Former President Bill Clinton is out of the hospital today after seeing a doctor in New York about chest pains this week. Clinton showed no evidence of a heart attack and his prognosis is excellent after a procedure Thursday to insert two stents in a coronary artery that had become blocked, said his cardiologist Dr. Alan Schwartz [Los Angeles Times].
Clinton’s rush to the hospital brought new attention to the common medical practice of using stents in heart patients. A stent is a small wire mesh tube that is inserted into an artery in order to prop it open, like a miniature scaffold. Surgeons use stents to improve blood flow to the heart muscle and relieve symptoms such as the chest pain that Clinton experienced [ABC News]. Most people who undergo coronary angioplasty procedures receive stents. Once the tube is in the artery, the artery grows over it and it becomes a permanent part.
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Scientists have argued before that controlling the earth’s burgeoning population would be one of the most effective ways to slow global warming, since keeping millions of little consumers from being born would reduce the amount of fossil fuel that would have to be burned to keep them warm and fed and happy. Now, an advocacy group that focuses on overpopulation is taking the argument the next step, suggesting that people or companies looking to offset their carbon dioxide emissions should buy contraception that would be distributed in poor countries.
Optimum Population Trust (Opt) stresses that birth control will be provided only to those who have no access to it, and only unwanted births would be avoided. Opt estimates that 80 million pregnancies each year are unwanted. The cost-benefit analysis commissioned by the trust claims that family planning is the cheapest way to reduce carbon emissions [The Guardian].
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Don’t let anyone treat you badly because of your genes. As of this weekend, it will be against the law.
The Genetic Information Nondiscrimination Act (GINA) prevents both employers and insurance companies from requiring genetic tests or from using your family’s medical history against you. The biggest change resulting from the law is that it will–except in a few circumstances—prohibit employers and health insurers from asking employees to give their family medical histories. The law also bans group health plans from the common practice of rewarding workers, often with lower premiums or one-time payments, if they give their family medical histories when completing health risk questionnaires [The New York Times]. The law also bars employers from requiring genetic testing or using such information to make decisions on hiring, firing or promoting employees.
To alleviate the privacy concerns of people that have had genetic testing, Congress stepped in and passed GINA last year. The act takes effect Nov. 21 for all employers with 15 or more employees. It applies to group health insurers whose plan years begin on or after Dec. 7, and it took effect for individual health insurance plans last May. The act does not apply to life insurers. The act would ban a company from not promoting a 49-year-old to chief executive because it knew his father and grandfather died of heart attacks at age 50 [The New York Times]. It is still legal for employers to glean information about an employee’s medical history from family obituaries, or to inquire why an employee missed work to care for a sick relative under the Family Medical Leave Act. However, it will now be illegal to use this information to somehow penalize the employee.
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Image: flickr / IRRI Images
Aficionados of 3AM Vodka, Max Fury, and Slingshot Party Gel, take heed! The Food and Drug Administration is casting a wary eye on your classy energy drinks. The federal agency has requested proof from the drink manufacturers that these combinations of caffeine and alcohol are, in fact, safe to drink. The FDA never has approved the addition of caffeine to an alcoholic beverage, and a task force of state attorneys general and other officials has urged the agency to scrutinize the combination. The task force argues that the caffeine can mask the intoxicating effects of alcohol, possibly leading to an increase in drunk driving, sexual assault and other destructive behavior [Los Angeles Times]. Since the FDA never approved the drinks in the first place, the burden of proof falls on the manufacturers, and now the FDA is forcing their hands.
And the FDA isn’t joking around. Companies including Diageo North America Inc., Constellation Brands Inc. and United Brands Co. were told that unless they could provide evidence of safety, the agency will “take appropriate action to ensure that these products are removed from the marketplace,” according to letters sent to the companies and released by the agency [Bloomberg]. The drink companies now have 30 days to respond to the request.
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In an Italian court, a murderer has just had his sentence reduced because the judge agreed that the man’s genes predisposed him to violent behavior.
Abdelmalek Bayout, an Algerian immigrant to Italy, admitted to stabbing and killing Walter Felipe Novoa Perez, a Colombian, when the two men got in a fight over the kohl eye make-up that Bayout was wearing. At trial, the defense team argued that Bayout was mentally ill at the time of the murder; the judge agreed that his psychiatric condition was a mitigating factor, and gave him a reduced sentence of 9 years. But at an appeal hearing, Bayout’s lawyers argued that his sentence should be shortened further based not just on psychiatric evaluations, but also brain scans and genetic testing.
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The United States will end its long-standing ban that prevents foreigners with HIV from entering the country. President Obama announced the change on Friday, saying that the exclusionary rule had been “rooted in fear rather than fact.” The policy has been in place for 22 years, and was enacted at a time when people still wondered whether HIV could be transmitted through physical or respiratory contact. It will officially be repealed at the start of 2010.
The ban applied both to tourists wishing to visit the United States and to foreigners who hoped to live and work here. Only about a dozen other countries still bar people with HIV or AIDS from entering. “If we want to be a global leader in combating H.I.V./AIDS, we need to act like it,” Mr. Obama said. “Now, we talk about reducing the stigma of this disease, yet we’ve treated a visitor living with it as a threat” [The New York Times].
Gay advocates said the ban also discouraged travelers and some foreigners already living in the United States from seeking testing and medical care for H.I.V. infection. “The connection between immigration and H.I.V. has frightened people away from testing and treatment” [The New York Times], said Rachel Tiven of the advocacy group Immigration Equality.
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Image: flickr / Doug Letterman
The U.S. Justice Department has officially instructed federal prosecutors around the country to stop going after medical marijuana users who are complying with state laws. A total of 14 states now have some provisions for medical marijuana use.
A memo from Deputy Attorney General David Ogden said it was “unlikely to be an efficient use of limited federal resources” to prosecute “individuals with cancer or other serious illnesses who use marijuana as part of a recommended treatment regimen” [The Wall Street Journal]. The memo emphasized, however, that prosecutors should continue to target drug traffickers and distributors who use state laws as a cover for illegal activity.
Supporters of the policy change say it represents a new emphasis on violent crime and the sale of illicit drugs to children…. But some local police and Republican lawmakers criticized the change, saying it could exacerbate the flow of drug money to Mexican cartels, whose violence has spilled over the Southwestern border [Washington Post].
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For many rape cases, the only leads investigators have to follow are the clues spelled out by a DNA sample. If after years the DNA isn’t matched to a suspect the case goes cold and the victim never has closure. A few years ago, when there was still a statute of limitations for rape in New York City, prosecutors devised a clever way to side-step the ticking clock—they decided to simply indict the DNA profile. Since then, New York City prosecutors have secured 117 indictments of DNA samples in rape cases, linked 18 of those profiles to specific people, and obtained 13 convictions, either through trials or negotiated pleas. Five cases are pending [The New York Times].
Called John Doe DNA indictments, the strategy is also used in a handful of other states to help solve sex crimes, and its success has prompted officials to expand DNA indictments to other types of crimes. In New York, authorities are now collecting more DNA evidence from the scenes of everyday crimes. They hope to use DNA to help solve unsolved crimes from the past that are subject to a statute of limitations, like burglary, robbery or serial car theft [The New York Times]. Opponents of John Doe DNA indictments say the passage of time, along with fading memories and disappearing witnesses, hinders the defendant’s ability to mount a defense, and that old DNA samples are subject to depredation and mishandling. However New York officials counter by saying it’s irresponsible to ignore genetic evidence, especially with modern molecular biology tools.
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Image: flickr / [puamelia]
Forget, for a moment, all those fancy geoengineering schemes that would alter the face of the planet in an attempt to reduce global warming’s impact. Population scientists argue that a cheaper and simpler strategy is to hand out birth control to those who want it–especially to people in the developing world, where birth rates are booming.
The world’s population is projected to jump to 9 billion by 2050, with more than 90 percent of that growth coming from developing countries…. In countries with access to condoms and other contraceptives, average family sizes tend to fall significantly within a generation. Until recently, many U.S.-funded health programs did not pay for or encourage condom use in poor countries, even to fight diseases such as AIDS [AP].
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“Killing season,” a term used to describe the time when junior doctors take over at hospitals, was thought to be just an unsettling joke. However, British researchers found hospital mortality rates rise by 6 per cent on the first Wednesday in August. Perhaps not coincidentally, that is also the day newly qualified doctors, fresh from medical school, are let loose on the wards of [England's National Health Service] hospitals [Daily Mail]. There could be lots of explanations for the increase, so the authors say their data doesn’t mean people should shy away from hospitals during this week, but they do say the increase is statistically significant. The report was published recently in the journal PLoS ONE.
To arrive at their result, an Imperial College team looked at 300,000 emergency patients admitted to English hospitals between 2000 to 2008. They compared death rates between the first week of August, when new doctors arrive, and the previous week in July [BBC News]. The study’s authors note that past studies looking at mortality rates before and after junior doctors take over did not find any difference. The results could be due to the different types of patients being admitted, but if it turns out to that there is some merit to the “killing season” myth, it could have large implications for how young doctors are turned loose.
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Another day, another swine flu story: Amidst all the chatter, it can be hard to find the most reliable sources and relevant info. To keep you informed of the latest intelligence, 80beats will round up the news each week.
On Monday, the President’s Council of Advisors on Science and Technology issued an alarming report spelling out a “plausible scenario” for how the swine flu pandemic will play out during the coming flu season. The report estimated that the H1N1 virus could hospitalize 1.8 million Americans, potentially clogging emergency rooms and intensive care wards, and could kill up to 90,000 people in the United States. In a typical year, the seasonal flu virus kills about 35,000 Americans.
But on Tuesday, some public health officials walked back the report’s conclusions. One expert who helped prepare the report said that the numbers were probably on the high side, given that some weeks had passed since the calculations were finished in early August. “As more data has come out of the Southern Hemisphere, where it seems to be fading, it looks as if it’s going to be somewhat milder,” said the expert, Marc Lipsitch…. “If we were betting on the most likely number, I’d say it’s not 90,000 deaths; it’s lower” [The New York Times].
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In an attempt to steer organ donation away from organs purchased on the black market or harvested from executed prisoners, China has announced a system to coordinate voluntary organ donation. The details of the new system are still under development, according to Chinese officials.
Although China is far from the only country facing a shortage of donor organs, the number of people who plan to donate is astoundingly low–since 2003, only 130 people have pledged to give up their organs after they pass away. Chinese officials estimate that 1.5 million Chinese need transplants annually but only 10,000 are performed due to donor shortages [The Wall Street Journal]. Of the transplants performed, officials estimate that at least 65 percent use organs from executed prisoners.
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In an effort to stop the spread of HIV, public health officials are considering initiating a program that would encourage circumcision for all newborn boys in the United States.
Studies have shown that heterosexual adult men reduce their risk of HIV by 50 percent by being circumcised. “We have a significant H.I.V. epidemic in this country, and we really need to look carefully at any potential intervention that could be another tool in the toolbox we use to address the epidemic…. What we’ve heard from our consultants is that there would be a benefit for infants from infant circumcision, and that the benefits outweigh the risks” [The New York Times], says CDC epidemiologist Peter Kilmarx.
On the other hand, circumcision has not been shown to reduce HIV risk among men who have sex with men–the U.S. demographic with the highest risk of contracting the virus. And the American Academy of Pediatrics does not currently endorse routine circumcision, as it doesn’t consider the procedure essential to a baby’s well-being. Finally, nearly four-fifths of American men are circumcised, so it’s not clear whether a policy recommending circumcision would have much impact.
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Researchers have found a way to reduce the ill-effects of heroin addiction and to generally keep the addicts out of trouble, but there’s a catch: The solution is to give the addicts injections of a pure form of pharmaceutical heroin twice a day. In a fascinating new study, Canadian researchers found that addicts who received the prescription heroin were more likely to stay in treatment than those given methadone, the commonly prescribed opioid that manages heroin cravings without providing the high. Experts say lengthy treatment is often needed to treat other diseases as well as provide counseling to reverse criminal behavior and otherwise stabilize addicts’ lives and improve the chances that they will stop using heroin [The Wall Street Journal].
The study enrolled 226 heroin addicts who had been using the drug for at least five years, and who had failed to stick with a methadone-treatment program at least once. Half the subjects came to the clinic to receive shots of diacetylmorphine—pure heroin—while the other half received standard methadone treatment. After one year, 88% of those in the diacetylmorphine group were still in treatment, compared with 54% in the methadone group [Los Angeles Times]. The test subjects who received heroin were also more likely to reduce their criminal behavior and their drug use outside the clinic, according to the study published in the New England Journal of Medicine.
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Antiviral treatments such as Tamiflu should not be administered to children under the age of 12 because the risks of the drugs outweigh the possible benefits in lessening symptoms of swine flu, according to a study published in the British Medical Journal.
Although antiviral drugs can shorten the duration of the flu in children by an average of 1.5 days, they fail to fight certain effects of the infection, having little effect on the risk of asthma flare-ups, for instance. In fact, the drugs can bring dangerous side effects like vomiting, which can be dangerous because it puts children at risk of dehydration. In the research review, scientists looked at four trials of 1,766 children treated with antivirals, including 1,243 with confirmed flu, and three trials of 863 who were exposed to flu but didn’t exhibit symptoms and were treated with antivirals preventively. Only one trial looked at children with asthma [CBC]. Overuse of antivirals can also increase the risk of viral strains that become resistant to such treatments.
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