Shorts. . .briefed by Jule Klotter

Tuberculosis Research

Tuberculosis kills more people than any other infectious discase. One third of the world's population is carrying the opportunistic tuberculosis bacillus; about 10% of these people will develop clinical TB. AIDS and the rising incidence of drug use, which weakens the immune system, are being blamed for the unexpected increase of TB in the US. In addition, malnutrition and crowded conditions encourage its spread among the homeless, prison population, and inhabitants of inner cities. "The World Health Organization estimates that new cases will have increased from 7.5 million per year in 1990 to 10.2 million by the year 2000."

Because few research laboratories had expertise with TB, US public health officials asked the Laboratory Research Branch (LRB) of G.W. Long Hansen's Disease Center (Carville, Louisiana) to begin research on the disease when TB cases suddenly increased. Although the two diseases are very different, Hansen's disease (leprosy) and tuberculosis are caused by related bacteria: Mycobacterium leprae and Mycobacterium tuberculosis. LRB tested seven drugs in two and three drug combinations for effectiveness. It has also screened thousands of synthetic and natural compounds for anti-TB activity.

Their research is important because new strains of M. tuberculosis have developed. Patients treated with the wrong drugs and those who do not complete the full six-month treatment regimen can develop drug-resistant strains of the bacteria. Not only do these patients continue to suffer from TB, they also spread drug-resistant organisms to others, organisms that do not respond to current drug combinations.

"Tuberculosis Research in the Laboratory Research Branch" by James L. Krahenbuhl, PhD. The Star September 1996. The Star is published quarterly by patients of the Gillis W. Long Hansen's Disease Center, P.O. Box 325, Point Clair Br., Carville, Louisiana 70721.

The MCS Simon Study

A few years ago, the Simon Study on multiple chemical sensitivities reported no immunological difference between MCS patients and its controls. This finding supported the hypothesis that MCS is a psychologic disorder, not an immunologic one. Half of the study's funding came from a major aerospace company; that does not automatically make the findings suspect. What does compromise the study's conclusion is a piece of information that one of the study's authors stated at a public forum: "reliability on most of [the lab's] measures is no better than chance." The researchers had sent pair-blinded specimens from 10 subjects to the lab used for the study. There was no "statistically significant" relationship between specimens from the same person. This vital bit of information was not included in the study itself.

MCS Referral & Resources, a patient advocacy group, complained to the federal Office of Research Integrity (ORI) that the Simon Study's authors "knowingly failed to disclose all data relevant to their findings, i.e. the pair-blinded immunologic tests." At least two University of Washington faculty members who reviewed the case recommended a full investigation, but the final review committee decided not to investigate further. Even before its publication, the Simon Study was being cited in depositions by the aerospace company's lawyers.

What sets the Simon Study apart from other weak studies that have been used to support powers-that-be: is the reaction to MCS Referral & Resources' complaint. Several publications, including the New England Journal of Medicine, New York Times, Regulatory Toxicology and Pharmacology and the Seattle PI, contained articles calling for "more protection for scientists who make discoveries that threaten Ôvested interests.'" The vested interests to which the articles referred included the tobacco industry, lead industries, pharmaceutical companies, and patient advocacy groups; the complaint filed by MCS Referral & Resources was given as a specific example. If a scientist reports a discovery that (s)he knows is based on inaccurate data - "reliability...no better than chance" - who needs protection from whom?

"Simon Study Continues...." New Perspectives Spring 1997. New Perspectives provides Washington MCS support and information. Its address is P.O. Box 532, Carlsborg, Washington 98324.

Stress-Relieving Therapies & Health Costs

Insurance companies, HMOs, the NIH, and businesses are finding ways to incorporate mind-body strategies to reduce stress and improve health. Regular use of yoga, meditation, relaxation techniques, biofeedback, and other similar practices have fostered improvements in several conditions, including arthritis, cardiac arrhythmias, hypertension, insomnia, pain, and nausea and vomiting associated with chemotherapy. Dean Ornish's heart disease program, proven to reduce coronary artery blockage and the need for surgery, relies on a low-fat vegetarian diet and mind-body therapies: yoga, meditation, and group support. Studies have found that health care costs drop an average of 33% among people who regularly practice stress-relieving techniques or who take part in a support group. The evidence has convinced Norman Anderson, PhD, associate director of the NIH and director of its Office of Behavioral and Social Sciences Research, to set up a committee that will decide how to integrate mind-body therapies into regular medical care.

Some insurers and HMOs are already integrating behavioral strategies to lower medical costs. In addition to offering some of the stress-reducing techniques already mentioned, several health plans are promoting health education. Kaiser Permanente (Southern California), for example, started an education program for parents. By improving their understanding of fever and how to cope with it, Kaiser experienced fewer office visits for childhood fevers.

One company, Texas Instruments (TI), is seeking ways to modify the work environment so that its employees have less need for stress-reducing techniques in the first place. Many studies have shown that high-demand, low-control jobs cause stress, stress that damages health and reduces productivity. A committee is looking at how the TI physical work environment and job design aids or hampers well-being. Its observations on the correlation between stress reduction, wellness, and sustainable job performance may encourage other businesses to take an active role in the prevention of ill-health.

"The mind, the body and the benefits budget" by Jan Ziegler. Business & Health, February 1997.

Integrating Holistic Principles

Slowly but surely, complementary and alternative medicine (CAM) is being integrated into the health care insurance programs. Some proponents of alternative medicine worry, however, that holistic principles will be distorted or discarded as CAM practices become part of a reimbursement system that focuses solely on the diagnosis and repair of physiological dysfunctions. Insurance forms require a designated code for a specific complaint and another code for its treatment. They ignore the complex and individual interactions of a patient's mind-body-soul. Healers - whether they use conventional or unconventional treatments - find themselves hog-tied by the impersonal nature of the current reimbursement system.

In his article "Reinventing Primary Care," Elliott S. Dacher, MD, suggests that, rather than let the insurance system strip CAM of its holistic principles and reduce it - as conventional medicine has been reduced - to a mechanical, prescribed treatment of disease, primary care practitioners can shift the focus from diseased conditions back to the art of medicine. The art of medicine balances the reductive and holistic perspectives. It is based upon the quality and character of the caring relationship that a practitioner has with him/herself, with his/her patients, and with his/her community. Dacher says that the essential component of a healing relationship is empathic listening, during which one seeks to fully and non-judgmentally understand another's experience. Empathic listening cannot occur unless one silences his/her own inner dialog and personal perspectives. Dacher also suggests that practitioners seek an expanded biographical history for each patient, one that includes the biological, psychological, social, and spiritual. Such a history prevents primary care practitioners from reducing the people who come to them to mere physical complaints and honors the humanity of both parties.

"As healers again begin to approach their clients and the healing process using both intellectual, sensory-based knowledge, and empathic, intuitive knowledge," writes Dacher, "the practice of medicine will be revitalized.

"...The art will return to medicine. And what exactly is this art of medicine? It is the creative capacity to enter into the experience of another human being, understand from the client's perspective the nature of that life and its forces (by empathic listening) and participate with this individual in composing a healthy life, involving recovery, healing, and health - the fully lived life."

"Reinventing Primary Care" by Elliott S. Dacher, MD. Alternative Therapies in Health and Medicine November 1995. For subscription information, call 800-345-8112.

Kaiser's Grievance Procedure in Action

A case in California illustrates the drawback of relying upon health maintenance organizations (HMOs) to address the grievances of clients who have complaints about their care. When Wilfredo Engalla joined Kaiser Permanente of California in 1980, he had to sign a contract agreeing to submit any medical malpractice claim to binding arbitration instead of filing a lawsuit. Arbitration is supposed to be less expensive and quicker than a court trial. According to the Kaiser Service Agreement, the opposing parties argue their case before a panel of three experts and submit to the panel's decision. One expert is chosen by Kaiser, one by the member, and a third neutral party is selected by the two chosen experts.

In 1986, Engalla was troubled by a constant cough and shortness of breath. A 1986 lung X-ray revealed abnormality, but no diagnostic tests for lung cancer were given. Over the next five years, the Kaiser diagnosis was that Engalla suffered from allergies and common colds. A new set of X-rays taken in 1991 showed that Engalla had inoperable lung cancer. Believing that the Kaiser physicians had been negligent in failing to diagnose the cancer sooner, Engalla and his family asked for arbitration of their grievance.

According to the service agreement, the first two experts were to be chosen within 30 days; and, they in turn were to select the third expert within another 30 days. Kaiser's outside attorney did not name an expert until 47 days after Engalla's lawyer had filed for arbitration on May 31, 1991. In mid-August, the Engalla family learned that Kaiser's expert would not be available until late November. Engalla's death was expected long before then. Under California law, the complainant could receive up to $500,000 for non-economic damages - if (s)he were alive. Upon the complainant's death, the limit drops to $250,000. When, after repeated requests from Engalla's counsel, Kaiser finally selected an alternate, Kaiser continued to stall by ordering its appointed arbitrator to reject neutral arbitrators proposed by the other side. It took 144 days, not 60 days, before all the arbitrators were selected. On the 145th day after his claim for arbitration had been filed, Engalla died.

Despite a request from Engalla's counsel to ignore the $250,000 award limit, Kaiser was determined to take advantage of its delay tactics; so, the Engalla family took their case to court. The court ruled that the Engalla family's charge that Kaiser had committed fraud had enough merit to be decided by court trial. Court records showed that it took an average of 674 days for a neutral expert to be named in Kaiser arbitration cases between 1984 and 1986 - well beyond the 60 days put forth in Kaiser's Service Agreement. If the court finds Kaiser guilty of fraud, the Engallas will not be bound by the service agreement. Their medical malpractice claim will be resolved by yet another trial instead of through Kaiser's arbitration system.

"HMO's Arbitration Process Provides Delay, Not Justice" Public Citizen Health Research Group Health Letter September 1997 (no address available)

Removing Amalgam Fillings

The American Dental Association refuses to admit that mercury amalgam fillings can affect health even though scientists have known for decades that mercury harms the immune system, reproductive system, central nervous system, kidneys, and beneficial mouth and colon bacteria. Dentists who advocate removing mercury amalgams risk censure and delicensure for promoting a costly procedure that, critics say, has no scientific basis.

In a recent study published in the Journal of Orthomolecular Medicine, proper amalgam removal reduced or eliminated 80% of the symptoms associated with chronic mercury poisoning in 118 patients. Before the fillings were removed, a survey listing 38 symptoms revealed that 83% of the patients experienced fatigue, 76% poor concentration, 65% poor memory, 64% irritability, 62% muscle fatigue, and 61% metallic taste. In addition, over half of the patients complained of bloating, headache, joint pain, throat pain, allergies, and poor appetite. Before amalgam removal, researchers tested each patient's serum globulin reaction to 34 different metals and dental materials so that replacement fillings would be biocompatible with each individual.

Filling removal followed the protocol recommended by Hal Huggins, DDS (Colorado Springs, Colorado). The protocol includes the use of antioxidants, vitamins, minerals, and dietary guidelines to support the immune system and the use of proper ventilation and oral suction to lessen contamination from the mercury and mercury vapor during its removal. One to four years after mercury (and, in some cases, other metal) fillings were removed, the subjects were given the same list of 38 symptoms and asked to indicate whether their complaints had improved, disappeared, or remained unchanged: 48% of symptoms were reduced, 31% were eliminated, and 21% were unchanged. Patients whose blood serum test showed a strong globulin reaction to amalgam metals "did not recover as favorably as those with mild reactions."

"Symptoms Before and After Proper Amalgam Removal in Relation to Serum-Globulin Reaction to Metals" by H. Lichtenberg, DDS. Journal of Orthomolecular Medicine Fourth Quarter 1996. Phone 416-733-2117; Fax 416-733-2352.

Schizophrenia and Omega 3

An excerpt from Leo Galland, MD's book The Four Pillars of Healing (Random House), reprinted in the newsletter Health Perspectives, recounts the case of a 16 year-old patient who had been diagnosed as paranoid schizophrenic two years before. Catherine was deeply troubled and frightened by voices that told her to kill schoolmates. When Galland first met her, she was taking Thorazine, a tranquilizer, to help control symptoms. On physical examination, Galland noticed that "[h]er skin had the texture of rough sand, visibly peeling, from her arms and legs; her hair had the texture of a rusty Brillo. She was about the driest teenager I had ever seen!."

That dryness made him wonder if Catherine had an omega-three essential fatty acid deficiency, which can cause abnormalities in the development and function of the nervous system. According to Galland, a small Nigerian study indicated that some people with schizophrenia metabolized omega-3 EFAs very slowly and seemed more prone to EFA deficiency. Also, Dr. Donald Rudin reported several cases of schizophrenia that responded to flax oil while performing research at the Pennsylvania Psychiatric Institute during the 1970s. Flaxseed oil and fish oil contain high concentratians of omega-3 EFAs.

Galland asked Catherine to take 3 tablespoons of flaxseed oil each day, along with a multivitamin. He recommended the multivitamin-mineral supplement because the body needs certain vitamins and minerals - especially E, C, A, B3 (niacin), selenium, zinc, and manganese - in order to use EFAs. When Galland saw Catherine one month later, he noticed that her skin and hair were less dry and that her behavior had changed. Instead of being withdrawn, Catherine smiled, made eye contact, and had opinions. She asked to stop taking Thorazine since the voices had disappeared. At her next month's appointment, Catherine's skin and hair appeared normal. "[S]he was attending school every day, doing well in her class work, engaging in sports, and visiting friends with whom she hadn't spoken for two years." She was no longer taking Thorazine. Galland recommended that she reduce her intake of flax oil to one tablespoon per day. Catherine and her parents believed that she was cured. Telephone follow-up by Galland over the next two years confirmed that "she had no further problems."

"Flaxseed Oil: Pillar of Health" by Leo Galland, MD. Health Perspectives Sept/Oct 1997. Health Perspectives, 315 S. Coast Hwy. 101, Suite U6, Encinitas, California 92024. Phone 800-200-9931.

Yeasts & Mental Illness

In an interview for the newsletter Mastering Food Allergies, Richard G. Jaeckle, MD discusses the role of yeasts in causing mental disturbances. "[E]very psychiatrist has probably treated patients whose schizophrenia, psychosis, and/or depression just wouldn't respond no matter how many potent psychotrophic drugs they tried," says Jaeckle. "This is the patient population I think we're finally able to help: I'm suggesting that we achieve mood improvement, improved self-control when necessary, and so on, by vigorously and aggressively addressing those patients' yeast infections."

Jaeckle relates the case of a periodically violent, 12 year-old girl who did not respond to anti-psychotic drugs. When the girl's symptoms cleared up for 24 hours after receiving Milk of Magnesia to clear her gut, Jaeckle focused on gastrointestinal allergies. Because psychotic symptoms flared up even with rotated single-food meals, Jaeckle convinced her to take gastrocrom, a medication that blocks the release of histamine. Gastrocrom enabled her to eat foods without reacting to them. Jaeckle used provocative neutralization to treat her food allergies; but, although she improved, symptoms continued to persist. Then, Jaeckle tested the girl for antigens of the body yeasts Tricophyton, Monilia, and Epidermophyton. Within minutes she became uncontrollable; it took two injections of benedryl to stop the reaction. Jaeckle gave her regular T-E antigen injections for several months along with nystatin, supplements of lactobacillus acidophilus, vitamin C, magnesium citrate, and diet suggestions used to treat candida. As long as this treatment continued, she displayed no symptoms and behaved normally. After several months, her platelet neurotransmitter levels, which reflects brain activity, had normalized.

Because of the link between body and mind, the biologic and the psychiatric, Jaeckle does thorough physicals on new psychiatric patients. He takes time to ask questions and look for signs of physical illness that may be linked to the patient's mental symptoms. Elevated white blood count, uric acid and CPK enzymes in patients' lab work may indicate yeast-induced psychosis, but not all patients reacting to yeast will be suffering from an overgrowth large enough to show up in lab tests.

"Yeast-Related Mental Disturbances: An interview with Richard G. Jaeckle, MD." Mastering Food Allergies January-February 1995. Mast Enterprises, Inc. 2615 N. Fourth St. #616, Coeur d'Alene, Idaho 83814.


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