Tuesday, September 30, 2008

Pain Promotes Disease State

If you understand that any condition ending is "itis" means inflammation, this report is reasonable. Arthritis means inflammation of the joints.

It doesn't go far enough in terms of identifying what creates the state and degree of pain.

Pain is interpreted individually based on socialization, culture, education and many other variables.

Some researchers have identified emotional states associated with arthritis and other health issues. Perhaps this is a step beyond the physical and mental components of health and moving forward toward the recognition of emotional and spiritual factors in today's industrialized medicine.
Study: Pain causes osteoarthritis
Sept. 30, 2008 ROCHESTER, N.Y., (UPI) -- Pain is not just a symptom of osteoarthritis, it causes the disease, say researchers at the University of Rochester Medical Center.

A study, published in the journal Arthritis and Rheumatism, revealed that pain signals originating in arthritic joints -- and the biochemical processing of the signals as they reach the spinal cord -- worsen and expand arthritis, causing disease at both ends.

In addition, the researchers found that nerve pathways carrying pain signals transfer inflammation from arthritic joints to the spine and back again.

"Until relatively recently, osteoarthritis was believed to be due solely to wear and tear, an inevitable part of aging," said Stephanos Kyrkanides, an associate professor of dentistry at the University of Rochester Medical Center.

"Recent studies have revealed, however, that specific biochemical changes contribute to the disease, changes that might be reversed by precision-designed drugs. Our study provides the first solid proof that some of those changes are related to pain processing, and suggests the mechanisms behind the effect."

Furthermore, if joint arthritis can cause neuro-inflammation, it could have a role in conditions like Alzheimer's disease, dementia and multiple sclerosis, the researchers suggest.

Health Privacy: You Have None

There has been a push to place your health records in electronic form for several decades. Our organization has always spoken against this plan and HIPAA. It is an important issue at this time, once again, because candidates for presidential office are in favor of electronic health records as a cost control action.

And you might ponder why Microsoft and Google are at odds with each other to get you to (hastily) post your medical records on their servers.

There is money to be made!
"A federal agency, not Congress, took away your right to control your health information. Your right to control the use and disclosure of your personal health information was eliminated in 2003 by regulatory changes made to HIPAA, the Health Insurance Portability and Accountability Act. HIPAA is a complex 1,500 page set of rules covering things such as the transfer of health insurance when you change jobs. (Read more about HIPAA and the Elimination of Consent)."
Become educated and just like the current bailout nightmare, vote against this type of legislation.

Is there anything in your health record that you would not want to share with others? Prescriptions for anti-depressants, anxiety, cancer, long-ago abortions, AIDS or HIV, testing for the Alzheimer gene, your child’s Autism or ADD, sexual impotency prescriptions, hospital admissions, or anything else?

You assume your most personal health information is private, right? It's not.

Like most Americans, you probably believe:

* What you tell your doctor is totally private
* If you sign "privacy notices" at a doctor's office, a pharmacy, a hospital or a lab, you health records will not be used or disclosed without your permission
* No one can look at your sensitive health records, prescriptions or tests without your permission

NONE of these assumptions are true. Your right to decide who can see and use your sensitive, personal health information was eliminated in 2003. See how.

Who Can See and Use your Health Records?

Over 4 million businesses, employers, government agencies, insurance companies, billing firms, and all their business associates that may include pharmacy benefits managers, and pharmaceutical companies as well as marketing firms and data miners. See a sample chart here.

Patient consent is no longer required to share health records, no matter how embarrassing or intensely personal the contents may be. While your doctor may wish to protect your information, once the records are sent out of their offices, they can no longer control who cna see or use your information.

Whose Health Records are Vulnerable?

Employees: Today, laws governing access to health records expose employees to the possibility of employment discrimination. Thirty-five percent of Fortune 500 companies admitted to looking at employee’s health records before making hiring and promotion decisions (65 Fed. Reg. 82,467). As employers seek to reduce health insurance costs, little prevents them from viewing employees’—and employee’s families—health records to get rid of capable employees with costly health conditions. Employment should be based on who can do the job—not what's in our health files.

Women: Women are particularly vulnerable to discrimination in employment, insurance and in the financial and credit arena. Women have specific, sensitive health issues that have nothing to do with what kind of job they can perform or whether or not they should get credit or insurance.

Children: In the age of genetic testing, how will information about our children’s health affect their futures? Should they be denied entry to college because they tested positive for a cancer gene or were treated for depression as a teenager? Should they be turned down for a job because they have a grandparent who had Alzheimers? Without privacy, our children’s health records could deny them the future they deserve.

Seniors: After a lifetime of health treatment, seniors’ health records contain a wealth of information that could harm them, their children and their grandchildren. Should a grandmother’s Alzheimer’s disease keep her grandchildren from getting a job? Should a widower’s depression over the death of a spouse keep him from getting auto insurance? Should a diagnosis expose a senior to drug company marketing disguised as "education"?

Consumers: As health records are spread over electronic networks, banks, insurance corporations, and lenders can access our most personal health records. Should homeowners pay higher interest rates because they are cancer survivors? Should drivers be denied automobile insurance because they have a medical condition? Without privacy, consumers’ health histories expose them to real financial risks and threaten their livelihoods.

How Did This Happen?

A federal agency, not Congress, took away your right to control your health information. Your right to control the use and disclosure of your personal health information was eliminated in 2003 by regulatory changes made to HIPAA, the Health Insurance Portability and Accountability Act. HIPAA is a complex 1,500 page set of rules covering things such as the transfer of health insurance when you change jobs. (Read more about HIPAA and the Elimination of Consent).

The changes mean that millions of strangers, as well as employers, can use your health records for reasons that have nothing to do with your treatment or improving your health care. In an era of Electronic Health Records (EHRs) and Personal Health Records (PHRs), the problem gets much worse.

Electronic health records are supposed to save lives and money -- how can you be against progress?

We're not. In fact, privacy is the key to progress with Health Information Technology (HIT). The potential benefits of electronic health systems cannot be realized unless Americans have confidence that ironclad privacy protections are in place for online health records, databases, and networks. As Americans realize how open their records actually are, they will avoid treatment and be much more selective about important information they share with their doctors. Patient Privacy Rights applauds the smart use of technology in medicine and the healthcare industry.

Bottom line: No one should have to choose between privacy and health.

The Who, What & Why’s of Dietary Supplements


WASHINGTON—The Council for Responsible Nutrition (CRN) and the Natural Products Association (NPA) hosted the Dietary Supplement Caucus this week on Capitol Hill for a briefing on the "The Who, What & Why’s of Dietary Supplements." More than 50 members of the Senate and House of Representatives, as well as various congressional committees attended the briefing, which featured presentations by CRN, NPA and Nutrition Business Journal (NBJ).

Among the highlights were:

Data presented from the 2007 CRN Consumer Confidence Survey and the 2007“Life...supplemented” Healthcare Professionals (HCP) Impact Study, showing 150 million American take dietary supplements annually, including 68 percent of adults.
Further, 72 percent of physicians and 89 percent of nurses take supplements, with roughly 80 percent of each group recommending them to patients. Other data included geographical supplement usage and lifestyle trends among users.

The dietary supplement industry posted its best growth in 2007, 5.9 percent, since 1998, according to NBJ, which indicated omega-3, probiotic and superfruit supplements were the primary drivers; ranked in terms of sheer volume, not growth rate, multivitamins and sports formulas reigned supreme. NBJ further noted the important influence of two key regulatory milestones, the final good manufacturing practice (GMP) rules and the implementation of the serious adverse event reporting (SAER), as well as the monumental acquisition in 2007 of the faltering Leiner Health Products by NBTY.

Rep. Frank Pallone (D-NJ), chairman of the Subcommittee on Health within the Energy and Commerce Committee and co-chair of the Dietary Supplement Caucus, discussed the importance of dietary supplements as key components of prevention and wellness. He also said dietary supplements and prevention would play important roles in the policy discussion during healthcare debates in Congress next year.

Rep. Chris Cannon (R-UT), co-chair of the Dietary Supplement Caucus, noted, “The reason the supplement market has grown is due to supplement consumers using the products. And [what we see in this industry is] a terrific movement toward people taking care of their own health.”

The results from the Lewin Group studies, performed on behalf of the Dietary Supplement Education Alliance (DSEA), were presented by Joan Davanzo, Davanzo & Dobson, who was affiliated with Lewin Group at the time of the studies. She reiterated the cost savings potential found for omega-3s ($3.2 billion), calcium/vitamin D ($16.2 billion), folic acid ($1.4 billion), and lutein/zeaxanthin ($3.6 billion), adding in stats for reduced hospitalizations for each ingredient/pair.

Beware! Flu Shot Propaganda Now on Fast Track

"It is now 30 years since I have been confining myself to the treatment of chronic diseases. During those 30 years I have run against so many histories of little children who had never seen a sick day until they were vaccinated and who, in the several years that have followed, have never seen a well day since. I couldn't put my finger on the disease they have. They just weren't strong. Their resistance was gone. They were perfectly well before they were vaccinated. They have never been well since. "---Dr. William Howard Hay

There are quite a few articles located on Natural Health News addressing vaccine issues. Should you have a greater interest, use the search function to locate them.

As one homeopathic MD I knew some years ago stated, "It's always the kids that get the vaccines that always seem to be sick."

“There is no evidence that any influenza vaccine thus far developed is effective in preventing or mitigating any attack of influenza. The producers of these vaccines know that they are worthless, but they go on selling them anyway.”
- Dr. J. Anthony Morris (former Chief Vaccine Control Officer of FDA)

Yes, there are risks to flu shots. Ask your health care provider exactly what they are beyond soreness at the injection site.

In the northern hemisphere we are moving into the colder fall and winter months, the time of year when you are bombarded with pressure to get a flu shot.

This campaign targets pregnant women, babies, children and adults, people with selected health issues and others.

This year, according to the FDA, six vaccines are available to protect against influenza virus types A and B including

* Afluria, for adults 18 years of age and older
* Fluarix, for adults 18 years of age and older
* FluLaval, for adults 18 years of age and older
* Fluvirin, for people 4 years of age and older
* Fluzone, for people 6 months of age and older
* FluMist, for people ages 2 to 49

Of the 146 million doses for this flu season, and in all years, efficacy of flu vaccine is always low. Often the efficacy is no more than 45 percent.

Vaccines for this year contain the following strains:

* an A/Brisbane/59/2007 (H1N1)-like virus
* an A/Brisbane/10/2007 (H3N2)-like virus
* a B/Florida/4/2006-like virus

Critics state that the death toll from flu may be inflated and the majority of deaths result actually from pneumonia, which causes symptoms similar to that of flu. In many cases people who have received the jabs are the ones who are getting ill. Other concerns about the nasal spray like FluMist is that is makes you contagious for several weeks.

The pneumonia shot isn't one I'd take either. Using vitamin A (cod liver oil is best as is a product blending vitamin A with beta-carotene) helps protect your respiratory system. Vitamin C and garlic are also antibacterial and antiviral. Adequate hydration is critical as is sound nutritional practice.

Vaccine ingredients

For more information on prevention, see Cold & Flu.

Remember, anyone providing flu shots or other vaccines is required by law to explain to you the risks and benefits of the treatment, including, but not limited to, what the ingredients are and what they do and what problems they can cause.

And some additional information for you to consider from Herbal Legacy -
The CDC has a goal to vaccinate an astonishing 261 million people this year!

Why the push? The CDC claims that 36,000 people die each year from the flu, and that getting the vaccine will prevent you from getting the flu, therefore saving your life.

How much of this is true? Do you need the vaccine? Is it safe or effective?

Let's take a look at the numbers first - do 36,000 people die from the flu each year?

According to the Centers for Disease Controls own Vital Statistics (the exact same website that claims that 36,000 people die from the flu each year), 1100 people died from the flu in 2004, 1812 in 2005 and 860 people died in 2006 from the flu. This has actually spiked dramatically - deaths in 2001 were only 257. Of those deaths attributed to the flu, very few are actually determined for sure that they are tied to influenza.

So why does the CDC claim that 36,000 people die from the flu each year? Apparently researchers with the British Medical Journal wondered the same thing when they asked, "Are US flu death figures more PR than science?" They concluded that the numbers are inflated to scare the public and sell more of the vaccine (3).

Consequently - they come up with the 36,000 based on two things - 1) a flu epidemic in Hong Kong that killed about 34,000 people, and 2) by combining flu deaths with pneumonia deaths (which is completely different from the flu and even if the flu vaccine did provide immunity against the flu it would not provide immunity against pneumonia).

Despite the outright false data and the numbers, if the flu shot is effective then you want to get the shot, right? Let's take a look at that question: Is the flu shot safe or effective?

If it were effective then certainly health care workers (HCWs), who are exposed to the flu and other diseases every day, would line up to get their vaccine. According to the Journal of Internal Medicine, that isn't the case. The overall vaccination rate among HCWs is just 38%. The study concluded that "The overall influenza vaccination rate among HCWs in the United States is low. Interventions seeking to improve HCW vaccination rates may need to target these specific subgroups" (4).

Regarding the effectiveness of the shot, it is important to know how the manufacturers determine what strains of flu to put in that year. They travel to Asia early in the year and collect data, then guess as to which three flu strains will work their way across the ocean for the beginning of the flu season.

According to the Think Twice Institute:

"Flu 'experts' often guess wrong. For example, in 1994 they predicted that Shangdong, Texas, and Panama strains would be prevalent that year, thus millions of people were vaccinated with a flu shot that contained these viruses. However, when winter arrived, the Johannesburg and Beijing strains of influenza circulated through society. The vaccine was ineffective. This happened again in 1996, and again in 1997. More recently, the vaccine created for the 2003-2004 flu season contained flu strains that did not circulate through society that year. Officials were once again forced to admit that millions of people were vaccinated with an ineffective vaccine."

But what if they guess right for the year and the flu vaccine does contain the correct strains? We'll answer that with a question: Do you know what is in your flu vaccine? You may not want one even if they do guess right, simply because of the ingredients.

Here are some of the ingredients:
· Chick embryos
· Three flu viruses that were collected in Asia in last January or February
· Formaldehyde (that's right - the stuff they embalm humans with and classified as a known cancer-causing substance by the International Agency for Research on Cancer)
· Thimerosal - a mercury based preservative which can lead to brain injury, autoimmune diseases and autism, and frequently aluminum substances that may contribute to Alzheimer's
· Sodium Phosphate or Sodium Chloride
· Gelatin

While we are not offering medical advice of any kind, we believe it is your right to know all of the above information and then make an informed decision about getting a flu shot.

For commentary on vaccines and children, please see this long but worthwhile letter from a mother.

And more here -

Monday, September 29, 2008

Pain Relief Short Changes Women

I am not surprised that this type of bias still exists after so many years and so many more women in health care.

It tells me that we really need a greater overhaul of medical education and the medical industry that people are willing to address.

And I am sure that it isn't an issue just for people with cancer.

There are many natural options for people experiencing pain that are as, if not more, effective that pharmaceuticals that may also promote addiction. The key to this, however, remains making the relief of pain tailored to the person's needs and also to include properly addressing the emotional component of what they are facing and living with every day.
Sex bias seen in control of cancer pain Fri Sep 26, 2008

How well pain is managed in people with cancer apparently differs between men and women, new research hints.

Dr. Kristine A. Donovan, of the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Florida, and colleagues examined pain severity and the adequacy of pain management in 131 cancer patients newly referred to a multidisciplinary cancer pain clinic.

Men and women did not differ significantly in terms of worst pain scores, least pain scores, or pain interference. However, average pain in the last week and pain right now were significantly higher in women.

In addition, the average total daily dose of pain-killers was significantly greater for men (130 versus 66 milligrams morphine equivalent value).

Women were also significantly less likely than men to receive prescriptions for high potency opioids (33 percent versus 51 percent).

Women were also significantly more likely than men to report inadequate pain control, as indicated by scores on a standard pain management scale.

These findings, Donovan and colleagues conclude, highlight the need to improve the treatment of pain in cancer patients and to "more closely examine physician and patient-related factors that may hinder adequate pain management."

SOURCE: The Journal of Pain and Symptom Management, August 2008.

Copyright © 2008 Reuters Limited.

Statins Anti-Aging?

Reducing the effects of aging are simple and effective through the use of supplements and foods. A very expensive drug known to have extremely dangerous side effects is not one I would include on my list.

Historically there was very little atherosclerosis and arteriosclerosis when people were still able to purchase raw milk, and especially milk that had not been homogenized. Once homogenization began the incidence if "clogged arteries" rose quickly.

I suppose this is one reason why I oppose any legislation making USDA cloned dieticians the resource for nutrition information.

Simply one might make an effort to increase the amount of vitamin C they take daily, The benefits of this vitamin alone could never be matched for health benefit by a statin drug.

Another helper is to mix unsweetened applesauce with yoghurt and enjoy a small serving daily. This combination makes your arteries more flexible and offers the benefit of improving gut health and providing some potassium and fiber.

Cod liver oil, olive oil, coconut oil and yes! even butter will help too by providing essential fatty acids that promote utilization of necessary fat soluble vitamins A, D, E, and K.

Just make it a point to avoid highly processed foods and those loaded with preservatives and artificial sweeteners.
Statins 'prevent artery ageing'
Drugs given to heart patients to lower cholesterol may have an additional benefit - keeping their blood vessels feeling younger.

Advanced heart disease patients have arteries which have effectively aged faster than the rest of their bodies.

University of Cambridge scientists, writing in the journal Circulation Research, say statins may be able to hold back this process.

They hinted the same drugs might also prevent damage elsewhere in the body.

Statins are seen as a key tool in the fight against heart disease, and in low doses have been made available "over-the-counter" at pharmacies.

While it has been known for some time that they can lower cholesterol levels, this did not fully account for the benefits experienced by some patients, and evidence is growing that they can boost the function of the cells lining the heart arteries.

The Cambridge study adds to this evidence, and may shed light on how statins do this.

Cells in the body can only divide a limited number of times, and in patients with heart disease, the rate of division in these arterial cells is greatly accelerated - dividing between seven and 13 times more often than normal.

As the cells "run out of " divisions, they can suffer DNA damage, and do not work as well.

One of the important roles of these cells is to keep the artery clear of fatty "plaques" which can expand and block them, causing angina or heart attack.

Cancer clue

The research found that statins appear to increase levels of a protein called NBS-1, which is involved in the repair of DNA within cells. This means they may be able to hold off the effects of old age in the artery wall for a little longer.

Professor Martin Bennett, who led the research, said: "It's an exciting breakthrough to find that statins not only lower cholesterol but also rev up the cells' own DNA repair kit, slowing the ageing process of the diseased artery.

"If statins can do this to other cells, they may protect normal tissues from DNA damage that occurs as part of chemotherapy and radiotherapy for cancer, potentially reducing the side-effects."

Professor Peter Weissberg, the British Heart Foundation's medical director, added: "Too much cholesterol in the blood induces a repeated cycle of damage and repair in the blood vessel wall which results in a heart attack if the repair mechanism is inadequate.

"Statins protect against heart attacks by reducing cholesterol levels and subsequent damage to the vessel wall - this research has shown they may also enhance the blood vessels' natural repair mechanisms."

Story from BBC NEWS:http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/7637937.stm
Published: 2008/09/28 23:13:23 GMT

Sunday, September 28, 2008

SPLENDA Effects Update

If you don't know the history of Sucralose or Splenda, it was originally developed as a pesticide. Information withheld from the manufacturer include shrinkage of the thmus (part of your immune system), liver swelling and calcification of the kidneys.
New Study of Splenda and Sucralose Reveals Shocking New Information About Potential Harmful Effect on Humans
MINNEAPOLIS, Sept. 22, 2008 (GLOBE NEWSWIRE) -- James Turner, chairman of the national consumer education group Citizens for Health expressed shock and outrage after reading a new report from scientists at Duke University. "The report makes it clear that the artificial sweetener Splenda and its key component sucralose pose a threat to the people who consume the product. Hundreds of consumers have complained to us about side effects from using Splenda and this study, published this past week in the Journal of Toxicology and Environmental Health Part A, confirms that the chemicals in the little yellow package should carry a big red warning label," said Turner.

Among the results in the study by Drs. Mohamed B. Abou-Donia, Eman M. El-Masry, Ali A. Abdel-Rahman, Roger E. McLendon and Susan S. Schiffman is evidence that, in the animals studied, Splenda reduces the amount of good bacteria in the intestines by 50%, increases the pH level in the intestines, contributes to increases in body weight and affects the P-glycoprotein (P-gp) in the body in such a way that crucial health-related drugs could be rejected. Turner noted that the P-gp effect "could result in crucial medications used in chemotherapy for cancer patients, AIDS treatment and drugs for heart conditions being shunted back into the intestines rather than being absorbed by the body as intended."

The study was conducted using male rats over a period of twelve weeks. The manufacturers of Splenda also used a rat study when they applied for and received approval to market the product from the U.S. Food and Drug Administration. At the time, the findings from their rat studies were extrapolated as to possible effects on humans. This is standard FDA practice and this study is consistent with that practice.

Turner said, "This report followed accepted policies and procedures and the results make clear the potential for disturbing side effects from the ingestion of Splenda. It is like putting a pesticide in your body. And this is at levels of intake erroneously approved by the Food and Drug Administration. A person eating two slices of cake and drinking two cups of coffee containing Splenda would ingest enough sucralose to affect the P-glycoprotein, while consuming just seven little Splenda packages reduces good bacteria." Although the effect of consuming Splenda does not result from a one time use, the side effects do occur after accumulated use. Turner also noted unmistakable evidence that Splenda is absorbed by fat, contrary to the claims of Johnson & Johnson.

Turner announced, "We are calling today on the FDA to immediately accept our petition filed over a year ago and initiate a review of its approval of sucralose and to require a warning label on Splenda packaging cautioning that people who take medications and/or have gastrointestinal problems avoid using Splenda. The new study makes it clear that Splenda can cause you to gain weight and lose the benefits of medications designed to improve and protect your health. The FDA should not continue to turn a blind eye to this health threat."

Citizens for Health will testify in Sacramento, CA, on October 3, 2008, before the California Assembly Committee on Health which is examining the use of deceptive advertising to promote sales of potentially unhealthy food additives, particularly artificial sweeteners.

Saturday, September 27, 2008

NCI Blunder Exposes Truth

If you are ill-informed on the microwave and health risks, EMF, cell phones/towers, WIFI, et al, perhaps you best start delving more into the issues.

After all, DTV is on the way in just a few more months.

See Also WEEP News and The WEEP Initiative
Robert Hoover, the director of the Epidemiology and Biostatistics Program in NCI's Division of Cancer Epidemiology and Genetics, will testify tomorrow before a House subcommittee chaired by Rep. Dennis Kucinich, the former Democratic Presidential candidate, on "Tumors and Cell Phone Use: What the Science Says."

Yesterday, the NCI Cancer Bulletin presented a preview of the NCI position. It is similar to that of the American Cancer Society and is based primarily on what has been learned about short-term risks (less than ten years of use).

Read the full story at: http://www.microwavenews.com

Louis Slesin, PhD
Editor, Microwave News
A Report on Non-Ionizing Radiation
Phone: +1 (212) 517-2800; Fax: +1 (212) 734-0316
Mail: 155 East 77th Street, Suite 3D
New York, NY 10075, U.S.A.

September 23… The latest issue of the NCI Cancer Bulletin, released today, presents the National Cancer Institute's outlook on the cancer risks associated with cell phones. It is based largely on the views of NCI's Peter Inskip.

Here is NCI's bottom line: "The suggestion that using a cell phone may increase a person's risk of developing brain cancer [is] not supported by a growing body of research on the subject." And Inskip adds this: Of all the potential health risks associated with cell phones that have been examined so far, the most convincing evidence concerns the risk of motor vehicle accidents among people distracted by using their cell phone while driving.

Inskip was scheduled to testify at Thursday's Congressional hearing (see September 17 & 18, below), but, at the last minute, he was replaced by Robert Hoover, the director of the Epidemiology and Biostatistics Program in NCI's Division of Cancer Epidemiology and Genetics.

As we have reported now many times, the primary concerns about tumor risks are over what happens in the long-term, that is, usually after at least ten years. This is based on both the work of Lennart Hardell and the Interphone teams from five Northern European countries. Like Hardell, the pooled data from these five countries show an increased risk of risk of glioma and acoustic neuroma (two types of tumors) on the same side of the head the phone was used, but only after ten years. Instead, Inskip and the NCI focus on what has been reported for exposures of ten years or less. As Inskip states and the NCI highlights in large type: "We now have studies covering up to ten years of cell phone usage, and we're still not seeing any convincing evidence of an increased brain cancer risk." With respect to Interphone, the NCI skips over the key findings on long-term risks in the two five-country meta-analyses, noting only: "[S]ome of the 13 participating countries have pooled their data and reported little or no effect on the risk of brain tumors."

To support the contention that there is nothing to worry about, the NCI cites two epidemiological studies: one on Motorola workers by a group at Exponent, a consulting firm, and one on Navy radar technicians during the Korean War. Both are vitiated by lousy exposure assessment. As was pointed out in a commentary accompanying the Exponent study: "A more notable limitation … is the absence of information on mobile telephone use or RF exposures." This means that no one knows whether the Motorola employees were actually exposed to any electromagnetic radiation (see MWN, M/A00, p.7).

In the process, the NCI makes a telling error: Instead of citing the Navy radar study, it links to a 1995 review by John Goldsmith, the noted environmental epidemiologist. In this paper, Goldsmith concluded that there was —even then— enough evidence pointing to microwave-induced health effects, including cancer, to warrant a precautionary policy of limiting exposures. Goldsmith closed with these prescient words:

"There are strong political and economic reasons for wanting there to be no health effect of RF/MW exposure, just as there are strong public health reasons for more accurately portraying the risks. Those of us who intend to speak for public health must be ready for opposition that is nominally but not truly scientific."

Maybe the NCI cited the right paper after all.

Thursday, September 25, 2008

New Kennedy Health Plan in the Works for 2009

This information doesn't tell me much that I'd get excited about in terms of a really effective health care plan.

Generally speaking, the people called in by Kennedy's staff seem to be the same industry fat cats with tunnel vision, all waiting for new insurance and better care, but not for less money.

I certainly don't read anything about the 'plan' being applied equally across the board, meaning that even members of Congress will get the same plan as the people they are elected to serve instead of the premium carte blanche system they vote in for themselves.

I'm not for IT inclusion in health care. It's been proven that it is just not a safe thing to do. Much too high of a risk considering all the hacking that's going on these days, and the proof that the felonious Real ID RFID chips are without any strategic safety and protection measures, like the new passports.

I am a bit taken aback by what appears to be exclusion of PREVENTION. There seems to be a focus on "disease management" but then the horse is already out of the gate. Not much for my public health hat on this one!

Cost control is good, but then there's that "private insurance" issue lurking in these words, which of course just drives up costs more all the time. Why do we need to give more to Big Insurance? It is sort of like this ridiculous financial bailout of the Wall Street dunces.

Big Pharma seems to get a little bit of a hit but not enough to make an impact. How about taking them out of the equation on the bogus "Senior Drug Plan" and see just how much is saved. Lives might be saved too if the numbers of Seniors "in the hole" without coverage for their drugs was a thing of the past.

And since not everyone is 'employed', what's the deal? What are you doing for self-employed and the retired that struggle just trying to find a doctor that will accept Medicare or those with Medicaid that can't find medical or dental providers.

Employers are taking more and more from the workers that make their businesses profitable. The CEOs aren't giving in on benefits when they want workers to pay more out of pocket.

What I don't see here is CHOICE. And I don't see anything for the hundreds of thousands of our people who want natural health care options, including coverage for supplements.

Wake up Teddy, or did too much anti-cholesterol drugging of your body give you brain cancer - along with your cell phone, added with the radiation and chemo, maybe it's BRAIN FOG.

It doesn't seem to me that any of your staff has a clear mind of what the people want either.

Maybe the new thing might be gathering a groups of every day people for their input instead of industry hacks who parrot the propaganda.

Back to the drawing board you all. I just don't think you are even asking the right questions. And I bet many others agree.
Kennedy Working Now for January Health Care Push
The ailing senator and his staff are moving quickly on a proposal likely to build on the existing concept of employer-based coverage.

By Martha Lynn Craver, September 25, 2008

Congress will lead the way on health care reform next year, not waiting for the next president, whoever he turns out to be. And key backers of a move toward universal coverage don't plan to waste any time either. Among the lessons learned from the last major attempt at health care reform in 1993 is that it needs to be tackled in the first year of the new Congress during the "honeymoon period" -- just after the election and before everyone starts focusing on the next campaign.

Sen. Ted Kennedy, the Massachusetts Democrat who has long championed health issues, plans to be ready in January, and he's determined not to let his own health issues keep him from being at the forefront of what will be difficult negotiations. Kennedy, who is chairman of the Senate Health, Education, Labor and Pensions Committee, is a man in a hurry. He wants to hit the ground running, introducing a plan soon after the new Congress convenes in January.

His goal: affordable and accessible health care for all. Kennedy is well liked on Capitol Hill, and there's a big emotional push to get this done "for Ted." Kennedy and his staff have already held meetings with his Republican counterpart on the Committee, Sen. Mike Enzi (R-WY), in hopes of crafting a bipartisan bill that will win broad support. Kennedy has a reputation for reaching across the aisle, and he and Enzi have partnered a number of times on other health care issues. But if the talks fall through, expect Kennedy to introduce a bill on his own and try to win bipartisan backing later.

Kennedy is also working with other committees in finance and budget jurisdictions committees, to ensure their cooperation so that the bill isn't bogged down by jurisdictional issues -- another lesson learned from the '93 battle. Major stakeholders are being called in as well -- business, labor, medical, insurance and consumer groups -- to sound them out on potential approaches. Also, Kennedy has added John McDonough to his staff -- he was in charge of implementing Massachusetts' groundbreaking universal health care law.

What will the proposal look like? Talks so far are just preliminary, with the more serious work to be done after the November election. But the betting is that it will seek to build on the employer-based system that now provides coverage for 177 million people. Universal coverage will be the goal, although it may have to be phased in, thanks to federal deficits likely to rise due to the financial crisis. The idea will be to make health care coverage available to all who want it, but not mandatory.

Getting coverage for the 46 million uninsured will focus on strengthening public programs such as Medicaid as well as providing more affordable options to people through the private insurance market.

Cost containment will be a big part of reform. Examples where there's great potential for agreement include:

Health care IT to cut down on medical errors and duplicative tests.
Comparable health effectiveness research to determine which treatments deliver the most bang for the buck.

Generic versions of biotech drugs as an alternative for costly brand-name biotech pharmaceuticals.

Pay-for-performance initiatives, to reward the best and most efficient caregivers.
Wellness programs and disease management to better control chronic diseases, such as diabetes and asthma.

How to finance the plan will be the biggest challenge. The tax treatment of health insurance will be on the table, but it's unclear if it will be in Kennedy's bill. Big revisions to the tax code are unlikely, and there may be a cap on the health insurance tax exemption for high earners.
This page printed from: http://www.kiplinger.com/businessresource/forecast/archive/Kennedy_Working_For_Health_Care_Push_080925.html
All contents © 2008 The Kiplinger Washington Editors

Tuesday, September 23, 2008

Clots and Cancer Care

One of the serious side effects of chemotherapy is severe nutritional depletion. This state is a factor in the 20% or more of people undergoing mainstream cancer therapy.

I would like to know how many people undergoing chemo know of this side effect, and of course I'd like to know how many of this group of people have support to promote prevention of this life-threatening risk.

Vitamin E is a preventive for colon cancer and most likely other cancers. It helps prevent hair loss from chemo, and it helps prevent throboembolic conditions.

As an anti-oxidant it is an anti-inflammatory, so one might surmise that it could/would be effective as a standard supplement for cancer treatment to reduce the side effects of the chemo drugs that must irritate the intima or lining of the blood vessels that contribute to an increased risk of developing VT.

Adding vitamin C can offer similar benefit, and it can fight the cancer as well, perhaps allowing a lower chemo dose with greater effect.
Should All Cancer Patients Receive Antithrombic Prophylaxis?

Roxanne Nelson, Medscape Medical News 2008. © 2008 Medscape

September 23, 2008 (Stockholm, Sweden) — Venous thromboembolism (VTE) is a common complication in cancer patients, and a significant cause of morbidity and mortality. It occurs in approximately 4% to 20% of cancer patients, although it is believed that these rates are underestimates. Although randomized trials have demonstrated that primary prophylaxis can reduce VTE, and professional guidelines from several associations have issued a number of recommendations, there is still considerable variation among practicing oncologists in terms of compliance.

Because the risk for VTE is so high among cancer patients, some experts believe that VTE prophylaxis should be extended to all cancer patients, including those in the outpatient setting. Conversely, others feel that there is insufficient evidence to support universal use in this population and that prophylaxis should be administered only to those with known risk factors. Both sides of the issue were presented here in a point/counterpoint discussion at the 33rd European Society of Medical Oncology (ESMO) Congress.

Hans-Martin Otten, MD, PhD, who presented the argument for the use of prophylaxis in all cancer patients, pointed out that VTE remains underdiagnosed and undertreated in cancer patients. Dr. Otten is a medical oncologist at Slotervaart Hospital, in Amsterdam, the Netherlands.

"There's a very high prevalence of VTE among cancer patients," said Dr. Otten. "In most cases, it is not recognized. There is effective prophylactic treatment. It is low in cost and low in bleeding risk, so why don't we use it?"

Use in Surgical and Hospitalized Patients

Current guidelines from the American Society of Clinical Oncologists (ASCO) recommend that cancer patients undergoing major surgery, along with hospitalized nonsurgical cancer patients, should be considered candidates for VTE prophylaxis in the absence of bleeding or other contraindications. Guidelines from the American College of Chest Physicians also recommend prophylaxis for bedridden patients with cancer.

Dr. Otten agrees: "Pulmonary embolism [PE] is a frequent cause of death in hospitalized patients, and 1 of the primary reasons for promoting antithrombic prophylaxis in high-risk patients," he said. "The in-hospital fatality rate from PE is about 12%. And not only are fatal PEs important, but symptomatic VTE is a burden for cancer patients."

Presenting the opposing viewpoint, Ajay Kakkar, MBBS, PhD, FRCS, agreed that there are a number of situations where the use of antithrombotics is warranted, especially among cancer patients undergoing surgery. Dr. Kakkar is professor and head of the Centre for Surgical Science and dean of external relations at Barts and the London School of Medicine and Dentistry, in the United Kingdom

"VTE is a very common problem for surgical cancer patients, and there are really hard data to support prophylaxis," explained Dr. Kakkar.

However, the data for other types of cancer patients are less robust. Among nonsurgical hospitalized cancer patients, there is a wide range of VTE incidence. "It is therefore inappropriate to offer all patients prophylaxis," said Dr. Kakkar. "We should identify the subsets that may be at risk and treat them."

He pointed out that the data on VTE risk in nonsurgical cancer patients are limited. Although studies have shown a clear benefit of prophylaxis over placebo, only a small number of the patients included in these trials have had cancer. "Results can be extrapolated for cancer patients," Dr. Kakkar said, "but right now we just don't have the information."

Although guidelines do recommend that nonsurgical hospitalized patients should be considered candidates for prophylaxis, Dr. Kakkar explained that physicians need to be selective in choosing who is at risk.

Ambulatory Outpatients

ASCO guidelines do not recommend routine prophylaxis in ambulatory patients receiving chemotherapy because of conflicting trial results, potential bleeding, the need for laboratory monitoring and dose adjustment, and the relatively low incidence of VTE.

However, Dr. Otten argued that prophylaxis should be extended to this population as well. VTE is poorly recognized and, in about 70% to 80% of patients who die in the hospital, a diagnosis of PE was never considered, he explained. "The majority of symptomatic PE occurs after discharge, in the outpatient setting, where doctors do not see patients very frequently."

Some reports show that the incidence of symptomatic VTE in patients with advanced metastatic disease is 9%, said Dr. Otten. "But the rate of asymptomatic VTE is more than 50%."

Conversely, Dr. Kakkar felt that routine prophylaxis is not warranted in this population, and supported current guidelines. The risk for VTE among patients undergoing outpatient chemotherapy is not well studied, and the overall risk is not high, he said. "I believe it is a question of our judgment and skills to select patients, rather than to prescribe it routinely to ambulatory patients.

Complicated Issue; Very Heterogenous Patients

"This is a complicated issue, but it is clear that cancer patients as a whole have a much higher risk than the general population," commented Alok A. Khorana, MD, FACP, assistant professor of medicine at the James P. Wilmot Cancer Center at the University of Rochester, in New York. "But this population is also very heterogenous, and the risk is not equally divided," he commented in an interview..

"Some patients are at much higher risk than others, and the main problem is that no studies have been done specifically in cancer populations," he said. Dr. Khorana did not participate in the ESMO point/counterpoint discussion; he was approached by Medscape Oncology for comment.

The exact mechanisms of VTE in cancer patients are still being defined, and the actual prevalence of tumor-induced VTE is not known, he said. There are numerous confounding risk factors, including chemotherapy with or without adjuvant therapy, immobilization, metastatic disease, surgery, tumor type, presence of certain comorbidities, and the presence of central venous catheters.

Dr. Khorana agreed that although ambulatory patients on chemotherapy are at higher risk for VTE, the risk does vary. "There are subgroups that are at higher risk because of the type of cancer and other comorbidities, and it is important to focus on the high-risk subgroups," he told Medscape Oncology.

To help identify that population among ambulatory patients, Dr. Khorana and colleagues developed a simple model for predicting chemotherapy-associated VTE, using baseline clinical and laboratory variables. A risk model was derived and validated in an independent cohort of 1365 cancer patients, and the results showed that it was able to identify patients with a nearly 7% short-term risk for symptomatic VTE. The data were published in the May 15 issue of Blood.

Prolonging Survival

An unanswered question is whether the use of antithrombotic therapy can prolong survival in cancer patients without VTE. There have been a few trials that did suggest a survival benefit, said Dr. Kakkar. Although some results have been encouraging, the results are variable and generally showed a clinical benefit only in subgroup analyses.

"More concise data are needed, and it is not possible now to make recommendations," said Dr. Kakkar.

33rd European Society for Medical Oncology (ESMO) Congress. Presented September 14, 2008.

Blood. 2008;111:4902-4907. Abstract

Here, have a glass of water

The issue of doctors being able to help with emotional issues of health has been a problem for as long as I can remember over the years I've been in the healthcare industry, some 35+ years.

I'd guess thirty years ago the idea of including this sort of class in medical school curriculum was raised. I see that's all that happened.

No wonder I hear so many hooror stories from my clients and others who participate in or attend my classes or community progrmas.

Before I worked in critical care I was working in mental health and psychiatry. I really never left that field in the sense that I integrated it into my work with very sick and dying people in ICU and the staff where I worked.

Sometimes I was ridiculed by peers, but often thanked by others, especially family members and patients.

Maybe the docs who can't find the time or don't want to deal with this part of medicine are missing core issues. Patch Adams had something going.

Healing is an art. It may or may not be driven by science. There is the physical part of it and the mental. Those don't get us where we need to be without the emotional and spiritual levels of healing that must be addressed if health care is to be effective.

Physicians Often Miss Opportunities To Show Empathy, Study Finds

ScienceDaily (2008-09-23) -- In consultations with patients with lung cancer, physicians rarely responded empathically to the concerns of the patients about mortality, symptoms or treatment options, according to a new study. The study found that physicians missed many opportunities to recognize and possibly ease the concerns of their patients and routinely provided little emotional support. ... > read full article

Emotional Intelligence Training Could Lead to Better Doctor-Patient Relations
Caroline Cassels
Medscape Medical News 2008. © 2008 Medscape

September 22, 2008 — Integrating emotional intelligence (EI) training into graduate medical education may improve young physicians' interpersonal and communication skills and ultimately create a more caring environment for patients.

In the September 10 issue of the Journal of the American Medical Association, a commentary by medical educators Daisy Grewal, PhD, and Heather Davidson, PhD, from Stanford University Medical Center, suggests there is a need to add such training, which includes both interpersonal and communication skills, to graduate medical education.

"The current medical education literature has focused primarily on communication skills, most likely because they are easier to define and observe than interpersonal skills. The value of communication skills is supported by continuing evidence that physician-patient communication affects a variety of important factors associated with positive health outcomes," they write.

According to Drs. Grewal and Davidson, the 4 components of emotional intelligence — the abilities to perceive, use, understand, and manage emotions — are building blocks for interpersonal and communication skills. The challenge in medical education is to understand the psychology behind these skills and build programs to develop them.

"The EI framework has the potential to deepen understanding about the set of factors that are related to acquisition of effective interpersonal and communication skills — skills that rest on the ability to perceive, use, understand, and manage emotions in self and others," they write.

A Concept Worth Exploring

Currently, many graduate medical education programs use self-assessments, which tend to rely on students' perceptions of their own personalities. Objectively evaluating physicians' EI could help give medical trainees a more objective assessment of their skills, the authors note.

Future research, they suggest, could link EI measurements with performance evaluations. For instance, graduate students who score low in 1 or a combination of abilities might benefit from targeted training.

Drs. Grewal and Davidson note that not all educators agree on the value of EI.

"Clearly, the concept of EI needs further development; popular conceptions have added confusion to the definition and measurement of this complex concept. However, EI should not be dismissed simply because of this complexity," they write.

Some research shows that EI training in medical schools has improved empathy and "soft" skills, suggesting that the right kind of training might help those who are not natural communicators to learn and develop their abilities.

"Emotional intelligence is a concept worth further exploration in medical education and may be one of several important theories that help move the culture of medical education ahead by creating a better learning, working, and caring environment," the authors conclude.

JAMA. 2008;12:1200-1202. Abstract

SPLENDA now known to cause weight gain and impair Rx.

As we have been telling readers for many years, SPLENDA is a seriously hazardous substance. Along with aspartame ( NutraSweet or other brand names) Splenda was first developed as a pesticide.

Your best options are Just Like Sugar and Agave or Stevia.
Splenda Study Raises Health WorriesTuesday, September 23rd, 2008

Splenda, an artificial sweetener, has been tied to a host of ills by researchers at Duke University, The New York Times reported today. According to an article published on The Journal of Toxicology and Environmental Health website, Splenda contributes to obesity, destroys “good” intestinal bacteria and prevents prescription drugs from being absorbed.

Splenda is a no-calorie sweetener made by McNeil Nutritionals. Splenda is 600 times as sweet as table sugar), twice as sweet as saccharin, and four times as sweet as aspartame. Unlike other artificial sweeteners, Splenda remains stable under heat and can be used in baking or in products that require a longer shelf life. Since its U.S. introduction in 1999, Splenda has overtaken Equal in the $1.5 billion artificial sweetener market, holding a 62% market share.

Splenda’s main ingredient is sucralose, which is manufactured in laboratories. While a sugar molecule is used in the process, there is no sugar contained in the end product. In 2004, the Sugar Association, and industry lobbying group, sued McNeil in federal court, alleging that the Splenda slogan, “made like sugar, so it tastes like sugar” misled consumers. The Splenda slogan has since been changed to “it’s made from sugar. It tastes like sugar. But it’s not sugar.”

The Sugar Association also funded the Duke University study of Splenda health affects. The study was conducted using male rats over a period of twelve weeks. The researchers found evidence that, in the animals studied, Splenda reduced the amount of good bacteria in the intestines by 50%, increased the pH level in the intestines, contributed to increases in body weight and affects the P-glycoprotein (P-gp) in the body in such a way that crucial health-related drugs could be rejected.

Because it was funded by the sugar industry, McNeil has dismissed the Duke study. The company also criticized the fact that the Splenda study used lab rats as test subjects. But the Food and Drug Administration (FDA) also tested Splenda on rats before approving it for sale to the public.

One of the lead researchers of the study, Dr. Mohamed B. Abou-Donia, told The New York Times that the Sugar Association had “no input” into the study’s findings and conclusions.

One group that is taking the Duke Splenda study seriously is Citizens for Health. The public advocacy group asked the FDA to accept a petition it filed over a year ago and initiate a review of its approval of Splenda. Citizens for Health also wants the agency to require a warning label on Splenda packaging cautioning that people who take medications and/or have gastrointestinal problems avoid using Splenda.

“The new study makes it clear that Splenda can cause you to gain weight and lose the benefits of medications designed to improve and protect your health. The FDA should not continue to turn a blind eye to this health threat,” James Turner, chairman of Citizens for Health said in a statement.

Gallbladder dis-ease

Related to the vitamin C and magnesium posts and comments recently, gall bladder health is an issue I help people with often.

My goal, through educating people, is to help them understand that they can avoid the surgery. In the long run, keeping your gall bladder is a better option. The outdated "it's a vestigial organ, you don't need to keep it" theory is worn out and not in keeping with current research.

A related issue is that once the gall bladder is removed, bile flows constantly into your small intestine. Without high quality enzyme supplementation and dietary changes, the risk of back flow and liver congestion are quite real.

Too much fat is a concern, wrong fat is a concern (like margarine and canola or soy oils) fast food, and lack of fiber, magnesium, calcium/phosphorus metabolism, and lack of other key nutritional factors.

This is similar to the faulty theory driving the use of acid blocking pharmaceuticals.

We offer a terrific and effective gall bladder health program, FMI: contact us.

What's The Main Risk Factor Of Gallstone Disease?

ScienceDaily (2008-09-23) -- Gallstone disease is very common and costly. Preventive strategies are based on the knowledge of GD risk factors. This study reports the results of a multicenter project aimed at evaluating GD incidence and risk factors. 9611 subjects (5477 males, 4134 females, aged: 30-79 years) were evaluated; 4.4 percent had gallstones, 0.6 percent had been cholecystectomized; incidence rate was 0.67 percent per year. Increasing age and body mass index were identified as true risk factors for GD. ... > read full article

Target Oxidative Stress to ease hypertension

For those of us in health care and especially in natural health care, we are fully aware of the keen benefits of anti-oxidants, especially vitamins C and E.

Orthomolecular medicine, founded decades ago, and fought against vehemently by the AMA and cookie cuter medicine, has been in the forefront for the effective use of vitamins and other supplements for the benefit of patient health.

The study is hopeful, but will we see a move by health care providers in this direction? I can only hope we so.
Vitamin C Might Help Lower Hypertension

By Alan Mozes, HealthDay Reporter, Friday, September 19, 2008

-- Vitamin C may help lower high blood pressure by calming an overactive central nervous system, new Italian research suggests.

Using intravenously delivered vitamin C, "our study demonstrated for the first time in humans that we can reduce sympathetic nervous system overactivity, and consequently blood pressure, (by) targeting oxidative stress," said study lead author Dr. Rosa Maria Bruno from the University of Pisa.

Bruno explained that the sympathetic nervous system (SNS) is part of the body's central nervous system that controls non-voluntary activities, such as blood pressure. Overactivation of the system has been identified as an underlying foundation for the onset of elevated blood pressure and resulting organ damage.

The Italian team was expected to report its findings Friday in Atlanta at the American Heart Association's Conference of the Council for High Blood Pressure Research.

The study builds on prior research touting the potential of vitamin C and other antioxidant nutrients to lower high blood pressure. For example, this past January, British authors presented evidence inThe American Journal of Clinical Nutritionthat suggested that having high levels of vitamin C in the blood might help reduce stroke risk.

In the current work, Bruno and her colleagues focused on 12 patients diagnosed with an "essential" form of high blood pressure -- namely, one with no known cause.

None of the patients had received any kind of prior treatment for their condition. Over a five-minute period, all the patients were intravenously administered three grams of vitamin C, after which they were monitored for 20 minutes to assess blood pressure and SNS activity. Electrocardiograms were also taken.

The researchers found that "antioxidant capacity" went up as a result of the IV infusions, while SNS activity dropped by about 11 percent.

In addition, the participants' blood pressure was found to have plunged nearly 7 percent on average, with a specific drop in diastolic blood pressure (the bottom number on a reading) of 9 percent. However, no significant drop in systolic blood pressure was observed.

But Bruno said it's too early to say that vitamin C can reduce either blood pressure or sympathetic activity among healthy patients -- just among those with high blood pressure.

"(And) our results cannot be directly translated into clinical practice, because to obtain this result, we used one high dose of vitamin C administrated intravenously," she added. "We don't know if chronic oral administration of vitamin C can achieve the same effect."

Dr. Suzanne Steinbaum, director of Women and Heart Disease at Lenox Hill Hospital's Heart and Vascular Institute in New York City, added a similar caveat.

"What's interesting about this particular trial is that the vitamin C was given intravenously," she noted. "And maybe that's why it worked here. It's really hard to know. Yet there's something to be said about the concept of vitamin supplementation in treating vascular disease because of the antioxidant content. It makes sense physiologically."

"However, although it would be nice to say to someone, 'if you eat right and take these vitamins, you're going to be OK,' rather than 'here -- take all these medications, with all these side effects,' this is a small esoteric study," Steinbaum said. "This finding is certainly not going to make me or anyone else run out and start giving vitamin C intravenously to our patients."

More information: For additional information on lowering blood pressure, visit the U.S. National Heart, Lung, and Blood Institute.

SOURCES: Rosa Maria Bruno, M.D., department of internal medicine, University of Pisa in Pisa, Italy; Suzanne Steinbaum, D.O., director, Women and Heart Disease, Heart and Vascular Institute, Lenox Hill Hospital, New York City; presentation, American Heart Association's Conference of the Council for High Blood Pressure Research, Sept. 17-20, 2008, Atlanta.

FDA and Big Pharma: Where's the Data?

The full report on this study is found at PLoS Medicine. It is certainly worth reading so you can get a better understanding of the serious iisues surrounding the FDA and drugs.

There is more than just an appearance of subverting the facts.

The European press is giving this much more coverage than here in the states.
The United States (US) Food and Drug Administration (FDA) approves new drugs based on sponsor-submitted clinical trials. The publication status of these trials in the medical literature and factors associated with publication have not been evaluated. We sought to determine the proportion of trials submitted to the FDA in support of newly approved drugs that are published in biomedical journals that a typical clinician, consumer, or policy maker living in the US would reasonably search.

CONCLUSIONS: Over half of all supporting trials for FDA-approved drugs remained unpublished 5 y after approval. Pivotal trials and trials with statistically significant results and larger sample sizes are more likely to be published. Selective reporting of trial results exists for commonly marketed drugs. Our data provide a baseline for evaluating publication bias as the new FDA Amendments Act comes into force mandating basic results reporting of clinical trials.

Friday, September 19, 2008

Hep C Treatment Sequelae

Since the standard treatment for Hep C is Interferon, a genetically engineered pharmaceutical, is anyone asking the question whether or not the elevated blood sugar levels are related to the drug therapy.

We do know that there are some serious consequences to both Hep C and Interferon.

We know, however, that there are safe, natural approached to treating and resolving Hep C that do not cause a risk of diabetes.
Hepatitis C patients may have abnormal blood sugarThu Sep 11, 2008

NEW YORK (Reuters Health) - Nearly two thirds of patients with chronic hepatitis C infection may have abnormal blood sugar levels, according to a report in the American Journal of Gastroenterology.

Blood sugar, or "glucose," abnormalities "are common and easily underestimated among patients with chronic hepatitis C infection," Dr. Ming-Lung Yu from Kaohsiung Medical University, Taiwan told Reuters Health. Careful evaluation for undetected glucose abnormalities is "essential" in caring for chronic hepatitis C patients.

Yu and colleagues compared the prevalence and characteristics of glucose abnormalities among 522 chronic hepatitis C patients and a comparison group of 447 without hepatitis C infection ("controls"), based on the results of an oral glucose tolerance test.

After excluding the subjects who were known to have diabetes, just over one third of the hepatitis C patients (34.2 percent) had normal results on the oral glucose tolerance test, the authors report, whereas 42.8 percent had impaired glucose tolerance and 23.0 percent had undiagnosed diabetes.

In contrast, 64.7 percent of the controls had normal levels of glucose, 32.4 percent had impaired glucose tolerance, and 2.9 percent had diabetes.

A family history of diabetes, male gender, advanced fibrosis stage of hepatitis, and increasing age each increased the risk of having glucose abnormalities, according to additional analyses.

Two consecutive fasting plasma glucose measurements or randomly measured glucose levels greater than 200 milligram per decaliter were not sufficient to confirm glucose abnormalities in the patients with chronic hepatitis C infection, Yu noted.

"Since family history, insulin resistance, age, and obesity are predisposing factors associated with diabetes in chronic hepatitis C patients, we would recommend an oral glucose tolerance test for chronic hepatitis C patients who are older than 40 years old," have a family history of diabetes or who are overweight, Yu advised.

SOURCE: American Journal of Gastroenterology, August 2008.

© Thomson Reuters 2008. All rights reserved.

Incineration Required

I discovered the rule of law on this issue, five or so years ago while serving as a member of my community's Health and Environment Commission.

These drugs are required by law to be incinerated, so how come these health care facilites aren't up to date?

Having been a hospital/health care administrator during my career I can surmise that the bottom line is the key factor. Incineration is costly.

But I guess that no one at these hospitals is aksing the question about the longterm effect to thousands of people harmed by the toxic effects of drugs poured into the municipal water supply.

Fluoride is bad enough, but who is asking the question about the impact of all these pharmaceuticals added to the already toxic chemical and fertilizer waste.

Surely it isn't Gary Locke or Christine Gregoire.
Health facilities flush estimated 250M pounds of drugs a yearBy Jeff Donn, Martha Mendoza And Justin Pritchard, Associated Press
U.S. hospitals and long-term care facilities annually flush millions of pounds of unused pharmaceuticals down the drain, pumping contaminants into America's drinking water, according to an ongoing Associated Press investigation.

These discarded medications are expired, spoiled, over-prescribed or unneeded. Some are simply unused because patients refuse to take them, can't tolerate them or die with nearly full 90-day supplies of multiple prescriptions on their nightstands.

NARCOTICS: Heavily controlled -- until it's time to dump them
REPORT: More towns test water, find drugs

Few of the country's 5,700 hospitals and 45,000 long-term care homes keep data on the pharmaceutical waste they generate. Based on a small sample, though, the AP was able to project an annual national estimate of at least 250 million pounds of pharmaceuticals and contaminated packaging, with no way to separate out the drug volume.

One thing is clear: The massive amount of pharmaceuticals being flushed by the health services industry is aggravating an emerging problem documented by a series of AP investigative stories — the commonplace presence of minute concentrations of pharmaceuticals in the nation's drinking water supplies, affecting at least 46 million Americans.

Researchers are finding evidence that even extremely diluted concentrations of pharmaceutical residues harm fish, frogs and other aquatic species in the wild. Also, researchers report that human cells fail to grow normally in the laboratory when exposed to trace concentrations of certain drugs.

The original AP series in March prompted federal and local legislative hearings, brought about calls for mandatory testing and disclosure, and led officials in more than two dozen additional metropolitan areas to analyze their drinking water.

And while most pharmaceutical waste is unmetabolized medicine that is flushed into sewers and waterways through human excretion, the AP examined institutional drug disposal and its dangers because unused drugs add another substantial dimension to the problem.

"Obviously, we're flushing them — which is not ideal," acknowledges Mary Ludlow at White Oak Pharmacy, a Spartanburg, S.C., firm that serves 15 nursing homes and assisted-living residences in the Carolinas.

Such facilities, along with hospitals and hospices, pose distinct challenges because they handle large quantities of powerful and toxic drugs — often more powerful and more toxic than the medications people use at home. Tests of sewage from several hospitals in Paris and Oslo uncovered hormones, antibiotics, heart and skin medicines and pain relievers.

Hospital waste is particularly laden with both germs and antibiotics, says microbiologist Thomas Schwartz at Karlsruhe Research Center in Germany.

The mix is a scary one.

In tests of wastewater retrieved near other European hospitals and one in Davis County, Utah, scientists were able to link drug dumping to virulent antibiotic-resistant germs and genetic mutations that may promote cancers, according to scientific studies reviewed by the AP.

Researchers have focused on cell-poisoning anticancer drugs and fluoroquinolone class antibiotics, like anthrax fighter ciprofloxacin.

At the University of Rouen Medical Center in France, 31 of 38 wastewater samples showed the ability to mutate genes. A Swiss study of hospital wastewater suggested that fluoroquinolone antibiotics also can disfigure bacterial DNA, raising the question of whether such drug concoctions can heighten the risk of cancer in humans.

Pharmacist Boris Jolibois, one of the French researchers at Compiegne Medical Center, believes hospitals should act quickly, even before the effects are well understood. "Something should be done now," he said. "It's just common sense."

'Major pollutants of concern'

Some contaminated packaging and drug waste are incinerated; more is sent to landfills. But it is believed that most unused pharmaceuticals from health care facilities are dumped down sinks or toilets, usually without violating state or federal regulations.

The Environmental Protection Agency told assembled water experts last year that it believes nursing homes and other long-term care facilities use sewer systems to dispose of most of their unused drugs. A water utility surveyed 45 long-term care facilities in 2006 and calculated that two-thirds of their unused drugs were scrapped this way, according to the National Association of Clean Water Agencies.

An internal EPA memo last year included pharmaceuticals on a list of "major pollutants of concern" at health care businesses. Still, few medical centers keep comprehensive records of drugs they cast down toilets or into landfills. When data are kept, drugs and tainted packaging are combined in the same totals.

In an attempt to quantify the problem, the AP examined records in Minnesota, where state regulators have pushed hospital administrators to keep closer track than elsewhere. Fourteen facilities were surveyed, in a range of settings from rural to urban. The AP projected those annual totals onto the national patient population for hospitals and adjusted for the relatively lower pharmaceutical use of Minnesotans. Since long-term care facilities generate more drug waste than hospitals, the AP conservatively doubled the number.

That calculation produced an estimate of at least 250 million pounds of annual drug waste from hospitals and long-term care centers, further complicated by the fact experts say drugs might account for only up to half of pharmaceutical waste, while the rest is packaging.

The AP estimate excludes many other sources of health industry drug waste, from doctors' to veterinary offices. Smaller medical offices typically dispose of expired samples and unwanted drugs like ordinary consumers — with little forethought.

Alan Davidner, president of Vestara of Irvine, Calif., which sells systems to manage drug waste, says his limited sampling suggests the health care industry's contribution could even be higher.

Plus, untold amounts of pills and tablets are being thrown away each year at federal and state correctional institutions.

At a state prison in Oak Park Heights, Minn., nurse Linda Peterson says the hospital unit serving inmates statewide has been throwing away up to 12,000 pills a year. She says some heart medicines and antibiotics are simply chucked into the trash. Tightly regulated narcotics susceptible to abuse go down the toilet.

"We flush it and flush it and flush it — until we can't see any more pills," she says.

She notes the presence of nursing homes, a hospital and another prison in the same area. "So what are all these facilities doing, if we're throwing away about 700 to 1,000 pills a month?"

Seeking solutions

The EPA is considering whether to impose the first national standard for how much drug waste may be released into waterways by the medical services industry, but Ben Grumbles, the EPA's top water administrator, says a decision won't be made until next year, at the earliest.

So far, regulators have done little more than politely ask the medical care industry to stop pouring drugs into the wastewater system. "Treating the toilet as a trash can isn't a good option," says Grumbles.

Some think it's time to do more than ask. "It's strange that we have rules about the oil from your car; you're not allowed to simply flush it down the sewer," says U.S. Rep. Tim Murphy, R-Pa. "So why do we let these drugs, without any kind of regulation, continue to be flushed away in the water supply?"

Landfills are one alternative. At least they don't empty directly, and immediately, into waterways like some sewage.

Marjorie E. Powell, a lawyer for the Pharmaceutical Research and Manufacturers of America, says landfills are "more environmentally friendly," while EPA spokeswoman Roxanne Smith contends that landfilling of hazardous pharmaceutical waste "poses little threat to the public."

Still, Grumbles acknowledges that landfills, while safer, are not a permanent solution. That's because pharmaceuticals can eventually reach waterways from landfills through leaks or intentional releases of treated seepage known as leachate.

An agency staffer wrote in a memo last year: "EPA recognizes that residuals in the leachate could contaminate groundwater supplies and ultimately reach water treatment plants, but disposal into the trash is currently considered a BMP" — or best management practice.

Already, researchers have detected trace concentrations of drugs — including the pain reliever ibuprofen and seizure medicine carbamazepine — in seepage or groundwater near landfills.

Environmental professionals outside government are reaching a consensus that incinerators are the best disposal method.

"That's the best practice for today because we don't really know what the hell to do with the stuff," says industrial engineer Laura Brannen, an executive at Waste Management Healthcare Solutions, of Houston. She says burning destroys more drug waste than all other methods, though some contaminants may escape in smoke and ash.

On a recent day at Abbott Northwestern Hospital in Minneapolis, Mary Kuch was getting ready to squirt leftovers from a syringe of hydromorphone, a powerful morphine derivative, into a sink. When she started out in nursing 18 years ago, "I took it for granted, because I was a young nurse, and that's what other nurses did," she says. "But I did find it strange."

These days, only four gallons — drugs with high potential for abuse — go down the hospital's drains each year. Nearly all leftover medicine and contaminated packaging are instead tossed into black bins and rolled to a hospital storage room crammed with scores of 55-gallon drums.

There, waste-company employee Bryant Sears — dressed in a Teflon suit, rubber gloves and goggles — conducts a sorting operation. Pills, blister packs and liquid medicines collected in vials, along with syringes and IV bags, are separated out according to differing disposal standards and methods. Occasionally, he glances at a wall-sized placard with details on which drug goes where — hazardous waste in one barrel, nonhazardous in another. A roll of "hazardous waste" stickers hangs from a pole on the wall.

Sears points to some epinephrine, a heart drug, saying, "Now that it's past its expiration date, it's waste."

These leftovers and discards ultimately will be incinerated.

EPA's Smith says even municipal burners unapproved for hazardous waste "will destroy all but a minute fraction" of organic compounds — the kind found in pharmaceuticals.

But Stephen DiZio, a manager with the California Department of Toxic Substances Control, says not so fast. "I don't think we're encouraging incineration of anything. The public outcry would be so great."

The push for incineration hides an irony. Several decades ago, drug waste was routinely chucked into the trash and burned in hospital or city incinerators.

Then came a national campaign against air pollution. Most hospitals shut down their burners, and city incinerator managers became pickier about what they'd accept. With options restricted, hospitals began shipping more drug waste to landfills — and dumping more into toilets and sinks.

More options

A few choices are expanding. Some states have passed laws to make it easier to contribute unused drugs to charity pharmacies that supply low-income patients.

Also, a small share of unused drugs is shipped back to manufacturers for credit — and incineration, waste consultants say. But the drugs are supposed to be sent back in original packaging — sometimes impractical because the packaging is discarded or damaged.

Several long-term care residences want to deploy automatic drug-dispensing machines that suppliers would refill often to reduce waste.

While not yet practical, there are several experimental technologies, such as destroying trace drugs with an electrical arc, microwaves, or caustic chemicals.

Increasingly, some bureaucrats and health professionals are suggesting that drug makers help pay costs of managing drug waste. But the pharmaceutical industry says there's insufficient evidence of environmental harm to warrant the expense.

But impatience is mounting. Even the EPA has begun to take such suggestions seriously. Grumbles says drug makers "should do more for product stewardship and meds retrieval now." He says it would be unwise to wait for all the proof.

For now, many health facilities, especially small ones, are put off by the cost of proper handling. Drugs deemed hazardous by the EPA — about 5% of the market — might cost up to $2 a pound to incinerate in a certified hazardous waste incinerator, says Vestara's Davidner. A pound might cost 35 cents to burn in a regular trash incinerator.

Tom Clark, an executive at the American Society of Consultant Pharmacists, wonders: "When you can flush it down the toilet for free, why would you want to pay —unless there's some significant penalties?"

Copyright 2008 The Associated Press.
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What should be the warnings

One might ask why the FTC is failing to warn consumers about the risks of chemotherapy and radiation treatments for cancer.

Or for that matter, educating women that the x-rays from the mammogram schedule is directly correlated with the increasing rate of breast cancer and it is included as a cause of this dreaded disease.

Both radiation exposure and chemotherapy lead to a weakened immune system and a higher risk of more cancer. Additionally it is a known fact that the real cure rate on current mainstream medicine's cancer care is 1-2%.

Perhaps the write of the article might look up the herbs that were used to help sure Patrick Kennedy and his Uncle Jack's Harvard MD of cancer: the same as Essiac tea.

Maybe if we could count on factual reporting, looking at both sides of the issue, the public would be more informed.

I guess the propaganda machine is in high gear again.
FTC warns consumers about bogus cancer cures By RANDOLPH E. SCHMID, AP Science Writer
Thu Sep 18, 2008

The Federal Trade Commission charged five companies with making false and misleading claims for cancer cures and said Thursday that it has reached settlements with six others. "As long as products have been sold there has been somebody out there selling snake oil to consumers," said Lydia Parnes, director of the FTC's bureau of consumer protection.

She said the agency, along with the Food and Drug Administration and Canadian authorities, is launching a consumer education campaign warning about bogus claims for cures.

"There is no credible scientific evidence that any of the products marketed by these companies can prevent, cure, or treat cancer of any kind," said Parnes.

The products the companies marketed include essiac teas and other herbal mixtures, laetrile, black salve — a corrosive ointment — and mushroom extracts.

Richard Jaffe, a Houston attorney who represents Native Essence Herb Company — one of those named by the FTC — argues that the government is trying to censor his client.

The company sells herbs over the internet and advises people that some herbs have a historical use for treatment of cancer and other medical conditions, he said. That is a truthful claim, he said, adding that because an herb was used by ancient Chinese or native Americans doesn't mean it works, "which most people understand."

In addition the agency wants to block reports on trials in other parts of the world, he said, because they might imply a claim.

"In our view it's a battle between the right to speak and the government's censorship," Jaffe said.

Douglas Stearn of the FDA said his agency is concerned that people may forgo effective cancer treatments when choosing these products. In addition, he said, some of these unproven products may have dangerous interactions with other drugs.

"We would urge folks to talk to their doctors," said Stearn.

Parnes said more than 100 warning letters were sent out and many advertisers dropped or changed their claims.

Of the complaints resolved by settlements, she said companies paid restitution ranging from $9,000 to $250,000.

The remaining five complaints of false and deceptive advertising will go before administrative law judges, she said.

Those cases are Omega Supply, San Diego, Calif.; Native Essence Herb Company, El Prado, N.M.; Daniel Chapter One, Portsmouth, R.I.; Gemtronics, Inc., Franklin, N.C., and Herbs for Cancer, Surprise, Ariz.

Copyright © 2008 The Associated Press.

Heads are still in the sand on this one

Rising Foe Defies Hospitals' War On 'Superbugs' by LAURA LANDRO is an article found in the Wall Street Journal's "THE INFORMED PATIENT" on SEPTEMBER 17, 2008.

Another related article is from Science Daily, and both are included below.

I am sitting here shuddering and thinking of these little critters that seem to be wreaking havoc world wide, with no relief in sight.
I have been following this issue of MRSA and C. diff along with the infection control crisis hospitals and other health facilities are facing, with little in the way of success, since the early 1990s.

Today I can only say, after reading these two articles, new to my currently very thick folder of articles I've collected for the last 8 years, that those in mainstream medicine (MSM) are just plain stupid!

I've put out a challenge to MSM on this single topic for close to a decade now and haven't seen one serious effort to explore the issues with me.

I worked in ICU, managed critical care units and taught critical care nursing in college level programs. I take infection control issues and people's lives very seriously.

I'm just wondering why others in health care are not on the same track.

As a graduate student in the mid 70s at the University of Pennsylvania one of my nursing instructors wrote a comment on a paper I wrote, "Too much of your own thinking."

I always thought grad school was for this purpose; honing your ability to engage in critical thinking. However, in one of the several classes that were a part of my graduate program I was taking at the Wharton School, I figured out that the only thing I needed to do was to parrot the instructor and I'd be sure to get an 'A'.

The same in their College of Nursing.

Of course, if you follow my BLOG and read on my web sites, or subscribe to my newsletter, you probably know I am not much for status quo. I am more for getting to the core of the problem and finding the solution(s).

Maybe more in health care need to think like me. After all, the life they save might be their own.

On a personal note, I was saddened to read about Hy Lit in the WSJ article. In addition to sitting in on med school classes and watching surgery as a young child at the side of my physician and surgeon father at Thomas Jefferson, I listened to Hy Lit on the radio as a teen. My condolences go out to his family. It is a death that could have been prevented.

If anyone out there is listening, reading or paying attention, and you are interested in what could be done differently, contact me and I will be pleased to continue the discussion.

World Faces Global Pandemic Of Antibiotic Resistance, Experts Warn

ScienceDaily (2008-09-18) -- Vital components of modern medicine such as major surgery, organ transplantation, and cancer chemotherapy will be threatened if antibiotic resistance is not tackled urgently, warn experts. ... > read full article

from The Informed Patient - Shortly after being admitted to a Cleveland-area hospital with severe abdominal pain, 52-year-old Maureen O'Hearn was transferred to intensive care. An intestinal infection had distended her abdomen so badly she appeared to be six months pregnant. To save her life, a surgeon had to remove her colon.

The cause of Ms. O'Hearn's illness was an epidemic strain of Clostridium difficile -- C. diff for short -- that is fast emerging as one of the most dangerous and virulent foes in the war against antibiotic "superbugs." C. diff is spawning infections in hospitals in the U.S. and abroad that can lead to severe diarrhea, ruptured colons, perforated bowels, kidney failure, blood poisoning and death.

Katie Lancey follows special procedures for cleaning a patient's room at SSM St. Joseph Hospital West in Lake Saint Louis, Mo.

Even as hospitals begin to get control of other drug-resistant infections such as MRSA, a form of staph, rates of C. diff are rising sharply, and a recent, more virulent strain of the bug is causing more severe complications. The Centers for Disease Control and Prevention estimates there are 500,000 cases of C. diff infection annually in the U.S., contributing to between 15,000 and 30,000 deaths. That's up from roughly 150,000 cases in 2001.

"We've been trying to sound the alarm repeatedly since 2004 that the trend is continuing upward," says Cliff McDonald, a CDC epidemiologist. He adds that C. diff, once mainly a concern for older patients, is now a growing risk for pregnant women, children and healthy adults.

Many patients get C. diff infections as an unintended consequence of taking antibiotics for other illnesses. That's because bacteria normally found in a person's intestines help keep C. diff under control, allowing the bug to live in the gut without necessarily causing illness. But when a person takes antibiotics, both bad and good bacteria are suppressed, allowing drug-resistant C. diff to grow out of control.

As a result, hospitals are more closely monitoring and limiting their use of antibiotics. It's a strategy that also has shown some success in preventing the spread of other drug-resistant bacteria. Once patients do contract a C. diff infection, hospitals sometimes can treat them with certain "last ditch" antibiotics, such as vancomycin, but many patients relapse after treatment.

Other efforts to stop the spread of C. diff include isolating infected patients; suiting workers and visitors from head to toe with scrubs, masks and gloves; and blasting patient rooms with super-strength bleach solutions. Milder "green" cleaners don't kill C. diff, undermining some hospitals' efforts to use these products.
Spreading Spores

One problem: C. diff produces spores that can dry out after cleaning and hang around on hospital cart handles, bed rails and telephones for months. Hand cleaning with alcohol, many hospitals' standard practice for keeping staff from spreading infection, can actually help disperse C. diff spores. Many hospitals now have special rules requiring staff to wash their hands with antibacterial soap when dealing with C. diff patients.
[Clostridium difficile spores can last a long time and make the bug hard to kill.] Photo Researchers

Clostridium difficile spores can last a long time and make the bug hard to kill.

Katie Lancey, lead environmental services aide at SSM St. Joseph Hospital West in Lake Saint Louis, Mo., says she spends up to an hour cleaning a room after a C. diff patient leaves. She wears protective garments and wipes down everything in the room with a bleach solution, including the TV, pillows, mattress and lower structure of the bed. "Anything you can think of, you make sure you wipe it down thoroughly," she says.

If a patient coming in to SSM St. Joseph is suspected of having C. diff infection -- severe diarrhea is one symptom -- they are put in isolation even before lab tests come back, says James Hinrichs, the infectious-disease specialist charged with the hospital's C. diff-prevention program. He says that when C. diff patients are discharged, he advises them to eat yogurt with so-called pro-biotics to help restore a healthy balance of bacteria in their intestines. He also tells families to follow strict cleaning and hand-washing rules at home.

The efforts, along with more careful use of antibiotics, have helped SSM St. Joseph reduce the rate of C. diff infections to 0.5 cases per 1,000 patient days currently from 2.5 cases in 2006, Dr. Hinrichs says.

C. diff was first recognized in the 1970s, when it was readily treatable. The more virulent strain was first identified at the University of Pittsburgh Medical Center in 2000, killing 18 patients. By 2004, the new C. diff strain was reported elsewhere in the U.S. and around the world, and studies showed it was producing 20 times more toxin than older strains.

Carlene Muto, medical director of infection control at the University of Pittsburgh, says the hospital was able to reduce its C. diff infections by 50% after the 2000 outbreak and has sustained that rate since then. It instituted strict cleaning practices, restricted its use of antibiotics and began relying on its electronic medical-record system to quickly flag lab tests of patients most at risk so they can be isolated. "You have to be constantly vigilant," Dr. Muto says.

Only 3% to 5% of healthy, non-hospitalized adults carry C. diff in their gut, but that rate is much higher in hospitals and nursing homes, where carriers can spread the bacteria to others. Studies at several hospitals in recent years have shown that 20% or more of inpatients were colonized with C. diff, and a 2007 study of 73 long-term-care residents showed 55% were positive for C. diff. Even though the majority had no symptoms of disease, spores on the skin of asymptomatic patients were easily transferred to the investigators' hands.

The CDC is launching a national surveillance effort to gather more precise data about the prevalence of C. diff. It is working with states to identify local outbreaks. It also is working with Medicare and the Environmental Protection Agency to develop new guidelines for fighting C. diff.
Nursing Home Infections

Ms. O'Hearn, the Cleveland-area patient, says she took an antibiotic for a sinus infection and then visited a nursing home, where she may have picked up the C. diff bug. During her hospital treatment, Ms. O'Hearn says she suffered an irregular heartbeat and dehydration, and required additional surgery to temporarily attach her small intestine to the abdominal wall to bypass the large intestine. "It was the worst nightmare that anyone could imagine," says Ms. O'Hearn, a nurse by training. Though she has returned to work and a more normal lifestyle, she continues to have digestive troubles, and must take medications to regulate her heart.

Kettering Medical Center near Dayton, Ohio, had 305 cases of C. diff last year and has had 165 cases so far this year. Even newborn babies have gotten the disease from their mother during birth, says Rebekah Wang-Cheng, Kettering's medical director for clinical quality. She says that among other measures, the hospital has cut its post-operative antibiotic doses for all joint-replacement surgeries to two from three to avoid C. diff infections. Patients who come into the hospital with suspected pneumonia now get an antibiotic within six hours, instead of four hours previously, to allow more time to assess the need for drugs.
Fecal Transplants

One controversial strategy: fecal transplants. For one patient with recurrent C. diff, Kettering suggested a stool transplant from a relative, to help restore good bacteria in the gut. But Jeffrey Weinstein, an infectious-disease specialist at the hospital, says the patient "refused to consider it because it was so aesthetically displeasing."

The Greater New York Hospital Association in March began a 40-hospital effort to halt the spread of C. diff from patient to patient. This included placing signs on patient rooms with pictures of a bottle of bleach and soap and water to remind staff the room needs special cleaning. The association also asks visitors not to use patient bathrooms.

Hospitals face growing legal concerns if they don't take such measures; relatives of 16 patients who were infected or died from a C. diff outbreak are suing a Quebec hospital, claiming that infection-control practices weren't followed.

C. diff infections can emerge days or weeks after antibiotic therapy. Earlier this year, Marcus Glover, a 40-year-old mailroom worker for the Greater New York Hospital Association, was discharged from hospital after a successful rotator-cuff surgery, which included antibiotic treatment. Ten days later, he landed in an emergency room with a C. diff infection that required another week in the hospital. Mr. Glover avoided the worst complications and was successfully treated with strong antibiotics.

But C. diff can be fatal. Philadelphia radio personality Hy Lit, 73, contracted a C. diff infection at a rehabilitation center after being treated at a hospital owned by Main Line Health System last fall. He died in another Main Line hospital two weeks later. "It was a multiple train wreck, when the bug permeated his bloodstream and his kidneys failed," says his son, Sam Lit. "It was a tragedy to lose him like that."

Main Line says it can't comment on individual patients but adds that it follows stringent prevention guidelines and is conducting ongoing initiatives to control infections in its hospitals.

Copyright 2008 Dow Jones & Company, Inc.