Saturday, October 03, 2009

A most instructive finding

Vaccinated British teenager killed by tumour NOT the vaccine. Temporal conjunction is not causation. Danger in a therapeutic product should be judged by the number who do NOT suffer ill effects. Drugs such as Vioxx that were taken safely by hundreds of thousands get taken off the market because of apparent adverse effects of the drug in a handful of cases. But it is just superstitious and implausible guesswork to assume that the rare ill-effects were due to the drug. The case below is instructive because the initial accusations against the vaccine could clearly be shown to be wrong

THE teenage girl who died shortly after being immunised against cervical cancer was killed by a malignant chest tumour and not by a reaction to the vaccine manufactured by GlaxoSmithKline, an inquest has heard. Natalie Morton, 14, fell ill on Monday after being vaccinated at her school under a national immunisation programme against the sexually transmitted human papilloma virus (HPV). She died a few hours later after being admitted to hospital.

"The pathologist has confirmed today at the opening of the inquest into the death of Natalie Morton that she died from a large malignant tumour of unknown origin in the heart and lungs," said Dr Caron Grainger, joint director of public health for the Coventry area where Natalie died. "There is no indication that the HPV vaccine, which she had received shortly before her death, was a contributing factor to the death, which could have arisen at any point," Dr Grainger said.

In paying tribute to Natalie, her stepfather Andrew Bullock said she was "kind, fun-loving and had a beautiful smile". "We will miss her very much", he said.

The Department of Health said the immunisation program was continuing and that to date more than 1.4 million doses of Cervarix have been administered. Manufacturer GlaxoSmithKline had recalled the batch of vaccine used at the school pending an investigation. "GSK's deepest sympathies lie with the parents at this very sad time," said a spokeswoman, adding that she did not want to comment further.

The program to vaccinate girls aged 12 to 13 began in September 2008 to fight cervical cancer, which is the 12th most common women's cancer in Britain, killing more than 1000 each year.

News of Natalie's death came shortly before US health regulators again delayed a decision on whether to allow Glaxo to sell Cervarix in the United States where a panel of specialists has recommended its use. An advisory panel to Japan's Health Ministry backed the vaccine earlier this week.


The elixir of life? Diabetes pill could help you live longer and stay healthier

Rather a lot of bright-eyed optimism here: The sort of optimism that can lead to iatrogenic disasters. These results derive from genetically defective mice and even findings from normal rodents do not always generalize well to humans -- and there will undoubtedly be side effects of as yet unknown severity

A cheap pill taken by millions of diabetics could hold the secret to a long and healthy life. Research suggests that metformin, which costs as little as 2p a tablet, could extend human life. It may also be able to keep us physically agile and mentally sharp in old age, it was found. There are even indications that it can help prevent people putting on weight.

Professor Dominic Withers, of University College London, said the findings suggest it would be possible to establish drugs to combat ageing. The researchers took their inspiration from studies on worms, flies and dogs that showed those on very low-calorie diets tend to live longer, healthier lives. To mimic the effect, without the need for dieting, they created designer mice unable to make a key protein called S6K1. Experiments showed that blocking S6K1 raises levels of an energy sensor called AMPK. When we eat less, levels of AMPK rise, and the body goes into a survival mode and ageing slows.

Metformin, which has been safely used for more than 50 years to control blood sugar levels in age and obesity-related diabetes, has also been found to raise levels of AMPK. The tests found that both sexes of mice were healthier, but the effects were most dramatic in the females, which also lived longer. Their lifespan increased by an average of 20 per cent. But a few saw an increase of more than 50 per cent, the journal Science reports.

In 'middle-age', the creatures were leaner than ordinary mice of the same age and had stronger bones and better balance, strength and co-ordination. They were also more inquisitive, suggesting they were mentally sharper. Even their immune systems appeared stronger and more youthful. It is hoped that metformin may mimic these other effects of blocking S6K1.

In the case of the diabetics who are already taking it, its ability to extend life may be cancelled out by the effects of the disease.

Professor Withers plans to test the drug's anti-ageing abilities in mice and hopes to start the first human trials within five years. These would be likely to be in obese people whose weight puts them at risk of diabetes and other conditions in later life. The researchers also want to test the drug's ability to ward off Alzheimer's.

Trials with laboratory mice have produced encouraging results so far. Metformin's long record as a safe drug means it would have to go through fewer safety tests than a brand-new medicine. But it is still likely to be 15 years before it is widely used to protect against the diseases of old age. In the meantime, the professor 'strongly advises' against healthy adults taking the medicine in the hope of extending their life.

Researcher Dr David Gems said: 'We are suddenly much closer to treatments for ageing than we thought. 'We have moved from the initial findings in worm models to having "druggable" targets in mice. 'The next logical step is to see if metformin can slow the ageing process in humans.'


Keep your self-righteous fingers off my processed food

Just in time for the worst economic downturn since the Depression, here comes a new crop of social critics to inform us that we're actually spending too little for the food we eat, the clothes we wear, the furniture we sit on, and the gasoline that runs our automobiles.

Never mind that US job losses these days range from 200,000 to 500,000 a month, that foreclosures are up 32 percent over this time last year, and that people are relearning how to clip newspaper coupons and save at the supermarket. Dire economic circumstances don't seem to faze these spending enthusiasts, who scold us for shopping at supermarkets instead of at farmers' markets, where a loaf of "artisanal" (and also "sustainable") rye bread sells for $8, a cup of ice cream for $6, and a pound of organic tomatoes goes for $4.

The latest cheerleader for higher prices is Ellen Ruppel Shell, a professor of science journalism at Boston University who has just published a book titled Cheap. It's not a guide to bargain-hunting. The theme of Shell's book, subtitled The High Cost of Discount Culture, is "America's dangerous liaison with Cheap."

Shell's argument goes like this: shopping at discount stores, factory outlets, and, of course, Wal-Mart (no work of social criticism is complete without a drive-by shooting aimed at that chain) exploits Chinese factory workers (who would much rather be back on the collective farm, wearing their Mao suits) and degrades the environment because much of the low-price junk wears out and ends up in landfills.

Even IKEA comes in for a drubbing in Shell's book. Yes, the Swedish chain's inexpensive, assemble-yourself furniture may look tasteful, but behind every Billy bookcase lies a gruesome tale (in Shell's view) of Siberian forests ravaged for all that pine veneer, and gallons of fossil fuel burned by couples motoring to IKEA's remote store locations, strategically chosen for their rock-bottom land values. Most damaging of all, says Shell, is the cost to America's soul.

"The economics of Cheap cramps innovation, contributes to the decline of once flourishing industries, and threatens our proud heritage of craftsmanship," she writes. In her view, we should all save up for "responsibly made quality goods," preferably from shops attainable by "public transit."

Maybe it's because I've got IKEA furniture in every room in my house (although my husband did finally lay down his Allen wrench and declare a permanent strike against "assemble-yourself," forcing us to move up the socio-furniture-nomic scale to Crate & Barrel), but I ask, what's wrong with low prices? If you don't care for the quality, well, as my mother always says, you get what you pay for.

In an online debate with the Atlantic's economics writer, Megan McArdle, Shell observes with disapproval that, when prices are adjusted for inflation, Americans today spend "40% less on clothes, 20% less on food, more than 50% less on appliances, about 25% less on owning and maintaining a car" than they did during the early 1970s. Over that same period, Census Bureau tables show, US median household income rose by at least 18% in constant dollars — despite the much-lamented (by Shell and others) decampment of "once-flourishing" manufacturing jobs to China and elsewhere. That's why even America's poorest people nowadays can afford automobiles, cell phones, and TVs.

Yet a significant number of social critics wish they couldn't. Robert Pollin, an economics professor at the University of Massachusetts-Amherst — cited approvingly by Shell — has argued for higher clothing prices and steep taxes on fossil fuels in the name of various social and green causes, even though, as he conceded in a January article in the Nation, the latter measure would "impose higher energy prices on businesses and individuals." "Even America's poorest people nowadays can afford automobiles, cell phones, and TVs. Yet a significant number of social critics wish they couldn't."

The most zealous of the spend-more crowd, however, are the food intellectuals who salivated, as it were, at a steep rise in the cost of groceries earlier this year, including such basics as milk and eggs. Some people might worry about the effect on recession-hit families of a 17% increase in the price of milk. Not Alice Waters, the food-activist owner of Berkeley's Chez Panisse restaurant, who shudders at the thought of sampling so much as a strawberry that hasn't been nourished by organic compost and picked that morning at a nearby farm — and she thinks everyone else in America should shudder too. "Make a sacrifice on the cell phone or the third pair of Nike shoes," Waters airily informed the New York Times in April.

Echoing Waters was her fellow Berkeley food guru, Michael Pollan, professor of science journalism (a hot field for social critics, obviously) at UC Berkeley. Pollan (no relation to Robert Pollin) is the author of the best-selling Omnivore's Dilemma and coiner of the mantra "Eat food, not too much, mostly plants" that is on the lips of every foodie from Bainbridge Island to Martha's Vineyard. Pollan, too, rejoices at the idea of skyrocketing prices for groceries, hoping they might "level the playing field for sustainable food that doesn't rely on fossil fuels."

Pollan also hopes that rising prices might constitute another weapon in his ongoing war against his agribusiness villain of choice: corn. Corn is a plant, of course, and thus should theoretically rank high on Pollan's list of permissible edibles. But it is also the basis of such dubious items as snack chips, Coca-Cola (made with high-fructose corn syrup, the godfather of obesity) and suspiciously plentiful beef (corn-fed).

Pollan is a "locavore," one of those people who believe that in order to be truly ethical, you should eat only foods grown or killed within your line of sight (for me, that would be my neighbor's cat). He once described a meal he made consisting of a wild boar shot by him in the hills near his Bay Area home and laboriously turned into pate, plus bread leavened by yeast spores foraged from his backyard.

Lately, Pollan has set his sights on Häagen-Dazs ice cream, not because it contains corn syrup (it doesn't) but because it's a commercially made product, and if there's one thing Pollan hates, it's commerce. His latest pronunciamento is "Don't buy any food you've ever seen advertised."

Demanding that other people impoverish themselves in the name of your pet cause — fostering craftsmanship, feeling "connected" to the land, "living more lightly on the planet," or whatever — goes way beyond Marie Antoinette saying "let them eat cake." It's more like Marie Antoinette dressing up in her shepherdess costume and holding court in a fake-rustic cottage at the Petit Trianon.

Those who think that there is something wrong with owning more than two pairs of sneakers or that exquisite fastidiousness about what you put into your mouth equals virtue need to be teleported back to, say, the Depression itself. Then, privation was in earnest and few people had telephones, much less cell phones.

Read some 1930s memoirs: Back then, people who couldn't afford "quality" furniture slept on mattresses on the floor and hammered together makeshift tables out of orange crates. They went barefoot during the summer and sewed their children's clothes out of (nonorganic) flour sacks. That was what "cheap" meant then — not today's plethora of affordable goods, which the social critics would like to take away from us.

Meanwhile, Professor Pollan, eat all the "plants" you like — but don't try to pry me from my Häagen-Dazs dark-chocolate ice cream. I bought it at Safeway, and it's sitting on my IKEA kitchen table.



John A said...

"The economics of Cheap cramps innovation, contributes to the decline of once flourishing industries, and threatens our proud heritage of craftsmanship"

Yep. Why, just that darned Ford feller plumb druv ninety percent of buggy-whip manufacturers outta busiess. Not to mention the bottom falling out of the willow-bark farmers when some company come up with that-thar "aspirin" stuff.

Lena said...

Hah. Metformin decreases your body's ability to absorb vitamin B12 from food. Vitamin B12 deficiency is one of the worst, it causes neuropathy and severe mental problems among other things, and is often misdiagnosed as multiple sclerosis, Parkinson's disease, or Alzheimer's. So if they think giving metformin will ward off dementia and illness, they are dead wrong. Metformin has also been known to cause pancreatitis.