Recently in Medicine and Health Category

This is my surprised face - Chicken Pox

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From FOX News:

Chickenpox outbreak at North Carolina school with high anti-vaccination rate leaves dozens sick
At least 36 students at a North Carolina school with a heavy anti-vaccine population have been sickened following an outbreak of the chickenpox virus, health officials said.

The outbreak, formally known as varicella, hit Asheville Waldorf School in Ashville, according to a news release from Buncombe County Health & Human Services.

That can lead to Shingles later in life. How widespread is the anti-vax lunacy?

Of the school's 152 students, 110 have not received the chickenpox vaccine, the news outlet reported.

Yikes - do not forget that the initial study linking the MMR vaccine and autism was published in the British medical journal Lancet. It was subsequently retracted and the author had his medical degree stripped away for fraud. From a purely numbers standpoint, his sample size was only 12 children - pathetic size for any statistical calculation. No connection, no correlation. Pure bunkum.

The fires themselves are being gradually contained and there is heavy rain forecast for later this week but the shelters just got really nasty really fast - from the Butte County, CA website:

Norovirus/Gastrointestinal Illness in Butte County Shelters
The Butte County Public Health Department has been using public health measures to stop a gastrointestinal illness (GI) outbreak in all monitored shelters. Since the shelters opened to house Camp Fire evacuees, 145 people have been sick with vomiting and/or diarrhea. As of Wednesday evening, there were 41 people experiencing symptoms at the following shelters:

    • Neighborhood Church: 179 total evacuees at the shelter, 21 currently experiencing illness
    • Oroville Nazarene Church: 352 total evacuees at the shelter, 10 currently experiencing illness
    • Butte County Fairgrounds: 142 total evacuees at the shelter, 9 currently experiencing illness
    • East Avenue Church: 200 total evacuees at the shelter, 1 currently experiencing illness

The number of sick people is increasing every day. Twenty-five people have been to the hospital for medical support. Staff serving the shelters have also been sick. The outbreak has been identified and confirmed by the Butte County public health laboratory to be the Norovirus which is highly contagious. Norovirus spreads through touching surfaces contaminated with the virus, close contact with someone who is infected, or eating contaminated food or drink.

You do not want to catch this disease - it passes within 48 hours or so but you are squirting from both ends and feeling pummeled all during that time. It hurts and in the confines of a contained population, it can spread like wildfire. Outbreaks are common on cruise ships.

Needless to say, prayers are going out to these poor people.

From the wonderful medical website Stat News:

Despite criticism and concerns, FDA approves a new opioid 10 times more powerful than fentanyl
In a highly controversial move, the Food and Drug Administration approved an especially powerful opioid painkiller despite criticism that the medicine could be a “danger” to public health. And in doing so, the agency addressed wider regulatory thinking for endorsing such a medicine amid nationwide angst about overdoses and deaths attributed to opioids.

The drug is called Dsuvia, which is a tablet version of an opioid marketed for intravenous delivery, but is administered under the tongue using a specially developed, single-dose applicator. These “unique features” make the medicine well-suited for the military and therefore was a priority for the Pentagon, a point that factored heavily into the decision, according to FDA Commissioner Scott Gottlieb.

Although an FDA advisory committee last month recommended approval, the agency was urged by critics not to endorse the drug because it is 10 times more powerful than fentanyl, a highly addictive opioid. Among those who opposed approval were four U.S. senators and the FDA advisory panel chair, who could not attend the meeting, but took the rare step of later writing a letter to the agency.

Despite all the nice language, this will find its way to the street in six months.

DOH! - I could have told you that

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From National Public Radio:

When Adolescents Give Up Pot, Their Cognition Quickly Improves
Marijuana, it seems, is not a performance-enhancing drug. That is, at least, not among young people, and not when the activity is learning.

A study published Tuesday in the Journal of Clinical Psychiatry finds that when adolescents stop using marijuana – even for just one week – their verbal learning and memory improves. The study contributes to growing evidence that marijuana use in adolescents is associated with reduced neurocognitive functioning.

More than 14 percent of middle and high school students reported using marijuana within the last month, finds a National Institutes of Health survey conducted in 2017. And marijuana use has increased among high schoolers over the past 10 years, according to the U.S. Department of Health & Human Services.

At the same time, the percentage of teens who believe that regular marijuana use poses a great risk to their health has dropped sharply since the mid-2000s. And, legalization of marijuana may play a part in shaping how young people think about the drug. One study noted that after 2012, when marijuana was legalized in Washington state, the number of eighth graders there that believed marijuana posed risks to their health dropped by 14 percent.

The use by youth is worrisome. People that young have no long-range planning skills - they do not think about what might happen 20-30 years later if they begin damaging habits.

Yikes - falsifying medial data

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This guy should face some serious time behind bars - from The New York Times:

Harvard Calls for Retraction of Dozens of Studies by Noted Cardiologist
A prominent cardiologist formerly at Harvard Medical School and Brigham and Women’s Hospital in Boston fabricated or falsified data in 31 published studies that should be retracted, officials at the institutions have concluded.

The cardiologist, Dr. Piero Anversa, produced research suggesting that damaged heart muscle could be regenerated with stem cells, a type of cell that can transform itself into a variety of other cells.

Although other laboratories could not reproduce his findings, the work led to the formation of start-up companies to develop new treatments for heart attacks and stroke, and inspired a clinical trial funded by the National Institutes of Health.

“A couple of papers may be alarming, but 31 additional papers in question is almost unheard-of,” said Benoit Bruneau, associate director of cardiovascular research at the Gladstone Institutes in San Francisco. “It is a lab’s almost entire body of work, and therefore almost an entire field of research, put into question.”

These are people's lives he was messing with. Not like he was just fudging some tree-ring data or something. Odd that his grad students didn't pipe up.

Very cool - President Trump

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He signed a great piece of legislation - from CNBC:

Trump signs ‘right-to-try’ allowing gravely ill patients to bypass FDA for experimental medicines
President Donald Trump signed the controversial “right-to-try” bill into law on Wednesday, which bypasses drug regulators to give gravely ill patients access to experimental medicines.

The legislation allows patients with life-threatening conditions to ask drugmakers for medicines that have cleared some testing but still haven’t been approved by the Food and Drug Administration. Previously, patients would need to ask the FDA for access to experimental treatments.

Trump and Vice President Mike Pence had been major supporters of passing the measure, which proponents say gives patients hope they would not otherwise have. Last week the House of Representatives approved the bill, the same version the Senate passed in August.

Wonderful - if someone is at the end of their rope, they deserve to be able to try experimental medication. I certainly would want this option.

Great news from ABC News:

FDA approves first generic EpiPen
The U.S. Food and Drug Administration has approved the first generic version of the EpiPen and EpiPen Jr auto injector for the emergency treatment of allergic reactions.

The approval is part of the FDA's "longstanding commitment" to providing access to low-cost generic alternatives, FDA Commissioner Scott Gottlieb said in a statement.

"This approval means patients living with severe allergies who require constant access to life-saving epinephrine should have a lower-cost option, as well as another approved product to help protect against potential drug shortages," the commissioner said.

It is unclear how much the generic product -- manufactured by Teva Pharmaceuticals -- will cost. In August 2016, Mylan Pharmaceuticals was criticized for raising the price of a two-pack of EpiPens to $600.

The price of two EpiPens was about $100 in 2009. The brand name version is by far the most popular epinephrine auto-injector on the market.

It will be interesting to follow Mylan's stock prices in the next day or two. A 50ml bottle of Veterinary Epinephrine sells for $24. A standard adult EpiPen dispenses 0.3ml so your $24 will buy about  166 doses at just under 15¢ per dose. The Veterinary grades are just as good as human doses. Someone with a prized racehorse or bull is not going to be putting crap into their animal.

Laser pointers - dangerous

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A cautionary tale. Laser pointers are NOT toys. From the New England Journal of Medicine:

Macular Hole from a Laser Pointer

20180627-eye.jpg

A 9-year-old boy was brought by his parents to our ophthalmology clinic for evaluation of decreased vision in his left eye. Visual acuity in the left eye was 20/100, as compared with 20/20 in the right eye. Funduscopic examination of the left eye revealed a large macular hole with a hypopigmented atrophic area inferiorly (Panel A). Optical coherence tomography confirmed the full-thickness macular hole. Fundus autofluorescence imaging highlighted two spots inferior to the macular hole that corresponded to additional areas of injury (Panel B). The child reported playing with a green laser pointer and repeatedly gazing into the laser beam. Although many national health agencies have warned about the potential eye hazards associated with handheld laser pointers, and the sale of devices with greater than 1 mW of power is restricted in many areas, more powerful laser devices remain accessible, especially through the Internet. Because of the large diameter of the macular hole and the accompanying atrophy in this patient, we favored conservative management rather than surgery. The patient’s vision has remained unchanged during 18 months of follow-up.

Emphasis mine - the damage is permanent. Barring some new development in medicine, the kid is going to have bad vision for the rest of his life. I own some lasers including one very powerful one but they are not used as toys.

Not surprised - the place certainly has its share of idiots. From BoingBoing:

Which American cities have lowest herd immunity due to anti-vaxxers?
Parents of Seattle, Spokane, Portland, Phoenix, Salt Lake City, Provo, Houston, Fort Worth, Austin, Plano, Detroit, Troy, Warren, Kansas City and Pittsburgh: beware.

According to a peer reviewed study of kindergartners whose parents had opted out of vaccination, these cities are the places with the lowest herd immunity to preventable, debilitating (and potentially fatal) diseases.

Vaccinations are not 100% effective, and some people can't be vaccinated due to illness. The reason vaccination keeps our children of dying or being maimed for life by the diseases that burned through generation after generation is "herd immunity": if all the kids get immunized, then the disease can't find enough people to infect and spread.

The parents need a good whack with a clue-bat - vaccines are not harmful. The guy who first claimed a link between vaccines and autism was in the pay of an insurance company and he had is license to practice medicine revoked. His "paper" was based on a sample size of 12.

Homeopathy in the news

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One word for it - BUNK!  From Ars Technica:

Doctor slammed by med board for selling $5 homeopathic sound waves for Ebola
The California medical board is threatening to revoke the license of Dr. William Edwin Gray III for selling homeopathic sound files over the Internet that he claims—without evidence or reason—can cure a variety of ailments, including life-threatening infections such as Ebola, SARS, swine flu, malaria, typhoid, and cholera.

In an accusation filed with the state (PDF), the medical board writes that Gray is guilty of gross negligence and requested a hearing in which the board would decide whether to possibly revoke or suspend his license.

In an interview with the Los Angeles Times, Gray said he had decided not to contest the board’s allegations, saying it would cost too much money to fight. He added: “Frankly, I think we'd lose anyway.”

Classic case of why this form of treatment should be regulated a lot more tightly - regulated into oblivion. These fools are paying this "doctor" for sounds to cure an infection instead of seeking qualified medical help. Their infections will only get worse until they finally go into sepsis and have to spend expensive time in the hospital. Could have been cured with a simple Doctor's visit and a prescription.

Yikes - Nipah Virus

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Hope it doesn't spread - an excerpt from this article at the Associated Press:

...At least 10 people have died of Nipah since an outbreak began earlier this month in Kerala, health officials say, and two more people are in critical condition. There is no vaccine for the virus, which can cause raging fevers, convulsions and vomiting, and kills up to 75 percent of people who come down with it. The only treatment is supportive care to keep patients comfortable...

A fairly recent development:

Nipah was first identified during a late 1990s outbreak in Malaysia. Later outbreaks have occurred in Bangladesh and India.

An explanation of his plan from David Catron writing at The American Spectator:

Trump’s Excellent Plan to Reduce Drug Prices
Last Friday, President Trump caused consternation among Democrats and their media allies by introducing an eminently sensible blueprint for reducing drug prices. The 50-point “American Patients First” plan addresses four broad challenges: High list prices for drugs, government programs overpaying for drugs, rising out-of-pocket costs for consumers, and foreign governments free-riding off American innovation. The blueprint relies on free market competition and private-sector negotiation rather than regulatory coercion and price controls. And, assuming his plan works as designed, President Trump will have succeeded where his predecessor proved utterly impotent. Consequently, the plan drew immediate criticism from the left.

The most common liberal complaint about the President’s blueprint involves his decision, as the New York Times laments, “not to have the federal government directly negotiate lower drug prices for Medicare.” Trump alarmed conservatives during his presidential campaign by flirting with that exceptionally bad policy idea, but sensibly abandoned it when working with his advisors to formulate a concrete plan. The term “negotiate” has no real meaning in the context of federal dealings with the drug industry. It is nothing more than a pseudonym for price controls. Allowing the government to “negotiate” with drug companies for lower Medicare drug prices would inevitably create shortages of badly needed pharmaceuticals.

Much more at the site - President Trump's plan seems to be effective and well thought out.

Reforming Medicare

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Excellent news - from PBS:

Medicare to require hospitals to post prices online
Medicare will require hospitals to post their standard prices online and make electronic medical records more readily available to patients, officials said Tuesday.

Let the informed customer make their own decisions. A bit more:

Seema Verma, head of the Centers for Medicare and Medicaid Services, said the new requirement for online prices reflects the Trump administration’s ongoing efforts to encourage patients to become better-educated decision makers in their own care.

“We are just beginning on price transparency,” said Verma. “We know that hospitals have this information and we’re asking them to post what they have online.”

Good - this will encourage clinics and hospitals to specialize and this will drive costs down. Clinics that specialize offer better service and cheaper prices. Eye Surgery, Hernias, etc...

Just wonderful - the Flu, round two

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From United Press International:

Second wave of flu season hits U.S.
The winter season ended last month but that doesn't mean the danger of getting the flu is over, even though it is springtime.

Rather than getting a strain of Influenza A, you have a greater chance of getting Influenza B. They carry roughly the same level of severity, having a similar cough, runny or stuffy nose, itchy or watery eyes, sore throat, fatigue and low fever.

They quote data from the Centers for Disease Control:

In the latest results, the CDC said the breakdown was 39.6 percent for Influenza A and 60.3 percent for Influenza B. Among 21,823 specimens tested, 15.4 percent were positive.

"The percentage of respiratory specimens testing positive for influenza in clinical laboratories remains elevated," the CDC said in the report.

A very bad year and it is just getting worse.

Homeopathy explained

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Excellent animation on what it is, why it took off when it did and why it is bunk.

Interesting story along the lines of British sailors contracting scurvy on long voyages. From Atlas Obscura:

How Killer Rice Crippled Tokyo and the Japanese Navy
IN 1877, JAPAN’S MEIJI EMPEROR watched his aunt, the princess Kazu, die of a common malady: kakke. If her condition was typical, her legs would have swollen, and her speech slowed. Numbness and paralysis might have come next, along with twitching and vomiting. Death often resulted from heart failure.

The emperor had suffered from this same ailment, on-and-off, his whole life. In response, he poured money into research on the illness. It was a matter of survival: for the emperor, his family, and Japan’s ruling class. While most diseases ravage the poor and vulnerable, kakke afflicted the wealthy and powerful, especially city dwellers. This curious fact gave kakke its other name: Edo wazurai, the affliction of Edo (Edo being the old name for Tokyo). But for centuries, the culprit of kakke went unnoticed: fine, polished, white rice.

Gleaming white rice was a status symbol—it was expensive and laborious to husk, hull, polish, and wash. In Japan, the poor ate brown rice, or other carbohydrates such as sweet potatoes or barley. The rich ate polished white rice, often to the exclusion of other foods.

This was a problem. Removing the outer layers of a grain of rice also removes one vital nutrient: thiamine, or vitamin B-1. Without thiamine, animals and humans develop kakke, now known in English as beriberi. But for too long, the cause of the condition remained unknown.

An interesting story - much more at the site. The Doctor who discovered the actual cause became a member of the Royal Family and was named Doctor Barley.

Great news from the CDC

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From United Press International:

Doctors visits for the flu down for second week in a row, CDC says
If the latest government data on doctor visits is any indication, a brutal flu season may be starting to wane.

For the second week in a row, there was a drop in doctor visits for flu-like illness in the United States. And the latest drop was more pronounced than the one before, the U.S. Centers for Disease Control and Prevention reported Friday.

As of Feb. 17, the CDC said that 6.4 percent of patient visits to doctors were for the flu, down from 7.5 percent of patient visits the week before.

But the news was not all good, and it doesn't look like the flu season is over yet.

Flu-linked hospitalization rates continued to rise -- from 67.9 per 100,000 people for the week ending Feb. 10, to 74.5 per 100,000 people for the week ending Feb. 17, the findings showed.

Pediatric flu deaths are also still increasing, with 97 children now dead from the flu so far this season, according to the CDC.

CDC officials have pinpointed one reason why this flu season has been so brutal: the flu vaccine is only 25 percent effective against H3N2 influenza, which is causing most flu cases this year.

This was a bad season - lost a dear friend to the flu. He was only 52 years old.

News you can use - longevity

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From the UC Irvine Institute for Memory Impairments and Neurological Disorders (UCI MIND)

The 90+ Study
The 90+ Study was initiated in 2003 to study the oldest-old, the fastest growing age group in the United States. The 90+ Study is one of the largest studies of the oldest-old in the world. More than 1,600 people have enrolled. Because little is known about people who achieve this milestone, the remarkable increase in the number of oldest-old presents a public health priority to promote the quality as well as the quantity of life.

The 90+ Study participants
Initial participants in The 90+ Study were once members of The Leisure World Cohort Study (LWCS), which was started in 1981. The LWCS mailed surveys to every resident of Leisure World, a large retirement community in Orange County, California (now incorporated as the city of Laguna Woods). Using the 14,000 subjects from the LWCS, researchers from The 90+ Study were able to ask, What allows people to live to age 90 and beyond?

Some of their findings are interesting:

Major findings
Researchers from The 90+ Study have published many scientific papers in premier journals. Some of the major findings are:

    • People who drank moderate amounts of alcohol or coffee lived longer than those who abstained.
    • People who were overweight in their 70s lived longer than normal or underweight people did.

I'm down with that - love a glass of two of red wine in the evening and maybe I'll ease up on getting that last ten pounds off my bodyweight...

Just fscking wonderful

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From the The Government of the Hong Kong Special Administrative Region:

CHP notified of human case of avian influenza A (H7N4) in Mainland
The Centre for Health Protection (CHP) of the Department of Health (DH) today (February 14) received notification from the National Health and Family Planning Commission (NHFPC) that a human case of avian influenza A (H7N4) was confirmed from February 10 to 14, and reminded the public to maintain strict personal, food and environmental hygiene both locally and during travel.

According to the NHFPC, this is the first case of human infection with avian influenza A (H7N4) in the world. The case involved a 68-year-old female patient living in Liyang in Changzhou of Jiangsu Province who developed symptoms on December 25, 2017. She was admitted to hospital for medical treatment on January 1 and was discharged on January 22. She had contact with live poultry before the onset of symptoms. All her close contacts did not have any symptoms during the medical surveillance period.

According to a report from the Chinese Center for Disease Control and Prevention, upon analysis, the genes of the virus were determined to be of avian origin.

"All novel influenza A infections, including H7N4, are notifiable infectious diseases in Hong Kong," the spokesman for the CHP said.

"Based on the seasonal pattern, the activity of avian influenza viruses is expected to be higher in winter. Travellers to the Mainland or other affected areas must avoid visiting wet markets, live poultry markets or farms. They should be alert to the presence of backyard poultry when visiting relatives and friends. They should also avoid purchasing live or freshly slaughtered poultry, and avoid touching poultry/birds or their droppings. They should strictly observe personal and hand hygiene when visiting any place with live poultry," the spokesman reminded.

Just what we need - a new strain of flu to watch out for... Lost a dear friend to it earlier this year. RIP Kurt.

Faster please - vaccine

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From The Wall Street Journal:

Experimental Drug Promises to Kill the Flu Virus in a Day
As Americans suffer through the worst influenza outbreak in almost a decade, a Japanese drugmaker says it has developed a pill that can kill the virus within a day. But even if the experimental drug lives up to the claim, it likely won’t be available in the U.S. until next year at the earliest.

A late-stage trial on Japanese and American flu patients found that for the people who took the Shionogi & Co. compound, the median time taken to wipe out the virus was 24 hours. That is much quicker than any other flu drug on the market, including Roche AG’s Tamiflu, which the trial showed took three times longer to achieve the same result. Quickly killing the virus could reduce its contagious effects, Shionogi said.

Also, Shionogi’s experimental drug requires only a single dose, while patients need to take two doses of Tamiflu a day, for five days.

Both Shionogi’s compound and Tamiflu take roughly the same amount of time to entirely contain flu symptoms, but Shionogi says its compound provides immediate relief faster.

Scientists at the Japanese company leveraged their work on a blockbuster anti-HIV drug to create the compound, which works differently from existing flu medicines. It blocks the flu virus from hijacking human cellular machinery, Chief Executive Isao Teshirogi said. Switzerland’s Roche has acquired the international license to distribute Shionogi’s experimental drug.

Not available in the USA as yet but great news nonetheless.

Not a good thing to do for many reasons - from The Atlantic:

The Startling Link Between Sugar and Alzheimer's
In recent years, Alzheimer’s disease has occasionally been referred to as “type 3” diabetes, though that moniker doesn’t make much sense. After all, though they share a problem with insulin, type 1 diabetes is an autoimmune disease, and type 2 diabetes is a chronic disease caused by diet. Instead of another type of diabetes, it’s increasingly looking like Alzheimer’s is another potential side effect of a sugary, Western-style diet.

And the upshot:

A longitudinal study, published Thursday in the journal Diabetologia, followed 5,189 people over 10 years and found that people with high blood sugar had a faster rate of cognitive decline than those with normal blood sugar—whether or not their blood-sugar level technically made them diabetic. In other words, the higher the blood sugar, the faster the cognitive decline.

Much more at the site. Trish and I are both eating reduced carb diets and are feeling a lot better for it. Trying to stay under 30 grams/day seems to be the real sweet-spot.

The Flu - three articles

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Just wonderful - flu season

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From Time magazine:

The Flu May Be Spread Just By Breathing, Study Says
For years, you’ve been told to cover your mouth when you cough or sneeze, especially when you’re sick. But a new study finds that it may be possible to spread the flu just by breathing—no coughing or sneezing required.

“People shed a lot of virus all the time, even when they don’t cough,” says Donald Milton, author of the study published in PNAS and a professor of environmental health at the University of Maryland School of Public Health. “As a result, it’s important to realize you can be infectious at any time.”

During the 2012-2013 flu season, Milton and his colleagues studied 142 University of Maryland students with active influenza, attempting to track how and when they expelled virus particles. During a total of 218 30-minute observation sessions, the students sat in a machine that could measure the droplets they shed while breathing, talking, coughing or sneezing. While coughing did expel some flu particles, the researchers discovered that almost half of the aerosol particles collected in the absence of coughing also contained flu matter, suggesting that simply inhaling germ-ridden air could get you sick.

Joyful news - especially since I am summoned for jury duty this coming week. I'll see how I feel and then give them a call on Monday morning to see if I can get out of it.

Scientific American has more:

Warning: A Flu Pandemic Today Could Kill As Many As 80 Million People
If the 1918 flu pandemic broke out today, it would likely kill at least 62 million people, or slightly more than the number that die in a single year from all other causes combined. The estimate stems from a new tally of flu deaths from 1918 to 1920 in different countries, which varied widely. Based on their findings, authors of the study say that 96 percent of the victims of a present-day pandemic would be in the developing world.

The report comes on the heels of fears that the H5N1 flu virus currently circulating among birds in Southeast Asia and Africa may be the precursor to a deadly global outbreak or pandemic. To gauge the potential threat, researchers reviewed the toll of the most severe previous case, which occurred in 1918 when a flu swept the world, claiming at least 20 million lives. "It's the benchmark against which we worry about future flu pandemics," says population health researcher Christopher Murray of the Harvard Initiative for Global Health.

Just great - we have another - and worse strain - waiting to cross over to humans.

News you can use - sneezing

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Makes perfect sense - I always use the inside of my elbow to stifle mine. From the UK Guardian:

Achoo! Why letting out an explosive sneeze is safer than stifling it
In a season where colds are rife, holding your nose and closing your mouth might seem like a considerate alternative to an explosive “Achoo!”. But doctors have warned of the dangers of such a move after a man was found to have ruptured the back of his throat when attempting to stifle a sneeze.

Medics say the incident, which they detail in the British Medical Journal Case Reports, came to light when a 34-year old man arrived in A&E with a change to his voice, a swollen neck, pain when swallowing and a popping sensation in his neck after he pinched his nose to contain an expulsion.

The team took scans of the man’s neck to investigate and discovered bubbles of air in the tissues at the back of the throat, and in the neck from the base of the skull to halfway down the man’s back. 

That, they say, suggested a tear had occurred at the back of the throat as a result of increased pressure from the stifled sneeze, leading to air collecting in his soft tissues. 

“For reasons of propriety and etiquette, one sometimes stops a sneeze. However on unfortunate rare occasions it might lead to potentially serious complications,” said Dr Sudip Das, co-author of the report from the University Hospitals of Leicester NHS Trust.

Propriety and etiquette be damned - use your elbow or a hankerchief. Do not spread it around but also, First Do No Harm.

The 2018 flu season

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It is getting worse - from the medical blog STAT:

Flu season is shaping up as one of the worst in years, officials say
The entire continental United States is experiencing widespread flu right now, the first time in the 13 years of the current tracking system that that has happened, according to the Centers for Disease Control and Prevention.

Officials said that this flu season is shaping up to be one of the worst in recent years.

The rate of flu hospitalizations — the number of people hospitalized with flu per 100,000 — nearly doubled last week compared with the previous week. Last week it was 22.7 per 100,000 people; the week before that rate was 13.7.

I lost a dear friend who was only 52 and in great health. His memorial service was less than a week ago.

The Flu - some advice

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Some great advice from Aesop - an Emergency Room Doctor and blogger: RACONTEUR REPORT

PSA: Flu 2018 - Updated
Thirty-six states report influenza activity as "widespread". That would be all the brown ones in the CDC map, above.
Nota bene the number of states with no influenza activity this year is "zero".
The CDC has identified 648 different active influenza virus sub-types this year, to date.

Anecdotally, where I am, approximately 4 out of every 6 persons swabbed for flu for URIs in the ER are coming back with positive results. (My patient pop. average age is markedly older than most of the county.) Just the other night, I admitted three different people over the age of 60 to the hospital, for flu which had debilitated the patients, who subsequently acquired pneumonia as well, the latter affliction being well capable of killing you deader than canned tuna untreated. Breathing underwater has that effect on people.

Flu symptoms are fever, sore throat, cough, body aches, fatigue, muscle aches, and possibly nausea/vomiting.

If you have a fever, you are infectious to others.
If you're treating a fever with Tylenol/ibuprofen/etc., you are infectious to others.
If either of those apply, keep your dumb ass at home, until you're over it. Period.
Anything else deserves a crotch kick.
(A co-worker was patient Zero at my ER, and another colleague gifted me with the crud for two weeks, followed by another four weeks of dreadfully lingering cough. This year's cold has a horrendous URI "tail" of hacking cough that just hangs on.)

Treatment
1) Stay the f*** home. Until it's ALL gone.
2) Get plenty of sleep and rest, but get up and move around, if only to use the bathroom, make a sandwich, pee, poop, or puke. Lying immobile increases your odds for bigger problems.
3) acetaminophen/ibuprofen for fever control and aches.
4) Water, water, water. Anything less than an hourly pee trip, and your pee isn't clear and mostly colorless, you're probably not drinking nearly enough water.
5) Soups, Gatorade, Jell-O, popsicles, etc. are also water.
6) And more water.
7) Caffeine and alcohol are diuretics, and dehydrate you more, and faster. Avoid both.
8) Take any number of "snivel" meds to mitigate symptoms, loosen congestion and mucus, suppress cough, etc.
9) If you find homeopathic voodoo meds that help, use them. They likely can't hurt.
10) Stay the f*** home. Until it's ALL gone.

This year's flu outbreak is in addition to normal viral illnesses (a "cold"), which are similarly rampant, especially from Thanksgiving to Easter, when intergenerational family members gather to share diseases and finger-bang everything they touch and cough on, for everyone from snot-monkey age to grandma and grandpa.

Prevention
1) Keep yourself and your little bastards home when they're sick.
2) Wash your hands.
3) Wash your hands before you eat, drink, or touch your face.
4) Wash your hands.
5) Wash your hands after you poop, pee, cough, or touch anything else in the entire world.
6) Wash your hands.
7) Cover your mouth when you cough.
8) Keep at home all your kids too young and stupid to learn to cover their mouths when they cough.
9) Carry personal disinfectant/sanitizer, and use it vigorously and frequently.
10) Understand that if I catch you or your kids out and about in public, coughing, sneezing, and dribbling your snot-mitts on everything, I may replace or augment my personal disinfectant with OC spray, and I will use it on you. If you can still identify me afterwards, and I'm still in the same area 30 minutes later when your vision clears up, I may express feigned/mock regret over my "mistake" in grabbing the wrong spritzer and using it on you.
11) Or, not.

NB: OC Spray is Oleoresin capsicum - pepper spray. - good words of wisdom...

Three headlines - romaine lettuce

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From Canada's Public Health AgencyOutbreak of E. coli infections linked to romaine lettuce

From the USA's Centers for Disease ControlCDC Investigating Multistate Outbreak of E. coli O157:H7 Infections

From Consumer Reports magazine: Avoid Romaine Lettuce for Now, Consumer Reports Says

Things are pointing to a Canadian source - 59 people ill and two fatalities - washing the lettuce does nothing. Time to switch to iceberg or butter...

The Flu in England

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From the UK Telegraph:

NHS hospitals ordered to cancel all routine operations in January as flu spike and bed shortages lead to A&E crisis
Every hospital in the country has been ordered to cancel all non-urgent surgery until at least February in an unprecedented step by NHS officials.

The instructions on Tuesday night - which will see result in around 50,000 operations being axed - followed claims by senior doctors that patients were being treated in “third world” conditions, as hospital chief executives warned of the worst winter crisis for three decades.

Hospitals are reporting growing chaos, with a spike in winter flu leaving frail patients facing 12-hour waits, and some units running out of corridor space.

The joys of socialized medicine - the system creaks along until something like this epidemic happens and then it collapses. There is no resiliency built into the system. That costs money and they do not have any.

Bad all over - flu

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Kurt died from the flu and he was in really good health. It is bad all around the USA - from the Los Angeles Times:

Severe flu brings medicine shortages, packed ERs and a rising death toll in California
So many people have fallen sick with influenza in California that pharmacies have run out of flu medicines, emergency rooms are packed, and the death toll is rising higher than in previous years.

Health officials said Friday that 27 people younger than 65 have died of the flu in California since October, compared with three at the same time last year. Nationwide and in California, flu activity spiked sharply in late December and continues to grow.

The emergency room at UCLA Medical Center in Santa Monica typically treats about 140 patients a day, but at least one day this week had more than 200 patients — mostly because of the flu, said the ER’s medical director, Dr. Wally Ghurabi.

Wash your hands frequently and stay away from crowds. This season is a bad one. There is a bit of good news from the Centers for Disease Control:

Flu vaccines have been updated to better match circulating viruses

Good news - the initial vaccines didn't cover this year's prevailing strain.

Influenza in the news

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My manager's husband died from the flu a few days ago - it has been a very bad season for this disease. Here are a few links:

The Centers for Disease Control show that the prevailing strain is not what people were being vaccinated for.

The California fires

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It will be interesting to see if the State of California will take funds away from social programs nad spend them on repairing their crumbling infrastructure. The winds caused power lines to arc and this is what caused the majority of the fires. Here is one other cause - from the Los Angeles Times:

Fire at a homeless encampment sparked Bel-Air blaze that destroyed homes, officials say
The blaze that swept through the hills of Bel-Air last week, destroying six homes and damaging a dozen others, was sparked by a cooking fire at a homeless encampment in a nearby ravine, Los Angeles officials said Tuesday.

The encampment was nestled in a canyon several hundred feet from Sepulveda Boulevard and the 405 Freeway, hidden from passing cars. For several years, it had been home to an unknown number of people, officials said.

Investigators said the fire had not been set deliberately and they have not found any of the people who lived there. The camp — one of scores of makeshift communities that have grown along freeways, rivers and open space across Los Angeles — was largely destroyed in the fire, leaving authorities with little evidence.

And of course, it is not the homeless who are at fault:

News that one of Los Angeles’ most affluent neighborhoods was damaged in a fire sparked by some of the city’s poorest residents added a sober note to the incident, with some officials saying it underscores the need to do more to house the homeless.

The majority of the homeless are mentally ill - they used to be institutionalized and although these institutions were mundane and many times underfunded, at least they were fed and kept clean and given things to do according to their mental abilities. Enter President John F. Kennedy and his Community Mental Health Act - passed in 1963, it caused widespread deinstitutionalization. Every single act by progressives have only exacerbated the homeless problem. We need to return to a program of institutionalization. People will cry that this would violate the "rights" of the mentally ill but the mentally ill - by the very definition - are not capable of acting on their own best interests.

From Dr. Helen Smith writing at PJ Media:

I Believe It: Vegetarian Men More Depressed
A recent study finds men who don't eat meat are more depressed:

From the same dataset that brought you the information that vegetarian mothers create drug-addled children, we learn that vegetarian men are more depressed than their meat-eating brothers. The study, Vegetarian diets and depressive symptoms among men, is in the Journal of Affective Disorders.

That dataset, Avon Longitudinal Study of Parents and Children (ALSPAC), has over 9,000 men self-reporting on their eating habits. This study looked at the 350 self-identified vegetarians in their midst. These men completed a survey including a set of measures on depression at roughly the 18th week of their spouses’ pregnancy. Vegans were lumped in with vegetarians because of their small numbers. The researchers found that vegetarian men were more likely, with an odds ratio of 1.71 (that is a 70% increased risk) to be depressed. The authors say they accounted for a range of sociodemographic factors including family history, prior childhood psychiatric contact, educational level, number of children at home, marital and employment status, alcohol and tobacco use and educational level. The longer time an individual had been a vegetarian did not correlate, at least at a statistical significance, with depression.

Dr. Smith closes with this excellent observation:

I have to say that the stricter people are with their diet, the more out of  control they seem to feel about their lives, and I think too many vegetables and not enough protein is a recipe for disaster, especially for men.

My chicken breasts should be thawed out by now - time to make a quick marinade and get them ready for dinner tonight.

News you can use

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Trish and I have been looking at getting some more exercise. We are both pretty fit but I want to take it up a notch or three - this news makes perfect sense. From Australia's University of Sydney:

Strength exercise as vital as aerobic
Push ups and sit ups could add years to your life according to a new study of over 80,000 adults led by the University of Sydney.

The largest study to compare the mortality outcomes of different types of exercise found people who did strength-based exercise had a 23 percent reduction in risk of premature death by any means, and a 31 percent reduction in cancer-related death.

Lead author Associate Professor Emmanuel Stamatakis from the School of Public Health and the Charles Perkins Centre said while strength training has been given some attention for functional benefits as we age, little research has looked at its impact on mortality.

“The study shows exercise that promotes muscular strength may be just as important for health as aerobic activities like jogging or cycling,” said Associate Professor Stamatakis.

Interesting and it looks like a well-run survey. 80,000 is a great sample size - good p-Value. The disgraced study that caused all the controversy about vaccines and autism had a sample size of 12.

America's Opioid crisis

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Americans are dying from opioid overdose and the numbers are rising sharply. It seems that people are looking into this - especially one of the families responsible. From the U.S. Attorney’s Office - District of Massachusetts:

Founder and Owner of Pharmaceutical Company Insys Arrested and Charged with Racketeering
The founder and majority owner of Insys Therapeutics Inc., was arrested today and charged with leading a nationwide conspiracy to profit by using bribes and fraud to cause the illegal distribution of a Fentanyl spray intended for cancer patients experiencing breakthrough pain.

John N. Kapoor, 74, of Phoenix, Ariz., a current member of the Board of Directors of Insys, was arrested this morning in Arizona and charged with RICO conspiracy, as well as other felonies, including conspiracy to commit mail and wire fraud and conspiracy to violate the Anti-Kickback Law. Kapoor, the former Executive Chairman of the Board and CEO of Insys, will appear in federal court in Phoenix today. He will appear in U.S. District Court in Boston at a later date.

And the charges:

(long list of people including Kapoor) conspired to bribe practitioners in various states, many of whom operated pain clinics, in order to get them to prescribe a fentanyl-based pain medication.  The medication, called “Subsys,” is a powerful narcotic intended to treat cancer patients suffering intense breakthrough pain.  In exchange for bribes and kickbacks, the practitioners wrote large numbers of prescriptions for the patients, most of whom were not diagnosed with cancer.

Emphasis mine. Lots more at the site. This is only one instance but it is a great place to start.

I have always wondered why we do not outright buy the entire Afghani opium crop each year and just destroy it after refining what the world medical industry needs. One sure way to get it off the streets.

A new Shingles vaccine

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Time to get the jab again - from UPI:

CDC recommends new shingles vaccine for people over 50
On the heels of approval of a better vaccine for the painful condition shingles, adults over 50 should plan to roll up their sleeves -- again.

The new vaccine, Shingrix, will likely be recommended even for those already inoculated with an older vaccine.

An advisory panel of the U.S. Centers for Disease Control and Prevention recommended Wednesday that all adults 50 and older receive the new two-shot vaccine, just days after the U.S. Food and Drug Administration announced its approval of Shingrix.

Planning to get this myself. I have known a couple people who had Shingles and would not wish this on anyone...

Great little eye-opener from Conservative Tribune:

Socialism at Work: British Feds Ban Surgery for Smokers and the Obese
Socialized medicine is a wonderful, compassionate system that brings important care to everyone… at least, that’s what leftists in the United States and Europe keep insisting.

As the United Kingdom is finding out, however, everyone is not actually equal under health care socialism. As soon as the system starts running out of other people’s money, people are quickly pushed out… and you’d better hope that you’re not one of the unlucky ones who gets thrown aside!

That’s exactly what happened this week in Britain, as the socialized National Health System announced that patients are being banned from important surgeries if they happen to be a bit overweight or smoke tobacco.

More at the site - tip of the hat to Wirecutter at Knuckledraggin My Life Away for the link.

The link between childhood vaccinations and autism is simply not there. It first reared its pointy little head in a 1998 paper in the British journal Lancet based on research by Dr. Andrew Wakefield. Slight problem - Wakefield's research was funded by an insurance company which hoped to profit off future lawsuits against vaccine makers. The paper was retracted and Dr. Wakefield now goes by Andy - his license to practice medicine was stripped from him.

Still, like a chicken, the head was chopped off but the body still twitches. From Canada's CBC News:

UBC researchers pull paper linking vaccine component to autism after data alleged to be manipulated
Researchers from the University of British Columbia are retracting their scientific paper linking aluminum in vaccines to autism in mice, because one of the co-authors claims figures published in the study were deliberately altered before publication — an issue he says he realized after allegations of data manipulation surfaced online.

The professor also told CBC News there's no way to know "why" or "how" the figures were allegedly contorted, as he claims original data cited in the study is inaccessible, which would be a contravention of the university's policy around scientific research.

The paper looked at the effects of aluminum components in vaccines on immune response in a mouse's brain. It was published in the Journal of Inorganic Biochemistry on Sept. 5.

Talk about a two-fer - not only the vaccine/autism fraud but they were looking at aluminum which has been featured highly in the do not use aluminum cookware as it can give you Alzheimers bullshit. A bit more:

However, subsequent scrutiny has raised questions about the validity of the data, with one doctor calling the paper "anti-vaccine pseudoscience."

The allegations were published last week on Retraction Watch, a site that reports on withdrawn papers as "a window into the scientific process."

By the middle of September, commenters on PubPeer — a database where users can examine and comment on published scientific papers — pointed out that figures in the study appeared to have been altered, and in one case lifted directly from a 2014 study also authored by Shaw and Tomljenovic.

Soo busted. A lot more at the site. One of the researchers had a previous paper retracted for dodgy data in 2016. Who is funding these idiots and why do they still have tenure at UBC?

Healthcare in Canada

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In the USA, our health-care system is a muddled mess. It started off fine but grew larger and larger as more and more activists lobbied for their niche causes. Add congressional lobbying by pharmaceutical companies and you have a big steaming expensive mess. As we look for alternatives, Canada keeps coming to mind. Turns out the numbers simply do not add up. From Canada's Financial Post:

Why Canada’s ‘best’ health-care system just got ranked last — again
Because liberal Americans see us, in this age of Trump, as an oasis of sanity in a worldwide desert of populism, The New York Times is doing more reporting on Canada, presumably so its U.S. readers don’t lose all hope that saner choices could be available in an alternative world.

It also offers a weekly “Canada letter” on worthwhile and actually sometimes interesting Canadian initiatives. Recently the letter reported on a health-care tournament the Times organized in which five experts decided which of eight rich countries had the best health-care system.

We didn’t win. In fact, we went out in the first round, losing to Britain, which then lost to Switzerland, which ultimately beat France, though only by three votes to two in the final. Other first-round losers were Singapore, Australia and Germany. The U.S. made it to the semis where it was beaten by France, three votes to two.

Wait times were the big issue. This is a perfect example of rationing which is what Obamacare and Single Payer will be implementing. "Free" medical is only good if you can get it in a timely manner.

Obamacare meltdown

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Looks like President Trump is taking Obamacare to the mat - three headlines:

Stick a fork in it - it is done and over with. Private insurance, free market competition. Those will drive down the costs - a centralized administration will drive up the costs.

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