New Hope for Children With Severe Peanut Allergies

Evidence is beginning to accumulate that severe peanut allergies can be made less severe over time by careful, regulated exposure to small doses of peanut flour. In a recent study, over 500 children aged 4 to 17 with severe peanut allergies were exposed either to small amounts of peanut flour delivered in their food for six months, or to a non-peanut flour. By the end of the study, 67% of those exposed to the peanut flour were able to tolerate the equivalent of several peanuts, compared to only 4% of those receiving the dummy flour. While children who have had severe peanut allergies probably wouldn't ever be able to eat peanuts with reckless abandon, the treatment should be enough to keep them safe if/when they are inadvertently exposed to tiny amounts of peanut allergen in their environment.

The study has not yet been peer-reviewed. And it's worth noting that 12% of the study's participants dropped out before completion of the study because of "adverse events" (reactions to the treatment). In other words, the treatment may not work for everyone.

When commercialized, a full course of treatment is expected to cost $5,000 to $10,000. That's a lot to pay for peanut powder, but presumably the real cost is in quality control and patient monitoring. For the patient with life-threatening peanut allergies, the treatment might be priceless.

A Blood Test for Concussions

Traditionally, people who are suspected of having a concussion are first evaluated by a series of neurological tests known as the Glasgow Coma Scale. If the results of the Glasgow test warrant it, a computed tomography (CT) scan is conducted to try to detect intracranial lesions requiring treatment. Problem is, most CT scans are negative for lesions, meaning that a lot of CT scans are done unnecessarily.

Now, however, there's a blood test for concussions. The test measures the levels of certain proteins that are released into the blood by damaged brain tissue in the first 12 hours after a concussion. The test is highly accurate; it correctly identifies a concussion 97.5% of the time in patients also identified by a CT scan, and correctly identifies a person as not having a concussion 99.6% of the time when a CT scan is also negative. Aside from being less expensive, the blood test could be done in the field (perhaps even on the sidelines of a sporting event), allowing better decisions about who does and doesn't need a CT scan.

The blood test is currently approved only for use on adults, but the company that makes the testing device is working toward getting it approved for children as well. That would make it available for the more than a million boys who play high school football each year, as well as athletes in other contact sports.

Keeping Human Organs Alive Longer Before Transplantation

One of the practical limitations to transplantation of organs from a recently-deceased donor to a recipient is the length of time that human organs remain viable outside a human body. Even if the organ is immediately cooled on ice, it's only a matter of hours before it is no longer considered healthy enough for transplantation. Sometimes it would take too long to transport the organ from where it is harvested to where it is needed, even if pilots and planes were standing by to transport it.

That may be about to change. Several companies (OrganOx and Transmedics) are working to extend the time during which human organs can be kept alive outside the body for up to a full day. This is being accomplished not by cooling the organ, but by keeping it warm and perfused with blood throughout storage and transport so that the organ's metabolic requirements are met and it can continue to function. The techniques require some expensive equipment (much more expensive than just a cooler of ice!), but if lives can be saved the extra cost may just be worth it.

And if we are allowed to dream, if the time of organ storage outside a human body could be extended to weeks or even months, it might be possible to establish human organ banks in some distant future!

New Treatment for a Penile Dysfunction Condition

Peyronie's disease - the disease we never knew existed until there was a cure for it. TV commercials about the condition ask cryptically "Are you curved below the belt?". It took me a minute to figure that one out! In fact, Peyronie's disease is a relatively rare condition in which scar tissue in the penis causes marked curvature of the penis during an erection, leading to painful erections and problems having sex. What causes the scar tissue to develop is generally unknown, although prior physical injury is suspected in many cases.

In December the FDA approved the first non-surgical treatment for Peyronies's disease after reviewing the results of two studies. Shortly thereafter the company producing the treatment, Endo Pharmaceuticals, launched an aggressive disease awareness and product marketing campaign. And why not? There's a lot of money to be made. Treatment will cost $26,000 in addition to the doctor's fees. Treatment involves 8 injections into the penis six weeks apart of Xiaflex, a collagenase derived from the bacterium that causes gangrene.

Endo Pharmaceuticals says that "3-9% of adult males worldwide are estimated to have Peyronie's disease", but no evidence is presented to back that up. Estimated by whom? Sigh. For now we'll just have to put up with those annoying ads.

IQOS Smokeless Cigarettes

Is it possible to produce a "smokeless" cigarette that will do less harm than regular cigarettes? The tobacco company Phillip Morris has created a device called IQOS that gently heats tobacco, rather than burning it. The company says that IQOS reduces the level of toxic chemicals produced, compared to regular cigarettes, by over 90%, and therefore it is a healthier alternative than regular cigarettes.

Phillip Morris has spent billions developing IQOS, but is it a good idea? Some health officials are skeptical. For one, the device still delivers nicotine. Health officials are concerned that IQOS may produce a whole new generation of smokers addicted to nicotine. And while nicotine may cause less harm than the toxic chemicals in cigarettes, is also has no known health benefits, so why encourage its use?

Then there's the FDA. Last month an advisory panel to the FDA recommended against approving IQOS for sale in the U.S., saying that while it may be true that IQOS generates fewer of the harmful chemicals found in cigarettes, that does not prove that IQOS would cause less harm to human health. It may seem like a fine point and it may be unlikely that IQOS would harm human health (much), but the FDA advisory panel is technically right.

In the meantime IQOS has gone on sale in Japan, so perhaps in time we'll know more about how it affects human health. I just hope for the sake of Japanese smokers that Phillip Morris is right. that IQOS at least proves to be less unhealthy than regular cigarettes.

Raw Water

What's in the water you drink? Pure water is just H2O - it contains just hydrogen and oxygen. But water from almost any natural source may contain a lot of other things, depending on where the water came from and how it was treated before it gets to you.

The latest craze is drinking raw water, loosely defined as water from a natural source, untreated and unfiltered. Proponents argue that it is better for you than filtered or treated water because it still contains certain useful minerals such as sodium, calcium, and magnesium, and that it is free of certain chemicals that may be added during water treatment, such as chlorine and fluoride. One seller of raw water even suggests that their water may be "naturally probiotic", meaning that it contains probiotic bacteria.

Naturally probiotic - really? If raw water contains bacteria, isn't it just as likely that some of them could be bad for you? And what about parasites and toxic chemicals that may be found in the environment? Do you want to take that risk? It's up to you.