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The overall economy added 243,000 jobs last month — with the health-care sector continuing to show strength — while the unemployment rate fell to 8.3%.

As the WSJ reports, that’s the lowest the jobless rate has been since Feb. 2009. (Here’s the full report from the Bureau of Labor Statistics.)

The health-care industry added 30,900 jobs in January, following a revised increase of 17,600 jobs the previous month. (Originally the government reported a larger December gain of 22,600 jobs in the sector, as we reported.)

Data from the BLS gives a snapshot of job growth by facility rather than job function. For example, the report shows that hospitals added 12,700 jobs, but doesn’t say whether those were nursing, IT or cafeteria positions.

Ambulatory health-care services added 12,900 jobs as doctors’ offices, outpatient care centers and home-health services all saw growth.

Nursing-care facilities added 2,700 jobs, while the broader category of nursing and residential-care facilities overall gained 5,300 jobs in January.

Image: iStockphoto

A Komen fundraising race from the fall.

It hasn’t been a great week for Susan G. Komen for the Cure, the breast-cancer advocacy group known for its pink-ribbon fundraising efforts.

Today the group reversed a decision — made public only Tuesday — to end Planned Parenthood’s eligibility for grants. Critics had said Komen planned to cut funding to the group for breast exams and education under pressure from anti-abortion organizations; Komen denied that.

In a statement, Komen’s board and its founder and CEO, Nancy Brinker, apologized “to the American public for recent decisions that cast doubt upon our commitment to our mission of saving women’s lives.” The statement continues:

The events of this week have been deeply unsettling for our supporters, partners and friends and all of us at Susan G. Komen.  We have been distressed at the presumption that the changes made to our funding criteria were done for political reasons or to specifically penalize Planned Parenthood.  They were not.

Komen’s short-lived move to defund Planned Parenthood spurred controversy, to put it mildly. Komen’s public rationale for its action changed over the week: A spokeswoman originally told the Associated Press it had changed its criteria to end grants to any organization under government investigation. But later in the week it said the decision sprang from a broader review of its criteria for grantees.

Today it said it would “amend the criteria to make clear that disqualifying investigations must be criminal and conclusive in nature and not political. That is what is right and fair.”

Planned Parenthood is the subject of a congressional investigation.

Komen’s statement continues:

Our only goal for our granting process is to support women and families in the fight against breast cancer.  Amending our criteria will ensure that politics has no place in our grant process.  We will continue to fund existing grants, including those of Planned Parenthood, and preserve their eligibility to apply for future grants, while maintaining the ability of our affiliates to make funding decisions that meet the needs of their communities.

It is our hope and we believe it is time for everyone involved to pause, slow down and reflect on how grants can most effectively and directly be administered without controversies that hurt the cause of women.  We urge everyone who has participated in this conversation across the country over the last few days to help us move past this issue.  We do not want our mission marred or affected by politics  — anyone’s politics.

Starting this afternoon, we will have calls with our network and key supporters to refocus our attention on our mission and get back to doing our work.  We ask for the public’s understanding and patience as we gather our Komen affiliates from around the country to determine how to move forward in the best interests of the women and people we serve.

We extend our deepest thanks for the outpouring of support we have received from so many in the past few days and we sincerely hope that these changes will be welcomed by those who have expressed their concern.

Planned Parenthood, in a statement, said it is “enormously grateful that the Komen Foundation has clarified its grantmaking criteria, and we look forward to continuing our partnership with Komen partners, leaders and volunteers.  What these past few days have demonstrated is the deep resolve all Americans share in the fight against cancer, and we honor those who are at the helm of this battle.”

So, readers, have the week’s events changed your opinion of Susan G. Komen for the Cure?

Photo: Associated Press

Medical Device Price Gap: A report from the Government Accountability Office finds that some hospitals pay thousands of dollars more than others for the very same medical device, the WSJ reports. The higher prices could affect Medicare spending, since payments to hospitals are in part based on the institutions’ costs, the paper says.

New Malaria-Death Estimate: A new calculation of malaria deaths published in the Lancet is about two times as big as the World Health Organization’s current estimate, the Washington Post reports. The report, which is expected to be controversial, agrees with the WHO that malaria deaths peaked in 2004 and are now on the decline. The two estimates diverge most widely when it comes to deaths in Africans aged five and older.

Nonprofit Controversy Continues: New York City Mayor Michael Bloomberg personally pledged $250,000 in matching funds to Planned Parenthood to make up for monies that will be lost when Susan G. Komen for the Cure stops most grants to the women’s health nonprofit’s affiliates for breast exams and education, the WSJ reports. Both groups say donations are up since Komen’s decision — which it says was prompted by several changes to its standards for grants — was made public earlier this week.

Supplement Ingredient Scrutinized: Dietary supplements containing an ingredient called DMAA are the subject of a safety review by the U.S. Army and have been removed from stores on military bases following the heart-attack deaths of two soldiers during workouts, the New York Times reports. Toxicology reports say DMAA was present in the soldiers when they died, but whether it played a role in the deaths isn’t yet known. Supplement makers and retailer GNC say products containing DMAA are safe, while other experts claim it should be classified as a drug rather than a supplement.

Image: iStockphoto

There are many mysteries when it comes to understanding Alzheimer’s disease, with one of the biggest questions centering on how the memory-robbing disease progresses.

Decades ago, researchers discovered that the damage starts in the same part of the brain in all patients and systematically moves on to affect nearby regions. It wasn’t clear, however, why this progression occurred. One intriguing theory was that the pathology “spreads” between neurons. But for years there wasn’t a good way of testing the hypothesis.

Now, two new studies conducted in mice, one published in PLoS ONE and the other in press at Neuron, offer evidence that the damage –  specifically the misfolding of a protein called tau –  is likely passed from one neuron to another.

The exact mechanism isn’t clear, but the researchers believe that somehow a flawed “template” for how tau should be folded gets released by one neuron and picked up by the next one, which then starts misfolding tau based on that new template, says Bradley Hyman, a Harvard neurology professor who is an author of the upcoming Neuron study.

Now, researchers can start figuring out how the errant message gets transmitted and picked up. Interrupting any step of this process could “plausibly” interrupt the progression of the disease, Hyman tells the Health Blog.

The papers have garnered a lot of interest. But some experts urge caution in interpreting the results.

The research “proposes a certain mechanism for tau spreading but that mechanism is unproven at this point,” William Thies, chief medical and scientific officer of the Alzheimer’s Association, tells the Health Blog.

“There’s a lot of work that needs to be done to clarify whether this is real” as well as how the findings could be used to inform therapy, says Thies.

Image: iStockphoto

Tobacco, alcohol … and sugar?

A new commentary published in Nature argues that just as the first two substances are regulated in various ways by government authorities, so should be sugar. While acknowledging that food, unlike alcohol and tobacco, is required for survival, the authors say taxes, zoning ordinances and even age limits for purchasing certain sugar-laden products are all appropriate remedies for what they see as a not-so-sweet problem.

The authors of the piece, Robert Lustig, Laura Schmidt and Claire Brindis, are all from the University of California, San Francisco. Lustig has been a particularly harsh (and longtime) critic of the impact of added sugars on health — here’s his widely viewed 2009 lecture on that topic. (Lustig was also a central character in a New York Times magazine piece on this subject last year.)

Note that they are talking about sugar added to foods. No one is arguing that we should spurn fruit, for example, because of the naturally occurring fructose.

“We believe attention should be turned to ‘added sugar,’ defined as any sweetener containing the molecule fructose that is added to food in processing,” the authors write. (And they argue the current dietary “bogeymen” — saturated fat and salt — deserve less scrutiny than the sweet white stuff.)

They’re talking about foods sweetened with sucrose — about half fructose and half glucose — and high-fructose corn syrup, which despite its name is mostly used in formulations that are 55% and 42% fructose.

The authors write that sugar is more than just empty calories — that growing evidence links fructose overconsumption with health problems including hypertension and diabetes. “Early studies” link it to cancer and cognitive decline, they write. They also argue that like tobacco and alcohol, “it acts on the brain to encourage subsequent intake.”

So, what’s a country to do? The authors propose taxing processed foods containing any kind of added sugars, including drinks and cereal. In addition, they suggest tightening licensing requirements on vending machines and snack bars selling sugary drinks in schools and at work, instituting zoning ordinances to restrict the number of fast-food restaurants and convenience stores in low-income neighborhoods and near schools, and even instituting an age limit for purchasing sugary drinks such as soda.

And they want the FDA to consider removing fructose from the list of ingredients deemed Generally Recognized as Safe. (Douglas Karas, an FDA spokesman, says that step is not currently being considered.)

The Sugar Association, not surprisingly, found a lot to dislike in the commentary. In a response published on its website, the industry group says that USDA stats show people are consuming about 425 more calories per day now than 40 years ago, with caloric sweeteners accounting for about 38 of those calories. Meantime, the group contends that consumption of cane and beet sugar has been falling even as obesity rates have been rising.

“We consider it irresponsible when health professionals use their platforms to instill fear by using words like ‘diabetes,’ ‘cancer,’ and even ‘death,’ without so much as one disclaimer about the fact that the incomplete science being referenced is inconclusive at best,” the association says.

The obesity problem “originates from the combination of overconsumption of all foods and lack of exercise. To label a single food as the one and only problem misinforms, misleads and confuses consumers, and simply adds to the problem,” the association says.

The National Confectioners Association, meantime, said that the group “supports realistic advice to Americans that accommodate all foods including occasional treats in moderation. There is a place for little pleasures, such as candy, in an overall lifestyle that supports health, wellness and happiness. In fact, helping the public understand how to incorporate little pleasures in their diet may well play the most important role in achieving and sustaining recommended dietary behaviors.”

If you do want to keep an eye on your sugar intake, the nutrition facts panel that appears on food packages now does not break out added and naturally-occurring sugars. But you can certainly see how many total grams of sugar you’re consuming.

Image: iStockphoto

Update: This post has been updated with comment from the NCA.

By Louise Radnofsky

The Obama administration is touting good news for seniors from the health-care overhaul law, pointing to $2.1 billion in discounts on prescription drugs for 3.6 million older consumers in 2011.

Part of the law was intended to fill the gap in prescription-drug coverage, the so-called doughnut hole, when Medicare beneficiaries have to to pay up to $4,550 out of pocket for drugs after their costs pass $2,840 for the year.

Under the law, drug companies have to offer discounts on brand-name and generic drugs for Medicare beneficiaries after they reach the gap. Discounts increase annually until 2020, when the hole is supposed to be filled entirely. In 2010, the first year when the discounts were in effect, seniors also got a $250 rebate check if they hit the doughnut hole.

The 2011 discounts — 50% on covered brand-name drugs and 7% on generic drugs — were worth an average of $631 per person who did reach the doughnut hole, the Department of Health and Human Services said.

Democrats have made closing the doughnut hole a priority in recent years and have tried to make the new provision a key element in their appeal to seniors to support the health-care overhaul law.

“Today’s good news is the latest evidence that as we continue to implement the Affordable Care Act, we’re taking the right approach to Medicare,” said Health and Human Services Secretary Kathleen Sebelius.

Blood-sugar-lowering drugs accounted for the largest single share of the discounts, according to the administration’s data.

Image: iStockphoto

Some of Komen’s funding to Planned Parenthood affiliates went towards referrals for mammograms.

The controversy over the defunding of Planned Parenthood affiliates by breast-cancer group Susan G. Komen for the Cure is showing no signs of cooling off.

A spokeswoman for Komen, Leslie Aun, told the Associated Press — which broke the story Tuesday — that the charity was ending its grants to Planned Parenthood affiliates after adopting a policy prohibiting the funding of organizations that are under investigation by government authorities.

That would apply to Planned Parenthood because a Republican congressman, Cliff Stearns, is leading an inquiry into whether the group spent public funds on abortion services, the A.P. says.

Planned Parenthood responded by saying that Komen had caved to pressure from “anti- women’s health political organizations,” and that low-income women in underserved communities stand to be hurt by the end of the grants, which cover breast health education, screenings and referrals for mammograms.

Komen tried to quell criticism with a video, released late yesterday. In it, the group’s founder and CEO, Nancy Brinker, says the decision was the result of a review of the group’s policies and procedures for making grants. “We are working to eliminate duplicative grants, freeing up more dollars for higher-impact programs, and wherever possible we want to grant to the provider that is actually providing the lifesaving mammogram,” she says. The group also added “more stringent eligibility and performance criteria to support these new strategies,” she says.

“We will never turn our backs on the women who need us the most,” Brinker says, calling criticisms of the group’s supposed cave-in to political pressure “scurrilous.”

But the Atlantic’s Jeffrey Goldberg reports today, citing “three sources with direct knowledge of the Komen decision-making process,” that the Komen rule was specifically adopted with Planned Parenthood in mind and that it’s the only organization that has been affected so far.

(We have reached out to Komen for comment, and will tell you if we hear back.)

Goldberg also reports that Mollie Williams, who was until recently managing director of community health programs at Komen, “resigned in protest immediately following the Komen board’s decision to cut off Planned Parenthood.”

Williams had no comment for Goldberg. When we reached out to her, she said via email that she “must honor the confidentiality of my former employer, Susan G. Komen for the Cure, and for this reason, I’m not responding to questions about Komen’s decision to no longer fund Planned Parenthood.”

She added that she believes “it would be a mistake for any organization to bow to political pressure and compromise its mission” and expressed her admiration for both groups.

Planned Parenthood, meantime, raised more than $400,000 online (from more than 6,000 donors) in the 24 hours ending Wednesday, according to Andrea Hagelgans, a spokeswoman for the group. She said the donations will “continue to help expand Planned Parenthood’s critical health care services nationwide, especially those affiliates impacted by the Komen cuts.”

Hagelgans added that the controversy has made more women aware that Planned Parenthood provides breast exams, leading to an increase in scheduled appointments.

Komen has come under fire in the past from anti-abortion groups for its grants to Planned Parenthood. In December a Christian publisher pulled from the market a “Cancer Awareness Bible” because some of the proceeds from the book went to Komen.

Readers, how do you think this will play out in coming days and weeks?

Bonus: Breast Cancer Charity in Bucket of Hot (KFC) Chicken

Photo: Associated Press

As we all gather ’round the Super Bowl snack spread this Sunday, how worried should we be about the health consequences of the party foul known as double dipping?

We tackled that question as part of our “Is It True?” video series here at the Health Blog — you can see the video below.

The WSJ’s Christina Tsuei set out to find if, as Seinfeld’s George Costanza was told by a horrified party guest, that re-dipping a chip after you’ve already taken a bite is “like putting your whole mouth right in the dip.”

The answer is probably not — but it could be compared to sharing a kiss with your fellow dippers, according to an expert she spoke with. (The Health Blog has written about of the research discussed in the video.)

Watch the video and tell us your best strategies for avoiding the double dip.

And look here, here, here, here, here and here for our previous videos, on weight-loss and sleep, giving and health, Thanksgiving dinner and tiredness, smiling and mood, the freshman 15 and melatonin’s effects on sleep.

Have a suggestion for a future video topic? Please email us at healthblog@wsj.com or leave a comment below.

Image: iStockphoto

Birth-Control Recall: Pfizer has recalled about a million packs of birth-control pills on concerns that incorrect packaging could lead to unplanned pregnancies, but says it believes only 30 packs actually had the troublesome glitches, the WSJ reports. Pfizer has identified three production problems that could permit pills to be placed incorrectly in the packs and go undetected. It’s not clear how many pills have already been used and how many are still in medicine cabinets, the paper says.

Regulating Sugar?: A commentary published in Nature calls for sugar added to foods to be regulated, using the taxes and limited availability of tobacco and alcohol as a model, WebMD reports. Commentary author Robert Lustig, of the University of California, San Francisco, says excess sugar is linked to health problems, while the Sugar Association disputes that sugar intake causes disease. The FDA says it is not reconsidering sugar’s current regulatory status as a “generally recognized as safe” product, WebMD reports.

Device Pact: Medical-device firms will pay the FDA $595 million over five years under the tentative terms of a new user-fee agreement, the WSJ reports. The FDA will add more full-time employees to consider medical-device applications and will have concrete goals for approval times, the paper says.

Surgery Risk Suggested: Research published in Mayo Clinic Proceedings suggests that children who undergo two or more surgeries by the age of two are more likely to develop ADHD in the future compared to children who experience one operation, possibly because of the effects of general anesthesia on the developing brain, Time’s Healthland blog reports. The study cannot prove that anesthesia causes the future problems, however, and a study author says that the benefits of surgery for infants usually outweigh any potential risk, Time says.

Image: iStockphoto

Why get a massage? Well, because it feels good, for one thing. But many people also hop on the table with the hope that massage therapy can help promote muscle recovery after a tough workout or provide other benefits.

No one has looked closely at what massage does to muscle at a cellular or molecular level, however. Researchers set out to do just that, and their findings are published in Science Translational Medicine.

The researchers exercised 11 young men to exhaustion over about 70 minutes, then massaged a single leg (determined randomly for each man) for ten minutes. The subjects received a muscle biopsy in both quad muscles to gather samples for massaged and non-massaged legs. The biopsy was repeated after a 2.5-hour rest period.

Researchers analyzed the samples from the different legs to see what was going on after the massage. They found two major changes: reduced signs of inflammation, and an increase in production of mitochondria, the cell’s energy factories.

Curbed production of inflammatory molecules “may reduce pain by the same mechanism as conventional anti-inflammatory drugs” like aspirin and ibuprofen, the authors write.

The authors say that an increase in the number of mitochondria can promote better recovery after a tough exercise session. That finding also means that massage after exercise could help enhance endurance, says Mark Tarnopolsky, an author of the study and a professor of pediatrics and medicine at McMaster University Medical Center in Hamilton, Ont. Nailing down that link would require further research, says Tarnopolsky.

The study didn’t turn up any signs that massage flushes out lactic acid from the muscle, he says.

Image: iStockphoto

Here at Health Blog headquarters, we’ve been intrigued by the career of John Johnson ever since he left a company called Johnson & Johnson.

That was back in 2007, when he became CEO of ImClone Systems, which was eventually acquired by Eli Lilly.

Today, Johnson, who is 53, was named president, chief executive and chairman-elect of Dendreon, succeeding 43-year-old Mitch Gold, who remains executive chairman until June 30. Gold has been CEO for nearly a decade. (Here’s the WSJ story.)

In an interview with the Health Blog, the two men described the move as a natural transition as Dendreon, which sells the prostate treatment Provenge, seeks to morph from a company that was focused on getting its first drug to market to one commercializing a product for a global market.

“We’re right at that cusp in the evolution of a company where you have to step outside the way you’ve operated,” says Johnson, who has been a Dendreon board member for about six months.

He takes over as the company is trying to regain traction after missing ambitious sales targets for Provenge in last year’s second half by a wide margin. The company partly blamed physician uncertainty around reimbursement for the $93,000 treatment, an issue it says is now essentially resolved.

Johnson says his top two priorities in his new post are to increase prescribing of Provenge by oncologists and urologists in the U.S. and to cut the cost of producing the treatment. Provenge, given in three separate infusions, works by prompting the body’s immune system to fight prostate tumors. It uses a patient’s own cells, which are shipped for processing at one of three manufacturing facilities and then returned to the patient’s doctor for infusion.

The treatment’s complexity and, some analysts believe, its hefty price have also affected adoption of Provenge. We asked Johnson if achieving lower production costs might lead to a price reduction.

“I haven’t dug into the sensitivity to the price and what physicans’ reactions are,” he says. He plans to meet with doctors at a cancer meeting in San Francisco during the next couple of days “to understand what’s going through their minds and what we can do to help.”

Dendreon may also have to contend with an increasingly competitive market for treatments for advanced prostate cancer, including a drug being developed by Medivation called MDV3100. Researchers released data Tuesday showing the pill extended survival in such patients and it could be on the market as soon as later this year.

Gold says he considers the data good news for Dendreon because he believes the drugs will be used in combination. “That’s going to result in a [better] overall survival benefit,” he says.

Johnson said he also plans to ramp up efforts to get Provenge on the market in Europe, which could happen beginning next year if it’s approved by regulators there.

Dendreon shares were up more than 6% to $14.43 in early afternoon trading.

Photo: Bloomberg News

Simple photos of green beans in cafeteria trays spurred more kids to take them.

The simple act of putting photos of green beans and carrots in cafeteria-tray compartments sparked increased consumption among elementary-school students, according to a small study that suggests one more potential avenue for getting kids to eat their veggies.

A research letter published online in the Journal of the American Medical Association describes the experiment, which took place at a Minnesota school cafeteria serving kindergartners through fifth graders. Researchers from the University of Minnesota compared carrot and green-bean consumption on a control day — with the usual cafeteria trays — to consumption on a day in which photographs of the two veggies were placed in tray compartments.

Researchers weighed all the uneaten vegetables left in the containers and even on cafeteria tables and on the floor in order to get an accurate gauge of consumption.

“You don’t just want them to take the food, you want them to eat it,” says Traci Mann, an associate professor of psychology at the University of Minnesota and an author of the study.

The photographs were associated with a bump in the percentage of kids taking green beans — from 6.3% to 14.8% — and of carrots — from 11.6% to 36.8%, the study found. The average amount of green beans eaten by students who took them didn’t change between the non-photo and photo days, and the average amount of carrots eaten fell slightly.

But because so many more kids took the veggies, more carrots and beans were consumed overall, she says.

Mann cautions that the kids still weren’t eating a ton of vegetables and that this type of intervention needs to be shown to work over a longer time period. The novelty of the photos might wear off, she says. “On the other hand, getting kids to even eat a few bites” of vegetables can help kids develop a taste for them over time, she says.

The researchers think this worked because seeing the photos in the compartments gives kids the impression that “this must be where everyone puts their vegetables,” and that everyone is eating them, says Mann. Kids don’t want to be told what to do, but they’re sensitive to what they think is the norm, she says.

Prepping the trays cost about $3 and took 20 minutes per 100 trays, the study says.

Schools will have to offer students more fruits, veggies and whole grains in lunches as part of new USDA rules announced last month.

“Getting kids to eat vegetables is the hardest thing in nutrition,” says Mann.

Image: iStockphoto

Prostate-Cancer Drug Studies: The results from two trials of experimental drugs for advanced prostate cancer add to recent progress against the disease, the WSJ reports. Medivation’s MDV3100 extended survival by nearly five months in a 1,199-patient study, while Bayer and Algeta’s Alpharadin, which homes in on cancer that has already spread to the bone, boosted survival by almost three months in a 922-patient study, the paper reports.

No Consensus on Repeat Breast-Cancer Surgery: Rates of repeat lumpectomies vary widely from doctor to doctor, according to a study published in JAMA, and averaged 22.9%, the New York Times reports. There is no broad agreement on when a second surgery — intended to make sure all cancer has been excised — is necessary. The study found that almost half of the repeat surgeries were in women whose lab reports showed no cancer had been left behind, while 14% of patients who did have some remaining traces of cancer did not receive a follow-up surgery to remove it, the NYT reports.

Birth-Control Recall: Pfizer is recalling about a million blister packs of birth-control pills because of packaging errors, including in some cases a lack of enough active tablets to prevent pregnancy, Time’s Healthland blog reports. Pfizer says 14 lots of Lo/Ovral-28 tablets and 14 lots of generic Norgestrel and Ethinyl Estradiol tablets with expiration dates ranging from July 31, 2013, to March 31, 2014 were affected, and that women who have been taking the pills should use back-up, non-hormonal birth control, Time says.

Grants Are Cut Off: Susan G. Komen For the Cure is ceasing hundreds of thousands of dollars in grants to Planned Parenthood affiliates for activities including breast exams and breast-cancer education, the WSJ reports. Komen said in a statement that had “implemented more stringent eligibility and performance criteria” for its grant programs. Planned Parenthood, which is being investigated by a Republican member of Congress about its compliance with federal restrictions on funding abortion, says Komen “appears to have succumbed to political pressure.” The Associated Press first reported Komen’s move.

Image: iStockphoto

A young patient holds Kalydeco, a cystic-fibrosis treatment from Vertex just approved by the FDA.

Certain cystic-fibrosis patients will now have an FDA-approved treatment that targets an underlying cause of their disease.

But that drug — Kalydeco, from Vertex Pharmaceuticals — won’t come cheap.

As Dow Jones Newswires reports, the annual cost will be $294,000. Vertex has set up a patient-assistance program to help patients pay for the treatment.

Kalydeco was approved to treat the estimated 4% of cystic-fibrosis patients who have a mutation called G551D in a certain gene responsible for the disease. About 1,200 people in the U.S. have that mutation, DJN says.

Kalydeco was approved for use only in patients aged six and up; Vertex is planning to study the drug in younger children. The company is also studying the drug in cystic-fibrosis patients with different mutations and in combination with other medications.

As the WSJ reported in the fall, progress in drug development for cystic fibrosis has come more than 20 years after the gene responsible for the disease was identified, in 1989. Pinpointing the gene was only one step. Scientists had to come up with a hypothesis as to how the defective gene actually causes the disease, then devise a way to address the problem. As the paper reported:

The gene makes the channels that carry chloride in cells up to airways, where it’s needed for clearing mucus that builds up, some scientists believe. Mutations impede the flow of chloride, causing the mucus to accumulate and impeding the hair-like particles called cilia from beating back and forth to clear out the mucus.

Attempts to use gene therapy to replace the mutated gene didn’t pan out, so researchers have instead turned to drugs to help chloride to reach the airways.

Other companies, including PTC Therapeutics, have experimental therapies at various stages of the development pipeline.

The median lifespan for cystic-fibrosis patients has risen over the years thanks to aggressive treatments addressing the disease’s symptoms. But most will still not live beyond their 30s and 40s.

Bonus: Not Just a Cheerleader: Foundation Helped Drive Cystic-Fibrosis Research

Correction: An earlier version of this post gave the incorrect number of U.S. patients with the mutation.

Image: Brett Deering for the WSJ

Quality-of-life questions are becoming increasingly important in medical care, especially when it comes to helping patients make decisions about treatments, today’s Informed Patient column reports.

Since the 1970s, researchers have been using quality-of-life measurement tools for a wide variety of medical conditions, primarily in population studies and clinical trials. Outside the U.S. they are often used by national medical systems to help determine payment policies for more costly drugs or treatments.

But there is growing interest in using such tools in the clinic — or at least getting doctors to more routinely ask patients how their disease or treatment is affecting their life.

“Understanding a patient’s experience and the effects of his or her condition on well-being is crucial to a good or quality clinical encounter, especially for chronic conditions,” University of California, San Francisco dermatology professor Margaret Chren tells the Health Blog.

Chren is a developer of one of the most popular quality-of-life measurement tools in dermatology, Skindex. While not routinely used in clinical care, Skindex is used in a number of research studies. (Potential users must apply to the MAPI Research Trust.)

In one study, for example, Chren and colleagues used Skindex to compare quality-of-life outcomes for different treatments for removal of skin cancers. In the study, two treatments — the surgical procedure known as Mohs surgery as well as excision — resulted in improved quality-of-life scores for patients compared to a treatment that involved burning and scraping off lesions.

Because clinical encounters are often brief, Chren says, the focus is often on easily measured and assessed features such as lab or X-ray results. And reimbursement incentives don’t encourage long talks with patients that might uncover quality-of-life concerns.

Some providers are offering the surveys to patients before doctor visits, and health systems are increasingly incorporating surveys and questionnaires into electronic medical records. Jim O’Connor, marketing director of QualityMetric, whose surveys are already widely used in research and public health programs, says the company has seen rapid growth in their use in clinical settings. The company offers an online system, Smart Measurement, that instantly scores quality-of-life questionnaires so doctors can refer to them during appointments with patients.

At Dartmouth-Hitchcock Medical Center, which uses surveys from QualityMetric in clinical care, researchers are also developing their own quality measurement tools including one that uses a “feeling thermometer” to compare how doctors and their patients perceive the impact of Crohn’s disease, an inflammatory bowel condition, on health-related quality of life. A study published in 2010 found that two questions using the feeling thermometer provide a quick and accurate assessment of the burden of the disease on patients, and that physicians’ perceptions of the burden of disease was similar to that of their patients.

Gastroenterologist Corey Siegel, a co-author of the study, says he is eager to get the tool into practice. For patients, while the “burden of symptoms” may go down, the “burden of treatment” — including routine lab tests, frequent colonoscopies, regular injections or IV infusions and 20 or more pills a day — might go up.

“The ideal is a low burden of symptoms and treatment, but realistically there are trade-offs that need to be made,” Siegel says. “The optimum use of this tool would be for patients to track the burden of symptoms and treatment so that their providers can understand how they are really doing overall as opposed to focusing on symptoms alone — which is only part of their experience with chronic disease.”

Many of the quality-of-life questionnaires can be found online or through disease advocacy groups. Bruce Bebo, director of research and medical programs at the National Psoriasis Foundation, suggests that patients whose doctors don’t offer quality-of-life questionnaires can review and answer survey questions like the ones it uses for its own research (via the Koo-Mentor Psoriasis Instrument) to help them think about the issues and bring them up at the next doctor’s visit.

“They may be surprised to learn how much the disease affects their quality of life,” says Bebo.

Consumer Unit Oversight Changes: Johnson & Johnson is replacing two company group chairmen who had been charged with turning around the company’s consumer health unit after a series of recalls, the WSJ reports. Patrick Mutchler, charged with overseeing McNeil Consumer Healthcare last April, is retiring and will be replaced by Roberto Marques. Meantime, the duties of Pericles Stamatiades, chief strategist for J&J’s consumer business since last spring, will be divvied up between other company officials when he departs the company, the WSJ says. Denice Torres will continue to lead day-to-day operations at the McNeil unit.

Circumcision Research: With research pointing to circumcision of adult heterosexual males as an effective way to curb the spread of HIV, experimental devices to make the procedure quicker and safer are being tested, the New York Times reports. One, called PrePex, uses a rubber band to cut off blood flow to the foreskin, which can then be painlessly clipped off, the paper says.

Hedgehog Success: The FDA approved Erivedge, a drug to treat advanced basal-cell skin cancer from Roche’s Genentech unit, the WSJ reports. The drug targets the hedgehog pathway, which is thought to play a role in several forms of cancer and is the subject of drug-development efforts by Pfizer, Bristol-Myers Squibb, Novartis and Infinity Pharmaceuticals, the paper says.

No Switching: People covered by state high-risk health insurance pools that predated the health-care overhaul may be looking enviously at the newer pre-existing condition insurance plans created by the law because of their often cheaper and more comprehensive coverage, Kaiser Health News’ Insuring Your Health column reports. Those in the older pools can’t just switch to a PCIP because the requirements for participation include being uninsured for six months, KHN reports. The requirement was put in place to keep a lid on PCIP costs.

Correction: A previous version of this post incorrectly equated the McNeil Consumer Healthcare business with J&J’s overall consumer unit.

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Many kids spend a not-insignificant chunk of their time in carpools, being shuttled to school, sports practices and various other commitments.

But as a 681-person study just published in Pediatrics shows, kids in carpools are sometimes missing out on something they get when driving alone with their parents: booster seats.

The American Academy of Pediatrics recommends kids use a booster seat until they’re 4’9″. Some states have laws requiring their use in kids up to a certain age or height. (The WSJ recently took a look at California’s new law, which sent a lot of unhappy 6- and 7-year olds back to boosters.)

Among parents of 4- to 8-year-olds who carpool and use a safety seat in the family car, only 79% said they’d always ask other drivers to use one when carpooling their children. And just 55% said they always make their own child use a booster seat even when friends riding in the car don’t have one, the survey found.

Why? The study and previous research point to a few reasons, including not having enough boosters for other people’s kids and the difficulty of transferring boosters between vehicles. Social norms may also play a role — parents may not want their kid to be the only one in a booster if his or her friends don’t have one, even if there’s a seat available.

Parents, how likely are you to use booster seats in carpools? Do you ever skip their use?

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Doctors who need to drop pounds themselves may be less likely to bring up the topic of weight loss with their obese patients, a new study suggests.

The study, published in the journal Obesity, covered 498 primary-care physicians. Of them, 47% were normal-weight, 38% were overweight and 15% were obese, based on their body mass index.

The survey found that doctors were likely to initiate a weight-loss conversation with an obese patient 89% of the time and to record an obesity diagnosis 93% of the time if they perceived the patient as being as heavy or heavier than themselves.

Doctors perceiving the obese patient to be smaller than themselves, however, talked about weight loss or put down a diagnosis 11% and 7% of the time, respectively.

The study can’t identify the reason behind that discrepancy, says Sara Bleich, an author of the study and assistant professor of health policy at Johns Hopkins Bloomberg School of Public Health. But it’s possible that subconsciously, obese physicians may look at a patient and think “they look like me, but I’m healthy” and focus on more acute problems rather than their extra pounds.

Normal-weight doctors were in general more likely to discuss weight loss with their obese patients than doctors who were overweight or obese. But even normal-weight doctors brought up weight loss with obese patients only 30% of the time — compared to 18% for overweight or obese doctors.

So most doctors, regardless of their own weight, are failing to bring up weight loss with their obese patients. Given that, even with the differences seen in this analysis, “the most appropriate clinical interventions may be to improve all physicians’ practices related to obesity care,” the researchers write.

Normal-weight doctors were also more likely to believe that doctors should be good examples to their patients by maintaining a healthy weight and exercising regularly. Supporting physicians in their efforts to eat more healthfully, get exercise and maintain a healthy weight could not only help doctors, but as this study suggests, might also indirectly help their patients, says Bleich.

She says electronic medical records could also help identify obese patients by automatically calculating a BMI based on a patient’s height and weight rather than leaving it up to the physician to do so.

Recent government stats show that 35.7% of U.S. adults were obese in 2009-10. Obesity rates are leveling off, but not reversing.

Bonus:  People May Not Know They’re Obese Unless a Doctor Tells Them

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Lipitor Benefit Changes: Pharmacy-benefit manager Express Scripts will move brand-name Lipitor to the third tier of its national drug formulary from the second tier as of Feb. 1, increasing co-pays for some patients and emphasizing Pfizer’s challenge of holding on to sales of the drug, the WSJ reports. The generic versions of Lipitor are already on the first — and preferred — tier. Mail-order customers won’t see higher co-pays, the WSJ says.

Both Arms, Please: Research published in the Lancet suggests the importance of measuring blood pressure in both arms as a way of detecting peripheral vascular disease, BBC News reports. That’s already advised — but rarely performed — in the U.K. and U.S., and experts say more research is needed to ascertain what physicians should do when a blood-pressure differential is detected, the BBC says.

New Leadership: Gabriel Jaramillo, the new general manager of the Global Fund to Fight AIDS, Tuberculosis and Malaria, says he’ll focus on “establishing a disciplined private-sector governance process” for managing grants, improving risk management, and trying to raise new money in his one year on the job, the WSJ reports. The fund has disclosed management shortcomings and some misuse of grant monies, the paper says.

Booster Seats and Carpools: A study published in Pediatrics finds that 30% of parents don’t make their kids use recommended car booster seats when another person is driving, and 45% don’t require their kids to use the boosters when driving other kids who don’t have them, CNN’s The Chart blog reports. Researchers say car overcrowding and “lack of time to coordinate booster seat switch offs” are likely responsible, CNN says.

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Bydureon, the once-weekly injection for treating patients with type 2 diabetes, has finally won the FDA’s okay.

As Dow Jones Newswires reports, it’s been a long, bumpy road to approval for the drug’s developer, Amylin Pharmaceuticals.

(Alkermes is behind the extended-release technology used to deliver the drug, a longer-acting version of Amylin’s twice-daily Byetta.)

Amylin started working on the drug in 1999 and first applied for FDA approval — with its then-partner Lilly — a decade later. But the agency in 2010 said it needed more information “about the drug’s prescribing label and the companies’ risk-management plan to ensure the drug’s benefits outweigh its risks,” DJN reports.

Later that year, the FDA said the info the companies provided wasn’t enough to approve it, asking for a new study looking at what high doses of the drug might do to heart rhythms. That study showed no problems.

As the FDA was weighing the drug, Amylin and Lilly terminated their partnership.

The prescribing label for Bydureon will carry a warning about certain thyroid tumors seen in rats who were exposed to the drug, DJN says.