Novartis working ’round the clock’ to clear flu shots withheld from distribution

By Helen Branswell, The Canadian Press - Tuesday, October 30, 2012 at 3:34 PM - 0 Comments

TORONTO – A senior executive with the pharmaceutical giant Novartis says the company is working around the clock to provide countries with the information they need to release flu vaccines currently being withheld from distribution.

Canada and a number of countries have suspended use of two types of Novartis flu vaccines in the past week after Italian authorities ordered the company to stop distribution of the products in Italy.

The two brands of flu vaccine are made at Novartis’s production facility in Italy; they are sold under the names Agriflu and Fluad in Canada.

The Italian action came after Novartis informed the regulator that it had found protein aggregates in one batch of vaccine.

Dr. Vas Narasimhan says Novartis held back the affected lot and hasn’t seen the problem in other batches of vaccines produced at the Italian facility.

Narasimhan says from time to time the proteins in flu vaccine fall out of suspension, but generally will disappear if the vaccine is shaken, as directed, before use.

He says flu vaccine always comes with instructions that the product should be shaken before injected. If particles are seen after the vaccine is shaken, doctors are advised not to use that dose or vial.

In testing that Novartis has done, the aggregates in the affected vaccine go back into solution with shaking, says Narasimhan, the global head of vaccines development for Novartis Vaccines and Diagnostics.

“We think that depending on temperature, depending on PH, depending on the strain we happen to use in a given year, you can see low levels of aggregates form on occasion. But generally speaking, these should go back into solution when shaken,” he said in an interview from Cambridge, Mass.

Narasimhan says potency and safety testing Novartis conducted on all batches of Fluad and Agriflu showed all of the lots met safety and potency specifications.

Protein aggregates are the bits of the killed viruses that are used in flu vaccine to provoke the immune system to produce antibodies against the strains included in the shot. If a vaccinated person comes in contact with flu viruses, those antibodies should kick into gear to prevent infection.

The proteins used in flu vaccine are mainly hemagglutinin and neuraminidase, the two proteins that sit on the outside shell of a flu virus.

A number of European countries that purchase Novartis vaccines made at the Italian plant have suspended use of the products while the issue is being resolved. Those countries include Spain, Germany, Switzerland and France.

The United States has not been affected by the issue. While it purchased Novartis vaccine this season, the product it bought, Fluvirin, is made at a plant in Liverpool, England.

Hospitals should make flu shots mandatory for health-care workers, journal says

By Helen Branswell, The Canadian Press - Monday, October 29, 2012 at 2:02 PM - 0 Comments

TORONTO – The Canadian Medical Association Journal is adding its voice to calls for mandatory flu shots for health-care workers.

The journal says hospital workers ought to be vaccinated to protect frail elderly patients whose immune systems are so weakened they don’t get much protection from a flu shot themselves.

There’s been a growing movement of late towards requiring health-care workers to take a flu shot, especially in the United States.

Earlier this year British Columbia became the first Canadian jurisdiction to require health-care workers to get flu shots.

From Dec. 1 until the end of March, any health-care worker in B.C. who hasn’t had a flu shot will have to wear a mask while caring for patients.

The journal’s support for mandatory flu shots is expressed in an editorial in this week’s issue.

The editorial was written by Dr. Ken Flegel, senior associate editor of the journal and a general internal medicine specialist who practises at Montreal’s McGill University Health Centre.

He says hospitals these days are filled with very fragile patients whose health conditions put them at serious risk of dying from influenza if they contract it.

Despite that, many of the health-care workers taking care of them don’t get flu shots, Flegel says, and many come to work when they are ill.

Even if they didn’t, people who are coming down with the flu are infectious for about a day before they know they are sick. And some people who contract flu have no symptoms, or such mild symptoms that they don’t realize they are infected and spreading the virus.

Those factors create a situation where health-care workers can be transmitting flu to the very people they are caring for, Flegel says.

“And is that fair? Would you like to have it happen to your grandmother or your mother, when she’s already sick with a cancer? Or an auto-immune disease?” he asks.

“We doctors see that in the hospital.”

Thirty-seven and counting

By Kate Lunau - Saturday, October 27, 2012 at 8:00 AM - 0 Comments

Illustration by Patrick Ledger

Brigitte Adams always wanted to have kids one day: a boy and a girl. “My mom’s a first-grade teacher, and there’s a whole library of children’s books she’s saved for me,” says Adams, 40. Two years ago, she talked to her doctor. “He said, ‘Just get pregnant now,’ ” but Adams, who divorced at 34, was single. “I’d like to have a traditional family,” she says. “I wasn’t ready to have children by myself.” Last year, she froze her eggs.

Like Adams, women in their mid- to late thirties are turning to egg freezing to slow the biological clock, putting aside a stash of eggs to gain more time to have a child. Elective egg freezing is fairly new, and not all fertility clinics offer it, but it’s about to go mainstream. On Oct. 19, the American Society for Reproductive Medicine (ASRM) lifted its “experimental” label on egg freezing, citing findings that younger women are about as likely to get pregnant whether using fresh eggs in a fertility treatment, or previously frozen ones. While the ASRM doesn’t set rules for fertility clinics, merely provides guidelines, more are bound to start offering the procedure—and more patients will seek it out. Women late in their reproductive years may be disappointed: not even this cutting-edge technology can halt the female fertility decline.

The ASRM’s new recommendations say egg freezing can help certain women, like cancer patients who might suffer infertility after chemotherapy, or couples using IVF, if the man can’t give a sperm sample the day his partner’s eggs are retrieved. But it stopped short of recommending egg freezing for the purpose of delaying childbearing, especially among older women. “We don’t have good data on women who are older,” says Dr. Samantha Pfeifer, head of the ASRM Practice Committee, which wrote the new recommendations; most of the studies so far have been in women under 30. Egg freezing can be a costly procedure, and takes a physical and emotional toll; there’s concern about giving patients false hope. Yet older women like Adams are the ones “most clamouring for the technology,” Pfeifer acknowledges.

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Canada suspends dispersal of Novartis flu shots following similar move in Europe

By The Canadian Press - Friday, October 26, 2012 at 8:56 PM - 0 Comments

TORONTO – Canada is following the lead of several European countries and suspending distribution of flu vaccine made by the pharmaceutical firm Novartis.

The decision relates to the discovery by the company of tiny clumps of virus particles in some batches of flu vaccines made at the Novartis production facility in Italy.

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Podcast: Science-ish tackles vaccines

By Julia Belluz - Tuesday, October 16, 2012 at 11:05 AM - 0 Comments

We asked you, dear Science-ish readers, for your burning questions about vaccines.

You tweeted and emailed what was on your mind. Some of you asked if fears about vaccines are irrational while others wanted to know how flu shots are made and whether we should bother with getting the things. Science-ish was asked why we don’t have an HIV vaccine, and what’s causing the whooping cough outbreaks. Even age-old worries about the link between autism, mercury and vaccines emerged.

Not to worry: Science-ish got answers.

Here are responses to some of your questions and a preview of what’s to come later this week.

Science-ish is a joint project of Maclean’s, the Medical Post and the McMaster Health Forum. Julia Belluz is the associate editor at the Medical Post. Got a tip? Seen something that’s Science-ish? Message her at julia.belluz@medicalpost.rogers.com or on Twitter @juliaoftoronto

New report questions science behind flu vaccine efficacy and use policy

By Helen Branswell, The Canadian Press - Monday, October 15, 2012 at 4:17 PM - 0 Comments

A new report says flu vaccine is not as effective as public health messaging suggests and new and better vaccines are needed.

The report suggests the current vaccines offer moderate protection some years and less in others.

The authors say the problem is that having vaccine that is deemed good enough is a disincentive for the industry to develop longer-lasting and more effective flu shots — especially given that better vaccines would likely cost significantly more.

The report of the CIDRAP Comprehensive Influenza Vaccine Initiative was written by public health experts at the Center for Infectious Diseases Research and Policy at the University of Minnesota.

The authors strongly advocate for major investments to develop new flu vaccines but say in the meantime, people should continue to use the currently available shots.

It questions many of the dogmas that are accepted about flu vaccine, including that vaccinating children will protect the elderly, who don’t mount a good immune response to flu vaccine.

As well, it says there is no evidence to support the idea that flu vaccine is more effective in years when the strains included in the shot are a good match for those circulating in nature.

The 160-page report is the result of a three-year investigation into the science supporting flu vaccine efficacy and safety and the decision-making processes that led to the U.S. policy to recommend all Americans get a flu shot every year.

The work was done with a grant from the Alfred P. Sloan Foundation.

Ontario’s first pig-to-human H1N1case confirmed

By Scaachi Koul - Wednesday, September 26, 2012 at 5:45 AM - 0 Comments

Ontario has confirmed its first case of a human contracting the H1N1 virus from a pig.

The adult male is in critical but stable condition in hospital. He came down with symptoms of the flu after being in close contact with pigs in either Canada or the U.S. The case was confirmed on Sunday after testing.

It’s rare for the virus to go from animal to human, and even rarer for human-to-human transmission.

H1N1 symptoms are similar to a flu, including chills and cough, followed by fever and fatigue. More severe cases can lead to pneumonia.

Scientific research hints at secret of weight loss

By The Canadian Press - Monday, September 17, 2012 at 2:43 PM - 0 Comments

TORONTO – Adequate sleep is a key component to dieting and maintaining a healthy weight, a growing body of scientific research suggests.

In a commentary published in this week’s Canadian Medical Association Journal, two obesity researchers argue that the old formula — energy in must be lower than energy out — is too simplistic.

“We tend to always talk about food and physical activity and we need to go beyond that to include what I call other non-caloric factors,” said Jean-Philippe Chaput, a specialist in preventive medicine who works on obesity in children at the Children’s Hospital of Eastern Ontario, in Ottawa.

“We know that obesity is very complex. It isn’t one-size-fits-all. People gain weight for different reasons. It’s not always an increase in food intake. It can be stress. It can be depression. Genes. Different factors.”

Inadequate sleep is among them, wrote Chaput and his co-author, Dr. Angelo Tremblay, of the department of kinesiology at Laval University in Quebec City.

It’s generally recommended that adults get seven to nine hours of sleep a night.

Scientific studies are increasingly pointing to the role sleep — or the lack of it — plays in maintaining a healthy body weight. The evidence suggests inadequate sleep influences body weight in a number of ways.

People who don’t get enough sleep are awake longer — no surprise there — and that gives them more time to consume calories.

“It’s well known that television viewing stimulates food intake in the absence of hunger,” Chaput said Monday in an interview.

Studies have found that people who stay up watching television, for instance, are likely to snack. And generally speaking, they don’t nibble on steamed broccoli or celery sticks.

In fact, late night TV watching is associated with consumption of high calorie foods. Chaput says a study showed people who go to bed late eat about 400 to 500 calories more a day than people who go to bed early and wake up early.

But the influence of short sleep isn’t just related to the fact that it gives people more time to eat. Studies show that people who sleep for shorter periods produce more ghrelin, a hormone that stimulates the appetite.

Inadequate sleep also puts the body under stress, creating higher levels of cortisol, a stress hormone. It’s well known that low-level stress makes people eat more, Chaput said.

These hormonal changes can sabotage weight loss efforts, he suggested.

“We know that short sleepers in general feel more hungry. And when we restrict calories in the diet of short sleepers, we know that if we already feel more hungry and you cut calories, hunger plus hunger means very hungry,” he said.

“If they want to lose weight, of course at some point they will need to cut some calories. But if they don’t take into account their sleeping patterns, they might fail.”

And there’s a third factor at play, suggested Dr. Arya Sharma, who holds a chair in obesity research at the University of Alberta in Edmonton. Sharma is not an author of the commentary, but he agrees with the points it makes.

“We’ve … known for a long time that people who don’t get enough sleep tend to be less physically active during the day,” Sharma said.

Sleep is part of the discussion when he meets with patients struggling to lose weight, Sharma said. And he welcomed the raising of the issue in the journal.

“I think the discussion is important because we tend to focus so much on what people do — how much they eat and how much they exercise — rather than looking at some of the factors that drive those behaviours,” he said.

“And not getting enough sleep is certainly one of the main, key drivers of unhealthy eating behaviours, and probably also not having the energy to be more physically active.”

Lack of sleep also affects mood, which has been shown to be a trigger of emotional eating, Sharma said. And maintaining impulse control is harder when a person is tired, he said.

“All of these things tie together.”

Unfortunately, just telling people to go to bed earlier isn’t likely to solve the obesity problem, Chaput said. There are a variety of reasons for why people don’t get enough sleep, and some may resist a quick fix.

Still, he and Tremblay suggested future research should try to identify ways to help people get more sleep, such as pushing back the start time for work or for school — especially for teenagers — or scheduling prime-time TV programs earlier in the evening.

Measles study raises questions about timing of vaccination

By Helen Branswell - Sunday, September 9, 2012 at 8:18 PM - 0 Comments

TORONTO – A second study from Quebec is calling into question the timing at which young children are vaccinated against measles.

The new research shows that teenagers who received the recommended two doses of measles vaccine but who got the first shot when they were 12 months old were six times more likely to go on to contract the disease than those who got their first dose at 15 months.

The work was done to try to puzzle out why a number of teenagers who would have been assumed to have been protected — because they got two doses of vaccine in childhood — nevertheless were infected during Quebec’s large measles outbreak in 2011.

More than 700 measles cases were reported in that outbreak.

Lead author Dr. Gaston De Serres of Quebec’s provincial public health agency presented the work Sunday at a major international infectious diseases conference in San Francisco. The study was a followup to an initial paper on the outbreak that he presented to the same conference last year.

While the situation bears watching, De Serres said Canadian policy on timing of measles vaccine delivery isn’t likely to change just yet.

“For Canada I would probably say that at this time we will not change the schedule,” De Serres said during a webcast press conference from ICAAC, the Interscience Conference on Antimicrobial Agents and Chemotherapy.

“We need to follow up with more studies.”

Prior to the introduction of the measles vaccine, most children contracted the disease and roughly two million a year died from it.

One of the most contagious diseases to afflict humans, measles has largely been quelled in the Americas and countries that use measles vaccine, though it remains endemic in a number of parts of the world.

Still, outbreaks do crop up in North America, triggered by cases imported from parts of the world where the virus still spreads.

Generally those outbreaks take place among children whose parents refused to vaccinate them for religious reasons or because the parents subscribe to anti-vaccination views. It is rare to see cases in vaccinated children.

While measles can be particularly dangerous for infants, they cannot be vaccinated. That’s because antibodies they get from their mothers while they were in the womb kill the virus in the vaccine before it has a chance to induce an immune response in the vaccinated child.

That phenomenon is called maternal antibody interference. Maternal antibodies protect an infant while its own immune system is just starting to develop. The effect of maternal antibodies wanes in the months after birth.

The World Health Organization recommends giving the first dose of measles vaccine at nine months, with the second dose to follow any time after 12 months.

Jane Seward, a measles expert with the U.S. Centers for Disease Control, said the goal is to vaccinate children as soon as the vaccine can take effect so as to minimize the risk of death and severe disease.

“It’s a balance between getting the first dose as early as possible to decrease deaths and as late as possible to get the best immune response,” she said.

In Canada, where an infant’s risk of encountering measles is lower than it would be in India or Africa, officials have pushed back the start of the immunization program to try to take advantage of the difference in the risk-benefit ratio.

Here the first dose of measles vaccine — it comes bundled in a vaccine that covers mumps, rubella and chickenpox as well — is generally given at 12 months of age. The second is given at 18 months or at four to six years of age, before the child starts school.

When De Serres and some of his colleagues saw twice-vaccinated teenagers among the measles cases in Quebec, they did a study in a high school trying to figure out why those cases had occurred.

That work, presented last year at ICAAC, showed that teenagers who got their first shot at 12 months were three times more likely to get measles than teenagers who had received their first shot at 15 months.

(It should be noted it is rare that twice-vaccinated children develop measles, regardless of when they got their first shot. De Serres’ study suggested the vaccine was 94 per cent effective in preventing measles in children who got two doses starting at 12 months, and over 97 per cent effective in children who got two doses starting at 15 months.)

To try to confirm their findings, the group did a second study. They found 61 cases of twice-vaccinated children — cases who weren’t in the original study — and compared them to 305 teens who did not contract measles. They found the risk for kids who received their first dose at 12 or 13 months was six times higher than those who were first vaccinated at 15 months.

De Serres said it isn’t clear whether this difference is all due to maternal antibody interference. It’s possible, he suggested, that waiting longer gives the immune system more time to mature and that results in a better response to the vaccine.

“We don’t know the contribution of maternal antibody and maturation of the immune system to what we’ve seen,” he said.

Figuring that out will be important, because experts expect to see changes in the pattern of maternal antibody interference in coming years.

That’s because the generations of women who had measles when they were children — and developed a strong antibody response to the disease — will be moving out of their childbearing years.

Vaccines are known to produce lower levels of antibodies than natural infection. So when women who never had measles, who got their measles protection from vaccine, pass on maternal antibodies to their fetuses, those antibodies may wane faster, Seward noted.

That would mean giving the first dose when it is currently given might not leave some children vulnerable in future, she said. “But we need to watch.”

New York investigating energy drink industry, source tells AP

By The Associated Press - Tuesday, August 28, 2012 at 10:08 PM - 0 Comments

ALBANY, N.Y. – New York officials are investigating marketing and health claims made by several energy drink makers.

A person familiar with the inquiry, speaking on condition of anonymity because the investigation hasn’t yet been made public, says New York state Attorney General Eric Schneiderman issued subpoenas this summer to the makers of 5-Hour Energy, AMP and Monster energy drinks.

Earlier this month, Monster Beverage Corp. disclosed in a Securities and Exchange Commission filing that an attorney general had sent it a subpoena. The firm didn’t reveal which state it was, but the person familiar with the inquiry said it was New York.

The person says subpoenas also were sent to PepsiCo Inc., which makes AMP drinks, and Living Essentials LLC, which makes 5-Hour Energy.

Company officials and Schneiderman declined to comment Tuesday.

HIV prevention pill recommended

By macleans.ca - Friday, August 10, 2012 at 3:59 PM - 0 Comments

A pill used to treat HIV can also prevent infection, the CBC reports. U.S. health officials say doctors should consider recommending the pill to men and women at high risk of contracting the disease.

Truvada is a drug that is taken daily to treat HIV, but studies have also shown it also reduces the probability of infection. Last month, the Food and Drug Administration approved its use for people having risky sex.

The only problem is that it costs between $6,000 and $12,000 U.S. a year. Not all insurers cover the drug, so condoms are still a better bet. But a U.S. official speculates that this drug might help protect couples who want to have a baby when one of the adults has HIV.

About 65,000 people in Canada are living with HIV.

A Science-ish guide to searching health info on the web

By Julia Belluz - Thursday, August 9, 2012 at 10:32 AM - 0 Comments

(Getty Images)

You’re achy, slightly feverish, and that rash you’ve had on your back for a week hasn’t gone away. In a haze, you log online to peruse WebMD. After all, you’re a pretty savvy researcher, even a nerd, and you just want to find out what might be ailing you.

POW! WAM! BAM! The suggestions about the causes of your symptoms cascade over you like a tsunami of anxiety. Syphillis! Lyme disease! Dengue Fever! All are equally plausible, according to Dr. Google. Even though you know the Internet has a tendency to tell you that you have cancer when you really have a cold, your heart begins to race, your cheeks flush, and you start imagining what your friends will say at your funeral.

In many ways, the Internet has leveled the playing field between health-care providers and patients, and the questions we ask Google about our health woes are probably more honest than the ones we’d ever dare ask our doctors.

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Canada’s fittest, and fattest regions

By Blog of Lists - Wednesday, August 1, 2012 at 2:28 PM - 0 Comments

Chuck Stoody/CP Photo

Amid the excitement over Canada’s first four medals going to Quebec based athletes, we wondered just how regional an issue fitness is in Canada.

Here, then, are the 10 fittest regions, by percentage of the population overweight or obese:

1. Vancouver Health Authority 35.0%
2. Toronto Central Health Integration Network 39.3
3. Fraser Health Authority, B.C. (incl. Burnaby and Surrey) 43.9
4. City of Toronto Health Unit 44.5
5. York Regional Health Unit, Ont. (includes Newmarket) 45.2
6. Central Health Integration Network, Ont. (incl. Newmarket and Richmond Hill) 45.6
7. Région de la Capitale-Nationale (incl. Gatineau) 46.7
8. Calgary Health Region 48.2
9. Calgary Zone 48.2
10. Région de la Mauricie et du Centre-du-Québec, Que. (incl. Drummondville) 48.2

And, the least fit regions, again, by by percentage of the population overweight or obese:

1. Burntwood/Churchill, Man. 73.4%
2. Colchester East Hants/Cumberland, N.S. 71.3
3. South Shore/South West Nova, N.S. (incl. Yarmouth) 70.2
4. Prince Albert Parkland Regional Health Authority, Sask. 69.9
5. Nor-Man Regional Health Authority, Man. (incl. Flin Flon) 68.6
6. Prairie North Regional Health Authority, Sask. (incl. North Battleford) 68.5
7. Interlake Regional Health Authority, Man. (incl. Gimli) 68.4
8. Kelsey Trail Regional Health Authority, Sask. (incl. Melfort) 68.3
9. Central Regional Integrated Health Authority, Nfld. (incl. Grand Falls-Windsor) 68.1
10. Sunrise Regional Health Authority, Sask. (incl. Yorkton) 68.1

Note: Because of how the data is collected, there can be overlap between the regions; names are those given
Source: Statistics Canada (2010)

Have you ever wondered which cities have the most bars, smokers, absentee workers and people searching for love? What about how Canada compares to the world in terms of the size of its military, the size of our houses and the number of cars we own? The nswers to all those questions, and many more, can be found in the first ever Maclean’s Book of Lists.

Buy your copy of the Maclean’s Book of Lists at the newsstand or order online now.

Laissez-faire food

By Aaron Wherry - Tuesday, July 24, 2012 at 1:21 PM - 0 Comments

Sarah Schmidt reviews the last few years of rejection at the Health department.

Aglukkaq’s office confirmed this week that the recommendations have been rejected … Aglukkaq prematurely disbanded her much-touted expert panel on sodium in December 2010 … Aglukkaq immediately shot down the idea and defended the way companies label their food products … After sitting on the report for over a year, Aglukkaq finally announced she was rejecting the advice … Five years after unveiling a proposal to end consumer confusion over “whole wheat” claims on bread products, Health Canada confirmed earlier this year it has no plans to change the food-labelling rule.

How much ‘busy’ is good for you?

By Julia Belluz - Friday, July 6, 2012 at 11:02 AM - 0 Comments

Getty Images

“Busyness serves as a kind of existential reassurance, a hedge against emptiness; obviously your life cannot possibly be silly or trivial or meaningless if you are so busy, completely booked, in demand every hour of the day.”—Tim Kreider, The New York Times

Like many of you, dear readers, Science-ish has been mulling over the recent op-ed “The Busy Trap” in the New York Times. For those who didn’t take time out of their pressure-cooker lives to read the piece, it argued that we’re not necessarily as busy as we think, that we may be choosing busyness because it “serves as a kind of existential reassurance, a hedge against emptiness” and that a little more stillness would probably render us a happier and more creative lot.

In an age when many of us are tethered to our smartphones, unable to stop working—even outside of the office—Science-ish wondered whether we’d really be better off if we resolved to choose stillness and collectively stop and smell the roses. After all, various philosophers, such as Bertrand Russell, have written in praise of idleness, and there is no end to the anecdotal evidence that would suggest that stillness is the font of creativity. One of the most creative people Science-ish knows noted, “René Descartes invented coordinate geometry—the basis of unifying algebra and geometry—when he was lying in bed daydreaming and a fly was buzzing around and he realized that he could lock in the position of the fly at any instant by three coordinate axes.” There are also the clichés about Isaac Newton under the apple tree and Archimedes’ “Eureka” moment.

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Testing for HIV in the privacy of your own home

By macleans.ca - Wednesday, July 4, 2012 at 2:13 PM - 0 Comments

The U.S. Food and Drug Administration have approved the world’s first do-it-yourself HIV test. The OraQuick test which detects the presence of HIV in saliva, collected using a mouth swab, will be available over the counter and would allow Americans to diagnose themselves with the STI in the privacy of their own homes. The test releases a result in 20 to 40 minutes.

Doctors are saying the introduction of a self-administered test will ultimately help stem the spread of HIV, as the sooner an infected person gets onto antiretroviral drugs, the less likely they are to spread the disease to others. The Centers for Disease Control and Prevention estimates that roughly 20 per cent of HIV-positive Americans do not know they have the disease. In the U.S., 1.2 million people have HIV, and 50,000 are infected each year.

The self-administered test is seen as a big step in the fight to make HIV testings anonymous. In the past, many have been deterred from seeking medical help due to the strong social stigma that has historically been attached to the disease.

Bullied girls have poor health in 40s, study suggests

By macleans.ca - Thursday, June 28, 2012 at 12:41 PM - 0 Comments

What’s worse than being an ostracized teenage girl at school? Growing up and suffering from heart disease and diabetes because of it.

According to a Swedish study, women are more likely to be obese, have high blood pressure, high cholesterol, and are more likely to develop diabetes by their early 40s if they were bullied as girls.

The study followed nearly 900 students in Sweden, ages 16 to 43.

From The Telegraph: 

“The effects of peer problems during secondary school on middle-age health were  much stronger in females than males, according to the study, published in  the journal PLoS One.

The academics, from the universities of Umea and Stockholm, found those who had the worst time at school socially — being bullied, cast out or isolating themselves — tended to be at the highest risk of poor health by  their early 40s.”

The study also noted that it didn’t just affect girls on the extreme end of the spectrum. “Our results support the notion that aspects of peer relationships are not only related to future health in the extreme end of the spectrum, e.g. restricted to those exposed to bullying or peer victimization, but that one’s difficulties with peers are represented by a health gradient in adulthood.”

Lessons from a year of ‘Science-ish’

By Julia Belluz - Thursday, May 31, 2012 at 6:28 PM - 0 Comments

Left: Erik K Veland/Flickr Right: ShironekoEuro/Flickr

It’s been a year since Science-ish launched with the aim of scrutinizing the news coverage of health topics, and holding politicians, opinion leaders and journalists to account for misusing or misrepresenting science. The modest goal of the blog was, and remains, to help readers wade through the evidence on a given subject and get a sense of what the science actually shows.

So what has Science-ish learned in 12 months of fact-checking the reporting on everything from the health effects of asbestos, to whether the benefits of urban cycling outweigh its harms, how and if cancer screening will save your life, the “cures” for autism, dubious mental health statistics, and just about every health story in between? Here are five key lessons for telling science from science-ish:

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Addicted newborn babies latest sign of alarming overuse of painkillers

By Gabriela Perdomo - Wednesday, May 2, 2012 at 10:04 AM - 0 Comments

Between 1999 and 2009 the number of American newborns showing signs of intoxication with opiates tripled, according to a new report by the Journal of the American Medical Association, reports the BBC.

The study links these cases, as many as 13,500 in 2009 alone, to the rise in consumption of painkillers. It also notes that they coincide with a five-fold increase in the number of pregnant women testing positive for legal and illegal opiates.

From BBC:

[Newborns showing intoxication symptoms] were often born earlier and smaller, suffered seizures, restlessness, breathing problems or difficulty feeding and often required treatment with the opiate-replacement drug methadone to help wean them off their dependency.

“They appear uncomfortable, sometimes they breathe a little faster. They’re scratching their faces,” said Dr. Stephen Patrick of the University of Michigan, who worked on the study.

The babies were kept in hospital for an average of 16 days, compared to three for healthy babies.

The disturbing study is just another sign of what has recently been deemed an epidemic in painkiller consumption—one also affecting Canada.

Medicine’s deadly gender gap

By Anne Kingston - Monday, April 30, 2012 at 11:01 AM - 0 Comments

Betsie Van Der Meer/Getty Images

In 2004, Barbara Colbourn began experiencing pain in her legs when walking. The 61-year-old London, Ont., office manager tried to ignore the discomfort at first. Six months later, she went to her doctor, who diagnosed peripheral artery disease, or PAD. Colbourn had never heard of it—and was shocked to learn it was a chronic disease caused by atherosclerosis, or hardening of the arteries, of the legs, feet or arms that puts people at higher risk of stroke, heart attack and death. When she was asked to participate in a 24-week international treatment trial organized by London clinical trials nurse Marge Lovell, a PAD awareness advocate, she agreed. Like many women over 60, Colbourn’s health concerns were fixated on breast cancer and heart disease. “Hardening of the arteries was something my grandma had,” she says.

Now 69, Colbourn takes baby aspirin and a cholesterol-lowering drug and exercises daily to prevent the disease’s progression and stave off invasive surgery. There were warning signs she ignored, she says. She had to give up curling in her 50s because her feet were always cold. “Never in my wildest dreams did I think it could be serious.” Just how serious was made clear in a study in the January 2012 American Heart Association journal Circulation: it called PAD an unsung “pandemic” that afflicts more women than men, contrary to previous assumptions. Research in women has lagged behind, says cardiologist Alan Hirsch, a professor at the University of Minnesota medical school who chaired the study. Just as heart disease manifests itself differently in women, so does PAD, says Hirsch, whose study revealed that women with PAD, which afflicts some 800,000 Canadians, are more likely than men to have a limb amputated.

Diagnosed by a simple test that compares arm blood pressure to leg blood pressure, PAD is the “most common, deadly and costly cardiovascular disease that the public hasn’t heard of,” says Hirsch; in 90 per cent of cases, it’s asymptomatic. That so few women have heard of PAD doesn’t surprise Hirsch, who says women have been routinely overlooked in vascular research: “It is embarrassing how many hypertension, lipid studies, and stent trials were done with low [female] enrolment. Every vascular disease I know of except aortic aneurysm is more common in women—venous diseases, lymphedema, PAD—yet we don’t know why and we don’t talk about it.”

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In conversation: Dr. Sanjay Gupta

By Dr. Elaine Chin - Tuesday, April 17, 2012 at 3:57 PM - 0 Comments

AP Photo/Mark Lennihan

Dr. Sanjay Gupta is best known as the chief medical correspondent for CNN and as a special correspondent for CBS. He’s also a practising neurosurgeon, on the faculty at the Emory University School of Medicine in Atlanta, and the author of two bestselling books of health advice, Chasing Life and Cheating Death. Gupta has now written a novel, Monday Mornings,published last month. Its title refers to the weekly morbidity and mortality (M&M) meetings where doctors at the novel’s fictional hospital, Chelsea General, discuss recent surgeries, including instances of medical error.

Q: What inspired you to move to writing fiction?

A: It was driven by the content. I kept a lot of notes when attending M&M meetings for 20 years. As I looked over them, I realized they contained a lot of amazing stories. Originally, I thought I’d write a book about medical mistakes, which wouldn’t be the first. What I found, when I started to write, is that in order to be as candid as I wanted to be and tell the stories that I could tell, it needed to be fiction, because it wasn’t about implicating particular doctors or particular institutions. It was about giving people a real look at what happens inside a hospital after a mistake occurs: what happens to the doctors, and what happens to the hospital.

Q: Two of your characters, Dr. Park and Dr. Ridgeway, learn there is more to life than chasing a career; that life is about caring for your family and your community of patients. Which of your characters do you relate to most, and why?

A: The characters were all composites of people that I’ve met in my life. Dr. Villanueva was the purest of the characters. You knew how he was going to behave in almost every situation. There were no soft edges to him, certainly, and he was insatiable. Dr. Ridgeway represents what we fear about organized medicine—working at this fancy hospital with all the bells and whistles, but there’s a free clinic just down the road and those people could really use my help.

Q: What are the three lessons you’d like us to learn from your novel?

A: First, most people who don’t work in hospitals or in the medical profession are unaware that a morbidity and mortality meeting even exists. Two is to recognize—as unsettling as it is to think about—that, ultimately, medicine moves forward because people learn from their mistakes, and that means that mistakes happen. But the worst crime of all would be that it continues to happen because no one learned from it. What I’m always struck by is when something has gone wrong and when everyone sort of knows that a mistake has happened, but hardly ever does anyone really have a completely candid meeting, not to be punitive, but to hold each other accountable and to say, “Look, can we all agree that this was a mistake? And can we all figure out a way not to let that happen again?” I think if we did that, if we applied what we know as surgeons and from M&Ms, to all sorts of different facets of our society, I just think things would run so much better, and there wouldn’t be so much dabbling around the edges with regard to these issues.

Q: How did you get your start in the media world?

A: I was a writer; I used to do a lot of writing for various magazines and then I worked at the White House as a fellow, where I primarily wrote speeches—mostly health care-related things in the early ’90s. Around that time there was an increasing demand for health care reporting in broadcast. I had been approached in 1997 and I didn’t really fully know how that would work. Then in 2001, I was coming to Emory University looking at a job and Atlanta happened to be CNN’s world headquarters. In the airport, I ran into the CEO, who had approached me originally. It was one of those serendipitous things. There wasn’t much of a plan when I agreed to do some television. It just sort of evolved, and in many ways I just sort of designed it as I was going along.

Q: You’ve got a venture under way now to bring Monday Mornings to television, as Chelsea General. Had you planned for your book to be developed into something for television?

A: That was not at all the intent. In fact, it’s tough sometimes to convert books to television shows. David E. Kelley, who is a terrific television writer and someone I’ve admired for some time, got a hold of the book early on and called me. He’s done a lot of legal shows, and he’s done other medical shows, including Chicago Hope and others, and he very much wanted to turn this into a TV show. So we had a lot of conversations, and eventually a pilot and it’s been accepted. We have to finish editing the pilot and then go back to the studios and figure out if there are changes to be made and all that. So it can be a long process.

Q: You’ve got at least three careers going simultaneously—neurosurgeon, TV correspondent for two networks, and you’re a bestselling author. How do you do it all? When do you sleep?

A: Some days if I’m really being very productive, I’ll be working late into the night, and other days, not as much. It varies, but [I usually get] about six hours sleep. I compartmentalize pretty well. So, I will operate every Monday and every other Friday, and see patients in the office on Thursdays. So, that’s 2½ to three days a week as a neurosurgeon, depending on the week. With the media stuff, I have some time Tuesdays and Wednesdays for my TV and magazine writing, and when I travel, the schedule varies.

Q: You’ve said that much of what you’ve learned about preventative measures was learned outside of medical school. If you became dean of your medical school at Emory, what would you change in the curriculum?

A: Well, keeping in mind it’s very hard to make broad sweeping changes, one thing I would focus on is nutrition, early on. I’d love to have a lot more focus on prevention. Some of the medical schools, certainly, over the last 20 years since I graduated, have gotten better about that, but not all. I’m always amazed at how poorly nutrition is either understood or taught and it’s sort of reflected in the practices of physicians today. I would rather see our patients never get sick in the first place; I think one place that begins is through smart nutrition, and doctors should be smart on this. They should be able to educate their patients. We shouldn’t be going to pills and procedures and diagnostic tests full of radiation so quickly.

Q: I know that you’ve worked hard to spread the message about prevention. What do you advise in the way of nutrition?

A: Very pragmatic sorts of things. One thing I try to do is to eat seven different coloured foods every single day. Two, is I would try to eliminate or greatly reduce meat intake. We’ve eaten meat, as a species, since the beginning of our existence, but we also combine that with lots of other things. We don’t exactly chase woolly mammoths through the forest anymore to get our meat. We sit down and eat meat all the time, and I think it’s probably one of the more significant risk factors for cardiovascular disease, along with sugar intake, which is something I would also greatly reduce. I think sugar is a calorie like no other. I think of the way it’s metabolized in the body, the way the liver becomes fatty as a result, and the way that your lipid levels can respond to sugar. Leaving aside diet for a second, I’m not a big person on gyms. I think that gyms can be a great idea, but I think the point is this: I don’t think the human body was designed to either sit or lie for 23 hours and then go to the gym for an hour a day. I think the more natural movements you can have in your daily life, the better.

Q: We’ve heard rumours you were considered for the surgeon general role by President Barack Obama. Had you accepted, what would have been your first act as surgeon general?

A: I would try to make us a healthier country and make sure that more people had access to health care. With regard to prevention, we have some incredible health tools and innovations nowadays that we didn’t have even a decade or two decades ago, but they’re not available to everybody. I think we’ll look back on this chapter of our collective history and say, “Well, that was pretty embarrassing that we did all these wonderful things and we made so many things possible in our lifetimes and yet people still died of preventable diseases.” I don’t think anyone finds that acceptable.

Dr. Elaine Chin is a regular contributor to Maclean’s, Canadian Business, Chatelaine and CityNews.

Women: The sadder sex?

By Julia Belluz - Thursday, April 12, 2012 at 11:00 AM - 0 Comments

Actress Charmiane Bonnet performs in the play, "I Am An Emotional Creature" in Johannesburg, South Africa. (Denis Farrell/AP Photo)

It’s seems to be a truth universally acknowledged in the scientific literature that women are the sadder sex. Women are twice as likely as men to suffer depression, and recent reports out of Canada add to the body of evidence on the collective female funk. According to Public Health Agency of Canada researchers, suicide rates are on the rise among teenage girls while they are dropping among young men. Another recent survey of 26,000 students across Canada found a higher prevalence of “emotional problems” among girls. In particular, while girls and boys reported feelings of depression at about the same rate in grade six, by grade 10, an inequality emerges: Thirty-eight per cent of girls reported feeling blue on a weekly basis, compared to 25 per cent of boys.

As one epidemiologist summed it up for Science-ish, “There is a saying among researchers at the population level: ‘Women live longer but they suffer more.’”

Theories about this gender gap in depression abound. There’s the biological explanation: Some say swinging sex hormones during a woman’s “window of vulnerability”—or her reproductive years—explain why females are twice as likely as males to develop depression starting around puberty. As this review put it, “Women are at a particularly high risk for depression during periods of hormonal fluctuation, such as during the premenstrual period, pregnancy, the postpartum period, the transition to menopause, and the early postmenopausal years.”

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Baby found alive in a morgue drawer—12 hours after being pronounced dead

By Gustavo Vieira - Wednesday, April 11, 2012 at 10:17 AM - 0 Comments

A mother found her newborn daughter alive 12 hours after the baby was pronounced stillborn—in a refrigerated drawer of a hospital morgue in Argentina.

In the Perrando Hospital of Resistencia, in the northern Argentine province of Chaco, Analia Bouter gave birth to her fifth child after a difficult and short 26-week pregnancy. According to the doctors, however, the baby girl was born without vital signs and later taken to the hospital’s morgue.

Quackbuster Joe Schwarcz takes on charlatans

By Joanne Latimer - Thursday, March 22, 2012 at 2:20 AM - 0 Comments

Photograph by Christine Muschi

The prognosis is not good for charlatans. Nor does the future look bright for wellness practitioners—the earnest touch therapists, energy healers and reiki masters—who post their business cards at health food stores. Those operating on the margins of the scientific and medical communities were served notice last November when Joe Schwarcz received a $5.5-million grant to further his work as Canada’s leading quackbuster.

“He’s the Carl Sagan of Canada,” said Lorne Trottier, the philanthropist who gave the endowment to McGill’s Office for Science and Society (OSS), where Schwarcz is the founding director. When Maclean’s reached Trottier via phone in Brazil, he was reading about climate science. “Like Joe, I’m appalled by the amount of sheer nonsense out there about health, the environment, everything,” said Trottier, co-founder of electronics company Matrox.

“Dr. Joe” is the public face of the OSS, as well as a working chemistry professor, radio host, newspaper columnist for the Montreal Gazette, author of 13 books and tireless tub-thumper against pseudoscience. The OSS was established in 1999, and McGill brought in Schwarcz, along with fellow chemists Ariel Fenster and David N. Harpp, to educate the public about matters of food, health, nutrition, medication, cosmetics—and misleading claims and possible fraud. The chemists and three interns offer continuing education classes, symposiums and public lectures. Working with the new cash injection—the interest from the $5.5-million endowment, minus the costs to run the annual Lorne Trottier Public Science Symposium to promote public science awareness—Schwarcz and his team have approximately $130,000 each year to extend the OSS’s reach and ensure the office continues when Schwarcz, 64, retires.

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