Kim’s public health blog

In a study published in the current online edition of the journal Human Brain Mapping, senior author Paul Thompson, a UCLA professor of neurology, lead author Cyrus A. Raji, a medical student at the University of Pittsburgh School of Medicine, and their colleagues compared the brains of elderly people who were obese, overweight and of normal weight to see if they had differences in brain structure — that is, if their brains looked equally healthy. They found that obese individuals had, on average, 8 percent less brain tissue than people of normal weight, while overweight people had 4 percent less tissue.

Around half of all tumors [including malignant] of the penis are linked to the most common forms of the sexually transmitted infection human papillomavirus (HPV), suggest research published ahead of print in the Journal of Clinical Pathology. Comment: Perhaps males as well as females should be immunized against HPV.

From Marcia Angell MD.  It’s not just the right-wing crazies who oppose health reform. In addition, there are many sane Americans who worry about committing a trillion dollars to it. They have a point. We already spend more than twice as much per person on health care as other advanced countries, and our costs are rising faster. How much is enough? Read the whlw post. Dr Angell is a past editor of the NEJM.

New research published by Yale School of Public Health has found that more people are likely to avoid illness if vaccines are given out first to those most likely to transmit viruses, rather than to those at highest risk for complications. This research differs from current vaccination recommendations of the Centers for Disease Control (CDC) and the Advisory Committee on Immunization Practices (ACIP). The Yale study appears in the August 20 issue of the journal Science online at the Science Express website, http://www.sciencemag.org/sciencexpress .

The AP reports that six cases of childhood lead poisoning “in Maine last year came from an unusual source — lead dust tracked into the family car.” Officials from the CDC and the Maine Department of Health and Human Services said that the cases were “the first ever attributed to lead dust on childhood safety seats. The car seats themselves weren’t the source; the inside of family cars were contaminated through a parent’s workplace.” The CDC explained that children’s parents, who worked in paint removal or metals recycling, did not change and shower before going home, and so tracked lead dust into their cars and onto children’s car seats. Then, “Kids chew on the sides of those seats … Or they put a cookie down” on the seat and then eat it, Mary Jean Brown, chief of the CDC’s Lead Poisoning Prevention Branch said. “Maine officials said they now include checks of cars and child safety seats in their lead investigations.”

Record high life expectancy was recorded for both males and females (75.3 years and 80.4 years, respectively). While the gap between male and female life expectancy has narrowed since the peak gap of 7.8 years in 1979, the 5.1 year difference in 2007 is the same as in 2006.

In Massachusetts, the individual mandate means “97 percent of residents there are covered. But while they have insurance, what some don’t have is a doctor.” CBS added, “Just having insurance doesn’t guarantee access. There aren’t enough doctors. It is a real problem. According to the Department of Health and Human Services, we are more than 16,000 primary care doctors short in the United States. About 26,000 new doctors enter the work force every year, but only 6,500 enter primary care. One reason is that starting salaries for primary care doctors are a lot lower than for specialists in radiology, cardiology and urology.” But it is “not just the pay…it’s the paperwork. Dr. Kate Atkinson is drowning in it and says that’s what’s keeping doctors away from primary practices.” COMMENT: There have been similar studies for over 20 years. When Commissoner in VA i had my staff present a simlar study to the General Assembly. It has been repeated all over the country but the Academic Centers consistently ignore the data because it does not lead to new research, only better care of people!

Scientists have used a new production technology to develop a vaccine for norovirus, the unpleasant package of diarrhea and vomiting that has destroyed the costly holidays of thousands of cruise ship vacationers.  Norovirus is the second most common viral infection in the U.S. after the flu, “can spread like wildfire through passenger liners, schools, offices and military bases.”

ABC World News reports, “Protection against the swine flu is going to be delayed for millions of Americans. Federal officials now say that only about a third of the swine flu vaccine the country is counting on will be available by mid-October. That’s when the mass vaccination campaign is scheduled to begin.” Comment: It is not surprising that politically dominated decisions about medial subjects rarely pan out as intended.  The usual rush to judgment was made without adequate scientific input, or else such input was ignored, the most likely event. At the same time we must not let ourselves be diverted from ensuring that children get all the recommended current immunizations.

In this morning’s Richmond Times Charles Krauthammer rails against the use of preventive interventions based on cost effectiveness in reducing chronic diseases.  His argument is based on a CBO study but he lacks knowledge of epidemiology and appropriate interventions.  At the same time we hear about a new report in the Journal of the National Cancer Institute (2009, August 18) that the public overestimates the value of screening. The authors found that the majority of participants have a dramatic overestimation of the benefits of such tests, and that doctors and other sources of information appear to have little impact on improving knowledge of the level of benefit. Ninety-two percent of women overestimated the benefit of mammography screening by at least one order of magnitude or reported they did not know; 89% of men overestimated the benefit of prostate-specific antigen screening or did not know. “Knowing the benefit of a treatment is a necessary condition for informed consent and rational decision making,” the authors write.