Human experiments in Guatemala by the US doctors

In the 1940s, US doctors deliberately infected thousands of Guatemalans with venereal diseases.

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In the early decades of the twentieth century, US health officials were consumed by the battle against STDs, much as subsequent generations of researchers have fought cancer and HIV. In 1943, Joseph Moore, then chairman of the US National Research Council’s Subcommittee on Venereal Diseases, estimated that the military would face 350,000 new infections of gonorrhoea annually, “the equivalent of putting out of action for a full year the entire strength of two full armored divisions or of ten aircraft carriers”. The government launched vigorous campaigns of research, treatment and advertising to combat the problem.

To test treatments and prophylaxis, the Public Health Service had argued in late 1942 that it was crucial to give the disease to people under controlled conditions. Officials debated the legality and ethics of this, and even solicited the input of the US attorney general. They decided to do the work at a federal prison in Terre Haute, Indiana, using volunteer inmates.

In 1945, a Guatemalan health official who was working for a year at the VDRL offered to host studies in his country. As director of the Guatemalan Venereal Disease Control Department, Juan Funes was uniquely positioned to help. Prostitution was legal in his country at the time, and sex workers were required to visit a clinic twice a week for examinations and treatment. Funes oversaw one of the main clinics, so he could recommend infected prostitutes for experiments. Cutler and other scientists at the VDRL were quickly sold on the idea: they proposed a programme, which was approved with a budget of US$110,450.

According to a Guatemalan report3, the US plan was a clear violation of contemporary Guatemalan law, which made it illegal to knowingly spread venereal diseases. But the country was experiencing political upheaval in the mid-1940s and the bureaucracy did not object to the US plan.

The Guatemala experiments are already considered one of the darker episodes of medical research in US history, but panel members say the new information indicates that researchers were unusually unethical, even when placed into the historical context of a different era.

“The researchers put their own medical advancement first and human decency a far second,” said Anita Allen, a member of the Presidential Commission for the Study of Bioethical Issues.

From 1946-48, the US Public Health Service and the Pan American Sanitary Bureau worked with several Guatemalan government agencies on medical research paid for by the US government that involved deliberately exposing people to sexually transmitted diseases.

The researchers apparently were trying to see if penicillin, then relatively new, could prevent infections in the 1,300 people exposed to syphilis, gonorrhea or chancroid. Those infected included soldiers, prostitutes, prisoners and mental patients with syphilis.

President Barack Obama called Guatemala’s president, Alvaro Colom, to apologise.



Stem cells blamed for cancer re-growth

PARIS: Researchers presented evidence on Wednesday for the existence of cancer stem cells, with three different studies seeking to end a decades-old scientific dispute about how tumours grow.

“The hypothesis (that cancer stem cells exist) has been around now for some time. Hopefully these three papers now make an end to the discussion,” Dutch researcher Hugo Snippert told AFP.

All the studies were conducted on lab mice.

Some experts have maintained that tumours are comprised of masses of cancer cells that are all the same, and all dividing.

But Snippert said the latest papers clearly show a hierarchy of cells in tumours, with different functions — including stem cells that act as cancer cell factories.

Stem cells are infant cells that develop into specialised tissues of the body, touted by medicine as a future source from which to replenish damaged tissue.

In the case of intestinal cancer, a healthy stem cell mutates to create a “cell of origin” from which a tumour grows, said Snippert. The tumour contains stem cells which then create new cancer cells.

“Since the cancer stem cells are so similar to normal stem cells, most treatments also harm the normal stem cells,” he said.

“That is why it is important now to have a look at cancer stem cells, comparing them to normal stem cells to find the differences.”

Focusing on incurable brain tumours, a US-based research team said they had found a subset of cells that appear to be the source of new tumour growth after chemotherapy.

“This study serves as a proof of principle that in at least some solid tumours functional cancer stem cells exist,” researcher Luis Parada of the University of Texas Southwestern Medical Center told AFP.

Also writing in Nature, a separate team in Belgium and the UK found a sub-population of tumour cells with stem-like properties in skin cancer.

“Taken together these reports provide evidence that point towards the existence of cells that may represent cancer stem cells,” said a Nature press statement.

“Better understanding of the cancer stem cells will be critical for re-evaluation of existing therapies and development of new ones,” added Parada.

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Chemotherapy can backfire and boost cancer growth: study

PARIS: Cancer-busting chemotherapy can cause damage to healthy cells which triggers them to secrete a protein that sustains tumour growth and resistance to further treatment, a study said Sunday.

Researchers in the United States made the “completely unexpected” finding while seeking to explain why cancer cells are so resilient inside the human body when they are easy to kill in the lab.

They tested the effects of a type of chemotherapy on tissue collected from men with prostate cancer, and found “evidence of DNA damage” in healthy cells after treatment, the scientists wrote in Nature Medicine.

Chemotherapy works by inhibiting reproduction of fast-dividing cells such as those found in tumours.

The scientists found that healthy cells damaged by chemotherapy secreted more of a protein called WNT16B which boosts cancer cell survival.

“The increase in WNT16B was completely unexpected,” study co-author Peter Nelson of the Fred Hutchinson Cancer Research Center in Seattle told AFP.

The protein was taken up by tumour cells neighbouring the damaged cells.

“WNT16B, when secreted, would interact with nearby tumour cells and cause them to grow, invade, and importantly, resist subsequent therapy,” said Nelson.

In cancer treatment, tumours often respond well initially, followed by rapid regrowth and then resistance to further chemotherapy.

Rates of tumour cell reproduction have been shown to accelerate between treatments.

“Our results indicate that damage responses in benign cells… may directly contribute to enhanced tumour growth kinetics,” wrote the team.

The researchers said they confirmed their findings with breast and ovarian cancer tumours.

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Inactivity – Fourth Leading Cause of Non-communicable-Desease-Deaths

  1.  Inactivity as not doing five 30-minute sessions of moderate activity, three 20-minute sessions of vigorous activity, or 600 metabolic equivalent minutes per week.
  2. About a third of people across the world do not meet the minimum activity recommendations (which is generally about 2.5 hours of moderate activity per week).
  3. Experts estimate that 5.3 million deaths worldwide are the result of inactivity, which is about the same number attributed to tobacco use, making the situation seem even more grave. The World Health Organization (WHO) says that physical inactivity is the fourth leading cause of deaths due to non-communicable diseases worldwide.
  4. Advances designed to make our lives easier and more enjoyable have made us less mobile. Not only do they contribute to the inactivity pandemic, but they may have the grimmer effect of shortening our lives.
  5. Getting just 1.5 hours per week can extend lifespan by three years.
  6. “Our environment has changed in terms of where we live. We drive a lot more, people spend more time in leisure-based activities, like watching television, and we also have more sedentary jobs.”

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Medical Mistakes – third leading cause of death in the US

When you’re a patient, you trust you’re in good hands, but even the best doctor or nurse can make a mistake on you or someone you love.

Dr. Sanjay Gupta, the associate chief of neurosurgery at Grady Memorial Hospital and the chief medical correspondent for CNN. This is what he said:

  • Doctors make mistakes. They may be mistakes of technique, judgment, ignorance or even, sometimes, recklessness. Regardless of the cause, each time a mistake happens, a patient may suffer. We fail to uphold our profession’s basic oath: “First, do no harm.”
  • According to a 1999 report by the Institute of Medicine, as many as 98,000 Americans were dying every year because of medical mistakes.
  • Today, exact figures are hard to come by …. But a reasonable estimate is that medical mistakes now kill around 200,000 Americans every year.
  • That would make them one of the leading causes of death in the United States.

“Mistakes are happening every day in every hospital in the country that we’re just not catching,” says Dr. Albert Wu, an internist at Johns Hopkins Hospital.

Medical errors kill more than a quarter million people every year in the United States and injure millions. Add them all up and “you have probably the third leading cause of death” in the country, says Dr. Peter Pronovost, an anesthesiologist and critical care physician at Johns Hopkins Hospital.

The harm is often avoidable.

Why have these mistakes been so hard to prevent?

  • Here’s one theory. It is a given that American doctors perform a staggering number of tests and procedures, far more than in other industrialized nations, and far more than we used to.
  • Since 1996, the percentage of doctor visits leading to at least five drugs’ being prescribed has nearly tripled, and the number of MRI scans quadrupled.
  • Certainly many procedures, tests and prescriptions are based on legitimate need. But many are not. In a recent anonymous survey, orthopedic surgeons said 24% of the tests they ordered were medically unnecessary.
  • Each additional procedure or test, no matter how cautiously performed, injects a fresh possibility of error.
  • CT and MRI scans can lead to false positives and unnecessary operations, which carry the risk of complications like infections and bleeding.
  • The more medications patients are prescribed, the more likely they are to accidentally overdose or suffer an allergic reaction.

What may be even more important is remembering the limits of our power. More — more procedures, more testing, more treatment — is not always better. In 1979, Stephen Bergman, under the pen name Dr. Samuel Shem, published rules for hospitals in his caustically humorous novel, “The House of God.” Rule No. 13 reads: “The delivery of medical care is to do as much nothing as possible.” First, do no harm.

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