In the mid-afternoon East coast time 10 days ago, the source of 65% of the world’s junk email was silenced in the blink of an eye.

But all that spam will return to an inbox near you somehow, some way, soon. If it hasn’t already that is.

A single computer firm—in Silicon Valley of all places—had up to that moment hosted computers that controlled distribution of more than half the spam on the planet.

But when security experts proved their case against the Internet hosting firm McColo Corporation to its 2 Internet service providers, they pulled the plug and the jig was up.

McColo hasn’t been charged with a crime by the way, and it likely never will.

All McColo does after all, is assign Internet addresses to the computers of its clients. McColo claims it had no idea these ‘computers’ were actually master servers that controlled gigantic networks of personal computers infected by malware which had reduced them to spam-producing drones.

These so-called botnets can contain hundreds of thousands of PCs. The big ones get names like Mega-D, Rustock and Srizbi from anti-virus companies. Spammers rent them, log on remotely and command them to send emails selling drugs, designer clothing knock-offs, sex toys and so on.

Security experts told the Washington Post that when the lights went out at McColo, the world’s 3 largest computer drone armies instantly lost their heads.

But few believe the change is permanent. The criminals who control those botnets will find a way to bring them back.

Senators Max Baucus and Charles Grassley are kicking around the idea of tying Medicare Part A reimbursement to hospital performance on a set of quality measures.

They mentioned myocardial infarction, heart failure, and several surgical causes of admission as candidates for the program, meaning that 20% or more of Medicare admissions could be affected.

The so-called value-based purchasing program would close the loop on Medicare’s pay-for-reporting program which began 5 years ago, according to the 2 senators. In the older program, hospitals earn bonus reimbursement by tracking and reporting performance against pre-established quality indicators.

In value-based purchasing, hospitals receive grades according to the degree to which they follow best practice guidelines, and bonuses are assigned accordingly. The scheme can be tweaked to reward improving performance over time.

“Paying for the quality, not just the volume, of care that patients receive will improve patient outcomes and reduce costs in our health care system,” Baucus told MedPageToday.

But the American Hospital Association wasn’t so sure. “While we support moving forward with a value-based purchasing plan, we remain concerned about many of the details,” said Tom Nickels, its senior vice president for federal relations.

Nickels added in a press release, “Issues such as the…total amount of payments at risk, and the process for identifying measures need to be addressed before a workable program can be adopted.”

If things get serious on value-based purchasing, Medicare should coordinate its pilot with deployment of its new ICD-10 coding system. Value-based purchasing only makes sense after all, if it’s running on good data.

Boys born to women that had significant occupational exposure to hair spray while pregnant are twice as likely to develop a certain urogenital abnormality according to a study in Environmental Health Perspectives.

The abnormality is known as hypospadias, in which the urethra exits the body on the underside of the penis rather than at the tip. Hypospadias is generally corrected surgically during the first year of life and there are few long term sequelae after the repair.

In the general population, the incidence of hypospadias is 3 per 1,000 male births.

Paul Elliott and his team at Imperial College, London reported the association after using a retrospective, case-control study design to compare 471 hypospadias cases from the London area with controls randomly selected from a birth registry.

They obtained detailed histories regarding maternal age, education, folate supplementation, income, occupation, smoking and vegetarianism.

They also inquired about occupational exposure during pregnancy to toxins and carcinogens which are found in disinfectants, hair spray, paints, pesticides, plastics and printing ink.

The scientists believe the hair spray risk is related to phthalates, organic compounds that are often used in plastics manufacturing. Phthalates are also found in cosmetics, deodorants, fragrances, nail polish and hair products.

Phthalates disrupt androgen synthesis, and low levels of the male sex hormone are known to cause male reproductive tract abnormalities like hypospadias.

In case you were wondering, hair spray contains lots more inhalable toxins including polyvinyl alcohol, polyvinylpyrolidone and so on but wouldn’t you know it? These other ones aren’t toxic to male sex hormone synthesis, only the skin, eyes and cardio-respiratory system.