Rand Paul and mandatory vaccination

Rand Paul vaccinatedRand Paul, whatever his other flaws and virtues, is a physician, so his comments on vaccination on Monday caused considerable eyebrow-raising, and accusations, muted or not, of either pandering to the tinfoil brigade or of his not being a very good physician.

Will Wilkinson at The Economist parses Dr Paul’s comments, and gives a cogent (IMO) “liberaltarian” defence of (virtually) mandatory vaccination.

Mammograms: when and how often?

At what age should we start getting mammograms and how often should we get them? It’s necessary to balance the dangers of ionizing radiation against the benefits of detecting cancer early. Read “Mammography’s Limits are Becoming Clear.”

Whooping cough epidemic in Western Australia

Four babies have already died as whooping cough cases shot up in Western Australia.

A record number of more than 3,500 cases were reported last year, more than double the 2010 total. Four babies have died from the infection in as many years and the Health Department is urging parents to be prepared for more cases.

The department’s Paul Armstrong says whooping cough in the community seems to be rising. “In 2011 we had the highest number of cases reported to us of whooping cough, we know that whooping cough epidemics happen every three to four years, and we’re well overdue in WA for a whooping cough epidemic,” Mr Armstrong said.

Health Minister Kim Hames says parents must take responsibility for the vaccination of their children. “Whatever you hear of the risks of vaccination – of a whole range of different things – are totally outweighed by the risk of the disease itself,” he said. “Measles kills, whooping cough kills. All of those diseases that you can now get a vaccination to stop, can kill children.

Does obesity, or even high-fat food, change the brain?

Experiments with mice suggest that fatty foods can cause inflammation in the hypothalamus of the brain. It’s an area that helps to regulate hunger and thus body weight; Isaac Asimov called it the “appestat” and suggested that fat people were hungrier people.

Brain, showing hypothalamus from "Gray's Anatomy"

(from Wikimedia Commons)

Here’s the article: “Could obesity change the brain?” Inflammation is seen after one high-fat meal. It does down after a week or so, but then a month later it comes back and persists for many months—a long time in the two-year life span of a mouse. Does it change the mice’s appetites? I’m not sure. Michael Schwartz, a professor and director of the Diabetes and Obesity Center of Excellence at the University of Washington, says “This might reflect fundamental biological changes in how the brain works that help explain why it’s so hard to keep weight off.” The research was published in the Journal of Clinical Investigation (J Clin Invest. 2012;122(1):153–162. doi:10.1172/JCI59660).

It’s also possible that obesity, a longer-term exposure to fat in the bloodstream, causes persistent inflammation, as found in earlier studies of obese lab animals. Exactly what does this mean? The researchers are now looking at NMRI scans of obese humans and finding have inflammation of the hypothalamus.

Inflammation in the human hypothalamus: A, normal weight; B, obese.

(from JCI article)

It’s suggestive that some of the best diets reduce the amount of fat eaten and gradually reduce the craving for fats.

Further research is definitely needed into diet, brain reactions, and appetite.

Nutrition news for endurance sports

Long-distance swimmers, cyclists, and runners need special nutrition to keep from running out of fuel or becoming dehydrated. The traditional “carbo-loading” involves a big supper of pasta the night before, to enable the body to build quick-energy glycogen stores. During the race, athletes ingest low-fibre, high-carbohydrate foods and slightly salted and sugared water such as Gatorade. This research suggests how athletes can meet their needs without loading up the night before: “Nutrition for endurance sports” by A. E. Jeukendrup.

Endurance sports are increasing in popularity and athletes at all levels are looking for ways to optimize their performance by training and nutrition. For endurance exercise lasting 30 min or more, the most likely contributors to fatigue are dehydration and carbohydrate depletion, whereas gastrointestinal problems, hyperthermia, and hyponatraemia can reduce endurance exercise performance and are potentially health threatening, especially in longer events (>4 h). Although high muscle glycogen concentrations at the start may be beneficial for endurance exercise, this does not necessarily have to be achieved by the traditional supercompensation protocol. An individualized nutritional strategy can be developed that aims to deliver carbohydrate to the working muscle at a rate that is dependent on the absolute exercise intensity as well as the duration of the event. Endurance athletes should attempt to minimize dehydration and limit body mass losses through sweating to 2-3% of body mass. Gastrointestinal problems occur frequently, especially in long-distance races. Problems seem to be highly individual and perhaps genetically determined but may also be related to the intake of highly concentrated carbohydrate solutions, hyperosmotic drinks, as well as the intake of fibre, fat, and protein. Hyponatraemia has occasionally been reported, especially among slower competitors with very high intakes of water or other low sodium drinks. Here I provide a comprehensive overview of recent research findings and suggest several new guidelines for the endurance athlete on the basis of this. These guidelines are more detailed and allow a more individualized approach.

PMID: 21916794 [PubMed – in process]

Death by Hantavirus in Saskatchewan

One person has died in Saskatchewan from a Hantavirus infection. It’s a severe, flu-like illness that is spread by rodents. In Saskatchewan, deer mice are the usual culprits. People can breathe it in if they disturb, i.e. sweep up, mouse droppings.

I would read this right after I cleaned out the dustiest corner of my basement.

Hantavirus was first noticed around the arid “four corners” area of the U.S. It’s one of those emerging diseases that we really don’t want to allow to get going.

Why haven’t we cured AIDS yet?

First, AIDS is caused by a virus, HIV that mutates very quickly, so much so that we can trace its family tree from the original simian virus, SIV.

Second, if you can believe Mother Teresa’s fanfic, we missed our opportunity. But commenter “MJ” had the answer to that!

MJ | August 20, 2007 7:38 PM:

“I have already prayed to God for healing for Aids, and God’s answer to me was “the one I sent to you was aborted in his mother’s womb.” –Mother Theresa to an AIDS victim

I always wanted to retort to people who use that quote: God told me that the woman who should have become the doctor who would have cured AIDS, never got the chance to go to college because she got pregnant in high school (thanks abstinence only sex ed), and couldn’t get an abortion because there was no nearby provider (86% of the counties in the USA), and she was too poor to afford one and travel (especially with the waiting restrictions in her state). Her family pressured her to keep the baby, and she dropped out of school to support her child.

Funny how some people expect an unborn fetus to solve the problems of the world, while women are thought to have so little potential themselves.

Talks and trash in Cairo

Promising news: Landmark talks in Cairo about the future government of Egypt are held.

Speaking of Cairo I watched a show on The History Channel about its sanitation history: Trashopolis. It has been the largest city in Africa for centuries. The city now houses eighteen million people who produce 25,000 tons of garbage each day. Garbage collection and disposal was, and is, part of the city’s ecosystem, including people and animals. There used to be pigs eating dead animals and food waste. There were dogs. There’s hand garbage collection and a whole recycling industry depending on hand labour. There’s also, since about 2000, a fleet of trash collection trucks. Here’s the teaser from the show:

Cairo’s Zabaleen – the traditional garbage people – collect the city’s trash by hand and haul it home on donkey drawn carts. Vast slums in the heart of the city are filled with mountains of stinking garbage, and in the alleys and roof tops, Zabaleen women and children sort trash for recycling. 300,000 pigs raised by the Zabaleen eat what can’t be re-sold, a practice that began in the days of King Tut.

Following the Romans, a tribe of slave warriors called the Mamelukes defeat the Christian Crusaders. Under Islamic rule, Cairo flourishes with strict laws regulating the disposal of trash, and public sanitation. Napoleon invades, and a large section of Cairo is rebuilt – inspired by the architects and engineers who rescued Paris from its own sewage and trash. Today, Cairo awards sanitation contracts to multinational corporations, and the Zablaeen take to the streets and begin a desperate fight to protect their livelihood.

The Zabaleen, who would be deprived of a livelihood by municipal trash collection, are employed along with the trucks to collect trash. Most of their pigs, who helped to recycle the garbage into meat, were slaughtered during a swine flu scare.

The show mentioned that the birth rate exceeded the death rate for the first time only after sanitary sewers were installed in 1915. (That was true of most cities, which is why going to the city to seek your fortune was so risky. It’s also what kept cities from depopulating.) By 1930 the population exceeded one million.

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