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Thursday, April 30, 2009

Patient Safety - Carjacking article

re : Warning from police please read:
I don't know if this is accurate, but better safe than sorry……A Warning..!!!! Just last weekend on Friday night, we parked in a public parking area. As we drove away I noticed a sticker on the rear window of the car. When I took it off after I got home, it was a receipt for gas. Luckily my friend told me not to stop as it could be someone waiting for me to get out of the car. Then we received this email yesterday....WARNING FROM POLICE; THIS APPLIES TO BOTH WOMEN AND MEN. BEWARE OF PAPER ON THE BACK WINDOW OF YOUR VEHICLE - NEW WAY TO DO CARJACKINGS (NOT A JOKE). Heads up everyone! Please, keep this circulating....You walk across the parking lot, unlock your car and get inside. You start the engine and shift into Reverse. When you look into the rear view mirror to back out of your parking space, you notice a piece of paper stuck to the middle of the rear window. So, you shift into Park, unlock your doors, and jump out of your car to remove that paper (or whatever it is) that is obstructing your view. When you reach the back of your car, that is when the carjackers appear out of nowhere, jump into your car and take off. They practically mow you down as they speed off in your car. And guess what, ladies? I bet your purse is still in the car. So now the carjacker has your car, your home address, your money, and your keys. Your home and your whole identity are now compromised! BEWARE OF THIS NEW SCHEME THAT IS NOW BEING USED. If you see a piece of paper stuck to your back window, just drive away. Remove the paper later. And be thankful that you read this email. I hope you will forward this to friends and family, especially to women. A purse contains all kinds of personal information and identification documents, and you certainly do NOT want this to fall into the wrong hands.

I may also add....look around before you open your car door and make it a habit to lock your car doors before you start your engine. I've never heard of this style of carjacking before, but it's very possible. This is a good piece of information; what will they think of next!

Sunday, April 26, 2009

The bipolar child is a purely American phenomenon

Psychology Today

"The bipolar child is a purely American phenomenon": An interview with
Philip Dawdy
By Christopher Lane, Ph.D. on April 7, 2009 - 12:17pm in Side Effects
Philip Dawdy, a prize-winning investigative journalist, has for
several years written a powerful, well-researched, and well-regarded
weblog, Furious Seasons, which focuses on American psychiatry, mental
health, and the way we think about treatment options. Given his
intensive work on the issues, I wanted to ask him several burning
questions about ADHD, bipolar disorder, and other controversies in
American psychiatry.
You've written extensively about the psychiatric diagnosis of teens
and preschoolers. How do you account for the astonishing rise in the
number of diagnoses we're seeing in these age groups, especially with
regard to ADHD and bipolar disorder?
To me, you can lay all of this squarely at the feet of the pharma
companies, which had a slew of newish drugs come online in the 80s and
90s and wanted them taken by as many humans as possibleâC"consequences
for the patients be damnedâC"and a crew of child psychiatrists at
Harvard/MGH who see deeply-flawed, ill-for-life children where other
psychiatrists might see personality disorders and issues that will
burn out over time. The pharma companies and the Harvard crew worked
hand-in-hand to bring America a generation of ADHD kids and bipolar
children, and their profound influence can be seen in the millions of
children and teens who now carry lifetime diagnoses and take gobs of
psychotropic drugs each day, often to their detriment.
That may sound extreme to some people, but it's worth noting that the
rest of the world has not embraced these diagnostic and treatment
paradigmsâC"except Britain, where there was an initial embrace of ADHD
and stimulants, but where there's now a significant backlash.
Meanwhile, in France and Italy ADHD is rarely diagnosed and it's
difficult to see where French and Italian culture have suffered as a
result. As for bipolar disorder in kids (meaning pre-teens and
younger), it's simply not an issue in the rest of the world. The
bipolar child is a purely American phenomenon, as big a metaphor of
our times as credit swaps, subprime loans, and government bailouts.
Why do you think so many more teenage and younger boys than girls are
being diagnosed with ADHD, and what does that say about our culture,
education system, parental expectations, and so on?
The data I'm familiar with pegs the boy-to-girl ADHD ratio at 3 to 1,
which is pretty dramatic. I suspect that boys get pegged with the
diagnosis more than girls do for two reasons: One, boys have always
been far more energetic and physically exuberant than girls, a point
going back through history, perhaps because they are developing their
hunter-gatherer beings. And, two, the hyperactivity piece of ADHD is
quite easy to spot and probably leads to greater pressure for kids to
be diagnosed because hyperactive boys can be disruptive, especially in
school environments.
As out there as this may sound, I think we are as a culture cheating
boys of their inherent natures and I have real questions about how
that affects their psychosocial development long-term and what it will
all mean for manhood a couple of generations down the road (I'm
concerned about comparable issues with girls as well). What's more, I
think the educational system places too much emphasis on having quiet,
compliant kidsâC"far more so than in the past. When I was a kid in the
1970s, boys were pretty much allowed to engage in all kinds of
wildness at recess in elementary school and after school, but from
what I hear that's being discouraged today. Why the change I couldn't
say, but I do know that there's been a real push in our culture to
silence outward signs of male aggressiveness, both in kids and adults.
As for parents, I think they are under a lot of self-imposed pressure
to have perfect kids with high grades who get into top universities or
they've somehow failed as parents. The ADHD drugs and the diagnosis
itself have been foisted on them as a way to have their kids better
liked among school peers and to achieve higher grades and perform
better on the many, many standardized tests kids must take these days.
What's interesting to me is that parents and our culture may well have
been sold a bill of goods here, as the recently released MTA study (a
long-term tracking study of kids through teens with ADHD, both on and
off-meds) showed that long-term treatment with stimulants didn't
appreciably improve GPAs and other test scores.
What influence do you think patent cycles exert over such diagnostic
trends? I'm thinking especially of the move to "bundle" depression
with bipolar disorder when the patents for so many SSRI
antidepressants ran out.
I think there is some influence here, even though diagnostic trends
should ideally be driven by unbiased science, independent of the needs
of pharma companies. What I've noticed over time is that, as you
suggest, there's been a great rush to get a drug approved for as many
indications as possible as it nears the end of its on-patent life,
likely because the drug companies can then market said drug directly
to the public. Certainly, that's part of what went on with Paxil and
social anxiety disorder in the late-1990s and, right now, I'm noticing
an epic push by Eli Lilly and AstraZeneca to have their atypical
antipsychotics (Zyprexa and Seroquel, respectively) approved for a
wide range of indications (including ones like depression) before the
drugs go off-patent in a few years.
Perhaps the most egregious example of a pharma company trying to
influence diagnostic trends came in 2002 when Eli Lilly launched a
massive sales campaign to convince PCPs that patients walking into
their offices complaining of depression actually had bipolar disorder
type 2 instead, and that Zyprexa was the perfect fix for that. The
results were utterly disastrous for patients, what with all the weight
gain and diabetes they experienced as a result. Interestingly, female
patients were the primary target of the campaign.
Do you think the black-box warnings that the FDA issued against
pediatric antidepressant use were effective as a deterrent?
I'm not sure they were much of a deterrent since there's been 14
percent growth in antidepressant prescriptions since 2004, according
to IMS Health. But to the degree that the black box on suicidality
gave patients and doctors important information that had long been
hidden from them by both the pharma companies and some researchers, I
think the warnings were a boon. It has at least forced people to think
long and hard about what drugs they are taking, and to pay closer
attention to side effects and any strange emotions that might arise
upon first taking the drug or changing a dosage.
Why do you think Bipolar II disorder is controversial as a diagnosis?
I may be the only writer in America who thinks BP2 is controversial
and I can hardly think of any doctors who do. For me, it's a
questionable classification and something of a cop-out by the DSM
writers for a couple of reasons: One, BP2 isn't bipolar disorder,
properly understood. There's no mania, there's no hospitalization for
mania, and there's no one running naked down the street. The most
prominent features of BP2 are depression (and that covers the vast
majority of a person's time who is diagnosed with BP2) and bursts of
energy, broadly understood. To me, that sounds a whole lot more like
depression and agitation than it does manic-depression.
Two, the minute someone gets hit with a bipolar disorder diagnosis of
any subtype, then they are faced with a profoundly bad set of social
assumptions; they get stigmatized by friends and family; and they lose
their jobs. I know of multiple cases along these lines, including one
of a sheriff's deputy in King County, Washington who was fired from
her job as soon as the brass learned she had BP2, even though she had
a stellar track record as a cop and had done nothing wrong on the job.
That hardly seems fair when we're talking about a disorder that
doesn't involve hallucinations or psychosis and has none of the
off-the-charts impulsivity of true manic-depression. While it's nice
of researchers and mental-health advocates to claim that we've got to
end this kind of stigma, in the real world that would take generations
and by then people with BP2 today will have reached the ends of their
natural lives.
Why BP2 wasn't called something else is beyond me, but the diagnosis
has sure caused a lot of unfair social damage.
Much of the rationale for medicating teens and preschoolers has to do
with arguments about early intervention. You've written that you find
such claims questionable and their underlying philosophies flawed.
Explain why.
Let me restrict this to psychosis. What you are referring to is the
prevention paradigm, or the use of psychotropics as prophylactics, all
of it trading off kindling theories of mental illnesses and disorders.
They are interesting theories, but in the real world they've not
turned out to be successful. Simply put, there is very little
long-term or short-term research to prove their validity. For example,
the PRIME study at YaleâC"which sought to identify kids at risk of
psychosis and then gave them Zyprexa to prevent psychosis from ever
arisingâC"was an epic failure and certainly raised questions about the
ethics of giving kids dangerous drugs for disorders that they, at
least in some of the cases, didn't even have.
The trouble is that the prevention paradigm is deeply seductive. If
true, psychiatry would be like cardiology where high cholesterol is
considered a risk factor for heart disease and people with high
cholesterol are given statins to prevent heart attacks. But psychosis
isn't so simple andâC"from what I've seen to dateâC"researchers have
not been able to predict with a high degree of accuracy who will
develop psychosis. That's why I find the whole thing suspect. Perhaps
I'll be warmer to researchers' claims here when they can predict
psychosis with great accuracy and replicate their findings in many
studies across different population subtypes.
As you noted on your site, the St. Petersburg Times recently reported
that in 2007 23 infants less than one-year-old were given
antipsychotics. Given all the media attention to the death of Rebecca
Riley, aged 4, from an overdose of antipsychotics (and a diagnosis of
bipolar disorder at age 2), how is it possible for psychiatrists to
continue prescribing to infants in such numbers without more
oversight?
Doctors have great powers to prescribe drugs off-label for whatever
they see fit and, to a degree, that's fine. What's gone on with
antipsychotics prescribed to infants and toddlers is simply
inexplicable to me. The drugs are known to cause huge problems in
adults, so why the heck would a doctor give them to little kids,
especially infants? It boggles my small mind.
There probably is no acceptable way to introduce oversight into this
situationâC"outside of insurance provider overviewâC"without trampling
all over doctors' traditional freedom to prescribe off-label. I'm no
fan of bans or restrictions, but this does strike me as a situation
where there needs to be a serious rethinking of what we are
doingâC"and maybe there should be a ban on the use of these drugs in
kids under, say, 6 years of age.
That said, perhaps the most effective short term fix is for parents
themselves to get educated about the problems with these drugs and to
demand a second opinion when a doctor tries to prescribe them to their
child.
Your web site Furious Seasons, which has earned you awards, includes
extensive documentation about Zyprexa. What will readers of your site
learn about the drug and its side effects?
Hopefully, they'll learn that this is a drug that causes rapid weight
gain, hyperglycemia, diabetes, lipid problems and the like in a high
percentage of patients, and that it's a drug the use of which demands
great caution. They'll also learn that Eli Lilly actively lied to
doctors and patients about problems with the drug and that the company
has had to settle almost $3 billion in lawsuits and has pleaded guilty
to a criminal misdemeanor charge in federal court for off-label
marketing of the drug for use in dementia.
One classic example: in April 2002, Japanese regulators forced Lilly
to warn doctors in Japan abut hyperglycemia and diabetes problems with
the drug, but at the time same time the company claimed in internal
documents that this did nothing to affect the safety of the drug in
the US market. Two months later, Lilly rolled out its extensive
Zyprexa marketing campaign to PCPs, which I referred to above. That is
some of the worst corporate behavior I have ever seen in my 15 years
as a reporter.
Some months ago, the government's Clinical Trials web site signaled
that the antipsychotic Seroquel was being tested for people with
public-speaking anxiety. What can and should the FDA be doing to stop
such clear signs of "mission creep" over pharmaceuticals?
I don't think the FDA has any interest in stopping this kind of
behavior, and it likely doesn't even have the regulatory authority to
do so. For instance, in the last two years the agency has approved
antipsychotics for use in pediatric bipolar disorder and in treatment
resistant depression. Neither diagnosis exists in the current edition
of the DSM, but the agency seems just fine with this situation. It
even went to great lengths to justify the diagnosis of pediatric
"mania" bandied about by some researchersâC"which amounted to little
more than agitationâC"to the point where the FDA's chief of psychiatry
products, Thomas Laughren, was actively involved in a conference where
researchers and pharma companies joined to design clinical trials of
this kiddie mania.
Likely the best solution here is for Congress to pass legislation
requiring the FDA to only approve psychiatric medications for
disorders that appear in the then-current edition of the DSM. I cannot
think of a more effective way to stop Big Pharma's making up of
disorders which they then repurpose their drugs to "treat."
Final questions: How do you keep up with all the news in pharmacology,
and what are your standard sources of information?
My sources are a mix of traditional media coverage of the field
(although that's sadly declining as newspapers fade away), as well as
original research in journals, plus items that get sent my way by my
many dedicated readers. On top of that, I've been an investigative
reporter (mostly of government and law enforcement) for a decade and I
know where to snoop. Suffice to say, I read a ton of journal articles
and reportage. It's gotten to the point where I've not read a novel or
nonfiction book outside of the mental health world in about three
years.
Philip Dawdy is the author and editor of the award-winning weblog
Furious Seasons. Christopher Lane is the author of Shyness: How Normal
Behavior Became a Sickness.

--

Yours in good health, happiness, and gratitude,

Dr. Alan C. W. Tang, DC FIAMA
Family Care Wellness & Rehab
805 Plainfield Rd, Darien, IL 60561
(630) 789-8080 http://www.FamilyCareWellness.com
Don't just manage symptoms, *FIX* the problem
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Wednesday, April 22, 2009

Vinegar and Hydrogen Peroxide as Disinfectants




Bottle of White Vinegar

You can make your kitchen a cleaner, safer place nd fight bacteria, without exposing yourself and your family to toxic chemicals that also damage the environment. You can use a simple safe disinfecting spray that is more effective than any of the commercial cleaners in killing bacteria. As a bonus, it is inexpensive!

Susan Sumner, a food scientist at Virginia Polytechnic Institute and State University, worked out the recipe for just such a sanitizing combo. All you need is three percent hydrogen peroxide, the same strength available at the drug store for gargling or disinfecting wounds, and plain white or apple cidar vinegar, and a pair of brand new clean sprayers, like the kind you use to dampen laundry before ironing. If you're cleaning vegetables or fruit, just spritz them well first with both the vinegar and the hydrogen peroxide, and then rinse them off under running water.

It doesn't matter which you use first - you can spray with the vinegar then the hydrogen peroxide, or with the hydrogen peroxide followed by the vinegar. You won't get any lingering taste of vinegar or hydrogen peroxide, and neither is toxic to you if a small amount remains on the produce. As a bonus: The paired sprays work exceptionally well in sanitizing counters and other food preparation surfaces -- including wood cutting boards. In tests run at Virginia Polytechnic Institute and State University, pairing the two mists killed virtually all Salmonella, Shigella, or E. coli bacteria on heavily contaminated food and surfaces when used in this fashion, making this spray combination more effective at killing these potentially lethal bacteria than chlorine bleach or any commercially available kitchen cleaner.


Bottle of Hydrogen Peroxide

The best results came from using one mist right after the other - it is 10 times more effective than using either spray by itself and more effective than mixing the vinegar and hydrogen peroxide in one sprayer.

Reference note: Articles on Dr. Sumner's original research work appeared in the scientific news journal, "Science News," in the issues that were published on August 29, 1996, and on August 8, 1998.

CAUTION:


"Can I mix the hydrogen peroxide and vinegar into one sprayer?" The short answer is: NO! The longer answer is: never mix hydrogen peroxide and vinegar together in one container. The resulting chemical, peracetic acid, can harm you when mixed together this way if you accidentally create a strong concentration in this fashion. Peracetic acid also has entirely different characteristics and properties than either hydrogen peroxide or vinegar. Additionally, we don't know if peracetic acid kills the same group of pathogenic food-borne bacteria when used this way as a spray - it very well may not.

Killing Power Of Bleach Increased By Vinegar

Killing Power Of Bleach Increased By Vinegar


Adding white vinegar to diluted household bleach greatly increases the disinfecting power of the solution, making it strong enough to kill even bacterial spores. Researchers from MicroChem Lab, Inc. in Euless, Texas, report their findings today at the 2006 ASM Biodefense Research Meeting.

Sodium hypochlorite (NaOCl) in the form of laundry bleach is available in most households. The concentrate is about 5.25 to 6 percent NaOCl, and the pH value is about 12. Sodium hypochlorite is stable for many months at this high alkaline pH value.

"Laundry bleach is commonly diluted about 10 to 25-fold with tap water to about 2000 to 5000 parts per million of free available chlorine for use as an environmental surface disinfectant, without regard to the pH value of the diluted bleach. However, the pH value is very important for the antimicrobial effectiveness of bleach," says Norman Miner, a researcher on the study.

At alkaline pH values of about 8.5 or higher, more than 90 percent of the bleach is in the form of the chlorite ion (OCl-), which is relatively ineffective antimicrobially. At acidic pH values of about 6.8 or lower, more than 80 percent of the bleach is in the form of hypochlorite (HOCl). HOCl is about 80 to 200 times more antimicrobial than OCl-.

"Bleach is a much more effective antimicrobial chemical at an acidic pH value than at the alkaline Ph value at which bleach is manufactured and stored. A small amount of household vinegar is sufficient to lower the pH of bleach to an acidic range," says Miner.

Miner and his colleagues compared the ability of alkaline (pH 11) and acidified (pH 6) bleach dilutions to disinfect surfaces contaminated with dried bacterial spores, considered the most resistant to disinfectants of all microbes. The alkaline dilution was practically ineffective, killing all of the spores on only 2.5 percent of the surfaces after 20 minutes. During the same time period the acidified solution killed all of the spores on all of the surfaces.

"Diluted bleach at an alkaline pH is a relatively poor disinfectant, but acidified diluted bleach will virtually kill anything in 10 to 20 minutes," says Miner. "In the event of an emergency involving Bacillus anthracis spores contaminating such environmental surfaces as counter tops, desk and table tops, and floors, for example, virtually every household has a sporicidal sterilant available in the form of diluted, acidified bleach."

Miner recommends first diluting one cup of household bleach in one gallon of water and then adding one cup of white vinegar.

----------------------------
Article adapted by Medical News Today from original press release.
----------------------------

MicroChem Lab can be found online at www.microchemlab.net

The American Society for Microbiology (ASM) is the largest single life science society, composed of over 42,000 scientists, teachers, physicians, and health professionals. Its mission is to promote research and training in the microbiological sciences and to assist communication between scientists, policymakers, and the public to improve health, economic well-being, and the environment.

Further information on the ASM Biodefense Research Meeting can be found online at http://www.asmbiodefense.org/.

Contact: Jim Sliwa
jsliwa@asmusa.org
American Society for Microbiology



Vinegar Kills Bacteria, Mold and Germs


Vinegar is a mainstay of the old folk recipes for cleaning, and with good reason. The vim of the vinegar is that it kills bacteria, mold and germs.

Heinz company spokesperson Michael Mullen references numerous studies to show that a straight 5 percent solution of vinegar—thekind you can buy in the supermarket—kills 99 percent of bacteria, 82 percent of mold, and 80 percent of germs (viruses). He noted that Heinz can’t claim on their packaging that vinegar is a disinfectant since the company has not registered it as a pesticide with the Environmental Protection Agency. However, it seems to be common knowledge in the industry that vinegar is powerfully antibacterial. Even the CBS news show “48 Hours” had a special years ago with Heloise reporting on tests from The Good Housekeeping Institute that showed this.

Just like antibiotics, common disinfectants found in sponges and household sprays may contribute to drug resistant bacteria, according to researchers of drug resistance at Tufts New England Medical Center. Furthermore, research at the Government Accounting Office shows that many commercial disinfectants are ineffective to begin with, just like antibiotics.

Keep a clean spray bottle filled with straight 5 percent vinegar in your kitchen near your cutting board, and in your bathroom, and use them for cleaning. I often spray the vinegar on our cutting board before going to bed at night, and don’t even rinse, but let it set overnight. The smell of vinegar dissipates within a few hours. Straight vinegar is also great for cleaning the toilet rim. Just spray it on and wipe off.

Monday, April 20, 2009

AP IMPACT: Tons of released drugs taint US water


U.S. manufacturers, including major drugmakers, have legally released at least 271 million pounds of pharmaceuticals into waterways that often provide drinking water — contamination the federal government has consistently overlooked, according to an Associated Press investigation.

Hundreds of active pharmaceutical ingredients are used in a variety of manufacturing, including drugmaking: For example, lithium is used to make ceramics and treat bipolar disorder; nitroglycerin is a heart drug and also used in explosives; copper shows up in everything from pipes to contraceptives.

Federal and industry officials say they don't know the extent to which pharmaceuticals are released by U.S. manufacturers because no one tracks them — as drugs. But a close analysis of 20 years of federal records found that, in fact, the government unintentionally keeps data on a few, allowing a glimpse of the pharmaceuticals coming from factories.

As part of its ongoing PharmaWater investigation about trace concentrations of pharmaceuticals in drinking water, AP identified 22 compounds that show up on two lists: the EPA monitors them as industrial chemicals that are released into rivers, lakes and other bodies of water under federal pollution laws, while the Food and Drug Administration classifies them as active pharmaceutical ingredients.

The data don't show precisely how much of the 271 million pounds comes from drugmakers versus other manufacturers; also, the figure is a massive undercount because of the limited federal government tracking.

To date, drugmakers have dismissed the suggestion that their manufacturing contributes significantly to what's being found in water. Federal drug and water regulators agree.

But some researchers say the lack of required testing amounts to a 'don't ask, don't tell' policy about whether drugmakers are contributing to water pollution.

"It doesn't pass the straight-face test to say pharmaceutical manufacturers are not emitting any of the compounds they're creating," said Kyla Bennett, who spent 10 years as an EPA enforcement officer before becoming an ecologist and environmental attorney.

Pilot studies in the U.S. and abroad are now confirming those doubts.

Last year, the AP reported that trace amounts of a wide range of pharmaceuticals — including antibiotics, anti-convulsants, mood stabilizers and sex hormones — have been found in American drinking water supplies. Including recent findings in Dallas, Cleveland and Maryland's Prince George's and Montgomery counties, pharmaceuticals have been detected in the drinking water of at least 51 million Americans.

Most cities and water providers still do not test. Some scientists say that wherever researchers look, they will find pharma-tainted water.

Consumers are considered the biggest contributors to the contamination. We consume drugs, then excrete what our bodies don't absorb. Other times, we flush unused drugs down toilets. The AP also found that an estimated 250 million pounds of pharmaceuticals and contaminated packaging are thrown away each year by hospitals and long-term care facilities.

Researchers have found that even extremely diluted concentrations of drugs harm fish, frogs and other aquatic species. Also, researchers report that human cells fail to grow normally in the laboratory when exposed to trace concentrations of certain drugs. Some scientists say they are increasingly concerned that the consumption of combinations of many drugs, even in small amounts, could harm humans over decades.

Utilities say the water is safe. Scientists, doctors and the EPA say there are no confirmed human risks associated with consuming minute concentrations of drugs. But those experts also agree that dangers cannot be ruled out, especially given the emerging research.

___

Two common industrial chemicals that are also pharmaceuticals — the antiseptics phenol and hydrogen peroxide — account for 92 percent of the 271 million pounds identified as coming from drugmakers and other manufacturers. Both can be toxic and both are considered to be ubiquitous in the environment.

However, the list of 22 includes other troubling releases of chemicals that can be used to make drugs and other products: 8 million pounds of the skin bleaching cream hydroquinone, 3 million pounds of nicotine compounds that can be used in quit-smoking patches, 10,000 pounds of the antibiotic tetracycline hydrochloride. Others include treatments for head lice and worms.

Residues are often released into the environment when manufacturing equipment is cleaned.

A small fraction of pharmaceuticals also leach out of landfills where they are dumped. Pharmaceuticals released onto land include the chemo agent fluorouracil, the epilepsy medicine phenytoin and the sedative pentobarbital sodium. The overall amount may be considerable, given the volume of what has been buried — 572 million pounds of the 22 monitored drugs since 1988.

In one case, government data shows that in Columbus, Ohio, pharmaceutical maker Boehringer Ingelheim Roxane Inc. discharged an estimated 2,285 pounds of lithium carbonate — which is considered slightly toxic to aquatic invertebrates and freshwater fish — to a local wastewater treatment plant between 1995 and 2006. Company spokeswoman Marybeth C. McGuire said the pharmaceutical plant, which uses lithium to make drugs for bipolar disorder, has violated no laws or regulations. McGuire said all the lithium discharged, an annual average of 190 pounds, was lost when residues stuck to mixing equipment were washed down the drain.

___

Pharmaceutical company officials point out that active ingredients represent profits, so there's a huge incentive not to let any escape. They also say extremely strict manufacturing regulations — albeit aimed at other chemicals — help prevent leakage, and that whatever traces may get away are handled by onsite wastewater treatment.

"Manufacturers have to be in compliance with all relevant environmental laws," said Alan Goldhammer, a scientist and vice president at the industry trade group Pharmaceutical Research and Manufacturers of America.

Goldhammer conceded some drug residues could be released in wastewater, but stressed "it would not cause any environmental issues because it was not a toxic substance at the level that it was being released at."

Several big drugmakers were asked this simple question: Have you tested wastewater from your plants to find out whether any active pharmaceuticals are escaping, and if so what have you found?

No drugmaker answered directly.

"Based on research that we have reviewed from the past 20 years, pharmaceutical manufacturing facilities are not a significant source of pharmaceuticals that contribute to environmental risk," GlaxoSmithKline said in a statement.

AstraZeneca spokeswoman Kate Klemas said the company's manufacturing processes "are designed to avoid, or otherwise minimize the loss of product to the environment" and thus "ensure that any residual losses of pharmaceuticals to the environment that do occur are at levels that would be unlikely to pose a threat to human health or the environment."

One major manufacturer, Pfizer Inc., acknowledged that it tested some of its wastewater — but outside the United States.

The company's director of hazard communication and environmental toxicology, Frank Mastrocco, said Pfizer has sampled effluent from some of its foreign drug factories. Without disclosing details, he said the results left Pfizer "confident that the current controls and processes in place at these facilities are adequately protective of human health and the environment."

It's not just the industry that isn't testing.

FDA spokesman Christopher Kelly noted that his agency is not responsible for what comes out on the waste end of drug factories. At the EPA, acting assistant administrator for water Mike Shapiro — whose agency's Web site says pharmaceutical releases from manufacturing are "well defined and controlled" — did not mention factories as a source of pharmaceutical pollution when asked by the AP how drugs get into drinking water.

"Pharmaceuticals get into water in many ways," he said in a written statement. "It's commonly believed the majority come from human and animal excretion. A portion also comes from flushing unused drugs down the toilet or drain; a practice EPA generally discourages."

His position echoes that of a line of federal drug and water regulators as well as drugmakers, who concluded in the 1990s — before highly sensitive tests now used had been developed — that manufacturing is not a meaningful source of pharmaceuticals in the environment.

Pharmaceutical makers typically are excused from having to submit an environmental review for new products, and the FDA has never rejected a drug application based on potential environmental impact. Also at play are pressures not to delay potentially lifesaving drugs. What's more, because the EPA hasn't concluded at what level, if any, pharmaceuticals are bad for the environment or harmful to people, drugmakers almost never have to report the release of pharmaceuticals they produce.

"The government could get a national snapshot of the water if they chose to," said Jennifer Sass, a senior scientist for the Natural Resources Defense Council, "and it seems logical that we would want to find out what's coming out of these plants."

Ajit Ghorpade, an environmental engineer who worked for several major pharmaceutical companies before his current job helping run a wastewater treatment plant, said drugmakers have no impetus to take measurements that the government doesn't require.

"Obviously nobody wants to spend the time or their dime to prove this," he said. "It's like asking me why I don't drive a hybrid car? Why should I? It's not required."

___

After contacting the nation's leading drugmakers and filing public records requests, the AP found two federal agencies that have tested.

Both the EPA and the U.S. Geological Survey have studies under way comparing sewage at treatment plants that receive wastewater from drugmaking factories against sewage at treatment plants that do not.

Preliminary USGS results, slated for publication later this year, show that treated wastewater from sewage plants serving drug factories had significantly more medicine residues. Data from the EPA study show a disproportionate concentration in wastewater of an antibiotic that a major Michigan factory was producing at the time the samples were taken.

Meanwhile, other researchers recorded concentrations of codeine in the southern reaches of the Delaware River that were at least 10 times higher than the rest of the river.

The scientists from the Delaware River Basin Commission won't have to look far when they try to track down potential sources later this year. One mile from the sampling site, just off shore of Pennsville, N.J., there's a pipe that spits out treated wastewater from a municipal plant. The plant accepts sewage from a pharmaceutical factory owned by Siegfried Ltd. The factory makes codeine.

"We have implemented programs to not only reduce the volume of waste materials generated but to minimize the amount of pharmaceutical ingredients in the water," said Siegfried spokeswoman Rita van Eck.

Another codeine plant, run by Johnson & Johnson subsidiary Noramco Inc., is about seven miles away. A Noramco spokesman acknowledged that the Wilmington, Del., factory had voluntarily tested its wastewater and found codeine in trace concentrations thousands of times greater than what was found in the Delaware River. "The amounts of codeine we measured in the wastewater, prior to releasing it to the City of Wilmington, are not considered to be hazardous to the environment," said a company spokesman.

In another instance, equipment-cleaning water sent down the drain of an Upsher-Smith Laboratories, Inc. factory in Denver consistently contains traces of warfarin, a blood thinner, according to results obtained under a public records act request. Officials at the company and the Denver Metro Wastewater Reclamation District said they believe the concentrations are safe.

Warfarin, which also is a common rat poison and pesticide, is so effective at inhibiting growth of aquatic plants and animals it's actually deliberately introduced to clean plants and tiny aquatic animals from ballast water of ships.

"With regard to wastewater management we are subject to a variety of federal, state and local regulation and oversight," said Joel Green, Upsher-Smith's vice president and general counsel. "And we work hard to maintain systems to promote compliance."

Baylor University professor Bryan Brooks, who has published more than a dozen studies related to pharmaceuticals in the environment, said assurances that drugmakers run clean shops are not enough.

"I have no reason to believe them or not believe them," he said. "We don't have peer-reviewed studies to support or not support their claims."

___

Associated Press Writer Don Mitchell in Denver contributed to this report.

___

The AP National Investigative Team can be reached at investigate (at) ap.org

Confessions of an RX Drug Pusher - Gwen Olsen



www.GwenOlsen.com

Sunday, April 19, 2009

Chiropractic Safety

Harvard Medical School Ethics


Should you be concerned about how the next generation of medical doctors are taught?


Harvard Medical School students like Kirsten Austad, left; Lekshmi Santhosh, Kim Sue and David Tian, members of the American Medical Student Association, object to the influence of drug companies in the school’s educational curriculum.



http://www.nytimes.com/2009/03/03/business/03medschool.html



Harvard Medical School in Ethics Quandary


Jodi Hilton for The New York Times

Harvard Medical School students like Kirsten Austad, left; Lekshmi Santhosh, Kim Sue and David Tian, members of the American Medical Student Association, object to the influence of drug companies in the school’s educational curriculum.

By DUFF WILSON
Published: March 2, 2009

BOSTON — In a first-year pharmacology class at Harvard Medical School, Matt Zerden grew wary as the professor promoted the benefits of cholesterol drugs and seemed to belittle a student who asked about side effects.

Mr. Zerden later discovered something by searching online that he began sharing with his classmates. The professor was not only a full-time member of the Harvard Medical faculty, but a paid consultant to 10 drug companies, including five makers of cholesterol treatments.

“I felt really violated,” Mr. Zerden, now a fourth-year student, recently recalled. “Here we have 160 open minds trying to learn the basics in a protected space, and the information he was giving wasn’t as pure as I think it should be.”

Mr. Zerden’s minor stir four years ago has lately grown into a full-blown movement by more than 200 Harvard Medical School students and sympathetic faculty, intent on exposing and curtailing the industry influence in their classrooms and laboratories, as well as in Harvard’s 17 affiliated teaching hospitals and institutes.

They say they are concerned that the same money that helped build the school’s world-class status may in fact be hurting its reputation and affecting its teaching.

The students argue, for example, that Harvard should be embarrassed by the F grade it recently received from the American Medical Student Association, a national group that rates how well medical schools monitor and control drug industry money.

Harvard Medical School’s peers received much higher grades, ranging from the A for the University of Pennsylvania, to B’s received by Stanford, Columbia and New York University, to the C for Yale.

Harvard has fallen behind, some faculty and administrators say, because its teaching hospitals are not owned by the university, complicating reform; because the dean is fairly new and his predecessor was such an industry booster that he served on a pharmaceutical company board; and because a crackdown, simply put, could cost it money or faculty.

Further, the potential embarrassments — a Senate investigation of several medical professors, the F grade, a new state law effective July 1 requiring Massachusetts doctors to disclose corporate gifts over $50 — are only now adding to pressure for change.

The dean, Dr. Jeffrey S. Flier, who says he wants Harvard to catch up with the best practices at other leading medical schools, recently announced a 19-member committee to re-examine his school’s conflict-of-interest policies. The group, which includes three students, is to meet in private on Thursday.

Advising the group will be Dr. David Korn, a former dean of the Stanford Medical School who started work at Harvard about four months ago as vice provost for research. Last year he helped the Association of American Medical Colleges draft a model conflict-of-interest policy for medical schools.

The Harvard students have already secured a requirement that all professors and lecturers disclose their industry ties in class — a blanket policy that has been adopted by no other leading medical school. (One Harvard professor’s disclosure in class listed 47 company affiliations.)

“Harvard needs to live up to its name,” said Kirsten Austad, 24, a first-year Harvard Medical student who is one of the movement’s leaders. “We are really being indoctrinated into a field of medicine that is becoming more and more commercialized.”

David Tian, 24, a first-year Harvard Medical student, said: “Before coming here, I had no idea how much influence companies had on medical education. And it’s something that’s purposely meant to be under the table, providing information under the guise of education when that information is also presented for marketing purposes.”

The students say they worry that pharmaceutical industry scandals in recent years — including some criminal convictions, billions of dollars in fines, proof of bias in research and publishing and false marketing claims — have cast a bad light on the medical profession. And they criticize Harvard as being less vigilant than other leading medical schools in monitoring potential financial conflicts by faculty members.

Dr. Flier says that the Harvard Medical faculty may lead the nation in receiving money from industry, as well as government and charities, and he does not want to tighten the spigot. “One entirely appropriate source, if done properly, is industrial funds,” Dr. Flier said in an interview.

And school officials see corporate support for their faculty as all the more crucial, as the university endowment has lost 22 percent of its value since last July and the recession has caused philanthropic contributors to retrench. The school said it was unable to provide annual measures of the money flow to its faculty, beyond the $8.6 million that pharmaceutical companies contributed last year for basic science research and the $3 million for continuing education classes on campus. Most of the money goes to professors at the Harvard-affiliated teaching hospitals, and the dean’s office does not keep track of the total.

But no one disputes that many individual Harvard Medical faculty members receive tens or even hundreds of thousands of dollars a year through industry consulting and speaking fees. Under the school’s disclosure rules, about 1,600 of 8,900 professors and lecturers have reported to the dean that they or a family member had a financial interest in a business related to their teaching, research or clinical care. The reports show 149 with financial ties to Pfizer and 130 with Merck.

The rules, though, do not require them to report specific amounts received for speaking or consulting, other than broad indications like “more than $30,000.” Some faculty who conduct research have limits of $30,000 in stock and $20,000 a year in fees. But there are no limits on companies’ making outright gifts to faculty — free meals, tickets, trips or the like.

Other blandishments include industry-endowed chairs like the three Harvard created with $8 million from sleep research companies; faculty prizes like the $50,000 award named after Bristol-Myers Squibb, and sponsorships like Pfizer’s $1 million annual subsidy for 20 new M.D.’s in a two-year program to learn clinical investigation and pursue Harvard Master of Medical Science degrees, including classes taught by Pfizer scientists.

Dr. Flier, who became dean 17 months ago, previously received a $500,000 research grant from Bristol-Myers Squibb. He also consulted for three Cambridge biotechnology companies, but says that those relationships have ended and that he has accepted no new industry affiliations.

That is in contrast to his predecessor as dean, Dr. Joseph B. Martin. Harvard’s rules allowed Dr. Martin to sit on the board of the medical products company Baxter International for 5 of the 10 years he led the medical school, supplementing his university salary with up to $197,000 a year from Baxter, according to company filings.

Dr. Martin is still on the medical faculty and is founder and co-chairman of the Harvard NeuroDiscovery Center, which researches degenerative diseases, and actively solicits industry money to do so. Dr. Martin declined any comment.

A smaller rival faction among Harvard’s 750 medical students has circulated a petition signed by about 100 people that calls for “continued interaction between medicine and industry at Harvard Medical School.”

A leader of the group, Vijay Yanamadala, 22, said, “To say that because these industry sources are inherently biased, physicians should never listen to them, is wrong.”

Encouraging them is Dr. Thomas P. Stossel, a Harvard Medical professor who has served on advisory boards for Merck, Biogen Idec and Dyax, and has written widely on academic-industry ties. “I think if you look at it with intellectual honesty, you see industry interaction has produced far more good than harm,” Dr. Stossel said. “Harvard absolutely could get more from industry but I think they’re very skittish. There’s a huge opportunity we ought to mine.”

Brian Fuchs, 26, a second-year student from Queens, credited drug companies with great medical discoveries. “It’s not a problem,” he said, pointing out a classroom window to a 12-story building nearby. “In fact, Merck is right there.”

Merck built a corporate research center in 2004 across the street from Harvard’s own big new medical research and class building. And Merck underwrites plenty of work on the Harvard campus, including the immunology lab run by Dr. Laurie H. Glimcher — a professor who also sits on the board of the drug maker Bristol-Myers Squibb, which paid her nearly $270,000 in 2007.

Dr. Glimcher says industry money is not only appropriate but necessary. “Without the support of the private sector, we would not have been able to develop what I call our ‘bone team’ in our lab,” she said at a recent student and faculty forum to discuss industry relationships. Merck is counting on her team to help come up with a successor to Fosamax, the formerly $3 billion-a-year bone drug that went generic last year. But Dr. Marcia Angell, a faculty member and former editor in chief of The New England Journal of Medicine, is among the professors who argue that industry profit motives do not correspond to the scientific aims of academic medicine and that much of the financing needs to be not only disclosed, but banned. Too many medical schools, she says, have struck a “Faustian bargain” with pharmaceutical companies.

“If a school like Harvard can’t behave itself,” Dr. Angell said, “who can?”


Monday, April 6, 2009

"Save Some Good People from Bankruptcy..."

One thing that really irks me are those guys that wear black socks and Bermuda shorts on the beach. But, that’s not really important.

What is important are the billions of dollars wasted every year for expensive medical care that doesn’t work. What bugs me even more is that the medics know (or should know) that the right choice for many patients is chiropractic. They are often bound, however, by the secret rules of the medical cartels in every town.

More people go through bankruptcy because of medical bills than any other reason. So, shouldn’t we be spreading the word about how to save money with chiropractic?

Yes, we should.

Within the realm of conditions we usually see people for, medical care is almost always more expensive, and often ineffective. People are often put through the medical mill, being referred from one doctor to another, leading to the specialist that says, “there’s nothing wrong with you”.

Consumers and insurance companies pay millions every day for expensive medical diagnostic testing designed to figure out what the hell is wrong with a patient with typical musculoskeletal complains. Usually, they come up empty, when a good chiropractor could easily figure it out (with his bare hands) that the patient has a vertebral subluxation.

How many people wind up in the ER every day for just migraines headaches? How much do consumers and government entitlement programs pay daily for the MRI and CAT scans just for migraines?

There are tons of studies showing the cost effectiveness of chiropractic care. One study tells us that ”a new retrospective analysis of 70,274 member-months in a 7-year period within an IPA, comparing medical management to chiropractic management, demonstrated decreases of 60.2% in-hospital admissions, 59.0% hospital days, 62.0% outpatient surgeries and procedures, and 83% pharmaceutical costs when compared with conventional medicine IPA performance. This clearly demonstrates that chiropractic non-surgical non-pharmaceutical approaches generates reductions in both clinical and cost utilization when compared with PCPs using conventional medicine alone.”

Thursday, April 2, 2009

Chinese sue Johnson and Johnson

http://www.consumeraffairs.com/news04/2009/03/toxic_baths03.html

In a reversal of a now-familiar pattern, a group of Chinese families is preparing to file suit against American manufacturer Johnson & Johnson, claiming that the company imported contaminated products into China, causing their children to suffer allergic symptoms.

The suit follows a report from American non-profit group Campaign for Safe Cosmetics (CFSC), which recently reported toxins in American-made bath products. The group reportedly found formaldehyde and 1,4-dioxane in Johnson & Johnson's baby shampoo and Procter & Gamble's Kandoo hand wash. The Environmental Protection Agency (EPA) lists both chemicals as possible carcinogens, and lists formaldehyde as a chemical with no safe level of exposure, meaning that even the smallest amount poses a risk to human health. Both chemicals are direct results of the manufacturing process and aren't listed on the ingredients label.

Eighty families have already organized in anticipation of the suit, and lawyers don't plan to stop there. Cui Baoyu, one of the attorneys involved, said that the group was pursuing a class action "because of the huge number of victims involved." More than 50 attorneys are already involved in the case, and Cui says that "the group continues expanding as more lawyers from all over the country ask to join every day."

The CFSC study, completed earlier this month, tested 48 products for 1,4-dioxane and formaldehyde, and found that a stunning 61% of products contained both. Since the release of the CFSC report, a major Chinese supermarket suspended sales of Johnson & Johnson products. Nonggongshan Supermarkets Corp., which owns more than 3,000 stores across eastern China, suspended sale of the products "until they are proved safe," according to quality control spokesman Gan Pingzhong. On March 16, the Vietnamese Drug Administration announced that it would begin testing Johnson & Johnson products in Vietnam.

'Minor' head injuries can turn serious rapidly, experts say

Dr. Tang's comment

This is why we take extra precaution when ou've been in an accident or have had a slip and fall.

Story Highlights
People with head injuries can seem perfectly lucid
Blood can leak into brain over minutes or hours, causing swelling, pressure
Important to watch for signs of brain injury: Nausea, severe headache, glassy eyes

By Danielle Dellorto
CNN Medical Producer


(CNN) -- A blow to the head that at first seems minor and does not result in immediate pain or other symptoms can in fact turn out to be a life-threatening brain injury, experts tell CNN.
Immediate treatment is essential after a brain injury because damage caused by swelling is often irreversible.
It's very common for someone who's had a fall or been in a car accident to appear perfectly lucid just after the impact but then to suddenly, rapidly deteriorate, Dr. Carmelo Graffagnino, director of Duke University Medical Center's Neurosciences Critical Care Unit, told CNN.
Actress Natasha Richardson was talking and joking after she fell Monday during a beginner ski lesson, according to officials at the Canadian resort where she was staying. But soon after she returned to her room she complained of head pain and was taken to a nearby hospital, then to a larger medical center in Montreal. She was flown by private jet Tuesday to a New York hospital. She died Wednesday, according to a family statement.
"A patient can appear so deceivingly normal at first," said Graffagnino, director of Duke University Medical Center's Neurosciences Critical Care Unit. "But they actually have a brain bleed and as the pressure builds up, they'll experience classic symptoms of a traumatic brain injury."
Such injuries are known as epidural hemorrhage. Blood gets trapped between the skull and the hard layer of skin between the bone and brain, known as the dura mater. As the blood flows from the ruptured artery, the fluid builds and punctures the dura.
Patients are often unaware they've fractured their skull. In these cases, the fracture generally occurs just above the ear, in the temporal bone. "There is an artery that runs above the skull and can get torn and begin to bleed above the lining of the brain." Graffagnino says.
"At that point all the pressure is pushed on the brain, causing it to swell but there is often no room for it to move inside the skull cavity. And as the pressure continues, it reduces blood flow to the brain and a patient would begin to feel the symptoms."
The condition is commonly referred to as "talk and die" syndrome among neuroscience physicians and surgeons, because the patient can decline so rapidly.
Graffagnino says the initial fall or injury doesn't have to be hard at all. The delay in symptoms can range from five minutes to three hours after the accident.
If an individual isn't medically evaluated after a car accident, sports injury, or just a slip in the driveway, recognizing the signs brain injury early is critical. Nausea, severe headache, glossy eyes, sudden sleepiness, are all common symptoms. Getting to a hospital within the first few hours is critical to prevent permanent brain damage, experts say. An emergency room team can quickly determine the severity of your injury. An emergency craniotomy -- opening of the skull -- surgery is often needed to stop the bleeding and control brain swelling.
Immediate treatment is essential after a brain injury because the initial damage caused by swelling often is irreversible.
"One of the things we teach to trauma teams, is if a group of people are in a car crash and someone dies, we have to assume everyone else has serious injuries--even if they look good, and say they feel totally fine," Graffagnino said.

Wednesday, April 1, 2009

Chiropractic and Pediatric Ear Infections

Access the original article here.

Journal of Pediatric, Maternal & Family Health - Chiropractic

Print ISSN: 0000-0000
Volume: 2009 | Issue: 1
Cover date: Winter 2009
Page(s): 1-7

Abstract text

Objective: The chiropractic care of a child with upper cervical vertebral subluxation, ear pain, and hearing loss after unsuccessful allopathic treatments for recurrent chronic otitis media with effusion is described.

Clinical Features: A three year old girl had bilateral ear pain and hearing loss after three unsuccessful implantations of tympanostomy tubes and multiple medications.

Intervention and Outcome: Contact-specific, high-velocity, low-amplitude adjustments (i.e. Diversified Technique) were applied to the sites of vertebral subluxation. Cervical distraction exercises were also recommended as an adjunct to care. The patient reported an increase in hearing and the child's mother reported the child had less ear pain, was less irritable, and had better speech after the initiation of chiropractic co-management. Medical audiology reports document speech and hearing improvements after the implementation of chiropractic care.

Conclusion: The chiropractic care of a child with chronic recurrent otitis media, effusion, bilateral hearing loss and upper cervical subluxation is presented. Marked resolution of the patient's chief complaint was observed and confirmed by a re-evaluation with her pediatrician and audiology tests. Reduction of an upper cervical vertebral subluxation of C1 aided the restoration of hearing and normal eustachian tube physiology.