In health care, long-lasting “facts” can be open to challenge

Facts line up in some challenging ways:

Cranberries20101210Cranberry juice doesn’t work on urinary tract infections

Despite longtime belief in its potency, cranberry juice doesn’t help women with urinary tract infections (UTIs), new research confirms. Experts administered cranberry capsules to 185 female nursing home patients for a year. The standardized doses were equal to  drinking 20 ounces of juice daily. They fared no better with UTIs. That led the peer-reviewed Journal of the American Medical Association to editorialize that, “The continuing promotion of cranberry use to prevent recurrent UTI in the popular press or online advice seems inconsistent with the reality of repeated negative studies or positive studies compromised by methodological shortcomings. Any continued promotion of the use of cranberry products seems to go beyond available scientific evidence and rational reasoning.” JAMA says it is time not only to bust this myth but for proponents, including those who have a well-intentioned wish to find antibiotic alternatives, to “move on.”

Genetic testing debunks tale of ‘Patient Zero’ as key cause of HIV-AIDS

Gaëtan_DugasJournalist Randy Shilts helped to transform American views about the late 20th Century HIV-AIDS epidemic with his book, “And the Band Played On.” Shilts put a human face on the virus’s terrible toll, forcing Americans to grow up and confront not only the disease but also then-shunned gay life. But the path-breaking best-seller also painted a falsehood, supported by information at the time: Shilts ascribed the explosion of AIDS infections to a “Patient Zero,” a flight attendant named Gaetan Dugas. The writer, citing medical researchers who did not publicly name Dugas but had researched infections associated with him, asserted that the Canadian had engaged in frequent, unprotected sex, spreading HIV-AIDS like wildfire. This scenario, described at the time as “appalling” and part of an unflattering depiction of gay promiscuity, turns out to be scientifically inaccurate. Based on genetic tests of blood samples collected long before researchers identified HIV-AIDS, scientists now say the virus had arrived long before Dugas’ notoriety. Researchers say the virus appeared in Haiti in the 1960s, then leap-frogged into New York as early as the 1970s before then moving to San Francisco and Los Angeles. Earlier work has suggested that HIV-AIDS was a primate disease before it infected Africans, with the virus detected as widespread and varied in what now is the Democratic Republic of Congo in the middle part of the 20th Century. Researchers say it was carried from Kinshasa to Haiti around 1967. Shilts and Dugas both died of HIV-AIDS, as have 500,000 Americans. In 2014, 44,000 Americans were newly diagnosed with the disease, though infections continue to decline and, due to anti-viral medications, many people live with HIV-AIDS as a chronic rather than a fatal condition.

Another St. Louis jury ties J&J talc to female cancer, renders $70 million verdict

jjbabypowderAlthough the medical science is mixed, yet another set of jurors in St. Louis has not only accepted the legal theory that frequent use of talcum powder leads to ovarian cancer, they have delivered a $70 million verdict to a California woman who sued Johnson and Johnson. This is the third big adverse result for J&J, which lost two previous talc cases with verdicts of $72 million and $55 million. The company reportedly has more than 1,700 similar cases filed against it in state and federal courts, asserting that J&J knew of baby powder risks and failed to inform women of them.  I’ve written about those earlier cases, and the mixed medical research that links women’s cancers to talcum powder. J&J, which has pledged to appeal these jury decisions, has prevailed in cases filed in courts outside of St. Louis. But observers note that courts in the Missouri metropolis appear to be eager to resolve cases quickly, and to render sizable verdicts.

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