Pediatricians Say to Minimize Pesticide Exposure

Good for the American Academy of Pediatrics. I am not aware of previous instances where a group representing the medical establishment has advocated for this.

Children should have as little exposure to pesticides as possible, the American Academy of Pediatrics urged.

A policy statement and technical report from the organization outlined steps for pediatricians to identify pesticide poisoning, evaluate for pesticide-related illness, provide appropriate treatment, and help prevent unnecessary exposure and poisoning.

“Children encounter pesticides daily and have unique susceptibilities to their potential toxicity,” James Roberts, MD, MPH, and colleagues wrote in the December issue of Pediatrics.

Household insecticides, pet flea and tick chemicals, and agricultural pesticide residues are all hazards but may not constitute the biggest impact.

“For many children, diet may be the most influential source,” the statement noted.

It pointed to an organic food intervention study that cut pesticides out of the diet, which showed “drastic and immediate decrease in urinary excretion of pesticide metabolites.”

NY Times Article: Flu Shot Benefits Substantially Overrated

I have never found the hype behind flu shots convincing. Here’s new evidence supporting that skepticism.

It’s flu-shot season, and public health officials are urging everyone over 6 months of age to get one. Many businesses provide on-site flu shots, and some hospitals have told staff members that they have to wear masks if they do not get the vaccine. By 2020, United States health leaders want 80 percent of the population to get yearly shots.

For vaccine manufacturers, it’s a bonanza: Influenza shots — given every year, unlike many other vaccines — are a multibillion-dollar global business.

But how good are they?

Last month,, in a step tantamount to heresy in the public health world, scientists at the Center for Infectious Disease Research and Policy at the University of Minnesota released a report saying that influenza vaccinations provide only modest protection for healthy young and middle-age adults, and little if any protection for those 65 and older, who are most likely to succumb to the illness or its complications. Moreover, the report’s authors concluded, federal vaccination recommendations, which have expanded in recent years, are based on inadequate evidence and poorly executed studies.

“We have overpromoted and overhyped this vaccine,” said Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy, as well as its Center of Excellence for Influenza Research and Surveillance. “It does not protect as promoted. It’s all a sales job: it’s all public relations.”

It’s my impression that it’s people over 65 to whom these vaccines have been most strongly promoted. And those are the folks who derive “little if any protection.”

 

 

Flaxseeds Help Hypertension

Great news from a study in Cuba presented at the meeting of the American Heart Association:

Adding flaxseed to the diets of patients with peripheral arterial disease (PAD) resulted in large drops in blood pressure (BP) of around 10 mm Hg systolic and 7 mm Hg diastolic after six months, according to the results of a double-blind, placebo-controlled study.

“This reduction of SBP and DBP after administration of dietary flaxseed is the largest decrease in BP ever shown by any dietary intervention,” said Dr Delfin Rodriguez (University Hospital Holguin, Cuba) speaking here today at the American Heart Association 2012 Scientific Sessions. Such reductions would be expected to result in around a 50% fall in the incidence of stroke and a 30% reduction in MI, he added.

 

Where the Affordable Care Act Goes from Here

Since the Supreme Court’s decision earlier this year declared the law to be constitutional, the next big hurdle was the November election. If Republicans had taken the White House, it would have been repealed. That’s not happening.

But what is happening? Here’s a helpful commentary from Christene Vessel in Health Affairs:

President Obama’s re-election puts the Affordable Care Act on firm ground for the first time since it was enacted. Now it is up to states to decide whether and how they want to participate.

At issue are two major decisions: whether states are willing and able to run their own health insurance exchanges, and whether they will consent to expanding their Medicaid programs to everyone with an income up to 133 percent of the federal poverty line, as envisioned in the law.

Most Democratic-led states are expected to fully participate in both, although some may seek flexibility. But among the 30 states that will be run by GOP governors starting next year, it is unclear how many will opt in. Many predict that the federal government’s offer of covering the full cost of the Medicaid expansion for the first three years, and 90 percent after that, will be too rich for states to refuse.

The first order of business is committing to running an exchange, entering a partnership with the federal government or opting out altogether. That decision is due next Friday, November 16. For some Republican-led states that have put off the uncomfortable decision to implement a law they oppose, a state-run exchange may no longer be an option.

So far, no deadline has been set for a decision on expanding Medicaid, but states can be expected to address the issue sooner rather than later. When state legislatures open next year, Medicaid expansion will be at the top of most agendas. Meanwhile, states will be carefully watching to see how much the federal government decides to reduce its share of Medicaid funding when a final deficit reduction law is enacted in January.