public health
tsmith | January 4, 2007I ran across this story study linking breast cancer protection to housework while browsing Scienceblogs briefly over the break (GrrlScientist mentioned it here), but hadn't had a chance until now to read through the actual publication. As usual, I'm late; Orac has a good overview, as well as some comments made by other bloggers railing against "feminism" and how this study proves that feminist philosophy kills women.
First, here's how the BBC story describes it:
Women who exercise by doing the housework can reduce their risk of breast cancer, a study suggests.
The research on more than…
mikethemadbiologist | January 4, 2007A while back I posted about how awful it would be for the FDA to approve the use of cefquinome, an antibiotic similar to the medically important drug cefepime. I even coauthored a letter about it. Well, it turns out the IDSA wrote a letter about cefquinome too (the whole letter, in pdf). There's good and bad things about the letter. First, the bad--the IDSA proposals about what to do if cefquinome is approved:
1. Limit the marketing status to prescription only.
2. Prohibit extra-label use of the product.
3. Limit the extent of use to "low," meaning that the drug will be administered…
mikethemadbiologist | January 2, 2007So Michael Fumento has issued a challenge to put 'odds' on avian influenza, thinking that somehow I've stated that an avian influenza pandemic is likely (he's also accused me, a scientist, of being "anti-scientist" and "alarmist"). Well, I'm not putting odds down because I've never said that a pandemic is likely. Then again, one should hardly be surprised when a professional conservative completely distorts what one says.
In fact, in the post, I wrote:
We can argue about public health priorities (avian flu isn't my top priority personally).
One would think that was clear, but I made the…
mikethemadbiologist | January 1, 2007From the archives, here's another post about influenza.
...you knew that starting in late September or early October there would be a series of bioterrorist attacks, and that these attacks would kill anywhere from 30,000 - 50,000 U.S. citizens. Now imagine that you could produce a vaccine that would be, at worst partially effective, and at best, completely effective, particularly if enough of the U.S. population were vaccinated. Imagine that, with enough vaccination, thousands of lives could be saved. A competent government, one that could do a heckuva job, would do something, wouldn't it…
mikethemadbiologist | December 31, 2006I've been called out by Michael Fumento regarding a post about avian influenza. While I'm putting that together, I thought it would be a good opportunity to revisit some previous posts about influenza. From the old site:
A think tank in Australia released a report claiming that an influenza pandemic might kill over 140 million people. So, after spending most of my professional career examining the evolution of infectious disease, I think...I don't have any idea if a pandemic influenza strain will evolve. Ultimately, we're trying to anticipate a unique historically contingent event:…
mikethemadbiologist | December 27, 2006Thankfully for the readers, most of the scientific literature I read doesn't make it into this blog. But one paper about a comparative drug trial had some very interesting results. In short, obesity and smoking are significant risk factors for post-operative infections.
The article, published in the NE Journal of Medicine, is a comparative study of which is the better antibiotic use to use after colorectal surgery to prevent infections: etrapenem or cefotetan. While cefotetan is typically used, etrapenem was was associated with significantly fewer post-operative complications.…
mikethemadbiologist | December 26, 2006From the archives, I'm reposting this article about MRSA and VRSA. I've made some changes because the science and medical practice have changed.
The Chicago Tribune reports that three children died from toxic shock syndrome caused by methicillin resistant Staphylococcus aureus ("MRSA"). Toxic shock syndrome is not typically associated with MRSA. What's worse is that these infections were "community-acquired" (CA-MRSA) In other words, the kids were not infected in the hospital-many staph infections are hospital acquired due to puncturing the skin barrier (e.g., catheters, IVs, surgery).…
mikethemadbiologist | December 23, 2006At a recent conference (pdf), Dr. Rebecca Roberts described how medical residents and doctors treat urinary tract infections. But first, a bit about 'empirical therapy.'
When a patient is sick it can take anywhere from 24-72 hours at a hospital with good facilities to identify what organism is causing the disease and which antibiotics will be effective against it. Empirical therapy uses the patterns of resistance (and infections) of previous cases at the hospital in conjunction with other guidelines to choose the most effective antibiotic therapy. Think of it as a highly educated guess--…
mikethemadbiologist | December 22, 2006At a recent conference I attended (pdf file), one speaker (Dominique Monnet) presented a very interesting observation about the relationship between the number of different antibiotics available and the amount of antibiotics prescribed.
Quite simply, as the number of potential competiting drugs increases, the amount of drugs prescribed increases:
(from here; the y-axis is the number of daily doses per 1000 residents)
There are at least two reasons for this pattern:
1) Advertising aimed at doctors and hospitals is more likely to increase use simply because doctors will be influenced to use…
mikethemadbiologist | December 21, 2006Revere, over at Effect Measure, has a solid critique of Michael Fumento's opinion piece about avian flu. What the piece shows is just how ignorant of public health Fumento really is:
1) Many of the necessary steps involved in preparing for a flu pandemic, such as surge production capacity, can be used to produce 'ordinary' flu vaccines.
2) Once a surveillance system is developed, it can be 'repurposed' for other threats as needed. This has happened several times, in different countries.
3) As Revere notes, Fumento's real target is government spending. When will we see Fumento's column…
tsmith | December 21, 2006Ho ho ho, and welcome to the early Christmas edition of Animalcules. Sit back, grab some hot cocoa, and click below to open your Christmas gift of some of the most interesting microbiology-themed blog posts over the past month.
To start us off with, in a new blog to me (the Cornell Mushroom blog), we learn how a fungus assists in the transmission of a nematode from the environment to the host--in this case, cattle. It's a fascinating example of commensalism.
From the same blog comes another post on Batrachochytrium dendrobatidis (or Bd), a fungus which is a cause of skin infections in…
mikethemadbiologist | December 20, 2006At a recent conference (pdf), I heard Dr. Rebecca Roberts describe the economic cost of antibiotic resistant infections at Cook County's Stroger Hospital. In a nutshell, it's terrifying.
The average cost per patient at that hospital is $10,000. The cost of treating an antibiotic resistant infection excluding acute respiratory infections ('ARI')--this does not include the average cost of antibiotic sensitive infections--is $1,934. That is, of the $10,000 average cost, $1,934 goes to 'subsidize' the cost of antibiotic resistant infections. The $1,934 figure is the low estimate: the average…
mikethemadbiologist | December 20, 2006The Guttmacher Institute has released a report showing that 90% of Americans have engaged in premarital sex. This isn't really an increase either: premarital sex was nearly as common among women in their sixties. Hopefully, that will dispel the notion that slutiness [/snark] is on the rise. I wonder what the right-wing nutjobs will make of this. I doubt anything other than abstinence-only education will be on their agenda. Oh wait, one other thing will probably be discussed:
BILL CLINTON'S PENIS!!!!!
Maybe this will move things away from faith-based public health, and towards the realm…
tsmith | December 19, 2006 Libya to execute HIV medics
(Previous posts on the topic)
A court convicted five Bulgarian nurses and a Palestinian doctor Tuesday of deliberately infecting 400 children with HIV and sentenced them to death, despite scientific evidence the youngsters had the virus before the medical workers came to Libya.
The United States and Europe reacted with outrage to the verdict, which prolongs a case that has hurt Libya's ties to the West. The six co-defendants have already served seven years in jail.
The sentence brought cheers in Libya, where there is widespread public anger over the infections.…
mikethemadbiologist | December 19, 2006...or at least, I was mentioned in Cell. Currently, we have very few new antibiotics in the pipeline, particularly for Gram-negative bacteria such as Acinetobacter. One of the things I'm involved with is a project to develop a not-for-profit screening library to find new antibiotics. From Cell:
Resistance of microbial pathogens to an increasing number of antibiotics is a serious problem. In the US alone, 90,000 people die every year from infections acquired while in the hospital. According to the Infectious Disease Society of America (IDSA), 70% of these deaths have been attributed to…
mikethemadbiologist | December 17, 2006Well, we do it for narcotics. From Yahoo News:
International experts debated whether antibiotics merit a separate regulatory drug category at a World Congress held on December 11 and 12 at the Hyatt Regency Boston Hotel. "We proposed this drastic action because antibiotic resistance is undermining infectious disease treatment worldwide and many large pharmaceutical companies are leaving the antibiotic field," explains Stuart B. Levy, MD, a Tufts Medical School professor and president of APUA, the global public health organization convening the meeting. Pharmaceutical companies spend an…
mikethemadbiologist | December 16, 2006In the past week, over 400 students and teachers in the Boston area have contracted norovirus, which causes nausea, vomitting and diarrhea:
"In close settings like a school or a nursing home or a family, the failure to adequately follow good hygiene will manifest itself with spread of this type of disease," said Dr. Bela Matyas of the Massachusetts Department of Public Health.
At Simmons, the outbreak traveled swiftly, although it was not concentrated in any single location, said Dr. Kay Petersen , medical director of the college's health center. To stem the spread, e-mails were sent to…
mikethemadbiologist | December 15, 2006I was recently at a conference (pdf file) where one speaker (Dr. Thomas O'Brien) suggested 'VRSA hospital insurance' to prevent the spread of vancomycin resistant Staphylococcus aureus outbreaks ('VRSA'). Before I get into the plan, let's talk about VRSA.
VRSA are staphylococci which are not only resistant to vancomycin, which is one of the last effective drugs against methicillin resistant Staphylococcus aureus ('MRSA'), but are also resistant to most (or usually) all other available antibiotics. While tigecycline can be used to treat some infections (skin and abdomindal), it is not used…
tsmith | December 14, 2006Today's New England Journal of Medicine has an article (free access) with more information on the Tripoli Six, who are still awaiting their December 19th verdict.
tsmith | December 13, 2006If the last circumcision post caused a lot of heat, this news is likely to cause even more of an uproar worldwide. From NBC News comes word that the NIH will be announcing shortly that they're stopping two trials looking at circumcision and HIV in Africa, because the intervention group (those who were circumcised) show far less HIV infections than the uncircumcised men:
NBC News has learned that the National Institutes of Health will announce at Noon ET Wednesday that two clinical trials in Africa have been stopped because an independent monitoring board determined the treatment was so…