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May 2010 Health in the News Archive[ Monthly Index of New Briefs ]Pesticides in food linked to ADHDMay 26, 2010 Children exposed to higher levels of a type of pesticide found in trace amounts on commercially grown fruit and vegetables are more likely to have attention deficit hyperactivity disorder than children with less exposure, a nationwide study suggests.Researchers measured the levels of pesticide byproducts in the urine of 1,139 children from across the United States. Children with above-average levels of one common byproduct had roughly twice the odds of getting a diagnosis of ADHD, according to the study, which appears in the journal Pediatrics. Exposure to the pesticides, known as organophosphates, has been linked to behavioral and cognitive problems in children in the past, but previous studies have focused on communities of farm workers and other high-risk populations. This study is the first to examine the effects of exposure in the population at large. Organophosphates are "designed" to have toxic effects on the nervous system, says the lead author of the study, Maryse Bouchard, Ph.D., a researcher in the department of environmental and occupational health at the University of Montreal. "That's how they kill pests," says Bouchard. "It's not a small effect. This is 100 percent more risk." Pesticides act on a set of brain chemicals closely related to those involved in ADHD, Bouchard explains, "so it seems plausible that exposure to organophosphates could be associated with ADHD-like symptoms." Environmental Protection Agency regulations have eliminated most residential uses for the pesticides (including lawn care and termite extermination), so the largest source of exposure for children is believed to be food, especially commercially grown produce. Dr. Grout's Comment: Detectable levels of pesticides are present in a large number of fruits and vegetables sold in the U.S., according to a 2008 report from the U.S. Department of Agriculture. Organic fruits and vegetables contain much less pesticides, and national surveys have shown that fruits and vegetables from farmers' markets contain less pesticides even if they're not organic. Is the U.S. healthcare system imploding?May 25, 2010 An essay by Richard Amerling, MD, predicts that current changes to the healthcare reimbursement system will create a dual system of medicine. Amerling is an Associate Professor of at Albert Einstein College of Medicine in New York, and the Director of Outpatient Dialysis at the Beth Israel Medical Center. He writes:"The [recent healthcare] legislation pushes millions into Medicaid… Flooding it with new beneficiaries will hasten its bankruptcy. Likewise, Medicare is to be cut by $500 billion at a time when the baby boomers will be enrolling. The program is already running at a deficit. In other words, both systems will implode. "At the same time, incentives for employers to provide health care will be lessened, and many will drop coverage, sending millions to the government cooperatives for coverage. These policies will be heavily subsidized by the taxpayer, and will dramatically swell an already very bloated public sector. "Collapse is inevitable unless Washington does an about-face. How is the medical profession responding? Two articles published this week provide a glimpse into the future. Scott Gottlieb writes in the Wall St. Journal, ‘In 2005, doctors owned more than two-thirds of all medical practices. By next year, more than 60% of physicians will be salaried employees. About a third of those will be working for hospitals.' On the other side, the Houston Chronicle reports that Texas physicians are not only declining to take new Medicare patients, but that ‘new data shows 100 to 200 a year are now ending all involvement with the program. Before 2007, the number of doctors opting out averaged less than a handful a year.' The article quotes Dr. Susan Bailey, president of the Texas Medical Association: ‘This new data shows the Medicare system is beginning to implode. If Congress doesn't fix Medicare soon, there'll be more and more doctors dropping out and Congress' promise to provide medical care to seniors will be broken.' "How to reconcile these reports? We are moving towards a dual system in medicine… Outside the hospital setting will be a thriving, private, medical marketplace, anchored by a growing number of private physicians who are opting out of Medicare and other third party arrangements. These doctors will develop busy practices, and will be able to stay in business by setting their own rates, cutting overhead, and controlling their volume. They will be able to spend enough time with patients to ensure a high quality experience, and will work to keep patients healthy and out of the hospital." Dr. Grout's Comment: To some extent here in Arizona we already have a dual system. Many homeopathic and naturopathic physicians do not take insurance. We still do it the old fashioned way – the patients actively choose us, get lots of time during appointments, have lots of options for treatment, and pay directly for services rendered. If indeed the health care system implodes as Dr. Amerling suggests, there could be a lot of upside. Climate warming an argument for more GM food May 24, 2010The U.S. State Department will aggressively confront critics of agricultural biotechnology as the United States seeks to mitigate the effects of climate change, Jose Fernandez told several hundred attendees from around the world at the Biotechnology Industry Organization's annual convention in Chicago this month. Fernandez is the assistant secretary for the U.S. Bureau of Economic, Energy and Business Affairs. Fernandez said the State Department is ready to take on the naysayers. Agriculture has greater potential to mitigate climate change than either energy or transport measures, he said. "There are more people in the world, and the world is getting warmer. Our challenge is to produce more food with less." Noting Turkey's recent ban on biotech food imports and India's rejection of biotech eggplant cultivation, Fernandez said the State Department is "working to overcome these obstacles." He outlined a four-pronged strategy to promote biotech crops worldwide: (1) highlighting the science; (2) confronting the critics; (3) building alliances; and (4) anticipating and addressing roadblocks to acceptance. Dr. Grout's Comment: This is a very unfortunate approach. A recent report by the Union of Concerned Scientists demonstrates that genetically modified crops do not increase crop yields. USAID has already spent millions of taxpayer dollars developing GM crops over the past two decades, without a single success story to show for it, and plenty of failures. GM seeds are more expensive, use more water, and create devastating weeds that are resistant to chemical weed killers. Statin drugs cause erectile dysfunction, low sex driveMay 21, 2010A 2010 study published in the Journal of Sexual Medicine found that statin drugs lower testosterone levels and contribute to ED. Research from 3,484 men demonstrated that "Statin therapy might induce an overt primary hypogonadism [decreased production of testosterone] and should be considered as a possible confounding factor for the evaluation of testosterone levels in patients with erectile dysfunction." Statins work by inhibiting an enzyme involved in synthesis of cholesterol, which in turn would inhibit the synthesis of steroids. Previous studies examining the possibility that inhibiting cholesterol synthesis may interfere with testosterone production have met with mixed results, the authors noted. Dr. Grout's Comment: Erectile dysfunction, ED, remains a greatly under-reported adverse drug reaction because men often are not forthcoming about it, and doctors do not usually ask men about ED when prescribing statins. Research presented at the Second Princeton Consensus Conference on Sexual Dysfunction and Cardiac Risk indicates that ED affects more than half of men who are 60 or older. The question of whether the drugs used to treat these conditions might also be contributing to ED has not received much consideration. Study finds a hint of evidence that cell phones cause cancerMay 18, 2010 The Interphone, a long-awaited study of cell phone use and brain health, was released this week. The study spans 13 countries and a decade in time. The results – unclear. The study results, published in The International Journal of Epidemiology, were delayed by four years, reportedly after researchers disagreed over how to present the results.The final paper states: "There were suggestions of an increased risk of glioma at the highest exposure levels, but biases and error prevent a causal interpretation. The possible effects of long-term heavy use [30 minutes or more a day] of mobile phones require further investigation." The problem, say the researchers, is how the study was done. The Interphone study was an epidemiological case-control study that began with cases — people with brain tumors — and controls — people with no cancer — and asked them to remember how much they had used mobile phones in previous years. According to Mireille Toledano, an epidemiologist at Imperial College London, case-control studies are particularly problematic when they are used for something like mobile phones. If the study were looking at another exposure, say asbestos at work, she explained, scientists would have other documents such as employer records, clocking-in times and other pieces of data to help build up a more objective picture. "The problem with mobile phones is that when you're trying to do a retrospective study like this, you're almost totally dependent on people recalling. You haven't got anything else on which to base your data," she said. "To me, there's certainly smoke there," said Elisabeth Cardis, who leads the Interphone project. "Overall, my opinion is that the results show a real effect." Dr. Cardis is with the Center for Research in Environmental Epidemiology in Barcelona. Siegal Sadetzki, the Israeli member of Interphone, pointed out that while the risks are inconclusive, a number of the results show some consistency. These include increased risks among the heaviest users, the fact that the risks were highest on the side of the head the phone was usually used and that the tumors were in the temporal lobe of the brain, which is closest to the ear. Sadetzki is with the Gertner Institute outside Tel Aviv. "The data are not strong enough for a causal interpretation, but they are sufficient to support precautionary policies," she said. Dr. Grout's Comment: Design flaws render this study almost inconclusive. Science requires data to meet very strong criteria before you can say there is an association. One also has to note that the study was funded primarily by the European cell phone industry and the European Commission. Unregulated chemicals cause cancerMay 11, 2010An expert panel that advises the president on cancer said that Americans are facing "grievous harm" from chemicals in the air, food and water that have largely gone unregulated and ignored. The President's Cancer Panel called for a new national strategy that focuses on such threats in the environment and workplaces. Epidemiologists have long maintained that tobacco use, diet and other factors are responsible for most cancers, and that chemicals and pollutants are responsible for perhaps just 5 percent. The presidential panel said that figure has been "grossly underestimated" but it did not provide a new estimate. "With the growing body of evidence linking environmental exposures to cancer, the public is becoming increasingly aware of the unacceptable burden of cancer resulting from environmental and occupational exposures that could have been prevented through appropriate national action," the panel wrote in a lengthy report. Children are particularly vulnerable because they are smaller and are developing faster than adults, the panel found. The report noted unexplained rising rates of some cancers in children, and it referred to recent studies that have found industrial chemicals in umbilical-cord blood, which supplies nutrients to fetuses. "To a disturbing extent, babies are born 'pre-polluted,' " the panel wrote. In 2009, about 1.5 million American men, women and children had cancer diagnosed, and 562,000 people died from the disease. "There are far too many known and suspected cancer-causing chemicals in products people, young and old, use every day of their lives," said Kenneth A. Cook, president and co-founder of Environmental Working Group, an environmental advocacy group. "Many of these chemicals are believed to be time bombs, altering the genetic-level switching mechanisms that lead to cancerous cellular growth in later life." Dr. Grout's Comment: Hallelujah! After 40 years of losing the war on cancer, this watershed report may finally signal a fundamental shift toward a winning strategy. The Panel levels a hefty critique of failed regulation of environmental contaminants, undue industry influence, and inadequate research and funding. It also says that the government - and institutions that advise the government - have been locked in a cancer-fighting paradigm that has failed to look at the complexity of cancer causation and, in so doing, have missed the opportunity to create a national campaign for cancer prevention. |
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