Your Weekly Update of News and Reviews
January 7, 2010
Consumer Health Digest is a free weekly e-mail newsletter edited by Stephen Barrett, M.D., with help from William M. London, Ed.D., M.P.H. It summarizes scientific reports; legislative developments; enforcement actions; news reports; Web site evaluations; recommended and nonrecommended books; and other information relevant to consumer protection and consumer decision-making.
Autism myths debunked. An expert panel has found no evidence that digestive problems are more common among children with autistic spectrum disorders (ASDs) or that special diets are effective for these children, as claimed by Dr. Andrew Wakefield. Its report states:
The existence of a gastrointestinal disturbance specific to persons with ASDs has not been established.
An immune or inflammation-mediated mechanism specific to ASDs, possibly vaccine-triggered in the setting of abnormal immune function or increased gut permeability (âleaky gutâ), has been hypothesized . . . mainly on the basis of a finding of ileal nodular lymphoid hyperplasia and/or chronic colitis seen on colonoscopy.
In 1998, Wakefield and others reported an association between ileocolitis and developmental regression in 12 children and coined the term âautistic enterocolitis.â From the same uncontrolled study they reported NLH of the ileum and colon as an abnormal finding in most children with ASDs. However, similar findings are known to be present in children with typical development, as well as children with food allergies and immunodeficiencies. The significance of these findings, therefore, is unclear. Wakefield and others also proposed a causal relation between measles, mumps, and rubella (MMR) vaccination and autism, a suggestion that was later retracted by many of the original authors.
Other study-design limitations in these reports included flawed control groups, lack of validated and standardized definitions, and speculative interpretation of results. [Buie G and others. Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: A consensus report. Pediatrics 125: S1-S18, 2010]
The report also notes that “available research data do not support the use of a casein-free diet, a gluten-free diet, or combined glutenfree, casein-free (GFCF) diet as a primary treatment for individuals with ASDs.” The British Medical Council has held hearings and is considering whether Wakefield should be disciplined for unprofessional conduct.
Ginkgo found ineffective in preventing cognitive decline. A randomized, double-blind clinical trial has found that ginkgo biloba extract did no better than a placebo in preventing mental decline among adults ages 72 to 96 with normal cognition or mild cognitive impairment. The study involved more than 3,000 people who, for about six years, were tested twice a year for memory, attention, language and several other abilities. [Snitz BE and others. Ginkgo biloba for preventing cognitive decline in older adults. JAMA 302:2663-2670, 2009] A previous study found that taking ginko extract did not prevent Alzheimer’s disease. This one looked for subtle effects such as a change in the rate of mental deterioration.
Carnegie Foundation recommends nursing education expansion. The Carnegie Foundation for the Advancement of Teaching has issued a reportâEducating Nurses: A Call for Radical Transformationâwhich calls for major changes in how nurses are educated. In addition to noting the current nursing shortage, the authors expressed concern that many nurses nurses are “ill-prepared for the profound changes in science, technology and the nature and settings of nursing practice.” Their recommendations include:
- Teaching capacity needs to be expanded.
- A baccalaureate degree in nursing should be the minimal educational level for entry into practice.
- Within ten years after graduation, all nurses should complete a masterâs degree in nursing.
- Coursework should be tied to what actually happens in patient care, including work outside of a hospital in addition to hospital work.
Extortionists are posing as FDA officials. The FDA is warning the public that criminals are posing as law enforcement personnel as part of an international extortion scam. The criminals call the victimsâmost of whom had purchased drugs over the Internet or via “telepharmacies”âand identify themselves as special agents for the FDA, DEA, FBI, U.S. Secret Service, or U.S. Customs Service, as well as for U.S. and Dominican prosecutors and judges.. They tell the victims that purchasing drugs over the Internet or the telephone is illegal, and that law enforcement action will be pursued unless a fine or fee ranging from $100 to $250,000 is paid. The criminals request that the money be sent by wire transfer to a designated location, usually in the Dominican Republic. Victims who refuse are often threatened with a search of their property, arrest, deportation, physical harm, and or incarceration. Recipients of such calls should refuse the demand and call the FDAâs Office of Criminal Investigations Metro Washington Field Office at (800) 521-5783 to report the crime. The FDA warns consumers to use caution when purchasing prescription drugs over the telephone or the Internet. In addition to the increased risk of purchasing unsafe and ineffective drugs from Web sites operating outside the law, there is the danger that personal data can be compromised. Victims have also had fraudulent transactions placed against their credit cards. [FDA warns public of continued extortion scam by FDA impersonators. FDA news release, December 29, 2009] Despite these potential problems, however, drugs can be safely purchased at discount prices from sites vetted by PharmacyChecker.com.
Anti-tobacco news. Americans for Nonsmoker’s Rights has reported on several noteworthy events related to tobacco control:
- An international panel of experts has concluded that smoke-free policies benefit public health and do not have a negative economic impact on restaurant and bar businesses. [Evaluating the Effectiveness of Smoke-free Policies. International Agency for Research on Cancer, September 2009]
- The Institute of Medicine has concluded that smokefree laws reduce heart attacks. Its report examined a long line of studies reporting dramatic reductions of 6% to 47%) in heart attacks once smoke-free laws are adopted. [Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence. National Academies Press, 2009]
- About 360 cities and 19 states cities have enacted laws to make all workplaces and public places 100% smokefree.
- About half of U.S. hospitals now have smoke-free campus policies. [Williams SC and others. The adoption of smoke-free hospital campuses in the United States. Tobacco Control August 20, 2009]
- The first action under the Family Smoking Prevention and Tobacco Control Act, which gives the FDA regulatory authority over tobacco products, went into effect on September 22. 2009. The sale of candy and fruit-flavored cigarettes, wrapping papers, and filtersâsuch as grape, clove, and vanillaâis now prohibited. However, menthol-flavored cigarettes, which are favored by many new and younger smokers and by most African-American smokers, are still permitted. The FDA has said it will examine the options for regulating both menthol cigarettes and flavored tobacco products other than cigarettes.
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