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Daily Rounds: A Help Shop For Pill-Poppers; Healthy Smart Phones For Obama; Kids Fight Back; Hormones And Asthma

Attacking Ailments In Small Doses (The New York Times) — ‘The “help shop,” which offers low-dose drugs for everyday woes, is the idea of Help Remedies, a start-up company that sells minimalist white packets directed at single medical issues like nausea, headache or insomnia. The company, the collaboration of two marketers, is creating quirky scenes including a high-heel wearing model walking on a treadmill to market its “Help, I have a blister” packet of bandages, or a performer sleeping in a store window to drum up interest for its “Help, I can’t sleep” caplets. This week, shoppers and passers-by attracted by the napper, for example, could go inside the temporary pharmacy to investigate its 10 over-the-counter remedies for conditions like body aches and allergies. The store’s team fanned out to polling stations on Tuesday to hand out its headache packets, and then on Wednesday to the nearby Republican National Committee to share nausea relief. Their marketing may be seen as fun and zany, but the company founders, Richard Fine and Nathan Frank, say they have a serious message. “We want people to see that there are simple solutions,” said Mr. Fine, who said his straightforward approach was influenced by his parents, who are medical professors specializing in epidemiology.’

What Health-Minded Smart Phone Users Have In Common With Obama Voters (NPR) — “The bottom line of the Pew report is that cellphone “owners who are Latino, African American, between the ages of 18-49, or hold a college degree are also more likely to gather health information” than other people on their mobile phones. Pew says the various factors are independent, so it’s not just that young people are more likely to have a smartphone, for instance. Each factor can “amplify,” in Pew’s words, the likelihood that people will use their phones to get health information. As you might expect, smartphone owners are even more likely to access health info with their devices than regular old cellphone owners are. When it comes to health apps on smartphones, women were more likely to use them than men. The Pew survey of more than 3,000 people was done in August and early September. Now, let’s review the profile of voters who went for President Obama in a big way, according the data from Edison Research.He dominated among African-Americans, Latinos and Asians. (No Pew breakout for Asians.) Female voters also preferred Obama. The president cleaned up among younger people, getting 60 percent of votes cast by those ages 18 to 29 and a majority of votes from those 30 to 44. Romney claimed a majority among people 45 and up. Among people with at least a college degree, Obama got half the voters, just a tad more than the 48 percent that went for Romney. And, as you’d probably expect, voters who thought health was the most important issue facing the country overwhelmingly went for Obama.”

Canton Schools Consider Training To Confront Columbine-Style Attackers (The Boston Globe) — “For years, the standard instructions to teachers and students if a Columbine- style attacker launched a rampage at their school were the same: lock down and hide. But now, in Canton and in a growing number of schools nationwide, police and school officials are training teachers, staff, and eventually even students that in some cases they should fight against armed attackers. School officials in Canton quietly adopted a program this year called ALICE — alert, lockdown, inform, counter, evacuate – and began training school personnel at Canton High School and Blue Hills Regional Technical School in Canton. They are trained to make active decisions, such as barricading classroom doors; coordinating on-the-spot evacuations; and, if all else fails, throwing objects and using body weight to topple a shooter.”

Hormones In Menstrual Cycle Affect Asthma (BBC News Health) — “A woman’s menstrual cycle affects the severity of respiratory symptoms, potentially worsening conditions such as asthma, a study suggests. Norwegian researchers studied almost 4,000 women, and found worse symptoms around ovulation. Writing in the American Journal of Respiratory and Critical Care Medicine, they said it may be possible to adapt women’s medication.”

Daily Rounds: Malia Generation; Crowd-Sourced Second Opinions; GMO Labeling Fight Continues; The Salt Debate

The Malia Generation (The New Yorker) — “Ann Romney and her husband were correct when they said, by way of dismissing the issue of reproductive rights, that women had other things to worry about, including issues of jobs and taxes. Romney just wasn’t able to persuade women that his economic plans, at this fiscal-cliff moment, were the right ones for them as wage-earners, as securers of health insurance for children and health aides for elderly relatives, as illusion-free members of the forty-seven per cent. These issues are intertwined, and not only because women’s health is also an economic issue. When you are insulted, when you are told that endless conversations about liberty do not include control of your own body, when it becomes clear that a politician views the crisis of a woman who has just been raped as an abstraction, you begin to think about sympathy, and its limits. And you begin to think about trust.”

Getting A Global Second Opinion (Slate) — “Salvatore Iaconesi is an engineer, artist, hacker and 2012 TED fellow who teaches interaction and digital design at Sapienza University of Rome, Italy. He hacked his medical records to put them online in a global search for the best treatments. Alison George: You were told you had brain cancer, and your response was to hack open your medical records and publish them online. Why? Salvatore Iaconesi: When I was diagnosed, I was a bit unsatisfied with what took place at the hospital: It was almost as if I had nothing to do with it. The doctor comes up, he tells you that you have a tumor, and it’s like you disappear and only your clinical records remain. I didn’t want to disappear. I’m not just a patient, I am a human being. I stepped out of the hospital with a copy of my digital medical records, but I found they were in a peculiar format which takes a lot of skill to open. So I hacked this format to make that data really accessible.”

After Loss, The Fight To Label Modified Foods Continues (The New York Times) — “Declaring that more than four million Californians are “on record believing we have a right to know what is in our food,” Dave Murphy, co-chairman of the Proposition 37 campaign and executive director of Food Democracy Now!, an advocacy group, said on Wednesday: “We fundamentally believe this is a dynamic moment for the food movement and we’re going forward.” Still, there is no doubt the defeat in California has robbed the movement of some momentum. Until Tuesday’s vote, labeling proponents had been saying that a victory in California, not a defeat, would spur action in other states and at the federal level. The defeat greatly reduces the chances that labels will be required, according to L. Val Giddings, a senior fellow at the Information Technology and Innovation Foundation, a Washington organization supporting policies that favor innovation. “I see little potential that the defeat in California could result in any increase in pressure for labels.” Dr. Giddings, who is a supporter of biotech crops, said it would now be more difficult for labeling proponents to raise money. “What justification can they present to their funders to pour more money down this drain?” he said. The election in California was closely watched because it had national implications. It could have led to a reduction in the use of genetically modified crops, which account for more than 80 percent of the corn, soybeans and sugar beets grown in the United States. That is because food companies, fearing that some consumers would shun products labeled genetically engineered, would instead reformulate their products to avoid such ingredients.”

Why Even Healthy People Should Watch Their Salt Intake (Time Healthland) — “Salt is a ubiquitous part of the American diet, but even healthy people should be cutting back to avoid high blood pressure and life-threatening heart disease and stroke. That’s the message from the American Heart Association (AHA) in its latest advisory. The AHA takes issue with recent studies disproving a link between salt and heart-disease risk that it says have been “widely misinterpreted.” It also re-affirms its 2011 recommendation that all Americans should limit their sodium intake to just 1,500 mg per day — less than the amount found in a single teaspoon of table salt (sodium chloride). The typical American now eats more than twice that amount.”

Daily Rounds: Obama Victory Means Health Reform Wins; Washington Legalizes (Non-Medicinal) Pot; Voting While In Labor

One big winner in Tuesday’s vote: Health reform (NBC) – “One of the biggest consequences of Tuesday’s vote is the survival of health reform. Now that President Barack Obama has won a second term and kept a Democratic majority in the Senate to back him up, Republicans have lost any chance at repealing his biggest domestic initiative. “Health reform goes ahead,” Timothy Jost, an expert on health law at Washington and Lee University, told NBC news. “It has survived two near-death experiences, with the Supreme Court decision (in June) and now with the election. Now it is time to move forward.” Republican analysts agree. “What it means is implementation of the law,” said Christopher Condeluci, a former Tax and Benefits Counsel to the Senate Finance Committee who is now at Washington law firm Venable LLP. It doesn’t mean smooth sailing, however. Many ruleshave yet to be rolled out – and there is little time to do that before the law begins to take full effect in 2014.”

Washington voters legalize recreational pot use (AP in the Seattle PI) – “Washington voters legalized recreational pot use on Tuesday, but people shouldn’t expect to see marijuana legitimately for sale anytime soon. Initiative 502 would create a system of state-licensed marijuana growers, processors and retail stores, where adults over 21 can buy up to an ounce. It also establishes a standard blood test limit for driving under the influence. The sales won’t start until state officials make rules to govern the legal weed industry, a process that could take a year. And when state and federal laws conflict, federal law takes precedence. Federal authorities could sue in an attempt to block I-502 from taking effect. The Justice Department has given no hints about its plans.”

Galicia Malone, Chicago woman in labor, votes en route to hospital (Huffington Post) – “A Chicago-area woman went into labor early Tuesday morning — but she wasn’t about to let that stop her from taking the opportunity to vote. Though her water had already broken, 21-year-old Galicia Malone voted around 8:30 a.m. Tuesday at New Life Celebration Church in south suburban Dolton, ABC Chicago reports. According to Cook County Clerk David Orr, Malone’s contractions were five minutes apart when she arrived at her polling place. Her labor reportedly began at 3 a.m. “If only all voters showed such determination to vote,” Orr said of Malone, according to NBC Chicago.”

The most contested public health questions (The Atlantic) – “On state and federal levels, decisions made by voters will have profound implications for public health. Here are the biggest issues being considered.”

Daily Rounds: Health Advice From Porn Industry; Filling The ER Gap; Sandy’s Baby Boom; Anti-Sitters Unite; Go Vote!

Unlikely Model In HIV Effort: Sex Film Industry (The New York Times) — “Before they take off all their clothes, the actors who perform as James Deen and Stoya go through a ritual unique to the heterosexual adult film industry.First, they show each other their cellphones: Each has an e-mail from a laboratory saying he or she just tested negative for H.I.V., syphilis, chlamydia and gonorrhea. Then they sit beside the film’s producer, Shylar Cobi, as he checks an industry database with their real names to confirm that those negative tests are less than 15 days old. Then, out on the pool terrace of the day’s set — a music producer’s hilltop home with a view of the Hollywood sign — they yank down their pants and stand around joking as Mr. Cobi quickly inspects their mouths, hands and genitals for sores. “I’m not a doctor,” Mr. Cobi, who wears a pleasantly sheepish grin, says. “I’m only qualified to do this because I’ve been shooting porn since 1990 and I know what looks bad.” Bizarre as the ritual is, it seems to work. The industry’s medical consultants say that about 350,000 sex scenes have been shot without condoms since 2004, and H.I.V. has not been transmitted on a set once.”

Filling A Gap Between ERs And Patient Inpatient Rooms (The Wall Street Journal) — “Patients who show up with complaints that can’t be quickly or conclusively diagnosed are more frequently being shifted to observation units adjacent to or close by emergency rooms. Not only does this reduce crowding in harried ERs, but the units allow emergency staff to closely monitor at-risk patients and conduct tests more quickly and cheaply than by admitting them as an inpatient to a hospital room. For patients, observation care that lasts longer than 24 hours can be costly, with higher copayments for services deemed by Medicare and some insurers to be outpatient care. But when operated efficiently, with decisions made within a day on whether to discharge or fully admit patients, they have been shown to reduce costs and improve care.”

Will Sandy Bring A Baby Boom Or Baby Bust? (Slate) — “Next year, expect to see a rise in the number of marriages in the areas hit by Sandy. Hurricane Hugo hit South Carolina in 1989 at a time when the marriage rate in South Carolina was declining. In their examination of the social consequences of Hugo, Catherine Cohan and Steve Cole found an upward hitch: The marriage rate increased by 0.7 per 1,000 people in 1990 before returning to the pre-storm decline. Although the overall effect was small, it was especially pronounced in the seven counties hit hardest by the disaster. The marriage-rate boost seems fairly intuitive. People seek security in the face of threats and grow closer to their sources of comfort. (The whole field of attachment theory is based on how this phenomenon plays out.) Catastrophes can also give people a push into the next stage of their lives and provide a reality check about what’s important. Those same bonding mechanisms should make the already coupled more likely to stay together after Sandy, right? After all, one of the least-known legacies of the 9/11 disaster was its impact on divorce: In September 2001, the number of couples filing for divorce in New York dropped by 32 percent. The researchers who analyzed the effects of Hurricane Hugo also examined divorce rates after 9/11 and found that the drop in filings couldn’t be explained by interruptions to civil services.”

Anti-Sitting Movement Gaining Followers (The Boston Globe) — “The don’t-take-a-seat trend, which has already made its way into offices, where workers are braving colleagues’ ridicule as they stand, walk or even cycle at special desks, is now infiltrating other spaces. It can be seen at restaurants, where some patrons would rather stand at the bar than grab a table; at meetings, where anti-sitters discreetly rise from their chairs, as eager to avoid detection as a scofflaw texting during a show; and at parties, where those eager to avoid chair time help the host serve — and not just to be helpful. How long before chairs are required to come with cigarette-pack-style health alerts? Warning: This La-Z-Boy can kill you. In some circles, friends and relatives engage in what Sara Rimer, a media relations specialist at Boston University, only somewhat jokingly calls “competitive non-sitting.” When she and her sisters get together, Rimer said, “I would notice my oldest sister seemed to be making a habit of standing while my middle sister and I were sitting. So then the two of us starting standing up, too.”

State By State, Battle For Presidency Goes To Voters (The New York Times) — “The most expensive presidential race in American history now becomes the biggest show on television, a night with enough uncertainty that it could become a telethon lasting well into morning.”

Daily Rounds: Bounce-Back Patient Penalty; Suicide Up; Harvard Health Costs; Campaign Focus On Abortion

Hospitals look to lower readmission penalties (The Boston Globe) – “In Massachusetts, 54 medical centers will lose some money, according to a Kaiser Health News analysis, and Beth Israel Deaconess is among 10 that will lose the maximum amount — 1 percent of their Medicare payments. Some also face state penalties. Many hospitals are rolling out new programs in response, hiring people such as the nurse who works with Sewell, installing technology to predict which patients need the most help once they leave the hospital, and forging new partnerships with nursing homes, doctor offices, and social services. But there has been considerable debate about whether the penalties are fair or will have a real impact on patient care.”

Increase seen in U.S. suicide rate since the recession (The New York Times) – “The rate of suicide in the United States rose sharply during the first few years since the start of the recession, a new analysis has found. In the report, which appeared Sunday on the Web site of The Lancet, a medical journal, researchers found that the rate between 2008 and 2010 increased four times faster than it did in the eight years before the recession. The rate had been increasing by an average of 0.12 deaths per 100,000 people from 1999 through 2007. In 2008, the rate began increasing by an average of 0.51 deaths per 100,000 people a year. Without the increase in the rate, the total deaths from suicide each year in the United States would have been lower by about 1,500, the study said. The finding was not unexpected.”

Harvard, large union at odds over health care (The Boston Globe) – “Members of Harvard University’s largest union reacted angrily Friday to assertions by the school in its annual report that health care costs for employees are growing at unsustainable rates. The Harvard Union of Clerical and Technical Workers, which represents about 4,600 skilled office, laboratory, and library staffers, is negotiating medical care contributions and wage increases with university officials. Its contract expired June 30…Harvard, in its annual report released Friday, said, ‘Our employee benefit expense, of which health care is the largest component, has been increasing at an unsupportable rate relative to actual and expected growth in the university’s revenue.'”

Why abortion has become such a prominent campaign issue (NPR-Shots) – “Abortion isn’t usually a major issue in presidential campaigns. But this year is different. Both President Obama and former Massachusetts Gov. Mitt Romney are putting the issue front and center, including official campaign-produced ads. A TV spot from the Romney campaign shows the candidate’s abortion stance in a different light. That’s a big change from many of the previous presidential races, where the campaigns normally let surrogates do the talking about one of the most contentious issues in politics. That’s because in both cases candidates wanted to secure their base voters – those who support abortion rights in the case of Democrats and those who oppose them for Republicans – without antagonizing the minorities in each party who hold the other view. This fall, however, GOP challenger Romney has been walking an interesting tightrope – appearing to moderate his position on the one hand, while maintaining a strict anti-abortion stance on the other.”

Daily Rounds: Romney Baffles On Medicare; Bellevue Struggle; Climate Excuses; Choosing Wellness Over College Sports

Romney’s baffling claim about Medicare pay cuts for doctors (NPR) – “Over the last couple of weeks, Republican Mitt Romney has been making a new claim that doesn’t quite clear the accuracy bar. It has to do with $716 billion in Medicare reductions over 10 years included in the federal health law, the Affordable Care Act. And it’s become a standard part of Romney’s stump speech. Here’s how he put it last week in his big economic speech in Ames, Iowa: “It matters to the senior who needs to get an appointment with a medical specialist, but is told by one receptionist after another that the doctor isn’t taking any new Medicare patients; because Medicare has been slashed to pay for Obamacare.” “Not true,” says Harold Pollack, a professor of public health policy at the University of Chicago. “I’m honestly rather baffled at the arguments that Governor Romney is making.”

A convenient excuse (The Boston Phoenix) – “First: We need to see a much greater sense of urgency in the media’s coverage of climate change, including in the Globe’s editorial and opinion pages. This is more than an environmental crisis: it’s an existential threat, and it should be treated like one, without fear of sounding alarmist, rather than covered as just another special interest, something only environmentalists care about. And it should be treated as a central issue in this election, regardless of whether the candidates or the political media are talking about it. Second: Business-as-usual, politics-as-usual, and journalism-as-usual are failing us when it comes to addressing the climate threat. If there’s to be any hope for the kind of bold action we need, a great deal of pressure must be brought from outside the system, in the form of a broad-based grassroots movement, in order to break the stranglehold of the big-money fossil fuel lobby on our politics. And in fact, there is a movement emerging on campuses and in communities across the country — especially here in New England — and the Globe should be paying attention to it.”

Related:Bloomberg backs Obama, citing fallout from storm (The New York Times)

At Bellevue, a desperate fight to ensure patient safety (The New York Times) – “Some doctors began urging evacuations, and on Tuesday, at least two dozen ambulances lined up around the block to pick up many of the 725 patients housed there. People carried babies down flights of stairs. The National Guard was called in to help. On Thursday afternoon, the last two patients were waiting to be taken out. The evacuation went quickly only because Bellevue had planned for such a possibility before Hurricane Irene hit last year, several doctors said. But the city, which had evacuated two nearby hospitals before that storm, decided not to clear out Bellevue. In the wake of Hurricane Sandy, the consequences of bad calls, bad luck and equipment failures cascaded through the region’s health care system, as sleep-deprived health care workers and patients were confronted by a new kind of disarray.”

Beyond sports (Inside Higher Ed) – “Spelman College is doing the exact opposite. The historically black liberal arts women’s college in Atlanta will announce today that it is completely eliminating intercollegiate athletics at the end of this academic year. Granted, Spelman’s presence in the NCAA was minuscule compared to that of many others, and the Division III college with 80 athletes is hardly getting the same attention as the Division I program that fields hundreds (and enjoys lucrative deals from championship appearances and television contracts). So rather than dedicate its resources to programs from which only 4 percent of Spelman’s 2,000 students benefit, President Beverly Daniel Tatum decided to direct that money — nearly $1 million — and energy toward a campuswide fitness and wellness initiative that she sees as crucial to her students’ health and overall well-being.”

Daily Rounds: Suicide And The Disabled; The Cost Of Longer Life; More Mumps Shots; Call For New Drug Lab Probe

Suicide By Choice? Not So Fast (The New York Times) — “If nobody wants you at the party, why should you stay? Advocates of Death With Dignity laws who say that patients themselves should decide whether to live or die are fantasizing. Who chooses suicide in a vacuum? We are inexorably affected by our immediate environment. The deck is stacked. Yes, that may sound paranoid. After all, the Massachusetts proposal calls for the lethal dose to be “self-administered,” which it defines as the “patient’s act of ingesting.” You might wonder how that would apply to those who can’t feed themselves — people like me. But as I understand the legislation, there is nothing to prevent the patient from designating just about anyone to feed them the poison pill. Indeed, there is no requirement for oversight of the ingestion at all; no one has to witness how and when the lethal drug is given. Which, to my mind, leaves even more room for abuse. To be sure, there are noble intentions behind the “assisted death” proposals, but I can’t help wondering why we’re in such a hurry to ensure the right to die before we’ve done all we can to ensure that those of us with severe, untreatable, life-threatening conditions are given the same open-hearted welcome, the same open-minded respect and the same open-ended opportunities due everyone else.”

The Cost Of Living Longer (The Wall Street Journal) — “The average rent at assisted-living facilities, which provide help with day-to-day activities but not necessarily round-the-clock skilled-nursing care, shot up 17% to $3,486 over the past five years, according to the study. That is based on facilities offering six to nine services. The price of a private room at a nursing home, meanwhile, rose 4% over the past year to $248 a day. And while prices for home-health aides and adult-day services didn’t rise, on average, the brief respite comes after increases in recent years. Home-health-care spending by Medicare beneficiaries, for example, climbed 129% to $19 billion from 2000 to 2010, according to a March report to Congress by the Medicare Payment Advisory Commission.”

To Stem Mumps Outbreak, Doctors Try An Extra Vaccination (NPR) — “But mumps spread so widely within the Orthodox Jewish communities in these areas that public health officials concluded that a quarantine, the usual response to a mumps outbreak, wouldn’t work. So they tried something new. After receiving approval from the New York State Department of Health and the Institutional Review Boards at the Centers for Disease Control and Prevention, the officials administered a third dose of MMR vaccine to children who hadn’t yet contracted the disease. Why didn’t the standard two-shot dose of the vaccine protect the children? Public health officials, who published their findings in this week’s New England Journal of Medicine, say it was the unique style of study in yeshivas, religious schools for Orthodox Jews. In a yeshiva, students are paired up in partnerships called chavrusas. The two students in a chavrusa share the same desk and the same book and engage in a vigorous dialogue about the day’s lesson. Throughout the school day, which lasts up to 15 hours in a yeshiva, the students rotate among different chavrusas, changing their study partner each time.”

AG Martha Coakley Calls For Independent Probe Of State Drug Lab Policies And Procedures (The Boston Globe) — “Attorney General Martha Coakley is asking the governor to appoint an independent investigator to review the policies, practices, and oversight at the state laboratory in Jamaica Plain where a chemist’s alleged mishandling of evidence has thrown thousands of drug cases into question. The attorney general’s office wants to focus on a criminal investigation of Annie Dookhan, the diminutive chemist from Franklin at the center of the drug lab scandal, and let the independent investigator conduct a broader look.”

Daily Rounds: How Sandy Killed; Beeper Madness; Sexualized Pink Ribbons; Big Sugar’s ‘Sweet Lies’

In storm deaths, mystery, fate and bad timing (The New York Times) – “They stepped in the wrong puddle. They walked the dog at the wrong moment. Or they did exactly what all the emergency experts instructed them to do — they huddled inside and waited for its anger to go away. Hurricane Sandy, in the wily and savage way of natural disasters, expressed its full assortment of lethal methods as it hit the East Coast on Monday night. In its howling sweep, the authorities said the storm claimed at least 40 lives in eight states…Most of all, it was the trees. Uprooted or cracked by the furious winds, they became weapons that flattened cars, houses and pedestrians. But also, a woman was killed by a severed power line. A man was swept by flooding waters out of his house and through the glass of a store. The power blinked off for a 75-year-old woman on a respirator, and a heart attack killed her.”

A medical calling (The Boston Globe) – “These are times of unremitting technological contact, we just can’t avoid each other, yet patients are admitted and — even more often — unsafely discharged, without a word of communication. The first I hear about the event is from the local pharmacist, asking for refills on medications I did not know had been begun, for patients I did not know had been hospitalized. I return the call with confidence. Pharmacists always pick up.”

Sexy breast cancer campaigns anger many patients (USA Today) – “Many breast cancer survivors say a crop of pink-ribbon campaigns have hit a new low — by sexualizing breast cancer. An online porn site this month has been using breast cancer to increase its Web traffic by offering to donate 1 cent for every 30 views of its videos. The intended recipient for the donation, Susan G. Komen for the Cure, rejected the offer and instructed the site to stop using its name. Yet pornographers are only the most extreme example of a disturbing trend: using sex to sell breast cancer — or simply get attention, say Gayle Sulik, author of Pink Ribbon Blues. Sulik, who recently lost a friend to the disease, notes that magazines and advertising campains now routinely use topless young women to illustrate a disease whose average victims are in their 60s.”

Big Sugar’s sweet little lies: How the industry kept scientists from asking: Does sugar kill? (Mother Jones) – “Precisely how did the sugar industry engineer its turnaround? The answer is found in more than 1,500 pages of internal memos, letters, and company board reports we discovered buried in the archives of now-defunct sugar companies as well as in the recently released papers of deceased researchers and consultants who played key roles in the industry’s strategy. They show how Big Sugar used Big Tobacco-style tactics to ensure that government agencies would dismiss troubling health claims against their products. Compared to the tobacco companies, which knew for a fact that their wares were deadly and spent billions of dollars trying to cover up that reality, the sugar industry had a relatively easy task. With the jury still out on sugar’s health effects, producers simply needed to make sure that the uncertainty lingered. But the goal was the same: to safeguard sales by creating a body of evidence companies could deploy to counter any unfavorable research. For 40 years, the sugar industry’s priority has been to shed doubt on studies suggesting that its product makes people sick. This decades-long effort to stack the scientific deck is why, today, the USDA’s dietary guidelines only speak of sugar in vague generalities.”

Daily Rounds: A Hospital Evacuates; Obama’s Storm; New Hope For HIV Vaccine; Dangers Of A Single Junk-Food Meal

Patients Evacuated From City Medical Center After Power Failure (The New York Times) — “A backup power system failed at one of New York City’s premier medical centers on Monday night, forcing the evacuation of all patients to nearby hospitals amid the storm’s strong gusts, officials said. The medical center, NYU Langone Medical Center, a sprawling complex in the low 30s near the East River, began transporting all 215 patients at the hospital to other facilities on Monday evening, They were still being transported to other nearby hospitals, including Sloan Kettering and Mt. Sinai, early Tuesday morning, a spokeswoman for the hospital said. “They evacuated everybody,” said the spokeswoman, Lorinda Klein, who said the main communications systems at NYU Langone — phones and e-mail — were down.”

Obama Takes Early Lead In Hurricane Sandy World Series (The New Yorker) — “To make matters worse for the Republicans, they have had to endure the sight of one of their own campaign surrogates praising the President for his rapid response to the crisis. At a press conference in Trenton on Monday, Chris Christie, the governor of New Jersey, thanked Obama for approving a state of emergency in New Jersey even before the storm had arrived, which enables the state government to access federal funds and help from FEMA. “We appreciate the president’s efforts in that regard,” Christie said. “He and his staff worked tremendously hard.” Confirming that Obama had promised to be there for New Jersey over the coming days, the governor added: “The President assured me on the phone that we’d get his immediate personal attention.” Doubtless, that’s true. With his adroit actions and reassuring words over the past twenty-four hours, Obama has done exactly what you might have expected a responsible President, and a smart politician, to have done. He’s looked engaged and concerned, but not panicked. He’s marshalled the resources of the federal government as best he can. And he’s kept a straight face while insisting that none of this has anything to do with November 6th. Before leaving the podium in the White House press room, he took one question, which, inevitably, was about the impact of Sandy on the election. “I’m not worried at this point about the election,” Obama said. “I’m worried about the impact on families and first responders… The election will take care of itself next week.”

A Weak Spot in H.I.V.’s Armor Raises Hope for a Vaccine (The New York Times) — “What we have that’s unique,” Dr. Karim said, “is that for the first time, we understand how a person can make broadly neutralizing antibodies.” The virus’s vulnerable spot — open to antibody attack — was created when a sugarlike surface compound called a glycan shifted positions. Antibodies are Y-shaped proteins produced by the immune system that attach to a virus and block its outer receptors — sort of the way sweater fuzz attaches to Velcro and renders it unsticky. There are many strains of H.I.V., and no known antibody incapacitates all of them. But in the last few years, several teams of scientists have isolated about a dozen that each can shut down up to 80 percent of all virus strains. These are said to be “broadly neutralizing.” Less than 20 percent of all patients naturally develop such antibodies in their blood, and even those who do aren’t fully protected. One of the women whose blood was crucial to Dr. Karim’s study has died of AIDS-related tuberculosis, and the other is on antiretroviral drugs. Nonetheless, experts hope it will eventually be possible to manufacture cocktails with large doses of several kinds of antibodies to treat patients — or even to induce the immune system to make those particular antibodies, which would amount to a vaccine.”

Every Single Junk Food Meal Damages Your Arteries, Study Finds (Science Daily) — “A single junk food meal — composed mainly of saturated fat — is detrimental to the health of the arteries, while no damage occurs after consuming a Mediterranean meal rich in good fats such as mono-and polyunsaturated fatty acids, according to researchers at the University of Montreal-affiliated ÉPIC Center of the Montreal Heart Institute. The Mediterranean meal may even have a positive effect on the arteries.”

Daily Rounds: The Medicaid Election; Conflict On The Pharmacy Board; Fat Doctors; Pricey Prostate Treatment

Medicaid On The Ballot (The New York Times) — “There’s a lot we don’t know about what Mitt Romney would do if he won. He refuses to say which tax loopholes he would close to make up for $5 trillion in tax cuts; his economic “plan” is an empty shell.But one thing is clear: If he wins, Medicaid — which now covers more than 50 million Americans, and which President Obama would expand further as part of his health reform — will face savage cuts. Estimates suggest that a Romney victory would deny health insurance to about 45 million people who would have coverage if he lost, with two-thirds of that difference due to the assault on Medicaid.So this election is, to an important degree, really about Medicaid.”

State Wants Pharmacist To Resign As Regulator (The Boston Globe) — “The lead pharmacist of a sister company to the pharmacy at the center of the meningitis outbreak has been asked to resign from the state board that oversees pharmacies.”

Would You Accept Obesity Advice From A Fat Doctor? (Kevin MD) — “Something that has been on my mind recently is obesity, specifically obesity in doctors. This may be because we cover obesity in a high percentage of our stories (1 in 3 Americans is obese, after all) or because I recently discovered that I gained ten pounds since moving to New York City. Either way, after watching Dr. Snyderman speak her mind on national television about how obese leaders are unfit to lead, I have been thinking: are patients less likely to trust doctors who are obese? It is a valid concern because you expect people in other careers to match what they’re selling – dentists have good teeth, dermatologists have nice skin, personal shoppers should be stylish, and so on. With that reasoning, shouldn’t doctors be the perfect picture of health in areas of medicine that they can control? I’m not talking about doctors being sick with a cold or having asthma; I’m referring to doctors who make lifestyle choices that are clearly not healthy – being obese, smoking cigarettes, doing drugs, dinking alcohol, engaging in unprotected sex, etc. The easiest one of these to spot is obesity. Would you really listen to someone tell you to lose weight if he or she can’t seem to do the same for health reasons? A study published in the journal Obesity from the Johns Hopkins Bloomberg School of Public Health in Jan 2012 shows that obese doctors are less likely to talk to their patients about weight loss — 18% of obese doctors talked to their patients about weight whereas 32% of normal weight doctors covered the same topic.”

Pricey New Prostate Cancer Therapy Raises Questions About Safety, Cost (NPR) — “But proton therapy has become the center of an intense debate. Critics say it’s an example of a big problem with the U.S. health system: Doctors start using expensive new treatments before anyone knows whether they work, whether they’re safe, and whether they’re worth the extra money. “There’s a concerning trend of us building new and expensive new technology and using it for a common cancer like prostate without proving, really, that it’s equivalent to the existing technology,” said Ronald Chen of the University of North Carolina at Chapel Hill. “New treatments can — even though they’re promising — can potentially not be better and can even be worse,” Chen said. “I think we have to do careful studies before we adopt new treatments.” The ProCure clinic is the newest of 10 proton centers around the country, and there are perhaps 10 more on the way. That has many experts worried.”