Thinking Harder
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Doctor Self-Referral: Should You Get That X-Ray or CT Scan?
Continue reading… 27 CommentsA front-page story in today's Washington Post might give you pause the next time a doctor offers to scan you to determine the source of a health complaint. The story, by Shankar Vedantam, gets to the heart of a financial conflict of interest that's rife in many outpatient medical practices. It's called physician self-referral. That jargony term is just a label for what occurs when a doctor tells you that you need a test or procedure and then offers to sell you—er, perform for you—that same test or procedure.
It happens all the time, and there's nothing intrinsically nefarious about it. In fact, self-referral is often an enormous boon and time-saver for patients. As Vedantam suggests, if you go to a doctor because you've hurt your foot, you'd probably be quite glad to find that she has an X-ray machine in her office and can determine on the spot if you've broken a bone. A doctor without a scanner, and therefore unable to self-refer, would have to prescribe a foot X-ray and send you elsewhere to get it. What would that mean for you? Another appointment, another copayment, and possibly a delayed diagnosis. Chalk one up for self-referral.
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Why a Man Let 2,000 Malaria-Infected Mosquitoes Bite Him
Continue reading… 8 CommentsSome people will go to extreme lengths to avoid mosquito bites. They'll wear long sleeves and pants in the heat of summer, surround themselves with citronella candles and torches, and spray foul-smelling chemicals all over their bodies—or simply not set foot outside when they know the bugs are biting.
Stephen Hoffman isn't quite like those people. In fact, he has gone out of his way to get bitten. Years ago, he let 2,000 mosquitoes feast on his arm and inject perhaps 200,000 parasites into his bloodstream. Why? Well, for one thing, it made him immune to malaria.
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Volunteering for a Clinical Trial: Have You? Would You?
Continue reading… 6 CommentsI once came very close to receiving an experimental vaccine that, let's face it, could conceivably have killed me. In retrospect, I'm glad the researchers running the trial decided that I wasn't eligible to be a study subject. But at the time I was actually disappointed when they turned me down.
I'm planning to write a feature about people who volunteer for clinical trials, why they do it, and what they get out of it. In my case, I was just doing my job; I was a reporter chasing a good story.
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Maggot Therapy: How to Find a Doctor Who Will Prescribe Maggots
Continue reading… 16 CommentsAlmost a decade has passed since maggots averted the amputation of Pam Mitchell's left foot, and the Akron resident still sounds tremendously grateful. In her case, maggot therapy accomplished something that modern medicine—specifically, three courses of antibiotics—was unable to do: Defeat a dangerous and persistent bone infection and heal the deep, open wounds that had developed on both of her feet.
Foot ulcers are a common complication of diabetes, which Mitchell, now in her 50s, has had since the age of 10. In the hospital where she was being treated, "they told me I had to have my foot amputated, that it would never heal," she says. "It's been healed for 9 years. I barely have a scar."
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Maggots, Leeches, and One More Utterly Revolting Medical Therapy
Continue reading… 12 CommentsU.S. News isn't in the business of ranking medical treatments by how disgusting they are (at least, it isn't yet). But I'll admit that gross medicine has fascinated ever since science writer John Travis suggested years ago that I write an article on the subject. So here's an unranked list of what I consider to be three of the world's grossest medical therapies. Got another one? Submissions welcome.
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Economic Crisis Is 'Unfortunate Opportunity' for Health Researchers
Continue reading… 24 CommentsPALM HARBOR, FLORIDA—In a presentation this morning at a conference on cardiovascular health, one researcher described a thin silver lining in the current economic downturn. Karen Matthews of the University of Pittsburgh told listeners that she sees the global economic crisis as an "unfortunate opportunity" for researchers to examine the health effects of socioeconomic changes such as job loss and employment-related stress. With so many people losing homes, jobs, or wealth, these hard times represent what epidemiologists call a "natural experiment," that is, a situation of changing circumstances that—while helpful to study for scientific purposes—would never be ethical to impose on people for the sole purpose of studying the effects.
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Like Crashed US Airways Plane, Space Shuttle Has Had Bird Collision
Continue reading… 6 CommentsToday's crash of a U.S. Airways jet into the Hudson River following the aircraft's collision with birds isn't the first or only problem flying machines have had with flying animals. In fact, NASA has been concerned for years about the possibility of a catastrophic post-launch collision of its shuttles with vultures that live in the area surrounding the launch site.
As I reported for National Geographic News in 2006:
During a launch [in 2005], Discovery's external fuel tank struck one of the birds a few seconds after takeoff. "There happened to be a group of three vultures flying over the vehicle, and we hit one of them," said Steve Payne, NASA's ground-based shuttle test director. Luckily, he said, "We weren't going very fast." The shuttle was still building up speed as it lifted off the launch pad, so the impact wasn't too intense. Also, the collision occurred on the side of the fuel tank opposite the shuttle, or orbiter, so the hapless bird fell away without striking the orbiter's fragile underbelly. "It could conceivably have done damage if it had come over the top side and hit the orbiter," Payne said. In 2003 a piece of foam insulation from the shuttle Columbia fell and fatally damaged the craft.
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Smoking Ban Prevented Heart Attacks; Does Each Obama Speech Do the Same?
Continue reading… 8 Comments"Every time Obama comes on television now, the collective blood pressure in the United States goes down 10 points."
That quote, attributed to Rep. Neil Abercrombie, a Democrat from Hawaii, appeared today in a Washington Post article on Obama's calm manner and how the president-elect's disposition reflects his upbringing in laid-back Hawaii. It suggests that Obama's cool is contagious is a positive way, that it reassures Americans rattled by the nation's state of crisis.
Rep. Abercrombie may have been speaking figuratively, but imagine for a moment the possibility that Obama's speeches actually do lower listeners' blood pressure. Since high blood pressure contributes to heart attacks and strokes, is it possible that Obama's status as president-elect has prevented some cardiovascular attacks?
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Sustainable Seafood Rankings: 4 Supermarket Chains Pass Greenpeace’s Review
Continue reading… 7 CommentsThe environmental advocacy group Greenpeace ranked the nation's 20 leading supermarket chains in June after assessing how well each adhered to ocean-friendly policies in its marketing of seafood. All 20 failed Greenpeace's review. Now, in a new review that takes into account small but significant changes in some chains' policies, Greenpeace has a little good news to report: Four chains passed the test, indicating that they generally sell ocean-friendly seafood. Those four are:
1. Whole Foods Market
2. Ahold USA (which owns Stop & Shop and Giant)
3. Target
4. Harris Teeter -
Do Folic Acid, B Vitamins Prevent Cancer—or Cause It?
Continue reading… 10 CommentsThe latest study of people taking folic acid and vitamin B supplements is either disappointing or reassuring, depending on how you look at it. Researchers set out hoping to show that these vitamins could prevent breast cancer—and perhaps other cancers—in women with less-than-ideal health. But they seem to have struck out, HealthDay reports.
On the other hand, recent research had raised the frightening possibility that folic acid accelerates the growth of malignant tumors, a subject I've explored in some detail. Experts theorize that folic acid, which is a crucial nutrient for pregnant women, might inhibit the development of new malignancies while paradoxically fostering the growth of cells that have already turned bad.
In that sense, the new study is reassuring. Researchers led by Shumin Zhang of Harvard Medical School found no sign of increased cancer risk in women who took folic acid and vitamins B6 and B12 for the duration of the trial, which followed each woman for up to 7.3 years. They reported their findings in the Journal of the American Medical Association.
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Hundreds of Birds Killed by School's Artificial Lights
Continue reading… 5 CommentsThe Charlestown (W. Va.) Daily Mail reported that "hundreds" of yellow warblers and other migratory birds died this week when they flew into a lighted school building that sits on a hill in Hambleton, W. Va. It appears that the slaughter was an example of a phenomenon known as bird kill or tower kill, in which nocturnal birds that find their way by natural light become disoriented by artificial lighting and crash into illuminated structures.
The Daily Mail reported that Assistant Principal Mickel Bonnett arrived at Tucker County High School about 6:30 a.m. Monday and saw birds smacking into the side of the building. "Bonnett said he thought the birds were attracted to the lights inside the school as it was dark outside," the paper reported.
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Democrats' Convention Logo Hints at Light Pollution in Denver
Continue reading… 2 CommentsThinking Harder reader Robert Wagner of Kansas City shared an interesting tongue-in-cheek observation yesterday about the Democratic National Convention Committee's logo (below). "I was wondering if anyone else noticed the logo for the DNC," he E-mailed me. "I think it has a little Light Pollution in it. (Orange Sky?)"
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Could Incense Burned in Church Give You Cancer?
Continue reading… 32 CommentsAt a funeral service I recently attended, a minister burned incense near the casket of the deceased. When the pleasant odor reached my nostrils, I inhaled deeply—and then began wondering if I should have. Sure enough, research published this week suggests that breathing in smoke from incense may be harmful. I doubt my exposure during the two-hour service shortened my life span, but it gave me something to think about.
After all, many religions around the world use incense in rituals, and the substance often gets burned in crowded, indoor spaces with limited ventilation. Two years ago, a study (subscription required) found that a Catholic church in Germany contained high concentrations of airborne soot particles during and for several hours after services that involved the burning of incense.
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Forces of Darkness Make Pitch to Congress to Fight Light Pollution
Continue reading… 9 CommentsThis afternoon, I attended a briefing on Capitol Hill about light pollution, a subject that has filled many of my notebooks. A representative of a major utility company, a conservation scientist, a medical researcher, and other experts addressed a roomful of congressional staffers in an effort to move the federal legislature to take action against wasteful artificial lighting. Several states, including Texas, and hundreds of towns across the country, including Homer Glen, Ill., have taken measures to control how much light gets cast into the sky rather than onto targets on the ground. But the federal government has not made rules aimed at limiting light pollution.
One presenter, biologist Travis Longcore of the Urban Wildlands Group in Los Angeles, ran through a litany of species that are harmed by misdirected illumination, such as migratory birds, which can become disoriented and crash fatally into lighted towers, and sea turtle hatchlings, which can be lured away from the sea—and to their inevitable death—by illuminated roadways. Another presenter, David Blask of the Bassett Research Institute in Cooperstown, N.Y., focused on explaining why nocturnal illumination is linked to health problems in one important species in particular: humans.
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Decoded Platypus Genome Spells Out 'Hybrid'
Continue reading… 10 CommentsThe duck-billed platypus looks and acts like an animal with an identity crisis. It swims a bit like a duck and walks like one, too (on those webbed little feet), but it's certainly no bird. It lays eggs, as if a bird or reptile, yet it nurses its young like the mammal that it is. Now, it turns out the animal looks like a hybrid even at the most minute level, its DNA. Along with today's announcement that the platypus's genome has been sequenced comes the revelation that its genes reflect its odd ancestry.
It's not that the platypus has mixed ancestry, so it's not a true hybrid. Rather, it's thought that the ancestors of the platypus evolutionarily diverged from the rest of the mammals about 166 million years ago, so it retains some of the genetic and physical characteristics that other mammals may have had at that time but have since lost.
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High-Fat Diet Found to Fight Seizures in Kids
Continue reading… 0 CommentsA diet high in fat—extremely high in fat, that is—has just been shown in a clinical trial to cut seizure frequency in children with severe, drug-resistant epilepsy. It's not a cure, and it's not an easy treatment to stomach, but it works, British researchers reported Friday in the journal Lancet Neurology.
Dr. Atkins himself might have gagged on the therapeutic regimen, which is called the ketogenic diet. It's so fatty that carbohydrates and protein combined aren't permitted to account for more than 25 percent of total calories. Each patient needs to have his or her diet specially designed by a dietitian, who calculates how many calories of fat, carbs, and protein need to be eaten each day. By comparison, fat can constitute "only" 50 percent of the caloric energy in the Atkins diet.
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Is the Polar Bear Threatened?
Continue reading… 10 CommentsThe Interior Department has barely two weeks to issue a ruling on whether the polar bear qualifies for protection under the Endangered Species Act, a federal judge decided this week. As the New York Times reports, Judge Claudia Wilken of Oakland, Calif., "rejected the government's contention that the case was too complicated to decide before June 30." Environmentalists argue that the melting of the Arctic icecap, which is reducing the polar bear's habitat, represents a serious threat to the species. The Times continues:
At a news conference earlier this month, the White House spokeswoman, Dana Perino, said environmentalists were inappropriately trying to use existing environmental laws, like the Endangered Species Act and the Clean Air Act, to address climate change. The result, Ms. Perino said, would be a "regulatory train wreck."
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Masturbation-Prostate Link: eFluxMedia Got It Wrong
Continue reading… 3 CommentsIn my last post, I called eFluxMedia on its erroneous coverage of five-year-old medical research. The publication calls itself "an online newspaper that aims to offer a public service. Its main purpose is to inform its readers correctly, impartially, and continually, according to journalistic principles." It reported today that masturbation reduces men's chance of developing prostate cancer. The story is time-stamped "13:40, April 24th, 2008."
The finding it then goes on to describe was reported by other news organization in July of 2003. In fact, eFluxMedia writer Anna Boyd paraphrased a BBC.co.uk report and a New Scientist story and pulled quotes from both of them (with attribution). Oddly, Boyd did not mention the timing of those reports or of the original medical study, referring to it only as the "latest study in this field." As I just reported, that study is no longer the latest study in the field. A very similar finding essentially confirmed the 2003 study the following year.
E-mails addressed to Anna Boyd and sent to several addresses at eFluxMedia.com were not immediately returned; at least one bounced back. A telephone number could not be found on the publication's website. If I hear back, I'll let you know.
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The Latest News on Ejaculations and Prostate Cancer
Continue reading… 31 CommentsWhat happened to the concept that news reporting should be about recent events? The Internet is suddenly abuzz with "news" reports of a five-year-old Australian study that suggested that masturbating protects men against developing prostate cancer.
I called out the erroneous reporting yesterday. Since then, eFluxMedia has made the same journalistic mistake that Fox News and others made earlier this week. (Either that, or eFluxMedia intentionally passed off as news a story that its staff realized was old. More on that in a forthcoming post.)
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Will We All Soon Eat Lab-Grown Meat?
Continue reading… 12 CommentsThe animals rights group People for the Ethical Treatment of Animals announced this week that it will offer a $1 million reward to the inventor of laboratory-grown, tastes-just-like-chicken (or beef or pork), no-animals-were-harmed-in-the-making-of-this-burger meat—should someone come along who can claim that mantle. The Associated Press quickly gobbled up the news, and Time offered its take yesterday. PETA lays out its rationale as follows: "More than 40 billion chickens, fish, pigs, and cows are killed every year for food in the United States in horrific ways. Chickens are drugged to grow so large they often become crippled, mother pigs are confined to metal cages so small they can't move, and fish are hacked apart while still conscious—all to feed America's meat addiction. In vitro meat would spare animals from this suffering. In addition, in vitro meat would dramatically reduce the devastating effects the meat industry has on the environment."
The environmental argument holds considerable weight. Large quantities of water, grain, antibiotics, and energy are used to produce hamburgers, and animal waste is a pungent and dangerous problem of its own. If meat could be grown efficiently in vitro, the benefits to society could be many. But not everyone is fully on board: Calling yesterday for a "measured approach," the New York Times editorial board opined that it "will be a barren world if the herds and flocks disappear in favor of meat grown in a laboratory tank." In the long run, I wonder if our omnivorous species has any choice.
