By a 3-2 vote, the board of supervisors in Santa Clara County, California has passed an ordinance prohibiting free giveaways of promotional toys associated with child-sized meal-deals at fast-food outlets, unless the meals meet certain nutritional standards.

The ban will apply to cheeseburgers, chicken nuggets and other fare containing excessive calories, sodium, fat or carbohydrates.

“What we’re trying to do is de-link the connection between unhealthy food and toys,” said Ken Yeager, the board president, who believes that many kids select their meal based on the toy that accompanies it.

“It’s the toys that they want,” Yeager, who does not have children, told the New York Times. “This ordinance does not attack toys. Toys, in and of themselves, do not make children obese.”

The ban takes effect this month in a county in which 25% of the children are obese. Nationally, between 11% and 18% of children are overweight or obese, with low-income residents affected disproportionately.

In adults, the problem is even more widespread: two-thirds of adults are overweight or obese, according to the National Center for Health Statistics.

McDonald’s spokesperson Walt Riker expressed disappointment with the board’s decision. “Our Happy Meals provide many of the important nutrients that children need,” including zinc, iron and calcium, he said.

Ongoing production problems at the factories of biotech giant Genzyme have caused massive disruptions in the lives of people with Gaucher disease and Fabry disease, a pair of rare, inherited conditions in which enzyme deficiencies allow fatty substances to build-up in the body and damage internal organs.

The factories produce Cerezyme, the enzyme used as replacement therapy for the 1,500 patients with Gaucher disease, and Fabrazyme, the enzyme used to treat about 1,000 patients with Fabry disease.

Genzyme’s production problems began nearly a year ago, after it discovered its main production facility had been contaminated by a virus.

Genzyme initially predicted the shortages would last 2 months, but subsequent glitches have impeded progress. At one point, some vials of the drugs were found to contain particles of fiber, rubber or steel.

The problems are particularly acute for Fabry patients, who can experience cardiac or kidney failure in the absence of drug replacement therapy. Fabry patients have been receiving about 30% of their normal doses during the crisis.

In Gaucher disease, which can cause anemia, bleeding and enlarged livers and spleens, severely affected patients have been receiving full doses of the drug, while others received nothing for months late last year.

“If most businesses run like this they’d be out of business,” one patient, Mark Malone told the New York Times. “Unfortunately, they have the drug we need.”

Henri Termeer, Genzyme’s CEO, acknowledged his company had let patients down. “We have to re-earn our standing with these patients,” he said.

Genzyme says it should be able to supply Cerezyme to all affected patients by May 1. Fabrazyme patients will have to wait until at least later this summer. Genzyme stock, which traded above $72 last year, now trades in the low 50s.

Genzyme booked a $175 million hit to its first quarter earnings in anticipation of a fine it expects the FDA to levy for the mess-up.

US physicians wrote 4.4 million prescriptions last year for nitroglycerin (TNG) tablets, those tiny pills in the tiny bottle that dissolve under the tongue and act in minutes to relieve chest pain associated with coronary artery disease.

TNG has direct vasdilatory effects on the coronary arteries. It also reduces blood pressure and cardiac “preload.” Patients take TNG when they first feel angina. They can take up to 3 if the first one doesn’t work. After that, they call 911.

TNG has been around forever, and it turns out that’s a problem. The pills predate the Food and Drug Administration itself, and were grandfathered-in as safe and above regulatory review in 1938 when the agency was formed.

The result is that 80% of the TNG prescribed in the US has never been tested for safety, potency or effectiveness. The only form of TNG that has received FDA approval is Nitrostat, which is made by Pfizer.

Amazingly, doctors just found this out last month. It’s possible that millions of patients may have been taking substandard or ineffective forms of the drug. Some of them may have been harmed by the oversight.

“If it’s not approved and no one has tested it, we can’t be sure that it’s safe and effective,” Harry Lever, a cardiologist at the Cleveland Clinic told the New York Times.

Late last month, the FDA warned the 2 other TNG makers to cease marketing their unapproved products. The companies, Konec Inc. of Tucson and Glenmark Generics Inc. of Mahwah, NJ have been given 90 days to halt production, and 180 days to stop shipping them.  Spokespeople from these companies said they’d comply, but insisted their products were safe.

Meanwhile Pfizer has ramped-up production of Nitrostat and claims it can handle the windfall.

Last week, a federal judge threw out patents on BRCA1 and BRCA2, genes whose mutations are linked to breast and ovarian cancer. The decision casts doubt on patents covering thousands of human genes.

In his decision, US District Court Judge Robert Sweet  ruled the patents were “improperly granted” since they involved a “law of nature.” He rejected the notion that isolating a gene made it patentable, calling that “a ‘lawyer’s trick’” which circumvents the “prohibition on the direct patenting of the DNA in our bodies but which, in practice, reaches the same result.”

The case had been brought by patients and medical organizations last May. They argued that genes, as products of nature, are discoverable and hence fall outside of the universe of things that can be patented. They also argued that patents drive up testing costs and stifle biomedical innovation.

Myriad Genetics is the company that held the BRCA patents. It markets a $3,000 test that scans for mutations in the genes which are associated with a high risk of breast and ovarian cancer.

Nearly 20% of all human genes have been patented. Enormous industries have been created around the intellectual property rights granted by these patents.

If the decision withstands a likely appeal, it might become difficult for companies to raise venture capital to support genomics research. “The industry is going to have to get more creative about how to retain exclusivity and attract capital in the face of potentially weaker patent protection,” said Kenneth Chahine, a law professor who filed an amicus brief for Myriad.

In that instance, “the government is going to become the funder for content discovery because it’s going to be hard to justify it outside of academia,” venture capitalist Bryan Roberts told the New York Times.

Many normal people abhor something about their physical appearance–a beauty mark, their nose, flabby thighs or whatever. In a few people however, the issue becomes an all-consuming, irrational obsession that prevents them from focusing on work or school or even leaving their homes. The obsession can lead to drug abuse or attempted suicide.

The latter instance, which is believed to affect tens of thousands of Americans, is known as body dysmorphic disorder (BDD), a syndrome that has been recognized for more than 100 years but that only recently made it into DSM-V, the diagnostic manual for psychiatrists.

Unlike eating disorders which disproportionately affect women, BDD is nearly as prevalent in men as in women. In one form of BDD affecting guys (muscular dysmorphic disorder), people who are totally jacked from compulsive weight training actually think they look puny and weak.

According to Katharine Phillips, a professor of psychiatry at Brown Medical School and a BDD expert, many individuals trace the problem to emotional trauma in childhood like being teased about their looks, parental neglect or abuse. Most people overcome this without developing BDD, especially if other factors in their lives lift self-esteem.

There may be a genetic component as well: about 20% of BDD patients have an affected parent, sibling or child.

Both cognitive behavioral therapy and serotonin-enhancing drugs (SSRIs) appear to be effective treatments for BDD. In the former, counselors help patients reorder their self-perceptions and expose their “defect” to others. SSRIs help 50-75% of affected individuals, although positive effects aren’t usually seen for months after drug therapy is initiated.

Cosmetic treatments do not work. They can modify one “defect,” but the affected individual often develops another.

The Senate Finance Committee is investigating patient deaths and allegations of substandard treatment at the Select Medical Corporation, a for-profit company that operates 89 long-term care facilities, making it the largest organization of its kind in the nation.

Long term care hospitals treat about 200,000 seriously ill patients per year, although they rarely employ full-time physicians. The facilities are defined solely by their length of stay, although they also tend to be smaller than acute care hospitals and do not have emergency rooms.

In a letter sent to Robert Ortenzio, the CEO of Select , the committee’s top two senators, Montana Democrat Max Baucus and Iowa Republican Charles E. Grassley demanded that his company provide records concerning staffing levels and turnover, and patient monitoring and the quality of care at its facilities.

The letter is not a subpoena, but companies typically respond voluntarily to things like this.

A New York Times article prompted the investigation. The article described poor treatment and several deaths at long-term care hospitals, including one owned by Select in which a dying patient’s heart alarm rang for 77 minutes before nurses showed up.

Former employees of Select told the Times that Select’s hospitals are understaffed, and that the company tries to keep patients for exactly 25 days since the most profit can be obtained by patients who stay for this duration, according to government reimbursement rules. 

Select spokesperson Carolyn Curnand said her company would cooperate with the Senate investigation. She said the Times article was misleading and inaccurate and that her company had a record for providing high quality care. She denied that Select discharged or held patients for financial purposes.

The Ortenzio family has made $400 million since starting Select 14 years ago.

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.