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A pretty good backgrounder from HealthDay (Forbes uses their feed on their site) on the controversy of the HPV vaccine and why it sparks debate. And relatedly, an informed friend writes:

Nice round up of genetic news, mostly new biomarker research, at Genetics & Health blog. Honestly, you could do these things every day - the research is pouring out all over - and it signals two things to me.

Just saw this story that the WHO announced this week that it could eradicate guinea worm from the globe in two years. Pretty incredible feat, eliminating disease altogether. And this one in particular will be nice to see disappear: More specifically known as dracunculiasis, guinea worm infections are particularly nasty. Here's how it works: Worm larvae live in water, and wait for a host-human to drink - then the larvae make their way from the intestines towards the lower extremities (usually the feet). In a nefarious bit of evolution, the worm festers just below the skin, causing a blister which is characterized by a burning sensation. The burning causes the host to, often enough, soak their foot in water - which is just what the worm has been waiting for. Once in contact with water, the worm releases thousands of larvae and the cycle starts all over again. The treatment is usually to draw the worm out of the body by twisting it around a stick - a grusome method that's been practiced for centuries and may be the source for the symbol of medicine, shown above, the Caduceus (though there's some debate about this).

Another day, another report on how a certain diet wards off certain diseases/conditions; this time, it's diets high in flavonoids - a kind of antioxidant - reducing heart disease. My interest here isn't in the fact that contary results that came out last month that purportedly refuted the worth of antioxidants - that sort of back/forth on research, especially dietary research, iswellcommented on elsewhere.

Food has long been seen as a delivery vehicle for public health - mostly for kids. We add vitamin D to milk to prevent rickets, iodine to salt, even flouride to water - all as a way to get certain substances into the diets of the maximum amount of people. It's always been an intriguing bit of paternalism - a government (usually) mandating an addition for the benefit of the people, whether they want it or not. Typically, the added ingredients are simple, almost benign vitamins and minerals. And the additions have little to do with the actual substance they're bolstering: Folic acid was first added to flour and cereal in 1998 not because iron makes sense as a baking ingredient, nor because most Americans want more iron, but rather as a way to raise the folic acid level in prenatal women, thus preventing neural tube defects (which afflict 2,500 newborns a year). Why cereal? No real reason – the acid is found in leafy green vegetables in nature – except that cereal is widely eaten, and therefore a good vector for the additive.

I've been tooling around with this idea that 1) may be brilliant in its simplicity and clarity or 2) may be totally obvious to everyone but me. It goes something like this: We are entering a Third Phase of medicine - one that spots disease and illness based on risks rather than one that responds to symptoms (phase 1, from pre-history to the mid 19th c), or one that seeks out the causes (phase 2, from circa-1850 to just about now).

There's an interesting trend story in the Washington Post about a new early-harvest technique with organ donors - called "donation after cardiac death," it basically means getting the organs as soon as possible, which in some cases means getting close to that vague line between life and death. A few things strike me here: First, implicit in the story - and in all organ transplant stories - is the incredible imbalance between those who need organs and the available supply of organs. Getting better sources and more efficient about supplying organs to those who need them can only be a good thing.

Following up on my post last week about the HPV vaccine, and the question of prevalence among men - the LATimes has a story (reg required) that discusses the idea of a male vaccine, and has a prevalence figure. Curiously, they put it at 60% - which is significantly less than the 75% prevalence among women. They don't discuss the discrepancy, however.

The pharmaceutical industry gets a bad rap for spotting profit opportunities with better skill than medical opportunities. No doubt profit is their primary motive - their public companies, after all - but pharma probably doesn't get enough credit for its overall record at creating medicines that help us live better lives. Sure, they don't do everything we'd ask of them (see the orphan disease problem), but that's the bargain we've made in asking the free market to do the bulk of our medical research. That backdrop makes a new paper at Nature Medicine especially interesting - Carl Nathan is arguing for new ways to align drug research with medical needs. He has two principal recommendations:

The elimination of smallpox is often hailed as one of the greatest triumphs of modern medicine and public health. It is a stunning achievement - with the concerted effort of the World Health Organization, a scourge of mankind was wiped off the face of the earth in a matter of one decade (well, almost eliminated). That success led to the belief that other diseases could likewise be eliminated, if enough effort, strategy and dedication was put to the task. The shortlist included yellow fever, polio, and measles.