Domain: nejm.org
Stories and comments across the archive that link to nejm.org.
Stories · 25
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Attackers Can Track Kids' Locations Via Connected Watches
secwatcher shares a report from Threatpost: A gamut of kids' GPS-tracking watches are exposing sensitive data involving 35,000 children -- including their location, in real time. Researchers from Pen Test Partners specifically took a look at the Gator portfolio of watches from TechSixtyFour. The Gator line had been in the spotlight in 2017 for having a raft of vulnerabilities, called out by the Norwegian Consumers Council in its WatchOut research. "A year on, we decided to have a look at the Gator watch again to see how their security had improved," said Vangelis Stykas, in a Tuesday posting. "Guess what: a train wreck. Anyone could access the entire database, including real-time child location, name, parents' details etc. Not just Gator watches either -- the same back end covered multiple brands and tens of thousands of watches." "At issue was an easy-to-exploit, severe privilege-escalation vulnerability: The system failed to validate that the user had the appropriate permission to take admin control," reports Threatpost. "An attacker with access to the watch's credentials simply needed to change the user level parameter in the backend to an admin designation, which would provide access to all account information and all watch information." -
E-Cigarettes Are Effective At Helping Smokers Quit, a Study Says (nytimes.com)
An anonymous reader quotes a report from The New York Times: The study, published Wednesday in the New England Journal of Medicine, found that e-cigarettes were nearly twice as effective as conventional nicotine replacement products, like patches and gum, for quitting smoking. The success rate was still low -- 18 percent among the e-cigarette group, compared to 9.9 percent among those using traditional nicotine replacement therapy -- but many researchers who study tobacco and nicotine said it gave them the clear evidence they had been looking for. The study was conducted in Britain and funded by the National Institute for Health Research and Cancer Research UK. For a year, it followed 886 smokers assigned randomly to use either e-cigarettes or traditional nicotine replacement therapies. Both groups also participated in at least four weekly counseling sessions, an element regarded as critical for success. The findings could give some new legitimacy to e-cigarette companies like Juul, which have been under fire from the government and the public for contributing to what the Food and Drug Administration has called an epidemic of vaping among teenagers. But they could also exacerbate the difficulty of keeping the devices away from young people who have never smoked while making them available for clinical use. -
Implanted Device Helps Two People With Paralysis Walk Again (nbcnews.com)
An anonymous reader quotes a report from NBC News: At least five people whose legs were completely paralyzed are walking again, two of them with no outside help, thanks to a specialized program of therapy and a pain stimulator implanted in their spines, researchers reported Monday. It's the latest and most dramatic advance in a new approach to treating spinal cord injuries developed at the University of Louisville in Kentucky. The reports show that electrical stimulation of the spine, when combined with a very intense and specialized training program, can re-educate the body and help move the legs even though signals from the brain are cut off.
The stimulator is implanted into the epidural layer surrounding the spinal cord, and sends controlled signals into the bundle of nerve tissue. The team also employs intense training techniques to try to get the body to make sense of the signals. "There were three types of training sessions: stepping on a treadmill, over-ground standing, and over-ground walking, with each type of session performed daily," the team wrote in their report, published in the New England Journal of Medicine. Two still need support and help from human trainers, but Marquis and another patient, 23-year-old Kelly Thomas of Citrus County, Florida, can walk alone using a walker or a cane. A second team at the Mayo Clinic reports somewhat similar results using the Louisville approach. In their study, published Monday in Nature Medicine, they report on one of two patients they have treated, who can walk with the assistance of physical trainers. -
The Most Important Study of the Mediterranean Diet Has Been Retracted (qz.com)
Zorro shares a report from Quartz: In 2013, the New England Journal of Medicine published a landmark study that found that people put on a Mediterranean diet had a 30% lower chance of heart attack, stroke, or death from cardiovascular disease than people on a low-fat diet. It received massive media and public attention when released, and since has been cited by 3,268 other scientific papers. The study had tremendous impact on the field of nutrition and health science. Yesterday (June 13), however, the journal retracted the study -- providing a new reason for skepticism about how effective the now-popular Mediterranean diet really is.
The reasons for the withdrawal are complicated, having to do with the methodology of the study. As Alison McCook of the Retraction Watch blog writes for NPR, this retraction is the result of the work of John Carlisle, a British anesthesiologist and self-taught statistician. Carlisle has spent recent years analyzing over 5,000 published randomized controlled trials (the gold standard of medical science research) to see how likely they were to have actually been properly randomized. In 2017, he reported his results: at least 2% of the studies were problematic. One was the 2013 NEJM article on the Mediterranean diet. -
In First, Doctors Treat Rare Genetic Disorder With an Injection In Utero (arstechnica.com)
An anonymous reader quotes a report from Ars Technica: Three babies with a rare genetic disorder have been spared the worst effects of their condition thanks to an experimental injection they received in utero, researchers report this week in The New England Journal of Medicine. The success marks the first time a genetic disorder has been partially reversed by such a treatment prior to birth. The in utero injections treated a rare, recessive genetic condition called X-linked hypohidrotic ectodermal dysplasia (XLHED), which affects the development of skin, hair, nails, and teeth. People with the disorder have sparse body and head hair, dry eyes, mouths, and airways, and few teeth, which are usually pointy. But most dangerously, the condition also disrupts development of sweat glands throughout the body. People with XLHED have fewer sweat glands and/or poorly functioning ones. This leaves individuals vulnerable to high fevers and over-heating (hyperthermia), which can be life-threatening and lead to medical complications.
For the new experimental treatment, the researchers realized that it all came down to timing. Humans develop sweat glands much earlier in their development, generally between the 20th and 30th week of pregnancy. To prevent XLHED from wreaking havoc, the researchers needed to deliver the protein prior to birth. After testing the idea for safety and efficacy in mice and monkeys, doctors in Germany got a compassionate-use approval to try it in a 38-year-old pregnant woman. She had a family history of XLHED, a young son with the condition, and was found to be carrying twin boys with it, too. [...] The researchers will track the babies' development to see if the effects are permanent, but data from animals suggests that they will be. -
Hospitals May Turn To Algorithms To Fight Fatal Infections (scientificamerican.com)
An anonymous reader quotes a report from Scientific American: Clostridium difficile, a deadly bacterium spread by physical contact with objects or infected people, thrives in hospitals, causing 453,000 cases a year and 29,000 deaths in the United States, according to a 2015 study in the New England Journal of Medicine. Traditional methods such as monitoring hygiene and warning signs often fail to stop the disease. But what if it were possible to systematically target those most vulnerable to C-diff? Erica Shenoy, an infectious-disease specialist at Massachusetts General Hospital, and Jenna Wiens, a computer scientist and assistant professor of engineering at the University of Michigan, did just that when they created an algorithm to predict a patient's risk of developing a C-diff infection, or CDI. Using patients' vital signs and other health records, this method -- still in an experimental phase -- is something both researchers want to see integrated into hospital routines.
The CDI algorithm -- based on a form of artificial intelligence called machine learning -- is at the leading edge of a technological wave starting to hit the U.S. health care industry. After years of experimentation, machine learning's predictive powers are well-established, and it is poised to move from labs to broad real-world applications, said Zeeshan Syed, who directs Stanford University's Clinical Inference and Algorithms Program. Shenoy and Wiens' CDI algorithm analyzed a data set from 374,000 inpatient admissions to Massachusetts General Hospital and the University of Michigan Health System, seeking connections between cases of CDI and the circumstances behind them. The records contained over 4,000 distinct variables. As it repeatedly analyzes this data, the ML process extracts warning signs of disease that doctors may miss -- constellations of symptoms, circumstances and details of medical history most likely to result in infection at any point in the hospital stay. -
Noninvasive Radiation Therapy Halts Deadly Heart Rhythm (nytimes.com)
schwit1 shares a report from The New York Times (Warning: source may be paywalled; alternative source): The patients were gravely ill, their hearts scarred by infections or heart attacks. In each, the electrical system that maintains a regular heartbeat had been short-circuited. They suffered frequent bursts of rapid heartbeats, which can end in sudden death. The condition kills an estimated 325,000 Americans each year, the most common cause of death in this country. And these people had exhausted all conventional treatments. So researchers at Washington University in St. Louis offered the patients something experimental: short bursts of radiation aimed at their hearts in an effort to obliterate the cells that were causing the electrical malfunctions. Results in the first five patients were published on Thursday in the New England Journal of Medicine, and the experiment seems to have worked -- offering hope to similar patients everywhere who have had no alternatives except a heart transplant. The treatment requires weeks to take full effect, so it cannot be used for cardiac patients who need immediate help. And the method must be studied in larger groups of patients over longer times, an effort that has already begun. -
An Unconscious Patient With a 'DO NOT RESUSCITATE' Tattoo (nejm.org)
A real-life case study, published on New England Journal of Medicine, documents the ethical dilemma that a Florida hospital faced after a 70-year-old unresponsive patient arrived at the hospital. The medical staff, the journal notes, was taken aback when it discovered the words "DO NOT RESUSCITATE" tattooed onto the man's chest. Furthermore, the word "NOT" was underlined with his signature beneath it. The patient had a history of chronic obstructive pulmonary disease, diabetes mellitus, and atrial fibrillation. Confused and alarmed, the medical staff chose to ignore the apparent DNR request -- but not without alerting the hospital's ethics team, which had a different take on the matter. From the report: We initially decided not to honor the tattoo, invoking the principle of not choosing an irreversible path when faced with uncertainty. This decision left us conflicted owing to the patient's extraordinary effort to make his presumed advance directive known; therefore, an ethics consultation was requested. He was placed on empirical antibiotics, received intravenous fluid resuscitation and vasopressors, and was treated with bilevel positive airway pressure. After reviewing the patient's case, the ethics consultants advised us to honor the patient's do not resuscitate (DNR) tattoo. They suggested that it was most reasonable to infer that the tattoo expressed an authentic preference, that what might be seen as caution could also be seen as standing on ceremony, and that the law is sometimes not nimble enough to support patient-centered care and respect for patients' best interests. A DNR order was written. Subsequently, the social work department obtained a copy of his Florida Department of Health "out-of-hospital" DNR order, which was consistent with the tattoo. The patient's clinical status deteriorated throughout the night, and he died without undergoing cardiopulmonary respiration or advanced airway management. -
How Flying Seriously Messes With Your Mind and Body (bbc.com)
dryriver writes: BBC Future has an interesting piece about how traveling in an airliner does strange things to people's minds and bodies, such as far more people starting to cry while watching even mildly emotional movies on airplanes than what is normal, some passengers experiencing decreases in acuity of sight, taste and smell (airline meals are over-seasoned to compensate for this), unusual tiredness or desire to sleep, your skin drying out by up to 37% percent and possibly becoming itchy, and some people breaking wind far more often than they normally would. Here is an excerpt form the report: "There can be no doubt that aircraft cabins are peculiar places for humans to be. They are a weird environment where the air pressure is similar to that atop an 8,000ft-high (2.4km) mountain. The humidity is lower than in some of the world's driest deserts while the air pumped into the cabin is cooled as low as 10C (50F) to whisk away the excess heat generated by all the bodies and electronics onboard. The reduced air pressure on airline flights can reduce the amount of oxygen in passengers' blood between 6 and 25%, a drop that in hospital would lead many doctors to administer supplementary oxygen. There are some studies, however, that show even relatively mild levels of hypoxia (deficiency in oxygen) can alter our ability to think clearly. At oxygen levels equivalent to altitudes above 12,000ft (3.6km), healthy adults can start to show measurable changes in their memory, their ability to perform calculations and make decisions. This is why the aviation regulations insist that pilots must wear supplementary oxygen if the cabin air pressure is greater than 12,500ft. A study in 2007 showed that after about three hours at the altitudes found in airline cabins, people start to complain about feeling uncomfortable." -
Vitamin B3 Supplement Can Prevent Miscarriages and Birth Defects, Says Study (news.com.au)
brindafella writes: The landmark finding about vitamin B3, made by the Victor Chang Institute in Sydney, Australia, has been described as "the most important discovery for pregnant women since folate." The study has been published in the New England Journal of Medicine. From News.com.au: "The historic discovery, believed to be among Australia's greatest ever medical achievements, is expected to forever change the way pregnant women are cared for around the globe. Every year 7.9 million babies are born with a birth defect worldwide and one in four pregnant women suffer a miscarriage in Australia. In the vast majority of cases the cause of these problems has remained a mystery. Until now. Professor Sally Dunwoodie from the Victor Chang Institute has identified a major cause of miscarriages as well as heart, spinal, kidney and cleft palate problems in newborn babies. The landmark study found that a deficiency in a vital molecule, known as NAD, prevents a baby's organs from developing correctly in the womb. Nicotinamide adenine dinucleotide (NAD) is one of the most important molecules in all living cells. NAD synthesis is essential for energy production, DNA repair and cell communication. Disrupting its production causes a NAD deficiency. The Victor Chang researchers have found this deficiency is particularly harmful during a pregnancy as it cripples an embryo when it is forming. At the heart of the paramount discovery is the dietary supplement vitamin B3, also known as niacin. Scientists at the Victor Chang Institute have discovered how to prevent miscarriages and birth defects by simply boosting levels of the nutrient during pregnancy." -
Unproven Stem Cell Treatments Blind 3 Women (npr.org)
An anonymous reader quotes a report from NPR: Scientists have long hoped that stem cells might have the power to treat diseases. But it's always been clear that they could be dangerous too, especially if they're not used carefully. Now a pair of papers published Wednesday in the New England Journal of Medicine is underscoring both the promise and the peril of using stem cells for therapy. In one report, researchers document the cases of three elderly women who were blinded after getting stem cells derived from fat tissue at a for-profit clinic in Florida. The treatment was marketed as a treatment for macular degeneration, the most common cause of blindness among the elderly. Each woman got cells injected into both eyes. In a second report, a patient suffering from the same condition had a halt in the inexorable loss of vision patients usually experience, which may or may not have been related to the treatment. That patient got a different kind of stem cell derived from skin cells as part of a carefully designed Japanese study. The Japanese case marks the first time anyone has given induced pluripotent stem (iPS) cells to a patient to treat any condition. The report about the three women in their 70s and 80s who were blinded in Florida is renewing calls for the Food and Drug Administration to crack down on the hundreds of clinics that are selling unproven stem cell treatments for a wide variety of medical conditions, including arthritis, autism and stroke. -
Unproven Stem Cell Treatments Blind 3 Women (npr.org)
An anonymous reader quotes a report from NPR: Scientists have long hoped that stem cells might have the power to treat diseases. But it's always been clear that they could be dangerous too, especially if they're not used carefully. Now a pair of papers published Wednesday in the New England Journal of Medicine is underscoring both the promise and the peril of using stem cells for therapy. In one report, researchers document the cases of three elderly women who were blinded after getting stem cells derived from fat tissue at a for-profit clinic in Florida. The treatment was marketed as a treatment for macular degeneration, the most common cause of blindness among the elderly. Each woman got cells injected into both eyes. In a second report, a patient suffering from the same condition had a halt in the inexorable loss of vision patients usually experience, which may or may not have been related to the treatment. That patient got a different kind of stem cell derived from skin cells as part of a carefully designed Japanese study. The Japanese case marks the first time anyone has given induced pluripotent stem (iPS) cells to a patient to treat any condition. The report about the three women in their 70s and 80s who were blinded in Florida is renewing calls for the Food and Drug Administration to crack down on the hundreds of clinics that are selling unproven stem cell treatments for a wide variety of medical conditions, including arthritis, autism and stroke. -
A Medical Mystery of the Best Kind: Major Diseases Are In Decline (nytimes.com)
Slashdot reader schwit1 quotes an article from the New York Times: Something strange is going on in medicine. Major diseases, like colon cancer, dementia and heart disease, are waning in wealthy countries, and improved diagnosis and treatment cannot fully explain it...it looks as if people in the United States and some other wealthy countries are, unexpectedly, starting to beat back the diseases of aging. The leading killers are still the leading killers -- cancer, heart disease, stroke -- but they are occurring later in life, and people in general are living longer in good health.
The Times cites one researcher's pet theory that the cellular process of aging itself may be gradually changing in humans' favor. -
Zika Virus Officially Causes Rare Microcephaly Birth Defects, CDC Says (cnn.com)
An anonymous reader writes: The U.S. Centers for Disease Control and Prevention said on Wednesday the Zika virus causes microcephaly and other birth defects. "This study marks a turning point in the Zika outbreak. It is now clear that the virus causes microcephaly," CDC director, Dr. Tom Frieden said. The CDC previously said it was likely the virus in pregnant women was the cause of the rare birth defect that results in an underdeveloped brain and that more evidence and research were needed to conclusively say it is causal. "We started using criteria about a month ago to see which ones had been met and which ones had not been met. We wanted to do this in a systematic and calculated way," said Dr. Sonja Rasmussen, lead author of the New England Journal of Medicine special report. There's was also no alternative explanation to account for the increase in these congenital defects among women who had the Zika virus during pregnancy. The CDC says they are not yet ready to conclude the virus causes Guillain-Barre syndrome. The World Health Organization (WHO) has reported more than 1,000 cases of microcephaly and other fetal malformations believed to be associated with the Zika virus from six countries. -
Researchers Uncover the Genetic Roots Behind Rare Vibration Allergy (vice.com)
derekmead writes: A team of National Health Institute researchers has for the first time uncovered the genetic roots of one of the strangest allergies: vibrations. The vibration allergy, which is just as it sounds, may be quite rare, but understanding it more completely may yield important insights into the fundamental malfunctioning of immune cells in the presence of allergens. The group's findings are published in the New England Journal of Medicine. In addition to being uncommon, the vibration allergy is not very dangerous. In most cases, the allergic response is limited to hives—the pale, prickly rash most often associated with allergic and autoimmune reactions. Other less-common symptoms include headaches, blurry vision, fatigue, and flushing. The triggering vibrations are everyday things: jogging, jackhammering, riding a motorcycle, towel drying. Symptoms appear within a few minutes of exposure and are gone usually within an hour. -
Giving Doctors Grades Has Backfired
HughPickens.com writes: Beginning in the early 1990s a quality-improvement program began in New York State and has since spread to many other states where report cards were issued to improve cardiac surgery by tracking surgical outcomes, sharing the results with hospitals and the public, and when necessary, placing surgeons or surgical programs on probation. But Sandeep Jauhar writes in the NYT that the report cards have backfired. "They often penalized surgeons, like the senior surgeon at my hospital, who were aggressive about treating very sick patients and thus incurred higher mortality rates," says Jauhar. "When the statistics were publicized, some talented surgeons with higher-than-expected mortality statistics lost their operating privileges, while others, whose risk aversion had earned them lower-than-predicted rates, used the report cards to promote their services in advertisements."
Surveys of cardiac surgeons in The New England Journal of Medicine have confirmed that reports like the Consumer Guide to Coronary Artery Bypass Graft Surgery have limited credibility among cardiovascular specialists, little influence on referral recommendations and may introduce a barrier to care for severely ill patients. According to Jauhar, there is little evidence that the public — as opposed to state agencies and hospitals — pays much attention to surgical report cards anyway. A recent survey found that only 6 percent of patients used such information in making medical decisions. "Surgical report cards are a classic example of how a well-meaning program in medicine can have unintended consequences," concludes Jauhar. "It would appear that doctors, not patients, are the ones focused on doctors' grades — and their focus is distorted and blurry at best." -
Ebola Lurked In Cured Patient's Eye
An anonymous reader writes: During the Ebola outbreak last year, Dr. Ian Crozier was infected. He was eventually airlifted to Emory University for treatment, and a couple months later he was cured of the disease — or so physicians thought. Not long after he was released, his left eye began bothering him. His sight faded, and he felt intense pressure and pain in his eye. Examination of the eye found it teeming with Ebola. His doctors were surprised. Cured patients frequently deal with health issues long after the virus is gone, but this adds a new dimension to the course of the disease.
Doctors say Crozier posed no threat to others through casual contact; the virus did not exist in his tears or on the surface of his eye. But in addition to the new symptoms, his eye turned from blue to green. And doctors had to rush to disinfect the exam area used for what they thought was an Ebola-free patient. Research is ongoing to determine whether and how to protect from this lingering ebola infection. One theory suggests the virus survived, but was damaged somehow. Crozier was treated with antiviral drugs, and his eye improved, but doctors aren't sure whether the drug actually helped. Either way, it's made the medical community realize this is a longer battle than they had thought. -
Study: Peanut Consumption In Infancy Helps Prevent Peanut Allergy
Mr D from 63 writes: According to a report from the Associated Press, "For years, parents of babies who seem likely to develop a peanut allergy have gone to extremes to keep them away from peanut-based foods. Now a major study suggests that is exactly the wrong thing to do. Here's the published paper in the New England Journal of Medicine. It's interesting how this peanut allergy fear is a bit of a self-fulfilling prophecy. The situation involves a complete misconception of risk by many parents, and probably it doesn't stop at peanuts. Is there a bigger underlying problem here? -
Smoking Is Even Deadlier Than Previously Thought
HughPickens.com writes Who still smokes?" as Denise Grady reports at the NYT that however bad you thought smoking was, it's even worse. A new study has found that in addition to the well-known hazards of lung cancer, artery disease, heart attacks, chronic lung disease and stroke, researchers found that smoking was linked to significantly increased risks of infection, kidney disease, intestinal disease caused by inadequate blood flow, and heart and lung ailments not previously attributed to tobacco. "The smoking epidemic is still ongoing, and there is a need to evaluate how smoking is hurting us as a society, to support clinicians and policy making in public health," says Brian D. Carter, an author of the study. "It's not a done story." Carter says he was inspired to dig deeper into the causes of death in smokers after taking an initial look at data from five large health surveys being conducted by other researchers. As expected, death rates were higher among the smokers but diseases known to be caused by tobacco accounted for only 83 percent of the excess deaths in people who smoked. "I thought, 'Wow, that's really low,' " Mr. Carter said. "We have this huge cohort. Let's get into the weeds, cast a wide net and see what is killing smokers that we don't already know." The researchers found that, compared with people who had never smoked, smokers were about twice as likely to die from infections, kidney disease, respiratory ailments not previously linked to tobacco, and hypertensive heart disease, in which high blood pressure leads to heart failure. "The Surgeon General's report claims 480,000 deaths directly caused by smoking, but we think that is really quite a bit off," concludes Carter adding that the figure may be closer to 540,000. -
Study Ties High Blood Sugar To Dementia
A study published last week in the New England Journal suggests that blood sugar levels may be a more important indicator than previously realized for non-diabetics: high blood sugar levels were linked by the study's authors with increased risk of dementia (summary free; full article paywalled). The study followed more than 2,000 elderly participants, and found a positive correlation between blood glucose levels and development of dementia, both for patients with and without diabetes. -
Copyright Claim Sets Back Cognitive Impairment Testing
Kilrah_il writes "A recent New England Journal of Medicine editorial talks about the mini-mental state examination — a standardized screening test for cognitive impairment. After years of being widely used, the original authors claim to own copyright on the test and 'a licensed version of the MMSE can now be purchased [...] for $1.23 per test. The MMSE form is gradually disappearing from textbooks, Web sites, and clinical tool kits.' The article goes on to describe the working of copyright law and various alternative licenses, including GNU Free Documentation License, and ends with the following suggestion: 'We suggest that authors of widely used clinical tools provide explicit permissive licensing, ideally with a form of copyleft. Any new tool developed with public funds should be required to use a copyleft or similar license to guarantee the freedom to distribute and improve it, similar to the requirement for open-access publication of research funded by the National Institutes of Health.'" -
New Vaccine Halves Malaria Risk
An anonymous reader writes "According to a report in Reuters, scientists are celebrating the end of a clinical trial which found a malaria vaccine reduces infection risk by half in children. From the article: 'While scientists say it is no "silver bullet" and will not end the mosquito-borne infection on its own, it is being hailed as a crucial weapon in the fight against malaria and one that could speed the path to eventual worldwide eradication. Malaria is caused by a parasite carried in the saliva of mosquitoes. It kills more than 780,000 people per year, most of them babies or very young children in Africa. Cohen's vaccine goes to work at the point when the parasite enters the human bloodstream after a mosquito bite. By stimulating an immune response, it can prevent the parasite from maturing and multiplying in the liver. ... Cohen said that if all goes to plan, RTS,S could be licensed and rolled out by 2015.'" -
The Fresca Rebellion
theodp writes "They can ban the Marlboros, tax the Cokes, and zone the Whoppers, says Slate's William Saletan on the subject of today's morality cops. But it's time to put the brakes on the paternalistic overreaching of the food police, Saletan argues, when they come after his editor's beloved Fresca ('there are concerns that diet beverages may increase calorie consumption by justifying consumption of other caloric foods'), which will have to be pried from his cold, dead hands. '40 states have enacted special taxes on soda or junk food. And the soda taxers are becoming ever bolder. Their latest manifesto is an article in the New England Journal of Medicine, co-authored by the health commissioner of New York City, the surgeon general of Arkansas, and several others. It declares soda fair game for government intervention (PDF) on the grounds that "market failures" in this area are causing "less-than-optimal production and consumption."' Where do we draw the line?" -
Believing In Medical Treatments That Don't Work
Hugh Pickens writes "David H. Newman, M.D. has an interesting article in the NY Times where he discusses common medical treatments that aren't supported by the best available evidence. For example, doctors have administered 'beta-blockers' for decades to heart attack victims, although studies show that the early administration of beta-blockers does not save lives; patients with ear infections are more likely to be harmed by antibiotics than helped — the infections typically recede within days regardless of treatment and the same is true for bronchitis, sinusitis, and sore throats; no cough remedies have ever been proven better than a placebo. Back surgeries to relieve pain are, in the majority of cases, no better than nonsurgical treatment, and knee surgery is no better than sham knee surgery where surgeons 'pretend' to do surgery while the patient is under light anesthesia. Newman says that treatment based on ideology is alluring, 'but the uncomfortable truth is that many expensive, invasive interventions are of little or no benefit and cause potentially uncomfortable, costly, and dangerous side effects and complications.' The Obama administration's plan for reform includes identifying health care measures that work and those that don't, and there are signs of hope for evidence-based medicine: earlier this year hospital administrators were informed by the Centers for Medicare and Medicaid Services that beta-blocker treatment will be retired as a government indicator of quality care, beginning April 1, 2009. 'After years of advocacy that cemented immediate beta-blockers in the treatment protocols of virtually every hospital in the country,' writes Newman, 'the agency has demonstrated that minds can be changed.'" -
Speedy DNA Test for 12 Viruses Approved by FDA
SoyChemist writes "Last week, the FDA approved a test that can check for twelve viruses at once. The device is made by Luminex which has a long history of building instruments that can check for almost anything — bacteria, viruses, antibodies, disease genes. In this case, doctors can simply swab their patient's nose or throat then send the sample to a lab where the viral genetic material is copied and stuck down to color-coated beads. Each type of bead recognizes a different virus. A scanner reads off which beads have DNA on them — thus identifying the pathogens. The new test can detect several types of influenza, but not H5N1, and is the first system approved to detect human metapneumovirus. It is a good step towards taking the guesswork out of medicine, which is desperately needed since viral infections are extraordinarily hard to diagnose, and antiviral medications like Tamiflu only work on some types of virus."