Dr. John L. Turner Blog

 CONSCIOUSNESS

We exist in this time and in this space. But where are we when we dream, before we are born, or after we die?

What if we exist in many times . . . in many spaces . . . now and forever?

It has been said, that we sleepwalk through life, but when we finally awaken to our spiritual nature, then there is no death. But, how do we awaken?

My friend Dr. Eldon Taylor says, "Consciousness IS!

    My friend Ernie Morgan says, "Where is Consciousness?"

     My friend and recently departed webmaster says, "That's the Question!"

          A stranger replied, "It's too early in the morning for a question like that!"

                   And finally,

                        Son Doushi says, "Because . . . that's the way it works!"

         Nuclear Physicist and Consciousness expert Tom Campbell will be in Honolulu, Hawaii on Saturday June 12, 2010 to tell you the correct answer to the question. What better reason is there to visit Hawaii?

The question will be answered

Honolulu, Hawaii - Saturday June 12, 2020
Time: 10:00 AM until 6:00 PM
Unity Church of Hawaii
3608 Diamond Head Circle, Honolulu, HI 96815

Cost: $80
Special Offer: 50% discount on the first 100 tickets sold!
Just $40 each! So book early!!

Contact for ticket purchases and more info at
baltich@hotmail.com or call Steve at 808-343-1935

It is interesting that some NDEs report the walls of the tunnel of light to be not solid as usually shown in drawings. Although the tunnel was a component of NDE, the most significant feature is the life review which was, in many cases, life changing. I spoke with a young man today, a patient, who said he believes that at death, this type of thing gives one the chance to forgive themselves.

According to Dr. Jeffrey Long's new book there are two things that you can take with you to the next level: Love and Knowledge!

Evidence of the Afterlife

I am half-way through this book now and at the time of this writing, I am happy to say that it is #19 at Amazon.com. This is info that began with Dr. Raymond Moody when he first heard Dr. George G. Ritchie speak of a near-death experience and more and more of us want to know more and more about what happens after we take our last breath on Earth.

You have time to do two things:

1.) Watch this clip of Dr. Long's patient

2.) Pat Robertson opened his mouth and lo, he opened the door for us to wake up and learn the truth about Haiti. In addition to sending Reiki and love, here is some NYT history from today's article to also allow us to learn!

January 22, 2010
Op-Ed Contributor
To Heal Haiti, Look to History, Not Nature
By MARK DANNER

HAITI is everybody's cherished tragedy. Long before the great earthquake struck the country like a vengeful god, the outside world, and Americans especially, described, defined, marked Haiti most of all by its suffering. Epithets of misery clatter after its name like a ball and chain: Poorest country in the Western Hemisphere. One of the poorest on earth. For decades Haiti's formidable immiseration has made it among outsiders an object of fascination, wonder and awe. Sometimes the pity that is attached to the land - and we see this increasingly in the news coverage this past week - attains a tone almost sacred, as if Haiti has taken its place as a kind of sacrificial victim among nations, nailed in its bloody suffering to the cross of unending destitution.

And yet there is nothing mystical in Haiti's pain, no inescapable curse that haunts the land. From independence and before, Haiti's harms have been caused by men, not demons. Act of nature that it was, the earthquake last week was able to kill so many because of the corruption and weakness of the Haitian state, a state built for predation and plunder. Recovery can come only with vital, even heroic, outside help; but such help, no matter how inspiring the generosity it embodies, will do little to restore Haiti unless it addresses, as countless prior interventions built on transports of sympathy have not, the man-made causes that lie beneath the Haitian malady.

In 1804 the free Republic of Haiti was declared in almost unimaginable triumph: hard to exaggerate the glory of that birth. Hundreds of thousands of enslaved Africans had labored to make Saint-Domingue, as Haiti was then known, the richest colony on earth, a vastly productive slave-powered factory producing tons upon tons of sugar cane, the 18th-century's great cash crop. For pre-Revolutionary France, Haiti was an inexhaustible cash cow, floating much of its economy. Generation after generation, the second sons of the great French families took ship for Saint-Domingue to preside over the sugar plantations, enjoy the favors of enslaved African women and make their fortunes.

Even by the standards of the day, conditions in Saint-Domingue's cane fields were grisly and brutal; slaves died young, and in droves; they had few children. As exports of sugar and coffee boomed, imports of fresh Africans boomed with them. So by the time the slaves launched their great revolt in 1791, most of those half-million blacks had been born in Africa, spoke African languages, worshipped African gods.

In an immensely complex decade-long conflict, these African slave-soldiers, commanded by legendary leaders like Toussaint Louverture and Jean-Jacques Dessalines, defeated three Western armies, including the unstoppable superpower of the day, Napoleonic France. In an increasingly savage war - "Burn houses! Cut off heads!" was the slogan of Dessalines - the slaves murdered their white masters, or drove them from the land.

On Jan. 1, 1804, when Dessalines created the Haitian flag by tearing the white middle from the French tricolor, he achieved what even Spartacus could not: he had led to triumph the only successful slave revolt in history. Haiti became the world's first independent black republic and the second independent nation in the Western Hemisphere.

Alas, the first such republic, the United States, despite its revolutionary creed that "all men are created equal," looked upon these self-freed men with shock, contempt and fear. Indeed, to all the great Western trading powers of the day - much of whose wealth was built on the labor of enslaved Africans - Haiti stood as a frightful example of freedom carried too far. American slaveholders desperately feared that Haiti's fires of revolt would overleap those few hundred miles of sea and inflame their own human chattel.

For this reason, the United States refused for nearly six decades even to recognize Haiti. (Abraham Lincoln finally did so in 1862.) Along with the great colonial powers, America instead rewarded Haiti's triumphant slaves with a suffocating trade embargo - and a demand that in exchange for peace the fledgling country pay enormous reparations to its former colonial overseer. Having won their freedom by force of arms, Haiti's former slaves would be made to purchase it with treasure.

The new nation, its fields burned, its plantation manors pillaged, its towns devastated by apocalyptic war, was crushed by the burden of these astronomical reparations, payments that, in one form or another, strangled its economy for more than a century. It was in this dark aftermath of war, in the shadow of isolation and contempt, that Haiti's peculiar political system took shape, mirroring in distorted form, like a wax model placed too close to the fire, the slave society of colonial times.

At its apex, the white colonists were supplanted by a new ruling class, made up largely of black and mulatto officers. Though these groups soon became bitter political rivals, they were as one in their determination to maintain in independent Haiti the cardinal principle of governance inherited from Saint-Domingue: the brutal predatory extraction of the country's wealth by a chosen powerful few.

The whites on their plantations had done this directly, exploiting the land they owned with the forced labor of their slaves. But the slaves had become soldiers in a victorious revolution, and those who survived demanded as their reward a part of the rich land on which they had labored and suffered. Soon after independence most of the great plantations were broken up, given over to the former slaves, establishing Haiti as a nation of small landowners, one whose isolated countryside remained, in language, religion and culture, largely African.

Unable to replace the whites in their plantation manors, Haiti's new elite moved from owning the land to fighting to control the one institution that could tax its products: the government. While the freed slaves worked their small fields, the powerful drew off the fruits of their labor through taxes. In this disfigured form the colonial philosophy endured: ruling had to do not with building or developing the country but with extracting its wealth. "Pluck the chicken," proclaimed Dessalines - now Emperor Jacques I - "but don't make it scream."

In 1806, two years after independence, the emperor was bayoneted by a mostly mulatto cabal of officers. Haitian history became the immensely complex tale of factional struggles to control the state, with factions often defined by an intricate politics of skin color. There was no method of succession ultimately recognized as legitimate, no tradition of loyal opposition. Politics was murderous, operatic, improvisational. Instability alternated with autocracy. The state was battled over and won; Haiti's wealth, once seized, purchased allegiance - but only for a time. Fragility of rule and uncertainty of tenure multiplied the imperative to plunder. Unseated rulers were sometimes killed, more often exiled, but always their wealth - that part of it not sent out of the country - was pillaged in its turn.

In 1915 the whites returned: the United States Marines disembarked to enforce continued repayment of the original debt and to put an end to an especially violent struggle for power that, in the shadow of World War I and German machinations in the Caribbean, suddenly seemed to threaten American interests. During their nearly two decades of rule, the Americans built roads and bridges, centralized the Haitian state - setting the stage for the vast conurbation of greater Port-au-Prince that we see today in all its devastation - and sent Haitians abroad to be educated as agronomists and doctors in the hope of building a more stable middle class.

Still, by the time they finally left, little in the original system had fundamentally changed. Haitian nationalism, piqued by the reappearance of white masters who had forced Haitians to work in road gangs, produced the noiriste movement that finally brought to power in 1957 François Duvalier, the most brilliant and bloody of Haiti's dictators, who murdered tens of thousands while playing adroitly on cold-war America's fear of communism to win American acceptance.

Duvalier's epoch, which ended with the overthrow of his son Jean-Claude in 1986, ushered in Haiti's latest era of instability, which has seen, in barely a quarter-century, several coups and revolutions, a handful of elections (aborted, rigged and, occasionally, fair), a second American occupation (whose accomplishments were even more ephemeral than the first) and, all told, a dozen Haitian rulers. Less and less money now comes from the land, for Haiti's topsoil has grown enfeebled from overproduction and lack of investment. Aid from foreigners, nations or private organizations, has largely supplanted it: under the Duvaliers Haiti became the great petri dish of foreign aid. A handful of projects have done lasting good; many have been self-serving and even counterproductive. All have helped make it possible, by lifting basic burdens of governance from Haiti's powerful, for the predatory state to endure.

The struggle for power has not ended. Nor has Haiti's historic proclivity for drama and disaster. Undertaken in their wake, the world's interventions - military and civilian, and accompanied as often as not by a grand missionary determination to "rebuild Haiti" - have had as their single unitary principle their failure to alter what is most basic in the country, the reality of a corrupt state and the role, inadvertent or not, of outsiders in collaborating with it.

The sound of Haiti's suffering is deafening now but behind it one can hear already a familiar music begin to play. Haiti must be made new. This kind of suffering so close to American shores cannot be countenanced. The other evening I watched a television correspondent shake his head over what he movingly described as a "stupid death" - a death that, but for the right medical care, could have been prevented. "It doesn't have to happen," he told viewers. "People died today who did not need to die." He did not say what any Haitian could have told him: that the day before, and the day before that, Haiti had seen hundreds of such "stupid deaths," and, over the centuries, thousands more. What has changed, once again, and only for a time, is the light shone on them, and the volume of the voices demanding that a "new Haiti" must now be built so they never happen again.

Whether they can read or not, Haiti's people walk in history, and live in politics. They are independent, proud, fiercely aware of their own singularity. What distinguishes them is a tradition of heroism and a conviction that they are and will remain something distinct, apart - something you can hear in the Creole spoken in the countryside, or the voodoo practiced there, traces of the Africa that the first generation of revolutionaries brought with them on the middle passage.

Haitians have grown up in a certain kind of struggle for individuality and for power, and the country has proved itself able to absorb the ardent attentions of outsiders who, as often as not, remain blissfully unaware of their own contributions to what Haiti is. Like the ruined bridges strewn across the countryside - one of the few traces of the Marines and their occupation nearly a century ago - these attentions tend to begin in evangelical zeal and to leave little lasting behind.

What might, then? America could start by throwing open its markets to Haitian agricultural produce and manufactured goods, broadening and making permanent the provisions of a promising trade bill negotiated in 2008. Such a step would not be glamorous; it would not "remake Haiti." But it would require a lasting commitment by American farmers and manufacturers and, as the country heals, it would actually bring permanent jobs, investment and income to Haiti.

Second, the United States and other donors could make a formal undertaking to ensure that the vast amounts that will soon pour into the country for reconstruction go not to foreigners but to Haitians - and not only to Haitian contractors and builders but to Haitian workers, at reasonable wages. This would put real money in the hands of many Haitians, not just a few, and begin to shift power away from both the rapacious government and the well-meaning and too often ineffectual charities that seek to circumvent it. The world's greatest gift would be to make it possible, and necessary, for Haitians - all Haitians - to rebuild Haiti.

Putting money in people's hands will not make Haiti's predatory state disappear. But in time, with rising incomes and a concomitant decentralization of power, it might evolve. In coming days much grander ambitions are sure to be declared, just as more scenes of disaster and disorder will transfix us, more stunning and colorful images of irresistible calamity. We will see if the present catastrophe, on a scale that dwarfs all that have come before, can do anything truly to alter the reality of Haiti.

Mark Danner is the author, most recently, of "Stripping Bare the Body: Politics, Violence, War," which chronicles political conflict in Haiti, the Balkans, Iraq and the United States.

LINK

This is an important blog entry as I have had personal experience with Alzheimer's disease. My mother, bless her soul, suffered from AD over the last several years of her life, robbed of her short-term memory. When I first noticed her memory lapses, I attributed them to senile dementia as she was in her early nineties at the time.  Has I realized the early onset of Alzheimer's disease, I could have started her on the appropriate medications and perhaps given her a few more years of quality life.

Now, it may be possible to detect this terrible disease twenty years ahead of symptoms and if and when it hits, early treatment will be highly beneficial.

Click HERE for article

I am sure you will like this, regardless of your political views!!

And this wish is good for every day until it is fulfilled or . . . the sun explodes!

 I call this short 14 minute audio file: "Obama's New Year's Eve Dream"

but it had another title when aired in 1945. When you click the link below,  right below the title:

Arch Obler Radio Plays "The Day The Sun Exploded" 1945  

you can click the play icon to listen, or right-click the Download link and save the mp3 file to listen later.

The Day the Sun Exploded

Peace to all of you, and may 2010 portend wonderful things!

All the best,

Dr. T

China succeeds in developing herbal medication to treat A/H1N1 flu

BEIJING, Dec. 17 (Xinhua) -- Chinese medical specialists announced Thursday they had developed a Chinese herbal medication to treat the A/H1N1 flu.

Seven months of scientific and clinical studies showed the remedy, called "Jin Hua Qing Gan Fang," was effective in treating A/H1N1 flu patients, said Wang Chen, president of Beijing's Chaoyang Hospital.

"It can shorten patients' fever period and improve their respiratory systems. Doctors have found no negative effects on patients who were treated in this way," he said.

"It is also very cheap, only about a quarter of the cost of Tamiflu," he said at a press conference held by the Beijing Municipal Government.

Tamiflu, a product of Swiss drugmaker Roche Holding, was recommended by the World Health Organization (WHO) for the treatment of the A/H1N1 flu.

"The municipal government has gathered the most outstanding medical experts in the Chinese capital to develop the new medication," Zhao Jing, director of the Beijing Municipal Administration of Traditional Chinese Medicine, said at the press conference.

Over the past seven months, more than 120 medical specialists, led by academicians Wang Yongyan and Li Lianda from the Chinese Academy of Engineering, had participated in the research, she said.

The municipal government earmarked 10 million yuan (1.47 million U.S. dollars) for the project, she said.

"Medical experts proved the effectiveness of Jin Hua in treating A/H1N1 flu from both the basic scientific studies and clinical studies," she said.

The basic scientific studies lasted for almost five months and were conducted by experts from the China Academy of Chinese Medical Sciences, Chinese Academy of Medical Sciences and Beijing University of Technology.

"In vivo and in vitro, experiments on mice and rabbits show JinHua can bring down a fever and resist the A/H1N1 flu virus," said Huang Luqi, vice president of the China Academy of Chinese Medical Sciences.

Thursday's Beijing Daily hailed the new herbal medication as the "world's first traditional Chinese medicine to treat the A/H1N1 flu".

Citing medical officials, the paper said "Jin Hua" was picked from among more than 100 classic anti-flu prescriptions based on traditional Chinese herbal medicine.

"Science workers proved its effectiveness through medical experiments on more than 4,000 mice and clinical studies on 410 patients with slight A/H1N1 flu syndrome," it said.

The "Jin Hua" prescription had been adopted in many local traditional Chinese medicine hospitals, it said.

Zhao Jing said 11 hospitals nationwide, including Chaoyang Hospital and Ditan Hospital in Beijing, had conducted clinical studies on "Jin Hua" and gave positive assessments.

"We are applying for patents for 'Jin Hua' both at home and abroad," she said.

"We are further developing the medicine and trying to present it to the whole country and world as soon as possible, thus offering an alternative to treat the A/H1N1 flu," she said.

The Chinese mainland has reported almost 108,000 A/H1N1 flu cases, including 442 deaths, according to the Ministry of Health.

Dr. Cris Tunon, senior program management officer at the WHO Representative Office in China, said Thursday the "WHO welcomes the clinical results," as the traditional Chinese medicine offered a low-cost treatment of A/H1N1 flu.

 From this link

Again, what appears to be a wake-up call is issued! You will read below:

The poll, conducted in a national sample of Americans from Nov. 12-18, shows that about half of Americans are worried that they or their families will get sick if they travel by airplane this year.

The poll suggests the other half of us should worry, too.

This is quite alarming material and should persuade you to consider receiving the H1N1 vaccine if you can get it. Those who have followed my blogs on H1N1 know that it was a C2C program that made me think carefully, even though the guest was at odds in the issue with George Noory, a man who I truly respect. But on this matter, I had to agree with his guest Linda.

H1N1 Influenza A (Swine Flu) Alert Center

From WebMD Health News
CDC: 10,000 H1N1 Flu Deaths
from WebMD - a health information Web site for patients

Daniel J. DeNoon

December 10, 2009 - H1N1 influenza killed 10,000 Americans, sent 213,000 to the hospital, and sickened 50 million - a sixth of the population - by mid-November, the US Centers for Disease Control and Prevention (CDC) estimates.

The CDC's new estimates reflect a flood of new cases from mid-October to mid-November, as the current wave of the US flu pandemic was climbing to its peak. The numbers represent the middle of a range of estimates made using statistical calculations to correct for underreporting of cases, hospitalizations, and deaths.

"Sadly, there were nearly 10,000 deaths: 1,100 in children and 7,500 among young adults," CDC director Thomas R. Frieden, MD, MPH, said at a news conference. "That is much higher than we would see in a usual flu season. This is a flu that is much harder on young people and that has largely spared the elderly."

The new estimates suggest that about 15% of the population - 1 in 6 Americans - has had the H1N1 flu.

"That leaves most Americans not infected or vaccinated and still susceptible to H1N1 flu," Frieden said. "Even if there were a lot of infections without symptoms and adding in those who have been vaccinated, that still leaves a lot of people unprotected. Only time will tell what the future will hold - but the more people who get vaccinated, the lower the probability of a third wave of the pandemic."

The estimates suggest that there may have been as many as 13,930 deaths and 67 million flu cases from the beginning of the epidemic in April to November 14. Here's the CDC's breakdown according to age:
                               Mid-Level Range*         Estimated Range *
2009 Cases
0-17 years          ~16 million                12 million to ~23 million
18-64 years        ~27 million               19 million to ~38 million
> 65 years           ~4 million                    3 million to ~6 million
Cases Total         ~47 million              34 million to ~67 million

Hospitalizations
0-17 years            ~71,000                     51,000 to ~101,000
18-64 years         ~121,000                   87,000 to ~172,000
>65 years             ~21,000                      15,000 to ~29,000
Hospitalizations Total ~213,000    154,000 to ~303,000

 Deaths
0-17 years           ~1,090                          790 to ~1,550
18-64 years        ~7,450                      5,360 to ~10,570
>65 years            ~1,280                           920 to ~1,810

Deaths Total       ~9,820                      7,070 to ~13,930

H1N1 Flu Vaccination Widens

The US H1N1 flu vaccine supply continues to grow. The federal government has now shipped 85 million doses to states. Many states have begun offering the vaccine to anyone who wants it; others have expanded eligibility to include most residents.

One of those states is Georgia, where the CDC is based. Frieden said that all CDC personnel will now be asked to get the vaccine.

"I will get vaccinated using the nasal spray in next few days," Frieden said. Frieden turns 50 next year, and the intranasal vaccine is approved only for healthy people age 2 to 49 years.

American Indians, Alaskan Natives Hit Hard by H1N1 Flu

American Indians and Alaskan natives are four times more likely to die or be hospitalized if they get the H1N1 flu, the CDC reported today.

The report comes from 12 states representing about half of the US native population.

The four-fold risk of severe disease is similar to the increased risk seen among indigenous populations in other parts of the world.

It's not clear why native Americans are more susceptible to severe H1N1 flu. However, diabetes and asthma are more prevalent in this population than among all other racial and ethnic populations in the United States.

And American Indians and Alaskan natives suffer the highest poverty rate in the United States: 30%. This suggests that delayed access to medical care and poorer nutrition may contribute to flu susceptibility.

22% of Americans Would Travel if Sick with Flu

It's impossible to predict the future, but a new Harvard poll suggests that many Americans may be giving an unwanted holiday gift to their countrymen: the flu.

More than 1 in 5 Americans - 22% - say they would get on a plane, train, bus, or cruise ship even if they were sick with fever, cough, and sneezing.

That, of course, flies in the face of CDC recommendations, which call for people to stay home if they're sick.

The poll, conducted in a national sample of Americans from Nov. 12-18, shows that about half of Americans are worried that they or their families will get sick if they travel by airplane this year.

The poll suggests the other half of us should worry, too.

SOURCES:

CDC news conference with Thomas R. Frieden, MD, MPH, Director, Centers for Disease Control and Prevention, Dec. 10, 2009.

CDC web site, "CDC Estimates of 2009 H1N1 Influenza Cases, Hospitalizations and Deaths in the United States, April - November 14, 2009," Dec. 10, 2009.

Authors and Disclosures
Journalist
Daniel J. DeNoon

Daniel J. DeNoon is senior medical writer at WebMD.

Oseltamivir Efficacy Questioned in Preventing Influenza Complications

Fran Lowry

December 9, 2009 - An updated Cochrane review has called into question the efficacy of neuraminidase inhibitors, including the most commonly used oral agent oseltamivir (Tamiflu, Roche Laboratories Inc), in preventing influenza complications in healthy adults.

The results of the review, published online December 8 in the British Medical Journal, appear with other articles on oseltamivir that all come to the same conclusion: The evidence for the drug's efficacy in reducing complications in otherwise healthy individuals with pandemic influenza is now uncertain.

According to a statement by the BMJ, the results have led to a joint investigation into oseltamivir by BMJ and Channel 4 News, based in London, United Kingdom.

Tom Jefferson, MD, from the Acute Respiratory Infections Group, Cochrane Collaboration, Rome, Italy, and colleagues updated a 2005 Cochrane review published in the Cochrane Library.

The researchers selected 20 randomized, placebo-controlled studies of neuraminidase inhibitors in otherwise healthy adults exposed to naturally occurring influenza to determine duration and incidence of symptoms, incidence of lower respiratory tract infections or their proxies, and adverse events.

They focused on oseltamivir because of the greater experience with the drug worldwide.

Few Trials Judged Adequate Also Had Shortcomings

Of the trials, only 5 were judged adequate by usual Cochrane Collaboration methods, Dr. Jefferson and colleagues write. Most of the trials were at risk for bias resulting from poor descriptions of the methods, no description of losses to follow-up, and blinding.

The authors write that their attempts to deal with these shortcomings failed. Only 3 of the 5 lead authors of the studies on oseltamivir replied to their request for more information. Of these authors, none possessed original data.

Instead, these authors referred them to Roche, oseltamivir's manufacturer. However, the company did not provide the information "as quickly as we needed it to update this review," Dr. Jefferson and colleagues write.

From their analysis, the reviewers found that oseltamivir did not reduce influenza-related lower respiratory tract complications (risk ratio, 0.55; 95% confidence interval, 0.22 - 1.35).

They also found that oseltamivir induced nausea (odds ratio, 1.79; 95% confidence interval, 1.10 - 2.93), that the evidence of rarer adverse events from pharmacovigilance studies was of poor quality, and that adverse events may have been underreported.

"Neuraminidase inhibitors have modest effectiveness against the symptoms of influenza in otherwise healthy adults. The drugs are effective postexposure against laboratory confirmed influenza, but this is a small component of influenza-like illness, so for this outcome neuraminidase inhibitors are not effective," Dr. Jefferson and colleagues conclude.

Paucity of good data has undermined previous findings for oseltamivir's prevention of complications from influenza.

Oseltamivir may be regarded as optional for reducing the symptoms of seasonal influenza, they add. "Paucity of good data has undermined previous findings for oseltamivir's prevention of complications from influenza. Independent randomized trials to resolve these uncertainties are needed."

In a related article, Peter Doshi, a doctoral student at Massachusetts Institute of Technology in Cambridge, and a coauthor of the updated Cochrane review, writes that his team of reviewers had been trying to obtain data to verify claims that oseltamivir lowers serious complications of influenza since August 2009.

Evidence Is Fragmented, Inconsistent, Contradictory

"We failed, but in failing discovered that the public evidence base for this global public health drug is fragmented, inconsistent, and contradictory. We are no longer sure that oseltamivir offers a therapeutic and public health policy advantage over cheap, over the counter drugs such as aspirin," he writes.

Mr. Doshi writes that the review team's suspicions were aroused after a Japanese pediatrician, Keiji Hayashi, MD, pointed out that their previous review, which had found that oseltamivir was effective in reducing pneumonia and other important complications of influenza, was based on a single peer-reviewed study by Kaiser and colleagues.

It turns out that the Kaiser study, which was a meta-analysis of 10 manufacturer-funded trials, included just 2 studies that were published in peer-reviewed journals. When the Cochrane reviewers tried to verify the data from the 8 unpublished trials, they found inconsistencies in the evidence for oseltamivir's effectiveness and safety.

Roche funded the Kaiser meta-analysis.

Mr. Doshi said the Kaiser paper was dropped from their new analysis. "The previous Cochrane review placed its trust in publications and included Kaiser's unpublished data, but to do so once again, despite our inability to obtain data sufficient to perform an independent analysis, would have shifted our position from that of trust in publication to that of trust in secrecy."

He also called into question US Food and Drug Administration's safety reporting rules. Manufacturers must report adverse events, but only if they occur in the United States. "In the case of oseltamivir, considering that 75% of global consumption has occurred in Japan, this has important implications for our knowledge of its safety," Mr. Doshi writes.

Treatment With Oseltamivir Unlikely to be Clinically Important

Nick Freemantle, PhD, and Melanie Calvert, MD, from the University of Birmingham, United Kingdom, were invited by BMJ to review the observational studies provided to the Cochrane reviewers by Roche. They said that in general, the studies support the conclusion that oseltamivir may reduce the incidence of complications of influenza in otherwise healthy adults, but as such events are rare, treatment with oseltamivir for most people is not likely to be clinically important.

They had several criticisms of the studies and said the studies were difficult to interpret. "Differences in baseline comorbidity or geographical distribution were present in several studies. It seems likely that some patients were included in more than one study, which undermines the ability of these studies to provide independent estimates," the authors write.

"We have remarkably few resources in this country to spend on pharmaceuticals on health and it's surprising to see such widespread use of oseltamivir. But I suppose that once you've gone and bought lots of doses then it's a bit like the situation with gun control in the US. If you have a gun in the house it's much easier to use it. But it does not mean it's the right thing to do," Dr. Freemantle said in a statement to BMJ.

Review Calls Entire Process Into Question

Fiona Godlee, MD, Editor-in-Chief of BMJ, and Mike Clarke, MD, Director of the UK Cochrane Centre, say the updated review is important because it calls into question "not only the effectiveness of oseltamivir but the whole system by which drugs are evaluated, regulated and promoted."

In her editorial, Dr. Godlee writes that the claims of the efficacy of oseltamivir, based on an analysis of 10 drug company trials, have formed a key part of decisions to stockpile the drug and made it widely available.

It was only after questions from the BMJ and Channel 4 News that Roche agreed to make full study reports available on a password-protected site, she writes.

It can't be right that the public should have to rely on this sort of detective work by academics and journalists to patch together the evidence for such a widely prescribed drug.

"It can't be right that the public should have to rely on this sort of detective work by academics and journalists to patch together the evidence for such a widely prescribed drug. Individual patient data from all trials of drugs should be readily available for scientific scrutiny," Dr. Godlee concludes.

In its reply, Roche says it has provided full responses to all questions from the BMJ and Channel 4, which "should leave no doubt about the high integrity of the data, publications, and interactions between Roche and independent investigators."

All reports were written to the standards of the regulatory authorities of Europe, the United States, and Japan, and have been accepted by all for licensing purposes. Roche has "willingly shared data and reports with numerous other eligible individuals and groups," writes James Smith, MD, International Medical Leader, Tamiflu, for Roche.

He voices concern that the Cochrane review team "chose to follow-up their inquiries through a television company rather than by approaching the manufacturer directly...it is unclear to us why Dr. Jefferson would adopt this approach, particularly given that he was a paid ad hoc consultant to Roche working on flu and oseltamivir between 1997 and 1999. During that period he worked closely with Roche experts, many of whom are still in the company, and he would therefore not have had difficulty in contacting them directly to discuss his requirements."

Dr. Smith ends by stating: "Why Dr. Jefferson and the BMJ chose to pursue their scientific enquiries through commercial television remains to be clarified."

Dr. Jefferson has reported he has received support from the UK National Institute for Health Research and the Australian National Health and Medical Research Council and that he was a paid ad hoc consultant to Roche from 1997 to 1999. Peter Doshi has reported he has no relevant financial relationships. Dr. Nick Freemantle and Dr. Melanie Calvert have reported that the BMJ helped them access 3 articles not available through their university library and that they supervise a PhD student who is supported and employed by Roche. Dr. Godlee has reported that she has published a number of articles critical of the drug industry and supports the idea that drugs should be evaluated by independent third parties rather than directly or indirectly by the drug's producers. As editor of the BMJ, she is a member of the International Committee of Medical Journal Editors and reports that the BMJ Group receives a proportion of its revenue from drug company advertising and sponsorship. Dr. Mike Clarke has reported that he is active in the Cochrane Collaboration and has a fixed-term contract with the National Institute for Health Research. Dr. Smith is international medical leader, Tamiflu, F Hofmann-La Roche.

BMJ. Published online December 8, 2009.

Aos, this link may interest you: H1N1 Influenza A (Swine Flu)Alert center

Aloha!

Check this Out

Erlier, I posted information about how neurons of the hippocampus interact with cortical neurons during sleep to strengthen memory. For the past 8 years, I have been experimenting with nightly us of an iPOD (then the iTuch and now the great Droid), listening not to music, but to audio books from topic in astronomy, to C2C, consciusness, physics and more!

 But look, it may be working: Brain listens, learns while we sleep

 "We are beginning to see that deep sleep actually is a key time for memory processing," Paller says. "Our little experiment opens the door to many questions." For example, would high-school students do better on SAT tests if daytime studying was supplemented with sleep sounds at night? Would students learning foreign vocabulary words or other facts do better in the morning after listening to related information as they slept?"

First Orthopaedic Surgeon in Space to Use His Medical Skills on Mission

by Kathleen Louden

November 19, 2009 (Chicago, Illinois) - Robert "Bobby" L. Satcher Jr, MD, PhD, made history on Tuesday when he lifted off in the space shuttle Atlantis, headed to the International Space Station. Dr. Satcher, who completed his first space walk today, will be the first orthopaedic surgeon to orbit the earth and is one of only 23 US physicians who have become astronauts.
Dr. Robert L. Satcher Jr (photo courtesy of NASA)

A musculoskeletal oncology surgeon who has been in astronaut training with the National Aeronautics and Space Administration (NASA) for 5 years, Dr. Satcher is serving as the flight crew medical officer and as a mission specialist on the 11-day assignment. On 2 space walks (known as "extravehicular activity" in space jargon), he will install an oxygen tank in the space station and perform maintenance work on the station's robotic arms, which he will get to maneuver.

"Operating the robotic arms is similar to performing arthroscopic surgery in many ways," Dr. Satcher said in a preflight interview with AAOS Now, a publication of the American Academy of Orthopaedic Surgeons. "Many of the skills an astronaut needs are the same skills surgeons need."

AAOS President Joseph Zuckerman, MD, agrees. In an interview with Medscape Orthopaedics, Dr. Zuckerman said, "Much of what we do as orthopaedic surgeons is mechanical in nature, such as installing screws and plates. So this [space mission] is a good use of Dr. Satcher's skills."

Still, very few physicians have done the type of work that Dr. Satcher will be doing 250 statute miles from the Earth.

"The fact that he was chosen for this mission is special," said Dr. Zuckerman, professor and chairman of orthopaedic surgery at New York University School of Medicine.

"Logical Choice" for Astronaut

Dr. Satcher "is the logical choice for this work," his former boss, Michael Schafer, MD, told Medscape Orthopaedics. Dr. Schafer is a professor and chairman of the Department of Orthopaedic Surgery at Northwestern University Feinberg School of Medicine in Chicago, Illinois, where Dr. Satcher was an assistant professor before going on leave.

When Dr. Schafer recruited him to Northwestern, the surgeon already had an impressive curriculum vita: an MD from Harvard University, a PhD in chemical engineering from Massachusetts Institute of Technology, and orthopaedic surgery residency training at the University of California-San Francisco, followed by fellowships in research and musculoskeletal oncology. At Northwestern, Dr. Satcher built a musculoskeletal oncology program "from ground zero," Dr. Schafer said.

In 2004, Dr. Satcher was in the clinic seeing a patient when he received the acceptance call from NASA that would transform him from a bone cancer specialist into an astronaut, reportedly his long-time dream. "The excitement was pretty intense," Dr. Schafer recalled.

That phone call came 4 years after Dr. Satcher first applied to the program - a delay caused by the interruption in training classes after the space shuttle Columbia disaster in 2003, he told a NASA reporter.

Despite the risks, he won the support of his family, and they moved to Houston, Texas, to be near the Lyndon B. Johnson Space Center. At this time, he also holds a position as clinical assistant professor at the University of Texas MD Anderson Cancer Center in Houston.

At Northwestern, Dr. Satcher had an active research program, and in 2002 he won the Orthopaedic Research and Education Foundation/Zimmer Career Development Award to study how bone responds to stresses. He will be able to satisfy his interest in this area as a proxy scientist aboard the Atlantis. Experiments he will perform include measuring vertebral disk height to see whether it changes in a microgravity environment, which could explain why astronauts become taller in outer space, he said in the AAOS Now interview.

Such research may help the orthopaedics field. Said Dr. Zuckerman, "The more we learn about how weightlessness affects the spine, the more we will learn how we can reduce the loss of bone mass that occurs with lack of weight-bearing exercise."

A Tweet From Space

Dr. Satcher is using the microblogging Web site Twitter to discuss medical issues for space exploration (www.twitter.com/ZeroG_MD) and his personal experience (www.twitter.com/Astro_Bones). In his first postdeparture tweet yesterday, he reported that he had no motion sickness and had slept well.

The grandson of Alabama sharecroppers who stressed the importance of an education for creating opportunities, Dr. Satcher appears to be using his education and experience well. As he told the NASA reporter, "Literally the sky's the limit."

The thing with Swine flu is that it can turn deadly.

The case of a 23-y.0. girl in California became ill with fever, temp and chest x-ray showed a "minor shadow," and was felt to represent a "mild pneumonia." initial H1N1 testing was negative. The next day, the patient was much worse, the chest x-ray showed a large part of the lung was now white on x-ray. The "mild case" was suddenly severe pneumonia. A lung biopsy confirmed H1N1. The patient died five days later . . . (10 days from the onset of symptoms).

 So, this is the thought on when to take antiviral medications, as of 12 days ago.

From Medscape Neurology

 New Guidelines on H1N1 Influenza Urge Quicker Use of Antivirals

Robert Lowes

November 12, 2009 - Updated treatment guidelines for H1N1 influenza from the World Health Organization (WHO) urge clinicians to administer antiviral medications as soon as possible to patients in at-risk groups with flu symptoms, patients with pneumonia, and those with uncomplicated influenza-like illness that worsens or fails to improve within 72 hours.

The reason for immediate antiviral therapy is that a mild case of H1N1 influenza can morph into a deadly disease such as pneumonia within 24 hours, according to the revised guidelines released Tuesday.

"The virus can take a life within a week," Nikki Shindo, MD, a medical officer in WHO's Global Influenza Programme, said during a press conference today. "The week of opportunity is very narrow in regard to the progression of the disease. The medicine needs to be administered before the virus destroys the lungs."

Patients in at-risk groups who should receive antivirals once they experience flu symptoms include pregnant women, children younger than 2 years, and individuals with chronic illnesses such as respiratory problems, according to Dr. Shindo.

Dr. Shindo said that earlier WHO guidelines focused on treating severe disease stemming from the H1N1 virus. The updated guidelines, she explained, have more to say about preventing severe disease, especially with the use of antiviral medications. Initial guidance about antivirals had been more conservative because WHO "had almost no experience" in regard to their effectiveness and because supplies were limited, said Dr. Shindo. Now, WHO has more data about the safety and usefulness of the medicine, and supplies are more ample.

The updated guidelines state that clinicians should not delay antiviral treatment for patients with suspected H1N1 influenza for the sake of conducting tests to confirm the diagnosis. In addition, a negative result from some rapid influenza diagnostic tests should not justify withholding antiviral therapy because these tests "miss many infections with pandemic H1N1 virus."

The first-line antiviral for treating the H1N1 virus is oseltamivir (Tamiflu), according to WHO. If oseltamivir is not available, it is not possible to administer it to a particular patient, or if the virus is resistant to oseltamivir, the guidelines recommend that clinicians use zanamivir (Relenza), which is inhaled.

To ensure easier access to treatment, public health authorities should distribute antivirals through general practitioners and not primarily through hospitals, said Dr. Shindo. "Patients should not have to visit the hospital to get antivirals prescribed," she said. "This should help ensure that individuals get the care they need faster. This will leave hospitals freer to treat the more severe cases."

Although Dr. Shindo emphasized the need for the earlier use of antivirals, she said that people not in the at-risk groups who are experiencing only mild flu symptoms do not need to take antiviral therapy. Nor should healthy individuals take it as a preventive measure.

WHO Guidelines Do Not Conflict With CDC Directives

The updated WHO guidelines specify watchful waiting for 72 hours for patients who have uncomplicated influenza-like illness and who do not have an underlying medical condition that puts them at risk. Hallmarks of progressive illness that warrant antiviral therapy include:

* Shortness of breath, hypoxia, and fast or labored breathing in children, which would suggest oxygen impairment or cardiopulmonary insufficiency.
* Altered mental status, unconsciousness, drowsiness, and seizures, which suggest central nervous system complications.
* Evidence of sustained virus replication or invasive secondary bacterial infection.
* Severe dehydration, expressed as decreased activity, dizziness, decreased urine output, and lethargy.

By necessity, this recommendation for follow-up requires patient education, Dr. Shindo said. Clinicians should instruct patients who initially present with uncomplicated influenza-like illness to return for another visit if they develop these or other symptoms of progressive illness - or do not get better - within 72 hours from the onset of symptoms, according to WHO.

The Centers for Disease Control and Prevention (CDC) have not issued any guidance on follow-up care for influenza patients that stipulates a 72-hour time frame, but the agency does advise patients who do not improve within a few days that they might have a complication like a secondary infection, said Anthony Fiore, MD, a medical epidemiologist with the CDC's National Center for Immunization and Respiratory Diseases.

"I do not see the WHO recommendations as being in conflict [with the CDC directives]," Dr. Fiore told Medscape Infectious Diseases. CDC recommendations on administering antiviral medications are revised on average every 4 to 6 weeks, said Dr. Fiore. "We will look at the WHO guidance and the evidence base used to develop the guidance as part of [our] revision."

The updated treatment guidelines are available on the WHO Web site.

CDC Update

At a CDC press briefing today, Anne Schuchat, MD, director of the CDC's National Center for Immunization and Respiratory Diseases, provided an updated estimate of H1N1 cases using data extrapolated from the CDC's Emerging Infections Program .

The CDC estimates that during the first 6 months of the pandemic (April through October 17, 2009), a total of 22 million people (range, 14 - 34 million) in the United States became infected with H1N1 influenza. Of these, 98,000 people (range, 63,000 to 153,000) were hospitalized; and 3900 (range, 2500 - 6100) died.

The data are also broken down by age group and highlight that fact that numbers of cases, hospitalizations, and deaths are disproportionately higher in people aged 64 years and younger than in older individuals.

These numbers will be updated every 3 to 4 weeks, she said.

Dr. Schuchat also discussed the effect of H1N1 influenza in patients with diabetes, which afflicts about 19% of adults hospitalized for H1N1. According to Dr. Schuchat, people with diabetes should be vaccinated (with the injectable vaccine not the nasal spray) against H1N1. People with diabetes who also have respiratory illness should receive antiviral therapy, which should be initiated prior to availability of test results. Patients with diabetes should also ensure that they have been vaccinated against pneumococcal infections.

To date, 41.6 million doses of H1N1 vaccine have become available. "This is more than we had before but not as much as we had hoped to have by today," Dr. Schuchat said. Currently, 94 million doses of seasonal influenza vaccine have been distributed, with 114 million doses total expected by the end of the year.

NB:Robert Lowes

Freelance writer, St. Louis, Missouri

Disclosure: Robert L. Lowes has disclosed no relevant financial relationships.