Monday, September 01, 2014
Some amusing medical news
One of the enduring myths among health freaks is the magical power of fish oil. There has however always been a lot of doubts about that among medical researchers so there have been many studies looking into the matter. The latest review of the medical literature knocks the whole thing on its head. The article concerned is hidden behind a fierce paywall but I think it is too amusing to stay only there. So I am reproducing the abstract below. Reproducing abstracts is not generally considered a breach of copyright. The abstract was in fact sent to me by JAMA so I infer that they want the findings to be known in professional circles
Fish Oil Supplements
Long-chain omega-3 polyunsaturated fatty acids (PUFAs), which are present in cold-water fish such as herring or salmon and are commercially available in capsules (over the counter and by prescription), can decrease fasting triglyceride concentrations 20-50% by reducing hepatic triglyceride production and increasing triglyceride clearance. 1 With long-term intake, they may increase HDL-C.
The results of recent studies do not offer any convincing evidence that fish oil supplements either prevent cardiovascular disease or improve outcomes in patients who already have it. 2 3
Lovaza (formerly Omacor), a combination of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), was the first omega-3 PUFA product to be approved by the FDA for treatment of severe hypertriglyceridemia (Table). Daily doses of 3-12 g can lower triglycerides by 20-50%, but have not been shown to prevent pancreatitis, which is a major concern in patients with very high triglycerides. Vascepa, the second FDA-approved omega-3 PUFA product for treatment of severe hypertriglyceridemia, is the ethyl ester of EPA. In controlled trials, it has reduced triglyceride levels by 22-33% compared to placebo. 4
DHA can increase LDL-C levels, but EPA apparently does not. Fish oil supplements are generally well tolerated. Adverse effects have included eructation, dyspepsia, and an unpleasant aftertaste. Worsening glycemic control has been reported in diabetic patients taking large doses. Fish oil in large doses can also inhibit platelet aggregation and increase bleeding time; whether it could cause clinically significant bleeding has not been established.
Omega-3 polyunsaturated fatty acids can lower high plasma triglycerides, but they have not been shown to decrease the risk of pancreatitis. The results of recent studies do not offer any convincing evidence that fish oil supplements prevent cardiovascular disease.
From The Medical Letter on Drugs and Therapeutics
JAMA. 2014;312(8):839-840. doi:10.1001/jama.2014.9758. Adapted from "Drugs for Lipids." Treat. Guide Med. Lett. 2014;12(137):1-6.
The Stage Is Set for Executive Amnesty
Just a few weeks ago, it appeared immigration would dominate the news headlines leading up to the November election. But war in the Middle East and Ukraine and riots in Ferguson have pushed the situation at the border down to a few sidebar stories.
Yet the political stakes are high, and the red line of Barack Obama’s promise to take steps on immigration reform by the end of summer – with or without Congress – means there could be an executive action on his part in the next few weeks. “[H]ave no doubt, um, in the absence of congressional action, uh, I’m going to do what I can to make sure the system works better,” he said Thursday. The president has nothing to lose and everything to gain politically.
Most likely his action will be an expansion of the 2012 Deferred Action for Childhood Arrivals (DACA) order, which essentially served as a permission slip for more than 1.5 million illegal aliens who came as children with their parents. Administration insiders believe five or six million more illegals will benefit from any new Obama move. Proponents argue it’s a necessary step to take because resources are limited and Congress didn’t act. Meanwhile, Democrats believe the Republican reaction would be beneficial to their side. They’re just daring Republicans to say the “i-word” should Obama go through with this DACA-expansion amnesty.
But Obama himself made the case against executive action not all that long ago. In 2012, he argued he couldn’t go any further than deferring deportations for children: “If we start broadening that, then essentially I would be ignoring the law in a way that I think would be very difficult to defend legally. So that’s not an option.”
Much of this could have been avoided, claims “Gang of Eight” member Sen. Marco Rubio (R-FL). “I’ve been warning that [Obama] would do something unilaterally on immigration at some point, despite his denials of any intention to do that,” said Rubio. “My fundamental warning was that if [Republicans] didn’t like the legalization provisions in the bill, it was quite possible, if we didn’t act, that we would get the Gang of Eight-style legalization but without any of the bill’s enforcement mechanisms,” he added, defending his participation.
While Rubio was in favor of the Gang of Eight approach at the time, he now believes it was a mistake. If done again, he would secure the border first, then install broader E-verify requirements and reform the tracking of visa entries and exits. Of course, enforcement is all up to the will of the Executive Branch. And House Speaker John Boehner (R-OH), for one, is of the opinion that Obama is “threatening to rewrite our immigration laws unilaterally” rather than provide enforcement.
Nor is enforcement on the mind of governors like California’s Jerry Brown, who introduced Mexican President Enrique Pena Nieto by saying all immigrants were welcome in his state, legal or not.
In his speech, the Mexican president called the United States “the other Mexico” and gushed that California had “evolved” compared to other states which “skimp on recognition of … the rights of immigrants.” It’s estimated that 11.4 million immigrants who were born in Mexico reside in the United States, a sizable chunk of the roughly 120 million who populate Mexico. A recent Pew survey found just over one-third of Mexicans would move to the United States if they had the chance, and one-sixth would even do so illegally. That’s about 20 million more for the permanent underclass of likely Democrat voters.
Clearly, much of this immigration furor is political posturing for both the November midterm elections and the 2016 presidential race. But with either result, Obama has the chance to emerge victorious – either he gets a Democrat-controlled Senate to keep House Republicans at bay, or he gets a completely Republican-controlled Congress that will incentivize him to use his pen, if not his phone. Amnesty is just one place where he can whet his appetite for dictatorial power, with climate change being another.
The irony, of course, is that mass amnesty will hurt Obama’s own low-income constituents most by depressing wages and making it hard to find jobs. All net job gains since 2000 went to immigrants.
Thus, despite polls which for years have shown Americans would prefer no greater number of immigrants – if not a decrease in the rate – it’s likely that executive policy will take us in the other direction while ignoring the vital function of border security. The system isn’t actually broken, but the laws aren’t being enforced.
The Democratic Shift to the Left
The Democratic Party is torn between a liberal establishment that wants more government, and an even more liberal wing that wants the same thing squared
It would take a heart of stone, as the fellow said, not to laugh out loud at President Barack Obama's recent comparison between the two major political parties.
"Ideological extremism," he told The New York Times, "is much more prominent right now in the Republican Party than the Democrats. Democrats have problems, but overall if you look at the Democratic consensus, it's a pretty commonsense, mainstream consensus. It's not a lot of wacky ideological nonsense, the way it is generally fact-based and reason-based."
Spoken like a true partisan: My Side is calm and reasonable, and Your Side is full of raving lunatics.
The tea party movement has indeed created a rift on the right between a somewhat conservative establishment and a viscerally conservative insurgency. The struggle between those two factions has provided the grist for roughly 2.3 gajillion news stories over the past few years.
But as Commentary magazine's Seth Mandel put it so nicely a few months ago, "complaints over the last few years about the GOP being pulled to the right by conservatives were not about liberals' desire to meet in the middle and compromise, no matter how much they might decry the supposed extremist drift of the right. What they wanted was their very own Tea Party."
The judgment is, as the president would say, fact-based. You can see that in the fawning adulation that greeted the Occupy protests, which amounted to one long primal scream against capitalism. Whatever the protests lacked in coherence (which was a lot), they made up for in passion. And for a while, the most dangerous place to stand in America was between a microphone and the cadre of Democratic politicians racing to express their proud solidarity with that inspiring movement of starry-eyed young dreamers.
You can see the desire for a Democratic tea party in the cheers that greet Sen. Elizabeth Warren, Tribune of the Proletariat, whose angry tirades against the moneyed interests draw standing ovations and chants of "Run, Liz, run!"
And you can see it in the polls: Two decades ago, 35 percent of active Democrats said their views were mostly or always liberal. Now 70 percent say so. The Democratic Party's mainstream consensus, as the president calls it, has moved decidedly to the left. (Granted, Democrats do not all think alike, any more than Republicans do; generalizations are vexing. But if the president employs them, so can we.)
Just as the Republican Party now has many big-government conservatives—those who think Washington should export democracy abroad and impose virtue here at home—the Democratic Party once had what might be called small-government liberals: those who thought government could make some things better, yet still leave other things alone.
Where is the small-government liberal today? He or she is not to be found in the economic realm, where the mainstream Democratic consensus supports a higher minimum wage, more regulation of business, systemic government control of certain sectors (e.g., education and health care) and massive government intervention in the rest.
Likewise, there is scant dispute on the left regarding the welfare state.
The biggest fight over social programs in the past few years dealt with health care, and it concerned whether to settle for Obamacare or push for single-payer. Liberals who argue that the country might have too many social-welfare programs and spend too much on them are mostly unheard from. To paraphrase conservative author William Voegeli: Democrats do not want the social-welfare state to grow indefinitely—they just want it to be bigger than it is right now.
One might think the small-government liberal shows up in the realm of personal choice. And it is true that on one very narrow band of issues—sex and abortion—liberals agree government should butt out. Yet this is where the butting-out largely ends.
For while liberals largely support, say, the legalization of marijuana, that is not owing to any broader sense that people own their bodies and should be free to do as they like with them—such as ride a motorcycle without a helmet, or engage in sex for profit, or drink a 64-ounce sugary soft drink, or forgo health insurance.
Rather, the contemporary mainstream liberal view of such things holds that individual choices affect the collective good. And since government's job is to safeguard the collective good, government should therefore regulate individual choices. If it allows people to smoke marijuana, that is because it has decided a little reefer now and then causes less collective harm than the harm caused by prohibition.
In other words, the mainstream Democratic view asks how much personal freedom smart public policy should permit. It has little room for the notion that some personal freedom should lie beyond the reach of public policy in the first place.
Does that seem too strong? Then consider the campaign to eviscerate the First Amendment. Democratic leaders such as John Kerry, Sen. Patrick Leahy, House Minority Leader Nancy Pelosi and many others—including countless grass-roots activists—want to amend the Constitution to nullify the Supreme Court's ruling in Citizens United, so the government can once again dictate what people can and cannot say about politicians in the weeks leading up to an election. Tellingly, the proposals include provisions stipulating that the press would still be allowed to speak freely about political candidates.
This is a tacit concession that everyone else would not. In that event, rights are no longer trumps; they are simply one more consideration to be balanced against all the rest. Which means they are not really rights at all.
In short, the Democratic Party is torn between a liberal establishment that wants more government, and an even more liberal wing that wants the same thing squared. At bottom, both wings believe the formula for perfection is simple: Put the government in charge of everything, and put the right people in charge of the government. Then just sit back and wait for Shangri-La.
History has falsified that premise time after time. But to the president, it's just plain common sense. Now who's peddling wacky ideological nonsense?
There is a new lot of postings by Chris Brand just up -- on his usual vastly "incorrect" themes of race, genes, IQ etc -- This week with pictures!
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Posted by JR at 12:41 AM