A federal judge has told the FDA to quit blocking the importation of electronic cigarettes from China and ruled the devices should be regulated like tobacco products rather than as drugs or medical devices.

Judge Richard Leon of Federal District Court in Washington issued the order in a lawsuit brought by e-cigarette distributors.

e-Cigarettes are battery-powered tubes that heat liquid nicotine into a vapor which is subsequently inhaled. The devices also add ingredients that give the vapor a taste and smell just like cigarette smoke.

According to e-cigarette distributors, the inhaled mix does not contain cancer-causing chemicals. The FDA argues they have not been proven safe.

Judge Leon ruled that last year’s tobacco legislation gave the FDA power to regulate the contents and marketing claims of e-cigarettes just like traditional tobacco products, but not to ban them.

The FDA released a statement in response: “The public health issues surrounding electronic cigarettes are of serious concern to the FDA. The agency is reviewing Judge Leon’s opinion and will decide the appropriate action to take.”

Ray Story, a VP at Smoking Everywhere, the plaintiff in the suit, claimed the ruling was a victory for people who want a safer cigarette. “The public will have a less harmful alternative to tobacco products,” Story said. “Wherever they’re sold, we are going to be sold.”

Matthew Myers, president of the antismoking advocacy group Campaign for Tobacco-Free Kids, decried the ruling. “These products could serve as a pathway to nicotine addiction for children,” Meyers told the New York Times.

People have estimated e-cigarettes could grow to become a $100 million business nationwide. Traditional cigarette makers are not involved in the e-cigarette business.

Last month, 7 CIA operatives stationed at a forward operating base in the mountains of Afghanistan were blown up by a suicide bomber. Among other things, the tragedy highlighted the CIA’s transformation into a paramilitary organization that operates on the front-lines of America’s war on terror.

The dead operatives had been begun a campaign against a radical nut job known as Sirajuddin Haqqani and his woefully enslaved followers. This crew has claimed responsibility for killing dozens of US soldiers.

In the past year, the CIA has amassed dozens of forward operating bases like this in eastern and southern Afghanistan. In so doing, it has exposed its operatives to enormous risk.

In the 1983 Beirut car bombing, remember, it took a car bomb loaded with 2,000 pounds of explosives to kill eight CIA officers who were based at the heavily fortified American Embassy. All it took this time was one guy dressed in loose-fitting Afghan army fatigues.

These remote outposts are just one feature of the newly militarized CIA. The clandestine agency also uses unmanned drone attack aircraft to pin down and kill nut jobs in Pakistan, and has many operatives in Yemen, home of Umar Farouk AbdulMutallab, the notorious testicle bomber.

According to the New York Times, the CIA has long-since maintained a paramilitary branch known as the Special Activities Division. But the branch was small and rarely used.

Things changed after 9/11 however, when President George W. Bush expanded the agency’s purview to include the capture and/or killing of al Qaeda operatives. The new responsibilities were assigned to Special Activities, which deftly moves and out of countries where the US military can’t operate legally.

The CIA’s expanded mission has included at various times activities such as running a war in Pakistan, organizing secret jails where terrorist suspects could be interrogated, and running an assassination program that once outsourced sensitive operations to Blackwater, a privately-held security company.

President Obama shut down the prisons and called off the dogs, literally, when it came to interrogating terrorism suspects, but green lighted the CIA’s drone program.

The radiation produced by CT scans performed in 2007 will cause 29,000 cancers and kill 14,500 Americans, according to a study published in the Archives of Internal Medicine. 

To reach this conclusion, Amy Berrington de Gonzalez and colleagues from the National Cancer Institute used a computer simulation to estimate the impact of the 70 million or so CT scans that were performed in the US that year (only 3 million were performed in 1980).

The scientists estimated that about a third of the future cancers will occur in people who were between the ages of 35 and 54 when they received their CT, and 15% of them will develop in people who were children or teens when the scan was performed.

About two-thirds of the new cancers will develop in women, since they are more vulnerable to radiation.

“There is a significant amount of radiation with these CT scans, more than what we thought, and there is a significant number of cancers,” Rita Redberg, the editor of the Archives of Internal Medicine, told the LA Times.

“While certainly some of the scans are incredibly important and life saving, it is also certain that some of them were not necessary,” Redberg added.

CT scans provide pristine images by combining data from multiple x-ray images. They can also expose patients to up to 400 times more DNA-damaging radiation than conventional chest x-rays. 

In another study, Rebecca Smith-Bindman and colleagues from UCSF found that radiation exposure varies almost 13-fold for different kinds of CT studies, from about 2 millisieverts for a routine head CT scan to 31 millisieverts for a scan of the abdomen and pelvis.

The average American receives about 3 millisieverts of radiation per year, a level not considered to be a health risk.

Four years ago, the Federal Communications Commission adopted “network neutrality” principles that protected consumers’ rights to use Internet-based applications, services, content and devices of their choosing, and to foster competition among Internet providers.

Last week, FCC chairman Julius Genachowski proposed formalizing these rules and adding an additional one designed to prevent Internet providers from discriminating against certain applications or content by using bans or service degradations against offerings that compete with their own.

Genachowski also proposed that the rules should apply to wireless networks, which had not heretofore been subject to the network neutrality principles.

The FCC invoked network neutrality last year when it called-out Comcast for attempting to degrade the Internet connections of users who were attempting to use a particular kind of file-sharing software. Comcast appealed the ruling on grounds that the neutrality principles had not been formally adopted.

Formal adoption of the rules promises to be a time consuming process since it requires an extended period for public comment. During this phase, the communications industry is sure to raise several objections.

In particular, some providers want to offer faster connections to companies that pay a premium for the service, such as those who provide high-definition movies online.

Public advocates fear that such services can transform the Internet into a tiered service in which premium offerings are available only to well-endowed users.

Genachowski will likely compromise in this area, allowing experimentation with premium services while assuring that sites which do not pay extra continue receiving service levels to which they have become  accustomed.

The formalization process should begin later this month. A final plan could be voted on by next spring.

Scientists have identified a single-gene mutation that enables people to function effectively with far less sleep than most, a discovery that could lead to improved understanding of sleep cycles and open up new paths toward the treatment of insomnia and other sleep disorders.

Ying-Hui Fu and colleagues at UCSF made the find while conducting routine DNA screening on blood samples from people that had participated in several sleep studies.

The scientists had been searching for gene variations that affect circadian rhythms and other aspects of the sleep cycle. When they identified 2 specimens having unusual mutations of the so-called DEC2 gene, they traced them back and found a mother and daughter who routinely functioned on 6 hours of sleep per night. The average requirement is 8 to 8.5 hours per night.

The scientists then bred mice to have the same mutation, and found they required less sleep and recovered more easily from experimental sleep deprivation than regular mice.

The study “opens up a window to understanding the genetic basis of individual differences in sleep duration. You have a piece of the puzzle and you can begin trace back,” Charles Czeisler told the New York Times. He’s chief of sleep medicine at Brigham and Women’s Hospital.

The 2 women turn in around 10 or 10:30 each night and wake up ready to rock and roll at 4 or 4:30 in the morning, according to Fu.

Many people sleep for six or fewer hours per night, but have to use stimulants and alarm clocks to pull off the feat. “That’s a very different thing,” Fu told the Times. “Our body needs 8 to 8.5 hours.” (more…)

Chinese news Web sites have been given secret orders by the government to require that new users log on using their true identities if they want to post comments, reversing existing policies allowing them to weigh in on stories anonymously.

News portals like Sina, Sohu and Netease began implementing the change about a month ago after receiving a confidential order from the State Council Information Office, a Chinese government agency that supervises the Internet.

Chinese authorities said the directive was part of an initiative to foster “social responsibility” and “civility” among users, according to the New York Times.

The chief editor of one portal, who requested anonymity, said the reason for the so-called real-name system was that, “the influence of public opinion on the Net is still too big.”

China’s online community includes 340 million people and is the world’s largest.

The new initiative is the just the latest effort to squelch freedom of speech in China. Earlier this year, Chinese officials shut down more than a thousand sites in a supposed war on “vulgarity,” shuttered liberal Web sites on grounds they spread “harmful information,” and temporarily blocked access to popular social media outlets like YouTube, Twitter and Facebook.

They also blocked Internet service to the Xinjiang region after deadly clashes erupted there between ethnic Uighurs and Han Chinese this summer.

In addition, China’s government had also attempted to require all computer makers to install “pornography-filtering software” that could be controlled centrally, but were forced to back off when various trade organizations protested and hackers revealed the software could also be used to interdict politically offensive material as well.

The State Council Information Office’s edict does not impact previously registered users. It also does not appear to impact most blogs or government news outlets like Xinhua and People’s Daily.

The news cycle, a process by which information becomes news, gains attention, and then fades from the public eye has been impacted by technology ever since Gutenberg invented the printing press.

Radio and TV had dramatic effects, and to the surprise of no one, Cornell scientists have concluded the Internet has as well.

Yet even in the Internet era, the scientists found that most of the time, traditional news outlets are out first with news stories, followed approximately 2.5 hours later by blogs.

To reach these conclusions, John Kleinberg and colleagues used computerized meme-tracking software to scan 1.6 million media sites and blogs during the final 3 months of last year’s presidential campaign. In all, they scrutinized nearly 90 million articles and blog posts.

The research is “a step toward understanding why certain points of view and story lines win out, and others don’t,” Kleinberg told the New York Times.

The most widely captured phrase was “lipstick on a pig,” which many will remember was the Big O’s response to claims by Top Gun that he represented the real voice for change in the campaign.

At the time, Republicans felt the comment represented a jab at McCain’s running mate, Sarah Palin. 

Only 3.5% of the story lines originated in the blogosphere, with the most memorable one being Obama’s response to a question about when life begins after conception. That’s “above my pay grade,” he said.  Blogs ran first with that story.

The blogs found to be quickest to identify stories that subsequently gained wide attention were Hot Air and Talking Points Memo.

But Sreenath Sreenivasan, a professor at the Columbia Journalism School said that the findings may already be outdated due to the rise of Twitter as a news recommendation and distribution network.

“Even from last fall to today, the dynamics of the news cycle are very different, because of Twitter,” Sreenivasan told the Times.

Back in August, 2005, physicians at Urological Associates ordered 9 CT scans for patients covered by the local BCBS carrier. They ordered 8 in September. That rate was lower than most physicians in the community.

But in October, the Iowa-based group ordered 35 scans and then 41 and 55 in the ensuing 2 months. That was about 3 times higher than local norms.

The sudden jump began when the practice purchased its own CT scanner, according to the Washington Post, and the tale repeats itself all over the US. 

The bump in imaging does not translate to improved health outcomes, as numerous studies have shown.

And the excessive radiation from the scans may cause up to 1% of all cancers in the US.

The self-referral problem was thought to be solved in 1992 with passage of the Stark Law, but a loophole allowed physicians to keep up the practice, so long as the devices were housed under the same roof as their practice.

The exception was intended to permit physicians to use the machines for expedited diagnoses of fractures, pneumonia and the like, but soon after Stark passed, CT and MRI scanners shrank magically in size.

“Physicians who purchase machines for their offices have a financial incentive to refer patients for additional services,” MedPAC stated in a recent report. “Physician ownership could influence the judgment of some physicians, particularly when there is not strong evidence to guide their decisions.”

Meanwhile the Web site of GE Healthcare posts testimonials from physicians about the nifty return on the imaging devices. “We’re already beating our pro forma in terms of the return on investment,” says one West Virginia physician.

Congress, by the way, is considering a proposal to prohibit the practice.

Feeling knackered? You’re not alone. On any given day, about 34% of US adults admit grabbing a quick nap, according to a report released by the Pew Research Center.

That number went up, by the way, among folks who reported sleeping difficulties the previous night or having exercised within the last day.

Napping was also more common among those who reported being unhappy, blacks and the poor. 

Men tend to nap more (38%) than women (31%) on any given day, with most of the disparity seen among people who are at least 50 years old. In this group, 41% of men  said they had napped in the past day, while only 28% of women fessed up to the simple pleasure.

Unemployed people tended to nap more frequently on week days than on weekends, while the people fortunate enough to be in the workforce were just slightly more likely to take naps on weekends.

The Pew study did not actually define a nap. Some respondents say they’ve just closed their eyes for a moment when in fact they’re completely conked out. Others will call it a nap when they nod off while reading a particularly boring blog post, or fall prey to the gentle swaying of the 6 train headed to the Bronx.

“Are we accurate reporters of our own habits?” Paul Taylor asked a New York Times reporter. The Pew center’s director then answered his own question. “If you asked my children whether I nap, their answer is yes. Their defining image of me is in an easy chair with a newspaper in my lap, dozing off. If you ask me, my answer is no. That’s my story, and I’m sticking with it.”

Napping is stigmatized by some as a sign of illness or lack of drive, but they are left to explain the puzzling pastime of well-known non-slackers like Thomas Edison, Winston Churchill, Albert Einstein, and Presidents Bill Clinton and Ronald Reagan.

For its part, the National Sleep Foundation states on its Web site that “while naps do not necessarily make up for inadequate or poor quality nighttime sleep, a short nap of 20-30 minutes can help to improve mood, alertness and performance.”

Reporting in Science on interim results from a study that began 20 years ago, University of Wisconsin scientists have concluded that rhesus monkeys placed on a calorie-restricted diet live longer than controls receiving a normal diet.

In the study by Ricki Colman and Richard Weindruch, monkeys between the ages of 6 and 14 were randomized to receive a normal diet or one that contained adequate nutritional ingredients but 30% fewer calories.

The svelte monkeys, it turned out, had significantly less risk of developing diabetes, cancer and cardiac disease. And their mortality rate from conditions usually associated with senescence was 13% compared with 37% for those on the normal diet.

“Caloric restriction slows aging in a primate species,” declared the scientists. The results make “it more likely it would apply to humans,” added Weindruch in an interview with the New York Times.

Weindruch estimated the dieting monkeys would live 10-20% longer based on extrapolations from  studies in mice.

Many scientists criticized the study, since a lot of dieting monkeys died of conditions not usually associated with aging (such as endometriosis, complications from anesthesia or gastric bloat). If these deaths were included, the mortality difference between the groups was not significant. 

“The results seem pretty inconclusive at this point,” said Steven Austad, an expert on aging at the University of Texas. “I don’t know why they didn’t wait longer to publish.”

Weindruch wasn’t looking back, however. After all, his monkeys didn’t begin calorie restriction until they were young adults. In mice, even more striking extensions of life occur when dieting begins at birth.

It’s another matter of course, whether rhesus monkeys, if given the option, would choose to adhere to such a diet forever.

Many believe that healthy people should examine themselves regularly or submit to cancer screening because early detection saves lives.

That’s likely true for women, who should begin cervical cancer (Pap) screening by the age of 21, and for adults 50 years or older, who should get colonoscopy.

And it’s probably true for women at least 40 years old, for whom many suggest it’s wise to get mammograms annually to screen for breast cancer.

But that’s about it, at least according to today’s best evidence.

Which brings us to a well-meaning but ultimately dangerous PR campaign by the Light of Life Foundation to raise awareness about thyroid cancer.

“Confidence kills. Thyroid cancer doesn’t care how healthy you are,” read ads in People magazine, Sports Illustrated and elsewhere.  “Ask your doctor to check your neck.”

Thyroid cancer kills about 1,600 Americans per year. In other words, it’s responsible for about 0.3% of all cancer deaths in this country.

And there’s not a shred of evidence that routine neck exams cut the risk of death from thyroid cancer, according to Barnett Kramer, an associate director for disease prevention at NIH.

Most thyroid cancers grow slowly and are curable surgically no matter when they’re found, and the remaining ones are so aggressive that early detection doesn’t’ improve outcomes anyway, according to Kramer. 

A routine thyroid screening program would trigger thousands of unnecessary ultrasounds and needle biopsies not to mention thyroidectomies that risk damaging the vocal cords.

And there’s no guarantee that cursory palpations of the gland by busy PCPs would detect more than a small percentage of the tumors anyway.

Healthy people should consult with their physicians about cancer screening. And they should contact their physicians if new symptoms develop or if their health status changes in any way.

How is it that a vile-tasting drink that costs 20 times more per ounce than a Pepsi can generate $700 million in revenues in just its fourth year of sales?

Because it contains caffeine. A lot of caffeine.

The so-called “energy shots” are now ubiquitous at convenience stores, especially those located near college campuses or at truck stops.

Students, truckers, construction workers and others need their caffeine after all, and why bother sipping a cup of Joe or being seen with a hopelessly passé 16 oz. canned energy drink when you can slam down a 2-oz. jolt in one gulp? 

“It helps me stay up all night when I have work to do,” University of Maryland sophomore Matt Sporre told the New York Times.

Energy shots cost $3-4 per 2-oz. plastic bottle. At that price, a large bottle of Coke would run $40, a price-point that would humble even Starbucks.

In the face of the explosion, sales of first-generation energy drinks like Red Bull have lost their luster. 

So Red Bull has recently introduced its own shot, as has venerable Coca-Cola. Dr Pepper Snapple will soon have an entry and a raft of smaller companies have flooded the shelves as well.

None of them has managed to steal much thunder from the industry leader however.

Living Essentials, a Detroit-based outfit, still controls 80% of the market with something called 5-Hour Energy.

But why not do something about that awful taste?  “Five-Hour Energy’s not supposed to taste fantastic,” said Joseph Sperber, a spokesperson for Living Essentials.

“This is supposed to be a functional product, not something for flavor or refreshment.”

Tian Lihua had just clocked in for work at a textile mill outside Jilin when she became nauseated, then dizzy. Moments later she passed out. In the next few days 1,200 of her co-workers developed medical issues ranging from seizures to shortness of breath and transient paralysis.

“When I came to, I could hear the doctors talking,” she told the New York Times last month. “They said I had a reaction to unknown substances.”

Tian and her colleagues believe those “unknown substances” had wafted downwind from the Jilin Connell Chemical Plant which makes aniline, a notoriously toxic chemical used to produce rubber, dyes,  polyurethane and herbicides.

Local hospitals began seeing befallen workers immediately after the plant opened this spring. On a bad day, so many workers showed up that the hospital was forced to put 2 in each bed.

The State Administration of Work Safety initially stated on its Web site that the cause was a “chemical leak,” but hours later the statement was pulled down.

Now, local health officials as well as those dispatched from Beijing contend the entire event is due to mass hysteria….psychological reactions on a massive scale to a presumed chemical exposure.

The officials have admonished the workers to “get a hold of their emotions” and get back to work, say afflicted individuals and their loved ones.

 “How could a psychological illness cause so much pain and misery?” asked 29 year-old Zhang Fusheng, who appeared to a Times reporter to be short of breath despite being hooked up to an oxygen mask. “My only wish is to get better so I can go back to work and take care of my family.”

The Ministry of Health in Beijing refused to release details of its investigation, but local officials insist they found no evidence of a toxic exposure.

The plant is partially owned by local government officials. Its president is Song Zhiping, who is also a representative to China’s legislative body, the National People’s Congress.

For a science project, Morgan DiSanto-Ranney, a 16 year-old Virginia high school student recently purchased 7 glucose monitors and asked her diabetic father to use them all.

“What I found was that the meters were off from one another by 60 to 75 points,” she told the New York Times.

About the same time, government researchers found that the results from 5 widely-used monitors varied by up to 32%.

Inaccuracies like this expose patients to seizures, loss of consciousness and rarely, death, so the American Association of Clinical Endocrinologists asked the FDA to act on the matter.

“Because of the highly variable quality of the meters and the glucose testing strips in widespread use, the safety of our patients who depend upon those meters is threatened,” it wrote in a letter obtained by the New York Times.

Nothing happened immediately but as it turned out, Morgan’s mother works for Iowa Republican Senator Charles Grassley, and before long the Iowa Republican had fired off a letter asking the FDA to investigate.

The FDA had for decades punted glucose QA responsibilities to the International Organization for Standardization, whose regulations permit the devices to be off by up to 20%.

Upon receipt of Grassley’s love letter, the FDA began pressing the IOS to tighten its standards, and warned that if it refused to do so, the FDA “may instead promulgate other (higher) performance standards” on its own.

As the matter simmers, glucose monitor manufacturers have warned that more stringent accuracy requirements would force them to jack up prices which would, in turn, discourage their use.

For his part, Morgan’s father has lost faith in his glucose monitors. “He doesn’t use them as much anymore,” sighed the high school student.

In 1924, Johns Hopkins biologist Raymond Pearl published a U-shaped graph showing high death rates for heavy drinkers and abstainers, and lower death rates among moderate drinkers.

Since then, hundreds of observational studies have confirmed the association and suggested reasons for it.

The juice is purported to reduce coronary disease, for example, because it increases HDL cholesterol and has anti-clotting effects.

Moderate alcohol consumption is also associated with slower cognitive decline in the mildly impaired elderly and improved bone mineral density in elderly women. In addition, light drinkers tend not to develop diabetes, and that those with diabetes tend not to develop coronary disease.

Could all this research be wrong?

“The moderate drinkers tend to do everything right — they exercise, they don’t smoke, they eat right and they drink moderately,” affirmed Kaye Fillmore, a retired sociologist from UCSF. “It’s hard to disentangle all of that, and that’s a problem.”

And alcohol consumption, even at moderate levels, has a dark side. It has been linked to multiple cancers, fatal accidents, neuropathies and of course, liver disease.

That’s why health guidelines on the matter walk a fine line. The American Heart Association warns that people should not start drinking to protect themselves from cardiac disease. And the US dietary guidelines hedge goes something like this: “alcohol may have beneficial effects when consumed in moderation.”

A confounding factor is that at least some studies showing a beneficial association were funded by the alcohol industry.

A few years ago for example, BU physician Curtis Ellison hosted a conference on the subject and published a summary one year later. The summary indicated the attendees had reached a “consensus” that moderate drinking “has predominantly beneficial effects on health.”

The meeting, as well as much of Ellison’s work, was partially financed by the industry, according to the New York Times. And the summary itself was co-authored by Marjana Martinic, a senior VP for the International Center for Alcohol Policies, an industry-supported group. Yeesh!

A CDC report says chicken is the most common source of food poisoning in the US, but vegetable eaters had better beware, too.
 
According to the report, the culprit behind most poultry-related illnesses is Clostridium perfringens, a bacterium that provokes  cramping and diarrhea approximately 10 to 12 hours after the fateful swallow.

Claustridia spores can survive cooking, so maintaining poultry meat at low temperatures during processing and storage ends up being the key preventive measure.

Researchers counted leafy vegetables, root vegetables, vegetables from stalks or vines, fungi and sprouts as separate categories. Had all that produce been combined, vegetable-associated outbreaks would have far exceeded those caused by poultry.

Salmonella is the pathogen responsible for most cases of food-borne illnesses associated with vegetables. It has caused national outbreaks from contaminated peanut butter, spinach and tomatoes in the last few years.

Interestingly, viruses—which can end up on food when restaurant workers fail to wash their hands before handling it—topped straight-up food borne illnesses by almost two to one.

These viruses cause most cases of “stomach flu,” a lovely 48-hour run of nausea and vomiting that has nothing to do with the actual flu virus.

“We’re glad that CDC is finally coming out with good attribution data,” Caroline Smith DeWaal told the New York Times. The director of food safety at Science in the Public Interest added, “it shows the need for improvement, not only at FDA but at the USDA’s food safety programs as well.”

The findings were based on an analysis of reports submitted to the CDC by state and local health departments. Unfortunately, most of the roughly 76 million annual cases of food-borne illness are not reported, and most reported cases are not investigated.