DR. MARILYN BRUNO VOLUME 7 ISSUE 6 JUNE 2014 WWW.GYNOSAPIENS.COM

Energy Savings Calculator

Here is a calculator to help zero in on the areas where we can save electricity: http://www.sdge.com/energy-savings-calculator:

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  Replace regular lights with CFL/LEDs
  
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  Use smart strips to power down TV/audio system
  
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  Lower water heater temperature 20°
  
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  Set thermostat to "right" temperature in summer/winter
  
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  Use cold water for clothes washing
  
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  Get rid of second refrigerator
  
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  Get ENERGY STAR® qualified appliances (refrigerator)
  
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  Use timers and motion sensors on outdoor lighting
  
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  Add insulation and weatherize home
  
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  Use an energy-efficient pool pump and limit filtering time
  

I am very allergic to bites from bees, mosquitoes, and insects of all sizes. I was told by a biologist that I am a magnet for mosquitoes because I had Type O blood – the same blood type of prehistoric man (and Gynosapiens) had, which mosquitoes have a long-evolved preference for. Unfortunately, mosquitoes are much more than an itchy annoyance. They transmit several serious diseases that are on the rise, including malaria, which kills nearly 1 million people every year, dengue, West Nile virus, filarial worms, etc. Let’s take precautions as the bug season starts in full swing.

Well, besides Type O blood, we know that carbon dioxide from our breath attracts mosquitoes. When I lived in Florida, I had a mosquito trap in my back yard. It worked by emitting small amounts of carbon dioxide, which lures the mosquitos into a mesh trap. It was wonderfully effective for an acre around my house, so my neighbors appreciated it too.

Now, researchers at the University of California, Riverside have discovered a receptor that mosquitoes use to detect both CO2 and skin odor. Female mosquitoes (the blood suckers) have nerve cells called cpA neurons that have a receptor to detect carbon dioxide and other nerve cells that detect the smell of human skin even in the absence of carbon dioxide. The great news is that the same researchers have discovered chemicals that shut down the CO2 and skin odor receptors in both Aedes aegypti and Anopheles gambiae mosquitoes—which transmit dengue and malaria respectively. They did this by developing a computer simulation method to screen almost half a million chemical compounds in search of structures that might interact with the receptor. They identified 138 compounds that were pleasant smelling, inexpensive, and considered safe for human use (as opposed to DDT, which blocks the mosquitoes’ CO2 receptor, but which is hazardous to health). The researchers focused on 2 of the compounds recognized as safe for humans: Ethyl pyruvate, which has a fruity smell and is approved as a flavor agent in food, blocked attraction of mosquitoes to a human hand; and Cyclopentanone, which is minty-smelling and is approved as a flavor and fragrance agent, attracted mosquitoes to a baited trap as effectively as CO2.

When I read this, I resolved to place my mint pot on the far end of the patio and try to get my hands on ethyl pyruvate to mask myself from the mosquitoes. No more Mojitos or Juleps for me! For more info: Results of the study appeared online on December 5, 2013, in Cell: http://www.nih.gov/researchmatters/december2013/12162013mosquitoes.htm

Even if you're lucky enough to be unappetizing to mosquitoes, there's another reason to choose your bug defense carefully: insect-borne illnesses are dramatically rising and can become serious, even deadly. Lyme disease, which is transmitted by deer ticks, causes debilitating symptoms in more than 20,000 people every year. As climate change intensifies, public health experts expect that more breeds of mosquito will thrive in the United States. As a result, they predict an increase in West Nile and other insect-borne illnesses, such as yellow fever.

In 2013, 2,374 people in 48 states contracted the mosquito-borne disease West Nile virus, and 114 of them died. And, malaria and dengue are making a strong comeback in tropical climates, primarily due to heavy rains and rising temps. Since 2001, Florida, Hawaii, and Texas have had outbreaks of dengue. In Venezuela, for the first time in 50 years, malaria has re-emerged and is spreading from jungle communities to urban centers. Over 23,000 cases have been reported since January. If you are going to travel in the tropics this summer keep an eye out for the symptoms of malaria (fever, headache, vomiting), which can take 8 to 10 days to appear. Dengue symptoms include fever, headaches and a measles-like rash. Get treatment fast. If left untreated, malaria and dengue can lead to death.

Insect Repellants

The insect repellent aisle of your local pharmacy offers a dazzling array of options to protect you from hungry bugs. Hardcore DEET-based sprays like Off! Deep Woods ($6.79 for 6 oz.) promise to ward off ticks, mosquitoes, flies, chiggers, and gnats for an entire day. Other products—such as Avon Skin So Soft Bug Guard Plus ($6.99 for 4 oz.)—contain sunscreen in addition to insect repellent. There are plenty of plant-based potions—Aromaflage ($30 for 8 ml) claims that its proprietary blend of "citrus fruit, warm cedarwood, and silken vanilla" makes for "a sophisticated, uplifting fragrance that also repels insects.

Despite massive industry lobbying, sunscreen manufacturers must now state clearly on the packaging how well and how long a product works. Repellent companies, however, are hardly required to follow any rules at all. In 2013, when the health watchdog Environmental Working Group (EWG) analyzed various repellents, researchers found that manufacturers' claims about how long products last varied widely—even with the same active ingredient in the same concentrations. Some manufacturers claimed that their products were waterproof, even though—beachgoers beware—they did not offer proof. Others boasted exotic active ingredients—like clove oil and lemongrass oil—that have not been adequately tested and may contain high concentrations of allergens.

EWG recommends avoiding products with plant-based active ingredients, even though they sound greener; the EPA does not require registration of these substances, and no one knows how safe or effective they are. The CDC recommends avoiding combined sunscreen-repellents because sunscreen requires much more frequent application than repellent—and the effect of over-application of repellent hasn't been well studied. And don't trust label claims about how long a product can last. That's determined by the percentage of its active ingredients—but without any way to compare, consumers are left to trial and error.

Last year, the EPA drafted a label template for the manufacturers to inform consumers what kinds of insects a product protects against and how often it needs to be reapplied. But it's completely voluntary, and only applies to repellents that you apply to your skin, not wristbands, patches, candles, coils, patches, sonic devices, fabrics, or any other products that claim to deter bugs. For example, according to Australian research since 2011, wristbands do not work as skin-applied repellents and only offer protection in a very small area around the wrist!


Pick your Poisons

For the best protection against both mosquitoes and ticks, the CDC recommends products containing DEET. Studies have found virtually no health risks associated with DEET at the concentrations found in commercial repellents. (In the '80s, we remember that there were reports of children having seizures after using DEET-based products, but the exact cause of the seizures was never determined.)

For just mosquitoes, the agency also approves of products with the active ingredients picaridin (the active ingredient in most Avon Skin So Soft products), IR3535, and oil of lemon eucalyptus—which, despite its natural-sounding name, is actually a synthetic formulation. EWG found all three of these ingredients to be just as effective as DEET.

Bottom line: use what works and prevent against the itchies and possible insect-borne diseases.

For more info: http://www.motherjones.com/environment/2014/05/truth-about-insect-repellent-deet

ALLERGIES AND ASTHMA

Allergies

We are already in the allergy season, often called “hay fever“ season. Plant pollens that cause seasonal allergies and can come from trees, weeds and grasses. Trees and grasses are typical Spring culprits in the U.S., while ragweed and other weeds ramp up in late Summer and early Fall. Indoor substances, such as dust mites, often cause the year-round type of allergies. Molds can cause seasonal and year-round allergies. Symptoms include repetitive sneezing, stuffy, runny nose, itching in the nose, eyes or on the roof of the mouth. I get itching inside my ears! Eye inflammation can occur when your eyes react to allergens with symptoms of reddening, itching and swelling.

As you know, an allergy is a heightened immune system reaction to a substance that your body has identified as an invader. If you have allergies and encounter a trigger—called an “allergen”—your immune system fights it by making antibodies, which causes your body to release chemicals called histamines. Histamines are responsible for symptoms such as repetitive sneezing and itchy, watery eyes – which aren’t just a nuisance -- they are real diseases. Allergic rhinitis affects more than 30 million children and adults in the United States and more than 500 million people worldwide. It may be seasonal or year-round, mild to severe, and can interfere with work, school or recreation.

Testing

If you suspect an allergy, see your health care provider, as conditions such as upper respiratory infections, sinus infections and eye infections can have similar symptoms. The doctor can test you using FDA-approved injectable allergen extracts (sterile liquids made from natural substances such as molds, pollens or animal hair). Tests include:

-a skin prick test, which involves placing the allergen extract on your skin and pricking so it goes under the skin’s surface. Your skin is studied for swelling or other signs of a reaction, which usually occurs in about 15 minutes.

-an injection of a small amount of an allergen, or

-a blood test, which can detect and measure antibodies to certain allergens.

Medications to Treat Symptoms

After testing, you need to discuss whether avoidance or medication is the best course of action. For instance, if you have a spring oak tree allergy, you can try to avoid the allergen by limiting outdoor activities on high pollen-count days and keeping your windows closed. But airborne pollen can be hard to avoid, so your health care provider may also recommend prescription or over-the-counter medications to relieve symptoms.

Antihistamines reduce or block symptom-causing histamines and are available in many forms, including tablets and liquids. First-generation antihistamines include medications such as diphenhydramine, marketed under the brand name Benadryl. Newer second generation antihistamines include fexofenadine and loratadine, which are marketed under the brand names Allegra and Claritin. When choosing an over-the-counter antihistamine, patients should read the Drug Facts label closely and follow dosing instructions. Some antihistamines can cause drowsiness and interfere with the ability to drive or operate heavy machinery. The drowsiness can be made worse by taking sedatives or consuming alcohol. Patients with chronic conditions such as glaucoma, or an enlarged prostate should talk to their health care provider before taking certain antihistamines.

Nasal sprays and eye drops can relieve some symptoms, but they should only be used for a limited time without talking to a health care provider. If some nasal sprays are used longer than intended they can make the congestion worse.

Medications that Help Desensitize

If you don’t respond to medications to relieve symptoms, you may be a candidate for allergen immunotherapy, often given via “allergy shots” that have small amounts of the allergen. These shots can decrease sensitivity to inhaled allergens. Patients can receive weekly injections from a health care provider for two to three months, during which time the dose increases. After the maximum dose is reached, treatment can continue monthly for three to five years.

New Immunotherapy Options

FDA just approved three sublingual (under the tongue) prescription products to treat hay fever (also called “allergic rhinitis”)—with or without eye inflammation (called “conjunctivitis”)—caused by certain grass pollens and short ragweed pollen. The new products, Grastek, Oralair and Ragwitek, can be taken at home, but the first dose must be taken in a health care provider's office. These medications have the potential for dialing down the immune response to allergens, doing more than just treating the symptoms of allergies. Sublingual therapy should start three to four months prior to allergy season so, depending on your geographic location, it may be something to explore in the next year.

Allergenic treatments can result in reactions such as swelling in the place where they are administered, or systemic reactions that can affect the airway. For injection therapy, local side effects like itching and swelling can be annoying but not life-threatening. But for the medications taken under the tongue, you must be especially careful to pay attention to side effects such as swelling and must take the first sublingual treatment under medical supervision. After that, you can take treatments daily at home, and your health care provider must prescribe an autoinjectable epinephrine device in case you need it for a severe reaction. You should read the medication guide that is distributed with Grastek, Oralair and Ragwitek each time you fill a prescription.

For more info on allergies, see: FDA's Consumer Updates page - http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm396321.htm?source=govdelivery&utm_medium=email&utm_source=govdelivery

Asthma

Asthma is a disease that affects the lungs of people of all ages. Asthma causes wheezing, breathlessness, chest tightness, and coughing at night or early in the morning. If you have asthma, you have it all the time, but you will have asthma attacks only when something irritates your lungs. In most cases, we don’t know what causes asthma, and we don’t know how to cure it. We know that if someone in your family has asthma you are more likely to have it

It can be hard to tell if someone has asthma, especially in children under age 5. Having a doctor check how well your lungs work and check for allergies can help you find out if you have asthma. During a checkup, the doctor will ask if you cough a lot, especially at night, and whether your breathing problems are worse after physical activity or at certain times of year. The doctor will also ask about chest tightness, wheezing, and colds lasting more than 10 days. They will ask whether anyone in your family has or has had asthma, allergies, or other breathing problems, and they will ask questions about your home, activities, etc. The doctor will also do a breathing test, called spirometry, to find out how well your lungs are working. The doctor will use a computer with a mouthpiece to test how much air you can breathe out after taking a very deep breath. The spirometer can measure airflow before and after you use asthma medicine.

An asthma attack (including coughing, chest tightness, wheezing, and trouble breathing) happens in your body’s airways. During an attack, the sides of the airways in your lungs swell and the airways shrink. Less air gets in and out of your lungs, and mucous that your body makes clogs up the airways even more. You can control your asthma by knowing the warning signs of an asthma attack, staying away from things that cause an attack, and following your doctor’s advice. When you control your asthma: you won’t have symptoms such as wheezing or coughing, you’ll sleep better, you can take part in all physical activities, and you won’t have to go to the hospital.

Control your asthma and avoid an attack by taking your medicine exactly as your doctor tells you and by staying away from things that can trigger an attack. Not everyone with asthma takes the same medicine.  Some medicines can be breathed in, and some can be taken as a pill. Asthma medicines come in two types—quick-relief and long-term control. Quick-relief medicines control the symptoms of an asthma attack. If you need to use your quick-relief medicines more and more, visit your doctor to see if you need a different medicine. Long-term control medicines help you have fewer and milder attacks, but they don’t help you while you are having an asthma attack. Asthma medicines can have side effects, but most side effects are mild and soon go away. Ask your doctor about the side effects of your medicines.

For more general information on asthma: May 12, 2014, Centers for Disease Control and Prevention; cdc.gov


Stay away from asthma triggers

Avoiding everything that makes your asthma worse is your first step toward feeling better. Some triggers are in the air we breathe, some are in our surroundings, and some are on our pets.

--Smoking: If you smoke, ask your doctor or nurse to help you quit. No one should smoke in your house. This includes you, your visitors, your child’s babysitters, and anyone else who comes to your house. Smokers should smoke outside and wear a coat. The coat will keep smoke particles from sticking to their clothes. They should leave the coat outside, or away from the child. Ask people who work at your child’s day care, preschool, school, and anyone else who takes care of your child, if they smoke. If they do, make sure they smoke away from your child. Stay away from restaurants and bars that allow smoking. Or, ask for a table as far away from smokers as possible.

--Pollen: When pollen levels are high:

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  Stay indoors and keep doors and windows closed. Use an air conditioner if you have one.
  
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  Save outside activities for late afternoon or after a heavy rain.
  
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  Wear a face mask while you are doing outdoor activities.
  
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  Do not dry clothes outdoors. Pollen will stick to them. Have someone who does not have asthma cut the grass, or wear a face mask if you must do it.
  

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  Wrap mattresses, box springs, and pillows with mite-proof covers.
  
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  Wash bedding and pillows once a week in hot water (130° F to 140° F).
  
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  If you can, get rid of upholstered furniture. Use wooden, leather, or vinyl.
  
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  Keep indoor air dry. Try to keep the humidity level lower than 50%.
  
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  Wipe dust with a damp cloth and vacuum once a week. Use a vacuum cleaner with a HEPA filter.
  
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  Replace wall-to-wall carpet with wood or other hard flooring.
  
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  Keep stuffed toys off the beds, and wash them weekly.
  
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  Replace slatted blinds and cloth draperies with pull-down shades. They will not collect as much dust.
  
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  Keep closets clean, and keep closet doors closed.
  

Use an exhaust fan in the bathroom when you are showering. Do not let damp clothes sit in a basket or hamper.

Clean or replace shower curtains when you see mold on them. Check your basement for moisture and mold. Use a dehumidifier to keep the air dryer.

--Pets Can Make Asthma Worse. Keep pets outside, if possible. If pets stay inside, keep them:

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  Out of bedrooms
  
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  Off upholstered furniture
  
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  Off of carpets
  
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  Wash your pet once a week.
  
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  If you have a central air conditioning system, use a HEPA filter to remove pet allergens from indoor air. Use a vacuum cleaner with HEPA filters.
  
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  Wash your hands and change your clothes after playing with your pet.
  

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  Keep kitchen counters clean and free of food crumbs. Do not leave dirty dishes in the sink. Keep food in closed containers.
  
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  Do not let trash pile up inside. This includes bags, newspapers, and cardboard boxes.
  
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  Use roach traps. Wear a dust mask and gloves if you touch or are near rodents.
  

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  Do not use wood-burning fireplaces. If you need to burn wood, use an air-tight wood-burning stove.
  
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  Do not use perfumes or scented cleaning sprays. Use trigger sprays instead of aerosols.
  

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  For some, cleaning products may actually aggravate asthma and allergy symptoms. Also, dust that is disturbed when cleaning can make the process a nightmare.
  
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  Numerous products have received a “green” seal of approval and are easy on the environment. Many of these come from plant or natural sources. An easy alternative to purchased cleaning products is cleaners that you make yourself from ordinary household ingredients such as lemon, vinegar, and baking soda.
  
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    Recipe 1: Straight vinegar sprayed on the walls. Don’t rinse, just air dry.
    
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    Recipe 2: Mix 2 cups vinegar, 2 cups very hot water, 1/2 cup salt and 2 cups borax. Apply solution to area and allow it to sit for 30 minutes. Apply the solution again, scrubbing with a soft bristled brush and rinse well with plain water.
    

Remember the 1973 movie Soylent Green – a view of New York in 2022, with a population of 40 million living with horrific air pollution and only the wealthy enjoying natural food and air-conditioned homes. Well, switch from New York in 2022 to Hong Kong in 2014. The fog over the HK harbor contains air pollution so severe that is now a health threat that it is projected to impact children's life expectancy. Those families that can afford it, are packing up and leaving behind jobs, friends, and lifestyles and moving out!

Studies are showing that any insult to growing organs causes a long-term impact, and children’s systems cannot remove toxins as well as adults, particularly lung tissues. The lung wall in a baby is proportionally much larger than an adult's. This means far more toxins circulates through the system. Also, children are physically active and prone to mouth breathing, which stops their noses filtering dirty air. Babies and small children also have tiny airways, so anything that aggravates them will have a far greater impact. Any toxin that interacts with a genetic predisposition can cause allergies and asthma. Just as back studies show that mothers living in polluted areas are at greater risk of having babies with low birth weights and congenital malformation, animal studies have linked attention deficit hyperactivity disorder (ADHD) and hyperactivity to early exposure to air pollution. Interestingly, the most impact occurs in teenagers, when the greatest expansion of their lung growth is occurring. Some studies also indicate that longer-term exposure can be linked to cancer.

The Division of Environment at the Hong Kong University of Science and Technology and HKU's School of Public Health’s research showed that 10mg of particulate matter will cause the loss of two years off life expectancy. In Hong Kong, the air is at 45-50mg of such matter. Theoretically, this means 10 years of life lost.

Unfortunately, Hong Kong is not alone. The WHO surveyed 1,600 cities in 91 countries and showed that that nearly 90% of people in urban centers breathe air that fails to meet levels deemed safe and about half of the world's urban population is exposed to pollution at least 2.5 times higher than it recommends. The WHO concluded 1 in 8 deaths globally is linked to air pollution, making it "the world's single largest environmental health risk." Of 7 million people around the world dying as a result of air pollution in 2012, 6 million were in China, Southeast Asia, and Western Pacific (http://www.who.int/phe/health_topics/outdoorair/databases/FINAL_HAP_AAP_BoD_24March2014.pdf?ua=1).

Hong Kong's problems are traced to cargo-ship emissions, traffic fumes and output from coal-powered power stations and factories in Guangdong province and the Pearl River Delta. The city's topography of mountains and high-rise buildings causes a canyoning effect, which prevents toxic air from dispersing. This smog consists of many substances. First is sulphur dioxide (SO2), an odorless gas that is caused by the combustion of fossil fuels in power plants, industrial boilers and vehicles on land and at sea. SO2 damages the respiratory system and aggravates respiratory disease, such as bronchitis. It causes wheezing, shortness of breath and coughing. It can also cause cardiovascular disease in people with sensitive respiratory systems, including asthmatics, the elderly and children. Second, nitrogen oxides (NOX) and nitrogen dioxide, which are formed through combustion at a high temperature in power plants and vehicle engines, at land and at sea. Nitrogen dioxide is a smelly brown gas that irritates the lungs and lowers the body's resistance to respiratory infections such as the flu. People with respiratory problems (for example, asthmatics) are more susceptible. In young children, these gases impair lung development and chronic exposure leads to structural changes in the lungs. Third is ozone, which is formed by the reaction of nitrogen dioxide in ultraviolet light and makes a photochemical smog. Ozone irritates mucous membranes in the nose, throat and airways. Because it's "consumed" by the gaseous pollutants found by roadsides, ozone is often more prevalent at higher levels in outlying areas where people may think there is less pollution. Ozone causes coughs, chest pain, throat pain and eye irritation, decreases lung function and inflames the respiratory system.

The WHO currently sets safe levels of air quality based on the concentration of polluting particles called particulate matter (PM) found in the air. It recommends that levels of fine particles called PM2.5 should not be more than 10 micrograms per cubic meter on average over a year, and slightly larger pollutants, called PM10, should not reach more than 20 micrograms per cubic meter on average. Among the non-gaseous nasties, there are fine particles called respirable suspended particulates (RSPs). They are made of liquids, solids or a mixture of the two that is suspended in the air. Measured by their size, RSPs are divided into two categories of particulate matter (PM): PM10 (10 micrometres or less) and PM2.5 (2.5 micrometres or less). These miniscule particles are produced by combustion - particularly in diesel vehicles and power plants, construction, incineration and, naturally formed in the sea. Often, the particulate matter is small bits of unburnt or partially burnt carbon attached to elements such as silicon, aluminum, sodium, calcium, manganese, iron, barium, mercury and lead. Lead is particularly dangerous to young children as it damages the nervous system, red blood cells and kidneys and can cause brain damage. Many RSPs are carcinogenic. PM2.5 particles are so small that our noses can't filter them out. Readings of over 10 micrograms/cu. meter of PM 2.5 is highly dangerous. They get breathed straight into the lungs, where they deposit on the lining and have no way out. RSPs cause a wide range of problems, such as blocked airways, coughs, decreased lung function, aggravated asthma, the development of diseases such as bronchitis, poor sleep, stunted growth, skin irritations and eczema. In people with existing heart and lung disease, they can cause premature death, including from lung cancer.

Global studies show that the highest impact on children's health is from roadside pollution. Living, walking or going to school next to a busy road is much more likely to harm children than ambient air pollution from a distant power station. The initial findings show that the distance from a road is a major factor in child health. A safe distance is defined as 200 yards. The direction the windows face, proximity of school buses, and general wind direction also dictate how much pollution enters a school environment. The season also has an impact. In summer, when the windows are shut and the air-conditioning is on, the air inside a classroom is much cleaner. In winter, when windows are more likely to be open, classroom air quality is dependent on outdoor air quality.

Chinese researchers fear “information fatigue.” If parents heed air quality warnings, they may never let their children outside, schools will cancel PE, etc. And the question remains, how much cleaner is indoor air? If there is indoor cigarette smoking, incense burning, gas cooking, new furniture and carpets that emit harmful volatile organic chemicals such as formaldehyde, house dust mites, pets, etc., indoor air is also a problem.

China is investing $hundreds of billions to phase out its most polluting older diesel vehicles, restrict emissions by buses and factories, and require low sulphur fuel while berthing in ports. By 2017, Guangdong is aiming to reduce PM2.5 levels by 15%. But these objectives still won't meet the WHO's standards. For the full article: http://www.scmp.com/magazines/post-magazine/article/1501490/bad-air-daze-air-pollution-and-our-children

Bottom line: Move to a mountain top or Invest in Air Purifiers and Face Masks! These are sure to be booming businesses globally. Over the past two years, 6% of Chinese households have acquired air purifiers at prices ranging from $320 to $640. In the U.S., 27% of households have air purifiers.

During the San Diego wildfires, I cleaned out Walgreen’s supply of face masks! They did work and protect my lungs. Not so my eyes, which teared badly.

Nearly all gasoline sold in the U.S. is 10% ethanol by volume, or E10. Ethanol is a renewable fuel made from plant matter (sugar cane, corn), and therefore “green”. The E10 gasoline mix was mandated by Congress in 2007 in an effort to reduce reliance on imported oil and cut greenhouse gas emissions (carbon dioxide, nitrogen dioxide) and other pollution – such as carcinogens created when nitrogen dioxide combines with hydroxyl radicals, a short-lived type of atmospheric chemical that cleans the troposphere of ozone.

Big Oil and other ethanol critics have long contended that ethanol’s effect on the environment is as bad or worse than oil. A recent National Academy of Sciences report concluded that the fossil fuel energy sources used to make ethanol and the amount of land devoted to corn cultivation may make ethanol use “ineffective” in reducing greenhouse gases.

Now researchers from Northwestern University have made the surprising discovery that a higher percentage of ethanol in our gas tank correlated to higher ground-levels of ozone, or smog! For more on ethanol/ozone, see: http://www.latimes.com/science/sciencenow/la-sci-sn-ethanol-ozone-levels-brazil-20140501,0,5517616.story

Time to buy a Tesla or another electric car!

E-cigarette Worries

Outdoor air pollution is not our only concern. Electronic cigarettes, which appear to be safer than ordinary cigarettes because there is no burning tobacco to inhale, may be a problem. Researchers are showing that some popular e-cigarettes get so hot that they, too, can produce a myriad of the same carcinogens found in cigarettes and at similar levels.

A study to be published in May 2014 in the journal Nicotine and Tobacco Research found that the high-power e-cigarettes known as tank systems produce formaldehyde, a known carcinogen, along with the nicotine-laced vapor that their users inhale. The toxin is formed when liquid nicotine and other e-cigarette ingredients are subjected to high temperatures. Unlike disposable e-cigarettes, which tend to mimic the look and feel of conventional smokes, tank systems tend to be larger devices heated with batteries that can vary in voltage, often resembling fountain pens or small flashlights. Users fill them with liquid nicotine, or e-liquid, and the devices are powerful enough to vaporize that fluid quickly, producing thick plumes and a big nicotine kick. Complicating the issue is that the tank systems are made by a variety of manufacturers, many overseas, and then sometimes tinkered with and modified by retail shops or users.

The new research suggests how potential health risks are emerging as the multibillion-dollar e-cigarette business rapidly evolves, and how regulators are already struggling to keep pace. In April 2014, the FDA extended its authority to e-cigarettes and is focusing on what goes into these products — currently, an unregulated brew of chemicals and flavorings — rather than on what comes out of them as wispy plumes of flavored vapor. The proposed rules give the FDA the power initially to regulate ingredients. Later, it may regulate emissions, particularly with concerns over third-party smoke.

A second study by Virginia Commonwealth University cites the impact of increased heat generated by the systems, particularly since users are modifying the devices to create more — and more potent — vapor. Rather than fill their tank systems with e-liquids (vegetable glycerin and propylene glycol), experienced users often trickle drops of the fluid directly onto the device’s heating element, a practice known as “dripping.” With dripping, the e-liquid heats with such intensity that formaldehyde and related toxins approach the concentration in cigarettes. Both studies point to the same phenomenon: intense heat can change the composition of e-liquids, creating new chemicals. Importantly, the researchers said, the chemical reactions apply not only to the liquid nicotine, but also to the 2 e-liquids.

The first study found, generally, that when battery voltage increased to 4.8 volts from 3.2 volts, toxin levels increased markedly. Since this does not generate enough heat to create combustion, most public health officials and researchers have in the past predicted they will prove less harmful than traditional cigarettes, which create thousands of chemicals and dozens of carcinogens. For more info: http://www.nytimes.com/2014/05/04/business/some-e-cigarettes-deliver-a-puff-of-carcinogens.html?ref=us&_r=0

As if all this news were not bad enough, the Centers for Disease Control and Prevention (CDC) said there was little progress in reducing food poisoning rates caused by bacterial contamination in the U.S. in 2013. The Foodborne Diseases Active Surveillance Network, a collaboration between Federal health administrations and State health departments, monitors infections linked to food caused by nine common pathogens at 10 sites in the U.S. The results were published in the CDC's Morbidity and Mortality Weekly Report (MMWR), which includes 2013 infection data and trends since 2006. In 2013, there were 19,056 lab-confirmed infections in the sample areas, more than 4,000 people were hospitalized, and 80 died from foodborne illnesses.

The most common infections in 2013 were Salmonella, affecting 15% of the population; Campylobacter, a bacterium found in poultry whose only remedies are culling flocks, vaccinating the poultry, and thorough cooking) affecting 14%, and Shigella, affecting 5%. All originate in contaminated food due to insufficient cooking or contaminated handling. Most of these bacteria are also found in human fecal matter, which explains why the infections are most common in children under five years old, including toddlers who are not fully toilet trained.

Illnesses caused by Vibrio rose by as much as 32%. The Vibrio family of bacteria includes the strain that causes cholera and are usually found in salt water and may contaminate undercooked seafood or enter wounds on a swimmer's body. According to the new report, Vibrio infected 0.5% percent of the population in 2013 and was most common among people over age 65.

In a separate report in the same issue of MMWR, researchers describe more than 100 cases in 2013 of people in Atlantic coastal areas made ill by a Vibrio strain previously associated only with Pacific shellfish. Infections by foodborne Vibrio can usually be prevented by rapidly refrigerating oysters after harvest and with thorough cooking, especially when the oysters come from warm waters.

Efforts to decrease infections originating in food focus on preventing contamination at the growing, harvesting and processing stages, monitoring contaminants in imported foods and educating food handlers in restaurants and consumers about risks and prevention measures. Pregnant women, infants, older adults and people with weakened immune systems are at higher risk for acquiring many infections.

What you can do to prevent infections: follow the basic steps "clean, separate, cook and chill." That means washing hands, cutting boards and utensils and keeping raw meat and fish separate from ready-to-eat foods. Whole cuts of meat should be cooked to an internal temperature of 145 degrees F., 160 degrees for ground meat, and 165 degrees for all poultry. Refrigerators should be kept below 40 degrees. For more info: 1.usa.gov/1i3kH8l Morbidity and Mortality Weekly Report, April 18, 2014.

Remember also to wash all fresh fruits and veggies, even if they say “triple washed.” I have been to plants packaging salad greens and they said they relied on the farmer to hose down the crops three times… My daughter recently attended a luncheon at a hotel and had to pull bugs out of her salad….

More bad news. That tree that grew in Brooklyn back in the day may have been healthy, but today lead and arsenic have been found at many times the acceptable levels in a community garden in Brooklyn. Most of the food — collard greens, cabbage, mustard greens, turnips — that was grown in the Sterling Place garden is given away for free to anyone who asks. The gardeners were unaware of any hazard. Now, experts warn that vegetables grown in Sterling Place and most urban settings can be unhealthy — perhaps even deadly.

The data come from a first-of-its-kind soil-contaminant study by scientists from the state Center for Environmental Health published in the journal Environmental Pollution earlier this year. A lead sample of 1,251 parts per million — triple the Federal guideline of 400 ppm — was detected in the Sterling Place garden in Brooklyn, along with an arsenic sample of 93.23 ppm, well above the Federal threshold of 16 ppm. Exposure to lead — at much smaller levels than those found in city plots — can lead to a range of maladies including brain damage, seizures and death.

There are about 1,500 community gardens citywide. So far, scientists found lead levels above Federal guidelines at 24 of 54 New York City gardens, or 44% of the total. Overall, they found toxic soil at 38 gardens — 70% of the total. Not to pick on Brooklyn, the worst single soil sample was found in The Bronx at Bryant Hill Garden — where lead was detected at 1531 ppm.

The volunteer gardeners dedicating time and money to the gardens are also at risk. They can breathe in lead, which can also get on their clothes and be accidentally ingested by kids playing in the toxic dirt. It can also be sucked up by root vegetables and leafy greens.

Some experts from Tulane University say that the Federal guidelines for lead are too high and should be well below 40 ppm — making the Big Apple data even more troubling. So, before you eat fresh produce, find out where it is being farmed. For more info: http://nypost.com/2014/05/04/high-toxic-levels-found-in-samples-taken-from-brooklyn-gardens/

On a related subject, here is some more info on what we consume:

If you’ve heard of the “yoga mat chemical,” you are one of the millions of Americans within the reach of Vani Hari, a blogger who calls herself, and her blog, the Food Babe. Hari was suffering from several intestinal inflammation, eczema, asthma, and lack of energy. She narrowed the problem to the “eat fresh” Subway sandwich and launched an Internet petition last February asking the Subway sandwich chain to stop using the yoga mat chemical, a dough conditioner called azodicarbonamide. The FDA approved its use as a food additive and as a blowing agent in the manufacture of foamed plastics. Is this chemophobia? Hari says she wants to give a wake-up call for the food industry to be much more open about the ingredients they use. The alternative is leaving the impression that they don’t care about customers’ concerns or that they have something to hide. Subway responded to Hari’s petition by disclosing that it was already in the process of removing azodicarbonamide, but food industry experts argue that the firm should have responded with information describing what the substance is, why it is safe when used in bread, etc.

What is encouraging is that consumers can have a voice in all this. For blogs on what we are eating, check out the following:

--Food Babe - http://foodbabe.com/

--Chemicals in my Food - http://johncoupland.tumblr.com/

--Food Politics - http://www.foodpolitics.com/

--Lunch Tray - http://www.thelunchtray.com/

The Lunch Tray founder successfully attracted 250,000 signatures to her petition asking the U.S. Department of Agriculture to stop purchasing lean finely textured beef for the National School Lunch Program. The product, made from processed meat scraps, had been the subject of controversial news stories and garnered the unfortunate nickname “pink slime.” Other consumer-driven Internet campaigns include one started by Sarah Kavanagh, a high school student concerned about brominated vegetable oil in sports drinks, including Coca Cola’s Powerade and Pepsi Cola’s Gatorade (http://www.chron.com/news/us/article/Powerade-drops-controversial-ingredient-5452124.php). That was followed by petitions decrying the use of synthetic dyes in such common fare as M&M’s candy and Kraft macaroni and cheese.

Results have been mixed. USDA now allows school districts the choice to serve lunch with or without pink slime, PepsiCo has removed brominated vegetable oil from its Gatorade drinks, and some lines of Kraft’s mac and cheese now have natural coloring. M&M’s, on the other hand, still contain a rainbow of artificial food colorings.

The industry nonprofit Center For Food Integrity, which represents food producers and works to help them communicate trust in the food system, has confirmed that consumers in general just want proof that food companies are acting ethically. Consumers think that mass production of food means too many opportunities for compromising safety, and that profit motives lead firms to choose ingredients on the basis of cost, not quality. For the full article: http://cen.acs.org/articles/92/i18/Food-Fights.html

“Sugar substitutes are called ‘high-intensity’ because small amounts pack a large punch when it comes to sweetness. Unlike sweeteners such as sugar, honey, or molasses, high-intensity sweeteners add few or no calories to the foods they flavor. Also, high-intensity sweeteners generally do not raise blood sugar levels.

The FDA has approved a new high-intensity sweetener called Advantame—which does not yet have a brand name (such as Sweet’N Low, a brand name for saccharin, or Equal, a brand name for aspartame). Advantame is chemically related to aspartame, although much sweeter. People who have phenylketonuria (PKU), a rare genetic disorder, have a difficult time metabolizing phenylalanine, should avoid both aspartame and advantame. (Newborns are tested for PKU using a common “heel-prick” test before they leave the hospital.)

The last high-intensity sweetener approved by FDA was Neotame (brand name Newtame) in 2002. The other four on the market are:

--Saccharin, first discovered and used in 1879, before the current food additive approval process came into effect in 1958. Brand names include Sweet‘N Low

--Aspartame, first approved for use in 1981. Brand names include Equal

--Acesulfame potassium (Ace-K), first approved for use in 1988. Brand names include Sweet One

--Sucralose, first approved for use in 1998. Brand name is Splenda

In addition to the six high-intensity sweeteners that are FDA-approved as food additives, the agency has received and has not questioned safety notices for two types of plant/fruit based high-intensity sweeteners: certain steviol glycosides obtained from the leaves of the stevia plant (Stevia rebaudiana (Bertoni) and extracts obtained from Siraitia grosvenorii or Swingle fruit, also known as Luo Han Guo or monk fruit.

While these high-intensity sweeteners are considered safe for their intended uses, certain individuals may have a particular sensitivity or adverse reaction to any food substance. Consumers should share with their health care provider any concerns they have about a negative food reaction.

Compare the Z-2 suit with Buzz’s outfit. It has a hard upper torso, desirable for the long-term durability that a planetary Extravehicular Activity (EVA) suit will require. The shoulder and hip joints optimize mobility, and the materials used are compatible with a full-vacuum environment and include cover layer design elements, like electroluminescent wiring, never used before in a spacesuit. NASA currently is planning a very comprehensive test campaign for the Z-2 suit at NASA’s Johnson Space Center in Houston in the Neutral Buoyancy Lab, the huge indoor pool used to train astronauts to spacewalk, and a site at Johnson that imitates the rocky Martian surface will help evaluate the suit’s mobility, comfort and performance.

I think they should just watch Toy Story and see how well it works! Follow NASA’s progress at http://www.nasa.gov/exploration and http://www.nasa.gov/mars.

TOUCHY FEELY ROBOTS

Then again, why use humans at all, when we have robots to do all sorts of work for us? I saw a History2 program about remarkable machines that can duplicate a huge variety of human tasks – under dreadful physical conditions – and with better mobility, balance, and strength than a human.

Well, the Office of Naval Research has funded research at Tufts, Brown and Rensselaer to develop a “moral,” autonomous robots with a sense for right, wrong, and the consequences of both. Of course, there is no universal agreement on what is right or wrong. Was HAL 9000 [HAL = (Heuristically programmed Algorithmic) computer] moral in the 1968 movie, 2001: A Space Odyssey? Who defines morality?

Hopefully, there will always be many women on the team programming the software, and one monitoring all this with an override button in case the robot goofs.

For more info: http://www.kurzweilai.net/can-robots-be-trusted-to-know-right-from-wrong?utm_source=KurzweilAI+Weekly+Newsletter&utm_campaign=2706e19639-UA-946742-1&utm_medium=email&utm_term=0_147a5a48c1-2706e19639-282020441

And, possibly on a related note, scientists have created the first living organism that can grow and reproduce using DNA base pairs that aren’t found in Nature. This sounds like Sci Fi to me, where new humanoids could be created.

Researchers incorporated synthetic non-standard amino acids, the building blocks of proteins, into protein structures in living cells. Until now, life on Earth in all its diversity has been encoded by only 2 pairs of DNA bases (A-T and C-G). Now, they have an organism that contains those 2 plus a third, unnatural pair of bases. That accomplishment raises the possibility that scientists might be able to retool Nature to create new forms of proteins, allegedly for new therapeutics and nanomaterials – and who knows what (or who) else!

For more on this: http://www.nih.gov/researchmatters/may2014/05192014genetics.htm

If you missed the 60 Minutes broadcast on May 4th on the remarkable success of residents at active retirement communities to surpass age 90 with their health and wits about them, here are the high points:

--daily exercise (as little as 15 minutes/day), healthy eating, socializing, etc. is great

--but don’t skip desserts --being a little overweight is good

--have coffee and 2 alcoholic drinks a day!

--forget vitamins – they are useless

In short, happiness = longevity. The study by UC Irvine tracked health data when the residents moved into the community in 1981, and yearly after turning 90. Many residents agree to donate their brains after death to advance the study of dementia and Alzheimers. What I found most fascinating was that a very lucid woman who died had many, many plaques on the surface of her brain. The brain of a man who had cognitive problems had no plaques – just the small signs of mini-strokes. So, scientists are using this data to better understand how and why dementia forms.

For an article on the 60 Minutes program with some clips: http://www.kurzweilai.net/want-to-live-to-90?utm_source=KurzweilAI+Weekly+Newsletter&utm_campaign=f6d42b1298-UA-946742-1&utm_medium=email&utm_term=0_147a5a48c1-f6d42b1298-282020441

 

Protected Drug Classes

The strongest bipartisan opposition was against the agency's proposal to take away the protected status of three costly drug classes where substitutes and generics are available. Lawmakers argued that all drugs in those classes must be available because not all of the drugs in those classes work for all patients. This remains on hold.

 

Preferred Pharmacy Networks

The opposition came primarily from Republicans, who complained that CMS was opening the door to government interference between plans and pharmacy contracts, and the drug makers and pharmacy benefit managers that negotiate those contracts. Smaller community pharmacies, which usually are left out of Preferred Pharmacy Networks, lobbied for the measure. Preferred Pharmacy Networks agree to lower cost sharing among Seniors who sign up in return for the greater volume of sales they anticipate. CMS had proposed to allow beneficiaries to get the same cost-sharing at non-preferred pharmacies to encourage competition for lower prices, save small pharmacies, and because Medicare ends up paying whatever the Preferred Pharmacies do not. Now, CMS is exploring restrictions on preferred pharmacy networks in a separate document, called “the call letter,” that would require that preferred pharma manufacturers and networks reduce drug costs paid by plans in order to reduce Medicare spending.

Limiting the Number of Plans any one Insurance Company may Offer

CMS also is holding off on its proposal to limit the number of plans offered by sponsors of stand-alone drug plans. The final rule makes a case for restricting insurance companies to one basic plan and one enhanced plan per coverage year and for limiting the type of coverage offered in those two plans. However, CMS is following through with the proposed rule's measure to limit parent organizations to one prescription drug plan sponsor contract per region.

What the final does do:

• 
  It Requires Part D prescribers to enroll in Medicare. "CMS is requiring that physicians and eligible professionals who prescribe covered Part D drugs be enrolled in Medicare, or have a valid record of opting out of Medicare, in order for their prescriptions to be covered under Part D. Requiring prescribers to enroll in Medicare would help CMS ensure that Part D drugs are only prescribed by qualified individuals," the rule states, adding that it allows extra time, until June 1, 2015, for that requirement to take effect. 
  
• 
  It simplifies Medicare Advantage Plan (MA) risk-adjustment data validation (RADV) audit appeals by combining error rate calculation appeals and medical record review-determination appeals. "The streamlined process will reduce administrative burden on both MA plans and CMS," the rules states.
  
• 
  It lets CMS, its antifraud contractors and other oversight agencies the ability collect information directly from pharmacy benefit managers, pharmacies and other entities that contract or subcontract with Part D sponsors to administer the Medicare prescription drug benefit. This provision, which the HHS inspector general recommended, aims to provide faster access to records for investigations of Part D fraud and abuse.
  
• 
  It revokes Medicare enrollment from physicians who abuse their prescribing rights.
  
• 
  It expands incentives for activities that promote improved health, efficient use of health care resources and prevent injuries and illness.
  
• 
  It allows the release of more privacy-protected Part D data. CMS is releasing to the public more unencrypted, prescriber, plan and pharmacy identifiers contained in prescription drug event records. 
  

Here is a heartwarming trip back to the ‘50s, which seem like yesterday but which were 60 years ago! Click on the link and enjoy:

Please let me know how topics you would like covered in our next Newsletters! E-mail:DrBruno@gynosapiens.com.