Tag Archives: Health

Is obesity a risk factor for H1N1 Novel Swine Flu infection?

… or is obesity simply Yet Another Risk Factor in severity of this illness?

Probably the latter, but health officials seem interested in the developing data.

From CTV:

… in a report released Friday, health officials detailed the cases of 10 Michigan patients who were very sick from swine flu in late May and early June and ended up at a specialized hospital in Ann Arbor. Three of them died.

Nine of the 10 were either obese or extremely obese. Only three of the 10 had other health problems. Two of the three that died had no other health conditions.

This hardly settles the question of whether obesity is its own risk factor for swine flu. It’s possible the patients had undiagnosed heart problems or other unidentified conditions.

The report is called Intensive-Care Patients With Severe Novel Influenza A (H1N1) Virus Infection — Michigan, June 2009 and is published in MMWR, the CDC’s rapid turnaround publication for disease. The report warns:

This report describes the clinical findings of a limited series of patients with novel influenza A (H1N1) virus infection and refractory ARDS …. This patient group represents the most severely ill subset of persons with novel influenza A (H1N1) virus infection and is notable for the predominance of males, the high prevalence of obesity (especially extreme obesity), and the frequency of clinically significant pulmonary emboli and MODS. All required advanced mechanical ventilator support, reflecting severe pulmonary damage. The pulmonary compromise described in this report suggests that severe pulmonary damage occurred as a result of primary viral pneumonia. Although data are not available, this damage also might be attributable to secondary host immune responses (e.g., through cytokine dysregulation triggered by high viral replication). However, bacterial coinfection in the lung not identified by blood culture or bronchoalveolar lavage cannot be excluded.

The high prevalence of obesity in this case series is striking. Whether obesity is an independent risk factor for severe complications of novel influenza A (H1N1) virus infection is unknown. Obesity has not been identified previously as a risk factor for severe complications of seasonal influenza. ….

Further characterization of severe cases of novel influenza A (H1N1) virus infection in the United States and worldwide is needed to determine the frequency of the findings from this limited case-series.

You can read the report here.

Clearly this is very preliminary and I suspect that this will not develop. In other words, I suspect that existing poor health related to the cardiopulmonary system is a serious risk factor with any flu. But we shall see.

FDA: Limits on Acetaminophen

Acetaminophen dose recommendations will be lowered significantly by the FDA, and some products will be pulled off the market, because of concerns over liver damage. If you look up “Tylenol” on Wikipedia as I write this, you see the following:

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Indeed.

From MSNBC:

Despite years of educational campaigns and other federal actions, acetaminophen remains the leading cause of liver failure in the U.S., according to the FDA.

Panelists cited FDA data indicating 60 percent of acetaminophen-related deaths are related to prescription products. Acetaminophen is also found in popular over-the-counter medications like Tylenol and Excedrin.

“We’re here because there are inadvertent overdoses with this drug that are fatal and this is the one opportunity we have to do something that will have a big impact,” said Dr. Judith Kramer of Duke University Medical Center.

Flu Update: Millionth American Case, Scams, Prospects

The novel swine flu has affected its one millionth American. The first death in England has been recorded (a 9 year old girl). Yesterday, the first Brazilian death was recorded. When we look at the map of the disease, note that many regions of Africa are totally devoid of cases. Just so you know … this is not some special African immunity. This is simply because the global health network has failed Africa and we have no clue what is going on there, and never have had a clue.

A new wrinkle in the process for North Americans, possibly with parallels elsewhere, is the summer camp phenomenon. This is where we take children from multiple communities, only some of which have some dreaded disease, or perhaps just an annoying meme, and we ship them all to one location either every day for the whole day, or for weeks at a time overnight. In this way, the diseases or annoying memes can spread among them and all the children can bring them home!

There have been some summer camp closings.

Despite rumors to the contrary, the novel swine flu is roughly as deadly as the regular flu. I’m still seeing people, even experts, indicate that it is relatively mild. It is not. It is typical.

The novel swine flu seems to be affecting younger individuals in part because of an immunity found in older individuals, presumably from exposure to a similar flu in the past. This is interesting news if confirmed. This touches on another area of confusion. The 1918 pandemic flu was famous for being extra deadly for healthy individuals. This was for a very specific medical reason. The current flu seems to be affecting ‘healthy’ individuals more as well. This is for a totally different and utterly unrelated reason, probably.

This is subject to revision, but here’s the story:

The 1918 pandemic flu killed healthy people more because healthy = stronger immune system. These people were killed by the way their immune system reacted to the flu. A person with a strong immune system would be more strongly affected by the flu, possibly fatally.

The novel swine flu appears to be affecting healthy people more because healthy = younger than a certain age. That age cut off separates individuals (older) who have an immunity from prior exposure to a similar virus from younger individuals who don’t.

Again, this is subject to revision. This is subject to revision in two ways:

1) The assertion I make above about the 1918 flu is very likely true and well demonstrated, but the assertion I make about the novel swine flu is speculative at this time; and 2) the phenomenon seen in the 1918 pandemic flu, while apparently not happening with the current novel swine flu, could develop later on during the pandemic.

Why do I say that? Because that is what happened in 1918. The flu went around the world ‘off season’ (as the current flu is doing) and was typical in virtually every way but its timing. Then it went around the world again with this extra glitch of killing people with their own immune system.

The fact that the 1918 flu did this has flu experts worried, and they should be. However, I have yet to see a biological argument for why this flu should follow the same pattern in regards to this specific feature.

What is going to happen next? In late (?) September (+/-) there will be a flu vaccine available for the regular flu. Get one.

Later, maybe in October (?) there may be a vaccine available for the novel swine flu. This may be a two dose vaccine. Get it, get them both if there are two. There will be instructions as to who should get it and when. But since those instructions will be filtered through the usual sources, be careful what you pay attention to. The little people sitting at the colorful desk on the news show will not be giving you useful information. They never get this stuff right. You should rely on the blogosphere this time around, I think.

(People who have gotten the novel swine flu already seem to be immune but unless you know you had it from a clear test, I would not assume that.)

And speaking of people getting it all wrong … have you heard about any of the flu woo scams going around regarding the flu? There is a treatment in which photons are passed into your cells to kill the virus. There is an anti-flu vaccine. There is a ‘do it yourself’ flu vaccine kit, which involves you sending in your credit card number but then never hearing back from them.

Obviously, don’t fall for that.


CDC flu site
; WHO

Bad Advice for Pregnant Women

People like to help pregnant women.

On buses it is routine to give up one’s seat for a pregnant woman. In Boston, drivers try less hard to run over pregnant women in crosswalks. And so on. But sometimes good intentions can lead to bad advice.

First, I’d like to point out that there is reasonably good evidence that obesity has negative health effects, and obesity in relationship to pregnancy is probably worse. So women who are planning on getting pregnant should probably trim down a bit if they need to. Also, exercise is good for many many reasons, so women who are planning on getting pregnant should look at their own exercise and activity routines and see if some adjustment can be made in those areas. And certainly, activity levels and patterns of diet and fat storage are all related, so in making these considerations do remember that this is all an interconnected complex whole.

And then, if you do actually get pregnant, don’t listen to anyone.

Or at least, think about the advice you are getting when people are yammering at you.

In particular, cast off and ignore the following pieces of advice that you will receive again and again and again:

1) Forget about healthy eating, just shove whatever food is in front of you into your mouth, preferably focusing on saturated fats; and

2) Stop all forms of exercise for the next several months as your brood develops inside you.

Now, you might be thinking “I’ve never heard anyone say those things to a pregnant woman” but if you are thinking that, then you are just not listening. You hear it all the time. Maybe not in exactly those words, but this is what people are telling the pregnant women.

You, the pregnant woman, are NOT eating for two. You are one person, you weigh somehwere between 90 and 160 pounds (leaving lots of room for variation) and for the first third of your pregnancy, the unit of additional biomass that you are also eating for will reach a whopping two pounds or so. So for your first trimester you need to increase your intake by about one percent to make up the difference. In the last trimester, you’ll have a lot more extra tissue that you are feeding via your blood supply, but still, imagine a 7 pound baby and add 7 pounds overhead (because for some reason we never weigh the placenta as part of the baby, even though it is, and there’s the expanded uterus) and you get 14 pounds. Maybe, maybe, the additional tissue that you are feeding will be about 8-15 percent.

If you were eating for two you’d be eating 200% of your normal diet, and to do that in terms of calories, you are going to have to eat a LOT of fatty foods because there is just not enough time in the day to double your caloric intake by eating leaves and other low-quality “diet” food.

In terms of activity levels, I would say that a pregnant woman should start, by the end of the first trimester, to avoid activities in which you have an elevated risk of injury. Motorcycle racing, water skiing, that sort of thing. This is because of the significant added medical complications of combining trauma with pregnancy. Later, activity levels will also have to be modulated in certain ways because of balance issues, and the simple fact that certain activities could damage the offspring directly. So no fencing or boxing.

But activity levels need to be maintained just to keep healthy for a reasonable amount of time, adjusting as needed for all those common issues that happen late in pregnancy.

In other words, when it comes to activity levels and types, as well as diet, follow the advice of:

  • Mainstream books and possibly web sites
  • Your doctor and/or
  • Your certified midwife

Ignore the advice of

  • Everybody else that you know, especially
  • Anyone who has had a baby but not in the last five years or more; and especially especially
  • Anyone who has not had a baby

…. when they tell you to sit quietly on the couch and eat ice cream for six months. As much as that sounds like it might be fun.

And take your prenatal/pregnancy vitamins, of course.

Swine Flu Alert Level Raised by WHO

The long-awaited pandemic announcement is scientific confirmation that a new flu virus has emerged and is quickly circling the globe. WHO will now ask drugmakers to speed up production of a swine flu vaccine. The declaration will also prompt governments to devote more money toward efforts to contain the virus.

This means that the alert level is going to Level Six.

Ominously, WHO chief Dr. Margaret Chan said: “The world is moving into the early days of its first influenza pandemic in the 21st century, … The (swine flu) virus is now unstoppable.”

We are warned that a second wave of the flu may pass through areas that have already experienced a first wave. We are also told that this flu is badly affecting a relatively larger percentage of relatively healthy people than does seasonal flu (another hallmark of the 1918 pandemic).

The core of the statement by WHO’s director is:

On present evidence, the overwhelming majority of patients experience mild symptoms and make a rapid and full recovery, often in the absence of any form of medical treatment.

Worldwide, the number of deaths is small. … we do not expect to see a sudden and dramatic jump in the number of severe or fatal infections.

We know that the novel H1N1 virus preferentially infects younger people. In nearly all areas with large and sustained outbreaks, the majority of cases have occurred in people under the age of 25 years.

In some of these countries, around 2% of cases have developed severe illness, often with very rapid progression to life-threatening pneumonia.

Most cases of severe and fatal infections have been in adults between the ages of 30 and 50 years.

This pattern is significantly different from that seen during epidemics of seasonal influenza, when most deaths occur in frail elderly people.

Many, though not all, severe cases have occurred in people with underlying chronic conditions. …

At the same time, it is important to note that around one third to half of the severe and fatal infections are occurring in previously healthy young and middle-aged people.

Without question, pregnant women are at increased risk of complications. This heightened risk takes on added importance for a virus, like this one, that preferentially infects younger age groups.

Finally, and perhaps of greatest concern, we do not know how this virus will behave under conditions typically found in the developing world. To date, the vast majority of cases have been detected and investigated in comparatively well-off countries.

Sources:

MSNBC
WHO

Danny Hauser’s Web Site Is Back Up (I think)

Danny Hauser, 13 year old shaman with cancer, recently returned from foray from the courts with his mother, now in treatment, had a web site dedicated to raising money for his ‘treatment’ (seemingly for the CAM part of his treatment … he is otherwise covered by insurance). That site was taken down early today or late yesterday, with the comment from the Hauser’s lawyer that it would stay down until certain “ramifications” were explored.

So, I was poking around this afternoon looking for ramifications and stuff, and instead found that the site is back up.

Since the last site disappeared without a trace, I made a copy of this one as soon as I found it.

Among other things, the site says:

Continue reading Danny Hauser’s Web Site Is Back Up (I think)

Oldest Evidence of Leprosy Found in India

ResearchBlogging.orgIt is funny how people play with history. If we talk about an important “first” that is viewed in a positive light … the origin of beer for instance … the slightest evidence will be used by the people of a given region to claim primacy. Also, since Africa almost always gets the shaft in this regard, all else being equal, an early African occurrence of something good will be assumed as not definitive, but vague evidence of the non-African first occurrence will be taken more seriously. Seriously.

Now, we have an important finding with the opposite effect: Whence did Leprosy first come? For some time, the main contenders have been South Asia and East Africa for (although that is based on a fairly weak argument). Now there is evidence of the earliest Leprosy being form South Asia. That in and of itself is interesting and the paper just out moments ago in PLoS is important. But what I fund funny (not in the “ha ha” funny way exactly) is that despite the recent shoring up of the Asian Origin model for Leprosy, the concususion seems to be that all that is lacking to support the African Origin for this desease … being treated here as though it was a leper … is, well, actual evidence. And in the absence of evidence, we’ll just pick the African Origin.

But never mind that. I’ll jump back on my high horse regarding the Anti-African Bias later. For now, let’s look at the evidence being reported in this new paper.

Leprosy is caused by Mycobacterium leprae and is one of those diseases that paleopathologists really love because it produces traces visible on bone. Leprosy is found in armadillos and can be induced in some rodents and primates, and occurs naturally (or so it is thought) in Cercocebus atys, so there are reasonable animal models (for the bone traces) and it has been around long enough that it is probably safe to say that we more or less know it when we see it. (N.B.: The paper at hand does not recognize the Mangabey connection, which is either a lack on the part of the authors or on my part, so let’s leave this connection as subject to revision.) You know of leprosy because of its significant social stigma and all the cultural trappings that go a long with that unnecessary and ethically questionable approach to this disease. Likely, that social stigma relates to the appearance of leprosy in the written record, where previously it was well documented and accepted by historians back to about 2,600 years ago. The present find seems to allow the interpretation of writing in the Sanskrit Atharva Veda as being about leprosy instead of some other disease.

It had previously been reported that Mycobacterium originated in Africa during the Late Pleistocene and spreading elsewhere after 40,000 b.p. At the same time, it was suggested that the same genetic analysis evinced a Late Holocene origin of the disease in. The present paper reports the observation of leprosy in skeletal material from around 2000 B.C. in Rajasthan, India, at the site of Balathal. Balathal was a large agrarian settlement peripheral to the Harappan (Indus) Civilization.

From a press release for this paper:

The presence of leprosy in India toward the end of this period indicates that M. leprae existed in South Asia at least 4000 years ago. This suggests that there may be some validity to Pinhasi and colleagues hypothesis that the disease spread between Africa and Asia during a period of incipient urbanization, increasing population density, and regular inter-continental trade networks. Dr. Robbins is currently attempting to recover ancient DNA from the skeleton to determine if the strain of M. leprae infecting the individual from Balathal is similar to strains common in Africa, Asia and Europe today. If it is successful, this work could shed additional light on the origin and transmission routes of this disease.

The presence of leprosy at Balathal 4000 years ago also supports translations of the Eber’s papyrus in Egypt and a Sanskrit text in India (the Atharva Veda) that refer to the disease as early as 1550 B.C. The Atharva Veda is a set of Sanskrit hymns devoted to describing health problems, their causes and treatments available in ancient India. Translations of leprosy have been questioned because it is difficult to perform a differential diagnosis on descriptions in such ancient texts particularly since diagnosis was not why the conditions were being described. The evidence from Balathal indicates that it is possible that the authors were describing leprosy as the disease was present in the subcontinent in prehistoric times.

It is possible that there are alternative interpretations of the bone evidence used to infer leprosy, but future DNA study may rule those alternatives out. At the moment, however, it is a reasonable interpretation given the fairly blatant way in which leprosy is manifest in human bones.

Continue reading Oldest Evidence of Leprosy Found in India

Is the Upper Midwest a center for medical denialism?

I was quite dissapointed this morning to hear the Minnesota Public Radio station interview a guy who had kept medical treatments from his son several years ago withoiut asking some of the truly critical questions that would be needed in this kind of situation. In that case, the father claims, doctors claimed that the boy had cancer, but the parents somehow knew that he did not, kept him from treatment, and he was fine. There was no great interest on their part in “alternative treatments” … just a disbelief that the doctors were competent.

Which may well have been the case … I have no idea … but if so, this cannot really be a relevant comparison with what is going on right now in Minnesota.

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Cathleen Hauser

A felony arrest warrant has been issued for Colleen Hauser of Sleepy Eye, Minnesota, and a nationwide manhunt is under way for her and her son, Daniel. This is the case of a young boy (13 years old) who may die of Hodgkin’s lymphoma if not treated, will likely live if treated, but whose treatment is being denied by his mother. The treatment method preferred by the medical community involves radiation ad chemotherapy. The method preferred by the Hausers is some sort of made up post-cultural mumbo jumbo thinly disguised as “Native American Healing.”

Meanwhile, elsewhere in the Upper Midwest, home of the Coen Brothers who really needed very little for inspiration for any of their movies ….

A mother accused of homicide for praying instead of seeking medical help as her 11-year-old daughter died of untreated diabetes decided Thursday to call no witnesses in her defense.

Leilani Neumann’s attorney, Gene Linehan, said the decision was reached after prosecutors agreed to tell the jury that to a “casual observer” Madeline Neumann appeared healthy on March 20, 2008, three days before she died at her rural Weston home surrounded by people praying for her….

strib

In all of these cases there is clear apeasment going on. As far as I know, at least for the first 48 hours of the Hauser’s disappearance, there was no amber alert. This case in Wisconsin appears to involve the D.A. stipulating what would normally require witnesses who are cross examined (imagine that this was a drug overdose related death and then try to imagine such a stipulation).

I’m all for alternative medicine. As long as you do it on yourself in your own time after first pursuing scientific medical options and mainly use it for stress reduction and to facilitate whatever it is good at facilitating, and avoid zero-return expensive claims or crazy shit like not getting your children vaccinated or any form of chiropractry or homeopathy and several other things. Well, OK, so I’m not all for alternative medicine. I just know a lot of people who I like who are into it to one degree or another and I don’t want them to hate me. Too much.

But I digress.

My point here has nothing to do with alternative medicine. It has to do with religious appeasement, which is unjustified, unconstitutional, and unwise.

I wonder if they’ll ever find Hauser? ?

Does Lithium in Drinking Water Reduce Suicide Rates?

ResearchBlogging.orgLithium has long been used as a psychotherapeutic drug, and treatment with lithium demonstrably reduces incidence of suicide. Lithium also occurs naturally in groundwater to varying degrees. This study explores the relative amount of Lithium in groundwater and suicide in 18 municipalities in Oita prefecture, Japan over a period running from 2002 to 2006. There are two principle findings:

Continue reading Does Lithium in Drinking Water Reduce Suicide Rates?

The new swine flu: don’t panic, but there is a very bad WCS

I have a handful of comments, mostly about how what you are seeing on the news is unimportant, and one comment about why you actually should worry. Within reason.

The new Swine Flu has now been verified in nineteen US states, with 141 cases. Technically there is 1 death, but since the young girl who died actually caught the flu in Mexico (and came to Texas for treatment) it is hard to say how that should be counted.

WHO characterizes the global spread of the flu as a “rapidly evolving” situation. As of an early morning update from WHO, the swine flu has been confirmed in Mexico (156 confirmed cases) as well as Austria, Canada, Germany, Israel, Netherlands, New Zealand, Spain, Switzerland and the UK. Each of these countries has between 1 and about a dozen cases, except Canada which has 34.

My comments:

Continue reading The new swine flu: don’t panic, but there is a very bad WCS

Grapefruit juice might boost cancer drug’s effects

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photograph of some grapefruit
Grapefruit juice contains enzymes that break down common types of compounds of which pharmaceuticals are made. This means that if you drink grapefruit juice along with some drugs, the effect of the drug will be enhanced.

(That was a slight oversimplification.)

So great, you say, why not just take all drugs with a glass of grapefruit juice? Well, I can think of two reasons. One, grapefruit juice tastes like ape-piss, so why would you ever drink it. Two, drug experts feel that they have more control over your dosage if you just leave the grapefruit juice out of the equation.

But, not always.
Continue reading Grapefruit juice might boost cancer drug’s effects