Medical research is a huge industry churning out scientific papers at quite a rate. How are doctors supposed to keep up and know what is deemed the 'appropriate' treatment for a condition? A supposed helping hand comes for doctors in the form of 'clinical guidelines' which can come from a variety of sources including one or more of the relevant professional college or society.

However, a recent article in the British Medical Journal casts considerably doubt on the reliability of these reports. The article, written by medical investigative journalist Jeanne Lenzer, focuses on the drug alteplase, a clot-busting drug given for acute stroke. Earlier this year, three US professional societies recommended use of the drug. However, it turns out that only two of the 12 studies on the drug found any benefit, and five of them had to be stopped early due to the finding of a lack of benefit, increased risk of brain haemorrhage or increased death rates.

So, how come the guidelines are at such variance with the science? Well, according to ms Lenzer: "Proponents of alteplase have launched projects to ensure uptake of the guidelines in the US, such as the development of "stroke certified hospitals," which require hospitals to commit resources to enable rapid administration of alteplase to eligible stroke patients. Since ambulances divert patients with suggestive symptoms to stroke certified hospitals, the project has substantial financial ramifications. These efforts, and others like the "Brain Attack" campaign, have been actively supported by the American Heart Association and American Stroke Association, which "partnered" with the Joint Commission (a quasi-governmental agency that accredits hospitals) to promote hospital stroke certification. Genentech, Boehringer Ingelheim and Novo Nordisk, which market alteplase, have contributed tens of millions of dollars to the associations."

Advertising is a powerful and effective tool for promoting the sale of products, especially from the drug and food industries, due to their huge profits. Awareness of a need for government to keep advertisers in line goes back to the end of the 19th century. The very first US Pure Food and Drug Act was passed in 1906, when Theodore Roosevelt was president. Currently, the Federal Trade Commission requires that advertising must be "truthful and non-deceptive." Advertisers must have evidence to back up their claims. Advertisements cannot be "unfair," and must inform about anything that may "materially affect" the consumer's decision. However, those terms are not easily defined. And corporations redefine them for their own benefit.

There has been a culture shift. We still like to stick it to the big corporations, but there is little concern for the nuances of false advertising. Many people today don't have the background to discern what they read, and may be inclined to trust a well-constructed ad. Even lawyers can barely determine what is "legal," let alone what is "right." More often, the aim is simply to construct effective advertising that boosts sales irrespective of morality.

Historically the American Medical Association (AMA) was the official "ethics police" for advertising of drugs, hospitals, clinics, individual physicians and medical devices. Initially, most advertising was forbidden. Members of the AMA were fined for violations. Since social standing in the community is important to a practicing physician, this embarrassment was enough to effectively chastise most offenders. Claims of the superiority of one clinic, hospital or specialist over another were rarely made. Advertising of drugs was minimal for many decades, but recently has been growing exponentially. I attribute this to two factors: the pharmaceutical industry's great power and influence on medical practice, and the private insurance industry that provides accessibility of drugs to its clients by covering the cost---whatever it is. The uninformed patient is usually not aware of the actual cost covered by the insurer. This enables a for-profit insurance company to have full say of what expenses are covered, because it does not have to face challenges from those covered.

Patients in life-saving operations could be up to 30 times more likely to die than others depending on their surgeon.

For the first time the NHS is to publish the death rates of doctors performing operations to repair major blood vessels and prevent strokes.

The figures are in a report due to be released today on the NHS Choices website. But last night there was speculation that its publication could be halted by legal challenges from some hospitals.

Previously experts have warned that publishing death rates will discourage surgeons from carrying out operations on patients most at risk of dying - such as the elderly.

Over the next few weeks, however, officials intend to release the mortality rates of surgeons performing nine other types of procedures in the hope that it will help patients choose where to have their operations done.

The figures, due to be released today, cover operations between 2008 and 2012.

They show a huge variation between the death rates of the 450 doctors in England who carry out vascular surgery - repairing blood vessels - mainly on the over-65s.

Researchers from Northwestern University's School of Medicine have determined that the use of certain pesticides over a lifetime produces a shortening of chromosome telomeres.

The researchers tested 1,234 men as part of a study of 57,310 licensed pesticide contractors - from the Agricultural Health Study, orchestrated by the National Cancer Institute, the National Institute of Environmental Health Sciences, and the U.S. Environmental Protection Agency. This particular study was conducted in partnership with the Robert H. Lurie Comprehensive Cancer Center.

The researchers had the subjects - adult males involved with pesticide application on farms or other environments - fill out extensive questionnaires on their pesticide use over their lifetimes. Some 48 pesticides were used and included in the study.

The researchers also collected from each subject buccal cells - taken from cheek swabs. Using what is called "Real-time polymerase chain reaction" testing, the researchers analyzed those cells for telomere length.

This is one of the most dangerous, covert, and global operations to which we have ever been exposed; and this is very difficult for people to understand: the serious implications of products (cell phones and Smart Meters) and invisible environmental toxins that damage our ability to think clearly. This is a major contributing factor to our diminished cognitive functions. However, it is not the only source of harm.

When we begin to connect the dots to the thousands of unsafe and often highly toxic chemicals, heavy metals, and hormone disruptors to which we are exposed daily, we then can collectively see that this is not just a one-issue health crisis we face. Rather, with corporations allowed free reign to poison us with impunity [the new Monsanto protection bill is the latest crime against us], we do not have any way to have any redress of decades of grievances. The ramifications of this are enormous.

Did you know that Aspartame was banned by the FDA twice? How is this product legal now?

The bittersweet argument over whether Aspartame is safe or not has been going on for a long time. On one side we have medical evidence that suggests we should avoid using it and on the other side we lean on the FDA's approval that suggests it is safe. Since generally that seems to be the factor that many continue to hold trust based upon, I thought we could look into the Aspartame story to find out how it came to be accepted as safe by the FDA. You would think that something so widely used and so well accepted would have quite the pristine story leading to its acceptance. I imagine one will discover otherwise after reading this post.

It all starts in the mid 1960′s with a company called G.D. Searle. One of their chemists accidentally creates aspartame while trying to create a cure for stomach ulcers. Searle decides to put aspartame through a testing process which eventually leads to its approval by the FDA. Not long after, serious health effects begin to arise and G.D. Searle comes under fire for their testing practices. It is revealed that the testing process of Aspartame was among the worst the investigators had ever seen and that in fact the product was unsafe for use. Aspartame triggers the first criminal investigation of a manufacturer put into place by the FDA in 1977. By 1980 the FDA bans aspartame from use after having 3 independent scientists study the sweetener. It was determined that one main health effects was that it had a high chance of inducing brain tumors. At this point it was clear that aspartame was not fit to be used in foods and banned is where it stayed, but not for long.

Consuming highly processed carbohydrates can cause excess hunger and stimulate brain regions involved in reward and cravings, according to a Boston Children's Hospital research team led by David Ludwig, MD, PhD director, New Balance Foundation Obesity Prevention Center. These findings suggest that limiting these "high-glycemic index" foods could help obese individuals avoid overeating.

The study, published in the American Journal of Clinical Nutrition on June 26, 2013, investigates how food intake is regulated by dopamine-containing pleasure centers of the brain.

"Beyond reward and craving, this part of the brain is also linked to substance abuse and dependence, which raises the question as to whether certain foods might be addictive," says Ludwig.

To examine the link, researchers measured blood glucose levels and hunger, while also using functional magnetic resonance imaging (MRI) to observe brain activity during the crucial four-hour period after a meal, which influences eating behavior at the next meal. Evaluating patients in this time frame is one novel aspect of this study, whereas previous studies have evaluated patients with an MRI soon after eating.

Twelve overweight or obese men consumed test meals designed as milkshakes with the same calories, taste and sweetness. The two milkshakes were essentially the same; the only difference was that one contained rapidly digesting (high-glycemic index) carbohydrates and the other slowly digesting (low-glycemic index) carbohydrates.

After participants consumed the high-glycemic index milkshake, they experienced an initial surge in blood sugar levels, followed by sharp crash four hours later.

This decrease in blood glucose was associated with excessive hunger and intense activation of the nucleus accumbens, a critical brain region involved in addictive behaviors.

Prior studies of food addiction have compared patient reactions to drastically different types of foods, such as high-calorie cheesecake versus boiled vegetables.

Another novel aspect of this study is how a specific dietary factor that is distinct from calories or sweetness, could alter brain function and promote overeating.

"These findings suggest that limiting high-glycemic index carbohydrates like white bread and potatoes could help obese individuals reduce cravings and control the urge to overeat," says Ludwig.

Though the concept of food addiction remains provocative, the findings suggest that more interventional and observational studies be done. Additional research will hopefully inform clinicians about the subjective experience of food addiction, and how we can potentially treat these patients and regulate their weight.

Researchers from UH Rainbow Babies & Children's Hospital report reasons behind the increase are unclear.

The largest investigation to date has found a dramatic increase in the number of hospitalizations for children with inflammatory bowel disease (IBD) during the past decade in the United States.

The new study, published online and scheduled for the August 2013 print issue of the Journal of Investigative Medicine, found a 65 percent increase in IBD hospital discharges from 2000 to 2009. The number increased from 11,928 discharges in 2000 to 19,568 discharges in 2009.

IBD refers to a group of inflammatory conditions of the colon and small intestine. The major types of IBD are Crohn's disease (CD) and ulcerative colitis (UC). When looking at these two types of IBD individually, the authors found a 59 percent increase in CD discharges and a 71 percent increase UC discharges.

The study looked at more than 11 million hospitalization records of patients 20 years old and younger using a federal children's inpatient database. For the decade, they identified more than 61,000 pediatric discharges with an IBD diagnosis.

UC Berkeley researchers have found that a lack of sleep, which is common in anxiety disorders, may play a key role in ramping up the brain regions that contribute to excessive worrying.

Neuroscientists have found that sleep deprivation amplifies anticipatory anxiety by firing up the brain's amygdala and insular cortex, regions associated with emotional processing. The resulting pattern mimics the abnormal neural activity seen in anxiety disorders. Furthermore, their research suggests that innate worriers - those who are naturally more anxious and therefore more likely to develop a full-blown anxiety disorder - are acutely vulnerable to the impact of insufficient sleep.

"These findings help us realize that those people who are anxious by nature are the same people who will suffer the greatest harm from sleep deprivation," said Matthew Walker, a professor of psychology and neuroscience at UC Berkeley and senior author of the paper, to be published tomorrow (Wednesday, June 26) in the Journal of Neuroscience.

State health officials continue to quietly investigate what may have caused one to two dozen students to exhibit unexplained vocal tics or repetitive hiccups at Essex Agricultural and Technical School in Danvers and, to a lesser extent, North Shore Technical High in Middleton, this past school year.

The state is reaching out to more than 2,600 doctors in the region while investigating environmental factors that may have caused the symptoms, including air testing and visual observations inside school buildings. So far, according to a May 10 status report from the state Department of Public Health, air tests did not turn up anything that would contribute to "significant neurological effects."

Danvers Health Director Peter Mirandi, in an update to the Board of Health on May 30, said the state is casting a wide net to gather information from doctors and their patients.

"They will be looking for correlations between the symptoms and the students," Mirandi said. "The effort from the Department of Public Health is very thoughtful, deliberate, and I wouldn't mind recognizing them for stepping up when we needed assistance."

A spokesman for the state Department of Public Health had no update on the investigation.