Category Archives: Health Care

Medical Study Integrity (or Lack Thereof)

The drug maker Merck drafted dozens of research studies for a best-selling drug, then lined up prestigious doctors to put their names on the reports before publication, according to an article to be published Wednesday in a leading medical journal.

The article, based on documents unearthed in lawsuits over the pain drug Vioxx, provides a rare, detailed look in the industry practice of ghostwriting medical research studies that are then published in academic journals.
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“It almost calls into question all legitimate research that’s been conducted by the pharmaceutical industry with the academic physician,” said Ross, whose article, written with colleagues, was published Wednesday in JAMA, The Journal of the American Medical Association, and posted Tuesday on the journal’s Web site.

Merck acknowledged Tuesday that it sometimes hired outside medical writers to draft research reports before handing them over to the doctors whose names eventually appear on the publication. But the company disputed the article’s conclusion that the authors do little of the actual research or analysis.

It is sad that the integrity of journals and scientists is so weak that they leave them open to such charges. The significant presence of the corrupting influence of too much money leaves doubt in my mind that the best science is the goal. Which is very sad. In, Funding Medical Research, I discussed my concern that universities are acting more like profit motivated organizations than science motivated organizations. I am in favor of profit motivated organization (those getting the micro-financing in this link, for example) but those organization should not be trusted to provide honest and balanced opinions they should be expected to provide biased opinions.

If universities (and scientists branding themselves as … at X university) want to be seen as honest brokers of science they can’t behave as though raising money, getting patents… are their main objectives. Many want to be able to get the money and retain the sense of an organization focused on the pursuit of science above all else. Sorry, you can’t have it both ways. You can, and probably should, try stake out some ground in the middle. And for me right now, partially because they fail to acknowledge the extent to which money seems to drive decisions I don’t believe they are trying to be open and honest, instead I get the impression they are leaning more toward trying to market and sell.
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Study challenges notion of ‘pandemic’ flu

Peter Doshi, a graduate student in the History, Anthropology, and Science, Technology and Society Program at MIT, based his study on an analysis of more than a century of influenza mortality data. He found that the peak monthly death rates in the 1957-1958 and 1968-1969 pandemic seasons were no higher than–and were sometimes exceeded by–those for severe nonpandemic seasons.

Doshi says the pandemic-equals-extreme-mortality concept appears to be a generalization of a single data point: the 1918 season, a period in which “doctors lacked intensive care units, respirators, antiviral agents and antibiotics.” He argues that “had no other aspect of modern medicine but antibiotics been available in 1918, there seems good reason to believe that the severity of this pandemic would have been far reduced.”

As may be expected given improvements in living conditions, nutrition and other public health measures, influenza death rates substantially declined across the 20th century. Doshi calculates an 18-fold decrease in influenza deaths between the 1940s and 1990s, a trend that began far before the introduction of widespread vaccination.

Eating Breakfast Keeps Teenagers Leaner

Breakfast ‘keeps teenagers lean’

In a five year study of more than 2,000 youngsters, those who skipped breakfast weighed on average 5lbs (2.3kg) more than those who ate first thing. This was despite the fact that the breakfast-eaters consumed more calories in the course of the day. But the study in Pediatrics found they were likely to be much more active.

The University of Minnesota research adds weight to a growing body of evidence that those who eat breakfast – whether young or old – are leaner than those who do not.
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“The real problem is the profusion of messages about obesity. We need to make clear that eating regular meals is vital – and that a proper breakfast is very important. “If you eat well first thing, you’ll feel brighter, you’ll have more get up and go – and that will mean you’ll expend more energy.”

Teenagers are not the only ones who may benefit from sitting down to a proper breakfast. In a study of nearly 7,000 middle-aged people in Norfolk, a team from Cambridge University found that those who ate the most in the morning put on the least amount of weight.

Self-assembling Nanofibers Heal Spinal Cords in Mice

Self-assembling Nanofibers Heal Spinal Cords by Prachi Patel-Predd

An engineered material that can be injected into damaged spinal cords could help prevent scars and encourage damaged nerve fibers to grow. The liquid material, developed by Northwestern University materials science professor Samuel Stupp, contains molecules that self-assemble into nanofibers, which act as a scaffold on which nerve fibers grow.

Stupp and his colleagues described in a recent paper in the Journal of Neuroscience that treatment with the material restores function to the hind legs of paralyzed mice.
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The new work is the first test for the material to heal spinal cord injuries in animals. And Kessler says that it worked better than the researchers expected. The researchers stimulated a spinal cord injury in mice and injected the material 24 hours later. They found that the material reduced the size of scars and stimulated the growth of the nerve fibers through the scars. It promoted the growth of both types of nerve fibers that make up the spinal cord: motor fibers that carry signals from the brain to the limbs, and sensory fibers that carry sense signals to the brain. What is more, the material encouraged the nerve stem cells to mature into cells that create myelin–an insulating layer around nerve fibers that helps them to conduct signals more effectively.

High Fructose Corn Syrup is Not Natural Food

HFCS is not ‘natural’, says FDA

Products containing high fructose corn syrup cannot be considered ‘natural’ and should not be labeled as such, the US Food and Drug Administration (FDA) has said.
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Industry group Sugar Association, as well as consumer groups such as the Center for Science in the Public Interest categorically maintain that HFCS cannot be considered natural because its chemical bonds are broken and rearranged in the manufacturing process. The debate raged on for one simple reason: FDA does not define the term ‘natural’, and it has therefore been left open to different interpretations.

However, in response to an inquiry from FoodNavigator-USA.com, the regulatory agency examined the composition of HFCS, which it said is produced using synthetic fixing agents. “Consequently, we would object to the use of the term ‘natural’ on a product containing HFCS,” the agency’s Geraldine June said in an e-mail to FoodNavigator-USA.com. June is Supervisor of the Product Evaluation and Labeling team at FDA’s Office of Nutrition, Labeling and Dietary Supplements.

High fructose corn syrup is also high on the list of problem foods from a health perspective.

Cancer Deaths Increasing, Death Rate Decreasing

Last year I questioned this quote “confirming” a declining trend of cancer deaths: “Cancer deaths in the United States dropped for the second year in a row, health officials reported yesterday, confirming that the trend is real and becoming more pronounced, too.” Well the data is in for the next year (2005) and cancer deaths increased – so much for the 2 year “trend.”

Despite a continuing decline in the cancer death rate from 2004 to 2005, there was an increase of 5,424 deaths (559,312 cancer deaths in 2005 compared to 553,888 cancer deaths in 2004). This increase follows a decrease in the number of cancer deaths in the two previous years.

The American Cancer Society provides much better wording this year, I believe:

“The increase in the number of cancer deaths in 2005 after two years of historic declines should not obscure the fact that cancer death rates continue to drop, reflecting the enormous progress that has been made against cancer during the past 15 years.” said John R. Seffrin, Ph.D., American Cancer Society chief executive officer. “While in 2005 the rate of decline was not enough to overtake other population factors, the fact remains that cancer mortality rates continue to drop, and they’re doing so at a rate fast enough that over a half million deaths from cancer were averted between 1990/1991 and 2004.”

Good news, and well stated. Related: Leading Causes of Death – Cancer Cure – Not so Fast

Don’t Eat What Doesn’t Rot

Here is a nice interview of Michael Pollan by Amy Goodman – Don’t Eat Anything That Doesn’t Rot:

Another assumption of nutritionism is that you can measure these nutrients and you know what they’re doing, that we know what cholesterol is and what it does in our body or what an antioxidant is. And that’s a dubious proposition.
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if you look at the layout of the average supermarket, the fresh whole foods are always on the edge. So you get produce and meat and fish and dairy products. And those are the foods that, you know, your grandmother would recognize as foods. They haven’t changed that much. All the processed foods, the really bad stuff that is going to get you in trouble with all the refined grain and the additives and the high-fructose corn syrup, those are all in the middle. And so, if you stay out of the middle and get most of your food on the edges, you’re going to do a lot better.

Warning on Two Cholesterol Drugs

Journal Issues Warning on Two Cholesterol Drugs

Two widely prescribed cholesterol-lowering drugs, Vytorin and Zetia, may not work and should be used only as a last resort, The New England Journal of Medicine said in an editorial published on Sunday.

The journal’s conclusion came as doctors at a major cardiology conference in Chicago saw for the first time the full results of a two-year clinical trial that showed that the drugs failed to slow, and might have even sped up, the growth of fatty plaques in the arteries. Growth of those plaques is closely correlated with heart attacks and strokes.

Merck and Schering-Plough, the companies that make Vytorin and Zetia, said on Sunday that despite the results of the trial, they would continue to promote their medicines as first-line treatments for high cholesterol.

Drug Price Crisis

I don’t think the suggestion below really solves the drug price crisis. But I do think it is an example of an educational and research institution actually proposing sensible role for themselves. As I have said too many universities now act like they are for-profit drug or research companies: Funding Medical Research. For some background on drug prices read my post on the Curious Cat Management blog from 2005.

Solving the drug price crisis

The mounting U.S. drug price crisis can be contained and eventually reversed by separating drug discovery from drug marketing and by establishing a non-profit company to oversee funding for new medicines, according to two MIT experts on the pharmaceutical industry.
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Following the utility model, Finkelstein and Temin propose establishing an independent, public, non-profit Drug Development Corporation (DDC), which would act as an intermediary between the two new industry segments — just as the electric grid acts as an intermediary between energy generators and distributors.

The DDC also would serve as a mechanism for prioritizing drugs for development, noted Finkelstein. “It is a two-level program in which scientists and other experts would recommend to decision-makers which kinds of drugs to fund the most. This would insulate development decisions from the political winds,” he said.

Book – Reasonable Rx: Solving the Drug Price Crisis by Stan Finkelstein and Peter Temin

Google Tech Webcasts #4

While I worked in the Eisenhower Executive Office Building (EEOB) – part of the white house complex, I was able to hear some great speakers. However, those talks were only available to those of us that could make it to room 450 of the EEOB when it was scheduled. Google has far more speakers and they have posted webcasts of those talks online. It is great stuff, some excellent recent examples:

Michael Pollan on In Defense of Food – related: Eat food. Not too much. Mostly plants.
Cory Doctorow on Overclocked: Stories of the Future Present
Annalee Newitz, Charlie Anders, Ellen Spertus, & Jenn Shreve discuss their book She’s Such a Geek: Women Write About Science, Technology, and Other Nerdy Stuff
Daniel Goleman on Social Intelligence: The New Science of Human Relationships