NEWSMEDICAL SCIENCE

Most people would rather have a cold or flu than a nasty bacterial infection that's incurable. Unfortunately, this is kind of the choice we're forced to make these days, as more and more research shows our overuse of antibacterial agents -- in consumer products, it's most commonly the ingredient triclosan -- contributes to the development of new "super bugs" that are resistant to antibiotics and antibacterials.

Triclosan is found in everything from Clearasil face wash and Colgate toothpaste to Playskool children's toys. Do we really need that much sterility? It makes sense to keep everything germ-free in a hospital setting where patients have compromised immune systems, but in our daily lives, according to the CDC, antibacterial products can lead to drug resistance, lower immunity and allergies. A recent study by the CDC detected triclosan in the urine of 75 percent of the people they tested.

In April, the FDA issued a statement regarding triclosan's health effects. In it, they note that triclosan alters hormone regulation in laboratory animals and may contribute antibiotic resistant bacteria. Although they state that the chemical does not currently present a health hazard, it does merit "further review" and they are currently reviewing the scientific evidence to determine its safety in consumer products. Some countries have already banned or limited the use of the chemical.

Perhaps most perplexing is why we use the chemical in the first place. Although it's been found to be useful to prevent gingivitis, overall, the FDA statement concludes that it "does not have evidence that triclosan in antibacterial soaps and body washes provides any benefit over washing with regular soap and water."

Even those of us who don't take hormonal medications are exposed to endocrine disrupting chemicals -- in agriculture, food, industry and consumer products.

Since hormones regulate a vast number of bodily processes, maybe it's time to cultivate a little more respect towards them.

When Sanjay Gupta first reported last Spring on the Safe Chemicals Act, (a new move to finally regulate toxic chemicals to protect our health), he interviewed a spokeswoman for the chemical industry who asked, "Why all this fuss about synthetic chemicals? Why don't you go after natural ones instead?"

Her statement perfectly captures our paradoxical cultural attitude: Anything man-made, patentable, and for sale, is inherently better than anything made by living biology.

For over 35 years, we’ve been laissez-faire about asbestos, formaldehyde, carcinogens and other chemicals which disrupt bodily hormones, and create DNA changes. We absorb these chemicals from products and the environment, and think nothing of it.

Meanwhile, we strive to control the ebb and flow of the natural hormones our bodies produce. It’s inconvenient to have your period or a hot flash and something has to be done. But carcinogens aren’t inconvenient?

I don’t get why we spend millions fine-tuning the female hormonal cycle, while we shrug over the impact of Corexit in Gulf waters, seafood and beaches? Our innate hormones are so inconvenient, that Seasonique, a new extended use birth control pill eliminates periods entirely. It's marketed to young women with an ad campaign with faux insurgent undertones,

"Who says 'that time of month'  has to be every month? Who says?"

How manipulative for pharmaceutical companies to empower women to reject the physical signs of their femaleness. In my FB page, where people love to speak up, a wise-ass commenter replied, "Mother nature, that's who!

In health care, what does our society reward more: improved health or financial gain?

Today, there’s no given that medications are healthy as claimed. Pharmaceutical companies pay for many drug studies. They publish favorable studies and shelve unfavorable ones.

“Objective” researchers frequently stand to gain financially if their study shows that a drug is beneficial. Plus massive marketing budgets, and financial incentives to doctors can push sales of nearly any product even if it’s ineffective or harmful.

The Food and Drug Administration (FDA) is less than an avid watchdog, thanks to a revolving door between the regulators and the regulated.

The protections from harm have weakened. The financial incentives have grown. It could therefore be argued that our societal values have turned a corner: Since its now profitable to harm people, where is the incentive not to do so?

Most recently, the diabetes medication Avandia has been the poster child for the downside risks of what Maggie Mahar called “money-driven medicine.”

After Avandia passed the gateways of research and FDA approval, clinical outcomes showed the drug had an upside and a downside.

Ever wondered if your doctor is receiving money from drug companies? Or if the doctors pushing pills are actually the qualified experts companies make them out to be? Usually this information isn't available online, but a new database compiled by the investigative team at ProPublica, called Dollars for Docs, makes it easy to find out if your doctor is being funded by pharma, and just how unethical that doctor may be.

Usually, drug companies try to keep compensation information secret, even though they claim that payments to physicians, for speaking and consulting jobs, don't unduly influence their prescribing habits. But numerous studies indicate that promotion helps sell drugs; a series of lawsuits brought against big pharma shows that compensation was often used illegally -- namely, to reward doctors for prescribing brand-name medications.

The lawsuits required companies to disclose their payments, and ProPublica used this information to compile payments made by seven pharmaceutical companies, totaling $258 million, to doctors across the country. It lists over 380 doctors who received at least $100,000 each from drug companies in the past 18 months.

Catherine Calhoun remembers the day with exacting clarity. It was October 16th, 2006. When she dropped her four-year-old son, Billy, off at school, she noticed he was limping. At first, the St. Francisville, La., mom didn't think too much of it. But when the limp was still there later that day, she took him to a doctor. Just in case.

After numerous X-rays, the doctor came back with the news -- Billy had multiple lesions throughout his leg bones. Another blow: the doctor didn't know why. Cancer? A bone disorder?

Wanting answers, Calhoun took Billy to New Orleans Children's Hospital, a two hour drive away. There, the doctors and medical students asked to see Billy's X-rays. Did he have birthmarks? Indeed, large cafe-au-lait spots that previous doctors had dismissed as normal. But these, combined with his X-rays, were telltale signs of a disorder the physicians had studied just that week: McCune-Albright Syndrome.

The diagnosis was bittersweet for Calhoun, a lawyer who has taken on her child's disease as her only client. His condition had a name, but it didn't have a cure. Resulting from a chance genetic mutation that happens while still in the womb, the disease can affect bones, skin and the endocrine system. Though the symptoms differ from person to person, usually people have fibrous dysplasia, where normal bone tissue is replaced with abnormal growth, leading to weak bones prone to fracture and deformity. In addition to the birthmark-like pigmentation, endocrine issues can result in growth and sexual development abnormalities, including precocious puberty, where girls as young as four menstruate.

When fifteen-year-old Rhys Morgan went searching for information on his newly diagnosed Crohn's disease, he wasn't looking for controversy. But his blogging helped bring greater attention to a dangerous substance being peddled internationally as cure for everything from AIDS to cancer, and has landed him at the center of what the blogosphere has dubbed "Bleachgate."

It all started a few months ago, when the British teenager found Crohn's Disease Forum, a popular website and interactive space for sufferers. After a few months on the site he noticed some groups promoting alternative therapies for Crohn's; one in particular, Miracle Mineral Solution (MMS), stood out. Touted as a breakthrough cure-all, the Solution claims to alleviate everything from cancer and flu to AIDS and obesity. Rhys decided to do some investigating to find out what MMS really is.

One alarming thing he found was an FDA consumer warning posted on July 30th, 2010. It states that the product instructs consumers to mix 28 percent sodium chlorite with an acid, such as citrus juice. This mixture makes chlorine dioxide -- a bleach used in stripping textiles and industrial water treatment.

"High oral doses of this bleach, such as those recommended in the labeling, can cause nausea, vomiting, diarrhea, and symptoms of severe dehydration," the FDA warning notes. They encourage people to throw the product away.

MMS=Industrial bleach. Seems pretty bad. So Rhys posted the information on the Crohn's forum. Their response? He was questioned, vilified and finally banned. But, smart kid, he began blogging.

Soon his plight was contributing to the information circulating by science bloggers and skeptics, many of whom had been following MMS since the FDA's consumer bulletin. Rhys's story was picked up Martin Robbins at the UK Guardian and "Bleachgate" was underway.

There’s a movie in which one of the characters is a sickly little boy who doesn’t go anywhere without his inhaler. When he gets short of breath, he takes a couple of hits off his inhaler, and within a minute or two he’s breathing easily again. Later in the movie it’s revealed that what’s actually in his inhaler is nothing more than aerosolized salt water. It’s a complete sham. Yet it still brought relief to this boy and his neurotic mother.

It’s a perfect example of the placebo effect -- benefit from a false treatment or intervention. It’s seen most commonly in situations where the symptoms are more subjective, such as pain or mood. In women, it's also seen in sex drive.

A recent study in the Journal of Sexual Medicine found that one in three women with diminished sexual desire who took a sugar pill as part of a control group reported an improvement in their symptoms. The study included 200 women diagnosed with female sexual arousal disorder; 150 of them took Cialis, the male erectile dysfunction drug, and 50 were chosen at random to receive placebo. Although the women taking Cialis showed no marked improvement in sexual arousal, a third of the women popping sugar pills reported restored sexual function. It seems that nothing had physically changed for these women, but psychologically a major shift had occurred.

Scientific integrity and good research have once again been put on the ideological chopping block. This past Tuesday, the federal judge who imposed a ban on federal funding of embryonic stem cell research denied the Obama Administration's request to lift the ban, despite urgent requests from patient groups and scientific institutions.

Last month, Judge Joyce Lamberth of the U.S. District Court in Washington, D.C. dealt a fierce blow to biomedical researchers when he ordered the National Institute of Health to cease funding for projects using embryonic stem cells. The cells are controversial because they are culled from human embryonic tissues, and some Christian groups oppose their use. Scientists, however, see them as invaluable tools in developing cures to diseases ranging from Parkinson's to heart disease. Banning their use curtails the work of thousands of researchers in federal labs and those that rely on federal funding. As npr.org reports, Francis Collins, director of the NIH, wrote in a filing to the judge that the injunction "will have extraordinary adverse effects not only on the prospect of delivering new therapies to patients suffering from numerous diseases and disorders but also on scientific progress from the wider medical researcher community."

In one of those “Oh my gosh I can’t believe they actually did that” moments of medical advancement, a group of researchers reported in the Lancet the successful regrowth of the entire articular surface of joints in rabbits.  In other words, the researchers made bunnies grow their own joint replacements.

Before you go taking granny’s walker away, bear in mind a few important points: They’re rabbits.  The same results may not be achievable in humans. The joints being evaluated were in their front legs, which – correct me if I’m wrong – don’t appear to be the major impact-bearing limbs in that particular species.

Further, the researchers looked at a very small number of these creatures (10 in the study group vs. 13 in two different control groups and one of the control groups contained three unfortunate bunnies who simply had their humeral heads removed, with no attempt at reconstruction.  The researchers astutely noted that “Defect-only rabbits limped at all times.”

I’ve just this very moment gotten my head above the surface after spending the better part of the last week and a half navigating the waters of the federal grant process.  The good news is that I think programs like mine are particularly well-suited to the grant for which we’re applying, and I’m quite optimistic about the outcome.  The bad news is that the process, and in the case of this grant the incredibly short turn-around time, may dissuade from applying the very programs that it’s meant to benefit.

The grant to which I refer is HRSA-10-277, the Affordable Care Act Primary Care Residency Expansion Program.  Announced June 17, 2010 and due July 19, 2010, this program offers $168 million to increase the number of primary care physicians by expanding enrollment in primary care residency programs.  Priority will be given to those programs who offer a minimum of six months of the residents’ training in a rural health clinic, community health center, community hospital, critical access hospital, or other community based settings.

Which sounds great, but I can’t help but wonder how programs so heavily invested in such priority areas could have the resources to come up with a 35-page grant in such a short period of time.  Do these places have grant writers?  Because there’s no way on earth I could have completed this grant application without my grant writer Donna.  Just none.  And most community health centers that I know of are so overextended and understaffed, the mere suggestion of adding a project of this size with such a precipitous deadline would probably be met with no small measure of laughter.