Folklore Based Medicine?

Byoliveridley

Breast cancer theory supports African folklore – CNN.com

While they stressed that women should always get screening and quick treatment for breast cancer, they said their theory could also help explain the belief, widespread in parts of Africa and the United States, that removing a tumor can hasten death. “I must say that I am sure there is more to this than just a myth,” said Michael Retsky of Children’s Hospital and Harvard Medical School in Boston, Massachusetts. His latest hypothesis, which he admits is not supported by any new direct research, is published in the International Journal of Surgery. He stressed that any woman with breast cancer should get the tumor removed. And he noted that in the United States, the women who could be considered at risk of having their cancer spread now get chemotherapy anyway, which would stop cancer’s spread.

Note, no direct evidence, no double blind trial, just a story? C’mon, you’re a Doctor. Surely, you know that CNN and the other media will take your qualifications, reservations and cautions  and shove them up your you know what to get a nice headline. Most people don’t read past the first two lines anyway, so nothing you say about your reservations will be transmitted to the public.

I hope you get the funding to prove/disprove your contention. Race based differences in treatment outcomes are not well studied, and are potentially very important. It is vital that more people look at this issue. But speculation based on modeling studies does not belong on CNN.

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    High fructose corn syrup makes you fat

    Byoliveridley

    This well designed and well executed study provides rather conclusive proof that High Fructose Corn Syrup, the sweetener most commonly used in North America, makes you gain weight in a way not explained by calories alone. These rats gained more weight on HFCS compared to a sucrose (regular sugar) diet even though they were fed the same calories. The effect was seen in the short term and in the long term, and abdominal fat increased the most. Gut fat, if you did not know is related to the infamous metabolic syndrome, causing diabetes, hypertension, coronary disease, etc.

    High-fructose corn syrup (HFCS) accounts for as much as 40% of caloric sweeteners used in the United States. Some studies have shown that short-term access to HFCS can cause increased body weight, but the findings are mixed. The current study examined both short- and long-term effects of HFCS on body weight, body fat, and circulating triglycerides. In Experiment 1, male Sprague–Dawley rats were maintained for short term (8 weeks) on (1) 12 h/day of 8% HFCS, (2) 12 h/day 10% sucrose, (3) 24 h/day HFCS, all with ad libitum rodent chow, or (4) ad libitum chow alone. Rats with 12-h access to HFCS gained significantly more body weight than animals given equal access to 10% sucrose, even though they consumed the same number of total calories, but fewer calories from HFCS than sucrose. In Experiment 2, the long-term effects of HFCS on body weight and obesogenic parameters, as well as gender differences, were explored. Over the course of 6 or 7 months, both male and female rats with access to HFCS gained significantly more body weight than control groups. This increase in body weight with HFCS was accompanied by an increase in adipose fat, notably in the abdominal region, and elevated circulating triglyceride levels. Translated to humans, these results suggest that excessive consumption of HFCS may contribute to the incidence of obesity.

    Miriam E. Bocarsly, Elyse S. Powell, Nicole M. Avena, Bartley G. Hoebel. High-fructose corn syrup causes characteristic of obesity in rats: Increased body weight, body fat and triglyceride levels. Pharmacology Biochemistry and Behavior, 2010; DOI: 10.1016/j.pbb.2010.02.012

    For a more layman friendly summary of the article, read the sciencedaily release.

    Do reconsider your food habits to avoid HFCS. Note that this whole corn syrup boondongle is made possible by the US government’s insistence on providing billion dollar subsidies to its farmers to grow corn while imposing tariffs on cane sugar from the tropics to make it less attractive. Free trade, my A$$.

    Thanks to Tom Laskawy at grist for the blog post.

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    How NAFTA infringes on local environmental regulations

    Byoliveridley

    Dow AgroSciences is considering using the controversial investor-protection provisions of the North American free-trade agreement to seek compensation from the federal government over Quebec's ban on the cosmetic use of pesticides.

    The company, a maker of the weed-killer 2,4-D, filed a notice of intent to submit a claim to arbitration under NAFTA in late August. The 27-page legal action was posted yesterday on the Foreign Affairs website, where it is listed as a dispute to which Canada is a party.

    via globeandmail.com: Ban on pesticides may face NAFTA test

    Here is Sierra Club’s assessment of 2,4-D. It is not as bad as, say, DDT, but not something an average householder would ever need to use. Limiting use and exposure is in everyone’s best interest except Dow’s, which is why they have filed this lawsuit.

    I would say it infringes on a province’s right to set strict health and safety standards for its people, but if we accept that corporations have more rights than people, we would expect this kind of lawsuit to happen with more frequency.

    Note that a much more egregious actor, lindane, which was deregistered by even the Bush EPA is subject of a similar challenge in Canada, and Bisphenol A is probably next.

    Can’t blame the companies for exploiting loopholes (that they no doubt inserted, of course), but it seems that countries should always have the right to enforce stricter standards if they so desire.

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    Small California Study Finds Correlational Link Between Organochlorine Pesticides and Autism

    Byoliveridley

    That would have been my headline! It was a study of 29 women, and the results show a six-fold increase in the incidence of autism in children whose mothers were close to fields being sprayed with organochlorine pesticides. A factor of 6 is a big number, which is why they found statistical significance at such a low sample size.

    Most organochlorine pesticides (the most famous being DDT) are already banned in the first world. The ones suspected here, endosulfan and dicofol are banned in quite a few countries including Belize, Singapore. Cambodia and Germany. The Stockholm convention (international treaty to identify and restrict the use of persistent organic pollutants) has identified endosulfan as a possible addition to its list of POPs.

    Of course, the US has not even ratified the Stockholm convention thanks to the pesticide lobbies. So, nothing the Stockholm convention decides about endosulfan will  carry any legal weight. In this country, pesticides and most other chemicals in current use are “innocent until proven guilty”, meaning harm must be conclusively proven in a manner that will withstand court challenge. With industry sponsored research and lobbying, such a burden of proof is often insurmountable and therefore, hazardous pollutants are used in the US well beyond their sell-by dates.

    Pesticide link to autism suspected – Los Angeles Times

    Women who live near California farm fields sprayed with organochlorine pesticides may be more likely to give birth to children with autism, according to a study by state health officials to be published today. The rate of autism among the children of 29 women who lived near the fields was extremely high, suggesting that exposure to the insecticides in the womb might have played a role. The study is the first to report a link between pesticides and the neurological disorder, which affects one in every 150 children. But the state scientists cautioned that their finding is highly preliminary because of the small number of women and children involved and lack of evidence from other studies.

    Clearly, the increase in autism incidence has many more factors linked to it than environmental chemical exposure, but this is interesting and good work. This study will doubtless be severely criticized by the pesticide lobby. After all, it’s only a correlation, no mechanism has been proposed, and the sample size is very small. But, as I mentioned before, you don’t normally see six-fold increases in disease incidences with ambient environmental exposure, so there is definitely something going on here.

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    Circumspection on Circumcision – Lessons for India

    Byoliveridley

    Circumcision May Help Protect Against HIV – washingtonpost.com

    Getting circumcised may reduce men’s risk of acquiring HIV, according to a study conducted in Africa. “Our study shows that circumcised men had 53 percent fewer HIV infections than uncircumcised men,” lead study author Robert Bailey, professor of epidemiology at the University of Illinois at Chicago (UIC), said in a prepared statement.

    This study, published in The Lancet (registration and kidney donation required!) adds to the growing body of research suggesting that circumcision significantly reduces the incidence of HIV infection. The doubts on circumcision as a protective factor against HIV are falling away.

    But, is this a viable public health strategy? In context, the US health and human services reports an 85% reduction in HIV risk through condom usage. This is probably a conservative estimate. There’s no indication yet that the gains from circumcision and condom use together are multiplicative.

    Let’s look at India, for instance. Circumcision is not practiced among Hindus. There is no history of circumcision, and when I was growing up, it was clear that circumcision was for Muslims and Muslims only. It was often laughed about and there was a sense of superiority about not having to mutilate. It was a clear distinction setting difference between “us” and “them”. This article by Jaishanker and Haldar provides some perspective on Hindu-Muslim identities.

    Apart from that, the other important identity of Muslim males is circumcision. It is found in many riots that Muslims were victimized based on their religious identity. In the riots if the perpetrators or the police are not able to identify victims with their religion they forcefully remove the pants of the victims to check whether they are circumcised or not. Once they find that the victim is circumcised he is targeted without further analysing which community he belongs to.

    For example in Bombay riot (1992) there is a case of man who was frisked by the police for assessing whether he was a Muslim. However, out of fear he gave his name as Raju (a Hindu name) the officer made him take out his trousers and, noticed that he was a circumcised Muslim, and fired at him.

    No Hindu parent in their right mind would circumcise their male child. It’s that simple. It’s part of the ingrained Hindu psyche that having an uncut member sets us apart from our Muslim brethren.

    Nothing has changed about AIDS prevention strategies. But it’s boring to study the same variables all the time, let’s recap them one more time, shall we!

    Education and awareness: Look at this picture from India (from the NFHS Survey):
    Now tell me that increasing awareness among women and empowering them is not the most important thing you can do!

    Condom use = 85% risk reduction

    Nothing more to say. Continuing to improve access to condoms is important. Avert indicates that condom use is very state dependent, especially among sex workers, with Tamil Nadu having an 80-90% use rate and Mysore in neighboring Karnataka having a 9% use rate.

    Access to antiviral therapy

    India is in a lucky position here with a very well established pharmaceutical industry. So, drugs are likely to be available (patent issues notwithstanding). The issue however is with infrastructure, getting the drugs to the right people at the right time. This 2004 paper from the Indian Journal of Medical Ethics indicates that coverage is spotty at best. India’s National AIDs Control Organization (NACO) recognizes this, but in my opinion does not go far enough to provide free/affordable drugs to infected people, especially to prevent mother-child transmission.

    So, to cut a long story short, circumcision in India is not likely to be a factor in the pantheon of choices available. We have a long way to go with our other major AIDS prevention challenges, and I hope this circumcision issue does not become an increasing distraction.

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    Feds punt on Bisphenol A

    Byoliveridley

    By studiously ignoring all the subtle hormone disruption effects of bisphenol A and concentrating on easily observable neurological effects, the CERHR essentially does the industry’s bidding.

    Some risk linked to plastic chemical – Los Angeles Times

    A federal panel of scientists concluded Wednesday that an estrogen-like compound in plastic could be posing some risk to the brain development of babies and children.

    Bisphenol A, or BPA, is found in low levels in virtually every human body. A component of polycarbonate plastic, it can leach from baby bottles and other hard plastic beverage containers, food can linings and other consumer products.

    Culminating months of scientific debate, the decision by the 12 advisors of the Center for the Evaluation of Risks to Human Reproduction — part of the National Institutes of Health — is the first official, government action related to the chemical. Their recommendation will be reviewed for a federal report that could lead to regulations restricting one of the most used chemicals.

    The scientists ranked their concerns about BPA, concluding they had “some concern” about neurological and behavioral effects in fetuses, infants and children, but “minimal” or “negligible” concern about reproductive effects. The findings put the panel roughly in the middle — between the chemical industry, which has long said there is no evidence of danger to humans, and the environmental activists and scientists who say it is probably harming people.

    For a detailed look at how bisphenol research has been corrupted by industry sponsored “focused counter research” – where the goal is to show no effects and the experiment is tiled to ensure this goal, read this excellent article in the The Public Library of Science Biology Open Source Journal. Note, because it is Open Access, you can actually read it without selling a kidney! Some highlights…

    The moment we published something on bisphenol A, the chemical industry went out and hired a number of corporate laboratories to replicate our research. What was stunning about what they did,” vom Saal says with a mix of outrage and bemused disbelief, “was they hired people who had no idea how to do the work. Each of the members of these groups came to me and said, ‘We don’t know how to do this, will you teach us?’”

    More…

    The HCRA report, commissioned before Schwartz’s tenure, concluded that “the weight of the evidence for low-dose effects is very weak” [15]. Industry groups hailed the report as a comprehensive review by independent experts and quickly disseminated its findings. Yet the “comprehensive” report reviewed just 19 of 47 studies available in April 2002, and when it was published more than two years later, three panelists asked not to be listed as authors.

    What the hell, just read the whole article, especially the bit about the Harvard Center for Risk Analysis and its well documented industry shillness.

    The key to understanding bisphenol research is to realize that it is a hormone disruptor that works at low doses. At high doses, normal toxicological testing doses that is, it floods the hormone receptors and slows down the receptor pathways. So, the usual technique of testing in rats and mice at high doses and extrapolating will not work.

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    Hog Factories Hit the NY Times

    Byoliveridley

    The tale is told from the pig’s viewpoint. Of course, as I have mentioned before, hog factories are evil and affect the people (mostly poor and black) who live around them in very many horrible ways.

    Pig Out – NY Times

    Of the 60 million pigs in the United States, over 95 percent are continuously confined in metal buildings, including the almost five million sows in crates. In such setups, feed is automatically delivered to animals who are forced to urinate and defecate where they eat and sleep. Their waste festers in large pits a few feet below their hooves. Intense ammonia and hydrogen sulfide fumes from these pits fill pigs’ lungs and sensitive nostrils. No straw is provided to the animals because that would gum up the works (as it would if you tossed straw into your toilet).

    In my work as an environmental lawyer, I’ve toured a dozen hog confinement operations and seen hundreds from the outside. My task was to evaluate their polluting potential, which was considerable. But what haunted me was the miserable creatures inside.

    They were crowded into pens and cages, never allowed outdoors, and never even provided a soft place to lie down. Their tails had been cut off without anesthetic. Regardless of how well the operations are managed, the pigs subsist in inherently hostile settings. (Disclosure: my husband founded a network of farms that raise pigs using traditional, non-confinement methods.)

    The stress, crowding and contamination inside confinement buildings foster disease, especially respiratory illnesses. In addition to toxic fumes, bacteria, yeast and molds have been recorded in swine buildings at a level more than 1,000 times higher than in normal air. To prevent disease outbreaks (and to stimulate faster growth), the hog industry adds more than 10 million pounds of antibiotics to its feed, the Union of Concerned Scientists estimates. This mountain of drugs — a staggering three times more than all antibiotics used to treat human illnesses — is a grim yardstick of the wretchedness of these facilities.