Eideard

Medical aid in the snow — does it matter which war?

The Army has removed the head of the Madigan Army Medical Center in Washington state during an investigation into whether soldiers had diagnoses of post-traumatic stress disorder reversed to reduce medical costs.

“This is a common practice during ongoing investigations and nothing more,” Maj. Gen. Phillip Volpe, who heads the Western Region Medical Command, said Monday about the removal of Col. Dallas Homas.

Homas is a West Point graduate whose career has included deployments to Afghanistan and Iraq, where he served as command surgeon. His military honors include two Bronze Stars…

The focus of the Army Medical Command investigation is a Madigan forensic psychiatric team that has the lead role in screening soldiers being considered for medical retirement due to PTSD, a condition that results from experiencing or seeing a traumatic event, such as a battlefield casualty.

Symptoms can include recurrent nightmares, flashbacks, irritability and feeling distant from other people. Soldiers diagnosed with PTSD gain at least a 50 percent rating of disability, and qualify for pensions, family health insurance and other financial benefits.

In 2011, an ombudsman investigated complaints from soldiers who said the forensic psychiatric team had reversed earlier diagnoses of PTSD and tagged some of them as possible malingerers.

The ombudsman also wrote a memo about a lecture in which a member of the forensic psychiatric team talked about the need to be good stewards of taxpayer dollars and not rubber stamp PTSD diagnoses that could result in a soldier earning $1.5 million in benefits over a lifetime…

I didn’t know there was a specific field of psychiatric study dedicated to oversight by beancounters.

The ombudsman investigation resulted in more than a dozen soldiers getting a chance for a second PTSD screening by doctors from Walter Reed National Military Medical Center outside Washington, D.C.

Fourteen of those soldiers will have the results of their Walter Reed reviews detailed in individual meetings at Madigan with Col. Rebecca Porter, chief of behavioral health, Office of the U.S. Army Surgeon General.

One would hope the analysis reverts to psychiatric concerns rather than saving the budget.

But, I shall never forget the times he woke in the middle of the night and rolled under his bed because he thought there was incoming artillery fire – and that he was back in Bastogne in the winter of 1944-45.

Fine atmospheric particles — smaller than one-thirtieth of the diameter of a human hair — were identified more than 20 years ago as the most lethal of the widely dispersed air pollutants in the United States. Linked to both heart and lung disease, they kill an estimated 50,000 Americans each year. But more recently, scientists have been puzzled to learn that a subset of these particles, called secondary organic aerosols, has a greater total mass, and is thus more dangerous, than previously understood.

A batch of new scientific findings is helping sort out the discrepancy, including, most recently, a study led by scientists at the University of California, Irvine, and the Pacific Northwest National Laboratory in Richland, Wash…It indicates that the compounds’ persistence in the atmosphere was under-represented in older scientific models.

“If the authors’ analysis is correct, the public is now facing a false sense of security in knowing whether the air they breathe is indeed safe,” said Bill Becker, of the National Association of Clean Air Agencies.

Taken together, the findings of the new study and of a handful of others published in the past two years could mean that two decades’ worth of pollution-control strategies — focused on keeping tiny particles from escaping into the atmosphere — have addressed only part of the problem.

Scientists and regulators say that new models, strategies and technologies would be needed to address the secondary organic aerosol particles, which are formed not during combustion but later, in the wake of interactions between pollutants and natural chemical compounds…

The Irvine study of the formation of secondary compounds in the atmosphere…upends previous assumptions about the fate of the byproducts of the pollution from internal-combustion engines. These gaseous byproducts were thought to incorporate themselves into tiny airborne drops of liquid that would then dissipate quickly as the drops evaporated.

The new study finds instead that they attach themselves more tightly to airborne organic particles, creating tiny tar balls that evaporate more slowly and persist longer than anyone had thought. E.P.A. models built on these assumptions now appear to understate the total amount of fine particles, according to Barbara J. Finlayson-Pitts…one of the study’s authors.

“If you’re going to use models in a predictive sense, you need to make sure they are getting the right answer for the right reasons,” she said. “Right now most models are not getting the right answer.”

Great. RTFA for a few more comments on the need for more study, greater concern. Comments which come from scientists associated with a wide range of that portion of the political spectrum that at least recognizes science as a means of understanding and perfecting life as we know it.

A Swedish man was dug out alive after being snowed in to his car on a forest track for two months with no food, police and local media have reported.

The 45-year-old from southern Sweden was found on Friday, emaciated and too weak to utter more than a few words. He was found not far from the city of Umea in the north of Sweden by snowmobilers who thought they had come across a car wreck until they dug their way to a window and saw movement inside.

The man, who was laying in the back seat in a sleeping bag, said he had been in the car since December 19.

“Just incredible that he’s alive considering that he had no food, but also since it’s been really cold for some time after Christmas,” a rescue team member told regional daily Vasterbottens-Kuriren, which broke the news…

Umea University Hospital, where the man is recovering after being rescued by police and a rescue team, said in a statement he was doing well considering the circumstances.

Doctors at the hospital said humans would normally be able to survive for about four weeks without food. Besides eating snow, the man probably survived by going into a dormant-like state, physician Stefan Branth told Vasterbottens-Kuriren.

“A bit like a bear that hibernates. Humans can do that,” he said. “He probably had a body temperature of around 31 degrees (Celsius) which the body adjusted to. Due to the low temperature, not much energy was used up.”

The police hope that sooner or later he’ll be able to tell folks what he was doing out there.

Doctor Allan LeReau

Pediatricians fed up with parents who refuse to vaccinate their children out of concern it can cause autism or other problems increasingly are “firing” such families from their practices, raising questions about a doctor’s responsibility to these patients.

Medical associations don’t recommend such patient bans, but the practice appears to be growing, according to vaccine researchers…

In a study of Connecticut pediatricians published last year, some 30% of 133 doctors said they had asked a family to leave their practice for vaccine refusal, and a recent survey of 909 Midwestern pediatricians found that 21% reported discharging families for the same reason…

Most pediatricians consider preventing disease through vaccines a primary goal of their job. The Centers for Disease Control and Prevention and AAP issue an annual recommended vaccination schedule, but some parents ask if their child’s immunizations can be pushed back or skipped altogether, pediatricians say.

It’s hard to imagine an outbreak of smallpox today. But for centuries the deadly virus wiped out entire populations. WSJ’s Christina Tsuei reports on how the discovery of vaccines (with the help of cows) eradicated the disease and led to the prevention of many other diseases.

While rates for several key inoculations in young children rose between 2009 and 2010, according to the CDC, lower immunization rates have been blamed as a factor in U.S. outbreaks of whooping cough and measles in recent years.

Parents often voice concerns about autism or that their child’s immune system may be overwhelmed by too many vaccines at once…Numerous studies since have dispelled these concerns among scientists. Rather, scientists say, it is more likely that autism symptoms begin showing up around the same age children are vaccinated…

But, parents whose primary source of medical knowledge is Mr. Stupid and Greedy who’s selling the latest spooky cure-all tome aren’t about to listen to their doctor.

Read the rest of this entry »

A newlywed woman in a village in the Indian state of Madhya Pradesh has won her struggle to have a toilet at her husband’s home.

Anita Narre left husband Shivram’s home two days after her marriage in May last year because the house had no toilet. She returned eight days later after Shivram, a daily wage worker, built one with savings and aid from villagers.

An NGO announced a $10,000 reward for Mrs Narre for her “brave” decision and forcing her husband to build a toilet.

More than half-a-billion Indians still lack access to basic sanitation. The problem is acute in rural India and it is the women who suffer most.

Shivram said he was not able to build a toilet at home because of lack of money. He admitted that his wife returned home only after he constructed one with his savings and “some support from the village council”.

“It is not nice for women to go outside to defecate. That’s why every home should have a toilet. Those who don’t should make sure there is one,” Mrs Narre told the BBC.

I’m with you Mrs Narre, Lots of younger folks won’t remember how primitive toilet accommodations can be. Even an outdoors privy can be made usable with care and good design. It’s always worth the effort in terms of health and sanity.

And we had a hell of a celebration when they finally installed the indoor crapper. Made winter visits practical.

A reasonable alternative

New research suggests that consuming between 2,100 and 6,000 calories per day may double the risk of memory loss, or mild cognitive impairment (MCI), among people age 70 and older. The study…will be presented at the American Academy of Neurology’s 64th Annual Meeting in New Orleans April 21 to April 28, 2012. MCI is the stage between normal memory loss that comes with aging and early Alzheimer’s disease.

“We observed a dose-response pattern which simply means; the higher the amount of calories consumed each day, the higher the risk of MCI,” said study author Yonas E. Geda, MD, MSc, with the Mayo Clinic in Scottsdale, Arizona…

The study involved 1,233 people between the ages of 70 and 89 and free of dementia residing in Olmsted County, Minn. Of those, 163 had MCI. Participants reported the amount of calories they ate or drank in a food questionnaire and were divided into three equal groups based on their daily caloric consumption. One-third of the participants consumed between 600 and 1,526 calories per day, one-third between 1,526 and 2,143 and one-third consumed between 2,143 and 6,000 calories per day.

The odds of having MCI more than doubled for those in the highest calorie-consuming group compared to those in the lowest calorie-consuming group. The results were the same after adjusting for history of stroke, diabetes, amount of education, and other factors that can affect risk of memory loss. There was no significant difference in risk for the middle group.

“Cutting calories and eating foods that make up a healthy diet may be a simpler way to prevent memory loss as we age,” said Geda.

The sharpest commentary I’ve heard about this study — “they should adjust for the amount of time participants spent sitting on their butts watching American Idol and snacking”…

Justin Meyer, right, with Devin Dobias

Viruses regularly evolve new ways of making people sick, but scientists usually do not become aware of these new strategies until years or centuries after they have evolved. In a new study…however, a team of scientists at Michigan State University describes how viruses evolved a new way of infecting cells in little more than two weeks.

The report is being published in the midst of a controversy over a deadly bird flu virus that researchers manipulated to spread from mammal to mammal. Some critics have questioned whether such a change could have happened on its own. The new research suggests that new traits based on multiple mutations can indeed occur with frightening speed.

The Michigan researchers studied a virus known as lambda. It is harmless to humans, infecting only the gut bacterium Escherichia coli. Justin Meyer, a graduate student in the biology laboratory of Richard Lenski, wondered whether lambda might be able to evolve an entirely new way of getting into its host…

Mr. Meyer set up an experiment in which E. coli made almost none of the molecules that the virus grabs onto. Now few of the viruses could get into the bacteria. Any mutations that allowed a virus to use a different surface molecule to get in would make it much more successful than its fellow viruses. “It would have a feast of E. coli,” Dr. Lenski said.

The scientists found that in just 15 days, there were viruses using a new molecule — a channel in E. coli known as OmpF. Lambda viruses had never been reported to use OmpF before…

To see if this result was just a fluke, Mr. Meyer ran his experiment again, this time with 96 separate lines. The viruses in 24 of the lines evolved to use OmpF…

The new experiment provides a surprising glimpse at how easily viruses can evolve entirely new traits — and thus give rise to new diseases…

…The chances that a single virus would acquire so many mutations at once are certainly small. In the case of lambda viruses, Mr. Meyer estimates the chance of all four mutations arising at once is roughly one in a thousand trillion trillion.

Yet the lambda viruses repeatedly acquired all four mutations in a matter of weeks. “There’s this thinking that it all has to come together at once,” Dr. Lenski said. “But that’s just not how evolution works.”

Ready for a remake of The Andromeda Strain? Only this time it will be a documentary.

Scientists say they “serendipitously” discovered that a drug used to treat a type of cancer quickly reversed Alzheimer’s disease in mice.

“It’s really exciting,” said Maria Carrillo, senior director for medical and scientific relations for the Alzheimer’s Association. “They saw very positive and robust behavior effects in the mice.”

In the study, researchers at Case Western Reserve University School of Medicine gave mice mega-doses of bexarotene, a drug used to treat a type of skin cancer called cutaneous T-cell lymphoma. Within 72 hours, the mice showed dramatic improvements in memory and more than 50% of amyloid plaque — a hallmark of Alzheimer’s disease — had been removed from the brain.

Gary Landreth, the lead researcher at Case Western, cautioned that even though his results were impressive in mice, it may turn out not to work in people. “I want to say as loudly and clearly as possible that this was a study in mice, not in humans,” he said. “We’ve fixed Alzheimer’s in mice lots of times, so we need to move forward expeditiously but cautiously.”

Mice — and humans — with Alzheimer’s have high levels of a substance called amyloid beta in their brain. Pathology tests on the mice showed bexarotene lowered the levels of amyloid beta and raised the levels of apolipoprotein E, which helps keep amyloid beta levels low.

Landreth said he hopes to try the drug out in healthy humans within two months, to see if it has the same effect.

Those participating in the trial would be given the standard dose that cancer patients are usually given.

I get to note this sort of occurrence more often than you’d think. One of the benefits of consistent, detailed scientific methodology in research is that tests sometimes appear with beneficial side effects. Part of the overwhelming conservatism of proper science. You note everything. You don’t throw anything away.

It’s only the nutballs and their magic saviors and solutions who pop up into the news stream with a magic cure they cooked up in the garage and tested on a neighborhood cat – if at all.

The intense battle that public health advocates have waged against trans fats appears to be working: A new report shows that since 2000, levels of trans fats in Americans’ bloodstreams have plummeted nearly 60 percent.

Once widely found in fried, baked and packaged foods, trans fats have been slowly removed from the food supply after studies linked them to heart disease and obesity. Many cities have banned their use in restaurants, and public health experts have pressed companies to strip them from processed foods like cookies, soups, crackers and frozen foods.

In a research letter published in the latest issue of The Journal of the American Medical Association today, researchers found that as trans fats have disappeared from supermarket shelves and restaurant kitchens, they have also been disappearing from Americans’ bloodstreams. The study showed that in a nationally representative sample of middle-aged Americans, levels of trans fats fell 58 percent from 2000 to 2009…

Trans fats have been widely vilified since the late 1990s, when large studies showed that even slight increases in their intake could significantly elevate heart risks. Advocacy groups like the Center for Science in the Public Interest, one of the most vocal opponents of trans fats, sued fast food companies that used them in their foods, and cities including New York and Philadelphia have prohibited restaurants from cooking with them.

As controversy grew, many food manufacturers and restaurants gave in to pressure to remove trans fats — also known as partially hydrogenated oils — and began using alternatives like canola or sunflower oil.

In the new study…trans fat levels fell 58 percent, but there were also improvements in cholesterol and triglycerides. Levels of LDL, or “bad” cholesterol, fell almost 10 units on average, to 119.2 milligrams per deciliter of blood from 128.2 milligrams. Meanwhile, levels of HDL, or “good” cholesterol, rose to 55.8 milligrams from an average of 49.6 milligrams.

At the same time, triglyceride levels, a measure of fat in the blood, fell on average about 20 units, to 109 milligrams from roughly 131 milligrams. The American Heart Association considers triglyceride levels of 100 milligrams to be “optimal.” Health authorities say HDL should be above 40 milligrams in men and higher than 50 milligrams in women, while LDL levels in men and women should ideally be lower than 100 milligrams…

Partially hydrogenated oils could be removed pretty much entirely from supermarkets, processed foods – and our bloodstreams – by an order from the FDA. I know every one has kept the heat on this medical/political enclave since the election of Obama. But, the pressure hasn’t been sufficient. Maybe we relented too soon when we started to get some movement on food quality, food safety.

Maybe it’s time to ask questions, try to turn the attention of our elected representative from oil-bearing sands in Canada to those partially-hydrogenated oils still being stuffed into our circulatory systems?

…In a surprising discovery, researchers from Tel Aviv University have found that dessert, as part of a balanced 600-calorie breakfast that also includes proteins and carbohydrates, can help dieters to lose more weight — and keep it off in the long run.

They key is to indulge in the morning, when the body’s metabolism is at its most active and we are better able to work off the extra calories throughout the day…

Attempting to avoid sweets entirely can create a psychological addiction to these same foods in the long-term, explains Prof. Daniela Jakubowicz. Adding dessert items to breakfast can control cravings throughout the rest of the day. Over the course of a 32 week-long study, detailed in the journal Steroids, participants who added dessert to their breakfast — cookies, cake, or chocolate — lost an average of 40 lbs. more than a group that avoided such foods. What’s more, they kept off the pounds longer…

A meal in the morning provides energy for the day’s tasks, aids in brain functioning, and kick-starts the body’s metabolism, making it crucial for weight loss and maintenance. And breakfast is the meal that most successfully regulates ghrelin, the hormone that increases hunger, explains Prof. Jakubowicz. While the level of ghrelin rises before every meal, it is suppressed most effectively at breakfast time.

Basing their study on this fact, the researchers hoped to determine whether meal time and composition impacted weight loss in the short and long term, says Prof. Jakubowicz, or if it was a simple matter of calorie count…

One of the biggest challenges that people face is keeping weight off in the long-term, says Prof. Jakubowicz. Ingesting a higher proportion of our daily calories at breakfast makes sense. It’s not only good for body function, but it also alleviates cravings. Highly restrictive diets that forbid desserts and carbohydrates are initially effective, but often cause dieters to stray from their food plans as a result of withdrawal-like symptoms. They wind up regaining much of the weight they lost during the diet proper.

…The group that consumed a bigger breakfast, including dessert, experienced few if any cravings for these foods later in the day.”

Worth a try. Especially chocolate. Or Nutella.