Category Archives: Medicine

Hunger for fuel leads to another health woe

From the Johns Hopkins Bloomberg School of Public Health, with a H/T to Newswise:

Study: Fracking Industry Wells Associated With Premature Birth

New research suggests increased risk of adverse pregnancy outcomes closer to active unconventional natural gas wells

Expectant mothers who live near active natural gas wells operated by the fracking industry in Pennsylvania are at an increased risk of giving birth prematurely and for having high-risk pregnancies, new Johns Hopkins Bloomberg School of Public Health research suggests.

The findings, published online last week in the journal Epidemiology, shed light on some of the possible adverse health outcomes associated with the fracking industry, which has been booming in the decade since the first wells were drilled. Health officials have been concerned about the effect of this type of drilling on air and water quality, as well as the stress of living near a well where just developing the site of the well can require 1,000 truck trips on once-quiet roads.

“The growth in the fracking industry has gotten way out ahead of our ability to assess what the environmental and, just as importantly, public health impacts are,” says study leader Brian S. Schwartz, MD, a professor in the Department of Environmental Health Sciences at the Bloomberg School. “More than 8,000 unconventional gas wells have been drilled in Pennsylvania alone and we’re allowing this while knowing almost nothing about what it can do to health. Our research adds evidence to the very few studies that have been done in showing adverse health outcomes associated with the fracking industry.”

In Pennsylvania in 2006, there were fewer than 100 unconventional gas wells; now there are more than 8,000.

For his study, Schwartz and his colleagues analyzed data from Geisinger Health System, which covers 40 counties in north and central Pennsylvania. They studied the records of 9,384 mothers who gave birth to 10,946 babies between January 2009 and January 2013. They compared that data with information about wells drilled for fracking and looked at how close they were to the homes of the pregnant mothers as well as what stage of drilling the wells were in, how deep the wells were dug and how much gas was being produced at the wells during the mothers’ pregnancies. Using this information, they developed an index of how active each of the wells were and how close they were to the women.

The researchers found that living in the most active quartile of drilling and production activity was associated with a 40 percent increase in the likelihood of a woman giving birth before 37 weeks of gestation (considered pre-term) and a 30 percent increase in the chance that an obstetrician had labeled their pregnancy “high-risk,” a designation that can include factors such as elevated blood pressure or excessive weight gain during pregnancy. When looking at all of the pregnancies in the study, 11 percent of babies were born preterm, with the majority (79 percent) born between 32 and 36 weeks.

The U.S. Centers for Disease Control and Prevention says that preterm-related causes of death together accounted for 35 percent of all infant deaths in 2010, more than any other single cause. Being born prematurely is also a leading cause of long-term neurological disabilities in children. Preterm birth cost the U.S. health care system more than $26 billion in 2005, they say.

Read the rest.

Video: Confronting the AIDS epidemic in Tijuana

And important and troubling documentary about battling the spread of AIDS just south of the California border, via University of California Television:

HIV/SIDA: Epidemic in Tijuana

Program notes from the UC San Diego News Center:

The new documentary “HIV/SIDA: The Epidemic in Tijuana” offers an unflinching look at the challenges facing researchers from the University of California, San Diego as they attempt to identify and treat people who inject drugs, sex workers, transgender women and others who are at high risk for HIV infection in Tijuana. The program. . .was shot over two years.

The documentary is split into four episodes, each telling a piece of the HIV/AIDS story in Tijuana. The series starts in El Bordo, a neighborhood of injecting drug users in the Tijuana River Canal, and then moves to Prevencasa where UC San Diego and Mexican medical students offer free care at the Health Frontiers in Tijuana clinic. From there, it turns its focus to a tattoo removal clinic and then a telemedicine program that connects patients with remotely located HIV doctors. The series continues with poignant stories and photos of people living with HIV and concludes with a wrap of what it would take to end the HIV/AIDS epidemic in Tijuana.

“HIV/SIDA” is organized around the research of UC San Diego epidemiologist Steffanie Strathdee, who is the chief of UC San Diego’s division of Global Public Health, UCSD psychologist Tom Patterson and their binational team of doctors, nurses and healthcare outreach workers. Their research has shown that Tijuana’s prevalence of HIV is three times higher than in Mexico at large. Strathdee said the documentary is a call to action to address the epidemic in a strategic and coordinated manner.

“It’s possible to end AIDS in Tijuana, but we need to take a broader look. Mexico as a whole should see Tijuana as a window for what could be the HIV epidemic for the rest of the country,” she said. “I also believe it shouldn’t just be Mexico’s responsibility to stop this epidemic because we have a shared population across the border. We need a binational response.”

The binational nature of Tijuana’s epidemic is reflected in the series title as SIDA is the Spanish term for AIDS, the acronym for síndrome de inmunodeficiencia adquirida.

“HIV/SIDA” was made possible through a grant from the Ford Foundation. UCTV Producer Shannon Bradley based the video series on Tomorrow Is a Long Time, a photo essay book with vignettes by photographer Malcolm Linton and Jon Cohen, two long-time collaborators who have travelled to more than 30 countries to document the HIV/AIDS epidemic for Science magazine.

Cohen said there is already a recipe for how to end the AIDS epidemic, which includes:

  • Identifying where high-risk groups congregate and then saturating those locales with rapid HIV testing and distributing educational materials as well as condoms, clean needles and syringes.
  • Testing all pregnant women.
  • Offering circumcision to men.
  • Connecting those who test positive with counselors who can emphasize the importance of treatment and not infecting others.
  • Providing antiretrovirals to all those infected with HIV and having case workers oversee their treatment so they achieve undetectable viral loads, which makes transmission to others less likely.
  • Offer antiretrovirals as preventatives to high-risk groups as a way to reduce transmission.

“We all know the recipe for ending AIDS,” Cohen said, “but it’s not happening aggressively enough in Tijuana. Could we do this? Could we break the back of the epidemic and get to the point where one person isn’t infecting another? Absolutely. The tools exist.”

Chart of the day: Resistance to malaria drug

UC Berkeley “bioengineer” Jay Keasling became a media darling after Bill Gates decided to bankroll Amyris [previously], a company that would tweak the genes to the antimalarial drug artemisinin which would be far cheaper than the standard version, refined from plants grown by small farmers in Africa and Southeast Asia.

By the time all was said and done, production of the GMO-derived drug was given to a Big Pharma outfit and produced at a price that was no cheaper than the existing drug.

The net result: Small farmer saw their incomes cut.

The notion of artemisinin as a panacea for the disease, a cause Gates no doubt saw as a way to use his wealth to do good, has been soundly defeated, as indicated in this graphic from the 31 July 2014 edition of the Wall Street Journal:

BLOG Artemisinin

World Malaria Day offered some key numbers in April:

BLOG Malaria

Keassling’s company repurposed itself to reengineer the bugs to produce cheap fuel from plant cellulose, fuels more efficient than the ethanol derived from more readily refined plant sugars.

The company went public with much fanfare and media hype, and stock soon rose to $33.85. But as the hype proved just that, shares began to fall, currently selling for $2.13 a share. But Keasling sold out early and walked away with an eight-figure payoff.

And the search for a more effective antimalarial is on.

Anorexia, a case of microbes and gut feelings?

In our anthropocentric arrogance, humans typically draw a sharp line between Self and Other. But the more we learn, the fuzzier the boundaries get. Each self contains a great deal of other, from the viral genetic invaders in our very DNA to the vast population of microbes inhabiting our digestive tracts.

And now we are discovering that our own mental states may be directly impacted by the nature of the population of all those intestinal flora.

From the University of North Carolina School of Medicine via Newswise:

Researchers at the UNC School of Medicine found that people with anorexia nervosa have very different microbial communities residing inside their guts compared to healthy individuals and that this bacterial imbalance is associated with some of the psychological symptoms related to the eating disorder.

The findings, published today in the journal Psychosomatic Medicine, provide more evidence that the abundance and diversity of the gut microbiota – the trillions of bacteria that affect digestive health and immunity – could also affect the so-called “gut-brain axis.” This research suggests that gut bacteria could play a prominent role in the debilitating symptoms of anorexia nervosa, a serious eating disorder that affects more than 3 million Americans and has the highest mortality rate of any psychological disorder.

“Other studies have linked gut bacteria to weight regulation and behavior,” said Ian Carroll, PhD, senior author of the paper and assistant professor of medicine in the UNC Center for Gastrointestinal Biology and Disease. “Since people with anorexia nervosa exhibit extreme weight dysregulation, we decided to study this relationship further.”

Carroll added, “We’re not able to say a gut bacterial imbalance causes the symptoms of anorexia nervosa, including associated symptoms, such as anxiety and depression. But the severe limitation of nutritional intake at the center of anorexia nervosa could change the composition of the gut microbial community. These changes could contribute to the anxiety, depression, and further weight loss of people with the disorder. It’s a vicious cycle, and we want to see if we can help patients avoid or reverse that phenomenon. We want to know if altering their gut microbiota could help them with weight maintenance and mood stabilization over time.”

The aliens Republicans should worry about

Instead of the two-legged support invoked by GOP candidates to elicit knee-jerks from jerks, they should cough up funds to counter a pair of tiny winged six-legged invaders capable of doing serious harm. But that would mean investing in public health, hardly a GOP ideal these days.

The two invaders are previously unknown-to-California species of mosquito, Aedes aegypti and Aedes albopictus, previously unknown to the Golden State, and what makes them particularly troublesome is their role as vectors for transmission of a variety of diseases.

This map from the latest issue of the Centers for Disease Control’s Emerging Infectious Diseases [PDF] maps the spread of the insects compared with outbreaks of two diseases they carry, dengue fever and chikungunya, in California:

BLOG Aedes

John Oliver on America’s mentally ill

Plus a qualification. . .

The very concept of mental illness remains a fraught subject for discourse, both for those to whom the term is applied and for those making the application.

Historically, stigmatizing labels have often been used to punish, banish, and even kill and used to incite mob violence. Just as a weed is a plant out of place, to quote my favorite college prof, so many of today’s mentally ill may be people who would fit comfortably into now-vanished societal niches where they wouldn’t be considered other than normal. And in the inverse conditions, men and women who once were considered sexual deviants and now joining the societal mainstream and are courted by advertisers.

Consider a mental illness diagnosis reported by the New York Times:

In 1851, Dr. Samuel A. Cartwright, a Louisiana surgeon and psychologist, filed a report in the New Orleans Medical and Surgical Journal on diseases prevalent among the South’s black population. Among the various maladies Dr. Cartwright described was “drapetomania” or “the disease causing slaves to run away.”

Though a serious mental illness, drapetomania, wrote Dr. Cartwright, was happily quite treatable: “The cause, in the most of cases, that induces the negro to run away from service, is as much a disease of the mind as any other species of mental alienation, and much more curable. With the advantages of proper medical advice, strictly followed, this troublesome practice that many negroes have of running away can be almost entirely prevented.”

Coined from Greek roots for runaway slave and madness, drapetomonia wasn’t the good doctor’s only neologism. Atlanta social worker and mental health historian Vanessa Jackson quotes from another of his“scientific” diagnoses:

Dr. Cartwright also diagnosed Dysaethesia Aethiopica, or “hebetude of the mind and obtuse sensibility of the body-a disease peculiar to Negroes called by overseers-Rascality. “ Dysethesia Aethiopica differed from other species of mental disease since physical signs and lesions accompanied it. The ever-resourceful Dr. Cartwright determined that whipping could also cure this disorder. Of course, one wonders if the whipping were not the cause of the “lesions” that confirmed the diagnosis. Not surprisingly, Dr. Cartwright was a leading thinker in the pro-slavery movement. Dr. Cartwright, in his article “Diseases and Peculiarities of the Negro Race, “ chided his anti-slavery colleagues by noting “The northern physicians and people have noticed the symptoms, but not the disease from which they spring. They ignorantly attribute the symptoms to the debasing influence of slavery on the mind without considering that those who have never been in slavery, or their fathers before them, are the most afflicted, and the latest from the slave-holding south the least. The disease is the natural offspring of Negro liberty-the liberty to be idle, to wallow in filth, and to indulge in improper food and drinks. “

And what did the good doctor use as evidence for the validity of his diagnoses?

To ascertain the true method of governing negroes, so as to cure and prevent the disease under consideration, we must go back to the Pentateuch, and learn the true meaning of the untranslated term that represents the negro race. In the name there given to that race, is locked up the true art of governing negroes in such a manner that they cannot run away. The correct translation of that term declares the Creator’s will in regard to the negro; it declares him to be the submissive knee-bender.

But there, almost certainly, some who are genuinely afflicted beyond the realm of mere external circumstances, those whose thoughts and emotions march to different drummers.

With that by way of preface, the latest from Last Week Tonight with John Oliver:

Last Week Tonight with John Oliver: Mental Health

Program note:

John Oliver explains how our national system of treating mental health works, or more often than not, how it doesn’t.

Fructose consumption impairs brain healing

Your mother was right: Drinking soft drinks does cause brain damage, or at least impairs healing from brain injuries.

Following up on yesterday’s item on the politics of Big Sugar comes this item from the UCLA Newsroom:

A diet high in processed fructose sabotages rats’ brains’ ability to heal after head trauma, UCLA neuroscientists report.

Revealing a link between nutrition and brain health, the finding offers implications for the 5.3 million Americans living with a traumatic brain injury, or TBI. According to the Centers for Disease Control and Prevention, an estimated 1.7 million people suffer a TBI each year, resulting in 52,000 annual deaths

“Americans consume most of their fructose from processed foods sweetened with high-fructose corn syrup,” said Fernando Gomez-Pinilla, a professor of neurosurgery and integrative biology and physiology at UCLA’s David Geffen School of Medicine. “We found that processed fructose inflicts surprisingly harmful effects on the brain’s ability to repair itself after a head trauma.”

Fructose also occurs naturally in fruit, which contains antioxidants, fiber and other nutrients that prevent the same damage.

In the UCLA study, published today in the Journal of Cerebral Blood Flow and Metabolism, laboratory rats were fed standard rat chow and trained for five days to escape a maze. Then they were randomly assigned to a group that was fed plain water or a group that was fed fructose-infused water for six weeks. The fructose was crystallized from corn in a dose simulating a human diet high in foods and drinks sweetened with high-fructose corn syrup.

A week later, the rats were anesthetized and underwent a brief pulse of fluid to the head to reproduce aspects of human traumatic brain injury. After an additional six weeks, the researchers retested all the rats’ ability to recall the route and escape the maze.

The scientists discovered that the animals on the fructose diet took 30 percent longer to find the exit compared to those that drank plain water.

The UCLA team found that fructose altered a wealth of biological processes in the animals’ brains after trauma. The sweetener interfered with the ability of neurons to communicate with each other, rewire connections after injury, record memories and produce enough energy to fuel basic functions.

Read the rest.