Today’s POV blog

The U.S. Preventive Services Task Force (USPSTF) is an independent panel of experts in primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services. In layman’s terms, this group reviews and gives advice to you and me about health services and healthy living.

The USPSTF makes recommendations on all sorts of topics — everything from alcohol misuse to cancer, from heart disease to Alzheimer’s, and from exercise to STDs. Last month, the USPSTF announced that the organization no longer recommends that women begin mammogram screening at 40, but rather that they delay until the age of 50.

As benign as this may seem at first blush, Republicans, such as Rep. Marsha Blackburn, are leveling accusations and intimating that this “medical rationing.” The concern is that this type of rationing will be commonplace under the new healthcare reform.

In support of the USPSTF’s recommendations and according to GlobalHealingCenter.org, while mammograms do help detect some breast abnormalities, they might actually be increasing the occurrence of breast cancer. Recent research has shown that repeated exposure to mammograms may act as an independent risk factor for breast cancer.

At the center of this concern is the amount of radiation to which the patient is exposed during her annual mammogram. A typical x-ray exposes the patient to 1 rad and each rad is believed to increase the breast-cancer risk by 1%. By starting annual mammograms at 40, the patient is exposed to an addition 10% risk.

In a story reported by Time, the USPSTF is surprised at all the political hoopla. According to member Dr. Diana Petitti, an Arizona State University professor and vice chair of the task force, “Our attempt to communicate [the risks and benefits of] routine screening was definitely lost.”

On 19 October 2009, the Obama administration announced new policy guidelines for federal prosecutors instructing them to cease arresting medical marijuana users and suppliers who are conforming to state laws.

Describing the new policy, two Justice Department officials said prosecutors will be told it is not a good use of their time to arrest people who use or provide medical marijuana in strict compliance with state laws. This policy is vastly different from that of the Bush administration that staunchly enforced federal anti-pot laws regardless of state codes.

Despite the announcement by the Obama administration, at an online town hall meeting in March of this year, Obama rejected the argument that legalizing, regulating, and taxing marijuana would be a good way to raise money in this recession. Obama did not elaborate with any particular details on his position.

Contrary to the opinion of Obama, in Colorado, Denver City Council members Chris Nevitt and Charlie Brown believe that the establishment of a city sales tax on medical marijuana sales could generate millions of dollars. “We’ve got to tax this damn thing at the city rate, which is 3.62 percent,” Brown told 420Butts.com.

There are currently fourteen states that allow some use of marijuana for medical purposes (Alaska, California, Colorado, Hawaii, Maine, Maryland, Michigan, Montana, Nevada, New Mexico, Oregon, Rhode Island, Vermont, and Washington), and about a dozen more have considered or are considering it. Polls across America show broadening support for marijuana legalization.

On Tuesday, the American Medical Association announced that it has reversed its policy establishied in 1997 that marijuana should be classified as a Schedule I controlled substance, the most restrictive category, which also includes heroin and LSD. The AMA now states that it will promote clinical research and development of cannabis-based medicines and alternative delivery methods. Despite the reversal, the AMA cautions, “This should not be viewed as an endorsement of state-based medical cannabis programs, the legalization of marijuana, or that scientific evidence on the therapeutic use of cannabis meets the current standards for a prescription-drug product.”

The American Medical Association has about 250,000 doctor members and as a body has urged the federal government to also reconsider its current classification of marijuana as a dangerous drug with no accepted medical use.

“This shift, coming from what has historically been America’s most cautious and conservative major medical organization, is historic,” said Aaron Houston, director of government relations for the Marijuana Policy Project.

Dawn Dearden with the Drug Enforcement Administration said: “At this point, it’s still a Schedule I drug, and we’re going to treat it as such.” The Food and Drug Administration has yet to comment on the announcement by the AMA.

In London, England, a one-year old baby born with a severe birth defect has caused discourse between his amicably separated parents on whether or not to disconnect the respirator that is keeping him alive.

The disease, congenital myasthenic syndrome, is a rare genetic condition that prevents the child from breathing on his own. It causes severe muscle weakness, feeding, and respiratory problems. According to the hospital, the disease is progressive, but the baby has been taken off his artificial respirator at least three times. Each time, the baby was able to breathe on his own for less time, until the third time when he was able to maintain for only five minutes.

Siding with the doctors, the mother is in favor of ceasing life support, but the father is pleading his case to the high courts in Britain.

According to lawyers in a story reported by CNN, the baby is “miserable, sad, and pitiful.” When describing the child’s plight, they lawyers say his lungs fill with fluid every few hours giving him the sensation that he is choking. Doctors must use suction to remove the fluid, causing further suffering.

The father claims the baby can play and recognize his parents and that his lawyers plan to show videos of the baby in court to demonstrate he is capable of responding.

Both parents feel they have the baby’s best interests at heart, and this is clearly a life or death matter. With everyone feeling they are right, where has it gone wrong?

Researchers at Stanford recently published a paper about affecting neurons in your brain with light. Our bodies are not normally receptive to information via light, except for our eyes of course, but in this study a gene, extracted from a photosensitive type of algae, is loaded into virus particles and a promoter. The virus infects neurons in the area and sets the stage.

In an experiment involving a mouse with a fiber-optic ponytail, when the light was triggered, the mouse moved in a counter-clockwise motion. Since the scientists were manipulating the neurons on the right side of the brain, the left side was being controlled. They successfully told the mouse’s brain to function in a particular manner using a bit of gene therapy and a light show.

Mind-controlling mice may be important for many reasons, but consider this: mice are often used for their genome similarities to humans (remember the mouse with an ear grown on its back in 1995?) and mice being tested had Parkinson’s — a human-afflicting disease. This team is trying to find a treatment that can “reprogram” functions of the brain to bypass these diseases.

Though meant to benefit, some are concerned that this type of experiment may be used nefariously. Imagine the benefit when using this to gain information from someone. Granted, telling the brain to put one foot in front of the other is far less complicated than “tell me what I want to hear,” but it’s concerning possibility when you delve into the realm of mind control.

This is a science in its infancy and these scientists have the purest of intentions, however, a tool or technique has a purpose intended by the creator that may not be shared by the user.

Is it important for the patient to have the decision-making power, even when contrary to medical advice? Hospitals around the country are straying from VBACs (vaginal birth after cesarean) because complications can arise when a woman attempts a vaginal birth after a previous cesarean.

Hospitals are either changing their policies or doctors are refusing to deliver a baby vaginally if the mother has received a c-section previously. One complication is a uterine rupture, which may result in the death in the baby.

The American College of Obstetrics and Gynecologists says that these risks are prevalent in a scant 1% of all VBACs. With such a low percentage, is it really the doctor’s decision to refuse the procedure? In the end, should we trust the opinions of trained professionals or should they do as the patient requests once they have been apprised of the risks?

Talking, walking, and even driving while on your cell phone presents untold danger. With a device so hazardous to our health, it’s a wonder that its popularity has reached all new heights. It is estimated that 60% of the worldwide population (4 billion people) subscribe to wireless services according to Reconstruction.ws.

Health agencies in Switzerland, Germany, Israel, France, the U.K., and Finland have issued health warnings with special emphasis on the risks to children (children have thinner skulls that are less able to provide protection from the radiation that is emitted).

EWG charges that the standards set by the FCC, based on 1992 recommendations, allow 20 times more radiation to penetrate the head than the rest of the body. The latest study on the topic of brain tumors caused by extended cell-phone use finds that there may be merit to the concern.

Yahoo reported on the study chronicled in the Journal of Clinical Oncology that could not document an overall link, but when the more methodologically rigorous studies were examined, a potentially harmful association was identified.

In earlier studies, similarly inconclusive and conflicting results were found. This study does little to add clarity to the general discussion but it does show that the more detailed the study, the more support there is for a link between the two.

At a more granular level, brain expert, Dr. Vini Khurana, warns that cell phones could kill far more people than smoking or asbestos and says people should avoid using them wherever possible. He furthers that “governments and the cell-phone industry must take immediate steps to reduce exposure to their radiation,” according to Independent.co.uk.

According to ScienceDaily.com, two new studies have concluded that talking on a cell phone while walking or driving is causing an increase in deaths to pedestrians, drivers, and passengers alike.

These studies that attempt to draw correlation between cell phones and accident fatalities found that there was a period where cell phones actually helped to reduce fatalities, but that the new data reflects changes that occurred once the number of cell phones being used reached critical mass of 100 million.

Another study, this one published in the latest issue of the journal Pediatrics, found that children walking to and from school while on the phone were not as diligent when crossing streets or making other safety decisions.

Research was conducted at the University of Alabama using a virtual-reality simulator and 77 children aged 10 and 11. In an article reported by About.com, children were monitored crossing a street while using a phone call and while undistracted.

It was found that while on the phone, the kids were less attentive to the threat that traffic posed including leaving less time crossing the street in between on-coming vehicles. The net results were more collisions, near misses, and longer wait times before attempting to cross.

According to the Insurance Institute for Highway Safety, the following bans are in place:

• Complete ban on cell-phone use while driving in California, Connecticut, New Jersey, New York, Oregon, Utah, and Washington, and the District of Columbia.
• Complete ban on cell phones while driving a school bus is prohibited in 17 states and the District of Columbia.
• Complete ban on cell phones by novice drivers is restricted in 21 states and the District of Columbia.
• Text messaging is banned for all drivers in 18 states and the District of Columbia.
• Novice drivers are banned from texting in Delaware, Indiana, Kansas, Maine, Mississippi, Missouri, Nebraska, Texas, and West Virginia.
• School bus drivers are banned from text messaging in Texas.

At what point should the government control our common sense and what responsibility do they have to conduct extensive studies evaluating safety?

In the last decade it seems that more people are quitting than starting. In fact, despite a significant decrease in the number of smokers, still more than 400,000 Americans die from tobacco-related illnesses every year. It is estimated that tobacco-related health-care costs exceed $100 billion annually. After a summer of government spending, that may seem like a drop in the bucket, but these numbers help to push up the cost of health insurance for all of us.

Though many long-term smokers believe that the damage has already been done, the American Cancer Society counsels us that within 12 hours of quitting, even a long-term smoker’s level of carbon monoxide can reduce to that of a non-smoker.

The longer, the better says the American Cancer Society — after ten years, many other health risks associated with smoking are reduced to a non-smoker’s level. Consider that quitting today you could rival the health of the average non-smoker on the topic of cancer, stroke, or heart disease risks.

According to LiveStrong.com, the average male smoker’s lifespan is reduced by 13.2 years and the average female smoker’s lifespan reduced by 14.5 years.

On 22 June 2009, President Obama signed legislation that gives the FDA regulatory power over the marketing and sale of tobacco. Known as the Family Smoking Prevention and Tobacco Control Act, this law gives the FDA power to ban candy-flavored and fruit-flavored cigarettes among other marketing-messaging and product-content control.

With that law now in place, this week, federal health officials, banned the sale of flavored cigarettes in a story reported by NYTimes.com. They also have indicated that more limits may be in store against the far-larger market of flavored little cigars and cigarillos.

Many believe that flavored tobacco products are appealing and enticing to first-time smokers, including America’s younger generations. “These flavored cigarettes are a gateway for many children and young adults to become regular smokers,” said Dr. Margaret Hamburg, commissioner of the Food and Drug Administration, in announcing the ban.

Even with a notable reduction in the number of smokers, statistics found at AmericanHeart.org and other sites are alarming:

• In the United States, an estimated 26.2 million men (23.5%) and 20.9 million women (18.1%) are smokers.
• In 2004, 17-year-old smokers were more than three times as likely as those over the age of 25 to smoke flavored cigarettes, and they viewed flavored cigarettes as safer.
• Among whites, 23.5% of men and 18.8% of women smoke (2006).
• Among blacks, 26.1% of men and 18.5% of women smoke.
• Among Hispanics, 20.1% of men and 10.1% of women smoke.
• Among non-Hispanic Asians, 16.8% of men and 4.6% of women smoke.
• Among American Indians/Alaska Natives, 35.6% of men and 29.0% of women smoke.

Passive rulings such as public-area smoking bans may not be the best path though. According to a new study quoted at BioMedicine.org, “it has been observed that motivating people to give up smoking, after a cancer diagnosis, is not necessarily more effective than just ordering them to quit.”

By following two groups — those that received motivation therapy and those that were told to quit — even though motivation therapy involved more time, effort, and expense, it was not more effective. Here again, many believed that once they had already been diagnosed with a smoking-related illness, it was too late to quit, but since smoking restricts blood supply and collagen metabolism, quitting may help you to heal faster.

Dave Hitt, in his blog on the facts of second-hand smoke, sheds some light on the famous EPA study released in 1992 by exposing a number of misconceptions and misquotes in reference to this report.

For starters, the report claimed that second-hand smoke (SHS) causes 3,000 deaths a year, and for this reason SHS has been classified as a class A carcinogen. Although the study has been found incredibly faulty and was legally vacated, governmental agencies refer to it frequently to support their stances in all sorts of bans against smoking, for example the elimination or reduction of public-area smoking sections. In actuality, the exposure (for people who live and/or work in smoky environments) is about six cigarettes per year as supported by studies that measured actual exposure by having non-smokers wear monitors.

Whether or not the study is correct, it is widely accepted that smoking simply isn’t good for you and combined with other drugs, such as birth-control pills, it can be downright life threatening.

I am a former smoker and occasionally feel the need to indulge. I think of it like salt: no, it’s not good for me, but in moderation it’s a lot less dangerous than texting while driving.

In an article appearing at NYTimes.com, Dr. John A Baron, professor of medicine at Dartmouth Medical School, says, “If I were on a desert island, one of the drugs I would choose to have with me, hands down, maybe number one, is aspirin. It’s a fascinating, wonderful drug, a great drug, but it is a real drug, and it has side effects.”

Doctors and researchers alike universally agree that you should not start a daily regimen of aspirin without consulting your physician. Since aspirin interferes with your blood’s clotting action, wounds tend to bleed longer or more profusely. This can be especially risky in the case of gastrointestinal bleeding. It may also create risk for hemorrhagic strokes or bleeding in the brain.

On the benefits side, there’s no arguing with authorities around the world, and there’s plenty to tout:

• In another article by NYTimes.com, a study found that people who took a low dose of aspirin every day for several years reduced their risk of developing Alzheimer’s by 13 percent.
• Reuters reports that a daily dose of aspirin can prevent cancer in people with a genetic disorder that increases their risk of developing the disease.
• At the University of Southern California, School of Dentistry, researchers found that aspirin can be key in the fight against osteoporosis, according to Medical News Today.
• In a story posted by the Telegraph, aspirin was found to help prevent liver damage.
• Women may protect themselves against some forms of breast cancer.
• A daily small dose of aspirin may aid in the prevention of asthma.
• A low dose along with a low dose heparin (an anti-coagulant) could help women have a baby who have suffered repeated miscarriages.
• Private health-care provider Bupa claims that aspirin can help prevent pre-eclampsia in women who are at risk of the condition.
• An Oxford University team found that among 13,356 patients, aspirin reduced deep-vein thrombosis by a third.
• Professor James Crabbe of Reading University found that aspirin could help reduce the risk of cataracts.

While the benefits are numerous, the risks cannot be ignored. According to the Mayo Clinic, aspirin therapy reduces the clumping action of platelets, and this action is believed to prevent or reduce the risk of heart attacks and strokes, but in a story posted by the University of Michigan, Dr. A. Mark Fendrick says, “Although taking aspirin leads to a wealth of potential health benefits for adults, people should realize that even a baby aspirin is not free of dangerous side effects.”

Aspirin use should be based on the tradeoff between the risk of disease you are trying to prevent, such as a heart attack, and the risk of side effects.