Bacteriophages at your local supermarket
My first post on bacteriophages was all a build-up to this piece of news that I found while perusing MRSA Notes.
A mix of bacteria-killing viruses may be sprayed on cold cuts, wieners and sausages to combat common microbes that kill hundreds of people a year, federal health officials ruled Friday.
The ruling, by the Food and Drug Administration, is the first approval of viruses as a food additive, said Andrew Zajac of the Office of Food Additive Safety at the agency.
[...]
The viruses, called bacteriophages, are meant to kill strains of the Listeria monocytogenes bacterium, the food agency said.
The bacterium can cause a serious infection called listeriosis, primarily in pregnant women, newborns and adults with weakened immune systems. In the United States, an estimated 2,500 people become seriously ill with listeriosis each year, according to the federal Centers for Disease Control and Prevention. Of those, 500 die.
Being bacteriophages, they don't attack humans. I say bring 'em on.
[tags]Medicine, food, phage therapy, bacteriophages, listeria[/tags]
Bacteriophages are not yet, but soon will be, the new black
There's lots of talk about drug-resistant bacteria these days in the medical community and the blogosphere. It's a real problem in operating rooms, locker rooms, state penitentiaries, and other places. When I was a wee freshman in pharmacy school, I came across a Wired magazine article — I think it was Wired, anyway — that discussed the use of viruses to achieve positive therapeutic outcomes, specifically against bacterial infections.
Since that time, the use of oncolytic viruses to destroy cancer tumors has become pretty hot, and is what most providers think of when they hear the word "virotherapy." Using non-pathogenic viruses (virotherapy) to treat an infection or cancer isn't new, though — it's actually older than penicillin, and fell out of favor with the medical community when penicillin started being mass-produced. Penicillin is easier to make, handle, store, and works just as effectively, and doesn't carry the stigma of introducing a live virus into the human body. It has always been more popular in Eastern Europe (particularly Russia) than here in the West. It is thought that due to language barriers, the West might not know everything the former Easter Bloc countries do about phage therapy — a problem that will be quickly corrected, I would think.
Except penicillin doesn't work all the time anymore. Neither do its successors. Drug-resistant bacteria and the infections they cause are becoming more prolific and causing more deaths.
Tales from the Pharm: The $15,000 delivery error
Today before my shift I got a phonecall asking me to stop by one of our other stores to pick a mis-delivery of Enbrel that had been delivered the day before.
Lucky for us, the pharmacist over there opened the box and saw what it was and was able to refrigerate it before it got warm. What you see in the picture below has an AWP of…
$15,151.48
I wonder if armored car drivers often make delivery errors on this scale? And if their deliveries have to be stored at a specific temperature? 
To give you an idea of how valuable this is, the entire volume of liquid here is 56mL. Assuming that it has the density of water, that means there's 56g of fluid, which is a hair under 2 ounces.
Right now, Gold is sitting at $480 an ounce. Platinum is sitting around $1217 an ounce. Enbrel has a value of $7500 an ounce.
Oopsie.
[tags]Medicine, pharmacy, Enbrel[/tags]
Good news for Apotex: Plavix gets another approval
Had BMS and S-A known they were going to lose patent protection through their own legal blunders, they probably wouldn't have conducted the COMMIT and CLARITY studies which led to this additional approval. (Trials cost money, you know.)
Two studies support the effectiveness of Plavix in treating STEMI heart attack patients. A large trial, the Clopidogrel and Metoprolol in Myocardial Infarction Trial (COMMIT) study, demonstrated that Plavix, when combined with other standard treatments including thrombolysis, a procedure to dissolve clots, reduced mortality and also reduced the combined number of recurrent heart attacks, strokes and deaths. COMMIT was a randomized, double-blind, placebo-controlled trial of 46,000 patients conducted in China.
The findings in COMMIT in China are supported by the results of the Clopidogrel as Adjunctive Reperfusion Therapy (CLARITY) study. CLARITY was a clinical trial of 3,500 patients undergoing thrombolysis for STEMI heart attacks. CLARITY showed that the coronary artery blood flow was better with clopidogrel treatment compared to placebo.
So who benefits from this? Patients and Apotex. Hilarity ensues.
[tags]Medicine, pharmacy, plavix, clopidogrel, COMMIT, BMS, Sanofi-Aventis, clopidogrel, Apotex[/tags]
Billionaires for banned scientific research
A lengthy article in Forbes this morning talks about how the ban on federal funding has led to a response from the private sector. Billionaires like Larry Ellison, Bill Gates, Michael Bloomberg, Ray Dolby and Andy Grove have jumped in, funding initiatives to advance embryonic stem cell research.
Some of you may recall President Bush's recent veto — so far the only veto during his two terms — of the lift of the ban on federal funding of ESC research. It angered lots of scientists and science enthusiasts, myself included. But the private industry has begun picking up some of the government's slack, pouring some three times as much money as the feds into ESC research. Bloomberg, a member of the president's party, and mayor of New York City, has promised $100 million by himself.
This is great and all, but the lack of cooperation and coversation that privately-funded scientists can have with their NIH-funded counterparts is both sad and funny at the same time:
Melton landed enough money to start a separate lab, and he works on turning his stem line into insulin-producing cells to study where they go wrong in diabetics. But half his budget goes to redundant lab gear and overhead he wouldn't need if it weren't for the NIH rules against stem-cell funding. His stem-cell colleague at Harvard, M. Wiliam Lensch, uses only private funding from Harvard but worries about getting in trouble if he merely talks to NIH-funded peers in his lab.
At Memorial Sloan-Kettering, stem-cell biologist Lorenz Studer has received money from Project A.L.S. and the Starr and Michael J. Fox charities (Fox, the actor, has Parkinson's). He cautiously puts yellow stickers on every piece of equipment used for banned experiments to inoculate his operation from any NIH contact. His grad students put stickers on wastebaskets to mock the NIH.
I wouldn't say his grad students should be mocking "the NIH," because I'm sure many (most?) in the NIH would like to see the ban on federal ESC funding lifted just as much as their privately-funded counterparts. Instead, the blame and mockery can be laid squarely at the feet of the Bush administration — something I rarely say about anything. This is what happens when a fundamentalist is elected to office and lets his faith rather than his reason rule his decision-making.
I'm waxing political, and perhaps sounding even a little rabid. That's because I think the objections to embryonic stem cell research are absurd and the ban on federal funding is hurting this country in the long run. The Forbes article makes a comparison to the late 1800s objections to using cadavers in the interest of medical science. Nowadays there's not a medical doctor practicing that didn't work on a cadaver while s/he was in school, and objections to their use are laughable. And that's exactly how this "debate" over ESC research will seem to our children 100 years from now.
This Reason piece puts things into perspective. The Bush administration would do well to read it.
Addendum: Good timing, Jack.
[tags]Medicine, abortion, stem cell research, biology, ethics[/tags]
When reaching for pills is easier than making lifestyle changes
The WaPo has an article on the increased use of sleeping pills, saying that consumers probably rely on them too much.
"We recommend that both the older and newer sleeping pills be taken more judiciously and less often than appears to be the current pattern of use by millions of people in the U.S.," the report states. CR says increased pill usage is due to a "growing awareness of the health risks of insomnia and intense advertising and marketing to doctors," as well as direct-to-consumer ads that "imply that medication is the best remedy for sleep problems."
You don't say? I could say the same thing for PPIs — why not try lifestyles changes, and then if that doesn't work, move to an H2 blocker, and then reach for the PPI? Why go right for the Nexium?
Because going for the Nexium and Ambien is simply easier for an overworked doctor to do than help a patient make healthy lifestyle changes that might work just as well, and more permanently. Consumers like magic bullets, too, again because they're easier. Take this, your problem will disappear. Easy. In the case of PPIs, they're almost guaranteed to work. The classic case of using a bazooka to kill a gnat — always effective and usually always overkill.
This trend isn't the healthiest, of course. Or the cheapest. Or the best. I think we'll see a swinging away from this style of medicine over the next ten years. Insurers are beginning to realize that CBT is often less expensive in the long run than medicating someone ad infinitum.
[tags]Medicine, pharmacy, therapy, ambien, sleep[/tags]
Is health insurance a "myth"?
I read an article today that got me thinking. At first I was inclined to agree with Thomas Szasz's opinions, but the more I thought about it, the more I understand why health insurance doesn't work the way he thinks it should.
Basically, the premise of the article is that health insurance is unlike any other type of insurance one can buy. Unlike, say, car insurance, health insurance pays for the normal upkeep of one's body, whereas car insurance only covers accidents. His whole article boils down to maintenance versus catastrophic coverage. See this for a nutshell summary of his premise:
The typical contractor of homeowner’s insurance is the homeowner. He buys insurance to protect himself from costly loss caused by events outside his control, such as fire, not to defray the recurring expense of maintaining it. The ideal outcome for both the buyer and the seller of home and automobile insurance is for the policyholder to never make use of his policy.