Tag Archives: diseases

RN #3: Health news: Exercise and depression. Aspirin for primary prevention. New stool sample test.

exercise-or-drugs-for-depression

Reading Notes #3: Some articles of interest I’ve come across while reading NEJM and JAMA. These items all fall into the category of health news.

Bulleted titles in the following list link to the individual items below. Under References I indicate the accessibility of articles: OA means open access, $ indicates a pay wall.

HEALTH NEWS

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Pharma finds creative new ways to be reprehensible

brand-vs-generic-drugsThe pharmaceutical industry is in the business of making profits. It’s not in the business of improving the health of individuals or populations, nor does it care about the cost of health care, even as those costs spiral out of control in the US.

This is hardly news, I know. The behavior of pharma, along with its reputation, has perhaps sunk lower than that of the tobacco industry. Public disapproval and huge monetary fines for illegal activities have no impact. In its quest for profits, pharma finds creative new ways to sink to ever greater depths.

An article in a recent issue of The New England Journal of Medicine illustrates this. Read more

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When healthy eating becomes unhealthy

healthy-eating-orthorexiaMeghan O’Rourke, poet and author (Halflife: Poems, Once: Poems, The Long Goodbye: A Year of Grieving), has written a wonderful piece for The New Yorker on living with a chronic illness. It’s called What’s Wrong with Me? I had an autoimmune disease. Then the disease had me.

For years O’Rourke experienced symptoms that she tried to attribute to her latest source of stress. Doctors were unable to offer a diagnosis, a situation that tends to suggest the suspicion that the symptoms may be all in your head.

She writes: “I was ill for a long time — at least half a dozen years – before any doctor I saw believed I had a disease.” Eventually, after she received a label for her symptoms (autoimmune thyroiditis or Hashimoto’s disease), she connected to the online community of chronic disease sufferers. There she found not only a great many individuals with similarly frustrating histories, but an abundance of home-grown advice for the relief of symptoms.

A more or less definitive diagnosis for a disease that is only vaguely understood may at least confer some legitimacy on one’s status as a patient (for an historical perspective on diseases that do not fall neatly into diagnostic categories, see Robert Aronowitz, Making Sense of Illness .) The individuals who suffer, however, are still very much on their own when it comes to recovery and the alleviation of symptoms. Thus the home-grown advice.

Orthorexia and healthism

What I’d like to focus on in this post is one small part of O’Rourke’s narrative: her attempts to alleviate her symptoms through a growing obsession with the selection and control of the food she ate. It’s not difficult to find media stories and blog posts that put a positive spin on (what amounts to) an excessive preoccupation with healthy eating. It’s rare, however, to find an experiential account that recognizes the obsessive pursuit of health as itself unhealthy.

A classic discussion of the latter is Steven Bratman’s Health Food Junkies: Orthorexia Nervosa – the Health Food Eating Disorder. In O’Rourke’s case, of course, she was not simply eating to be healthy. She was seeking relief from very real and disturbing symptoms. That’s not quite the same thing as orthorexia, although both provide the health food consumer with an opportunity for reflection. Read more

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Old age and the limitations of a healthy lifestyle

Old age and Alzheimer'sA nice op-ed in the NY Times touches on our belief that living a healthy lifestyle guarantees a long and able-bodied life. The author, Susan Jacoby, speaks specifically to the issue of dementia and Alzheimer’s.

Members of the “forever young” generation — who, unless a social catastrophe intervenes, will live even longer than their parents — prefer to think about aging as a controllable experience. …

Contrary to what the baby boom generation prefers to believe, there is almost no scientifically reliable evidence that “living right” — whether that means exercising, eating a nutritious diet or continuing to work hard — significantly delays or prevents Alzheimer’s. …

Good health habits and strenuous intellectual effort are beneficial in themselves, but they will not protect us from a silent, genetically influenced disaster that might already be unfolding in our brains.

Jacoby cites a review of knowledge about Alzheimer’s sponsored by the National Institute of Health. (emphasis added) Read more

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Tony Judt lives on

Tony Judt The Memory ChaletI miss Tony Judt. As I read the news every day, I speculate on what he would have to say. I was thinking of him during the mid-term elections as I listened to blatant misinformation about the Affordable Care Act coming from conservative politicians. Judt was interested in broader themes than mid-terms and health care, but his life was about intellectual honesty. He was never afraid to speak the truth, even if his position was controversial. Timothy Garton Ash makes this point quite nicely in his obituary of Judt.

So I was momentarily shocked today to see – in The New York Times – an op-ed by Judt. Turns out it’s from a collection of essays, The Memory Chalet, which goes on sale this Thursday. I was pleased to see that this particular essay – on New York City — was not one that I’d already read in The New York Review, so there are more new essays to read. The New York piece is a good example of how superbly Judt could write.

According to Timothy Synder, there is also a forthcoming book that he and Judt worked on together. Read more

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Knowing when you’ll die: Tony Judt’s last interview

Tony Judt on Charlie RoseTony Judt died on August 6. He had been diagnosed with ALS (Lou Gehrig’s disease) in September of 2008. Over the years he had been both guest and guest host on the Charlie Rose show. Rose interviewed Judt just eight days before he died. As you can see from the video, Rose was visibly moved as he introduced the interview – Judt’s last, as it turned out.

Contemplating death

Death is a huge uncertainty in anyone’s life. A friend once told me of a woman with leukemia who said “At least now I know what I’m going to die from.” For some, this knowledge brings relief.

What I find fascinating about the shared experiences of those with a limited time to live is the uniqueness of each response. What I find valuable is the opportunity to contemplate my own life and death.

Here is Judt’s answer to a question on his thoughts on dying and any insights into living.

I’m better on living than I am on dying because, until you die, you know nothing about it, but by then it’s too late. But I can tell you a little bit about the peculiarity of knowing you’re going to die and knowing when – roughly speaking.

Most of us, most of the time, have absolutely no idea where we’ll be in five years – you, me, anyone — anything could happen to a normal person. But we’re pretty clear where we’ll be next month: doing the same thing we’re doing this month.

My situation is exactly the reverse. I have no idea where I’ll be next month. I could be silent. I could be dead. I could be exactly like this. I could be in a variety of stages. But I know, absolutely with certainty – within reason – that I’ll be dead in five years. And that reversal of consciousness means that I am very focused upon life in the next two weeks.

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Tony Judt — continued

Tony JudtMore tributes to Tony Judt following his death on Friday.

Tony Judt, Historian And Author, Dies At 62 (NPR)

Focuses on the controversy over Judt’s position on Israel.

“I think he was one of the most important intellectual historians of our era,” said Rashid Khalidi, a professor of Middle East history at Columbia University and a friend of Judt’s. “He was also, I think, one of the most courageous public intellectuals of his generation.”

His 2003 essay on Israel caused a firestorm. In it, Judt called for a single, binational Jewish-Arab state in the Middle East. He lost many friends over that essay.

“I think he thought he was performing a public service,” said Khalidi. “I think he felt there is so much misinformation that it would be inevitable that he was saying things frankly and bluntly that people didn’t want to hear [and] would inevitably make him unpopular. I don’t think he cared about it.”

Tony Judt, scholar of European history, dies at 62 (Washington Post)

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I am saddened by the death of Tony Judt

Tony JudtI feel as if I’ve been on a death watch for Tony Judt all year. In his January essay, “Night,” in The New York Review of Books, he discussed his 2008 diagnosis of amyotrophic lateral sclerosis (ALS), commonly known as Lou Gehrig’s disease.

Helplessness is humiliating even in a passing crisis—imagine or recall some occasion when you have fallen down or otherwise required physical assistance from strangers. Imagine the mind’s response to the knowledge that the peculiarly humiliating helplessness of ALS is a life sentence (we speak blithely of death sentences in this connection, but actually the latter would be a relief).

Judt’s brilliant mind remained undiminished by the disease. He dictated a series of essays – autobiographical reminiscences with contemporary insights. They appeared in each new issue of the NYRB.

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Tony Judt and the Move for ALS bike ride

Saul Goldberg and Tony Judt
Saul Goldberg and Tony Judt
Saul Goldberg, a student of Tony Judt, will be cycling across the country this month to raise money for ALS (Lou Gehrig’s disease) and to increase awareness of this devastating disease. Goldberg will travel from Astoria, Oregon to Brighton Beach, New York, leaving on May 25th and arriving on July 25th.

Those who would like to participate in the Move for ALS ride are welcome to join for any portion of the trip, moving on foot, by bike, or in a wheelchair. The trip itinerary is posted on the Move for ALS website, and I’ve posted the map below. Goldberg will be accompanied the entire length of the ride by Augustin Quancard.

Move for ALS hopes to raise $75,000 for Project A.L.S., a non-profit organization that seeks to find effective treatments for ALS and ultimately a cure. Currently more than half that sum has been donated. The Move for ALS website has more information, plus videos and a blog.

Here is a statement from Tony Judt on ALS and the Move for ALs project:

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Why we passed health care: WellPoint and breast cancer

Reuters has a terrific investigative piece on WellPoint’s practice of canceling health insurance, a practice known as rescission. When a woman develops breast cancer, WellPoint immediately flags her for investigation to see if there’s some reason her policy can be canceled. Grounds for cancellation can be anything on the original insurance application that appears to be an omission or misrepresentation.

The grounds for cancellation are often flimsy at best. A 2007 California investigation of a WellPoint subsidiary looked at 90 randomly selected cases of dropped insurance. There wasn’t a single case where the evidence indicated the applicant had intentionally omitted or misrepresented anything.

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FDA video on health fraud: So boring it makes you wonder

FDA health fraud awareness

Source: Dipity

The Food and Drug Administration (FDA) has a new video on health fraud awareness. A worthy topic. It touches on weight loss products, HIV scams, cures for cancer and diabetes. What’s noteworthy about the video is that it’s SO boring. The inflections of the voiceover are totally inauthentic. It has the pacing of a 1970s newscast. There’s almost no music. It’s not sufficiently interesting to grab and hold anyone’s attention.
News – and not just TV news — has become infotainment. I would be the first to complain that this is a tragedy with major implications. But it’s also a reality. To compete for attention, you need some creativity. The chances that this video had any input from a decent ad agency are slim.

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Daily Dose: Climate change: How bad can it get; FDR's death; Yawns; Facebook

Penguins fight back on climate change

Source: Sacramento for Democracy

Climate change

Copenhagen climate summit: Five possible scenarios for our future climate (The Guardian)
Concise summary of what we can expect for each increase of one degree Celcius (1.8 degrees Fahrenheit) in global temperature. Here are a few of the health implications.
1C: “Most of the world’s corals will die, including the Great Barrier Reef. Glaciers that provide crops for 50m people with fresh water begin to melt and 300,000 people are affected every year by climate-related diseases such as malaria and diarrhoea.”
2C: “The heatwaves seen in Europe during 2003, which killed tens of thousands of people, will come back every year. … More than 60 million people, mainly in Africa, would be exposed to higher rates of malaria. Agricultural yields around the world will drop and half a billion people will be at greater risk of starvation. … Glaciers all over the world will recede, reducing the fresh water supply for major cities including Los Angeles.”

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Can you get swine flu by eating pork and other myths

Nasal vaccine

Source: China View

Christopher Beam, writing on Slate, points out that opposition to vaccines unites both ends of the political spectrum. “Swine flu may have an unexpected side effect: political unity. The far left and far right agree that they’re sure as heck not getting vaccinated against swine flu.”
The far right objects to the vaccine because it comes from the government. The sentiment is not limited to US citizens. I found this comment from an Israeli in response to an article in the UK’s Daily Mail:
“I find it very interesting that the vaccine does the opposite of what its supposed to do. Is any one open to the thought that this is intentional? That the people in power are using this is a means for population control? And the fact that governments are in the process of making this vaccine MANDATORY??”

Thermerosal

Opposition on the left comes from doctors, lawyers, and celebrities. Jim Carrey promotes the claim that vaccines cause autism. The usual culprit is mercury in the preservative thermerosal. Note that a definitive study (PDF) published last week finds that children with autism have the same levels of mercury in their blood as “typically developing” children. The study found that children who chew gum have higher levels of mercury.

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Questions worth asking about swine flu vaccinations

Child getting vaccinated

Source: TopNews

The questions raised by Dr. Mercola about swine flu vaccinations – such as, Are you willing to let the government experiment on your child? – are simply inflammatory and self-serving.
There are some legitimate questions, however. For example: Where is the vaccine manufactured?
The current supply of H1N1 flu vaccine comes from US and European manufacturers. For what it’s worth, these manufacturers are approved by the FDA. I add that caveat only because the FDA has limited capabilities, as we’ve seen with recent episodes of food poisoning.
Since an adequate supply of the vaccine is now a problem, it’s reasonable to ask if the roster of suppliers will expand. Two manufacturers in China are now licensed to produce the vaccine. It may not happen during the current flu season, but how long will it be before vaccines manufactured in Asia are shipped to the US?

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Why it’s safe to completely ignore Dr. Mercola

A chiropractor for whom I have considerable respect – she’s a scientist, formerly an aeronautical engineer – is handing out copies of an article by Dr. Mercola that recommends against the swine flu vaccine. Another chiropractor told me she knew of no one in her profession who would receive, or allow their children to receive, vaccinations of any sort. She promptly added that, being “only” a chiropractor, she couldn’t legally make such a recommendation anyway.
Is the safety of vaccines merely a difference of opinion? Everything I’ve read on the scientific evidence for vaccine side-effects – which is the primary grounds for opposition – favors vaccination.

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Swine flu prevention: It’s OK to wash in cold water

Hand washing

Source: NAPS Company

Most people would prefer to wash their hands in comfortably warm water. And it’s usually available. The scientific question remains, however: Is warm or hot water more effective than cold if we want to prevent spreading the flu?
The FDA’s position has been that water hot enough to kill bacteria would be too hot for hand washing. Still, they maintained, warm water is more effective than cold because it removes oil from our hands. And there can be bacteria in that oil.

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Swine flu and hand washing: The how, the when, and the why

Hand washing children mother

Source: PR Newswire

There are a number of things about the H1N1 (swine) flu that are different from the seasonal flu we see each year. For example, adolescents are at a greater risk of dying than younger children. This is just the opposite of what we typically expect. In a normal flu season, at least half the deaths are among children younger than 5. With swine flu, 80% of deaths have occurred in children ages 5 to 18.
Normally, flu fatalities are higher among older adults, but that’s not true for swine flu. Three out of five deaths have happened in people younger than 50. “Sophisticated” laboratory tests indicate that the immune systems of older adults are providing an unusual amount of protection against the swine flu virus. This suggests that adults over 50 were exposed to an ancestor of the H1N1 virus – probably when they were children – and their immune systems are now prepared to defend against related strains.

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Swine flu, kids, and a "wash your hands" rap video

Mother and sick child

Source: Feelgood Health

Here’s a well-written story by a mother (Brigid Schulte) whose son caught the flu at summer camp. She ended up nursing a houseful of sick patients, including herself. Everyone survived, but it was no picnic.
The subtitle of the article is “During the Swine Flu Season, Think Before You Share a Drink With Someone.” She had innocently offered her water glass to her thirsty son the day before he started showing symptoms.

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Flu season: Should we stop shaking hands?

Greetings during flu season

Source: The New York Times

Click photo for larger view.

What with the start of school, the flu season may already be here. Washington State University has already reported over 2000 students with flu symptoms.
Public health officials recommend staying three to five feet away from anyone who coughs or sneezes. Also from anyone who might be infected. But how do we know if someone is carrying the flu if they’re not yet showing symptoms? Are we to stop shaking hands with business colleagues and giving hugs to arriving friends?

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Preparing for the flu: Why don't we do it in our sleeves?

Sneeze in your sleeve

Source: Coughsafe.com

Goodness! I’ve been sneezing into my elbow and didn’t realize it was socially unacceptable.
It makes so much sense. You should never sneeze into your hands unless you can wash them without first touching something. Handkerchiefs collect germs and tissues should be used only once.
This first video is from the CDC and makes a good lesson for kids.

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Health Culture Daily Dose #16

Here are some things I’ve come across recently. Categories include: Aging/End of Life/Death, Doctors, Influenza, Genetics, and Health Care Reform.

AGING, END OF LIFE, AND DEATH

End-of-Life Care: Where Ethics Meet Economics (The New York Times – Uwe Reinhardt)
Health spending in the United States has doubled every 10 years during the last four decades. Americans sooner or later will have to confront the hard questions about access to expensive treatments, perhaps after a rational national conversation, if such can still be had in America.
Health Care’s Generation Gap (The New York Times – Richard Dooling)
Money spent on exorbitant intensive-care medicine for dying, elderly people should be redirected to preventive care for children and mothers.

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Fear of flying: Will I catch swine flu on an airplane?

When you breathe recirculated airplane air, do you expose yourself to the coughs and sneezes of everyone onboard?
Well, not quite everyone. Most airlines do not circulate air along the length of the cabin, allowing it to interact with every passenger. Air is circulated from side to side in discrete sections of the plane. The passengers you’re most exposed to are those sitting near you, which would be true even if the air wasn’t recirculated.
A review of research, published in The Lancet, concluded that the chances of contracting an air-borne disease increase when you sit no more than two rows away from an already-infected passenger. This assumes an eight-hour flight. More recent evidence suggests the safety margin is more like seven rows on a three-hour flight. This risk is not unique to airplanes, of course. It applies to any confined public space, such as a classroom.

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You want salt with that Moons Over My Hammy?

You already know Denny’s doesn’t exactly serve health food, so is it worth getting worked up over how much salt is in a typical Denny’s meal? The Center for Science in the Public Interest (CSPI) thinks so. They’ve initiated a lawsuit against Denny’s over the salt content of their meals.
Salt is 40% sodium, and it’s the sodium you want to limit in your diet, especially if you have high blood pressure. The recommended amount of sodium in the daily diet of a normal, healthy person is 2,300 mg. People with high blood pressure are advised to limit their sodium to 1,500 mg. The lawsuit claims that 75% of Denny’s meals contain more than 1,500 mg and that this puts the health of unsuspecting diners in jeopardy.
Not only is there too much salt at Denny’s, but it’s almost impossible to find out how much you’re eating. Some information is online, and if you’re very persistent, you may be able to get one of Denny’s little pamphlets with nutritional facts. According to the lawsuit (PDF), however, “the nutrition information available from Denny’s is so incomprehensible that calculation of each meal’s sodium content is impossible for the reasonable consumer to perform.”

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Sotomayor's diabetes: A legitimate reservation or discrimination?

Sonia Sotomayor

Source: 103.7 The Buzz

Just how important are medical issues when considering a nominee for the Supreme Court? Living to a ripe old age is important, since justices serve for life. Clarity of mind is also important, given the nature of the job. Low blood sugar, for example, could theoretically impair judgment. Both of these health issues have been raised in connection with Supreme Court nominee Sonia Sotomayor’s Type I (juvenile) diabetes.
Diabetes increases the risk of kidney and heart disease, stroke and nerve damage. According to Joana Casas, who’s with the Juvenile Diabetes Research Foundation, “The average life expectancy for people with Type One is lowered by an average of ten years.” According to other sources, a woman with Type I diabetes who has already reached age 50 can expect her life to be shortened by eight years. Sotomayor appears to be healthier than most, with no evidence of eye, kidney, nerve, or heart problems, so her prospects may be even better.

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Will health care reform stop the rising cost of health care?

healthcare-costsAs we get into the nitty-gritty of health care reform, critcs from both left and right are asking whether current proposals will reduce costs. Here we have a historic opportunity to make major changes in health care, but it appears no one is willing to address the problem of escalating costs.

The public insurance option might reduce the cost of insurance by competing with for-profit insurers. But this doesn’t reduce the number of unnecessary procedures. As David Brooks points out in a NY Times column, the public option, as it’s currently formulated, would have no effect on the fundamental incentives that lead to higher costs. Read more

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Health Culture Daily Dose #15

In today’s Dose: Health care reform (A public option plan emerges from HELP committee; Arguments for the public option from the Urban Institute; Obama stands Harry & Louise on their heads) Health news (Should Steve Jobs use his celebrity status for pancreatic cancer awareness and funding?) Industrialized agriculture (Labeling organic food: What can you believe?;… Read more

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Health Culture Daily Dose #3

In today’s Dose: Health care reform (Gawande radio interview; Public option) Health news (Bayer and prostate cancer) Obesity politics (Michelle Obama) Social networking technology (Doctors on Twitter and email) Health care reform National Public Radio has an interview with Atul Gawande about his recent New Yorker article. It’s 30 minutes and covers much the same… Read more

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Flu news overdose

Source: SeniorArk Newsweek has a feature where you can compete for the best six-word tweet on the cover story. The winners for the swine flu cover story: “Over estimated, over reported, over it” and “Blah, blah, swine flu, blah, blah.” The public health establishments, such as the Centers for Disease Control and the World Health… Read more

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