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August 2008 Archives

August 1, 2008

A cure for AIDS?

Doctors in Houston think they may have found a way to kill the virus that causes AIDS. They say they have found a way to attack the virus by attacking a key protein in it that does not mutate -- that, in effect, makes the virus what it is despite any mutations it undergoes. The virus has persisted as long as it has in part by mutating, rendering treatments ineffective.

Obviously that would be a huge breakthrough if it turns out to be true. But the caveats attached to this story are, to state the obvious, huge. Just for starters, there have been no human trials, just lab and animal studies, and there's no funding on the horizon for human trials. And in science, breakthroughs of this type are far less common than incremental increases in knowledge gained through research.

Still, to state even more of the obvious, if this research pans out, the lives of millions of people in the U.S. and around the world could be saved.

Highlighting breast feeding

Today through Thursday is World Breastfeeding Week. In observance of the Olympics taking place this month in China, the World Alliance for Breastfeeding Action is pushing what the N.C. Department of Health and Human Services calls the "gold standard" for infant feeding: breastfeeding exclusively for six months, followed by mixing breastfeeding with other, complementary food until the child is 2.

Breastfeeding a child until he or she can ask for it by name might not be common in the U.S. (although one woman I know did it until her daughter was about 2, toward the end of which time the girl would demand "Boobie!" not only at home but also in public places). There are a lot of reasons for that, ranging from Mom's work schedule to the problem of needing to breastfeed in public places.

But it is common in many other cultures, and it's undeniably good for the baby. As HHS says in its news release, "Breastfeeding is the normal and optimal food source for babies. Human milk meets all of the needs of babies’ rapidly developing brains and bodies. It provides an ideal balance of nutrients and a high degree of natural immunity against infection, and reduces the risk of allergies, diabetes, obesity, SIDS and environmental pollutants. Breastfeeding contributes to healthy growth, psychosocial and intellectual development, and an overall healthy lifestyle."

Yet another reason to do it? It's good for Mom as well, reducing her chances of developing breast and ovarian cancer, postpartum depression and Type 2 diabetes. Plus, it's free. (HHS also says it's environmentally safe, although anyone who has ever had to change a diaper knows that no food for baby is completely environmentally safe.)

The state also has a Web site for more information about breastfeeding.

The Olympics tie-in is a bit of a reach, but the goal is to get healthier moms and kids through a process known to work.

August 4, 2008

Kids and contact lenses: How young is too young?

A couple of months ago, The Wall Street Journal's Health Blog reported that Johnson & Johnson's Vistakon division wants to start marketing contact lenses to kids as young as 8. That's a good bit earlier than the way things generally work now. The company has its own study out -- the usual caveats about self-funded studies apply.

I've got calls out to a couple of local ophthalmologists who work with kids, but I'd be interested in hearing from you on 1) who else I ought to talk to and 2) whether you, yourself, if you have kids, think this is a good idea, particularly if you use contact lenses yourself. If you respond to the latter question, you might be quoted in the paper and/or online.

You can post contact suggestions here in the comments, but if you're answering question # 2, I'd prefer you e-mail me, including your contact info and a daytime phone number where I can call to verify you're you.

More on the anthrax-killings suspect, from anthrax expert

Dr. Meryl Nass is an expert on anthrax (she has done research into its possible use as a biowarfare weapon, among other things). Recently she has focused on the possible dangers of the military's mandatory anthrax vaccines, to the point of testifying on behalf of service members disciplined because they refused to receive the vaccine out of fears for their health.

But the government's announcement that a scientist at an Army base in Maryland -- who committed suicide this past week -- was probably behind the deadly anthrax-letter mailings of late 2001 has brought her focus onto this particular case. (She knew Bruce Ivins, the suspect, from professional meetings, among other things.) Those mailings, which began within days of the 9/11 terrorist attacks, killed five people and sickened others.

Nass maintains a blog called Anthrax Vaccine, and while that's primarily what it's about, since last week's announcement she has been blogging about the case. Her posts on that subject began on Friday (8/1) and go forward from there.

UPDATE: Dr. Nass also has a piece online from February 2002 offering clues as to how the anthrax investigation should proceed. Judge for yourself how well or poorly her assertions and predictions have held up in light of what's being reported and blogged about.

August 8, 2008

Wasted mice

Via the Wall Street Journal's health-care blog, and because I know you have nothing better to do on a Friday (ahem), here's something to pep up your day and educate you a bit as well.

It's called Mouse Party. It's an animated feature that lets you examine what effect such substances as alcohol or methamphetamine have on the bodies of mice. And it's kind of scary.

August 12, 2008

Second opinions: How and why

If you're not sure about a diagnosis you've received or a course of treatment your doctor has suggested, one often-worthwhile option is to seek a second medical opinion. In fact, research suggests that far more Americans should be doing it than actually do.

Via the Wall Street Journal's Health Blog, here's a story from the San Diego Union-Tribune that talks about why you might want to do it and how best to go about it.

I've had one occasion to seek a second opinion, and it confirmed the first in every respect. Have you ever gotten a second opinion that has resulted in a significant change in your diagnosis or treatment?

August 18, 2008

From paper medical records to electronic medical records

The government is nudging medical practices toward electronic record keeping, and I'm going to do a story on how that is affecting local practices. If you work in a practice that uses paper records -- whether you're a doc, a nurse or an administrator -- I'd be interested in hearing from you about what you see as the pluses and minuses. Ditto folks in practices that have already made the switch, and I'd also like to hear from these folks about what they learned from the transition that they'd like to pass on to other practices that haven't done so yet. Leave a comment or e-mail me. Thanks!

UPDATE:
Electronic medical records (EMRs) are already such a sore subject within the health-care information-technology community that they have spawned at least two satire sites: SEEDIE.org (The Society for Enormously Expensive and Difficult to Implement EMRs) and Extormity.com, "a mega-corporation dedicated to offering highly proprietary, difficult to customize and prohibitively expensive healthcare IT solutions." These might be the most highly evolved geek-humor sites I've ever run across that don't involve actual programming languages as part of the punch line.

August 19, 2008

Medicine: What works, what doesn't and why there's so much of the latter

My Sunday article examined why there's so much medicine being practiced in the U.S. that's either unproven or ineffective, and what it's costing us in lives and health-care dollars. Feel free to discuss it here. (Coincidentally, the Wall Street Journal's health blog has two articles on that subject today -- one on the painkiller Vioxx, now withdrawn from the market, and one on cellulite treatments).

Harry and Louise: They're baa-aaack

Back when the Clinton administration was trying to revamp U.S. health insurance in 1994, a barrage of TV ads featuring a fictional couple named Harry and Louise helped sink the plan (which, to be fair, sank for a lot of other reasons as well).

Now that the two presumptive presidential nominees, John McCain and Barack Obama, have made health care a key part of their respective agendas, Harry and Louise are returning.

The effects of long-term military deployments

As the conflicts in Iraq and Afghanistan go on, so does the military's growing trouble finding enough people to serve there. Enlistment terms have been lengthened, as have National Guard and reserve commitments. Deployments have been lengthend. And it's still not enough.

Via the Health Beat Blog comes news of two studies in this area that have been published in the Journal of the American Medical Association. They point toward serious problems within the military that effect both service members and their families.

August 20, 2008

Playing biotechnical catch-up

One reason Wake Forest University is starting a master's program in bioethics is that biotech advances are outstripping the framework the medical profession has for examining the ethical issues such advances raise. Here's one example: direct-to-consumer genetic testing that gives people interpretations of their own DNA, which has gained regulatory approval in California.

What exactly a layman is supposed to do with this information isn't entirely clear. But as knowledge about the human genome grows, we're likely to see more such services -- and need to be prepared to wrestle with the ramifications.

August 21, 2008

Experts talking about medical care

The current New England Journal of Medicine has a couple of publicly available pieces online to which I thought I'd draw your attention.

* * *

"I went to medical school. I'm loaded with debt. I've got an office full of people pushing paperwork every day. I don't have time to talk to anybody. No one in Washington seems to care what I think. I can't function this way. I don't get reimbursed enough."

"Unless we do more fundamental surgery on making primary care a more compelling field, I think in the future primary care will be practiced by others than doctors."

"If there's one lesson that we've learned about health reform in the last few decades, [it's that] being right doesn't count for very much. ... if we're going to fight this battle for health reform on moral grounds, we're going to lose."

A panel of distinguished physicians and professors discusses some of the issues surrounding health-care costs for Americans. Excerpts, with links to video, are here.

* * *

How cost-effective is vaccinating girls and young women against human papilloma virus (the virus implicated in cervical cancer)? Some research is here. There's a term in the piece, "quality-adjusted life-year," that isn't fully explained, but medical treatments are often rated in terms of cost per quality-adjusted life-year. That cost for the HPV vaccine is $43,600 in some populations. That sounds like a lot, but the same cost for some commonly drugs tops $500,000.

* * *
The issue also has editorials on both subjects. The one on insurance coverage is here and the one on the HPV vaccine is here.

August 25, 2008

A brief, possibly non-health-related digression.

I have had the same N&R phone number, 373-7088, for 20 years, give or take a couple of months. It has led to some adventures.

The person who held the number before me was Stan Swofford, and for at least 10 years after I inherited the digits, I also inherited calls from some of his sources, sometimes late at night. (Most of them, upon finding out the mistake, either didn't return my callbacks or else found some other way to get in touch with Stan. Face it, we staffers aren't that hard to find.)

Also, for several years before we switched from the 910 to the 336 area code, I frequently got calls intended for the Cape Fear Valley Regional Medical Center, one of whose phone numbers was identifical to mine except for being in the 343- exchange instead of 373.

(Thank goodness I never had the number 867-5309.)

But over the weekend I got the strangest call yet. A distraught-sounding woman called and left a voicemail message saying, "I need a service y'all provide -- quickly." She left two numbers. I somehow sensed that she wasn't talking about a new subscription. Puzzled, I called back and left messages at both numbers, then tried to figure out what that was all about.

Since I've taken over this beat, when I've written stories about a doctor or clinic or experiment, I've occasionally gotten calls from people mistaking the number in my article tagline for the number to call to reach the subject of the story. I thought perhaps this might be the case, but I couldn't think of anyone or anything I'd written about recently that might have engendered that kind of emotional response (except maybe this).

Then, on a hunch, I looked up the phone number for this place. And its number is kind of like mine. Sort of. If you turn your head just the right way and sqint. Or maybe if you're incredibly upset and on the verge of tears.

Whoever she is, I hope she gets the help she needs.

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