Supreme Court Accepts Gene Patenting Case

In the long run, this case may have greater influence than many of the higher profile cases on which the Court decides.

The U.S. Supreme Court on Friday agreed to decide whether human genes can be patented, a hotly contested issue with broad practical and ethical consequences for the future of gene-based medicine for millions of people worldwide.

The nation’s highest court in a brief order agreed to review a case over whether Myriad Genetics Inc may patent two genes linked to hereditary breast and ovarian cancer.

In a 2-1 ruling on Aug. 16, a panel of the U.S. Federal Circuit Court of Appeals in Washington, D.C., upheld the biotechnology company’s right to patent “isolated” genes that account for most inherited forms of the two cancers.

That ruling also denied Myriad’s effort to patent methods of “comparing” or “analyzing” DNA sequences.

The appeal against Myriad and the University of Utah Research Foundation was being pursued by a variety of medical associations and doctors, led by the Association for Molecular Pathology. Their case is being handled by lawyers for the American Civil Liberties Union.

There are many issues at play here. Consider this one: gene patents like these held by Myriad can be used (and are used) to deny researchers the right to conduct research related to the patented genes (i.e., breast cancer research) unless they pay the patent holder whatever fee the corporation wishes to charge.

From both ethical and economic perspectives, this is a most controversial topic. I hope the Court decides that genes are the common heritage of all humanity and are not patentable under any circumstances.

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.

“Antibiotic Stewardship” Program Helps Pediatricians Cut Off-Guideline Antibiotic Use

This needs to spread across the medical profession and across the nation.

A program of education and feedback for pediatricians cut inappropriate antibiotic use by about half, a researcher reported here.

In a cluster-randomized trial, the off-guideline use of broad-spectrum antibiotics for acute respiratory infections fell 48% in nine practices that got the intervention, according to Jeffrey Gerber, MD, of the Children’s Hospital of Philadelphia.

In contrast, the use of broad-spectrum drugs in nine control practices fell by 18%, Gerber told reporters at the IDWeek meeting here.

While so-called antibiotic stewardship programs have been successful in hospitals, Gerber said, most antibiotics are prescribed in an outpatient setting, especially for children.

“It made sense to see if we could extend some of these principles to the outpatient setting,” Gerber said.

The Children’s Hospital of Philadelphia, he noted, is associated with 29 pediatric practices that share a common electronic health records system. He and colleagues recruited 18 of them, including 174 clinicians, to take part in the trial.

Practices in the intervention arm got an education session with Gerber or a colleague to discuss guidelines for three diseases – sinusitis, group A streptococcal pharyngitis, and pneumonia – that are best treated, according to guidelines, with narrow-spectrum drugs.

Preventing Unintended Pregnancies and Abortions Through No Cost Contraception

Research evidence confirms beneficial effects of Obamacare’s contraception mandate.

Here’s the abstract of the article from Obstetrics and Gynecology, along with news and commentary from Think Progress Health:

A new study focusing on low-income women in St. Louis, MO concludes that expanding access to free contraception — just as the health care reform law does through its provision to provide birth control without a co-pay — leads to significantly lower rates of unintended teen pregnancy and abortion. Researchers found that when women weren’t prohibited by cost, they chose more effective, long-lasting forms of birth controland experienced much fewer unintended pregnancies as a result.

Researchers from the Washington University School of Medicine in St. Louis worked in partnership with the local Planned Parenthood affiliate to track over 9,200 low-income women in the St. Louis area, some of whom lacked insurance coverage, during a four-year Contraceptive CHOICE study. The CHOICE project simulated Obamacare’s birth control provision by allowing teens and women to select from the full range of FDA-approved contraceptive options and receive their preferred method at no cost. They found that birth rates among the teens who received free birth control in the CHOICE project were less than a fifth of the national teen birth rate — just 6.3 births per 1,000 teens, compared to 34.3 per 1,000 teens nationwide in 2010 — and abortion rates were less than half of both the regional and national rates.

Undergraduate Public Health Education Expands

Some good news from the excellent Public Health Newswire:

At Worcester Polytechnic Institute in Massachusetts, all first-year students participate in a “great problems” seminar focusing on issues such as food sustainability, the world’s water supply or chronic disease. The early public health exposure means a number of those students end up doing public health work in their junior and senior years.

At Kapi’olani Community College in Hawaii, students choose from the service learning “pathways” of health, the environment and elder care as part of their general education curriculum. A recent service project matched Native Hawaiian students with native elders to work on health literacy.

“Their curriculum is just shot through with public health,” Susan Albertine, PhD, vice president at the Association of American Colleges and Universities, told The Nation’s Health. “It’s a beautiful thing.”

Retired Generals and Admirals See Obesity Epidemic as a National Security Issue

Calling the obesity epidemic among America’s young people a national security issue, a group of retired generals and admirals have begun a project called Mission: Readiness to urge the civilian sector to join the military’s effort to bring healthier foods to schools, dining facilities and vending machines. 

This letter from Lt. Gen Norman Seip explains:

I am one of more than 100 retired generals and admirals who supported the Healthy, Hunger-Free Kids Act that Congress passed with bipartisan support in 2010.

The retired generals and admirals of Mission: Readiness know that the poor state of nutrition among children is more than just a national health issue. It is a national security issue and an economic security issue.

The Department of Defense reports that being overweight or obese is the leading medical reason why young adults cannot enlist, with 1 in 4 too overweight to join.

In a time of record deficits, the Department of Defense spends well over $1 billion per year treating weight-related illness among those who have served and their dependents. That pales beside the $150 billion annual medical price tag of obesity in the general population.

The experts at the Institute of Medicine and U.S. Department of Agriculture used the best-known dietary science and consulted widely with stakeholders around the country before establishing the updated school meal standards that have gone into effect this fall. Many schools are doing a creative job in making healthy meals appealing. We need to give the standards a chance to work and give kids a chance to adjust to eating more fresh fruits and vegetables and a little less sugar, salt, and fat.

Schools should not undermine parents’ efforts to instill better eating habits in their children.  Today, hundreds of retired generals and admirals stand alongside nutritionists and parents across America who believe that children deserve to eat healthful meals at school based on sound dietary science, not politics or special interests.

We need to keep in mind that the childhood obesity crisis is serious and is not going away. Any retreat from these new standards would mean turning our backs on the obesity crisis and on the future well-being of our children. With 1 in 4 young adults too overweight to serve our country in uniform, failure is not an option.

Some voices in Congress are intent on blocking and/or rolling back all efforts to decrease calories and increase nutrient density in foods. As noted in a Think Progress article about Mission: Readiness:

Some Republican lawmakers stand in stark disagreement with the generals’ call to regulate nutrition standards in school lunches. Rep. Todd Akin (R-MO), for one, does not believe that schools should provide lunch programs at all. Rep. Steve King (R-IA) — who has referred to efforts to cap calories in school lunches as “the nanny state personified” — claims that constituents have told him “kids are starving in school” and introduced the No Hungry Kids Act to remove the calorie limits on school lunches that are currently in place.

However, even with the current calorie limits, junk foods in school lunches already account for almost 400 billion calories — which, according to the generals’ study, would weigh more than the aircraft carrier Midway if converted to candy bars.

h/t The Schwartz Report

Russia Suspends Import of Monsanto GMO Corn After Study Finds Cancer Link

This French study is clearly having a political impact, causing governments to look more closely at the supposed safety of GMOs. From my point of view, that heightened scrutiny is long overdue. Whether this particular study holds up on further review and is replicated in further studies is at this point unknown. I would also suggest that such review is urgently needed for the industry-funded studies claiming safety.

The biotech industry and university researchers involved in GM research have mounted a major PR campaign over the last year to win over sceptical consumers.

In the past week, pro-GM scientists have been lining up to undermine the French experiments and criticise the way they were conducted.

However, a number of independent academics have praised the French team’s work, describing it as the most thorough and extensive feeding trials involving GM to date.

Mustafa Djamgoz, the Professor of Cancer Biology, at Imperial College, London, said the findings relating to eating GM corn were a ‘surprise’.

Prof Djamgoz, who describes himself as a neutral on GM, said: ‘The results are significant. The experiments are, more or less, the best of their kind to date.’

However, he said that it is now important to ensure they are repeated with more animals by independent laboratories to confirm the outcome.

‘We are not scaremongering here. More research, including a repetition of this particular study are warranted,’ he said.

The professor said it will take two to three years to get a definitive answer.