is here: MMWR Morb Mortal Wkly Rep. 2010 Jun 4; 59(21): 657–661, Centers for Disease Control and Prevention (CDC). CDC calculated it caused 1.77 times as many cases of GBS as expected, or 177 percent more than expected.

Source: AnthraxVaccine.blogspot.com/2011/10/this-years-flu-vaccine-setting-things.html

Doctors, anesthetists, and nurses always gear up to become as efficient as possible when a case is critical. But when one is scheduling a routine operation, timing is important. (Ali Al-Saadi/AFP/Getty Images)

A report in the Canadian Medical Association Journal (CMAJ) says it’s much safer to time your sickness. If not, there is a good risk of ending up with inferior medical care. So when should you get ill? And what is the prime time to have an operation?

Jesse Gruman, president of the Washington, D.C.-based nonprofit Center for Advancing Health, says: “Anybody who’s been in hospital knows that it’s a kind of banker’s hours after 6 o’clock. You feel really vulnerable if something happens at night because of the sparseness and responsiveness of the night staff.”

But is this also a problem in Canada? Dr. David Wilson, president of the Canadian Society of Hospital Medicine, isn’t reassuring. He says, “In comparison with the United States, I don’t think that after-hour coverage is as well funded in our country.”

No one who has spent a night in hospital would disagree with these opinions.

Wilson adds: “Canada’s single-payer health care system makes it more difficult to provide financial incentives.” So it’s often the luck of the Irish if you happen to receive the same care after hours as during the normal workday.

Since none of us can decide that a ruptured appendix, broken leg, or heart attack will occur during the day, what can be done to decrease the risk of after-hour neglect?

Trying to fix this Russian roulette of nighttime care isn’t easy. But some U.S. hospitals have turned to nocturnists, doctors who come to work at night, expect to be there all night, and work all night.

Other hospitals, such as the Vancouver General, treat after-midnight medical issues by telephone managed by a critical-care outreach team or by the most responsible physician. How effective these measures are when dealing with emergency situations is questionable.

Besides, it’s not just surgical emergencies or heart attacks that occur after hours. For instance, it would be interesting to know how many patients who desperately cry out for a bedpan during the night receive one only after it’s too late.

The report in the CMAJ reminded me of Arthur Hailey’s best-selling book “Wheels.” Hailey warned his readers not to buy cars built on Monday or Friday. , He said Monday’s cars had a bit of weekend hangover built into them. Friday’s cars often lacked nuts and bolts left out by a worker anxious to get away for the weekend.

What about surgeons? Are they more reliable than autoworkers? Or are they more likely to leave a sponge or instrument in the abdomen on a Friday or after hours? If so, what is the best time-slot for an operation?

Like Hailey, for the same reasons, I’d prefer that my gallbladder or bypass operation didn’t happen on a Monday or Friday. I’d also be less concerned if it were performed early in the day, as surgeons are not robots. They are subject to fatigue like everyone else.

So, for me, prime time is Tuesday at 8:00 a.m. The first operation starts on time. Later in the day, surgical emergencies may occur, and scheduled operations may have to be canceled or delayed. This rarely happens at 8:00 a.m.

A Tuesday booking has one other advantage. If a complication occurs, the surgeon is usually available for the rest of the week. If it happens on Saturday, you may be treated by another surgeon less familiar with your case.

Remember, this is not an ideal world, so I doubt that nighttime care will ever be as good as daytime care. Nor can everyone expect to have what I consider primetime surgery.

But let me leave on this reassuring note. Maybe Hailey is right about cars. But I’ve done enough nighttime surgery to know that 99.9 percent of the time, after-hours care does not differ when a patient’s life is at stake.

Doctors, anesthetists, and nurses always gear up to become as efficient as possible when a case is critical. Medicine continues to be the most noble and caring profession of all.

Dr. Gifford-Jones is a medical journalist with a private medical practice in Toronto. His website is DocGiff.com He may be contacted at Info@docgiff.com

Obesity predisposes to diabetes, which increases the chances of one's developing Alzheimer's disease. (Sloan/AFP/Getty Images)

In 1999, a study called the Rotterdam Study uncovered the strong association between diabetes and Alzheimer’s disease. In this landmark study carried out in the Netherlands, 6,370 elderly men and women were followed for an average of two years.

In what was perhaps one of the first reports on this issue, they found that having diabetes almost doubled the risk of dementia. Since then, several studies have confirmed these findings and have thrown light on the probable mechanism for this connection.

A nine-year study published in 2004 followed 842 older Catholic priests, brothers, and nuns. Although none of them had any signs of Alzheimer’s at the beginning of the study, at the end of it, 151 of them had developed Alzheimer’s.

A statistical analysis found that those who had Type 2 diabetes had a 65 percent increased risk of getting Alzheimer’s. Later, it was also found that this increased risk applies to both Type 1 and Type 2 diabetes.

Type 1 diabetes frequently occurs before the age of 20. Antibodies destroying the pancreas, the organ that produces insulin, cause it. This type of diabetes occurs in 10 to 15 percent of diabetics.

In type 2 diabetes, which occurs in 85 to 90 percent of diabetics, the cause is primarily insulin resistance, where the body’s cells are not as sensitive to the action of insulin as they should be.

Type 2 diabetes has a strong genetic component but can be prevented with changes in diet and lifestyle.

In the United States, Alzheimer’s disease affects 1 in 10 Americans over 65 years of age and almost 50 percent of those over 85. Almost 26 million Americans have diabetes, and close to 80 million are prediabetic. While care for diabetics represents $174 billion in health care costs, the cost for the estimated 5.4 million Americans who have Alzheimer’s is over $180 billion.

A Swedish study published in 2008 found that men with low insulin production at age 50 were nearly 1.5 times more likely to develop Alzheimer’s disease than people without insulin problems. That study also found that the strongest association between diabetes and risk of Alzheimer’s was strongest in people who have the APOE4 gene. That gene has been found to increase the risk for Alzheimer’s disease.

Diabetes may also lead to people developing mild cognitive impairment (MCI), which is a transitional stage between the cognitive characteristics of normal aging and the more serious problems resulting from Alzheimer’s or other kinds of dementia. For example, because diabetes damages the blood vessels, it has long been known as a serious risk factor for vascular dementia, manifested by cognitive and memory problems.

What explains the association between these two serious diseases? Studies carried out over the last several years show that both diabetes and Alzheimer’s share some very damaging molecules known as advanced glycation end products (AGEs). Once produced, these substances affect the structure and functions of important proteins in the body.

Is it possible to affect Alzheimer’s by altering insulin levels? By mimicking high insulin levels in healthy adults ranging in age from 55 to 81, researchers were able to elevate some markers of Alzheimer’s in the brain.

But, how about lowering insulin levels? Would that also have an effect? Researchers from the Boston University School of Public Health reported that individuals who used thiazolidenedione (TZD) drugs to lower their blood sugar levels had lower rates of Alzheimer’s disease. Of 142,328 patients, those who received a first prescription for TZDs or insulin without previous prescription for either medication had up to 20 percent fewer cases of Alzheimer’s than patients who hadn’t received them.

These important studies suggest that preventing or effectively treating diabetes may lower the risks for Alzheimer’s disease. The positive effects on diabetes of dietary changes, exercise, and nutrients are well known. Now there is an additional reason to put them to use.

Dr. César Chelala has carried out research in biochemistry, molecular genetics, and pharmacology.

According to the Archives of Internal Medicine: 'Until there is such data for statins for primary prevention, we will continue to classify it as an intervention without known benefit, but with definite risks, in our Less Is More series.' (Tim Boyle/Getty Images)

In April, the editors of Archives of Internal Medicine launched a series titled “Less Is More” to highlight the overuse of investigations and treatments in medicine. One example they cited was the use of statins for people without known heart disease, saying that this practice has “known adverse effects despite the absence of data for patient benefit. …”

The September edition of the journal carries a response to this comment from several doctors who attempt to make the case that statins do indeed have a role in “primary prevention” of cardiovascular disease (that is, the treatment in individuals with no known cardiovascular disease or previous heart attack or stroke).

Among other things, the authors write about how studies show that in primary prevention, one meta-analysis (collection of several studies) showed statins reduced the risk of major coronary events (for example, fatal and non-fatal heart attacks) by 30 percent.

This sounds impressive, but in the primary prevention setting, overall risk of heart attacks is generally low, so a 30 percent risk reduction translates into only a very small actual reduction in risk in the real world.

This particular meta-analysis included data from studies that included data from individuals with known cardiovascular disease. These individuals, actually candidates for “secondary prevention,” are at high risk of further problems. Their inclusion with primary prevention data makes the benefits in primary prevention look better than they really are.

To properly judge the impact of statins in primary prevention, we need to look at data from primary prevention only. To date, only one meta-analysis has done this, and this was published in June 2010 in the Archives of Internal Medicine. The most notable result from this meta-analysis is that statins (in primary prevention) do not save lives.

The editors end with this damning statement: “For a medicine to be recommended to healthy patients for a lifetime of use, there should be robust evidence that this regime will reduce suffering or extend life and evidence that the benefit outweighs adverse effects.

“Until there is such data for statins for primary prevention, we will continue to classify it as an intervention without known benefit, but with definite risks, in our Less Is More series.”

Dr. John Briffa is a London-based physician and author with an interest in nutrition and natural medicine. His website is DrBriffa.com

Maybe i will wait on that surgery. (Photos.com)

The time-honored tradition has always been to fix it. But is this approach always the right one? Or is “tincture of time,” namely watchful waiting, the best way to treat this common condition?

A hernia is a protrusion of bowel through a weak spot in the abdominal wall near the groin. But there is no gender fairness in this condition. As one of my surgical professors used to say, “Sometimes you get the big brown egg.” In this case the egg goes to men, as 90 percent of hernias occur in males.

In the past, surgeons believed that failing to return the bowel to its natural location inside the abdomen was fraught with danger. They worried that the bowel would become trapped in the hernia causing intestinal obstruction, a serious complication.

If this happens, the bowel may lose its supply of oxygenated blood, resulting in gangrene and death if an emergency operation is not done. There was also the concern that small hernias could become larger, making surgical repair more difficult.

Several years ago, a study involving five U.S. medical centers found that these surgical worries rarely happen. To prove this point, doctors followed 700 men with hernias that were causing minimal or no discomfort.

Half of the men were randomly selected to have the hernia repaired. The other 50 percent were told to monitor their symptoms and to report back for regular medical checkups.

To their surprise, surgeons discovered that the most feared complication, intestinal obstruction, occurred in less than 1 percent of patients per year. This is much better than the odds at Las Vegas. Moreover, any discomfort that was initially present did not increase over a two-year period in the majority of cases.

Twenty-five percent of the watchful-waiting group did eventually ask for surgery due to an increase in pain. But this delay in surgery had no effect on the rate of complications such as infection, length of operation, or recurrence of hernia.

What about the other half who initially were chosen to have the hernia repaired? About 20 percent developed complications such as infection and difficulty passing urine after the surgery, and three had life-threatening problems. Other studies show that even after a successful hernia repair, about 5 percent of patients continue to have pain. No surgical procedure offers a “free lunch.”

Since this study involved only men, it’s not known whether women or children who also develop hernias would have the same result. But one would suspect little or no difference.

Dr. Michael Alexander is an expert on hernia surgery at the Shouldice Hospital in Toronto. This facility specializes in hernia repair and is a world authority on this operation.

Dr. Alexander believes that surgeons must get rid of the idea that all hernias must be repaired. This applies particularly to the elderly if they are without discomfort. But age is not a factor as long as the patient is free of cardiovascular and other problems that increase the risk. He says his oldest patient was 99 years old!

We have all heard the phrase “If it’s not broken, don’t fix it.” Now we can add another equally sound surgical dictum: “If it’s only partially broken, there may be no need to fix it.”

In the past, the usual medical practice was to tell patients that gallstones had to be removed. It is still true if there are repeated attacks of gallstone colic or if gallstones are small and are blocking the common bile duct that drains bile into the intestines.

Today, X-rays, CT scans, and MRIs often detect gallstones even though these procedures are done for other conditions. In these instances, if the gallstones are not causing any problems, they are normally left for the crematorium.

So if a hernia is present, just remember that porcupines make love very, very cautiously. Be just as cautious about hernia surgery. Always ask yourself, how much trouble is the hernia causing me? Your doctor should then make the final decision.

Dr. Gifford-Jones is a medical journalist with a private medical practice in Toronto. His website is DocGiff.com He may be contacted at Info@docgiff.com

Taking blood tests to measure cholesterol is a part of routine lab testing. However, a recent study has found that higher cholesterol levels were not associated with heart disease and were associated with a reduced risk of stroke. (Stuart Franklin/Getty Images)

It was Cholesterol Week, Sept. 19–25, in the U.K. The week was accompanied inevitably with a rash of stories about the perils of cholesterol and how we should be more aware of our cholesterol levels and do something about them if they are elevated.

This will all no doubt help to swell the coffers of the drug and food companies that sell solutions to cholesterol. Let’s spend a moment analyzing the basic premises on which the cholesterol hypothesis is based:

• Cholesterol causes heart disease.
• Reducing cholesterol levels lowers the risk of heart disease.

Actually, studies show that taking dietary steps to reduce cholesterol do not bring broad benefits for health or save lives. We also have drugs that reduce cholesterol that do not appear to improve health. What this means is that the second assumption above is on distinctly shaky ground. But what about the first assumption?

The idea that cholesterol is a risk factor for heart disease is repeated loudly and often. However, there is at least some evidence that this supposed fact does not stand up to scrutiny.

A recent study was published in the journal Atherosclerosis on Aug. 22. More than 82,000 adults in England were followed for an average of more than eight years. The relationship between a range of lifestyle factors and health markers and risk of stroke and heart disease were assessed.

Some of the factors that were associated with an increased risk of both stroke and heart disease were smoking, high blood pressure, diabetes, and low levels of physical activity.

• Higher total cholesterol levels were NOT associated with an increased risk of death due to heart disease.
• Higher total cholesterol levels were actually associated with a REDUCED risk of death due to stroke.

Here’s what the authors of this study concluded:

“Consistent with our findings, the existing evidence has generally shown that cholesterol is a stronger risk factor for coronary events than for stroke, whereas high blood pressure is a better predictor of stroke. We demonstrated an inverse association between total cholesterol and stroke risk, which is consistent with prior work, particularly in relation to fatal hemorrhagic stroke.”

What the authors appear not to be able to say up front is that their mammoth study found that higher cholesterol levels are not a risk factor for heart disease, though they do admit to the fact that higher cholesterol levels are associated with lower stroke risk.

But then they add: “Nevertheless lipid-lowering therapy with statins has shown to reduce the incidence of both thrombotic stroke and coronary disease.”

What they appear to be suggesting is that we should gloss over their findings because cholesterol-reduction with statins reduces the risk of stroke and heart disease, so cholesterol must cause these conditions after all.

But the thing about statins is that they don’t just reduce cholesterol but have range of effects that might reduce risk of cardiovascular disease, including anti-inflammatory and blood-thinning properties.

Here’s what I believe to be a more logical and honest appraisal of their study’s findings:

• Higher cholesterol levels were not associated with heart disease and were associated with a reduced risk of stroke.
• Statins reduce the risk of stroke and heart disease.
• Any benefits of statins in this regard cannot be due to their cholesterol-reducing properties.

Don’t be expecting much in the way of this sort of honest appraisal from the scientific establishment any time soon. For whatever reason, some seem keen to twist and turn in an effort to keep the cholesterol hypothesis alive.

Dr. John Briffa is a London-based physician and author with an interest in nutrition and natural medicine. His website is DrBriffa.com

Protesting mandatory vaccination of health care workers. (Louise McCoy/The Epoch Times)

Although the CDC [Centers for Disease Control and Prevention] said it would not support mandatory flu vaccinations for health care workers (imagine the lawsuits if this were a federal government mandate), various organizations have recently published policy statements in favor of such mandatory inoculations for all workers in health care facilities.

What is truly strange about this effort is that you cannot find convincing medical studies that show that vaccinating health care workers for flu actually decreases cases, on a statistical basis.

Sure, patients come down with flu after being admitted to hospital, and one can cite a death here or there. But no one has shown that vaccinating workers leads to healthier patients or fewer deaths, and the lack of convincing evidence undercuts the scientific and legal basis for mandating health care worker vaccinations.

Gregory A. Poland, M.D., has authored a large number of papers pushing mandatory flu vaccinations and has been the prime mover for this initiative since the 1990s. Dr. Poland has been a member of the CDC Advisory Committee on Immunization Practices and has done vaccine studies for many pharmaceutical firms at Mayo Clinic, where he heads the vaccine-research group.

He also was hired by the Defense Department in 1999 to go to military bases and promote anthrax vaccinations. After I noted about 20 misstatements in his presentation on anthrax and anthrax vaccine on my website, the talks abruptly ceased.

Poland acknowledges the lack of evidence supporting vaccinations in this 2007 piece: Jacobson RM, Targonski PV, Poland GA, “Why is evidence-based medicine so harsh on vaccines? An exploration of the method and its natural biases.”

Here is the abstract for Poland’s article: “Vaccines have been hailed as one of the greatest success stories of public health in the 20th century. The 20th century also produced a call for evidence-based medicine (EBM) with applications inclusive of preventive health. Since then, several major EBM analyses have called into question vaccine practices well-accepted by physicians, public health officials, and even the lay public.

“For example, while counter to existing studies and policies, EBM analyses have concluded that data are lacking to support influenza vaccination of healthcare workers to prevent flu complications among the elderly. In this review, we examine the criticisms and consider the shortcomings in the field of vaccinology as well as in the methodology of evidence-based medicine.” Vaccine. 2007 Apr 20;25(16):3165-9.

Here are Poland’s disclosures for another 2007 article: Gregory A. Poland, M.D., is the director of the Vaccine Research Group at Mayo Clinic, Rochester, MN, and has disclosed that he has served as a consultant to Dynavax, Novavax, Merck, Protein Sciences, GlaxoSmithKline, Novartis Vaccines, CSL Biotherapies, and Avianax.

Poland has also disclosed that he has received research grants from Novavax and Merck. Poland has also disclosed that he has served as a chair for the novel vaccine DMSB for Merck.

There will always be people who think they know (or are paid to know) what is best for the rest of us, evidence be damned, and will do their best to coerce us to comply.

Most of the know-it-alls in this case have been shown to be compromised by their income from the vaccine industry, and it appears their input was critical in creating the swine flu boondoggle last year. Funny how failure doesn’t stop them.

Source: AnthraxVaccine.blogspot.com/2010/09/mandating-flu-vaccine-for-health-care.html