Does Vaccination Prevent Cancer?

7 03 2011

The history of anxiety about possible negative effects of vaccines is long, tracing back at least as far as Benjamin Franklin. Countering these worries is the fact that vaccines are one of the greatest public health successes of our time, saving millions of lives worldwide.

Now we know that vaccine benefits may extend beyond prevention of the target childhood disease.

An already recognized extra benefit comes with the vaccines for varicella. A varicella vaccine not only can prevent chickenpox in young people, but may also stop the occurrence of shingles in older folks.

Shingles, a neurological attack by the chickenpox virus decades after an infection, can cause a rash that leaves behind chronic, unbearable pain. Vaccination in childhood may protect against shingles, and according to a new study from a Texas group, published in The Journal of Pediatrics, childhood vaccines may offer reduced odds of childhood cancer.

The researchers, going on hints from earlier studies, looked at vaccine rates in specific areas and compared those numbers to childhood cancer rates in the same region. While childhood cancers are rare, they are, of course, devastating. The most common cancers in children are leukemia and brain and spinal cord cancers. According to previous studies, some common childhood infections might increase a child’s risk of leukemia, while vaccinations might reduce that risk. It’s not a nutty idea that some infections—especially viral infections—might be associated with cancer. Indeed, a few viral infections have an established association, including human papillomavirus (HPV, associated with cervical and anal cancers), hepatitis B (associated with liver cancer), and Epstein-Barr (the “mono” virus, linked to a type of lymphoma).

The researchers looked at the 2800 cases of childhood cancer diagnosed in Texas from 1995 to 2006, focusing only on cases diagnosed in children two years or older. For every child diagnosed with cancer, the team identified four more children who had not had cancer, matched for age and sex. As a final step, they then mapped how many children from each group had been born in Texas counties with high vaccination rates.

Their results showed that where hepatitis B vaccination rates were high, odds of all childhood cancers fell by almost 20%. Where rates of inactivated polio virus, hepatitis B, or a specific mix of childhood vaccinations were high, odds of finding cases of a common childhood leukemia, acute lymphoblastic leukemia (ALL), dropped by as much as 38%. The biggest dip in odds came with higher rates of Hib (Haemophilus influenzae type b) vaccine and ALL, with a 42% decrease in ALL odds where Hib vaccination rates were high.

It’s important to remember that the authors didn’t establish a cause–effect link here. This study is based on the numbers, and the take-home message here is a simple one. The authors put it best in their abstract: “Some common childhood vaccines appear to be protective against ALL at the population level.”





Keep Your Illness to Yourself

17 02 2011

It starts with a sneeze and a sniff over the cubicle wall. “Ugh!” you think as you slather yourself in hand sanitizer, “Why is that person at work while they’re sick? I have a vacation next week, I cannot get sick!”

According to a recent study, nearly three out of four people go to work when they’re sick and about one in three Americans said they would show up to work no matter how sick they feel.

Image by Leonid Mamchenkov

Why do we do it?  Why do we insist on going to work sick and making ourselves and everyone else miserable?

Turns out there are reasons. We often have a lot of anxiety about taking a sick day. A study by the U.S. Bureau of Labor Statistics found that 19% of Americans feel pressure by their boss or supervisor to go to work when they are feeling sick. Some of us don’t have the luxury of sick days and taking a day off means less pay. While this might seem unfair, it’s a reality for many.

The truth is — everyone loses when we go to work sick.

We can prolong our illness or exacerbate it by not getting the rest our body needs to fight the infection.

Our coworkers lose by being exposed to a microbe that can sicken them and that they in turn will share with their family and friends. More than half of workers have pointed a finger at a coworker as the source of their illness.

There’s also a cost associated with coming to work sick. Presenteeism, when an employee shows up sick and isn’t productive, costs the U.S. economy $180 billion annually in lost productivity.

OK, maybe that’s not the best motivation for staying home when sick, but we need to give our coworkers a break.  Don’t be the coughing, hacking, germ-spreading guy who ruins everyone’s weekend or worse, vacation, by making them sick.  Stay home, watch TV, eat ice cream, sleep.  Your body deserves it.





Medicine: Modern v. Ancient

18 11 2010

As the number of Americans with no health insurance soars and more people use the emergency room as a primary care clinic, it is no wonder many Americans have the jitters about healthcare.

With all the news coverage and grim forecasts, it’s easy to forget that many aspects of modern medicine are dramatically superior to days of yore.

Take Arcagathus for example: the first doctor in Rome, he was widely admired until word got around that his use of knives and cautery was more likely to bury the patient than heal him.  Thereafter, he was known as the “Executioner.”

Nowadays, we can be grateful that physicians have to go to school and learn all sorts of ways not to harm a patient before they’re allowed near one.

Modern medicine may be expensive and over-prescribed, but as a rule it doesn’t contain heroin.

In the late 1800s, Bayer added heroin to their cough suppressant for kids, and boy did it work.  But after a few years, people noticed the hospitals were filling up with addicts.  They still weren’t coughing, but what a trade-off!  By the early 1900s, Bayer pulled the drug.

On the upside, and at about the same time, Bayer brought aspirin to us, and where would we be without it?

Reports from two centuries ago of experimental treatments by the surgeons of the Royal Navy provide additional perspective on today’s healthcare woes: One pneumonia patient had pints of blood removed in an effort to cure him—it was called bloodletting. He still managed to expire, confounding his surgeon.  Another Royal Navy favorite was “tepid salt water baths.” Surprisingly, there were never any survivors of this therapy.  One poor sod who fell overboard and nearly drowned had tobacco smoke blown on him as a cure.  He did survive, but ended up hospitalized for pneumonia.

In ancient Mesopotamiaa sorcerer would be called in to determine which god caused what illness in a patient. Having identified the god, the sorcerer would attempt to send it away with charms and spells.  We do not have accurate records as to the success rate of this treatment.

The Egyptians believed mightily in the practice of medicine and left copious notes on papyrus for following generations.  Dr. Bob Brier shared some of their cures in his book, Ancient Egyptian Magic. After reading a bit, our mood elevated, our perspective shifted, and we decided to just shut up and soldier on, happy with the modern medicine we have.

In case you’re curious about what was written on some of that papyrus, read on, but do not try this at home:

Cure for Indigestion

  • Crush a hog’s tooth and put it inside of four sugar cakes. Eat for four days.

Cure for Burns

  • Create a mixture of milk of a woman who has borne a male child, gum, and ram’s hair. While administering this mixture say:

Thy son Horus is burnt in the desert. Is there any water there? There is no water. I have water in my mouth and a Nile between my thighs. I have come to extinguish the fire.

Cure for Lesions of the Skin

  • After the scab has fallen off put on it: Scribe’s excrement. Mix in fresh milk and apply as a poultice.

Cure for Cataracts

  • Mix brain-of-tortoise with honey. Place on the eye and say:

There is a shouting in the southern sky in darkness, There is an uproar in the northern sky, The Hall of Pillars falls into the waters. The crew of the sun god bent their oars so that the heads at his side fall into the water, Who leads hither what he finds? I lead forth what I find. I lead forth your heads. I lift up your necks. I fasten what has been cut from you in its place. I lead you forth to drive away the god of Fevers and all possible deadly arts.

Modern healthcare certainly has its problems, but at least today’s patients are free of spells, tobacco smoke and bloodletting. Is that better than a 4-hour ER visit? You be the judge.





Genetically Modified Mosquitoes: The End of Malaria?

30 08 2010

Every year on this planet, malaria kills roughly one million people, many of them children. Scientists are trying to change that number.

Given that malaria is transmitted by the mosquito, which only lives about a month, shortening the mosquito lifespan could reduce the number of infections.  At least in theory.

Dr. Michael Riehle and his staff at the University of Arizona have been busy engineering a GM (genetically modified) mosquito. They’ve shortened the lifespan of the mosquito without modifying its essential functions, and this could change the lives of people who live with the threat of malaria on a daily basis.

The bugaboo is that genetically modifying insects, plants, and animals can result in unintended consequences.  There are scenarios that can’t be tested in a laboratory environment, or anticipated in the wild.    For instance, what if the GM mosquito, unable to transmit malaria due to a shortened life span, is the perfect vector for transmission of some other disease?

In the U.S., numerous exotic species have been introduced accidently—and intentionally. Many have become invasive species.  The kudzu vine, the Japanese beetle, the snakehead fish, pythons, and the elm bark beetle are a few in a long list of  species that have endangered indigenous plants, fish and animals because they have no natural predators in their new habitat.

Today we have GMOs (genetically modified organisms), including bacteria, plants and animals, that have been highly successful in the lab advancing medical research.

GM plants have been used in the fields and the foods we eat since the early 1990s.   Staple crops like corn, soy beans, and tomatoes are some GM crops.  Have there been ramifications?  Are there health implications?  Can we even identify the products that are genetically modified?

Just recently, GM canola plants, which are pesticide-resistant, have been found cross-pollinating in the wild with weeds.  The repercussions are not yet known.  Meanwhile, genetically engineered sugar beets, responsible for 50 percent of our sugar, have been tabled due to a federal court ruling.

Various GM lab animals and GM crops and livestock are on the docket for FDA review.  There is the potential for benefit, but there is also concern.

Currently there is nothing stopping someone from introducing these GM mosquitos, which could be the answer to many prayers, or a possible “frankenfish.”

There are proponents and opponents in the GM debate.  On which side do you land?





Medical Info on the Internet. Reliable?

14 06 2010

When we or our loved ones are diagnosed with a condition, many of us turn to the Internet for information.

Last year, 61 % of Americans used the Internet to research health topics.

The question is, how do we know if the medical information we find online is worth the time spent looking it up?

The National Library of Medicine has a 16 minute tutorial in both English and Spanish that helps users distinguish between reputable sites and those that may not be credible.

When faced with a potentially catastrophic diagnosis, we want to believe the hopeful sites that promise a cure, no matter who the authors may be, but we’re better served in the end by paying attention to details that tell us if a website is trustworthy.

Following are some things to note when determining a site’s credibility:

  • Who sponsors the website and are they easy to identify?
  • Is the sponsor’s contact information easy to find?
  • Who are the sites’ authors?
  • Who reviews the text?
  • Is it easy to determine when something was written?
  • Is there a privacy policy?
  • Does the information sound too good to be true?

The Internet can provide real assistance to us as we work to become team members in our own health care.

One benefit to having access to new technology is we can arrive at our doctor’s office better prepared for the visit. Given that doctor/patient visits last on average only eight to10 minutes, this is good news.

The more we understand walking in the door, the more time we’ll have to get the information that only comes from our healthcare professionals.

Bottom line is, we shouldn’t believe everything we read on the Internet, but if we become discerning in our online research, we’ll be more effective health advocates for ourselves and those we love.

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PubMed: Obtaining Full-Text Journal Articles

23 04 2010

In our previous PubMed articles, we discussed finding free articles online and conducting more effective searches. In this PubMed post, we discuss ways to get full text articles that are not free online.

Visit Your Libraries

Local Library

Check with your local library to see if they have the journal in question, or if they can get it in for you. This may be your only recourse for getting full articles at no cost, even if you have to wait awhile to get the journal.

Nearest Medical Library

If your local library doesn’t have or cannot get the journal or article you want, contact your nearest medical library. Call the National Network of Libraries of Medicine at 800-338-7657 or visit their website to locate your nearest library. (You can’t call this number to get help finding information, but they can help you locate a library.)

Order Online Through PubMed

Loansome Doc

PubMed is primarily for medical students and professionals, which is why it provides a service called Loansome Doc that enables you to 1) find medical libraries in your state serving the general public, and 2) easily and conveniently order journal articles through PubMed.

When viewing an article’s abstract, clicking on the “Send To” link opens a box from which you can select “Order.” Clicking the “Order articles” button will direct you to enter your Loansome Doc login information.

PubMed Loansome Doc

Ordering option for Loansome Doc

Registration for Loansome Doc is free; you only pay when you order an article. To sign up for Loansome Doc, visit the Loansome Doc signup page.  The first step will help you locate a medical library near you. You will need to contact the medical library of your choice to get signed up with them.

If you are not a healthcare provider or student, the medical library will consider you an “unaffiliated user.” Each library will have different criteria regarding unaffiliated users, pricing, and document delivery formats (hardcopy vs. electronic, e.g.).

LinkOut

If you click on an article’s title in your PubMed search results, you can click “LinkOut” at the bottom of the abstract to see online sources providing full text. You do not need a Loansome Doc account for these, but you may have to set up an account on the website of the online source to place an order.

PubMed - LinkOut

Viewing options for ordering under LinkOut

So to sum up:

  • Try your local library or visit a medical library (if you have one close to you).
  • If you are planning to order articles on a relatively frequent basis, sign up for Loansome Doc so you can place all your orders from within PubMed.
  • If you are planning to order articles relatively infrequently, try ordering from a LinkOut service.




PubMed: Refining Searches with MeSH

5 04 2010

Our previous PubMed article described how you could search for journal articles using simple search terms, like you would on the Internet. However, if you want your search to be more targeted and effective, you should use MeSH search terms.

What’s MeSH? Sounds messy.

MeSH (Medical Subject Heading Terms) terms are medically-oriented keywords. Because PubMed is indexing medical journal articles, you will generate better search results if you use medical terms used by PubMed. Previously, our approach was:

  1. Enter keywords into PubMed
  2. Get results

Using MeSH terms, our approach will be:

  1. Enter keywords in MeSH to find MeSH terms
  2. Enter those MeSH terms into PubMed
  3. Get more targeted results

Great! How do I do this?

First, go to the MeSH homepage. Then enter a keyword in the search box, and click the “Go” button. In this example, we’ve entered “hepatitis” and the results are displayed below the term.

Finding MeSH terms

Click to enlarge

Every term or phrase listed here by number is a MeSH search term. Below each term is the definition for that term. Find the terms that most closely match what you have in mind, and check the box next to them. Then click the “Send to” drop-down box and choose “Search Box with AND.” A second search box appears above your search results with the MeSH term inside.

Sending MeSH terms to the new search box

Click to enlarge

Now you can add additional MeSH terms to further refine your search. Try entering “child” in the field at the top, and click “Go” to get MeSH terms related to “child.” Then click the box(es) next to your desired terms, and send them to the search box as you did in the step above.

If you want to exclude a term, choose “Search Box with NOT.”

If you want to search for articles that contain at least one of the terms you’ve sent to the search box, but not necessarily all of them, choose “Search Box with OR.”

Once you’ve sent your desired MeSH terms to the search box, click the “PubMed Search” button directly below it. You will then see a page of results, like the example below:

Getting results from your MeSH terms

Click to enlarge

You can now interact with the search results as we discussed in our previous PubMed article. Watch the blog for future articles on PubMed searching.