Monday, April 8, 2013

The Ultimate Fast Food Heart Attack Combo


The Heart Attack Grill may have found the perfect compliment for its Bypass Burgers. A cool Monster Energy 24 fl oz drink can, that comes premixed with L-Carnitine.

According to a study published on Nature Medicine website, dietary L-carnitine, a trimethylamine abundant in red meat, is metabolized by intestinal bacteria to produce trimethylamine-N-oxide (TMAO) which accelerates atherosclerosis in mice, a condition in which artery walls thicken, and harden due to accumulation of fatty materials.

How about humans? Apparently, meat eaters produce more TMAO than vegetarians or vegans.
Source: Nature Medicine (2013) doi:10.1038/nm.3145 http://www.nature.com/nm/journal/vaop/ncurrent/abs/nm.3145.html

#heartattackgrill #ultimateburgercombo #triplebypassburger #quadruplebypassburger #lcarnitine #monsterenergy #atherosclerosis #energydrinks

Saturday, April 6, 2013

Drug Companies Should be Known by the Data they Keep

That is, Undisclosed Data!

What if the prescription bottle for your medications carried a label like this.
“Half of these capsules will work as expected, and as demonstrated, in our published clinical trials. The other half could work unexpectedly, causing some problems which we have not published. “


In his TedTalks presentation, Dr Ben Goldacre, a British physician, revealed how he felt duped when the drug he had himself prescribed to his patients, reboxetine, an antidepressant, sold in the UK under the brand name Edronax, was favorably seen in one clinical trial that was published, and unfavorably in 6 clinical trials which remained unpublished.
In his book, Bad Pharma, Dr Goldacre contends that clinical trials are conducted by drug manufacturers who have an obvious stake in outcomes. He writes that pharmaceutical companies enroll ‘unrepresentative’ patients, in small sample sizes, and employ flawed analysis that lead to positive outcomes for their medicine. Data shared with regulators to gain approval, is generally not shared with doctors or patients. Additionally many top regulators come from pharma companies, and return to them upon completion of their stints in government, perpetuating the infamous ‘revolving door’ paradigm.



It goes without saying the public and medical profession deserve to have access to negative outcomes along with favorable results in clinical trials.

Even though the FDA requires trial sponsors and collaborators to publish results within 12 months of completion of a study, a quick look at the ClinicalTrials.com site reveals that compliance, in reality, is far from it.

Researchers use medicine intervention to study, and report on the effects of the drug. Thus thorough interventional studies are conducted, to evaluate a drug's efficacy, and effectiveness, and safety issue outcomes measures are assessed. As shown in chart below, less than 9 % (6826/77874) of drug and biologic results have been posted. Oddly enough, this low number may be aided by the FDA not requiring posting for unapproved drugs. Thus, a sponsor is asked to post results after, instead of before, FDA approval.

Source: [3]

It is interesting to note that 1,487 [4] completed Interventional studies in the clinical trials database for  drugs, and biologics had safety issue outcome measures.
Of those 1,291 [5] have not posted results as of April 5, 2013.
(Trials updated after January 1, 2008)

1- Flickr photostream; Jackman Chiu
2- TedTalks Ben Goldacre video
3- http://clinicaltrials.gov/ct2/resources/trends
4- http://1.usa.gov/ZesS3J
5- http://1.usa.gov/140BiEv

#clinicaltrials #unpostedclinicaltrials #interventionaltrials #FDA #clinicaltrials.gov #bengoldacre # #unpostedresults #badpharma #drugcompanies


Saturday, March 2, 2013

What Every Man Should Know about Women


In case you conveniently forgot, or ignored, your parent’s advice on respecting women, here is another opportunity to understand and appreciate what our female counterparts endure for the sake of humanity.
Procreation is something the male gender takes rather lightly; after all how difficult can it be? Looking at it from a man’s perspective who assumes he does his part, readily, easily, and enjoyably in the act of creating a child, obviously it must be just as simple for a woman. In this, if men are from Mars, then they could not be farther away from Venus.
Highlighting this gap is the following excerpt from ‘Care to Have a Joint’ (Chapter-3) in the Knee Deep in Pain book……

...........................
“Well for one I would have to shrink your pelvis so you can stay erect with ease…..”
This was welcomed warmly by the bipeds. Their girth was still large giving them a frontal center of mass. The stooping was giving them constant pains in the back. A huge waist and a large bottom were not entirely attractive.

Obesity was not yet a problem since more calories were burned in tracking, finding, and killing meat than were available from eating the hunted food. And if one grew too fat, other tribes might want to take ‘them’ out for dinner. The local Yalmart was still only carrying greens and half dried raw meats, fresh berries, and nuts. There was no provision for 90% of the store space that would be dedicated to manufactured and boxed foods for which earliest deliveries were expected to be at least 4 million years away.

“.. but I must caution you with the narrower pelvis… your little bipettes will be born with great difficulty giving excruciating pain to your mates.”

“Did you ever have pain with your bipette?”.. jumping up and down they asked each other. Amidst the mocking and catcalls “No! I have never even had a bipette” was the answer going around. Mother Nature was quite taken aback with the arrogance and selfishness of the homo-sapiens, but to no avail.
The all-male crowd demanded they be given the privilege of walking super straight at any cost. The quadrupeds watched in disbelief, clutching their infants close to their chests and muttering “… ohh these fools are gonna regret this..”
The male bipeds were preoccupied with their low fiving, showing off their awkward swagger in victory, and shouting insults at the other primates; it would be a few million years before they would raise this celebration to a high five.

For the balance of infinity, human beings would be doomed to working endlessly at finding better and easier methods of childbirth with little success.
 “Idiots!”  Mother Nature exclaimed. Disgusted by their decision she decided to make preparations to help the females who would be responsible for carrying the billions of members of the newly minted species.

She gave them a larger opening both on top and bottom of the pelvic canal, made the promontory at the rear of the opening less prominent, reduced the size of the pubic bone joint, and made the angle wider. Additionally, the baby’s skull plates were made to overlap to reduce the size of the head during delivery.

She also increased the distance between the pubic joint and the acetabulum where the thighbone articulates via the femoral head. It may not appear much but where every millimeter counts, even a little bit helps. These changes would facilitate fetal growth and childbirth. 10

Many millennia later we are finding that the sacroiliac joints in the lower back, and the symphysis pubis in the front allow for some movement during childbirth. The sacrococcygeal joint is quite flexible and allows free movement. It helps guide the baby through the delivery channel.


Figure-5.  Adapted from Anatomy of the Human Body.
Henry Gray 1918. Courtesy of Google Books.
© 2012 Nouvelle Sante Knee Deep in Pain


Even so, if all goes well, a newborn goes through several rotations before finally arriving in this world. 

If there is ever a miracle, childbirth is one of them.  But it takes a heavy toll on the mother. Women suffer greatly from the physical trauma of delivery and many experience severe back pain which keeps haunting them long after the years of child bearing are over. 

When fetal weight and bulk increase during pregnancy, the 
lower back comes under stress as women try to offset the forward tilt in the pelvis, and a shift in the center of mass, by 
standing with a backward erect tilt. (See lordosis in Figure-6). Such  abnormal weight distribution causes compression of intervertebral discs and apophyseal joints leading vertebrae to rub against each other, and to loss of height, and “degenerative instability”.12 

Figure-6. Normal [left] and exaggerated 
lordosis spine [right]. Courtesy of BMC  11
This is somewhat similar to the way obesity affects the spine. 13  That pain generally starts with the lower back but it could spread to the legs because of the location near the sacroiliac joint of the peroneal and tibial nerve bundles collectively known as the sciatic nerve. 14  

To prepare for delivery as pregnancy progresses, naturally released hormones relax ligaments in the pelvic joints and allow slight movements at the pubic and sacroiliac joints. This movement of bone against bone, even in the presence of cartilage can be very painful 15 and many women continue to suffer from sacroiliac joint pain long after delivery. 

With the body designed for upright gait and accommodation made for childbirth in the form of a slightly wider pelvis, women ended up with a larger Q-angle than men. Also in presence of weight gain, as in obesity, or due to pregnancy, they tend to bring their knees together for better weight distribution. This condition is called valgus or ‘knock knees’. When the knees end up being too close they rub against each other. Generally, larger the Q-angle, the more pronounced the valgus problem. Most infants start out with varus knees which, in a few years, resolves by itself, and after the early years most of us revert to being slightly valgus. 16 


Figure-7. Patellar Dislocation. 
Orthopaedia Clerkship. 26
The Q-angle, or quadriceps angle, is measured between two lines; one drawn through the kneecap (patella) and the tibial tuberosity, and the second drawn between the patella and the front hip bone known as ASIS (Anterior Superior Iliac Spine). The tibial tuberosity is the bump about 5 centimeters below the kneecap on the front of the shin bone (tibia).  


As people who suffer from it, an exaggerated Q-angle can have serious impact on the knee joint, especially in presence of moderate or extreme valgus. It is implicated in conditions such as ACL injuries, 17,9 chondromalacia, patellofemoral problems, and of course, endless pain.
.........................
continued in Chapter-3 of Knee Deep in Pain book.

#osteoarthritis #kneepain #kneejoint #cartilage #Q-angle #ACL #femalePelvis 

Sunday, February 24, 2013

From Hunter Gatherer to Waddler Hoarder

Excerpted from Knee Deep in Pain Chapter-9; a book on Knee Osteoarthritis.

B
ut first; Why is the earth tilting?
Not too many people know about this but there is a sinister plot underway put in place by powerful business and political interests in North America.
[An investigative report filed by the ‘Christmas in July Desk’ staff at Faux News Center. In other words this is a strictly fictional account presented here only to underscore the seriousness of a global epidemic]


[Figure-1. Hunter-Gatherer Image-Adapted from Scientific American February 1922 Cover. Courtesy of National Oceanic and Atmospheric Administration.  Waddler-Hoarder Image- Adapted from © Willie Lunchmeat Flickr Photostream.… © 2013 NovelleSante.]

It is being planned and executed by major energy and agricultural corporations. These mega companies are investing heavily in solar energy and buying up vast tracts of desolate, uninhabited land in remote areas of the Northwest Territories and the Yukon in Canada and also in southern parts of Tasmania, New Zealand, Australia, Chile and Argentina.

Why?

We all know the top soil in major agricultural producing regions is now pretty much depleted. Crop yields are falling and food production is down. It is taking more and more fertilizer, chemicals, and energy to maintain high agricultural output.

But don’t shed any tears for the food industry; thanks to explosive increases in world population and resulting price hikes, they are awash in profits. The tons of monies being made by agriculture companies did not go unnoticed. Where ever fresh money is being born energy companies swarm to that opportunity. They have this innate ability to smell oil and money equally well, much like predators in the wild smell newborns and quickly move in for the kill.

As anyone can tell, it takes sun, soil and water to grow crops. Sunlight, for now, is free but soil and water are getting expensive. The 3% or so, of fresh water that has been frozen at the poles is an invaluable resource even though it is starting to crumble and drop into the oceans. Also land masses near the ice caps are worthlessly cheap. No one lives there and no one has any desire to move there to live. Hence real estate is worthless for all intents and purposes. So while this land may be dirt cheap, that dirt lies under several meters of ice. Nothing can grow in it given its current state.

Well, with untold wealth and rising profits at their disposal the energy and food conglomerates, seeing common interests, quickly got together. Was Shell Oil there? Was Cargill, the food giant present? No one will confirm it but the name for the syndicate was chosen to be Schmell. It’s anybody’s guess what the name of the syndicate would have been if Kellogg had shown up before Cargill did, but quite likely the group would not have been allowed to operate in Israel.

Wasting no time, sparing no expense, and acting like a true syndicate, Schmell brought together the world’s most brilliant evil minds under one roof to work on strategies to further consolidate money and power for themselves.
And thus, elite teams of super smart scientists and engineers have worked diligently and relentlessly over the past so many years on this top secret project which they have come to call ‘Tilting to Perpetuate Solar Yields’, code named TIPSY so outsiders don’t have a clue of this top  secret, highly classified undertaking.

The solution, the evil geniuses came up with, was to tilt the earth just enough so the areas closest to the poles get a lot more sun in the summers. Of course that would mean longer winters for the other side of the earth, but by owning land in both hemispheres close to the north and south poles the Schmell syndicate will be able to produce food and energy all year round. It will always be spring or summer some place in the world. And with its proximity to melting ice caps at the poles there will be plenty of clean, fresh water to catch before it gets polluted by the oceans.
This was Phase I of the plan and the acquisition of land in the Yukon, the southern tips of Chile and Argentina, Tasmania, and New Zealand appears to have been essentially completed by now. 

This was the easy part. But to their surprise what they thought would be an impossible feat; Phase II seems to be a piece of cake too. May be the entire cake!
Tilting the earth in favor of the Yukon and Tasmania would require placing infinitely massive amounts of weight on the land masses in the U.S. Canada, and Mexico.
Looking to construction would not solve the problem since colossal office towers and apartment complexes have already been built around the world over the last 100 years in major cities, and it would be financial suicide, in this day and age, to attempt to build up more in the face of non-existent demand.
A thing about dirty politicians; whenever and wherever there is an opportunity for quick money or kinky sex, a dirty politician can usually be found lurking in the shadows, somewhere nearby.
One of the members of the syndicate was an ex-politician from a Midwestern state who made his money lobbying congress for his friends in the conglomerate. He came up with a novel idea; it was sheer genius.
Under his scheme people will actually pay Schmell money while furthering its goal for world domination.
How sweet can it get? It was quickly and unanimously accepted. Given the enthusiasm, implementation teams energetically went to work implementing Phase II, code named SCROO. Needless to say success was imminent.

In the hallways of this most secret of organizations inside highly classified buildings, it was not uncommon to hear agents high fiving each other exchanging victory information, and claiming such and such community had been scrood.
The state that fell hardest and fastest for this diabolical scheme, was Mississippi, followed soon, by West Virginia and South Carolina. Other states succumbed steadily enough. Soon most communities around the country had been scrood. But Colorado seemed to still be somewhat of a hold out being a bit tough for agents to crack. 1

After much clandestine, undercover work, our investigative reporter was finally able to unearth details about SCROO. The code name stood for five S foods;  Sugar,  Sodium, , Soy oil, Starches, Syrups, Corn Oil (and other corn based products), and other vegetable Oils. Someone on the project with a dark sense of humor added the R.

The syndicate’s plan was to place as much scroo ingredients as possible, in processed foods for consumers.
As expected, and clairvoyantly foretold by the corn belt politician, the junkification of natural foods was warmly received, not just by grocers but even consumers.
Large grocery stores rushed to dedicate up to 70% or more of their floor and shelf space to endlessly stack processed and packaged foods sky high.
And for their VIP customers they made the aisles wider to allow for a freer, unrestricted waddling gait.
For the supreme, most exalted customers they brought in battery powered riding shopping carts.
Some Schmell agents wanted to introduce turbo charged gas powered engines so patrons could charge certain aisles at great speed before all the ‘goodness loaded’ boxes were raided by someone else. That idea was quickly squashed for fear of carbon monoxide fumes and other exhaust gases.
Besides, next thing you know people will be clamoring for traffic lights at major aisle intersections inside huge food stores. Then there will be cops directing traffic to the pasta, candy, or soda lanes in the event of an in store special being announced on the overhead PA system; and soon enough you will have DUI violations inside grocery stores.
Who needs all that?

Cereal companies were the first ones to step up to the plate, or bowl, if you will. Thus, it is rare to find a cereal box on grocery shelves which does not have at least three, if not all five, of the ingredients.

One company used slick midriff images of slim, female models on their cereal boxes, somehow trying to convey subliminal messages ‘the more you eat of it, the more weight you will lose’. Obese people with ‘Shallow Hal’ 2  syndrome bought it and still continue to buy it by the ton load.

Also quickly jumping on board was the fast food industry with ‘fried everything’ and if that was not enough, using high fat, corn fed, meats to make burgers. Sugar loaded sodas would round off the calorie bombs one would buy at a restaurant. Staff were so nice, just in case you felt a 1000 calories were not enough to make you happy, they would supersize both the fries and soda for a mere 50 cents or so. Better get melted cheese on your fries too.
 To make life easier fast food establishments put in drive in service to make ordering and pickup easier for consumers who would like to conserve the 0.5 calories that would be terribly wasted on that useless trip to the inside of the restaurant.

Team leaders on the scroo project were admirably focused. When they discovered Mexican agents walking in the august halls of the TIPSY buildings high fiving each other, were shouting greetings of Arriba! Arriba! they asked that agents to shout Uribe! Uribe!, instead.  (To get the really big picture, readers are encouraged to Google Manuel Uribe for details as public domain images are not available at time of writing).


Figure-2. Toronto, Canada street scene. Flickr Photostream. © 2012 Sandra Cohen-Rose and Colin Rose  4

The beauty of the plan was it was devilishly simple; if people voluntarily consume scroo based foods first thing in the morning, then there are another sixteen or so hours  during the rest of the day for them to repeat the experience.

Scientists not affiliated with the syndicate were to later find out there was a connection between eating soy oil based products and then having uncontrollable urges to eat more. (Please see below for Gus). You could practically gorge yourself to death with the vicious circle created by scroo consumption. The more you ate, the more you wanted.

This is exactly what the syndicate had hoped for. Schmell could not be happier or prouder. 
With 2/3rds of the population in North America being voluntarily overweight, many of them obese,
success was near. Even if each person is overweight by just 20 pounds then 2/3rd of the NAFTA population of 444 million 3 would mean an incredible impact of an extra 3 million ton load on the ground in the northern hemisphere.

Only scientists on the project would know what would be the tipping point before the world would finally tilt by enough of an angle to meet the nefarious ambitions of the syndicate. Looking at obesity trends it would appear the TIPSY project is closer to realizing its goal than we would like to admit.

There are reports some energy companies jumped the gun in their haste by breaking ranks with the syndicate and started ‘fracking’ (Definition: Forcing water at very high pressure in underground rock formations to release trapped gas deposits). The syndicate had advised them if they waited a little longer millions of obese people pounding the earth every day, (please see Table-3 below for BMI 40) would create enough vibration to have the same effect in releasing trapped subterranean energy. 

+++++

It is not clear if the desired tilt will get underway because of excessive obesity in North America but NASA scientists say the earth does change its tilt, currently at 23.5 degrees. In reality it is supposed to vary from 21 degrees to 25 degrees and back to 21 degrees over a 41,000 year cycle. 5

Meanwhile cereal producers insist the sugar, per serving, in their products is really not that much. They compare their offerings to higher sugar content foods and point out it is much better to consume their ‘healthy’ alternatives. Besides downplaying sugar content, some cereal manufacturers also make outlandish health claims that can land them in trouble with regulators and oversight agencies.

There are times it feels really good to see our tax dollars being put to good use. Thankfully and admirably, the FTC and the FDA, do have our backs. Case in point; the Federal Trade Commission got a little miffed by Kellogg’s advertising claims over Rice Krispies’ “contribution to immunity” and Frosted Mini-Wheats  “increased attentiveness” in children and in 2010, using some choice words, the regulatory agency openly reprimanded the company:

Figure-3.  Flickr Photostream of Ben + Sam  © Ben+Sam. Rice Krispies are a trademark of Kelloggs Inc. 6

“We expect more from a great American company than making dubious claims – not once, but twice – that its cereals improve children’s health,” said FTC Chairman Jon Leibowitz. “Next time, Kellogg needs to stop and think twice about the claims it’s making before rolling out a new ad campaign, so parents can make the best choices for their children.”
Apparently Kellogg Co had been feeding its coporate staff plenty of Frosted Mini Wheats. They were attentive enough to listen to the commission 7 and pulled the claims from their products after a short period following FTC action. 



Figure-4. Source: FTC, Exhibit C. FTC File No. 082 3145. Frosted Mini Wheats are a trademark of Kelloggs Inc.

Not to be outdone, General Mills, the maker of Cheerios and other leading cereals, almost became a pharmaceutical company without even trying. At least that is what the Food and Drug Administration’s complaint implies.



Figure-5 Cheerios is a trademark of General Mills. 

 Essentially the FDA complaint made the point “look here guys, if you want to sell
 Cheerios as a food, we don’t have a problem with that. But when you start making it sound like some kind of a drug, what with lowering cholesterol and all, you need to apply for registering it as a medicine”. Calling it an ‘Unapproved New Drug’ the operative phrase used in the FDA notice was “prevention, mitigation, and treatment of disease”.

Here is the actual wording on the FDA action 8:


Figure-6. Source FDA


Imagine the possibilities if General Mills actually got away with its cholesterol labeling. Next thing you know we could have Cheerios in gel caps available without prescription and sold in a bottle instead of a cereal box. Even healthier and more compact would be ‘Oil of Cheerios’. Pour it on your salad and lower your cholesterol even further.

Clearly the folks at General Mills may have also been eating plenty of Kellogg’s Frosted Mini-Wheats  as they were quite attentive. They too, changed the wording on Cheerios cereal boxes rather promptly.

As they say in Canada; “Pretty clever, Eh!”

But if the 3 million tons of extra fat this side of the Atlantic seems to be large it pales in comparison to the massive CO2 footprint of our heavy relatives based on actual scientific evidence in the following section.

Using disconcerting language for the title, The Sun (U.K.) carried this story in June 2009. While the reporter could have used more appropriate words, the spirit of the story was sincere. Not only overweight people drive larger cars and drive more than walking, they consume more food, and the extra food production over that consumed by a thin person, dumps about a ton of CO2 in the environment. Scientists 9, 10 estimate a billion extra tons of CO2 annually are created by obese people, exacerbating global warming resulting in a faster meltdown of polar icecap, rising water levels, destroying rain forests and wreaking havoc on the lives of 375 million people globally who will become victims of climate related disasters in the next few years.

Figure-7. Copyright 2009 The Sun, U.K.
Being overweight comes with a host of social and health problems. Not only does it cause 11 Heart Disease, Stroke, Metabolic Syndrome, Sleep Apnea, Osteoarthritis, Gallbladder Disease, and Fatty Liver Disease, it can make getting pregnant more difficult and complicate birth. It is also complicit in causing Cancer. There is hardly any known disease which cannot be further exacerbated or made more difficult to treat in the presence of excess body fat. One such disease, aggravated by excessive weight, and the one affecting our knees, is arthritis.

If humans are piling on the pounds, domesticated animals like cats and dogs, are now considered to be facing obesity risk, through no fault of their own. A 2009 study conducted in the Netherlands 12 concluded dogs of obese owners tend to be obese as well. There might be some explanation for that as overweight owners are less likely to go running or exercising with their dogs. However the study did not find the same relationship between owner obesity and cats.

It would be a worthwhile pursuit to find out if any animals in the wild, other than bears that have to build fat reserves for winter hibernation, gain excessive weight. Survival theories require fitness for all species, well may be all, except one. Bears thin down dramatically by mid spring as they must be agile and swift to chase and kill their prey. Humans, interestingly, eat like bears in the fall and winter but continue to pig out for the rest of the year.

As long as there are mega food grocers and the motorized ‘buggy’ is available to facilitate the ‘consumption experience’, humans can chase any different varieties of food in massive quantities without expending even a minimum amount of calories. The hunter-gatherer has given way to the waddler- hoarder.

In its service to obesity, vegetable oil production and availability, a phenomenon made possible by powerful business interests in the 20th century, have had profound and pervasive influences on our health.
What if animals, naturally programmed to stop eating when satiety centers in their brains signal them to stop, were fed like humans? What if we could identify and use changes in nutrition in the human diet in the 20th century, and apply them to animals?

Well, this is the question, CAPT Joseph Hibbeln, M.D, a psychiatrist and lipid biochemist by training and acting chief of the Section on Nutritional Neuroscience, Laboratory of Membrane Biochemistry and Biophysics, NIAAA, wanted to find answers to. He has done extensive research on alcoholism, violence, depression, and anxiety and has attributed much of learning deficiencies and behavioral disorders to inadequacies of essential fatty acids, such as DHA and EPA in the human diet. Working with scientists from Norway, Denmark and Japan the team modeled human consumption and applied it to lab mice: 13

“During the 20th century, elevations in Arachinoid Acid-PL have been estimated from the dramatic increase in dietary LA (linoleic acid) resulting from a more than 1,000-fold increase in the estimated per capita consumption of soybean oil from 0.006 to 7.38% of energy. Here, we modeled these ecological dietary changes in mice to determine if increasing LA as a controlled dietary variable could elevate AA-PL composition, increase endocannabinoid levels, and induce metabolic and phenotypic changes consistent with obesity.”
For this study, researchers took rodents that were given specific diets for 14 weeks, consisting of 1% energy provided by linoleic acid (LA) typical at the turn of the century (1900s) and compared them to other rodents that were fed a diet of 8% LA energy reflecting end of century (1999) consumptions of soy and other vegetable oils....... End of Excerpt

Tags: Obesity, BMI, overweight, fat, vegetable oil, hunter gatherer, Kelloggs, General Mills, cereals, Cheerios, Frosted Mini Wheats.

Friday, February 22, 2013

Demons in the Closet

We all have demons in the closet. Some of us carry serious grudges, others have minor complaints and issues. If it was not for the use or abuse of foreign chemical agents with unknown, unpredictable, and unintended consequences, a lot of precious people would still be with us. One thing is undeniable; these substances release the worst in the best of us and amplify evil thoughts to unimaginable and uncontrollable intensities.




We will probably never know what was going through Oscar Pistorius’ mind in the early hours of Valentine’s day morning. It is also quite unlikely we will ever find out why Reeva Steenkamp, a beautiful, full of life, model and passionate activist for her causes, was shot and killed. The tragedy is made worse by the fact that she was killed by her boyfriend, Mr. Pistorius, the Olympian who endeared and inspired people all over the world with his courage and determination in overcoming his disability. He claims; he thought it was an intruder he was shooting.
Many famous athletes and celebrities have run-ins with the law, and the trouble they usually get into has to do with rage and aggression.

Keys to the Closet
There are many mind and mood altering drugs that hold the key to the demon closet. That list includes steroids. Known commonly as AAS, androgenic anabolic steroids (the two A’s can be transposed) they are primarily used by people who want to quickly add muscle mass and bulk up. Hence the universal appeal for athletes, and body builders. They may also be used by people who are planning a criminal act but feel they need the extra courage which in their perception might come from taking AAS. Such was the case with Anders Behring Breivik, the Norwegian terrorist, who, self admittedly had been taking steroids, eventually embarking on a chilling mass rampage, bombing and slaughtering innocent people, many of whom were children and young adults. [1]

It is not known what caused Oscar Pistorius’ rage, other than alcohol, but his face does not show any telltale signs, bulging cheekbones and disproportionate facial muscles, of heavy steroid abuse. The testosterone allegation was also disputed by the athlete’s attorney.


A closer look at the Devil’s details
Produced by the male testes in response to chemical messages received from the pituitary gland, testosterone plays a vital role in keeping men healthy and functioning.
AAS’ are essentially synthetic testosterone, as opposed to the natural form which gives men their masculinity. The lab version is prescribed by physicians to make up for deficiencies in both men and women. That is the only use allowed by the FDA and many other regulatory authorities around the globe. But the lure of huge muscles is irresistible, resulting in unnatural and mostly grotesque physical forms. Male users can end up with enlarged breasts and women may end up with smaller breasts, as some muscles may disproportionately grow bigger than others. Males also suffer from shrinking testicles as natural testosterone is not needed as much in presence of excess amounts of the hormone, albeit synthetic, is already in the bloodstream.
Since endogenous, or the body’s own testosterone is derived from cholesterol, when the testes go dormant, guess what goes up? Cholesterol!

Because it is possible to rapidly lose muscle mass when coming off steroids long term dependence is quite normal amongst heavy users. But the reasons for continued usage may not be muscle mass maintenance alone. Researchers working at the Department of Pharmaceutical Biosciences, Uppsala University, in Sweden have found that when AASs are taken along with other drugs may interact with the bodies own reward system leading to sensitivity towards narcotics and stimulants. This indicates people on steroids build acceptance for, and are more likely to, get addicted to opioids like heroin. [2]

Do steroid users take more than one drug? Many do. The Anabolic 500 study carried out by researchers at Touro University College of Pharmacy, Vallejo, California recruited 506 users from fitness, bodybuilding, weightlifting, and steroid Web sites, and also 771 self reported non users to answer a 99-item Web-based survey. More than 70% of the AAS users were recreational exercisers who reported using an average of 11performance-enhancing agents in their routine. These AAS users were found to be were more likely than nonusers to meet criteria for substance dependence disorder, report a diagnosis of an anxiety disorder, report recent cocaine use, and have a history of sexual abuse. [3]

Synthetic testosterone has been linked to many crimes in domestic violence. Frequently the victim is a wife or girlfriend, someone very close and familial, someone not in the least bit a stranger. This is a known pattern. A study conducted by the Psychology Department at the University of Nottingham, England, concluded that “wives and girlfriends of AAS users may be at risk of serious injury from users while they are on-drug.” [4] This has been driven home often enough. In June 2007, Chris Benoit, a professional wrestler, methodically strangled his wife and son, and then took his own life. Testosterone in addition to brain damage, were cited as factors in that violent murder-suicide spree. [5]

To be sure there are other studies that have not shown a significant enough relationship between testosterone and aggressive behavior. For hypogonadal men, there is strong evidence they benefit from a boost in testosterone, exhibiting a more healthy and positive outlook. But when supplemented to excessive levels in normal adults the steroid can bring out the monster fairly quickly. [6]

South Africa has a dismal record of protecting women against domestic violence. But it is not the only country where women are not protected with laws that tend to go easy on men. A competent lawyer can get many murderers, rapists and violent criminals off the hook or negotiate for lenient terms. In the third world, women are often murdered in so called honor killings. In the western world such violent murders are considered crimes of passion. They can easily be facilitated, in fact, in many cases brought on by the presence of drugs. It does not matter. Cultural, chemical, instrumental or impulsive; [7] the object of their wrath is almost always a woman, and almost always a family member. A wife, a daughter, a mother, sister, sometimes even little children, anyone can be their target. People should not be considered worthy of getting a high school diploma, or getting a job, if they can not demonstrate respect for life.

Sources:
[1]
http://www.guardian.co.uk/world/2012/aug/24/anders-behring-breivik-profile-oslo?INTCMP=SRCH
[2]
Int Rev Neurobiol. 2012;102:189-206. doi: 10.1016/B978-0-12-386986-9.00008-9.
Interactions between opioids and anabolic androgenic steroids: implications for the development of addictive behavior.
Nyberg F, Hallberg M.
Source
Division of Biological Research on Drug Dependence, Department of Pharmaceutical Biosciences, Uppsala University, P.O. Box 591, Uppsala, Sweden.
[3]
Pharmacotherapy. 2011 Aug;31(8):757-66. doi: 10.1592/phco.31.8.757.
The Anabolic 500 survey: characteristics of male users versus nonusers of anabolic-androgenic steroids for strength training.
Ip EJ, Barnett MJ, Tenerowicz MJ, Perry PJ.
Source
Department of Pharmacy Practice, Touro University College of Pharmacy, Vallejo, California 94592, USA.
[4]
Annals of Clinical Psychiatry. American Academy of Clinical Psychiatrists.
1994 Mar;6(1):21-5.
Violence toward women and illicit androgenic-anabolic steroid use.
Choi PY, Pope HG Jr.
Department of Psychology, University of Nottingham, England.
[5]
http://en.wikipedia.org/wiki/Chris_Benoit_double_murder_and_suicide
[6]
Aging Male. 2006 Dec;9(4):195-9.
Testosterone and the brain.
Zitzmann M.
Source
Institute of Reproductive Medicine, University of Münster, Münster, Germany.
[7]
Motivation and Emotion
March 2012, Volume 36, Issue 1, pp 65-73.
Published online 2011 November 25. doi:  10.1007/s11031-011-9264-3
PMCID: PMC3294220
Testosterone, cortisol, and serotonin as key regulators of social aggression: A review and theoretical perspective
Estrella R. Montoya, David Terburg, Peter A. Bos, and Jack van Honk
[8]
Aggression by *mrgraphicsguy
Deviant Art.
Creative Commons Attribution-No Derivative Works 3.0
http://mrgraphicsguy.deviantart.com/art/aggression-46569524

Tags:
Oscar Pistorius, Reeva Steenkamp, South Africa, gun violence, demons, violence against women, steroids, roid rage, drugs, alcohol



Monday, February 11, 2013

If Guns Don’t Kill People… There is Always Food.

Zafar Hayat Khan

The debate about gun control has brought out some real gems. ‘Guns don’t kill people’; presumably people kill people. Absurdly profound, or profoundly absurd, it is countered, or tempered by an argument from the other side that guns that shoot multiple rounds rapidly should be banned, but other guns are okay. The non-automatics perhaps introduce an element of reflection in between shots, a sort of a shoot-think-shoot-think paradigm. In our post- primitive thinking, violence can always be justified, as long as we perceive ourselves to be on the right side. But, for those of us who find the possession, or use of guns unacceptable in civilized society, other than for law enforcement agencies, we have other means of inflicting some serious damage.

One such tool is food. Well actually, a way of life that involves less physical activity and a cuisine that adds significant pain. Not exactly that blunt, nor unexpected, was the suggestion from the study presented at the American Stroke Association 2013 International Stroke Conference in Honolulu, Hawaii.

What better venue than the Aloha State, incidentally known as the State with the happiest people, if one were to believe Gallup; not that sun, sand, surf, and clean air might have something to do with it, to reveal findings about dietary practices of the nation’s least happiest people.

Taking over 20,000 respondent’s answers, half of which came from the southeastern region, study leader, Suzanne Judd, Ph.D., assistant professor in the University of Alabama at Birmingham (UAB) Department of Biostatistics, classified the diets into 5 groups.
Southern: Salty greens, fried and processed meats and sugar-sweetened beverages. People who ate this type of food about 6 times a week were found to be at a 41% higher stroke risk compared to those who ate it less than once a month. Black people are at a higher risk, 63%, compared to that of whites.
Traditional or Convenience: Common Chinese or Mexican dishes, pasta, pizza, soup, and other mixed dishes.
Sweets: Excessive sweet snacks and desserts.
Alcohol: Proteins, alcohol, and salad.
Healthy: Primarily fruits, vegetables, and grains. This diet, understandably, had the lowest stroke risk than other diets, 29% lower.

The findings from this study may just be the tip of the cheese melt on top of the fries. For a strict practitioner of the southern diet, almost invariably, obesity and overweight problems will set in before getting to the stroke. Once you get to the lofty state called Obesity, you have arrived. From that point onward it is all downhill, so to speak.
Indeed, if food were a weapon, the southern diet would be the assault rifle. Without waiting to reload, it relentlessly targets almost all body functions; Stroke and heart disease risk are joined by arthritis, diabetes, renal and other cancers, liver diseases, hypertension, pancreatitis, sleep apnea, the list goes on. Some of its known victims are illustrated in the ‘Cornucopia of Obesity’ chart. Regardless of diet, the disease incidence maps below show the southern region is at great risk for many chronic conditions.


Borrowing the gun rights advocates’ logic, food does not kill people, people abuse and kill food, and then use it to kill them selves. At least, in this, the gun rights people are correct. Let’s face it; you can weaponize any food by deep frying it, especially if it is done in engine oil, commonly known to us as vegetable oil. Popular frying oils are rich in linoleic acid, which metabolizes to omega-6 fatty acids, an abundance of which can create a host of problems for a human being. The longer a batch of frying oil is re-used, the higher its trans fat content becomes. Here is something interesting; we all know fish is supposed to be good for us, what with all the omega-3 fatty acids, DHA and EPA, in dark, oily fish, right? Deep fry it in vegetable diesel and what have we here? A trans fat torpedo! Talk about a weapons grade fat!

The other popular diets, the shoot-think-shoot-paradigm-hand-gun foods such as the so called convenience, as well as the excessively sweet diet are probably just as toxic, aided by enriched white flours and corn syrup sugars, but they allow you a moment of reflection in between shots, before arriving at the cornucopia. If the objective is to get fat, the end result, medically, is probably bound to be the same.

Looking at the disease prevalence charts above, one can quickly surmise the southern-southeastern region is not doing well. It is something that needs to be addressed by educators, and parents with a seriously heightened level of urgency.

Sources:
Gallup-Healthways Well-Being Index
Southern diet could raise your risk of stroke
American Stroke Association Meeting Report - Abstract 144 - Embargoed until 7 a.m. HT/ Noon ET on Thursday, Feb. 7, 2013
Frying in Oil
Knee Deep in Pain: Chapter 9- ‘From Hunter-Gatherer to Waddler-Hoarder’.
REGARDS Study

Chart Sources
http://apps.nccd.cdc.gov/DCPC_INCA/DCPC_INCA.aspx
2007 Estimates of the Percentage of Adults with Diagnosed Diabetes Division of Diabetes Translation, Center for Disease Control and Prevention, Feb 8, 2013
Prevalence of obesity among adults — Behavioral Risk Factor Surveillance System, United States, 2009
Stroke Death Rates, 2000-2006, Adults Ages 35+, by County Schieb, Linda, CDC, Feb 8, 2013
Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion
Division for Heart Disease and Stroke Prevention: Data Trends & Maps Web site. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA, 2010.



Friday, January 25, 2013

Blindsided by Aspirin


A new study published in JAMA [1] reports that regular aspirin use is associated with a 2-fold increase in risk of neovascular AMD (age related macular degeneration) during a 15-year period. These findings appear to be independent of CVD, smoking, and other risk factors. This risk of incident neovascular AMD became 4-fold for regular aspirin users that already had a history of cardiovascular disease.

The study points out that AMD caused blindness affects up to half a million Americans  over the age of 55. This is serious news for an aging population that actually places the fear of going blind above that of stroke and heart attacks. It is interesting to note that the more serious form of AMD, the wet or neovascular kind, is a result of bleeding in blood vessels most of which form behind the retina.


It is already known that frequent use of aspirin causes gastrointestinal and cerebral bleeding. Authors of the Italian study [2] that looked into this relationship and have found results to be highly significant, have cautioned that people with a low risk for cardiovascular disease should be careful in using aspirin.

Originally known for the relief acetyl salicylic acid gave to sufferers of rheumatoid arthritis, it was later discovered, platelet aggregation, a common characteristic of healthy blood, could be lowered by aspirin and thus prevent blocking of arteries namely those that nourish heart muscles.  Thence was born the popular advice “taking a daily aspirin” would lower your risk of heart disease. But as seesaws work in the outside world, so do they inside our bodies. When something goes down, other things might go up. Macular Degeneration is a disease in which cells in the macular area in the center of the retina start to die, usually in older people. That is the early, or the dry, stage. At this point the central part of the vision starts to become fuzzy. As the disease progresses, it becomes difficult to read or drive or to do anything that requires a sharp focus or finer detail. In late stages the body responds by developing new blood vessels behind the retina which start to grow under the macula. Growth of these vessels is supported by something called the vascular endothelial growth factor, or VEGF. When this happens the central part of the vision becomes an empty dark spot. People with wet AMD see dark spots on anything they look at.

But, paradoxically, various studies have demonstrated aspirin’s inhibitive effect on VEGF [3, 4, 5, 6]. So, if that is the case then why is aspirin complicit in macular degeneration, especially the neovascular or wet MD, which is tied to VEGF?
Circularly, why is the primary treatment for MD inhibition of VEGFs?

Incidentally, Bayer the company that commercialized aspirin and possibly still supplies a significant portion of the 100 billion tablets swallowed annually by human beings all over the planet, obtained FDA approval in 2011 for, you guessed it, a macular degeneration drug called Eylea [7], developed in partnership with Regeneron Pharmaceuticals.  

Tags: rheumatoid arthritis, osteoarthritis, cardiovascular disease, blood clotting, macular degeneration, blindness, aspirin, acetyl salicylic acid.

[1] The Association of Aspirin Use With Age-Related Macular Degeneration. 
Gerald Liew, PhD; Paul Mitchell, PhD; Tien Yin Wong, PhD; Elena Rochtchina, MAppStat; Jie Jin Wang, PhD
JAMA Intern Med. 2013;():1-7. doi:10.1001/jamainternmed.2013.1583.

[2]Association of Aspirin Use With Major Bleeding in Patients With and Without Diabetes
Giorgia De Berardis, MSc; Giuseppe Lucisano, MSc; Antonio D’Ettorre, MSc; Fabio Pellegrini, MSc; Vito Lepore, MD; Gianni Tognoni, MD; Antonio Nicolucci, MD
JAMA. 2012;307(21):2286-2294. doi:10.1001/jama.2012.5034.

[3]Therapeutic levels of aspirin and salicylate directly inhibit a model of angiogenesis through a Cox-independent mechanism
Gillian M. Borthwick*,1, A. Sarah Johnson1, Matthew Partington*, John Burn*, Robert Wilson† and Helen M. Arthur*,2
doi:
10.1096/fj.06-5987com
October 2006
The FASEB Journal
vol. 20 no. 12 2009-2016

[4]Aspirin decreases vascular endothelial growth factor release during myocardial ischemia          Rabin Gerrah, Mina Fogel, Dan Gilon
International Journal of Cardiology - March 2004 (Vol. 94, Issue 1, Pages 25-29, DOI: 10.1016/j.ijcard.2003.03.007)

[5]Acta Haematol. 2001;106(4):148-56.
The role of vascular endothelial growth factor in angiogenesis.
Ferrara N, Gerber HP.
Source
Department of Molecular Oncology, Genentech, Inc, South San Francisco, Calif 94080, USA. nf@gene.com

[6]Recent Results Cancer Res. 2010;180:51-81. doi: 10.1007/978-3-540-78281-0_5.
Angiogenesis inhibition in cancer therapy: platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF) and their receptors: biological functions and role in malignancy.
Appelmann I, Liersch R, Kessler T, Mesters RM, Berdel WE.
Source
Department of Medicine/Hematology and Oncology, University of Münster, Albert-Schweitzer-Strasse 33, 48129, Münster, Germany. Iris.Appelmann@ukmuenster.de

[7]
EYLEA
FDA Application No.(BLA) 125387
Active Ingredient(s). AFLIBERCEPT
Company: REGENERON PHARMACEUTICALS
Original Approval or Tentative Approval Date November 18, 2011

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