[Welcome to Mary Chaffee, who went to see the movie Sicko with me; Mary is a friend and wonderfully creative and versatile writer, with extensive credits as a scriptwriter, direct marketer and media producer]
Saturday, June 30, 2007
[Welcome to Mary Chaffee, who went to see the movie Sicko with me; Mary is a friend and wonderfully creative and versatile writer, with extensive credits as a scriptwriter, direct marketer and media producer]
“Scientists said yesterday that they had transplanted a microbe's entire, tangled mass of DNA into a closely related organism, a delicate operation that cleanly transformed the recipient from one species into the other.
After the operations, the "patients" -- single-celled organisms resembling bacteria -- dutifully obeyed their new genomes and by every measure exhibited the biological personas of the donors.
"This is equivalent to changing a Macintosh computer into a PC by inserting a new piece of [PC] software," said study leader J. Craig Venter, chief executive of Synthetic Genomics, a Rockville company racing to be the first to create fully synthetic, replicating cells.
The success confirms that chromosomes can survive transplantation intact and literally rewrite the identity and occupation of the cells they move into. That is a crucial finding for scientists who hope to make novel life forms by packing synthetic chromosomes into hollow, laboratory-grown cells.” (full text)
The same research was also reported by the English online journal firstname.lastname@example.org under the catchy title “genome transplant makes species switch” on June 28 with emphasis on the potential for researches to design a new species from scratch. Though both articles pointed out that the research is still in an early stage and the design rules for an entirely artificial genome are still poorly understood, the fact that the “world’s first synthetic bug” is thriving in a test tube in Rockville has provoked many ethical concerns.
Earlier this month (June 7), while it was still uncertain if this synthetic bug would thrive, the Action Group on Erosion, Technology and Concentration (ETC Group) launched a campaign against Venter’s attempt to patent this research worldwide. “These monopoly claims signal the start of a high-stakes commercial race to synthesize and privatize synthetic life forms,” claimed ETC Group’s Jim Thomas. Pat Mooney, also from ETC Group, said: "For the first time, God has competition. Venter and his colleagues have breached a societal boundary, and the public hasn't even had a chance to debate the far-reaching social, ethical and environmental implications of synthetic life." (related report)
“Patenting of genes has been a controversial matter for many years, but the advent of synthetic biology takes the debate to a new level.” commented Philip Ball from email@example.com.
Another controversy, with different focus, lies in synthetic biology’s link to global problems. While ETC Group dismisses efforts to use synthetic biology to address global problems as one of their marketing strategies, reporters consider Venter’s goal to use his microbes to provide cheap biofuels as a replacement for oil applausive. Similar attempt includes Jay Keasling of the University of California, Berkeley, who also has been working for several years to engineer microbes to synthesize a compound called artemisinin — one of the best available drugs for fighting malaria.
For more details:
Patenting Pandora’s Bug: Goodbye, Dolly...Hello, Synthia! J. Craig Venter Institute Seeks Monopoly Patents on the World’s First-Ever Human-Made Life Form (ETC Group)
The patent threat to designer biology (firstname.lastname@example.org, subscription required)
Minimal genome patent from the Venter Institute
[Editor's note, added June 30, 2007 at 5:17pm: Welcome to Kuan-Ting Chi! She is an attorney and a full-time research student at the law department of the Sheffield Institute of Biotechnological Law and Ethics,
Friday, June 29, 2007
Our colleague, Art Caplan, has written that there is nothing funny about Sicko in his MSNBC column.
Jon Stewart interviewed Michael Moore, who quipped, "This is America, Even Cancer Should Make a Profit" -- The video can be viewed here.
PBS NOW Host David Brancaccio will sit down with the " controversial chronicler of American culture to find out what makes him tick, and why our health care system ticks him off." (More on that after the show airs).
NY Times, Washington Post, CNN are all covering this -- and my husband and some friends and I are going to see the movie this evening. So, more on this topic and our bloggers and friends colleagues go out in droves to witness this event -- One message is coming through loud and clear, and that is what Michael Moore has repeated about the end of for-profit healthcare in the US: "It's wrong and it's immoral. We have to take the profit motive out of healthcare. It's as simple as that."
Thursday, June 28, 2007
"...neither SSRIs as a group not individual SSRIs are major teratogens on the order of thalidomide or isotretinoin. Patients and physicians alike would prefer it if there were clear lines separating "risk" and "no risk" and if all studies gave consistent results pointing in the same direction. Unfortunately, this is often not the case, and the data to inform potential risks of SSRIs are no exception. The two reports in this issue of the Journal, together with other available information, do suggest that any increased risks of these malformations in association with the use of SSRIs are likely to be small in terms of the absolute risks."
I've listened to and read some of the media reports on these studies and want to commend the authors and journalists for presenting a balanced picture of the risks. The researchers are quick to point out that these studies do not compare the very small increase in absolute risks that they found for some very rare birth defects to the risks of not treating depression during pregnancy. Inadequate treatment of depression during pregnancy has been linked to self-neglect, poor nutrition, tobacco and alcohol use, lower utilization of prenatal care, exacerbation of postpartum depression, and maternal suicide. Maternal depression increases stress hormones that may also affect placental function and fetal development, disrupt mother-infant bonding, contribute to low birth weight and prematurity, and result in long-term physical and behavioral complications. The Committee of Research on Psychiatric Treatments of the American Psychiatric Association identified treatment of major depression during pregnancy as a priority area for improvement in clinical management.
Studies indicate that between 10-20% of pregnant women experience depression. Women with a history of depression have a 70% chance of a recurrent depressive episode in the first trimester when antidepressant drugs are discontinued prior to or at the point of conception.
Based on the findings from these two studies and what we already know about depression during pregnancy, health-care providers and members of the media are being responsible when they caution pregnant women about stopping the use of SSRIs simply because they are pregnant. The decision about whether to continue or discontinue taking an antidepressant during pregnancy is one that women need to make with all the facts and with the assistance of an informed health-care provider.
Wednesday, June 27, 2007
"When nurse Julie Thao put a spinal drug in Jasmine Gant's arm at St. Mary's Hospital in Madison a year ago, the fatal mistake struck many as a freak event.
But Thao's intravenous delivery of an epidural pain medication was an unusually public example of a quiet but dangerous health care problem: tubing misconnections.
At least 1,200 times in the past nine years, U.S. hospital workers have inadvertently given patients solutions meant to flow through one tube -- an IV, an epidural, a feeding tube, a bladder catheter, a blood line -- into another tube, frequently causing harm and sometimes death. The true tally is much greater." To read on, click here.
"The bishops, who believe that life begins at conception, said that they opposed the creation of any embryo solely for research, but they were also anxious to limit the destruction of such life once it had been brought into existence. In their submission to the committee, they said: 'At the very least, embryos with a preponderance of human genes should be assumed to be embryonic human beings, and should be treated accordingly.'"
For the full article, click here.
On becoming less-than-human, the Geek says wryly: "The middle ground, perhaps, comes when society realizes that progress is inevitable, "evil" may exist alongside altruism, and — while hindsight is 20/20 — a little foresight and humor can help to create a gray area for a future where machines may outsmart a Mensa member. Even if you live on a limited budget, you can try a few of the following ideas on for size. Who knows? You might decide that you enjoy being less human and more resistant to all the limitations that the flesh endures."
For the whole enchilada, click here.
Tuesday, June 26, 2007
Advanced Cell Technology (ACT) announced in Nature Magazine in August of 2006 that they were creating embryonic stem cell lines from biopsied embyros. The headlines were a bit misleading, suggesting that this method did not result in the destruction of the embryos, when it did. Today, ACT announced at the fifth annual meeting of the International Society for Stem Cell Research (ISSCR) in Cairns, Australia that they had created three separate embryonic stem-cell lines without actually destroying the biopsied embryos. These three embryos are still alive in a freezer. ACT is now calling upon NIH to fund research using these three stem-cell lines because their creation is compatible with President Bush's statement he made following his veto of a bill from Congress that would have expanded federal funding for embryonic stem-cell research. While I applaud ACT's creativity in trying to work within the current US regulatory limits on embryonic stem-cell research, I'm curious what ACT plans to do with these frozen embryos. Will they ever be gestated, or will they just remain "undestroyed" for the next few decades? Another question that bugs me: who actually "owns" these embryos? If they are gestated and born, will they have "registered trademarked" stamped on their foreheads?
Full text here.
Monday, June 25, 2007
April 12-13, 2008
Yale University, New Haven, Connecticut
Keynote Addresses By: Dr. Jeffrey Sachs, Dr. Sonia Sachs, Dr. Susan Blumenthal, and Dr. Jim Yong Kim Call For Abstracts - DEADLINE JULY 15, 2007 - http://uniteforsight.org/conference/2008/abstracts.php
Plus More Than 130 Featured Speakers
Register For Conference - EARLY BIRD RATE ($45 Students, $70 All Others) http://www.uniteforsight.org/conference/2008 REGISTER BY JULY 15th TO SECURE LOWEST RATE
Who should attend? Anyone interested in international health, public health, international development, medicine, social entrepreneurship, eye care, nonprofits, philanthropy, microfinance, bioethics, anthropology, health policy, advocacy, and public service.
- Susan Blumenthal, MD, MPA, Former U.S. Assistant Surgeon General; Senior Advisor For Health and Medicine; Former Deputy Assistant Secretary for Women's Health, U.S. Department of Health and Human Services; Clinical Professor of Psychiatry at Georgetown School of Medicine and Tufts University Medical Center
- Jim Yong Kim, MD, PhD, Co-Founder, Partners in Health; Director, François Xavier Bagnoud Center for Health and Human Rights; François Xavier Bagnoud Professor of Health and Human Rights, Harvard School of Public Health; Chair, Department of Social Medicine, Harvard Medical School; Chief of the Division of Social Medicine and Health Inequalities, Brigham and Women's Hospital; Former HIV/AIDS Director at World Health Organization
- Jeffrey Sachs, PhD, Director of Earth Institute at Columbia University; Quetelet Professor of Sustainable Development, Professor of Health Policy and Management, Columbia University; Special Advisor to Secretary-General of the United Nations Ban Ki-moon
- Sonia Sachs, MD, MPH, Health Coordinator, Millennium Villages
- Ted M. Alemayhu, Founder, Chairman & CEO, US Doctors For Africa
- Greg Allgood, PhD, Director, Children's Safe Drinking Water, Procter & Gamble
- Thomas Baah, MD, MSc, Ophthalmologist, Our Lady of Grace Hospital, Ghana
- Michele Barry, MD, FACP, Professor of Medicine and Global Health Director, Office of International Health; Chief, General Medicine Firm, Yale University School of Medicine
- Georges Benjamin, MD, Executive Director, American Public Health Association
- Terry Blaschke, MD, Professor of Medicine and of Molecular Pharmacology (Active Emeritus), Stanford University School of Medicine
- Neil Boothby, EdD, Professor of Clinical Population and Family Health; Director, Program on Forced Migration and Health, Mailman School of Public Health
- Harry S. Brown, MD, Founder, Surgical Eye Expeditions (SEE) International
- Donald Budenz, MD, MPH, Professor of Ophthalmology, Epidemiology, and Public Health, University of Miami Miller School of Medicine
- Michael Cappello, MD, Professor of Pediatrics and Epidemiology and Public Health; Director, Program in International Child Health; Co-Director, International Adoption Clinic, Yale University School of Medicine
- Emily Moore and Mark Carlson, PhD, Adjunct Professor, Sociology, San Diego State University
- James Clarke, MD, Ophthalmologist and Medical Director, Crystal Eye Clinic, Ghana
- Margaret Duah-Mensah, Ophthalmic Nurse, Crystal Eye Clinic, Ghana
- Susan Hall Forster, MD, Associate Clinical Professor, Department of Medical Studies, Department of Ophthalmology, Yale School of Medicine; Chief, Ophthalmology, Yale University Health Services
- David Friedman, MD, MPH, Associate Professor of Ophthalmology and International Health, Johns Hopkins University
- Michael Gyasi, MD, Ophthalmologist and Director of the Bawku Eye Care Program, Ghana
- Heskel M. Haddad, MD, Clinical Professor of Ophthalmology, New York Medical College
- Leon Herndon, MD, Associate Professor of Ophthalmology, Duke University Eye Center
- Ibrahim Jabr, Interim President, International Trachoma Initiative
- Rosemary Janiszewski, MS, CHES, Deputy Director, Office of Communication, Health Education and Public Liaison; Director, National Eye Health Education Program, National Eye Institute (NEI), National Institutes of Health
- Dean Karlan, PhD, President and Founder of Innovations for Poverty Action; Assistant Professor of Economics, Yale University
- Zachary Kaufman, MPhil in International Relations; DPhil Candidate in International Relations, University of Oxford; JD Candidate, Yale University Law School
- Kaveh Khoshnood, PhD, Assistant Professor in Public Health Practice, Division of Epidemiology of Microbial Diseases, Yale School of Public Health
- Doug Lawrence, Vice President/General Manager, BD Medical - Ophthalmic Systems
- Fiona Macaulay, President, Making Cents International
- Tshepo Mbalambi, BSc, Med Sci, MBcHB Candidate, University of Ghana School of Medicine
- Christine Melton, MD, MS, Friends of Aravind Association
- Mini Murthy, MD, MPH, MS, Assistant Professor, Department of Behavioral Science and Community Health, Program Director Global Health, New York Medical College School of Public Health
- Thomas Novotny, MD, MPH, Director of International Programs; Professor in Residence, Epidemiology and Biostatistics, UCSF School of Medicine
- Edward O'Neil Jr, MD, Founder, Omni Med; Author, Awakening Hippocrates: Primer on Health, Poverty, and Global Service, and A Practical Guide to Global Health Service
- Cliff OCallahan, MD, PhD, Pediatric Faculty, Middlesex Hospital Family Practice Program; Chair, AAP Section on International Child Health
- Elijah Paintsil, MD, Associate Research Scientist, Department of Pediatrics, Yale School of Medicine
- Matthew Paul, MD, Danbury Eye Physicians and Surgeons
- Steven C. Phillips, MD, MPH, Medical Director, Global Issues and Projects, Exxon Mobil Corporation
- Louis Pizzarello, MD, MPH, Secretary General, International Agency for the Prevention of Blindness
- Thomas Quinn, MD, Director, Johns Hopkins Center for Global Health
- Nathan Radcliffe, MD, Glaucoma Service at New York Eye & Ear Infirmary
- Ian Rawson, MD, CEO/Directeur General, Hopital Albert Schweitzer Haiti
- William Reese, President and CEO, International Youth Foundation
- Ilya Rozenbuam, MD, GANY Glaucoma Fellow, New York Eye and Ear Institute
- Lisa Russell, MPH, Filmmaker
- Sarwat Salim, MD, Ophthalmologist
- Werner Schultink, MD, Chief Child Development and Nutrition, UNICEF
- Bruce Shields, MD, Professor of Ophthalmology, Chairman Emeritus, Department of Ophthalmology, Yale University School of Medicine
- Satyajit Sinha, MBBS, Ophthalmologist, AB Eye Institute, Patna, India
- Kari Stoever, Senior Program Officer, Neglected Tropical Diseases, Sabin Vaccine Institute
- Glenn Strauss, MD, Vice President of International Health Care and Programs, Mercy Ships, Int'l
- Robert Farris Thompson, PhD, Col. John Trumbull Professor of the History of Art, Yale University
- Jamie Lachman and Tim Cunningham, Clowns Without Borders
- James C. Tsai, MD, Chair, Department of Ophthalmologist, Yale University School of Medicine
- Satya Verma, OD, FAAO, Director, Community Eye Care, Pennsylvania College of Optometry
- Seth Wanye, MD, Ophthalmologist, Eye Clinic of Tamale Teaching Hospital, Ghana
"The new technology in Japan could let you control electronic devices without lifting a finger simply by reading brain activity.
The "brain-machine interface" developed by Hitachi Inc. analyzes slight changes in the brain's blood flow and translates brain motion into electric signals.
A cap connects by optical fibers to a mapping device, which links, in turn, to a toy train set via a control computer and motor during one recent demonstration at Hitachi's Advanced Research Laboratory in Hatoyama, just outside Tokyo...
Underlying Hitachi's brain-machine interface is a technology called optical topography, which sends a small amount of infrared light through the brain's surface to map out changes in blood flow."
Although this brain-machine interface technology has traditionally focused on medical applications (such as helping individuals with disabilities to operate electric wheelchairs, beds or artificial limbs), manufacturers such as Hitachi and Honda have been seeking commercial applications; Honda is looking to apply the interface to intelligent, next-generation automobiles.While this technology actually has been around for several years, one major advantage to Hitachi's technology is that the technology is non-invasive; previous technologies have required implantation of a chip under the skull.
To read more, click here.
Saturday, June 23, 2007
Unlike the author of that post, I had actually met Dr. Denton a few times; our time at UW overlapped, and although I was in the humanities, I had occasion to hear her speak, and she attended the funeral of a friend of mine, a graduate student doing work in neuroscience and engineering. Sort of ironic, since prior to her untimely death, said friend had been telling me to brace myself for severe culture shock, if I did decide to stay in academia. You see, my friend spent a lot of time experiencing firsthand the gendered bias in science and engineering that Dr. Denton was working to change.
In the years since both of their deaths, I've experienced my fair share of gendered assumptions and biases in academia, and I've discovered that I actually deal better with the blatant issues more than the subtle. Larry Summers making pompous claims about women in math and science is a lot easier to deal with because it's easy to get irate over the blatant stupidity. It's less easy to become irate when people pay you compliments for behaviour you only later realize would not be complimented in a man.
Reading over the story of Denton's life in the months prior to her suicide, it's hard to imagine that the response to her hiring - protests, people throwing things through her windows - would have been the same if Denton had been a man - or at least a straight man.
Thursday, June 21, 2007
Most arguments favoring strategies to reduce multiple births have focused on the poorer health outcomes for the babies, but there is now clear evidence that there are both physical and mental health risks for the mothers as well. European countries have taken strong steps to reduce the rates of multiples caused by infertility treatment. While the ASRM has practice guidelines that, if followed, would reduce the rates of multiple births, we still need to do more to help educate infertile consumers that a multiple pregnancy is not necessarily the best outcome of treatment.
Wednesday, June 20, 2007
While overall mortality rates and death rates due to heart disease declined over the past three decades for men, women, and diabetic men, the percentages for diabetic women seem to have jumped pretty dramatically.
A quote from the Tribune article: "This study adds to the evidence that there is a gender gap in health care ... and it has a bottom-line impact on mortality," said Sherry Marts of the Society for Women's Health Research.
Here's a link via The Seattle Times website:
Are women with diabetes less likely to get appropriate treatments for heart disease, as an accompanying editorial suggests? What factors are at work here? Is this a legacy of the absence of female subjects in research of decades past, leaving physicians lacking in appropriate dosing and other treatments for female patients? Are there socio-economic elements to this negative trend?
"Smoking may be bad for you, but researchers and biotech companies are quietly developing pharmaceuticals that are decidedly good for brains, bowels, blood vessels and even immune systems -- and they're inspired by tobacco's deadly active ingredient: nicotine.
Nicotine acts on the acetylcholine receptors in the brain, stimulating and regulating the release of a slew of brain chemicals, including seratonin, dopamine and norepinephrine. Not surprisingly, the first scientific work that identified these chemicals and how they affect the body came out of nicotine research -- much of it performed by tobacco companies.
Now drugs derived from nicotine and the research on nicotine receptors are in clinical trials for everything from helping to heal wounds, to depression, schizophrenia, Alzheimer's, Tourette Syndrome, ADHD, anger management and anxiety.
"Nicotine is highly stigmatized -- and for good reason, because the delivery system is so deadly," says Don deBethizy, CEO of Targacept. "But the drug itself and the research generated by studying its effects on the brain both show great promise for helping us improve our physical and mental health."
DeBethizy worked for R.J. Reynolds Tobacco Company for 15 years -- he was one of the first to publicly declare that tobacco is addictive -- before he spun Targacept off as a separate company. RJR retains a 4 percent share of the Winston Salem biotech, which has one mission: to develop drugs that target the so-called "nicotinic receptors" in the human central-nervous system.
Nicotine performs that function to an unhealthy extreme. "Nicotine itself is hugely potent and not specific enough," says Linda Gretton, Targacept's director of communications. "But the research we have allows us to take the best therapeutic qualities of nicotine and develop treatments that target receptors."
With funding from pharma giant AstraZeneca, Targacept is headed into Phase II clinical trials for a compound that could help overcome cognitive deficits in people who have Alzheimer's or schizophrenia. The company is also in Phase I trials for a compound that treats pain from molar extractions. The drugs both resemble nicotine in their molecular makeup, but are missing nicotine's addictive properties and toxicity.
Research into the medicinal qualities of nicotine was spurred in the 1990s by the availability of nicotine skin patches. For the first time clinical researchers had a form of nicotine that would deliver a reliable dose for study, and could be paired with placebos in blind trials."
"Imagine that you are depressed and see a psychiatrist who explains that you have clinical depression and would benefit from an antidepressant. So far, so good. But then the doctor tells you there is a 60 percent chance that you’ll feel better with this antidepressant and that it could take as long as four to six weeks to find out, during which time you’ll probably have some side effects from the drug.
I have just described the state-of-the-art pharmacologic treatment of major depression in 2007. Don’t get me wrong; we have very effective and safe treatments for a broad array of psychiatric disorders. But in everyday clinical practice, we have little ability to predict which specific treatment will work best for you.
Laura is a case in point. A successful management consultant in her late 30s, she sought help for lifelong depression. Her treatment began with four weeks of the antidepressant Lexapro, a selective serotonin reuptake inhibitor, or S.S.R.I., without any effect. Next, I switched her to Zoloft, another S.S.R.I., since the chance of response to another member of the same drug family is about 60 percent. Again, no response. Then we moved on to Wellbutrin, an entirely different type of antidepressant, but this didn’t work either. Laura was now ready to call it quits, and who could blame her?
After nearly three months, I had still not found an effective treatment for her. Then she came in one day and said her father had recently revealed that he had been depressed and had done well on Prozac, another S.S.R.I., and she wondered if she could try it. Within three weeks, she felt markedly better, and the symptoms of her depression began to melt away.
Instead of the hit-or-miss approach I had to use with Laura, it will soon be possible for a psychiatrist to biologically personalize treatments. With a simple blood test, the doctor will be able to characterize a patient’s unique genetic profile, determining what biological type of depression the patient has and which antidepressant is likely to work best.
Scientists have identified genetic variations that affect specific neurotransmitter functions, which could explain why some patients respond to some drugs but not to others. For example, some depressed patients who have abnormally low levels of serotonin respond to S.S.R.I.’s, which relieve depression, in part, by flooding the brain with serotonin. Other depressed patients may have an abnormality in other neurotransmitters that regulate mood, like norepinephrine or dopamine, and may not respond to S.S.R.I.’s.
In a report last October in the journal Science, Dr. Francis Lee, a colleague of mine at Weill Cornell Medical College, identified a genetic mutation that could potentially predict patients’ responses to an entire class of antidepressants."
For the rest of the article, click here.
"I have now heard or seen this grim chronology recounted hundreds of times in conversations, e-mails and letters from mothers: At 2-1/2 years old, Christian Wright exceeded all milestones. He had 1,000 words, was toilet-trained, and enjoyed excellent social relations with his brother and others. Then his pediatrician gave him Thimerosal-laced vaccines. He cried all night, developed a fever and, over the coming months, this smart, healthy child disappeared. Christian lost the ability to speak, to interact with family members, to make eye contact or to point a finger. He is no longer toilet trained. He engaged in stereotypical behavior--screaming, head-banging, biting and uncontrolled aggression, and suffers continuously the agonizing pain of gastrointestinal inflammation.
After hearing that story a couple dozen times, a rational person might do some more investigation. That's when one encounters the overwhelming science -- hundreds of research studies from dozens of countries showing the undeniable connection between mercury and Thimerosal and a wide range of neurological illnesses. In response to the overwhelming science, CDC and the pharmaceutical industry ginned up four European studies designed to disguise the link between autism and Thimerosal. Their purpose was to provide plausible deniability for the consequences of their awful decision to allow brain-killing mercury to be injected into our youngest children. Those deliberately deceptive and fatally flawed studies were authored by vaccine industry consultants and paid for by Thimerosal producers and published largely in compromised journals that neglected to disclose the myriad conflicts of their authors in violation of standard peer-review ethics. As I've shown elsewhere, these studies were borderline fraud, using statistical deceptions to mislead the public and regulatory community.The CDC and IOM base their defense of Thimerosal on these flimsy studies, their own formidable reputations, and their faith that journalists won't take the time to critically read the science. The bureaucrats are simultaneously using their influence, energies and clout to derail, defund and suppress any scientific study that may verify the link between Thimerosal and brain disorders. (These would include epidemiological studies comparing the records of vaccinated children with those of unvaccinated populations like the Amish or home-schooled kids who appear to enjoy dramatically reduced levels of autism and other neurological disorders.) The federal agencies have refused to release the massive public health information accumulated in their Vaccine Safety Database (VSD) apparently to keep independent scientists from reviewing evidence that could prove the link. [emphasis added] They are also muzzling or blackballing scientists who want to conduct such studies."
As Mark Twain said, there are "lies, damn lies, and then there is statistics" -- so why wouldn't the federal agencies allow access to this Vaccine Safety Database? Afraid someone will 'spin' them the wrong way?
The Pan American Health and Education Foundation is accepting nominations for the Manuel Velasco-Suárez Award in Bioethics. We are pleased that the Government of Mexico’s Secretariat of Health supports this bioethics award.
This award is one of five awards of The Awards for Excellence in Inter-American Public Health Program, a partnership between the Foundation and the Pan American Health Organization (PAHO).
The Bioethics Award stimulates young scholars in the development of their capacities for bioethical analysis.
The winner is recognized with a certificate of honor, a grant of US $10,000, and a paid trip to Washington DC. Nominations must be received no later than 1 August 2007.
The Foundation encourages you to submit nominations, and invites you to share this information with others.
Beca Manuel Velasco-Suárez en Bioética
La Fundación Panamericana de la Salud y Educación está aceptando nominaciones para el Premio Manuel Velasco-Suárez en Bioética. Estamos complacidos de que el Gobierno de México, a través de la Secretaria de Salud, apoyan este premio en bioética.
Este premio es uno de los cinco galardones otorgados por la Fundación a través del Programa de Premios a la Excelencia en la Salud Pública Interamericana, en sociedad con la Organización Panamericana de la Salud (OPS).
Cabe destacar que este premio en Bioética estimula, entre los jóvenes docentes e investigadores, el desarrollo del análisis bioético.
El ganador o la ganadora es reconocido/a con un diploma de honor, una beca de EUA $10.000 y un viaje con todos los gastos pagos a Washington D.C. La fecha límite para recibir nominaciones es el 1 de agosto de 2007.
La Fundación promueve las nominaciones y agradece compartir esta información con otras personas.
News outlets go gaga and forget to report the downside of megamultiples:
One of the biggest problems arising when megamultiples — more than three babies born all at one time — arrive is the gushing media coverage of the births. First, there's the dash to get a camera into the nursery for baby pictures. Exhausted moms are interviewed right after birth, dazed but thrilled about their little miracles. Dads are shown looking exhausted and overwhelmed as they meet their basketball or hockey team to be.
Why quintuplets,and septuplets happen and what the real price is in the long run for megamultiple births are subjects that, while crucial for understanding the reproductive revolution and its benefits and costs, remain almost unexamined in newspaper, television and magazine accounts. And that is unfortunate, because these costs aren’t limited to just health and financial challenges faced by the family welcoming the new additions, but to society as well.
Earlier this month, two sets of sextuplets were born after their parents used assisted reproductive technologies, and their births generated a lot of media attention. Brianna and Ryan Morrison had four boys and two girls at Abbott Northwestern Hospital in Minneapolis on June 10. Ten hours later, Bryan and Jenny Masche welcomed three boys and three girls at Banner Good Samaritan Medical Center in Phoenix.
The “TODAY” show spent a considerable time cooing about the births of two sets of sextuplets in such a short period of time. The show jumped right into the lives of the Phoenix family. Thirty seconds did not elapse during story promos or actual coverage without the word “miracle” being invoked. The NBC program was hardly alone in going weak-kneed over the births of so many of babies.
CNN chimed in with “good news” reports on its “American Morning” program. The newscaster noted gleefully how “tiny” the babies were.
TV coverage in Phoenix described the births as “gifts” and “bundles of joy,” among other gushing terms. Stations pitched in to help the family raise money and collect baby diapers and clothes. The Minnesota media did not miss a chance to refer to their local sextuplets as “blessings.”
The Boston Globe, Newark Star Ledger and many other papers ran short stories that heavily emphasized the good news about the sextuplet births and noting how pleased and happy the parents were.
There is plenty to celebrate when babies are born. I am not arguing that joy and delight have no place in media coverage of these events. But the media owe us more than just cheering, gushing and cooing when reproductive technologies create babies in numbers that do not occur naturally and, more seriously, that carry tremendous risks.
The babies themselves are put at grave risk when there are more than two. Having megamultiples means the babies face less room to grow in the womb, prematurity and low birth weights. All of these translate into high risk for mental retardation, learning disabilities, cerebral palsy and vision and hearing loss for the babies. They are also 20 times more likely to die in the first month of their lives than singletons.
Infants born in big numbers also need to spend a lot of time in neonatal intensive care units to allow vital organs to develop, which means they require expensive, high quality medical care. Those costs are almost always borne by either insurance plans or state Medicaid funds, meaning you and I pay their bills. And obviously, if there are complications that affect the children as they grow, helping the kids — and the parents — with their health problems through special education, multiple surgeries and rehabilitative care can run into the millions of dollars.
Multiple births are not, as the media coverage would have you believe, unadulterated, wondrous miracles with no downside, nor are they generally the result of accidents, divine will or luck.
Fertility clinics sometimes transplant more than three embryos at a time into women, knowing that megamultiples could result. But a clinic can look good in comparison to its competitors by saying it can succeed in delivering babies to infertile couples. So some, incredibly, continue the practice, understanding it may be at the cost of the mom and babies’ health.
Some infertility programs also give women drugs to make them ovulate more, but then don’t monitor the patients carefully to ensure that the couple doesn’t have unprotected sex if the drugs are a little too successful and produce too many eggs.
And some clinics do not explain clearly what the real dangers are of having megamultiples. Nor do they fully encourage the option of eliminating one or more of the fetuses in utero — a procedure called selective reduction — to preserve the health of the more viable babies if there are complications or problems in the pregnancy.
Megamultiple births are not the miracles the media makes them out to be. In fact it could be argued that we should be doing more as a matter of public policy to discourage megamultiple births by getting infertility programs to do more to minimize the risk of creating them. But, given the kind of “check your critical senses at the door” media coverage that always seem to accompany these births, these are not ideas you are likely to be asked to consider in thinking about the realities about megamultiple births.
Tuesday, June 19, 2007
“Contraceptive advertising must stress health-related uses rather than the prevention of pregnancy.”That quote was from Fox's written refusal to air the commercial for Trojan's new advertising campaign Trojan Evolve.
After watching the commercial I fail to see where or when Fox decided that this ad was promoting the prevention of pregnancy and not the health-related issues surrounding sex. The ad doesn't appear to make that distinction so for all we know the pigs were sterile and HIV positive.
According to the Trojan Evolve website, there are 750,000 unintended teenage pregnancies in the US each year and one in four Americans have a sexually transmitted infection by the age of 25. Imagine for a moment the number of teenagers and young adults this commercial would reach (and potentially impact) if Fox chose to broadcast it during American Idol. The fact that Fox refuses to do so is particularly disturbing in light of their past and present prime-time programming.
To be fair, CBS also refused to air the commercial stating:
“while we understand and appreciate the humor of this creative, we do not find it appropriate for our network even with late-night-only restrictions.”
I could go on about the irony of both these statements coming from TV networks, but really the rest of this post is best summed up by this quote from the NYT article:
“It’s so hypocritical for any network in this culture to go all puritanical on the subject of condom use when their programming is so salacious,” said Mark Crispin Miller, a media critic who teaches at New York University. “I mean, let’s get real here. Fox and CBS and all of them are in the business of nonstop soft porn, but God forbid we should use a condom in the pursuit of sexual pleasure.”
Friday, June 15, 2007
According to the website of cutting-edge RYT hospital (who also brings us NanoDocs, Genochoice and "all the miracles of modern medicine" here's the scoop on how Clyven came to be:
"Margaret A. Keyes, M.D., Ph.D., is a researcher in genetic medicine and Professor of Cell Biology and Genetics at RYT Hospital-Dwayne Medical Center. She is exploring the use of embryonic stem cells as a means to cure neurological conditions such as Alzheimer's Disease and Creutzfeldt-Jakob Disease.
By implanting human brain cells (grown from a human embryo's stem cells) into a mouse engineered to have Alzheimer's, Dr. Keyes inadvertently made a remarkable and startling discovery: she not only cured the mouse's Alzheimer's Disease, but the animal soon developed the relative intelligence of a human being.
After extensive consideration by RYT Hospital's Institutional Review Board (IRB) and Institutional Animal Care and Use Committee (IACUC), it was decided that this mouse would be placed under a new study led by Dr. Keyes' lab."You can chat via neuro-dialogue interface with Clyven and test your intelligence against his in the cheese maze!
Providing much food for thought...
[Editor's note, added June 21, 2007 at 11:03 am: the above site is merely one artist's entertaining, fantastical rendition of possible developments in science -- neither POP, nor Genochoice, nor Nanodocs are 'real' -- we've blogged about POP before, here, noting that's the artist's knowledge of the science is very impressive]
Magnetoencephalography (MEG) is a completely noninvasive, non-hazardous technique for functional brain mapping. A MEG facility is being established at the Material Science division, Indira Gandhi Centre for Atomic Research (IGCAR), Kalpakkam through an entirely indigenous effort by a team headed by Mr. M. P. Janawadkar and Dr. T. S. Radhakrishnan.
Magnetoencephalography (MEG) is a completely noninvasive, non-hazardous technique for functional brain mapping. A MEG facility is being established at the Material Science division, Indira Gandhi Centre for Atomic Research (IGCAR), Kalpakkam through an entirely indigenous effort by a team headed by Mr. M. P. Janawadkar and Dr. T. S. Radhakrishnan.
Dr. T. S. Radhakrishnan is the Co-principal Investigator of the Magneto encephalography project funded by the Department of Science and Technology (DST), Government of India. He is a specialist in experimental low temperature physics and the major part of his research work was carried out at IGCAR. In his early career, he has worked with the Tata Institute of Fundamental Research, Mumbai.
Priya: Could you explain what Magnetoencephalography (MEG) is all about?
Dr. T. S. Radhakrishnan : The human brain generates electrical impulses and this in turn produces a very weak magnetic field. A popular diagnostic method used is Electroencephalography (EEG), which measures the electrical activity of the brain. Though effective in many medical cases, EEG does not reflect accurately the electrical responses generated by the brain. This is because EEG is probed by electrodes attached to the head and the skull happens to be a poor conductor of electricity.
However MEG uses a non-invasive sensor called SQUID, which is an acronym for Superconducting Quantum Interference Device. With a number of SQUIDs positioned in the shape of a helmet over the human head, it is possible to map the weak magnetic fields generated due to brain activity and infer the information as to the origin of the electric signal (causing the magnetic signal) in the brain. Unlike the EEG, the MEG is a very fast technique and can probe the dynamics of the brain with a millisecond response(1/1000th of a second). The magnetic signals from the brain are extremely tiny. They are about a billion times weaker than the ever present magnetic field due to our earth (the latter about 40 MicroTesla, Tesla being the unit of magnetic field intensity). This is precisely why we need SQUIDs, as it is the most sensitive sensor known for detecting changes in the magnetic field due to any origin.
The MEG technique allows neurosurgeons to localize the cortical activity in the brain due to any external stimulus very precisely to the order of one millimeter. Here MEG can be used to provide a pre-surgical evaluation of the brain non-invasively which can help the surgeon to distinguish between the affected and non-affected areas before hand in case of brain diseases, such as epilepsy. In addition, the MEG technique offers vast scope for scientists to unravel the mysteries in neuroscience which is the most challenging task of this century. Hence the SQUID sensor is a boon in this context.
Priya: How much research has been conducted in this field and how unique is this project?
Dr. T. S. Radhakrishnan : As the name implies, the SQUID is a major development in the field of superconductivity, discovered in 1911, as an off shoot of the developments in low temperature physics. Since then a lot of progress has been made in the field of superconductivity, superconducting materials and applications of which the MEG technique is a prime example. Presently, there are around 40 to 50 centres working on MEG spread over only a few advanced countries.
In India however IGCAR is the first centre to pioneer the development of SQUID leading to the development of the MEG. As Dr. Baldev Raj, the Director of IGCAR often said, this MEG project as well as the developments of other SQUID based systems in IGCAR is directly the result of sustained basic science pursuit by IGCAR in the field of superconductivity and this makes the project unique. I stress on this because although SQUIDs are available commercially in the market, very few people even internationally truly know the science and technology behind making SQUIDs. In the MEG project, we are collaborating with Dr. L. Shobini Rao of the National Institute of Mental Health and Neurological Sciences (NIMHANS), with whom we will carry out joint investigations when the instrumentation is set up by us.
Priya: Your team has constructed the first SQUIDs in India. What are the applications of this device?
Dr. T. S. Radhakrishnan : It is a very sensitive and non-invasive probe. At IGCAR we have a group of experts on this field working towards the development of SQUID based instrumentation for many applications. In basic research for example, it is being used to probe the magnetic properties of materials and superconductors leading to advancement in materials science and condensed matter physics. IGCAR has developed the SQUID NDT (non-destructive technique) to detect deep-rooted flaws in materials and components of relevance in engineering, non- invasively.
SQUIDs have several distinct applications in the field of science, medicine, engineering and industry. It is also used in geophysical mineral explorations and for mining purposes.
Priya: How much does this project cost the Department of Science and Technology and is this grant sufficient?
Dr. T. S. Radhakrishnan : I must mention that it was a tremendous thing that the Department of Science and Technology recognized our work on SQUIDs and invited us to establish this MEG project. I must in particular thank Dr. V. S. Ramamurthy, Secretary, DST for this. The Governmental initiative of this project furthering the development in laboratories has evoked admiration even in some advanced countries. I must also mention that the project proposal was reviewed and approved by a very eminent Committee chaired by Dr. R. Chidambaram, the Principal Scientific Advisor to the Cabinet and it consisted of the eminent neuroscientists and former chairman of ICMR, Dr. P. N. Tandon. The projection for the cost of the project is about Rs. 6 Crores which is our estimate and which has been sanctioned entirely. In terms of funding, we feel that this is adequate. There are other supports as well. The infrastructure costs like the provision of a building exclusively for setting up this project are being taken care of by IGCAR.
As I mentioned, the Director of IGCAR and the Department of Atomic Energy (DAE) have been highly supportive of this project due to the inherent strength of our group and the merit of the project and its applications and its scope for further technological fallouts. Six other scientists from IGCAR, well trained in the development and use of SQUIDs are also contributing to the project in one way or another. And of course we will also be using the SQUIDs developed in IGCAR for this project. This project is a prime example that the scientists of DAE have been able to enjoy full creative freedom even in areas not pertaining to main stream activity.
Priya: Can a developing country like India afford to indulge in such a project? What relevance would this have in the common man’s life?
Dr. T. S. Radhakrishnan : Such technical advancements and scientific developments are what help India develop in the first place. As I mentioned earlier, several established scientists working on MEG in Europe, have appreciated that we have embarked on setting up this complex technology from scratch. For many practicing scientists in the world using commercial instruments, this technology is a black box but they are only interested in the science it generates. For us, it is the coming together of basic and application oriented science, through entirely indigenous pursuits. Hence India has every reason to feel proud about this project.
As for its relevance, many present day diagnostic equipments commonly available today are a result of painstaking developments in the laboratories. The X-ray machine is a prime example. Similarly the MEG will be a futuristic diagnostic tool to study the human brain.
Priya: What is the current status of the project?
Dr. T. S. Radhakrishnan : Owing to the presence of extraneous magnetic fields due to environmental noise which are a million times stronger than the magnetic signals of the brain, proper shielding is necessary for the MEG technique to work without interference. We are establishing a special building with non-magnetic stainless steel for reinforcement in concrete and also a Magnetically Shielded Room (MSR) made of special alloys. Both of these are the first of their kind in India. We are also simultaneously working on the necessary SQUID instrumentation for this project.
Priya: Being a scientist at IGCAR, one is compelled to ask you as to why the post-tsunami reports claiming that there were leaks in the Kalpakkam nuclear power plant were hushed up?Dr. T. S. Radhakrishnan : This is not my area of specialization but I shall nevertheless answer this from my general understanding. First and foremost there was no occurrence of such a leak . No disastrous effect has been reported so far and things as pernicious as radioactive leaks can never be hushed up. There is a fresh water pond and a bird sanctuary 3 kilometres away from the reactor and life there goes on very normally. IGCAR has a specialist Radiological Safety Division working on overseeing safety aspects. There are other checks and controls as well in place. There is an Environmental Survey Laboratory as part of the reactor complex with a mandate to monitor increases in radioactivity in the background. So far, I have not heard of any significant increase.
Priya has a Masters in Economics from Stella Maris College , India, a Masters in Journalism from the Asian College of Journalism, India and an MBA from the Great Lakes Institute of Management, India. She is a freelance journalist and is the Chief Editor of 'Gravity' (a business journal) and we're hoping she'll be a guest blogger for us!
Thursday, June 14, 2007
Apparently, the FDA agreed -- citing data as which indicated that the drug doubled a patient’s risk of psychological problems, including anxiety, depression, aggression and psychosis; the data reflected an increase in suicidal thinking among users of the drug, and included four patients who did commit suicide while using the drug.
The full article can be found in the NY Times here.
From the NY Times this morning, too:
"Stark evidence that high medical payments do not necessarily buy high-quality patient care is presented in a hospital study set for release today.
In a Pennsylvania government survey of the state’s 60 hospitals that perform heart bypass surgery, the best-paid hospital received nearly $100,000, on average, for the operation while the least-paid got less than $20,000. At both, patients had comparable lengths of stay and death rates.
And among the 20 hospitals serving metropolitan Philadelphia, two of the highest paid actually had higher-than-expected death rates, the survey found.
Hospitals say there are numerous reasons for some of the high payments, including the fact that a single very expensive case can push up the averages.
Still, the Pennsylvania findings support a growing national consensus that as consumers, insurers and employers pay more for care, they are not necessarily getting better care. Expensive medicine may, in fact, be poor medicine."
Complete article can be accessed here.
"Cancer experts have identified a set of health problems that may be symptoms of ovarian cancer, and they are urging women who have the symptoms for more than a few weeks to see their doctors.
The new advice is the first official recognition that ovarian cancer, long believed to give no warning until it was far advanced, does cause symptoms at earlier stages in many women.
The symptoms to watch out for are bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly and feeling a frequent or urgent need to urinate. A woman who has any of those problems nearly every day for more than two or three weeks is advised to see a gynecologist, especially if the symptoms are new and quite different from her usual state of health."
Full text here.
Wednesday, June 13, 2007
Feminist Approaches to Bioethics (FAB), was founded in 1992 at the Inaugral Congress of the International Association of Bioethics, but it has recently taken steps to be a much stronger presence in the international bioethics arena. First, FAB has revamped its website. Second, FAB has founded a new international journal. There are descriptions of the first three planned issues with a call for papers listed on the website. FAB members always get together at the annual American Society for Bioethics and Humanities meeting, so if you plan to attend ASBH this October in Washington, DC, don't forget to attend. Membership for FAB will be changing next year. The modest dues, based on income level, will include a subscription to the new international journal. Consider joining FAB and helping it grow as an international presence in bioethics. Congratulations FAB!
Tuesday, June 12, 2007
From USA Today:
"Hollywood figure, filmmaker Jerry Zucker, is trying to influence the [stem cell] debate with his own video, this one a slickly produced spot posted on youtube.com.
The 3½-minute film, which is not scheduled to run on TV, portrays Bush in a video conference with two workers at a fertility clinic who plead for guidance about what to do with the embryos that are no longer wanted by couples...
For Zucker, it's personal. His 19-year-old daughter, Katie, has Type I diabetes. A sometime dinner partner of California Gov. Arnold Schwarzenegger, Zucker was a backer of California's 2004 voter proposition that set aside $3 billion for taxpayer-funded stem cell research in the state. Zucker and other proponents of stem cell research believe it will lead to breakthroughs in combating diabetes, Parkinson's, Alzheimer's and other diseases."
Monday, June 11, 2007
"A year after Harvard University scientists began trying to create cloned human embryonic stem cells, they have been stymied by their failure to persuade a single woman to donate her eggs for the groundbreaking but controversial research.
The goal of the work is to create embryonic stem cells -- all-purpose formative cells that can develop into virtually any cell in the body -- that are genetically matched to a patient with a particular disease, such as diabetes. Studying such cells could give scientists new insights into the diseases and possibly lead to treatments.
"It's an important experiment and we can't do it," Kevin Eggan, an assistant professor of molecular and cellular biology at Harvard.
Without unfertilized eggs, scientists cannot create cloned embryonic stem cells through the conventional method. Called somatic-cell nuclear transfer, the procedure involves replacing the DNA in a donated egg with DNA extracted from a patient's cells. Scientists coax this new egg to grow for several days in a laboratory dish until it is an early embryo and stem cells can be obtained.
Over the last year, Harvard has spent tens of thousands of dollars on local newspaper ads in an attempt to recruit egg donors. Hundreds of women have responded to the ads, but none has followed through with donations, for a variety of reasons, Eggan said in an interview.
For one thing, egg donation requires repeated clinic visits and minor surgery under general anesthesia to remove the eggs from the ovaries. Women also face a small risk of ovarian hyperstimulation syndrome, an excessive absorption of fluids."For access to the full article, click here.
Israeli scientists imprint multiple, persistent memories on a culture of neurons, paving the way to cyborg-type machines
"The main achievement was the fact that we used the inhibition of the inhibitory neurons" to stimulate the memory patterns, says physicist Eshel Ben-Jacob, senior author of a paper on the findings published in the May issue of Physical Review E. "We probably made [the cell culture] trigger the collective mode of activity that … [is] … possible."
The results, Ben-Jacob says, set the stage for the creation of a neuromemory chip that could be paired with computer hardware to create cyborglike machines capable of such tasks as detecting dangerous toxins in the air, allowing the blind to see or helping someone who is paralyzed regain some if not all muscle use.
Ben-Jacob points out that previous attempts to develop memories on brain cell cultures (neurons along with their supporting and insulating glial cells) have often involved stimulating the synapses (nerve cell connections). So-called excitatory neurons, which amplify brain activity, account for nearly 80 percent of the neurons in the brain; inhibitory neurons, which dampen activity, make up the remaining 20 percent. Stimulating excitatory cells with chemicals or electric pulses causes them to fire, or send electrical signals of their own to neighboring neurons.
According to Ben-Jacob, previous attempts to trigger the cells to create a repeating pattern of signals sent from neuron to neuron in a population—which neuroscientists believe constitutes the formation of a memory in the context of performing a task—focused on excitatory neurons. These experiments were flawed because they resulted in randomly escalated activity that does not mimic what occurs when new information is learned.
This time, Ben-Jacob and graduate student Itay Baruchi, who led the study, targeted inhibitory neurons to try to bring some order to their neural network. They mounted the cell culture on a polymer panel studded with electrodes, which enabled Ben-Jacob and Baruchi to monitor the patterns created by firing neurons. All of the cells on the electrode array came from the cortex, the outermost layer of the brain known for its role in memory formation.
Full text can be found here.
Friday, June 08, 2007
Seems that Luigi Ambrosio, lead researcher on the project, which is currently undergoing clinical trials at Rome's Policlinico Gemelli hospital, and a colleague traveled to America, were horrified by the expanding waistlines as far as the eye could see, and decided that an absorbent material related to work they were doing for a Swedish paper product company had promise as an appetite suppressant and satiatant. Plus treating edemas and...watering plants. (No, I'm not going to let that one go.)
Basically, you pop this little cellulose pill and drink two eight ounce glasses of water. The water helps the pill expand into a tennis ball size/shape lump of gel, which sits in your tummy until being flushed through and out your GI tract. It's essentially gastric banding, but with a spacer instead of a clamp. (Many people commenting in other places say that drinking a glass or two of water alone is the same thing, but it's pretty clear - heh - that the benefit of this is that it can't quickly flush out of your stomach, and won't create the sloshy indigestion that is possible when food hits a stomach full of liquid.)
And on the one hand, this sounds interesting. Weight loss, proper diet, the whole nine yards, are undoubtedly a major issues in not just America, but much of the world. This seems like it could offer a method by which people who might otherwise be frustrated at the inability to feel full while eating calorically accurate amounts of food could learn what the right size meal is while not feeling hungry and any associated psychological twinges of failure that goes along with it.
On the other hand, though, what's the potential for abuse here? It sounds like the makers are hoping to release it as a supplement, which means no FDA or medical oversight. What would this do to someone who's already thin, but convinced they need to lose more weight? Would it enable anorexias to further depths of not eating? Is it possible to overdose, fill up with too much gel, rupture something? Is it a choking hazard? How hard would it be to clear from an airway, if the gel expanded in the throat and not the stomach? There are a lot of questions around implementation and safety that need to be addressed before it's released on the general market.
Still, using plant hydration gels is undoubtedly clever, and in a society that is battling the dual self-image issues of seeing virtuous beauty in thinness, and loathing in the expanding size many people have or are becoming, the jiggling, wiggling, belly-ful pill will undoubtedly find a home in many medicine cabinets.