Archive for the ‘Medicine’ Category

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Get yourself a luck-bucket

January 2, 2015

The new paper in Science showing that two-thirds of all cancers are due to random cell mutations and not due to life-style, environmental conditions or inherited predispositions, is getting a lot of attention today.

Abstract: Some tissue types give rise to human cancers millions of times more often than other tissue types. Although this has been recognized for more than a century, it has never been explained. Here, we show that the lifetime risk of cancers of many different types is strongly correlated (0.81) with the total number of divisions of the normal self-renewing cells maintaining that tissue’s homeostasis. These results suggest that only a third of the variation in cancer risk among tissues is attributable to environmental factors or inherited predispositions. The majority is due to “bad luck,” that is, random mutations arising during DNA replication in normal, noncancerous stem cells. This is important not only for understanding the disease but also for designing strategies to limit the mortality it causes.

Nearly every newspaper headline describes these random cell mutations as being “bad luck”. And that got me to wondering about the nature of “luck” and our perceptions of “luck”.

To be “lucky” an event has to be improbable. The consequences of the lucky event may be good or bad. “Luck” or “fortune” if not qualified by the word “bad” are generally taken to be “good”. Any event which is expected is never classified as being “lucky”. That somebody will win the lottery is highly likely and is not a matter of luck. That one particular person shall win the lottery will always have a very low probability and therefore becomes a lucky happening. All those who didn’t win are not “unlucky” because their loss was expected. But to have the winning ticket which is then carried away in an improbable gust of wind could be considered “unlucky”.

I like to think of luck or fortune as a flowing river. But not everybody is near this river and not all the flow is advantageous. Some of the flow is downright poisonous. The person with “good luck” is then the person who is not only near the river but also has a bucket to capture some of the advantageous flow. The difference between the lucky person and the ordinary person is then access to the river and the existence and the suitability of the “bucket”. I think of a person with “bad luck” as one with an ineffective bucket who picks up some of the “poisoned” or disadvantageous flow. The bucket is both a container and a filter. The Romans praying to the Goddess Fortuna or Hindus praying to Lakshmi are effectively trying to buy their “luck catching buckets”. Sportsmen or gamblers going through superstitious rituals before a match or a play are trying to prepare their “luck buckets”. I used to have a “lucky tie” that I always wore to job interviews. I see athletes and footballers cross themselves before their race or their game but they are only praying for their buckets.

Statistically it may be inevitable that there will be some lottery winner. The intelligent designer of the lottery well knows that he will pay out. But he does not know to whom. And he cannot exercise the control to determine (except in a rigged lottery) the winner. There are – in a simple lottery – two random events to consider:

  1. the process by which the lottery tickets are distributed, and
  2. the process by which the number of the winning ticket is selected.

Suppose there are a million tickets numbered one to one million and that one of these numbers will be selected. There is a certainty that a winning ticket will be declared. The operator of the lottery has no need of and no recourse to luck. I have to first acquire a ticket and then my number has to be selected. The odds of my being in the game are somewhat less than one and only then would I have a one-in-a-million chance of winning. My luck-catching bucket does not have to control both these events but it does need to be able to ensure that I get a number and that the particular number allocated to me is also the particular number selected to win.

So the task is to get myself an effective luck-bucket which is not too unwieldy. An instruction manual on how to use it would be helpful But first I need a map showing me where the Luck River flows. But if I don’t have a lottery ticket my luck-bucket won’t help me. So perhaps the first thing to do is to get myself into the right game.

But my buying a lottery ticket is so improbable that this too is a matter of Luck.

There’s a hole in my bucket, dear Liza, dear Liza,
There’s a hole in my bucket, dear Liza, a hole.

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Big Pharma’s “Pay-for-delay” tactics delay generic drugs and kill people

October 30, 2014

It is not often that the Huffington Post can bring itself to criticise President Obama. But even their usual blind support for Democrats in general and for Barack Obama in particular has taken a back-seat to their outrage over Obama’s support for Big Pharma and his opposition to generic drugs (often from India) and to Medicines Sans Frontiers (Doctors without borders).

Much of their indignation is due to the collusive practice of “pay-for delay” agreements made by Big Pharma with drug manufacturers – often in developing countries – to delay the introduction of generic medicines – many for life threatening conditions. The purpose of course is to keep their prices high and to maximise their profits on their successful drugs. They delayed the introduction of generic AIDS drugs and are now opposing the introduction of cancer fighting generics.

ThinkProgress: ….. the widespread and arguably collusive practice of “reverse payment” settlements — commonly referred to as “pay for delay” — between brand name drug manufacturers and their cheaper generic drug counterparts. Such arrangements involve brand name drug makers paying off generic manufacturers to delay a generic drug’s release into the market, allowing the brand name producers to further profit off of their significantly more expensive drugs. …..

The practice has been quite successful in maintaining profits. But in the developed world the high – and protected – cost of medicines take away from other resources (people and equipment). In the developing world it denies treatment to many who need it. The difference in price between a generic drug and a “brand name” drug is almost obscene. AIDS treatments of over $12,000 per year reduced to less than $400 using generics from India. A generic version of Nexavar (for treatment of liver and kidney cancer) reduced cost of treatment from $5,000 per month to just $157 per month.

A generic drug only enters the market after patent protection has expired. The original developer has by then had his time to exploit his invention. Production costs at Big Pharma are perhaps upto twice that at low-cost manufacturers – but not much more. Yet they often have support from their governments in the developed countries (in extension of patent protection through patent “bombing” and in global and bi-lateral trade agreements) in maintaining prices which are hundreds of times higher than the production cost.

In an article today HuffPo writes:

Obama Has Been Fighting Doctors Without Borders For Years

It’s a little unusual to see the Obama administration singing the praises of Doctors Without Borders, the Nobel Peace Prize-winning nonprofit that is shipping doctors, drugs and supplies to West Africa to combat the Ebola outbreak. …… But the recent executive branch acclaim for Doctors Without Borders obscures a long-running struggle between the humanitarian group and the White House over global drug prices. Through trade talks, meetings with foreign governments and negotiations with multiple U.N. bodies, the Obama administration has aggressively pursued policies that prevent poor countries from accessing low-cost generic versions of expensive name-brand medications, despite persistent calls from Doctors Without Borders for the White House to reverse course.

Americans pay the highest prescription drug prices in the world. Those prices are elevated in large part by aggressive intellectual property standards that grant pharmaceutical companies long-term monopolies on new drugs, letting firms charge whatever they want without regard to traditional market pressures. Generic drugs can’t enter the market whenever those monopolies are in place. Doctors Without Borders, along with many other medical groups and nonprofits, has spent years advocating for looser standards and greater flexibility for developing countries.

Drug companies, of course, argue that they need patents and other government perks to recoup their research and development costs. Large U.S. drug companies don’t seem to be having trouble breaking even, however. Pfizer made $22 billion in 2013, while Merck & Co. posted a $4.5 billion profit and Eli Lilly & Co. earned $4.7 billion.

India’s generic drug market has been at the center of disputes between the White House and Doctors Without Borders. AIDS and HIV medication was wildly expensive in developing countries in the late 1990s — about $12,000 a year per patient in South Africa, a country with an average income of just $2,600 a year, for instance. When Indian generics entered the global market, they were priced as low as $1 a day, enabling programs like George W. Bush’s global AIDS relief plan to serve millions of people.

U.S. drug companies are particularly concerned about repeating that experience with expensive cancer treatments, and they’ve been backed up by the Obama administration, which has placed India on it’s international trade blacklist. In the spring of 2012, U.S. Patent and Trademark Office Deputy Director Teresa Stanek Rea attacked India’s government in congressional testimony for approving a generic version of a Bayer AG cancer drug called Nexavar. The generic version cost patients$157 a month. Bayer had been charging over $5,000 a month there, in a country with a per capita income of just $1,410 per year, a price so high that less than 2 percent of potential patients were able to access the drug. But before Congress, Rea falsely called the generic approval an “egregious” violation of World Trade Organization treaties.

Doctors Without Borders called it “unprecedented, really shocking testimony,” but it wasn’t a one-time gaffe from an obscure agency official. In the summer of 2013, Secretary of State John Kerry went to India to pressure its government over its approval of generic versions of patented U.S. and European drugs. When India’s new prime minister, Narendra Modi, made his first visit to the United States in September of this year, Doctors Without Borders urged him to resist the Obama administration’s demands on generic medicine.

“India’s production of affordable medicines is a vital life-line for MSF’s medical humanitarian operations and millions of people in developing countries,” said Rohit Malpani, director of policy and analysis for MSF’s Access Campaign. “India’s patent laws and policies have fostered robust generic competition over the past decade, which has brought the price of medicines down substantially — in the case of HIV, by more than 90 percent. The world can’t afford to see India’s pharmacy shut down by U.S. commercial interests.”

Big Pharma is surely entitled to make a reasonable profit from its inventions. The development costs of unsuccessful drugs also has to be paid for. But any concept of Intellectual Property (which itself is deeply flawed) can be defended when it is based on the denial of the benefits of the invention to other than a privileged few. A denial to the point of loss of life.

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More speech gives fewer malignant breast tumours!

October 25, 2014

Who would have thought the ability to develop speech may be linked to the malignancy of breast cancer cells.

A new paper in Cell Stem Cell apparently shows that “silencing the Speech Gene FOXP2 Causes Breast Cancer Cells to Metastasize”. Forkhead box protein P2 (FOXP2) is a protein that in humans is encoded by the FOXP2 gene and which is thought to enable speech and language development in the brain. It is also known to affect tissue development. While Neanderthals had the physical capability for speech it is not known if they had the FOXP2 gene. The new paper reports that suppressing the FOXP2 gene leads to more breast cancer cells turning malignant.

Perhaps the ability to talk is a survival factor for women?

The number of genes may be finite and limited but they are expert not only at multi-tasking but also in working in very many different “teams” with other genes.

Beth Israel Press Release:

It is an intricate network of activity that enables breast cancer cells to move from the primary breast tumor and set up new growths in other parts of the body, a process known as metastasis.

Now a research team led by investigators at Beth Israel Deaconess Medical Center (BIDMC) has identified an unexpected link between a transcription factor known to regulate speech and language development and metastatic colonization of breast cancer.

Currently described online in Cell Stem Cell, the new findings demonstrate that, when silenced, the FOXP2 transcription factor, otherwise known as the speech gene, endows breast cancer cells with a number of malignant traits and properties that enable them to survive – and thrive. …

…….. FOXP2 has primarily been implicated in regulating speech and language development and several reports have described functions for this protein in developmental neurogenesis. Additional reports have also linked FOXP2 to tissue development, such as the lung.

“We were curious and wanted to find out the business of FOXP2 in breast cancer,” he adds. “Surprisingly, we found that its suppression in the tumor cells was sufficient to expand cancer stem cell traits and caused the cancer cells to metastasize much more vigorously.”

These findings agreed with similar results in which the authors determined that miR-199a upregulation and FOXP2 repression are prominent features of aggressive clinical breast cancers and represent independent prognostic parameters for overall patient survival.

“We are one step closer to understanding how cells in the tumor microenvironment, such as MSCs, promote the malignancy of neighboring cancer cells,” says Karnoub. “We’re now more closely investigating FOXP2’s potential role as a metastasis suppressor that needs to be downregulated for metastasis to take place.”

 

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Study shows that season of birth affects personality – sounds like astrology

October 20, 2014

A new study to be presented at the European College of Neuropsychopharmacology (ECNP) suggests that there may be something in astrology after all. The study is being presented at the ECNP Congress in Berlin. The researchers from Hungary find statistically significant links between season of birth and mood disorders.

astrology

I have always thought of astrology being ridiculously fanciful and horoscopes just so much hokum. But a tiny little part of my brain is always a touch uncertain. Clearly the seasons are controlled by the Earth’s relative position and its motion around the Sun. If the season of birth can affect personality then the effects of the Sun and other celestial bodies become real. That the moon may have effects on the results of cardiac surgery is apparently not just rubbish. The lunar nodal cycle does seem to correlate with happenings on Earth. The mechanisms leading to most lunar effects on tides and sedimentation and geologic accumulations and tidal flows and sea surface temperatures and climate can be put down to some interplay of gravitational forces. It is not such a long stretch to think that the gravitational effects of the larger planets may have some quite unlooked for effects on life on Earth.

Back in the days of psychedelia and Hair, we used to think that strange things would take place as the age of Aquarius dawned,  “When the moon is in the seventh house, And Jupiter aligns with Mars”.

Neuropsychopharmacology however is something quite new for me and sounds almost as arcane as astrology.

 Neuropsychopharmacology, is an interdisciplinary science related to psychopharmacology (how drugs affect the mind) and fundamental neuroscience, and is the study of the neural mechanisms that drugs act upon to influence behavior.

Professor Xenia Gonda is a clinical psychologist and pharmacist currently working as assistant professor at the Department of Clinical and Theoretical Mental Health at Semmelweis University, Budapest.

AlphaGalileo: According to lead researcher, Assistant Professor Xenia Gonda 

“Biochemical studies have shown that the season in which you are born has an influence on certain monoamine neurotransmitters, such as dopamine and serotonin, which is detectable even in adult life. This led us to believe that birth season may have a longer-lasting effect. Our work looked at over 400 subjects and matched their birth season to personality types in later life. Basically, it seems that when you are born may increase or decrease your chance of developing certain mood disorders”.

“We can’t yet say anything about the mechanisms involved. What we are now looking at is to see if there are genetic markers which are related to season of birth and mood disorder”.

The group found the following statistically significant trends:

  • cyclothymic temperament (characterized by rapid, frequent swings between sad and cheerful moods), is significantly higher in those born in the summer, in comparison with those born in the winter.
  • Hyperthymic temperament – a tendency to be excessively positive –  were significantly higher in those born in spring and summer
  • Those born in the winter were significantly less prone to irritable temperament than those born at other times of the year.
  • Those born in autumn show a significantly lower tendency to depressive temperament than those born in winter.

 Commenting for the European College of Neuropsychopharmacology, Professor Eduard Vieta (Barcelona) XY said:

“Seasons affect our mood and behavior. Even the season at our birth may influence our subsequent risk for developing certain medical conditions, including some mental disorders. What’s new from this group of researchers is the influence of season at birth and temperament. Temperaments are not disorders but biologically-driven behavioral and emotional trends. Although both genetic and environmental factors are involved in one’s temperament, now we know that the season at birth plays a role too. And the finding of “high mood” tendency (hyperthymic temperament) for those born in summer is quite intriguing.”

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WHO’s politically appointed country heads in Africa dropped the Ebola ball

October 18, 2014
Dr Louis Sambo

Dr Louis Sambo, WHO Regional Director Africa

Why are the WHO’s Regional Directors (for Africa, Dr. Luis Sambo) not answerable to the head of the WHO in Geneva?

The first indications that the Ebola ourbreak was getting out of control were raised in April by Medecins Sans Frontieres (MSF).

BBC: Medical charity Medecins Sans Frontieres (MSF) warned in April that the outbreak was out of control – something disputed by the WHO at the time.

…… In the worst affected countries – Liberia, Guinea and Sierra Leone – the Ebola virus has now killed 4,546 people with cases of infection numbering 9,191, according to the latest WHO figures.

AP carries a damning story of the complacency of the African WHO representatives who seem to have been unwilling to even acknowledge that there was a problem on their turfs. That the country heads of the WHO are mainly political appointments is not perhaps so surprising, but even all the Regional Directors around the world are apparently not responsible or accountable to the WHO head in Geneva.  That does not seem to be an organisation very conducive to taking actions on medical reasons alone. Presumably the African Regional Director is himself a political appointee (from Angola in this case) and  was elected to his position in 2005. It would seem that the position of Regional Director primarily reflects some political balance rather than just competence for the job to be done.

The outbreak began at least in January and by April had already killed 69 just in Guinea (around 70% fatalities of those infected).

AP:

In a draft document, the World Health Organization has acknowledged that it botched attempts to stop the now-spiraling Ebola outbreak in West Africa, blaming factors including incompetent staff and a lack of information.

In the document obtained by The Associated Press, the agency wrote that experts should have realized that traditional infectious disease containment methods wouldn’t work in a region with porous borders and broken health systems.

“Nearly everyone involved in the outbreak response failed to see some fairly plain writing on the wall,” WHO said in the document. “A perfect storm was brewing, ready to burst open in full force.”

The U.N. health agency acknowledged that, at times, even its own bureaucracy was a problem. It noted that the heads of WHO country offices in Africa are “politically motivated appointments” made by the WHO regional director for Africa, Dr. Luis Sambo, who does not answer to the agency’s chief in Geneva, Dr. Margaret Chan.

 ….. The document — a timeline on the Ebola outbreak — was not issued publicly but the AP was told the health agency would be releasing it earlier this week. However, WHO officials said in an email Friday that the timeline would now probably not be released publicly. No official at the agency would comment Friday on the draft report.

Dr. Peter Piot, the co-discoverer of the Ebola virus, agreed in an interview Friday that WHO acted far too slowly, largely because of its Africa office.

“It’s the regional office in Africa that’s the front line,” he said at his office in London. “And they didn’t do anything. That office is really not competent.” 

WHO’s other regional directors — the Americas, Southeast Asia, Europe, Eastern Mediterranean and the Western Pacific — are also not accountable to Geneva and are all elected by their regions.

Piot, director of the London School of Hygiene and Tropical Medicine, also questioned why it took WHO five months and 1,000 deaths before the agency declared Ebola an international health emergency in August.

“I called for a state of emergency to be declared in July and for military operations to be deployed,” Piot said. But he said WHO might have been scarred by its experience during the 2009 swine flu pandemic, when it was slammed for hyping the situation.

In late April, during a teleconference on Ebola among infectious disease experts that included WHO officials, Doctors Without Borders and the U.S. Centers for Disease Control and Prevention, questions were raised about the performance of WHO experts, as not all of them bothered to send Ebola reports to WHO headquarters, according to the draft document.

In the timeline, WHO said it was “particularly alarming” that the head of its Guinea office refused to help get visas for an expert Ebola team to come in and that $500,000 in aid was being blocked by administrative hurdles. ….

In fact the outbreak dates back at least to the beginning of this year. In Guinea, 69 people had already died between January and April 21st of Ebola:

MedicalDaily: Apr 21, 2014

Sixty-nine people have died since January of Ebola in the West African country of Guinea with 109 cases now confirmed by the World Health Organization (WHO). … WHO’s Dr. Rene Zitsamele-Coddy said in a press release. “As soon as the outbreak was confirmed on March 21, we started to work with [Guinea officials] and other partners to implement necessary measures,” she said. ”It is the first time the country is facing an Ebola outbreak, so WHO expertise in the area is valuable.”

 

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Juxtaposition: Call for health care strikes in Liberia and in the UK

October 13, 2014

There was a time when societies accepted that certain professions and essential activities and vocations were considered to transcend the right to strike. But even today there are strikes and there are strikes.

There are many heroes in West Africa who in spite of low pay, delayed salaries and a shortage of protective equipment continue to treat the many Ebola patients around them. Ninety-five health workers have so far died from the virus in Liberia.

I am sure that the calls to strike in both Liberia and the UK have their own justifications. It is just that they both come today and it is the juxtaposition of the two strike calls which I find interesting.

Liberia

BBC: Nurses and medical assistants fighting the Ebola outbreak in Liberia have largely ignored a call to strike over danger money and conditions. Most health workers were working as normal on Monday, the BBC’s Jonathan Paye-Layleh in Monrovia said. A union official said the government had coerced workers to ignore the strike – but the government said it had simply asked them to be reasonable.

Liberia is the country hit hardest by the deadliest ever Ebola outbreak. Health workers are among those most at risk of catching the disease. Ninety-five have died from the virus in Liberia.

The latest outbreak has killed more than 4,000 people in Liberia, Sierra Leone, Guinea and Nigeria since it was identified in March. …….. Liberia’s National Health Workers Association, a union, had called the strike to demand an increase in the monthly risk fee paid to those treating Ebola cases.

It wants workers to be paid a risk fee of $700 (£434) a month. The fee is currently less than $500 a month, on top of basic salaries of between $200 and $300. The association also wants more protective equipment and insurance for workers, and has accused the government of not providing enough protection from the virus.

UK

The Guardian: NHS staff are to take further industrial action next month unless ministers agree to give them a 1% pay rise.

Unions whose members are taking part in the first walkout by NHS staff over pay since 1982 will undertake further action in November if the health secretary, Jeremy Hunt, does not meet them for talks and offer more money.

“We are already planning, and will definitely be taking, further industrial action if the government doesn’t put more money on the table and doesn’t talk to us,” said Rachael Maskell, head of health at the Unite union. “There will definitely be more industrial action by NHS staff if Jeremy Hunt doesn’t sit down and talk and make more money available. It’s clear that the government are going to have to find money [to settle] this [dispute].”

The seven unions taking part in Monday’s action were discussing three options for the next stage of their attempts to force the coalition to pay all NHS staff the 1% rise recommended last year by the NHS Pay Review Body but rejected by Hunt.

Union sources said one option could be a repeat of the four-hour walkout by midwives, paramedics, porters and other non-medical staff. Another option would be to escalate that into a full-day stoppage. Or they may opt for different groups of workers taking action at different times over the course of a day.

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Safety protocols for Ebola treatment are not fool-proof

October 12, 2014

A hospital worker in Texas who helped treat Thomas Duncan, the Liberian Ebola patient who died last Wednesday, has now tested positive (to be confirmed) for the disease. He had used a full protective suit and all the safety protocols of the Center for Disease Control and Prevention (CDC) were apparently followed. If confirmed, it would be the first known case of the disease being contracted or transmitted in the U.S. The infected health worker apparently has a pet which is now being tested. A Spanish nurse in Madrid who treated a priest who had contracted Ebola was the first person infected outside West Africa. Her dog Excalibur was put down as a precaution.

One other person is in isolation at the hospital,  the Texas Health Presbyterian Hospital, which is no longer accepting emergency patients.

There is some serious speculation that the Ebola virus could become air-borne and the disease would not only be subject to transmission by contact with body fluids. Even if the case in Texas was due to some breach of safety protocols, these procedures are clearly not fool-proof. And they would be obsolete and quite ineffective if the virus is already mutating on its way to going air-borne.

It also brings into sharp focus the risks being run by health workers treating Ebola patients in West Africa.

Washington Post:

…. The worker is in isolation and in stable condition, the hospital system said.

Daniel Varga, chief clinical officer for Texas Health Resources, which operates Texas Health Presbyterian Hospital Dallas, said the worker had been under self-monitoring in recent days, which includes taking a temperature twice daily. When the health worker showed signs of a fever, the person notified the hospital, went directly there and immediately was admitted to an isolation room. Varga said the entire sequence of events took less than 90 minutes. 

The CDC did not consider person to be “high risk,” Varga said. The person treated Duncan, the Ebola patient, after his second visit to the ER, on Sept. 28. The health worker was “following full CDC precautions,” including wearing a gown, gloves, a mask and a protective face shield.

“We’re very concerned,” Varga said, though he added that the hospital is “confident that the precautions that we have in place are protecting our health-care workers.”

The hospital has put its emergency room on “diversion,” which means that ambulances are not currently bringing patients to the ER, though patients already in the hospital are still being cared for.

“The system of monitoring, quarantine and isolation was established to protect those who cared for Mr. Duncan as well as the community at large by identifying any potential Ebola cases as early as possible and getting those individuals into treatment immediately,” Varga said.

Dallas officials deployed hazmat teams to decontaminate the entrance and common areas of an apartment complex in the 3700 block of Marquita Avenue where the health worker presumptively lives and the vehicle that the person used to travel to the hospital.

This Ebola epidemic has now claimed over 4,000 lives in West Africa predominantly in Liberia, Sierra Leone and Guinea. If the disease does become air-borne it would probably happen first where the virus is present in abundance and that would probably be in West Africa.

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Effects of influensa medicines exaggerated by sponsored research

October 8, 2014

I have posted earlier about how flu vaccines tend to be over-hyped and over-promoted. A new study confirms that research sponsored by pharmaceutical companies were much more positive than those by independent researchers.

The manufacture and sale of flu vaccines is enormously lucrative. Just in the UK the program costs £120 million every year. Worldwide just influensa vaccine sales are an estimated $4 – 5 billion. The total vaccines market is expected to grow from about $30 billion in 2012 to about $40 billion in 2015! For adult vaccines the biggest growth comes from public health programs pushing influensa vaccines:

Moreover in public health programs

The names of the members of the committees which recommend wholesale flu vaccinations are often shrouded in secrecy and often  – when revealed – are found to have unhealthy ties to the manufacturers of the vaccines.

Swedish Radio reports:

In the world of research meta-analyses, reviews of research studies available, act as a quality assurance. But when Australian researchers reviewed 26 meta-analyses of so-called neuraminidase inhibitors it was apparent that researchers sponsored by pharmaceutical companies had made more positive conclusions than their independent counterparts.

The study is published in Annals of Internal Medicine, writes The Guardian.

But the phenomenon is not new in the scientific community.

“There are lots of examples of how corrupt the system has been” said Björn Beermann, former professor at the MPA.

Last spring, it was revealed through the research network Cochrane that Tamiflu in principle was ineffective and that the pharmaceutical company Roche had regularly concealed “negative” research findings. It caused a debate about Sweden’s decision to buy into a giant stock of Tamiflu for a quarter of a billion kronor. Globally the bill amounted to nearly seven billion kronor ($1 billion).

In recent years it has become more difficult to conceal studies with undesirable results. Now, all the studies that seek publication have to be notified in advance of the study being conducted.

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And the Medicine Nobel goes to …..O’Keefe, Moser and Moser

October 6, 2014

The Nobel Assembly at Karolinska Institutet has today decided to award The 2014 Nobel Prize in Physiology or Medicine with one half to John O´Keefe and the other half jointly to May‐Britt Moser and Edvard I. Moser for their discoveries of cells that constitute a positioning system in the brain

The winners were not among the Thomson-Reuters predictions.

Chillies will have to wait.

===============================================

I like chillies.

After all chillies are what distinguish humans from animals. As Paul Bloom, a Yale psychologist, puts it,

“Philosophers have often looked for the defining feature of humans — language, rationality, culture and so on. I’d stick with this: Man is the only animal that likes Tabasco sauce.”

 

And few chutneys are better than a Vengayaa chutney with onions and red chillies.

Which is as good a reason as any for suggesting that David Julius will be awarded the prize for his discovery of the genes that determine how we feel pain, heat and cold. He has studied chilies and how pain and heat are experienced.

I am not sure if he is the favourite but his name is tipped by the Svenska Dagbaldet this morning

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Low-salt pseudo science

August 19, 2014

For almost 100 years, some scientists have been warning about the harmful effects of salt in our diets. For the last 40 years or so that has also been the “consensus” view of the medical/regulatory establishment. It was “settled science” we were told. There was complete “consensus” within the medical world it was proclaimed.

Salt was evil.

But apparently the “settled” science was not quite so settled after all. The “consensus” was nothing more than “group think”. In the words of the Wall Street Journal:

Yet the latest USDA food pyramid, which was updated as recently as 2011, clings to simplistic low-salt pseudo-science. The FDA is pressuring food manufacturers and restaurants to remove salt from their recipes and menus, while the public health lobby is still urging the agency to go further and regulate NaCl as if it were a poison.

The larger point is that no scientific enterprise is static, and political claims that some line of inquiry is over and “settled” are usually good indications that real debate and uncertainty are aboil. In medicine in particular, the illusion that science can provide some objective answer that applies to everyone—how much salt to eat, how and how often to screen for cancer, even whom to treat with cholesterol-lowering drugs, and so on—is a special danger.

It is not so easy now to retrace exactly how the salt scare developed and became part of the establishment view. Certainly Lewis Dahl of the Brookhaven National Laboratory was one of the key actors who spread the alarm. He was well placed within US Government circles and soon rather dubious and alarmist conclusions became part of the “establishment view”. Pseudo science became “settled science”:

Scientific American:

In 1904 French doctors reported that six of their subjects who had high blood pressure—a known risk factor for heart disease—were salt fiends. Worries escalated in the 1970s when Brookhaven National Laboratory’s Lewis Dahl claimed that he had  “unequivocal” evidence that salt causes hypertension: he induced high blood pressure in rats by feeding them the human equivalent of 500 grams of sodium a day. (Today the average American consumes 3.4 grams of sodium, or 8.5 grams of salt, a day.)

Dahl also discovered population trends that continue to be cited as strong evidence of a link between salt intake and high blood pressure. People living in countries with a high salt consumption—such as Japan—also tend to have high blood pressure and more strokes. But as a paper pointed out several years later in the American Journal of Hypertension, scientists had little luck finding such associations when they compared sodium intakes within populations, which suggested that genetics or other cultural factors might be the culprit. Nevertheless, in 1977 the U.S. Senate’s Select Committee on Nutrition and Human Needs released a report recommending that Americans cut their salt intake by 50 to 85 percent, based largely on Dahl’s work.

Thereafter “group think” took over. Consensus opinion – and not objective science – ruled. Now we are finding out that there is no clear evidence that salt is harmful and there is some evidence that too little salt is dangerous and can increase the risk of heart disease.

Scientific American:

In April 2010 the Institute of Medicine urged the U.S. Food and Drug Administration to regulate the amount of salt that food manufacturers put into products; New York City Mayor Michael Bloomberg has already convinced 16 companies to do so voluntarily. But if the U.S. does conquer salt, what will we gain? Bland french fries, for sure. But a healthy nation? Not necessarily.

This week a meta-analysis of seven studies involving a total of 6,250 subjects in the American Journal of Hypertension found no strong evidence that cutting salt intake reduces the risk for heart attacks, strokes or death in people with normal or high blood pressure. In May European researchers publishing in the Journal of the American Medical Association reported that the less sodium that study subjects excreted in their urine—an excellent measure of prior consumption—the greater their risk was of dying from heart disease. These findings call into question the common wisdom that excess salt is bad for you, but the evidence linking salt to heart disease has always been tenuous.

It has taken 40 years for this alarmist meme that salt is harmful to be brought down to earth. Group-think and “consensus science” has its own inertia which makes it difficult to overturn what becomes matters of faith rather than of evidence.

And just a few days ago another establishment paper created headlines when it stated that salt “causes 1.65 million deaths every year across the globe. A published study in New England Journal of Medicine on Thursday, found that an average consumed salt (sodium) per day is twice the amount recommended by the World Health Organization. A 3.95 gm consumption per day beyond the recommended amount of 2 gm”. But all they actually did was measure/estimate salt consumption and then multiplied that by an assumed death rate.  By the time the headlines were written a simple measurement of salt consumption became evidence of the dangers of salt! That’s consensus science!

The 1970s and 80s saw many such alarmist memes – based on little and dubious science – become the “consensus view” and the “politically correct” faith to be followed. It was the time when the nonsensical “Limits to Growth” became the bible of the day. It was the time of the DDT scare where the disadvantages were blown out of all proportion and the subsequent ban has been a case of “throwing the baby out with the bath water. Natural variations of the ozone hole were taken to be due to the human use of fluorocarbons. Acid rain was going to kill all the forests.

Whenever I now hear that some science is “settled” or that there is a consensus around some “belief” – as with climate science today – I am inclined to view the claims with a very large bushel of salt.

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Posted in Alarmism, Medicine | Comments Off on Low-salt pseudo science

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