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Friday, September 26, 2008

How a $2 toy ball saved a little girl's life

In a world first, a Sydney surgeon has used the radical method in a transplant operation, which has won him international accolades.

Dr Albert Shun, from The Children's Hospital at Westmead, used the unorthodox approach when confronted with a medical problem while operating on the two-year-old.

Born with biliary artresia, Mackenzie, from Canberra, needed the life-saving operation earlier this year.

But after inserting a portion of the adult-size liver in the little girl, Dr Shun discovered it was too big and was placing pressure on her blood vessels which could have been fatal.

Having heard about the use of ping-pong balls in operations overseas, he decided to test their suitability in transplant surgery.

"I rang my wife and asked her to go to Big W and buy me some ping-pong balls," he said.

"I was using a sponge as a back-up purpose but there was no way I could close her up the way it was.

"She is the first (transplant patient) in the world that the ping-pongs have been used for these purposes."

In Mackenzie's case, the ball keeps the liver off the arteries. Since Mackenzie's operation, Dr Shun and his team have performed the procedure several times.

However, the ball has only remained in the patients for a few days to allow the swelling to reduce after the transplant.

Dr Shun said Mackenzie's liver would grow around the ball without causing an infection.

"There shouldn't be any complications. We are in a unique situation in Australia because we have a low donor rate so we have to be adaptable," he said.

Unaware she has a foreign object inside her body, little Mackenzie is now running around like every toddler her age.

Her parents Letice Darswell and Guy Argaet are thrilled their daughter is well after she was so seriously ill from birth.

"We didn't get told about the ping-pong until after the operation," Ms Darswell said.

"It was a shock when (Dr Shun) came out of surgery."

Biliary artresia is a rare gastro-intestinal disorder in newborns where the ducts that carry bile from the liver to the intestine are destroyed. Mackenzie's liver became so scarred that she began to develop cirrhosis and needed a transplant.

"She is so normal now. She is a happy kid," Ms Darswell said

Yes, Smoking Is a Health Hazard

Eighty-six years before the U.S. surgeon general issues a report confirming the dangers of smoking tobacco, a letter from English physician Charles R. Drysdale condemning its use appears in The Times of London.

Drysdale, the senior physician to the Metropolitan Free Hospital in London, had already published a book on the subject, Tobacco and the Diseases It Produces, when he wrote the letter that described smoking as "the most evident of all the retrograde influences of our time."

Drysdale had been on an anti-smoking crusade since at least 1864, the year he published a study documenting the effects on young men of consuming ¾ ounce of tobacco daily. That study reported cases of jaundice, and at least one subject having "most distressing palpitations of the heart."

Drysdale's book pinpointed nicotine as the dangerous agent and reported its ill effects on the lungs, circulation system, even the skin. Havana-cut tobacco contained roughly 2 percent nicotine, while Virginia tobacco was a more toxic 7 percent, Drysdale pointed out. (Tobacco was a product of the New World and had to be imported to Europe.)

He also warned against exposure to second-hand smoke: "Women who wait in public bar-rooms and smoking-saloons, though not themselves smoking, cannot avoid the poisoning caused by inhaling smoke continually. Surely gallantry, if not common honesty, should suggest the practical inference from this fact."

The prolific Drysdale wrote on a variety of other related subjects as well, including medicine as a profession for women and issues related to population control.

Despite Drysdale's warnings, and despite the establishment of numerous anti-smoking movements, little was done to curb smoking anywhere in the world. Though physicians and scientists understood there were numerous health hazards associated with the practice, the number of smokers increased dramatically in the first half of the 20th century. Thank you, Madison Avenue. Thank you, Hollywood.

The turning point probably came in 1957, when then-Surgeon General Leroy Burney reported a causal link between smoking and lung cancer. It was left to Burney's successor, Luther Terry, to lower the boom.

Under Terry's direction, a special committee produced Smoking and Health: Report of the Advisory Committee to the Surgeon General. This 1964 bombshell -- so volatile that it was released on a Saturday to minimize the effect on the stock market -- began a massive change in people's attitudes toward smoking.

Caffeine experts call for warning labels for energy drinks

"The caffeine content of energy drinks varies over a 10-fold range, with some containing the equivalent of 14 cans of Coca-Cola, yet the caffeine amounts are often unlabeled and few include warnings about the potential health risks of caffeine intoxication," says Roland Griffiths, Ph.D., one of the authors of the article that appears in the journal Drug and Alcohol Dependence this month.
The market for these drinks stands at an estimated $5.4 billion in the United States and is expanding at a rate of 55 percent annually. Advertising campaigns, which principally target teens and young adults, promote the performance-enhancing and stimulant effects of energy drinks and appear to glorify drug use.

Without adequate, prominent labeling; consumers most likely won't realize whether they are getting a little or a lot of caffeine. "It's like drinking a serving of an alcoholic beverage and not knowing if its beer or scotch," says Griffiths.

Caffeine intoxication, a recognized clinical syndrome included in the Diagnostic and Statistical Manual of Mental Disorders and the World Health Organization's International Classification of Diseases, is marked by nervousness, anxiety, restlessness, insomnia, gastrointestinal upset, tremors, rapid heartbeats (tachycardia), psychomotor agitation (restlessness and pacing) and in rare cases, death.

Reports to U.S. poison control centers of caffeine abuse showed bad reactions to the energy drinks. In a 2007 survey of 496 college students, 51 percent reported consuming at least one energy drink during the last month. Of these energy drink users, 29 percent reported "weekly jolt and crash episodes," and 19 percent reported heart palpitations from drinking energy drinks. This same survey revealed that 27 percent of the students surveyed said they mixed energy drinks and alcohol at least once in the past month. "Alcohol adds another level of danger," says Griffiths, "because caffeine in high doses can give users a false sense of alertness that provides incentive to drive a car or in other ways put themselves in danger."
A regular 12-ounce cola drink has about 35 milligrams of caffeine, and a 6-ounce cup of brewed coffee has 80 to 150 milligrams of caffeine. Because many energy drinks are marketed as "dietary supplements," the limit that the Food and Drug Administration requires on the caffeine content of soft drinks (71 milligrams per 12-ounce can) does not apply. The caffeine content of energy drinks varies from 50 to more than 500 milligrams.

"It's notable that over-the-counter caffeine-containing products require warning labels, yet energy drinks do not," says Chad Reissig, Ph.D., one of the study's authors.

Griffiths notes that most of the drinks advertise their products as performance enhancers and stimulants – a marketing strategy that may put young people at risk for abusing even stronger stimulants such as the prescription drugs amphetamine and methylphenidate (Ritalin). A 2008 study of 1,253 college students found that energy drink consumption significantly predicted subsequent non-medical prescription stimulant use, raising the concern that energy drinks might serve as "gateway" products to more serious drugs of abuse. Potentially feeding that "transition" market, Griffiths says, are other energy drinks with alluring names such as the powdered energy drink additive "Blow" (which is sold in "vials" and resembles cocaine powder) and the "Cocaine" energy drink. Both of these products use the language of the illegal drug trade.

Hollywood cut secret deals to promote smoking

Tobacco companies paid stars like Al Jolson, Bob Hope and Clark Gable to promote smoking as part of secret advertising deals with movie studios, according to a new analysis of cigarette endorsement contracts between 1927 and 1951.

The stars made thousands of dollars peddling cigarettes to consumers. But the analysis shows that major studios and tobacco companies reaped far bigger benefits.

In exchange for star testimonials of brands such as Lucky Strike, tobacco companies promoted movies in adverts worth millions of dollars, the documents show.

"The link between Hollywood and tobacco go back to the beginning of talking pictures,” says Stanton Glantz, director of the Center for Tobacco Control Research and Education at the University of California, San Francisco. "It was a way to thoroughly embed tobacco use in the social fabric."

Glantz and colleague Kristin Lum mined 246 documents, including cigarette endorsement contracts (made public as part of the tobacco industry legal settlement with state governments), contemporary news reports, and a collection of cigarette advertisements collected by Robert Jackler, a neurosurgeon at Stanford University.

"I was surprised that the amount of scholarship around [the advertisements] was very little," says Glantz.

'Sweet and soothing'

According to the documents, Hollywood and tobacco companies began their relationship in 1927, when an advertising firm brokered deals between two of its clients: American Tobacco and RCA. Other studios, including Paramount, MGM and Columbia, soon followed.

Between 1927 and 1951, major studios and tobacco companies partnered on at least 215 cigarette advertising campaigns, Glantz's team found.

Stars contract-bound to a single studio touted the benefits of brands like Lucky Strike and Camel in advertising agency written testimonials. "Folks, let me tell you, the good old flavour of Luckies is as sweet and soothing as the best 'Mammy' song ever written,” said Jazz Singer star Al Jolson in one such endorsement.

In exchange for the praise, Hollywood studios received free advertising for their movies.

For example, cigarette ads would mention specific movies and endorsements would be tied to their release dates. In some cases, tobacco companies sponsored radio programs featuring their pocketed Hollywood stars. American Tobacco, maker of Lucky Strikes, spent $2.3 million producing The Jack Benny Program.

The US Federal Trade Commission attempted to clamp down on the relationship beginning in 1929 on the grounds that advertiser-written endorsements misled consumers, but studios easily circumvented these rules through lobbying and carefully worded disclaimers.

Restricted access

Television, not government regulation, ended the formal relationship between studios and tobacco companies. More recently, product placements in movies have replaced overt Hollywood tobacco advertising, Jackler says.

Glantz has called on studios and the Motion Picture Association of America, which rates films, to remove smoking from youth films and restrict access to films with smoking. He estimates that such restrictions would cut youth smoking by 60% and keep cigarettes out of the hands of 200,000 youths each year.

The commercial relationship between tobacco companies and Hollywood undercuts objections to such limitations, he says.

"One of the excuses that comes out of the studios and Motion Picture Association [of America] and a lot of individuals who make movies, is smoking in the movies is an integral part of the art form itself," he says. "What this shows is that that’s not true."