Hearing Aids
Dr. Mead Killion, whom The Wall Street Journal calls "a hearing aid pioneer," is petitioning the FDA to relax its regulations on hearing aids so that the devices can become more affordable. Dr. Killion contends that aids for mild-to-moderate hearing loss could be sold over-the-counter for about $100. Current FDA regulations require consumers to have a medical doctor check for infection, acoustical nerve tumors, too much ear wax, or other medical problems before getting a hearing aid. This requirement can be waived if a person goes to a state-licensed hearing-aid specialist. Testing and fitting sessions, performed by these specialists, increase the average cost of a pair of hearing aids to $2200, according to an industry study sponsored by Knowles Electronics. The high cost means that most people who need hearing aids cannot afford them. Neither Medicare nor many private insurers will pay for the devices. A recent Journal of the American Medical Association article reported that hearing loss is the third-most-common chronic condition in older people. Uncorrected hearing loss is linked to depression, anxiety, and paranoia.

In February 2004, the FDA rejected the first petition submitted by Dr. Killion and his wife Gail Gudmundsen, who also has a PhD in audiology. That petition asked the FDA to rescind its requirement for a physician screening or waiver and to permit over-the-counter sale of hearing aids. Instead of a medical screening, the two audiologists had suggested that hearing aid packages list warning signs of a serious medical problem such as bleeding from the ear and chronic dizziness. Dr. Killion has submitted another petition to the FDA. This one asks the agency to create a 'one size fits most' category that would have fewer restrictions.

Technology for effective, inexpensive hearing aids already exists. Dr. Killion points to hearing devices for hunters, sold in sporting goods stores, as an example. These devices effectively "muffle" gun shots while amplifying quiet sounds, such as those made by animals moving through vegetation. He also says that new materials decrease the need for custom-made molds for the ear pieces. Low-cost aids are already being sold in India and other less-regulated markets.

As Richard Goode, a professor at Stanford University and the former president of the American Academy of Otolaryngology — Head & Neck Surgeons, said to The Wall Street Journal: "If the FDA does not require the public to see a doctor to rule out glaucoma or other disease before getting reading glasses [sold in pharmacies], why does it do so for hearing aids?"

Zimmerman, Ann. The Noisy Debate Over Hearing Aids: Why So Expensive? The Wall Street Journal 24 March 2004

Stossel Takes on Homeopathy
ABC News "20/20" aired a piece on homeopathic medicine on its January 30, 2004 program. The story behind the segment (see www.homeopathic.com) is far more interesting than the eight-minute segment engineered to conclude with John Stossel's signature "Give me a break." Initially, a producer from ABC contacted homeopath Dana Ullman and told him that "20/20" wanted to do a segment on homeopathy that would include a replication of recent European research. Ullman agreed to an interview if Madeleine Ennis, professor of clinical biochemistry at Queen's University (Belfast), okayed the protocol for the experiment.

Dr. Ennis had taken part in two experiments involving human basophils and homeopathic dilutions of histamine. Basophils contain granules that can be stained with a special dye and, then, decolorized (degranulated) with anti-immunoglobulin E. As basophils degranulate, they release histamine. Large amounts of histamine, in turn, inhibit degranulation.

The first experiment took place at four independent research laboratories in 1999 (Inflammation Research 1999, 48:s17-s18). Building on the experiments performed by French biologist Dr. Jacques Benveniste in the 1980s, the group compared degranulation of basophils exposed to homeopathic ('ghost') dilutions of histamine to those exposed to control solutions of pure water. Three laboratories that had nothing further to do with the experiment prepared the homeopathic and control solutions. An independent researcher coded the solutions and collated the data so that the scientists performing the experiment remained 'blind.'

To the researchers' surprise, three of the four labs involved in the trial reported that the homeopathic histamine solutions caused statistically significant inhibition of the basophil degranulation reaction when compared with the controls. The fourth lab also observed that the 'ghost' histamine solution inhibited basophil degranulation, but it was not statistically significant. The basophils that remained intact (and dyed) after the histamine-inhibition reaction occurred were hand-counted "and, therefore, subject to human error." Dr. Ennis, who had taken part in the four-lab trial, performed yet another experiment — this time measuring active (colorized) basophils by machine. Ennis, who admits being skeptical of homeopathy, found that "histamine solutions, both at pharmacological concentrations and diluted out of existence, lead to statistically significant inhibition of basophil activation by anti-immunoglobulin E" (Inflammation Research 2001: 50: 47-48).

After being interviewed by John Stossel, Dana Ullman learned that the London experimenter hired by ABC changed the protocol in a way that assured negative results. Dr. Ennis informed Ullman of several concerns that she had with the new protocol including the use of ammonium chloride, which destroys basophils, and the use of fetal calf serum, which alters the binding reactions of basophils and has other unknown effects. In addition, the experimenter left the blood that contained the fragile basophils to sit and sediment for four hours, compromising their viability. The "20/20" transcript says that "Dana Ullman tried to get the test called off before it even began, saying it was not an exact replica of earlier tests. He later complained the test wasn't designed or conducted properly. We then consulted leading university scientists who reviewed the test protocols and said they were 'technically sound' and 'meticulously conducted.'" ABC would not tell Ullman who these 'leading university scientists' were. Professional skeptic and former magician James Randi was the only 'authority' with a negative view of homeopathy that "20/20" chose to name. To further support his skepticism of homeopathy, Stossel inaccurately defined homeopathic dilution: "At 6C, the amount is like one drop of medicine in 50 swimming pools." "In actual fact," Ullman explains on his website, "the total amount of water used to make a 6C potency is around six test tubes (or around 6 ounces of water)."

Milgrom, Lionel. Thanks for the memory. Guardian. 15 March 2001. www.guardian.co.uk
Stossel, John. Homeopathy: Can Water Really Remember" (Commentary) www.abcnews.go.com
Ullman, Dana. John Stossel and "20/20" program on "Homeopathy: Junk Science Creates Junk Journalism — When TV Science Creates Science Fiction." www.homeopathic.com

Intestinal Dysbiosis
In their article "Intestinal Dysbiosis and the Causes of Disease," Leo Galland, MD, and Stephen Barrie, ND, delineate four patterns of intestinal dysbiosis: putrefaction, deficiency, fermentation, and sensitization. Dysbiosis refers to the presence of harmful microorganisms that can cause widespread effects. Galland and Barrie say that dysbiosis can be a contributor to several conditions, including chronic gastrointestinal, inflammatory or autoimmune disorders, food allergy and intolerance, breast and colon cancer, and unexplained fatigue, malnutrition or neuropsychiatric symptoms. To be treated effectively, the pattern of intestinal dysbiosis must first be identified.

"Putrefaction dysbiosis results from diets high in fat and animal flesh and low in insoluble fiber," the authors state. "This type of diet produces an increased concentration of Bacteroides sp. and a decreased concentration of Bifidobacteria sp. in stool." Enzymes in Bacteroides break down bile acids and excreted estrogens, raising plasma estrogen levels. Deconjugated bile acids cause diarrhea and are toxic to colonic epithelium, contributing to colon cancer. In a high meat environment, Bacteroides also produces the enzyme urease, which hydrolyzes urea to ammonia, raising stool pH. The risk of colon cancer increases when stool pH is relatively high. Bifidobacteria sp., the 'good' bacteria that decreases during putrefaction dysbiosis, ferments soluble fiber, thereby making short-chain fatty acids like butyrate. Butyrate counteracts many of the negative effects caused by harmful bacteria like Bacteroides sp. It lowers stool pH, causes neoplastic cells to differentiate, decreases inflammation in ulcerative colitis, and decreases absorption of ammonia from the intestine. The authors say that putrefaction dysbiosis is usually corrected by maintaining a diet that is high in soluble and insoluble fiber and low in saturated fat and meat and by supplementing with Bifidobacteria and Lactobacillus, Fresh yogurt or kefir may also be helpful.
Deficiency of beneficial normal fecal bacteria, such as Bifidobacteria, Lactobacillus, and E. coli, can be caused by antibiotic use (particularly metronidazole) and/or insufficient soluble fiber in the diet. Deficient numbers of these bacteria are associated with irritable bowel syndrome, characterized by diarrhea, cramps and food intolerance. The authors call deficiency and putrefaction dysbiosis "complementary conditions," saying they often occur together and respond to the same treatment.

The third pattern, fermentation, occurs because of an overgrowth of endogenous bacteria in the stomach, small intestine, and cecum and results in carbohydrate intolerance. Such overgrowth can result from gastric hypochlorhydria, tasis due to abnormal motility, immune deficiency, or malnutrition. Small bowel parasitosis can also be a factor. Fermentation dysbiosis can play a significant role in inflammatory bowel disease. E. Gottschall has used a diet that avoids cereal grains and added sugar and restricts disaccharide sugars to alter gut flora. Long-term anti-microbial therapy is also used to treat fermentation dysbiosis. The authors suggest citrus seed extract — 600 to 1600 mg/day — as a first-line treatment because of its low toxicity and broad spectrum of action against bacteria, fungi, and protozoa. Very high doses can cause diarrhea.
Sensitization, the fourth pattern, involves aggravated abnormal immune responses to components of microflora normally found in the GI tract. It may accompany fermentation dysbiosis and may respond to the same type of diet and anti-microbial therapy.

Galland, Leo, MD and Barrie, Stephen, ND. Intestinal Dysbiosis and the Causes of Disease. www.healthy.net/asp/templates/Article.asp?Id=423

Jungle Virus
The origin of Nipah virus, which killed 40% of the 257 Malaysians who got it in the late 1990s, is the subject of a study organized by the Consortium for Conservation Medicine (Palisades, New York). The four-year study is trying to determine if human-induced environmental changes caused the outbreak. Nipah appeared suddenly in 1998, infecting pigs then moving on to the men in contact with them. The pigs developed encephalitis and a loud cough before they died. After the Malaysians killed 1.1 million pigs, the virus disappeared.

Scientists believe that the world's largest bats (Pteropus vampyrus) host Nipah virus. These fruit-eating bats, which have a five-foot wingspan, have antibodies that protect them from the virus. Like SARS, Nipah is an example of a virus that has lived peaceably with one species but wreaks havoc when it moves on to others. Some scientists believe that the bats flew to Malaysian fruit tree farms in search of food after massive fires in 1997, which destroyed over 12 million acres of virgin forest in Borneo and Sumatra, affecting fruit production in the bats' native habitat. On Malaysian fruit farms, the trees are fertilized by hog manure from animals that live in pens on the premises. Scientists believe that the bats dropped fruit pulp as they ate into the hog pens below, delivering a "lethal dose of virus-laden saliva." The virus, which became more potent while in the pigs, then moved on to the men working with the animals. "In the case of almost every emerging disease, complex human changes to the environment drive emergence," says Dr. Peter Daszak, a parasitologist and executive director of the Consortium that organized the study. The study will try to identify the many variables that caused this sudden epidemic.

Fritsch, Peter. Scientists Search for Human Hand Behind Jungle Virus. The Wall Street Journal 19 June 2003.

Palliative Care
In May 2000, Virginia Commonwealth University Medical Center opened an 11-bed palliative-care unit that has become a model for other US hospitals. Slow to gain acceptance in the US, palliative care has been a recognized medical specialty in Britain since 1987. Palliative-care physicians focus on comfort rather than cure when treating terminally-ill patients. Although they use procedures such as blood transfusions and radiation to treat symptoms of a disease, palliative-care physicians do not use all the drugs and technology at their disposal "to preserve life at any cost." Like hospice care, palliative care emphasizes pain management and easing mental-emotional stress. Palliative care, however, can begin earlier than hospice.

VCU's palliative care unit exemplifies its humane as well as economic advantages. In order to increase the comfort of cancer patients who suffer shortness of breath, the unit's physicians developed a 'misting device' that delivers pain medication directly to the lungs. The palliative-care doctors are also more comfortable prescribing strong narcotics, such as Dilaudid, to help patients suffering from intense pain. The staff goal is that patients can die peaceably in the familiar comfort of their own home, if possible. In the process, the palliative-care unit saves millions of dollars. The Wall Street Journal compared the average care cost for terminally-ill cancer patients during the five days before dying in a palliative vs. a non-palliative unit. Drugs and chemotherapy, lab tests and diagnostic imaging, medical supplies, room, and other expenses average $12, 319 for five days of care in a non-palliative unit. The average cost in the palliative unit is $5,312. Non-palliative care involves far more lab testing and drug treatment — even though a patient is near death — than palliative care. Right now, about 50% of Americans who die each year die in a non-palliative hospital unit.

Naik, Gautam. Unlikely Way to Cut Hospital Costs: Comfort the Dying. The Wall Street Journal 10 March 2004.

Soil
Soil and Your Health, a Basic Earth Guide book written by Beatrice Trum Hunter, explains how organisms contribute to the quality and fertility of the Earth's soil and how farming/gardening practices affect the soil and food quality. "Soil formation is dynamic, a living process," writes Ms. Hunter. Microbes such as actinomycetes ("aerobic organisms classifiable between bacteria and fungi") and earthworms help decompose organic matter, forming spongy-textured humus. Humus improves soil structure and increases the soil's ability to retain moisture and nutrients. Humus and the microorganisms that thrive in humus also help plants resist pests and disease.

Unfortunately, these beneficial soil organisms, including earthworms, are destroyed by the acidic pH of chemical fertilizers and pest-poisoning sprays. Manure from antibiotic-free livestock, on the other hand, encourages earthworm activity. In addition to creating nourishing humus, earthworms aerate the soil, increase the number of actinomycetes, and make minerals bioavailable to plants. A 21-year Swiss study comparing conventional and organic farming practices confirmed that organic methods resulted in a rich soil with microbial diversity (Science, 31 May 2002). Although the organic fields, depending on the crop, produced slightly less than conventionally-farmed fields, organic fields require less energy to till them, less fertilizer, and far fewer pesticides — which means a farmer doesn't have to spend as much money to grow the crops when using organic methods. Profits made by organic farms in Europe are comparable to conventional farms.

The quality of the soil affects crop health and nutritious content of the food we eat. Scientific analysis of pesticide residue data collected by the USDA (1994 to 1999), data collected by California's Department of Pesticide Regulation (1989-1998), and tests by Consumers Union (1997) show that organically-grown food contains significantly less pesticide residue than conventionally-grown food. Virginia Worthington, MS, ScD, CNS, collected data from 37 papers about specific nutrients and toxins in various crops. She found "higher amounts of nutritionally significant minerals in organic, compared to conventional crops." An anecdotal report from a Japanese businessman claimed that racehorses that graze on manure-fertilized grass have stronger legs and fewer leg fractures than those who graze on chemically-fertilized grass.

Flavorful taste, good nutrition, and a desire to avoid pesticides have encouraged US consumers to buy organic food. The amount of farmland devoted to organic practices doubled during the 1990s to meet growing consumer demand, and the USDA's Agricultural Research Service began to turn its attention to organic practices. It now has test sites looking at organic-compatible ways to control plant diseases and weeds, biological pest controls, and soil fertility. Perhaps, one day, the US government will take that final leap and stop subsidizing conventional farming practices, choosing instead to encourage less costly, ecologically-sound organic practices.

Soil and Your Health gives readers a comprehensive overview about an important environmental topic so that they can make informed choices in everyday life. Consumers, gardeners, and farmers need to understand that the health of the Earth's soil affects the health of the plants that grow in it and, ultimately, the health of those who eat the plants.

Hunter, Beatrice Trum. Soil and Your Health. (Basic Health Publications, 2004) ISBN 1-59120062-8

The Sun Safety Alliance
The Sun Safety Alliance (SSA), a nonprofit coalition, is preparing to inundate practitioners and the public with information about skin cancer prevention, according to the group's web site (www.sunsafetyalliance.org). The bulk of the advice focuses on the need to apply sunscreen "liberally" and "often." Although the group is supported by the American Academy of Dermatology, its members come from the commercial sector and include the National Association of Chain Drug Stores (NACDS), Schering-Plough HealthCare Products' Coppertone^® sun care line, Roche Vitamins, and The Walt Disney Company's DisneyHand program. The information on the web site emphasizes the dangers of UV rays and ignores the benefits of sunlight's role in the creation of vitamin D, "the sunshine vitamin."

When exposed to UVB rays in sunlight, skin produces vitamin D. Skin production accounts for most of the body's supply. Vitamin D is involved in calcium absorption. Low blood levels of this vitamin are linked to an increased risk of breast and colon cancers. Scientists at an October 2003, National Institutes of Health conference, "Vitamin D and Health in the 21st Century," reported an 'alarming prevalence' of vitamin D deficiency in the US. Scientists attribute the deficiency partly to diet and partly to worries about UV rays and skin cancer that keep people indoors or coated with sunscreen.

Although much is made of the thinning ozone layer as a reason to wear sunscreen, some of the UV rays in sunlight are able — and have always been able — to pass through the ozone layer. The ozone layer primarily stops UVC rays, which have the shortest wavelength. UVB rays, which have a medium length, are only partially absorbed by the ozone layer. They do not penetrate the skin as deeply as the longer UVA rays do and are the primary cause of sunburn. While the body uses UVB rays to make vitamin D, too much of a good thing can cause tissue damage. The ozone layer does not stop UVA rays at all. UVA rays, which account for 90-95% of the ultraviolet light that reaches earth, are absorbed by melanocytes that cause the skin to tan. These rays can also weaken the skin's connective tissue and make it more susceptible to sun damage. In addition, UVA rays suppress immune function. Tanning beds use mostly UVA light sources. Melanoma has increased sharply, even in areas where no change has occurred in the ozone layer. Professor Johan Moan of the Norwegian Cancer Institute looked at the yearly incidence of melanoma in Norway from 1957 to 1984 and found a 350% increase among men and 440% increase among women during that period

Some researchers believe that the increased use of chemical sunscreens that absorb rather than reflect UV rays is the main cause for the rise in skin cancer. Oxybenzone, a principal ingredient in most sunscreens including Coppertone, absorbs UVA light and then is readily absorbed through the skin and excreted in the urine. Although Cameron Hayden and colleagues at the University of Queensland, Australia, who performed the research, do not know the long-term effects of sunscreen use, they are wary. (The Lancet, 9/20/97). In his article "Sunscreens: Do They Cause Skin Cancer?" Hans R. Larsen, MSc ChE, says that benzophenone derivatives, which include oxybenzone, are powerful free radical generators: "Benzophenone is activated by ultraviolet light. The absorbed energy breaks benzophenone's double bond to produce two free radical sites. The free radicals desperately look for a hydrogen atom to make them 'feel whole again.'" Larsen also notes that wherever chemical sunscreens are promoted, the incidence of melanoma rises. Part of the problem may be that sunscreens give people a false sense of safety and they stay out in the sun longer since their skin does not burn.

Rather than relying on frequent and liberal applications of absorbing sunscreens, consumers can use a reflecting physical sunscreen such as calamine lotion, based on zinc oxide, or wearing protective clothing and a wide-brimmed hat while outside. A moderate natural suntan also offers some protection. Hans Larsen says, "regular and moderate unprotected sun exposure in the early morning or late afternoon will help maintain a protective tan and keep your vitamin D stores at an optimum level."

The active ingredient in sunscreen: is it safe? (oxybenzone) Healthfacts, July 1998 http://www.findarticles.com/p/articles/mi_m0815/is_n7_v23/ai_20963314
Federal Trade Commission. Indoor Tanning. http://my.webmd.com
Larsen, Hans R., MSc ChE. Sunscreens: Do They Cause Skin Cancer? International Journal of Alternative & Complementary Medicine, Vol 12, No 12, December 1994, pp.17-19
Stephens, Anastasia. What the ingredients in sun cream can do to your health. www.taylor-jackson.com/suncreams_that_damage.htm
Sunscreens — cancer in a bottle? The dangers of PABA/Oxybenzone. www.natural-health-information-centre.com/paba-oxybenzone.html
Toor, Daryl. American Academy of Dermatology Teams Up with Drug Stores and Coppertone to Mislead Sun-Tanners about Health Benefits of Sunshine. Press release from Wolff Systems Technology, April 1. 2004

Toxoplasma gondii
Toxoplasma gondii is a parasite that produces eggs (oocysts) in the digestive tract of cats. The eggs are excreted in feces and remain in that form until a mammal or bird eats them. If the next host isn't a cat, the eggs hatch, and the parasites migrate to various tissues where they form cysts. If this intermediate host becomes dinner for a cat, the parasites move to the cat's digestive tract and begin producing eggs. Researchers at Oxford learned that rats and mice that have been infected with T. gondii become less cautious, more active, and have slower reaction times. The rodents also show an attraction to cat urine. All of these behaviors increase the likelihood that the parasites in the rodents will be returned to a cat's digestive tract where they will lay the next generation of eggs.

Humans can become infected with T. gondii (toxoplasmosis) via infected water or meat products or from cat feces. Acute infection is characterized by fever, enlarged lymph nodes, muscle aches and pains, and flu-like symptoms. The primary danger comes when a pregnant woman become infected. T. gondii can pass through the placenta and reach the fetus, causing serious problems that include hydrocephalus, retinochoroiditis, enlargement of the liver and spleen, and heart problems.
Chuck Louch writes in the Port Townsend Marine Science Center newsletter that the large number of cats, particularly feral cats — about 60 million — and the use of flush-able kitty litter means that T. gondii oocysts are affecting more species than ever. Large numbers of oocysts are being washed down storm sewers and into streams, rivers, and eventually to the sea. These T. gondii eggs can survive water and waste treatment plants. In 1995, contamination of the municipal water supply of the Greater Victoria area of British Columbia led to an outbreak of toxoplasmosis in humans.

T. gondii has also entered the marine food chain. Sea otters, for example, are apparently getting the parasites from clams, oysters, or other benthic bivalves that they eat. Unlike land mammals, sea otters have little or no immunity to the parasites. Instead of forming harmless cysts, T. gondii parasites invade a sea otter's brain and eventually cause death. Louch reports that otters that live in coastal areas that receive a high flow of water from streams, rivers, or storm drains are three times more likely to become infected with T. gondii.

Louch, Chuck. Of Cats, Protozoans, and Sea Otters: A Tale of Villainy. Octopress (Port Townsend Marine Science Center newsletter) Vol. XX, No. 1, Winter 2003
Toxoplasma gondii. http://cvm.msu.edu/courses/mic569/docs/parasite/TOXO.HTML

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