Breast Cancer Awareness Month Fails to Disclose Limitations of Mammography by Jeffrey Dach

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October was Breast Cancer Awareness Month, which is an advertising campaign for national mammography screening. An eminent radiologist, Leonard Berlin MD says this message fails to disclose the limitations of screening mammography, namely that mammography will miss 30-70% of breast cancers, and leads to over diagnosis and over treatment. He also says mammography disclosures should be mandated, just like the cigarette and drug warnings that appear on their ads.

Otherwise, we create unrealistic expectations for mammography which cannot be met. The public expects every breast cancer to be detected. They are not. This translates into increased medical malpractice payouts for the missed cancer, which is now the most prevalent medical malpractice case against all physicians. (1) (1A) (1B) (2) (3) (4)

The fact is that mammograms are difficult to interpret, cancers can be hidden, and many are missed. This cancer miss is not from lack of training or competency on the part of the radiologist. It is inherent in the mammogram technique itself.

The American College of Radiology says that 30-70% of breast cancer are missed on the initial mammogram, and are seen in retrospect a year later by going back to the previous mammogram interpreted as normal.With this legal environment, it is a miracle that mammography has survived at all.(5) (6)

Screening Mammography is Not Prevention.

Leonard Berlin points out that 57% of the American women believe that mammograms prevent breast cancer, a misleading message from Breast Awareness Month. (1B) Mammograms are designed to detect cancer, not prevent it. Thinking that a mammogram can prevent breast cancer is like thinking that checking your house annually for broken windows, prevents robberies.

Secondly. the most likely outcome of a positive mammogram is an unnecessary biopsy, causing emotional distress, breast deformity and scarring. 80% of all breast biopsies done for a positive finding on a mammogram are negative for cancer. (5)

My Own Experience with Mammography

When I began residency training in radiology at Rush Presbyterian Hospital in Chicago in 1971, the state of the art was Xeromammography. This was a machine made by the Xerox Company which was prone to mechanical failure, and always breaking down. It produced a blue photo on paper with blue toner powder. (27) (29)

Example of Xeromammogram

Example of X-ray Film Mammogram

In those days, Franklin S Alcorn MD, was the only brave soul willing to read the Xerox images, and the book was Xeroradiography by John N. Wolfe. In 1972, the consensus in the department was that mammography was an orphan procedure and might never become acceptable. Some docs thought xeromammography was bordering on quackery, and screening mammogram had not been invented yet. (30)

Useful to the Surgeon

In those early days, the surgeon's criteria for doing a breast biopsy was a palpable mass. Many women have palpable lumps and bumps called fibrocystic breast disease which is quite common, and now known to be caused by iodine deficiency. (7)

Cyst or Solid Breast Mass?

In those days, the surgeon approached a breast mass with needle aspiration to differentiate between a fluid containing cyst or a solid mass. Nowadays, ultrasound determines this easily.

Back to the needle aspiration procedure; if the lesion is a cyst, the fluid is removed and the mass disappears. If no fluid can be obtained, then the mass is solid, and surgical removal is the next step. This is where the surgeons found the xeromammogram useful, occasionally showing a second occult mass or calcification which alerts the surgeon to remove additional tissue.

Invention of Needle Localization

Sometimes the surgeon had trouble actually finding the tiny calcifications at surgery since they couldnt feel them, so needle localization was invented. The radiologist placed a needle in the breast tissue near the calcifications which guided the surgeon to the spot to be removed. The surgically excised breast tissue was returned to the X-ray department for another mammogram of the specimen to determine if the lesion had been removed (see below).

Example of excised specimen with needle localization (done for calcifications)

Example of Needle Localization for spiculated mass typical for malignancy in specimen.

The Switch from Blue Paper to Gray Xray Film

Grey X-Ray film mammograms replaced the blue Xerox paper images around 1982. By that time, I had joined a radiology group in Hollywood, Florida, but they were still using the xerox machine even though the whole country had already made the switch to regular x-ray film. This inevitable switch-over to X-ray film made possible the large scale national breast screening programs, since the mammogram could be done at any hospital x-ray department. (27)

Finally, We All Learn Mammography

My radiology group made the plunge into film mammography. None of us had prior training or experience reading mammograms, so we traveled to expensive meetings and teaching courses on mammography from leaders in the field, such as Marc Homer MD and Laszlo Tabar MD (Sweden), and then we started reading on our own. (8)

From Breast Needle Biopsy to the Creation of a New Department

Soon we were doing the needle localizations (using the Marc Homer needle) and needle biopsies in the radiology department. Initially, biopsies were done with simple supplies, a standard 20 gauge needle and 10 cc disposable syringes. A few years later, the radiology industry came out with spring loaded and vacuum assisted biopsy guns, and later invented dedicated biopsy tables using stereo-tactic guidance. This machine allows the operator to take two x-rays at different angles, and uses a computer to calculate the exact position for the biopsy needle.

By 2005, the cranky unreliable blue toner xeromammogram had been replaced with a shiny new department on the third floor with all the new modalities: hi-resolution digital mammography, stereotactic biopsy, breast ultrasound, and breast MRI. There is no question that the combination of these modalities makes a powerful and useful tool for diagnosis, treatment and follow up of breast cancer cases. However, this is quite different from screening mammography which is discussed below.

Victimization of Women?, No, Merely Good Medical Care.

When we started the screening mammogram program, many of the suspicious findings were false positive meaning they looked like something, but were in fact nothing. The radiologist would send a report of "suspicious requires biopsy" to the doctor who would tell the patient it might be cancer, and the terrorized woman would then not only submit to surgical biopsy under anesthesia, she would become hysterical and insist on the biopsy immediately. The negative biopsy would be a relief to the patient making the surgeon a hero. Feminists call this victimization of women, and healthcare professionals would call this good medical care.

Occasionally, about 10-20% of the time, a real cancer would be found at surgery. These were typically spiculated masses or branching tell-tale calcification patterns. In the early days, the punctate calcifications and the milk-of calcium (teacup) were called benign and did not require biopsy, and the branching calcifications indicated malignancy requiring biopsy and further treatment, However, nowadays, even the benign calcifications are routinely sent for biopsy, sometimes showing a controversial non-aggressive cancer called DCIS. (9) (10)

What's Your Track Record ?

At first, we had no idea how many of our mammogram readings of suspicious for cancer were actually found to be cancer by surgical biopsy and pathology evaluation. So, we started compiling the pathology data and attended monthly conferences to review the data and our track record. The average is one cancer every 5 biopsies, but each radiologist and hospital may have more or less. Optimally, this information should be posted on the wall of the waiting room. Unfortunately, this type of data is rarely available to the patient.

Questioning Screening Mammography

In the 1980s I believed, along with every one else in the health care industry, that mammography was capable of early detection of breast cancer, and that mass screening programs were capable of reducing breast cancer mortality. I even wrote a short editorial that appeared in the Miami Herald to this point which won the praise of my associates at the hospital.

Starting around 1995, however, I began to question the idea of screening mammography. Even from the beginning, there was a debate between proponents and critics of mammogram screening. They argued that the studies either did, or did not show reduction in breast cancer mortality. The critic, Samuel Epstein says mammograms cause harm from overtreatment with unnecessary breast biopsies, and the radiation increases breast cancer risk.

Luck of the Draw - Mammography Malpractice

One of radiologists in my group had the misfortune of being sued for malpractice. He missed a cancer on a mammogram that was visible in retrospect a year later. Remember, this happens 30-70% of the time, routinely.

This event happened early in his career, just out of training, before I joined the group. His insurance company quickly settled the case by paying the woman a settlement of a million dollars, with no attempt at defending the case. As you can imagine, this was a major event which changed how he interpreted mammograms. After that, he was gun shy, almost always did a callback for additional views, and always recommended biopsy for any vague density. The problem is that almost every mammogram has vague densities. Almost all of these biopsies were unnecessary for the patient, but they were quite necessary for the radiologist, considering the medico-legal climate.

The x-ray techs quickly learned to bring the mammograms over to my reading area for a quick negative, rather than to the other reading room, where they usually end up doing more views and send the patient for biopsy of a questionable area. This went on for years, and I was never sued for malpractice on a mammogram reading during my entire career. I consider this "the luck of the draw".

Realizing the high rate of false positive biopsies and the emotional impact on women, I did my best to call the negative mammograms negative realizing there could be a cancer hiding somewhere, and the visible cancers were sent to biopsy.

Biopsy Everything and Anything

The reality of a hostile medico-legal malpractice climate and financial pressure dictates the practice of mammography in most community hospitals. Current practice is to basically biopsy anything and everything that shows up on the mammogram, as long as the patient is compliant. Its not difficult getting compliance by telling patient that it might be cancer, we cant be sure. That usually is enough to make the woman hysterical and submit to biopsy. The radiologist is happy because he thinks he is reducing his chances of being sued for malpractice. His partners and the hospital administrators are happy because the procedures bring in more income. If cancer is found, the surgeons are happy because they have more lumpectomies and cancer operations to keep them busy.

DCIS, the Controversial Non-Aggressive Cancer

Over half of the cancers detected with mammography are DCIS (ductal carcinoma in situ). This is a non-aggressive form of cancer which has a 98% survival after 5 years even with no treatment, although when found, they are treated with surgery as any other cancer. Some consider this detection and treatment of DCIS a form of overtreatment, others consider it good medical care.

Example small calcifications representing DCIS on an old Xerox-mammogram..

Some critics have said that increased mammographic detection of DCIS has skewed the statistics, falsely reducing breast cancer mortality. This makes it look like we are reducing breast cancer mortality, and we are not.

Without mammography, most of these DCIS cases would go undetected, and probably never cause a problem. Autopsy studies of women dying from car accidents have shown occult DCIS in up to 15% of the population. The actual incidence of cancer mortality is 0.4 per cent, not 15 per cent, suggesting that 96% of DCIS cases never go on to clinical disease. Yet, when DCIS is detected on the mammogram, these cases are treated with the same mastectomy or lumpectomy.

A third of the time, pathologists will disagree on the diagnosis of DCIS while looking at the same case. (11) (12)

Lung Cancer Screening

Screening tests in radiology have been tried before. For example chest x-ray screening for lung cancer was tried, studied and abandoned. It was found that when you do a chest X-ray on smokers every 6 months, find the cancers and send the patient to surgery for treatment, there is no change in mortality figures. No lives are saved. In addition to make matters worse, when you go back to the earlier films 6 months before, on the film that was read as negative or normal in retrospect the lesion is visible 90% of the time. (13) (14)

We thought these problems would be solved by moving up to CAT scans, a more advanced imaging technique. However, now we have a problem with seeing too many "suspicious" lesions and the false positive diagnosis. The net result is that lung cancer screening even with CAT scanning has not caught on. (15)

Mammogram screening in the under 50 age group NOT recommended by all other countries.

Current guidelines recommend a screening mammogram every 2 years for the 40-50 year age group. No other western country does this, as these women have dense breast tissue difficult to image and are most prone to a false positive reading, or a diagnosis of DCIS, the controversial less aggressive form of cancer. Most European countries restrict screening to post-menopausal women, after 50, when breast tissue involutes to fat and the cancers become more conspicuous.

Efficacy of Breast Cancer Screening - Does It Reduce Mortality?

The public perception is that breast cancer screening reduces breast cancer mortality. The reality is that this is a fiercely debated question in the medical literature with no clear winner. Leonard Berlin's articles summarize this debate in the medical literature. (3)

The debate is best shown by one example mentioned Dr. Berlin in the Sept 2002 issue of the Annals of Internal Medicine in which two conflicting articles appeared in the same issue, one stating that mammography has no mortality benefit, and the other saying it does.

Here are the two articles:

(1) Canadian researchers concluded that mammography screening did not reduce breast cancer mortality (16) (17)

(2) United States Preventive Services Task Force concluded mammography reduces breast cancer mortality among women 40-74 years old. (18) (19)

Another excellent review of major Mammography Screening Studies can be found at the National Breast Cancer Coalition (web site). (44)

Bottom line, the debate rages on with no clear winner.

One observation which might clarify the debate is this: in two countries with socialized medicine, Canada and Sweden, careful studies of mammography screening were found to have NO Mortality Benefit compared to breast clinical exam.

Here in the US, however, with a 4 billion dollar fee-for-service screening mammogram industry, the mammography studies are interpreted to show that Yes, there is a Mortality Benefit of about 15-20% .

The influence of money and politics over medical science is pervasive, and mammography is certainly not immune. A few MD PHD's from Canada or Sweden are not about to derail a 4 billion dollar industry in the US.

Conflict of Interest in Sponsoring Breast Cancer Awareness Month?

Screening mammography critic, Samuel Epstein MD, irritates the establishment every time he points out that in 1984, the American Cancer Society created the October National Breast Cancer Awareness Month sponsored by money from the Astra-Zeneca Company, the maker of Tamoxiphen, the best selling breast cancer drug. In addition, Astra-Zeneca also manufactures industrial chemicals that cause breast cancer. Some consider this a conflict of interest.

Epstein also points out that past ACS advertisement promised early detection results in a cure nearly 100% of the time. Even more seriously, the Awareness Month advertisements avoid any reference to information on avoidable causes and prevention of breast cancer. (20) (21)

What is breast cancer prevention?

A previous newsletter discusses Iodine supplementation as the most effective way to prevent breast cancer. Iodine tablets are safe, inexpensive and readily available. This is true prevention.(7)

Samuel Epsteins landmark book, "The Politics of Cancer" discusses carcinogenic chemicals in our food supply, home and workplace. Removing them can reduce breast cancer. This is true prevention. (22) (23)

The Untold Message of Breast Cancer Awareness Month:

To summarize, here is the untold message of Breast Cancer Awareness Month:

1) mammography screening is detection, not prevention and has several limitations, namely 30-70% missed cancers, and a tendency towards over diagnosis and over treatment. (5)

2) Many different carcinogenic chemicals cause breast cancer, and removing these chemicals from the workplace or home can reduce breast cancer rates. (22) (23)

3) Iodine deficiency causes fibrocystic disease, and Iodine supplementation prevents breast cancer.(7)

4) Synthetic hormones like Provera increase breast cancer risk. (WHI Study)(24)

5) Bio-Identical Hormone programs are safe, and do not increase risk of breast cancer. (French Cohort Study) (25)

Will mainstream medicine ever endorse Dr. Leonard Berlin's Truth-in-Mammography disclaimers ? No, this will never happen. The public's unrealistic expectation that a breast cancer nodule will be detected 100% of the time will continue, and the high cost of medical malpractice will simply be absorbed into "the cost of doing business". The screening mammogram is here to stay.

As for my own opinion, I am not opposed to the status quo of mammogram screening in the over 50 age group. However, I am opposed to creating unrealistic expectations with false and misleading advertising.

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Jeffrey Dach MD
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References

(1) American Cancer Society Breast Cancer Prevention Page: Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health.

(1A) 3-29-2005 Leonard Berlin, M.D, FACR, Chairman of Radiology at Rush North Shore Medical Center, Skokie, will be awarded the Distinguished Service Gold Medal Award of the Chicago Radiological Society, its highest honor at a ceremony on April 21, in Chicago, IL. The Gold Medal is awarded annually to an individual who has rendered unusual service to the science of radiology and will be presented to Dr. Berlin by his son, radiologist Jonathan W. Berlin, M.D. Berlin is Charman of Skokie Valley Hospital Department of Radiology.

(1B) Leonard Berlin, MD Mammography Screening Can Survive Malpractice . . . If Radiologists Take Center Stage and Assume the Role of Educator

(2) Berlin L. The missed breast cancer redux: time for educating the public about the limitations of mammography? AJR Am J Roentgenol 2001; 176:1131–1134.

(3) Malpractice Issues in Radiology, Breast Cancer, Mammography, and Malpractice Litigation: The Controversies Continue Leonard Berlin,Excellent discussion of controversy of screening mammography and impact on mortality figures.

(4) Perspective Dot Size, Lead Time, Fallibility, and Impact on Survival Continuing Controversies in Mammography Leonard Berlin MD

(5) STATEMENT of Leonard Berlin, M.D. To the U.S. Senate Committee on Health, Education Labor and Pensions Re: Mammography Quality Standards Act Reauthorization April 8, 2003. Leonard Berlin: Suffice it to say that research studies performed at some of the most prestigious medical institutions in the United States reveal that as many as 90% of lung cancers, and 70% of breast cancers, can at least partially be observed on previous studies read as normal.

(6) A Manifesto for Truth-in-Mammography Advertising by Leonard Berlin MD Imaging Economics, November 2004 From cigarettes to pharmaceuticals to financial services, all advertisements feature a disclaimer: Why not those for mammography? Of all medical malpractice lawsuits filed in the United States that allege a delay in the diagnosis of breast cancer, radiologists are the most frequently sued specialists. Of all medical malpractice lawsuits lodged against radiologists, the most frequent cause is the allegation of a missed breast cancer on mammography. Why has "missed breast cancer" risen to first place in the medical malpractice standings? I suggest that it is because we have oversold mammography. We have marketed mammography without informing the American public all that we know about not only the benefits, but more important the limitations and potential harms of mammography.

(7) Iodine Prevents Breast Cancer by Jeffrey Dach MD

(8) Screening mammogram studies Swedish Study by Dr. Laszlo Tabar (1977- 1984) Population-based randomized controlled study 31% reduction in breast cancer mortality in women 50 plus

(9) INTERACTIVE MAMMOGRAPHY ANALYSIS WEB TUTORIAL Images of benign calcifications, secretory disease, milk of calcium, etc.

(10) Tutorial 2 : CALCIFICATIONS ASSOCIATED WITH A HIGH PROBABILITY OF MALIGNANCY

(11) Ductal Carcinoma In Situ of the Breast Elisabeth L. Dupont, MD; Ni Ni K. Ku, MD; Christa McCann, BA; and Charles E. Cox, MD, FACS DCIS, 60% of DCIS cases are discovered solely by mammography Seven major autopsy studies of women not known to have had breast cancer have provided insight. Six studies found an incidence of 4% to 18%.7 The seventh and largest study showed a 0.2% incidence (1 in 519 cases).8 However, this study included a significant proportion of groups known to have a smaller than usual risk of breast cancer. Of the more than 1,000 cases comprising these seven studies, only one case of invasive cancer was detected. Further analysis with fixed criteria is needed. (DCIS) this type of cancer now accounts for nearly half of mammographically detected cases of cancer.

(12) Using Autopsy Series To Estimate the Disease "Reservoir" for Ductal Carcinoma in Situ of the Breast: How Much More Breast Cancer Can We Find? H. Gilbert Welch, MD, MPH, and William C. Black, MD Annals of Internal Medicine December 1997 Volume 127 Issue 11 Pages 1023

(13) DOES LUNG CANCER SCREENING SAVE LIVES?

(14) Lung cancer screening

(15) Corporate Medical Policy Lung Cancer Screening, CT Scanning or Chest Radiographs BC BS doesn’t cover Lung cancer screening with chest CAT or Xrays.

(16) Miller AB, To T, Baines CJ, Wall C. The Canadian national breast screening study. 1. Breast cancer mortality after 11 to 16 years of follow-up. Ann Intern Med 2002;137:305 312 After 11 to 16 years of follow-up, four or five annual screenings with mammography, breast physical examination, and breast self-examination had not reduced breast cancer mortality compared with usual community care after a single breast physical examination and instruction on breast self-examination. The study data show that true effects of 20% or greater are unlikely. Controversy will persist because other studies suggest that screening causes small reductions in breast cancer mortality.The Editors

(17) Journal of the National Cancer Institute, Vol. 92, No. 18, 1490-1499, September 20, 2000 Canadian National Breast Screening Study-2: 13-Year Results of a Randomized Trial in Women Aged 50–59 Years Anthony B. Miller, Teresa To, Cornelia J. Baines, Claus Wall, For the Canadian National Breast Screening Study-2 Results: Randomization achieved virtually equal distribution of demographic and breast cancer risk variables. At the first annual screen, 21% of the cancers found by mammography alone (in the mammography plus physical examination group) were 20 mm or more in size compared with 46% of those found by physical examination in the mammography plus physical examination group and 56% in the physical examination-only group. The corresponding percentages for screens were 10%, 42%, and 50%, respectively. Screening detected 267 invasive breast cancers in the mammography plus physical examination group compared with 148 in the physical examination-only group. By December 31, 1993, 622 invasive and 71 in situ breast carcinomas were ascertained in the mammography plus physical examination group, and 610 and 16 were ascertained in the physical examination-only group. At 13-year follow-up, with 107 and 105 deaths from breast cancer in the respective groups, the cumulative rate ratio was 1.02 (95% confidence interval = 0.78 ). Conclusion: In women aged 50 - 59 years, the addition of annual mammography screening to physical examination has no impact on breast cancer mortality.

(18) Humphrey LL, Helfand M, Chan BKS, Woolf SH. Breast cancer screening: a summary of the evidence for the U. S. Preventive Services Task Force. Ann Intern Med 2002;137:347 -360 The U.S. Preventive Services Task Force recommends screening mammography, with or without clinical breast examination, every 1 to 2 years for women aged 40 and older.

(19) United States Preventive Services Task Force concluded mammography reduces breast cancer mortality among women 40-74 years old.

(20) Dangers and Unreliability of Mammography: Breast Examination is a Safe, Effective, and Practical Alternative Samuel S. Epstein, Rosalie Bertell, and Barbara Seaman International Journal of Health Services, 31(3):605-615, 2001.

(21) Cancer, Inc - National Breast Cancer - Awareness Month Sierra, Sept, 1999 by Sharon Batt, Liza Gross THEY MAKE THE CHEMICALS, THEY RUN THE TREATMENT CENTERS, AND THEY'RE STILL LOOKING FOR "THE CURE"--NO WONDER THEY WON'T TELL YOU ABOUT BREAST CANCER PREVENTION Astra Zeneca Sam Epstein

(22) Cancer Prevention Coalition

(23) The Politics of Cancer, Revisited 1998 By Samuel S. Epstein, M.D. Foreword by Congressman David Obey,Introduction by Congressman John Conyers In this book, world-cancer expert Dr. Samuel Epstein indicts the National Cancer Institute and the American Cancer Society for responsibility in losing the cancer war-

(24) Postmenopausal Hormone Replacement Therapy Scientific Review Heidi D. Nelson, MD, MPH; Linda L. Humphrey, MD, MPH; Peggy Nygren, MA; Steven M. Teutsch, MD, MPH; Janet D. Allan, PhD, RN JAMA. 2002;288:872-881.

(25) French Cohort Study

(26) Leonard Berlin MD biography

(27) Breast Imaging: From 1965 to the Present Edward A. Sickles, MD, Radiology. 2000;215:1-16.) Examples of xeromammograms and film mammograms, speculated lesion, needle localization.

(28) Case 41: Ductal Carcinoma in Situ, Alanna T. Harris, MD The detection of ductal carcinoma in situ has increased markedly in recent years secondary to the widespread use of screening mammography, and it now accounts for 25 to 40% of mammographically detected breast cancers

(29) History of Breast Cancer WILLIAM L. DONEGAN

(30) History: Narratives Radiology in Illinois By Franklin Alcorn, M.D. Dr. Alcorn's history appeared in the program of the Chicago Radiological Society at the Centennial of Radiology in 1995.

(31) Miller AB, To T, Baines CJ, Wall C. The Canadian national breast screening study. 1. Breast cancer mortality after 11 to 16 years of follow-up. Ann Intern Med 2002;137:305-312 After 11 to 16 years of follow-up, four or five annual screenings with mammography, breast physical examination, and breast self-examination had not reduced breast cancer mortality compared with usual community care after a single breast physical examination and instruction on breast self-examination. The study data show that true effects of 20% or greater are unlikely. Controversy will persist because other studies suggest that screening causes small reductions in breast cancer mortality.The Editors

(32) Journal of the National Cancer Institute, Vol. 94, No. 20, 1546-1554, October 16, 2002

Detection of Ductal Carcinoma In Situ in Women Undergoing Screening Mammography Virginia L. Ernster

Results: A total of 3266 cases of breast cancer were identified, 591 DCIS and 2675 invasive breast cancer. The percentage of screen-detected breast cancers that were DCIS decreased with age (from 28.2% [95% confidence interval (CI) = 23.9% to 32.5%] for women aged 40 to 49 years to 16.0% [95% CI = 13.3% to 18.7%] for women aged 70 to 84 years). However, the rate of screen-detected DCIS cases per 1000 mammograms increased with age (from 0.56 [95% CI = 0.41 to 0.70] for women aged 40 to 49 years to 1.07 [95% CI = 0.87 to 1.27] for women aged 70 to 84 years). Sensitivity of screening mammography in all age groups combined was higher for detecting DCIS (86.0% [95% CI = 83.2% to 88.8%]) than it was for detecting invasive breast cancer (75.1% [95% CI = 73.5% to 76.8%]).

Conclusions: Overall, approximately 1 in every 1300 screening mammography examinations leads to a diagnosis of DCIS. Given uncertainty about the natural history of DCIS, the clinical significance of screen-detected DCIS needs further investigation.

(33) Ductal Carcinoma In Situ of the Breast Elisabeth L. Dupont, MD; Ni Ni K. Ku, MD; Christa McCann, BA; and Charles E. Cox, MD, FACS

DCIS, 60% of DCIS cases are discovered solely by mammography Seven major autopsy studies of women not known to have had breast cancer have provided insight. Six studies found an incidence of 4% to 18%.7 The seventh and largest study showed a 0.2% incidence (1 in 519 cases).

However, this study included a significant proportion of groups known to have a smaller than usual risk of breast cancer. Of the more than 1,000 cases comprising these seven studies, only one case of invasive cancer was detected. Further analysis with fixed criteria is needed. (DCIS) this type of cancer now accounts for nearly half of mammographically detected cases of cancer.

(34) STATEMENT of Leonard Berlin, M.D. To the U.S. Senate Committee on Health, Education Labor and Pensions Re: Mammography Quality Standards Act Reauthorization April 8, 2003.

Leonard Berlin: Suffice it to say that research studies performed at some of the most prestigious medical institutions in the United States reveal that as many as 90% of lung cancers, and 70% of breast cancers, can at least partially be observed on previous studies read as normal.

(35) A Manifesto for Truth-in-Mammography Advertising by Leonard Berlin MD Imaging Economics, November 2004

From cigarettes to pharmaceuticals to financial services, all advertisements feature a disclaimer: Why not those for mammography?

Of all medical malpractice lawsuits filed in the United States that allege a delay in the diagnosis of breast cancer, radiologists are the most frequently sued specialists. Of all medical malpractice lawsuits lodged against radiologists, the most frequent cause is the allegation of a missed breast cancer on mammography. Why has "missed breast cancer" risen to first place in the medical malpractice standings? I suggest that it is because we have oversold mammography. We have marketed mammography without informing the American public all that we know about not only the benefits, but more important the limitations and potential harms of mammography.

(36) Mammography Books

(37) AJR 2001; 176:1123-1130

Perspective Dot Size, Lead Time, Fallibility, and Impact on Survival Continuing Controversies in Mammography Leonard Berlin

mammography had become the most prevalent procedure involved in malpractice lawsuits filed against radiologists, and that the allegation of an error in the diagnosis of breast cancer had become the most prevalent condition precipitating medical malpractice lawsuits against all physicians.

An article published in the ACR (American College of Radiology) Bulletin pointed out that 30-70% of breast cancers detected at followup mammography are visible in retrospect on initial mammograms that had been interpreted as showing normal findings

The debate as to whether screening mammography saves lives and lengthens survival rages on and will certainly not be resolved in the foreseeable future .

This article is not intended to be a comprehensive review of all available data on the subject of mammographic efficacy. Even if it were, no definitive answer to the question of whether mammography does indeed reduce mortality from breast cancer would be found.

(38) Journal of the National Cancer Institute, Vol. 92, No. 18, 1490-1499, September 20, 2000 Canadian National Breast Screening Study-2: 13-Year Results of a Randomized Trial in Women Aged 50 to 59 Years Anthony B. Miller, Teresa To, Cornelia J. Baines, Claus Wall, For the Canadian National Breast Screening Study-2

Results: Randomization achieved virtually equal distribution of demographic and breast cancer risk variables. At the first annual screen, 21% of the cancers found by mammography alone (in the mammography plus physical examination group) were 20 mm or more in size compared with 46% of those found by physical examination in the mammography plus physical examination group and 56% in the physical examination-only group. The corresponding percentages for screens were 10%, 42%, and 50%, respectively.

Screening detected 267 invasive breast cancers in the mammography plus physical examination group compared with 148 in the physical examination-only group. By December 31, 1993, 622 invasive and 71 in situ breast carcinomas were ascertained in the mammography plus physical examination group, and 610 and 16 were ascertained in the physical examination-only group. At 13-year follow-up, with 107 and 105 deaths from breast cancer in the respective groups

Conclusion: In women aged 50 to 59 years, the addition of annual mammography screening to physical examination has no impact on breast cancer mortality.

(39) Pink Ribbon Madness: Say No to Breast Cancer Exploitation for Corporate Profit

(40) article critical of mammographhy

(41) Dangers and Unreliability of Mammography: Breast Examination is a Safe, Effective, and Practical Alternative Samuel S. Epstein, Rosalie Bertell, and Barbara Seaman International Journal of Health Services, 31(3):605-615, 2001.

(42) AJR 2001; 176:1131-1134 Malpractice Issues in Radiology The Missed Breast Cancer Redux Time for Educating the Public About the Limitations of Mammography? Leonard Berlin

(43) Cancer, Inc - National Breast Cancer - Awareness Month Sierra, Sept, 1999 by Sharon Batt, Liza Gross

THEY MAKE THE CHEMICALS, THEY RUN THE TREATMENT CENTERS, AND THEY'RE STILL LOOKING FOR "THE CURE"--NO WONDER THEY WON'T TELL YOU ABOUT BREAST CANCER PREVENTION Astra Zeneca Sam Epstein

(44) National Breast cancer Coalition, Position Statement on Screening Mammography Updated May 2007

Excellent review of all studies up to May 2007. Overall, mammography screening has a modest effect on breast cancer mortality. When analyzed in absolute terms, the death rate is reduced by just 0.05%.

(45) Dr. Nortin Hadler is professor of medicine and microbiology/immunology at the University of North Carolina at Chapel Hill, and an attending rheumatologist at University of North Carolina Hospitals.

Does Screening Mammography Save Lives? Numbers May Not Justify Practice for Routine Mammograms

OPINION By NORTIN HADLER. M.D. In the United States, radiologists are so hesitant to read a mammogram as "normal" that false positive rates can reach 80 percent. This hedging on the readings is driven by the fact that "missing a breast cancer" on mammography is the most frequent reason for malpractice litigation in the United States.

But screening mammography is so terribly blunt that it approaches useless: It finds very few cancers that are truly treatable, it misses many of these and it is awash in false positives. Norway, Sweden, Australia and the United Kingdom are re-examining their national experience with screening mammography because of appraisals similar to mine.

If a woman's life was saved because of early detection of an evil breast cancer, she should thank her lucky stars rather than her mammographer. I would relegate mammograms to the archives of false starts, next to radical mastectomy

(46) After 40 Years, Mammography Remains as Much Emotion as Science Judith Randal

Journal of the National Cancer Institute, Vol. 92, No. 20, 1630-1632, October 18, 2000

For the better part of a century, it would have been unthinkable to treat primary breast cancer with anything but the operation pioneered in the 1890s by William Halsted, M.D., one of the most prominent surgeons of his day. Beginning in the 1970s, the Halsted era drew gradually to a close when randomized controlled trials found that the operation generally known as radical mastectomy was no more effective than less drastic surgery (sometimes in combination with radiation). Could a similar fate await the current gold-standard status of screening mammography? Will a time come when its popularity dwindles, too?

mammography now a $4 billion a year industry in the United States alone

Absent unforeseen developments, it is probably safe to predict that mammography for screening will continue to be as much about strongly held opinions and political pressures as about science.

(47) Good News and Bad News About Breast Cancer by David Plotkin M.D. The Atlantic Monthly

Breast cancer is a major public-health concern; it kills 0.04 percent of all American women yearly.

Most of the time the news is reassuring; two thirds to four fifths of all biopsies reveal that the abnormality is not malignant. (Women in their forties are more likely than older women to have negative biopsies, because mammograms of their naturally lumpier breasts are harder to interpret.)

An official nationwide mammography program would be a huge commitment: 51.5 million American women are aged forty or above. And one must bear in mind the cost of needless medical procedures generated by the huge number of false-positive mammograms—two to four false positives for every true positive, according to some measures.

On balance, then, I reluctantly support the status quo. When my patients come in for their mammograms, I do not try to dissuade them. But I tell them that the most optimistic interpretation of the available evidence suggests that routine mammography has only a marginal effect on a woman's chances of surviving breast cancer—and that it may have no effect at all.

(48) Journal of Clinical Oncology, Vol 21, Issue 1 (January), 2003: 41-45

High Prevalence of Premalignant Lesions in Prophylactically Removed Breasts From Women at Hereditary Risk for Breast Cancer

N. Hoogerbrugge, P. Bult, L.M. de Widt-Levert, L.V. Beex, L.A. Kiemeney, M.J.L. Ligtenberg, L.F. Massuger, C. Boetes, P. Manders, H.G. Brunner Full text

The fact that an occult carcinoma was present in only one of 67 patients in our study might indicate that surveillance is as effective as prophylactic mastectomy. However, in our study, all 10 DCIS cases were missed by surveillance, and it was recently shown by Meijers-Heijboer that surveillance is less effective than prophylactic mastectomy in preventing breast cancer deaths.

(49) Mammographic Screening for Breast Cancer Suzanne W. Fletcher, M.D., and Joann G. Elmore, M.D., M.P.H. NEJM Volume 348:1672-1680 April 24, 2003 Number 17

(50) POINT COUNTERPOINT On the efficacy of screening for breast cancer David A Freedman,1 Diana B Petitti,2 and James M Robins International Journal of Epidemiology 2004;33:4355

(51) International Journal of Epidemiology 2004;33:6973 Rejoinder David A Freedman, Diana B Petitti and James M Robins REJOINDER

(52) Screening for Breast Cancer. Joann G. Elmore, MD, MPH; Katrina Armstrong, MD; Constance D. Lehman, MD, PhD; Suzanne W. Fletcher, MD, MSc JAMA. 2005;293:1245-1256.

All major US medical organizations recommend screening mammography for women aged 40 years and older. Screening mammography reduces breast cancer mortality by about 20% to 35% in women aged 50 to 69 years and slightly less in women aged 40 to 49 years at 14 years of follow-up.

Approximately 95% of women with abnormalities on screening mammograms do not have breast cancer with variability based on such factors as age of the woman and assessment category assigned by the radiologist. Studies comparing full-field digital mammography to screen film have not shown statistically significant differences in cancer detection while the impact on recall rates (percentage of screening mammograms considered to have positive results) was unclear.

(53) Cancer Epidemiology Biomarkers & Prevention Vol. 13, 501-510, April 2004

Fear, Anxiety, Worry, and Breast Cancer Screening Behavior: A Critical Review Nathan S. Consedine, Carol Magai, Yulia S. Krivoshekova, Lynn Ryzewicz and Alfred . Neugut3

Women's fears surrounding breast cancer seem to encompass nearly "everything" but certainly include fear of a breast cancer diagnosis, fear of pain/discomfort, and more complicating, fear of embarrassment. To this list, we can add fear of the medical establishment, radiation, nonspecific "cancer worry" general anxiety, or phobia .

(54) Cancer: When it isn’t a killer DCIS: Precancer, benign cancer or what? What Doctors Don't Tell You (Volume 13, Issue 10)

The cancer establishment was recently rocked to its core when Professor Michael Baum, an eminent and well-respected breast surgeon and researcher, claimed that screening for breast cancer should be scrapped because it caused hundreds of healthy women to undergo risky, mutilating and unnecessary treatments even when they may never develop the disease. His comments, made at a meeting of the Royal Society of Medicine, cut even more deeply because Baum was one of the physicians who helped set up the 50-million-a-year breast-screening service (Frith M, Scrap Breast Cancer Screening, Evening Standard, 10 December 2002, p 1).

Baum has stated publicly that the most dramatic consequence of the rise in the numbers of routine mammographies has been a huge increase in the incidence of small, well-contained, relatively benign breast cancers known as ductal carcinoma in situ (DCIS) (BMJ Rapid Responses at bmj.com/cgi/eletters/325/ 7361/418#24945, 24 August 2002).

(55) Michael Baum, Emeritus Prof. of Surgery University College London The Portland Hospital, 212-214 Great Portland Street, London W1W 5QN Re: Screening and Mastectomy rates

(56) 'Scrap breast cancer screening' By Maxine Frith, Health Correspondent, Evening Standard 10.12.02

The man who helped to set up the NHS breast screening programme claims today that it does more harm than good.

Professor Michael Baum, a leading expert in the field, said that screening for the disease causes hundreds of healthy women to have risky, mutilating and unnecessary treatments even when they may never develop the disease.

Fifteen years after he established one of the first screening centres in the UK, Professor Baum has now called for the £50million a year service to be shut. He believes the techniques used for screening are not accurate enough and lead to too many false alarms.

Professor Baum, who is to address the Royal Society of Medicine in London today, has been a long-standing critic of screening but has never before gone so far as to say it should be scrapped entirely,

He is one of the most eminent breast surgeons in the country and a respected researcher into the disease. His comments have sparked a furious row among experts over the benefits of the NHS breast screening programme

(57) Breast screen 'wrong care' fears, Breast screening may produce false positives. Concerns have been raised that breast cancer screening might lead to some women undergoing unnecessary treatment. Researchers looked at international studies on half a million women. They found that for every 2,000 women screened over a decade, one will have her life prolonged, but 10 will have to undergo unnecessary treatment. UK experts said women over 50 should go for their breast checks, but a screening pioneer raised doubts about the NHS programme's future. The report, published in the Cochrane Library, involved a review of breast cancer research papers from around the world.

(58) Doubts raised by the pioneer of screening By Nic Fleming, Medical Correspondent 18/10/2006

(59) Screening for breast cancer with mammography. Gotzsche PC, Nielsen M Cochrane Reviews

Main results: Seven completed and eligible trials involving half a million women were identified. We excluded a biased trial from analysis.

Two (Canada and Malmo)trials with adequate randomisation did not show a significant reduction in breast cancer mortality, relative risk (RR) 0.93 (95% confidence interval 0.80 to 1.09) at 13 years; four trials with suboptimal randomisation showed a significant reduction in breast cancer mortality, RR 0.75 (0.67 to 0.83) (P = 0.02 for difference between the two estimates). RR for all six trials combined was 0.80 (0.73 to 0.88).

The two trials with adequate randomisation did not find an effect of screening on cancer mortality, including breast cancer, RR 1.02 (0.95 to 1.10) after 10 years, or on all-cause mortality, RR 1.00 (0.96 to 1.04) after 13 years. We found that breast cancer mortality was an unreliable outcome that was biased in favour of screening, mainly because of differential misclassification of cause of death.

Numbers of lumpectomies and mastectomies were significantly larger in the screened groups, RR 1.31 (1.22 to 1.42) for the two adequately randomised trials; the use of radiotherapy was similarly increased.

Authors' conclusions: Screening likely reduces breast cancer mortality. Based on all trials, the reduction is 20%, but as the effect is lower in the highest quality trials, a more reasonable estimate is a 15% relative risk reduction. Based on the risk level of women in these trials, the absolute risk reduction was 0.05%. Screening also leads to overdiagnosis and overtreatment, with an estimated 30% increase, or an absolute risk increase of 0.5%.

This means that for every 2000 women invited for screening throughout 10 years, one will have her life prolonged. In addition, 10 healthy women, who would not have been diagnosed if there had not been screening, will be diagnosed as breast cancer patients and will be treated unnecessarily. It is thus not clear whether screening does more good than harm. Women invited to screening should be fully informed of both benefits and harms.

(60) Should We Offer Routine Breast Cancer Screening with Mammography? SEAN P. DAVID, M.D., S.M., Brown Medical School, Pawtucket, Rhode Island July 15 2003

(61) Screening for breast cancer with mammography Gotzsche PC, Nielsen M cochrane collaboration 2006 full text pdf

(62) BMJ 2001;323:956 (27 October)

Row over breast cancer screening shows that scientists bring "some subjectivity into their work Susan Mayor, London

The review claimed that there was no reliable evidence to support the value of mammo-graphy screening in reducing deaths from breast cancer and alleged an association with increased rates of breast surgery.

Ole Olson and Peter Gotsche from the Nordic Cochrane Centre, Righospitalet, Copenhagen, Denmark, reassessed as part of a Cochrane review a meta-analysis of seven randomised trials of screening mammography which they had previously carried out. This confirmed their original conclusion, they said, that there was no evidence of a reduction in either total or breast cancer mortality in two of the trials that they considered to be of sufficient quality to analyse.

They added: "We have also confirmed that screening leads to more aggressive treatment, increasing the number of mastectomies by about 20% and the number of mastectomies and tumourectomies by about 30%" (Lancet 2001;358:1340-2 ).

(63) BMJ 2002;324:677 ( 16 March ) Hazel Thornton, independent advocate for quality in research and healthcare. Letters Breast screening seems driven by belief rather than evidence.

(64) BMJ 2001;323:1131 ( 10 November ) Letters. Office of NHS cancer screening programme misrepresents Nordic work in breast screening row Peter C Gotzsche, director. Nordic Cochrane Centre, Rigshospitalet, DK-2100 Copenhagen ø,

(65) List of articles in Lancet on Screening Mammography

(66) Professor of Radiology Course Director LÃzlo³ TabÃr, M.D. Professor of Radiology Course Director 2007 BREAST SEMINAR SERIES Covering the world of breast diagnosis

(67) Screening mammogram studies Swedish Study by Dr. Laszlo Tabar (1977- 1984) Population-based randomized controlled study 31% reduction in breast cancer mortality in women 50 plus

(68) National Breast Cancer Coalition (NBCC) The Mammography Screening Controversy:Questions and Answers February 8, 2002

(69) www.stopbreastcancer.org National Breast Cancer Coalition 1707 L Street, NW, Suite 1060 Washington, D.C. 20036 (202) 296-7477 voice (202) 265-6854 fax
Position Statement on Screening Mammography Updated May 2007

(70) BreastCancerChoices.org cancer advocacy Iodine Supplement Information
contact lynne. Breast Cancer Choices, Inc., a nonprofit organization
helping patients make informed choices about breast screening,
diagnostic procedures and treatment.

Womens perception of the benefits of mammography screening: population based survey in four countries. Domenighetti G, DAvanzo B, Egger M, et al.Int J Epidemiol 2003; 32:816 821.

Xeromammography is not quackery done by quacks says John Wolfe MD, author of Xeromamogram interpretation. Film screen mammography replaced it shortly there-after.

Enthusiasm for cancer screening in the United States. JAMA 2004; 291: 7178. Schwartz LM, Woloshin S, Fowler FJ Jr, Welch HG

Bartow SA, Pathak DR, Black WC, et al. Prevalence of benign atypical, and malignant breast lesions in populations at different risk for breast cancer: a forensic autopsy study. Cancer. 1987;60:2751-2760.

Ringberg A, Palmer B, Linell F, et al: Bilateral and multifocal breast carcinoma: A clinical and autopsy study with special emphasis on carcinoma-in-situ. Eur J Surg Cancer 17:2029, 1991

Do Vaccinations Cause Autism? by Jeffrey Dach MD

If you ask this question to anyone in the medical establishment, government or drug industry, the answer would be a firm NO, with supportive peer review medical publications. However, if you asked this question to mothers of autistic children, or the (DAN) physicians treating them, the answer would be a an equally emphastic YES, of course , pointing to their own supportive medical studies. (1)(2)(3)(3A)(4)(5) (93-99)

Canary in the Coal Mine

Autistic kids are the canaries in the coal mine, having genetic variations called SNP's (Single Nucleotide Polymorphisms), so they can't easily eliminate environmental toxins from their bodies. The most toxic is the ethyl mercury preservative in vaccines, unwittingly injected into young children before they are old enough to eliminate the mercury. Mercury impairs the immune system, causes auto-immune diseases, and is directly toxic to the brain, causing neurological disorders. (6)(7)(8)(9)

It's a Crime in Iowa and California

Iowa was the first state to ban mercury containing vaccines, Jan 2005. (106)

California has followed suit and more than 30 other states have similar bans under consideration.

In California, Governor Arnold Schwarzenegger signed the Thimerosal (Mercury) Law which took effect on July 1, 2006 prohibiting vaccination with mercury-containing vaccines to pregnant women or to children under age three. At the federal level, however, Pres. George Bush plans to veto similar legislation (FY 2008 HHS-Labor-Education Appropriations Bill). (10) (11)

The Most Bitter Debate

There is no greater rancor in medicine than the autism-vaccine debate, and this debate has reached the federal vaccine court where 5000 autistic kids and their families are requesting compensation for vaccine injury.

Vaccination Deemed Necessary to Protect Society

Society has deemed vaccination necessary to protect the nation from diseases such as smallpox, polio, diphtheria, and tetanus. In return for these benefits, society accepts the inevitable injury or death of the unlucky few from adverse effects. After all, vaccines contain foreign substances which provoke an immune response.

Examples of vaccine injury include the 1 death per million from viral encephalitis and disseminated viral infection after smallpox vaccination. Another example of vaccine injury is paralytic polio after receiving the live Sabin oral polo vaccine. With the eradication of polio, there are now more polio cases caused by the vaccine then are prevented by it in the US. (12)(13)(14)

The Swine Flu vaccine caused more deaths than did the Swine Flu itself, and there were 500 cases of vaccine associated Guillan Barre paralysis. Both the live polio vaccine and the Swine Flu vaccines have been discontinued in the US for these reasons. (15) (16)

The National Childhood Vaccine Injure Act

Large jury awards arising from DPT vaccine injury litigation in the 1980’s induced some vaccine makers to cease production, representing a threat to national military readiness in the case of biological warfare. (17)(18)

So, Congress passed the 1986 National Childhood Vaccine Injury Act to provide for uninterrupted vaccine production. This law made the vaccine manufacturers immune from civil litgation, and instead established a Federal Court system to provide speedy compensation for vaccine-related injuries or death. (19)

The court uses a table which lists the types of injuries which automatically qualify for compensation. However, Autism is not included in this table. (20)

5000 Autism Cases Before the Vaccine Court

There are currently 5,000 cases before the Federal Vaccine Court requesting compensation for vaccine related autism, and a ruling is expected within the next 6-12 months.(21)(22)(108)

The 5,000 autistic families are represented by Kevin P. Conway, Ronald C Homer & Syvia Chin-Caplan, 16 Shawmut Street, Boston, MA 02116, Phone: 617-695-1990 (23)(24)

Acceptance by the Medical Establishment Not Necessary

A previous case was a victory. In Capizzano 05-5049 (3/9/2006),the Court decided that peer-reviewed scientific literature was not needed to win compensation. All that was needed was a medical theory linking an injury to the vaccine, a logical sequence of cause and effect, and a temporal relationship between them. This can be accomplished by medical records, or by an expert opinion. Peer-reviewed literature, pathological markers, rechallenge and general medical acceptance, are not required to win compensation.

In other words, it is not necessary for the acceptance by the medical establishment that vaccines cause autism., nor was it necessary for the peer review literature to show that vaccines cause autism. All that is needed is to show that Johnny was OK before the vaccination, and after the vaccination, Johnny developed autism.

280 Billion Dollars for Autistic Children - Do the Math

The current rate of autism as 1 in 150 children. Since there are 4 million live births annually in the US, this calculates out to 28,000 autistic kids annually, or 280,000 autistic kids per decade. Assuming the 5000 autistic families prevail in court with an average payout of one million dollars per autistic child, with the potential for 280,000 claims, the potential payout could amount to 280 billion dollars. This is an incredibly large amount of money, about the same amount of spending for 2 years of war in Iraq.(25) For this reason alone, it seems inconceivable that the federal vaccine court would grant compensation for autism. However, only time will tell.

Vaccine-Strain Measles Detected in Autistic Kids from MMR

The Vaccine Court’s compensation table includes Vaccine-strain measles infection, so these autistic kids would automatically be entitled to compensation. There are a number of reports of measles infection in the small bowel in autistic kids shown with endoscopic biopsy and PCR testing. Of course, mainstream medicine claims these findings are debatable, as seen in this article in Nature by DeStefano. (26)(27)(28)(70-75).

Lack of Evidence of Harm

As expected, the medical establishment claims there is a lack of evidence that thimerosol vaccines cause autism, and lack of evidence that the MMR vaccine causes persistent measles infection. (29)(30)(31)(32)(33)(34)(35)(36)

A recent Sept 2007 New England Journal of Medicine (NEJM) article speaks against the notion that thimerisol containing vaccines cause neurological problems.(37)

Autism is Increasing to Epidemic Proportions

A decade ago, the rate of autism was 1 per 10,000. The CDC now says that the current autism rate is 1 per 150. Some say that this dramatic rise in autism rates correlates with the increase in mercury exposure with Thimerosal, as children vaccination schedules have increased. See diagram below. (38)

Mothers Report the Children Are Fine until the Vaccinations, and then Develop Autism

Thousands of families are reporting their normal children changed after receiving mercury-containing vaccines, and began displaying Autism symptoms (which mimic mercury poisoning). (100).

Children with autism have more measurable mercury in their bodies than normal children, because they have difficulty eliminating it. A typical mercury dose received by a two-month old after three mercury vaccines is 125 times EPA's daily allowable exposure levels. In 2001, the Institute of Medicine (IOM) stated it is "biologically plausible" that Thimerosal in vaccines caused autism, ADD/ ADHD and neurodevelopment disorders in general. (40) (41) (42) (43) (44)(45)(46)(47)(48)

Videos on You Tube

There are many videos posted on U-Tube showing a typical story. The new born child develops normally, is then vaccinated and becomes autistic. After biologic treatment by a DAN physician the child dramatically improves. (Click Here for Video) (39)

What are the Features of autism?

The autistic child becomes non-verbal, with no self expression, and assumes postures to put pressure on lower abdomen (indicating pain). There may be hand flapping, and stacking objects. The autistic child shows no interest in other people, or he may be interested in people, but does not know how to talk with, play with, or relate to them. Initiating and maintaining a conversation is difficult. Speech and language skills may begin and then be lost, or they may develop very slowly, or they may never develop. The autistic child may have repeated ritualistic actions such as spinning, rocking, staring, finger flapping, and hitting self. Autistic kids have neurological disorders including epilepsy, gastro-intestinal problems, fine and gross motor deficits, and anxiety and depression. Boys are nearly 4 times more likely to have a parent-reported autism diagnosis than girls. There are about (80 Videos) on You Tube which show the typical signs of Autism: (49)

See Dr. Arthur Krigsman’s (video presentation) on Autism (DAN 2004 meeting) (50)(52)(53).

Symptoms and Biologic Treatment of Autism - Dr. Arthur Krigsman

50-70 % of autistic kids get a gasterointestinal disorder called autism associated entero-colitis, with inflammation of small bowel, stomach, and esophagus. They may have abdominal pain, diarrhea (loose stool, unformed stool, chronic oatmeal consistency, undigested food, malabsorption, constipation, malodorous stools. They may have abdominal distention, due to bowel inflammation and excessive gas. Growth curve may show regression at the onset of GI symptoms and onset of cognitive regression at the 15 month time frame.

Endoscopy finds pathology in these 70% who may have constipation/diarrhea with difficulty passing stool, or 3-4 days without a bowel movement. Endoscopy of small bowel shows lymphoid nodular hyperplasia, and severe LNH resembles Crohns disease.

Leaky Gut Syndrome in Autistic Kids

Autistic kids have an inflamed gut membrane which has increased intestinal permeability, also called “leaky gut” syndrome. In leaky gut, the undigested food macromolecules are absorbed by the leaky gut into the blood stream, an abnormal event. Metabolic pathways to break down these macromolecules are not normally in use.

Gluten from bread, and Casein from milk derivatives produce opioids, which are found in urine of autistic children. By removing the offending foods, the opioids disappear. There are 28 other proteins present in urine whih can b detcted with organic acid testing at the Great Plains Lab, William Shaw. (54)(55)(56)

Gut inflammation can be controlled on long term basis with anti-inflammatory drugs for biopsy proven inflammation on endoscopy. These are 5ASA drugs like Sulfadiazine, and the Salicylates. Very few patients cannot tolerate these drugs. Some kids need steroids (2-4 weeks), same as Crohn’s disease cases. Anti-Fungals (nystatin, diflucan) are widely used by DAN practitioners. Parents will say the kids do better on anti-fungals even though it is difficult to demonstrate fungus found on culture. Organic acid urine tests typically show presence of fungal metabolites which disappear with anti-fungal drugs. Autistic kids are also given digestive enzymes and probiotics which help to improve GI and cognitive symptoms.

Mothers Claim their Autistic Childs with Chelation therapy which removes Mercury

Katie Wright revealed that her autistic son Christian (grandson of NBC Chair Bob Wright), recovered significant function after chelation treatments to remove mercury. (101)(102).

As customary, she was viciously attacked by the medical establishment for her public statement. However, Katie was vigorously defended by John F Kennedy Jr. in this Huffington Post article.(57)(58)(59)(105)(107)

How To Make Vaccinations Safer

To make vaccination safer, Stephanie Cave MD and Sherry Tenpenny have suggested waiting until child is older to give the vaccinations, use single dose mercury-free vaccines, and use vitamin supplements such as Vitamin A and C prior to vaccination. They suggest avoiding vaccination when the child is sick. (60) (61)

Dr. Cave recommends waiting to vaccinate until ther child is at least 6 months of age, preferably older. Do only one vaccine at a time, at least a month apart.

Vaccination is NOT mandatory. Use an Exemption

Information on exemptions was mentioned in a previous newsletter. (62)

New Medical Discoveries Are Usually Rejected

Ignatz Semmelweis, for example, was ridiculed for his suggestion that surgeons should wash their hands before an operation.(63) The British Navy finally gave limes to sailors 50 years after James Lind’s showed citrus fruit cured scurvy.(64) As a reward for his discovery that elevated homocysteine causes heart disease, Kilmer McKully MD, was fired from his job and research grant terminated.(65 ) The thimerisol-autism connection is just another example of the above.

In Iowa and California, it is a illegal to inject a newborn with mercury with the newborn Hepatitis B shot, and and it should be crime in your state as well. Hepatitis B is obtained through IV drug abuse, or via sexual transmission, both activies not possible for newborns.

Hopefully, the injection of mercury into newborns will soon become a relic of the past, taking its rightful place in the museum along with bloodletting and leeches. Until then, there is much work to be done to remove mercury from our vaccinations. As a nation, we can’t afford not to. (66)

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Regards,

Jeffrey Dach, M.D.
4700 Sheridan, Suite T.
Hollywood Florida, 33021
954 983 1443

www.drdach.com
www.jeffreydach.com
www.truemedmd.com

References can be found at th orihinal article at:

http://jeffreydach.com/2007/10/11/autism-vaccines-and-robert-f-kennedy-jr-by-jeffrey-dach-md.aspx

(1) Do Vaccines Cause Autism ?

(2) DEFEAT AUTISM NOW! (DAN!) Physician Referral List: Implementing the Defeat Autism Now!

(3) Biological Evidence of Significant Vaccine Related Side-effects Resulting in Neurodevelopmental Disorders. Presentation to the Vaccine Safety Committee of the Institute of Medicine, The National Academies of Science, February 9, 2004.Jeff Bradstreet MD, ICDRC, 321-953-0278

(3A)Molecular Aspects of Thimerosal-induced Autism Richard C. Deth, Ph.D. Professor of Pharmacology Northeastern University Boston, Massachusetts

(4) Deth's research has uncovered evidence thimerosal creates deficits in the D4 receptor-mediated phospholipids methylation essential for detoxification and sustaining attention to tasks. The research provides the first scientific link between attention deficits and autism. Deth has identified the metabolic process, called methylation, whereby thimerosal can cause the brain damage associated with autism.

(5) An enzyme critical to methylation, methionine synthase, uses an active form of vitamin B12 to complete its chemical function, according to Deth. Thimerosal interferes with the conversion of dietary forms of B12 into the active form and so impedes DNA methylation and disrupts some normal gene actions.

(6) Mercury Poisoning

(7) EPA mercury Site

(8) HHS agency for Toxic Substances

(9) Mass Dept of Environmental Protection

(10) California Mercury Law

(11) Bush will VETO similar Mercury Law

(12) WHO Cessation of Oral (live) polio vaccine,Policy paper.

(13) Oral Polio Vaccine Cessation

(14) vaccinia smallpox CDC info

(15) Swine Flu Vaccination

(16) The Sky is Falling: An Analysis of the Swine Flu Affair of 1976, by Joel Warner

(17) The Tainted History of the DPT Vaccine by Harold Stearley

(18) At Risk: Truth About Vaccines, Lawsuits & Shortages Barbara Loe Fisher

(19) Office of Special Masters of the U.S. Court of Federal Claims,

(20) Vaccine Injury Table outlining which vaccine related injuries are to be compensated.

(21) Current status of 4900—claims for vaccine injuries resulting in autism spectrum disorder before US Court of Federal Claims, Special masters Patricia Campbell Smith, Denise Vowel and George L Hastings Jr. Ruling is expected after Jan 15, 2008.

(22) Audio and written transcripts of this first test case. the Cedillo Case No. 98-916V are available at this page:

(23) Homer legal web site. news and links relating to vaccine litigation.

(24) Federal Vaccine Court decisions with summary and full pdf file of transcripts.

(25) The Possible Costs to the United States of Maintaining a Long-Term Military Presence in Iraq September 2007

(26) references pertaining to measles MMR vaccine and autism. The vaccine strain of measles virus has been found in 85% of samples taken from the guts of children with regressive autism, according to Dr. Stephen Walker of the Wake Forest University School of Medicine.The study replicates findings made by Dr. Andrew Wakefield, a gastroenterologist, in 1998, and by Prof. John O’Leary, a pathologist, in 2002.

(27) Potential viral pathogenic mechanism for new variant inflammatory bowel disease. Mol Pathol. 2002 April; 55(2): 84–90. V Uhlmann, C M Martin, O Sheils, L Pilkington, I Silva, A Killalea, S B Murch, J Walker-Smith, M Thomson, A J Wakefield, and J J O'Leary.

Results: Seventy five of 91 patients with a histologically confirmed diagnosis of ileal lymphonodular hyperplasia and enterocolitis were positive for measles virus in their intestinal tissue compared with five of 70 control patients. Measles virus was identified within the follicular dendritic cells and some lymphocytes in foci of reactive follicular hyperplasia. The copy number of measles virus ranged from one to 300 000 copies/ng total RNA. onclusions: The data confirm an association between the presence of measles virus and gut pathology in children with developmental disorder.

(28) VACCINES AND AUTISM Detection of measles virus in children with ileo-colonic lymphoid nodular hyperplasia, enterocolitis and developmental disorder Molecular Psychiatry (2002) 7, S47–S48. Martin CM, Uhlmann V, Killalea A, Sheils O, O'Leary JJ.

(29) wikipedia MMR vaccine

(30) VACCINES AND AUTISM MMR vaccine and autism: a review of the evidence for a causal association Molecular Psychiatry (2002) 7, S51–S52. CDC finds NO causal association F DeStefano National Center on Birth Defects and Developmental Disabilities, CDC

(31) New Data refutes Measles Virus from Vaccine in Children with Autism,

(32) PEDIATRICS Vol. 118 No. 1 July 2006, pp. e139-e150 Pervasive Developmental Disorders in Montreal, Quebec, Canada: Prevalence and Links With Immunizations Eric Fombonne, MDa, Rita Zakarian, MEda, Andrew Bennett, PhD, CPsychb, Linyan Meng, MSca and Diane McLean-Heywood, MAb The findings ruled out an association between pervasive developmental disorder and either high levels of ethylmercury exposure comparable with those experienced in the United States in the 1990s or 1- or 2-dose measles-mumps-rubella vaccinations.

(33) The "Wakefield" Studies: Studies Hypothesizing That MMR Causes Autism Dr. Paul Offit, M.D., FAAP, Chief of Infectious Diseases and Director of the Vaccine Education Center at Children's Hospital of Philadelphia. Those who claim that MMR causes autism often cite two papers by Andrew Wakefield and colleagues. This section summarizes those studies and lists their critical flaws.Conclusion; autism is not caused by thimerosol vaccines

(34) Web site which states that Autism not caused by vaccines, funded by CDC

(35) The relationship between the MMR vaccine and autism, From The Vaccine Education Center Newsletter AMA page denying link between thimerosol vaccines and autism

(36) VACCINE STUDY IN NEW ENGLAND JOURNAL OF MEDICINE WRONG IN CONCLUDING MERCURY EXPOSURES ARE HARMLESS, STATES SAFEMIN"Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years," appearing in the New England Journal of Medicine (NEJM, 9/27/07 issue), DS

(37) A Sept 2007 NEJM article speaks against the notion that thimerisol containing vaccines cause neurological problems. Volume 357:1281-1292 September 27, 2007 Number 13 Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years

(38) VOLUME 114 | NUMBER 7 | July 2006 • Environmental Health Perspectives diagram of autism epidemic rise

(39) Video BioMedMom,on YouTube showing Autistic Child Development

(40) Critical Issues, Mercury from Safe Minds.org

(41) Stephanie Cave Book, What Your Doctor May Not Tell You About Children's Vaccinations, by Stephanie Cave, M.D., F.A.A.F.P and Deborah Mitchell.

(42) Video: Dr. Mark Geier Speaks at Mercury-Free Vaccines Rally in front of CDC 2007

(43) Video You Tube: Dr. Mary Megson Speaks on Autism Epidemic and Vaccines in front of CDC 2007

(44) Video: Boyd Haley, PhD Speaks at Mercury-Free Vaccines Rally at CDC 2007

(45) Video: Shows How Mercury Kills the Brain ~ Autism Connection

(46) Sherri J. Tenpenny, D.O. Vaccinations, Alternative Medicine, Mothering MAgazine.

(47) A prospective study of mercury toxicity biomarkers in autistic spectrum disorders. Geier DA, Geier MR. J Toxicol Environ Health A. 2007 Oct;70(20):1723-30.

(48) Urinary porphyrin profile analysis (UPPA) to assess body-burden and physiological effects of mercury in children diagnosed with ASDs.

(49) Video on You Tube: Signs of Autism

(50) Video:Current Concepts in the Treatment of Autistic Spectrum Associated Enterocolitis, Arthur Krigsman, M.D.Presented at DAN conference 2004. next meeting appearance National Autism Association November 9-11, 2007, Atlanta

(52) Arthur Krigsman MD Web Site, pediatric gasteroenterologist, Bio

(53) Arthur Krigsman MD Gasteroenterologist Wikipedia

(54) Great Plains Lab web site

(55) Biological Treatment of Autism by William Shaw PhD

(56) The Official Autism 101 Manual is the most comprehensive book on Autism"

(57) Robert F. Kennedy Jr defends attack on Mothers, The poisonous public attacks on Katie Wright this week--for revealing that her autistic son Christian (grandson of NBC Chair Bob Wright), has recovered significant function after chelation treatments to remove mercury -- surprised many observers unfamiliar with the acrimonious debate over the mercury-based vaccine preservative Thimerosal. But the patronizing attacks on the mothers of autistic children who have organized to oppose this brain-killing poison is one of the most persistent tactics employed by those defending Thimerosal against the barrage of scientific evidence linking it to the epidemic of pediatric neurological disorders, including autism. Mothers of autistics are routinely dismissed as irrational, hysterical, or as a newspaper editor told me last week, "desperate to find the reason for their children's illnesses," and therefore, overwrought and disconnected.

(59) Video: Christian and Makena, Non verbal aggressive little guy has turned into a wonderful healthy little boy with the help of the specific carbohydrate diet, vitamins, supplements, chelation therapy, ABA, Occupational and Speech therapy.

(60) Interview with Stephanie Cave MD, Mothering MAgazine

(61) Dr. Sherry Tenpenny. In 1987, the World Health Organization advocated the combined administration of Vitamin A with the measles vaccine. When a dose of 100,000 IU of Vitamin A is given with the vaccine, lower rates of side effects occur, and antibodies still develop. Therefore, be sure to give your child is given Vitamin A on the day s/he receives the vaccine. I would also suggest giving powdered Vitamin C (10mg per pound), for 3 days before, the day of, and for 5 days after any vaccine. If you chose to vaccinate, I recommend that you wait until your child is at least 6 months of age, preferably older. Do only one vaccine at a time, at least a month apart

(62) Guard Your Daughters from Gardasil

(63) Ignaz Semmelweiss

(64) James Lind and the Story of Scurvy

(65 ) Kilmer McCully MD and the discovery of the Homocytseine cause for heart disease

(66) Blood Letting Antique Medical Museum

(67) Wakefield AJ and Montgomery SM. Autism, viral infection and measles mumps rubella vaccination. Israeli Medical Association Journal 1999;1:183-187

(68) A prospective study of mercury toxicity biomarkers in autistic spectrum disorders. Geier DA, Geier MR. J Toxicol Environ Health A. 2007 Oct;70(20):1723-30.

(69) Press Release September 30, 2007 WASHINGTON, DC – A new peer-reviewed scientific/medical case study confirms that many children with autistic spectrum disorders (ASDs) suffer from mercury poisoning. The new study, “A Prospective Study of Mercury Toxicity Biomarkers in Autistic Spectrum Disorders” by Mr. David A. Geier and Dr. Mark R. Geier has been published in the most recent issue of the Journal of Toxicology and Environmental Health, Part A (volume 70, issue 20, pgs 1723-1730).

(70) Uhlmann V., Martin C, Shiels, Wakefield AJ, O’Leary JJ. Possible viral pathogenesis of a novel paediatric inflammatory bowel disease. Molecular Pathology 2002;55:84-90

(71) Singh VK, Lin SX, Yang VC. Serological association of measles virus and human herpesvirus-6 with brain autoantibodies in autism. Clin Immunol Immunopathol. 1998;89:105-8.

(72) Singh VK, Jensen RL, Elevated levels of measles antibodies in children with autism, Pediatric Neurology, 2003;28:292-294.

(73) Abnormal measles-mumps-rubella antibodies and CNS autoimmunity in children with autism. Singh VK, Lin SX, Newell E, Nelson C.Department of Biology and Biotechnology Center, Utah State University, Logan, Utah 84322, USA. singhvk@cc.usu.edu, J Biomed Sci. 2002 Jul-Aug;9(4):359-64.

(74) Wakefield, A.J., et al.Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children Lancet 351: 637-641, 1998.

(75) Uhlmann, V., et al. Potential viral pathogenic mechanism for new variant inflammatory bowel disease. Journal of Clinical Pathology: Molecular Pathology 55:1-6, 2002.

(76) Taylor, B., et al. Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association. Lancet 353:2026-2029,1999.

(77) VACCINES AND AUTISM IMMUNIZE, Paul A. Offit, MD, Director, Vaccine Education Center, Children’s Hospital of Philadelphia

(78) Dales, L., et al. Time trends in autism and in MMR immunization coverage in California. JAMA 285:1183-1185, 2001

(79) Lancet. 2000 Oct 7;356(9237):1273.Response to the MMR question.Taylor B, Miller E, Farrington CP.

(80) Kaye, J.A., et al. Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time trend analysis. Brit Med J 322:460-463, 2001.

(81) Taylor, B., et al. Measles, mumps, and rubella vaccination and bowel problems or developmental regression in children with autism: population study. Brit Med J 324:393-396, 2002.

(82) Adrien, J., et al. Blind ratings of early symptoms of autism based upon family home movies. J Am Acad Child Adolesc Psychiatry 32:617-626, 1993.

(83) Adrien, J., et al. Early symptoms in autism from family home movies: evaluation and comparison between 1st and 2nd year of life using I.B.S.E. scale. Acta Paedopsychiatrica 55:71-75, 1992.

(84) Adrien, J., et al. Autism and family home movies: preliminary findings. J Autism Devel Disorders 21:43-49, 1991.

(85) Osterling, J., et al. Early recognition of children with autism: a study of first birthday home videotapes. J Autism Devel Disorders 24:247-257, 1994.

(86) Mars, A.E., et al. Symptoms of pervasive developmental disordeers as observed in prediagnostic home videos of infants and toddlers. J Pediatr 132:500-504, 1998.

(87) Proc Natl Acad Sci U S A. 1998 Nov 10;95(23):13982-7. Links Movement analysis in infancy may be useful for early diagnosis of autism.Teitelbaum P, Teitelbaum O, Nye J, Fryman J, Maurer RG.

(88) Jefferson T, Price D, Demicheli V, Bianco E. Unintended events following immunization with MMR: a systematic review. Vaccine 2003; 21: 3954-3960

(89) Demicheli V, Jefferson T, Rivetti A, Price D. Vaccines for measles, mumps and rubella in children (Review). The Cochrane Collaboration 2005

(90) Balzola F, Daniela C, Repici A, Barbon V, Sapino A, Barbera C, Calvo PL, Gandione M, Rigardetto R, Rizzetto M. Autistic enterocolitis: confirmation of a new inflammatory bowel disease in an Italian cohort of patients. Gastroenterology. 2005;128:Suppl.2;A-303

(91) Balzola F., Barbon V.,Repici A., Rizzetto M., Clauser D., Gandione M., Sapino A., Panenteric IBD-Like Disease in a Patient with Regressive Autism Shown for the First Time by the Wireless Capsule Enteroscopy: Another Piece in the Jigsaw of this Gut-Brain Syndrome? American Journal of Gastroenterology. 2005;100:979

(92) González L., López K., Martínez M., Navarro D., Negrón L., Rodríguez R., Villalobos D., Flores L., Sabrá A. Endoscopic and Histological Characteristics of the Digestive Mucosa in Autistic Children with Gastrointestinal Symptoms. Preliminary Report. G.E.N. Suplemento Especial de Pediatría-Nº 1, 2005; pp41-47.

(93) Autism articles and References

(94) Measles-Mumps-Rubella Vaccine and Autistic Spectrum Disorder: Report From the New Challenges in Childhood Immunizations Conference Convened in Oak Brook, Illinois, June 12-13, 2000 Neal A. Halsey, MD, Susan L. Hyman, MD, and the Conference Writing Panel Conclusions. Although the possible association with MMR vaccine has received much public and political attention and there are many who have derived their own conclusions based on personal experiences, the available evidence does not support the hypothesis that MMR vaccine causes autism or associated disorders or IBD. Separate administration of measles, mumps, and rubella vaccines to children provides no benefit over administration of the combination MMR vaccine and would result in delayed or missed immunizations. PEDIATRICS Vol. 107 No. 5 May 2001, p.e84

(95) Vaccine truth

(96) Regressive Autism, Ileal-Lymphoid Nodular Hyperplasia, Measles Virus and MMR Vaccine Summary of Published Studies Offering Evidence for Linkages By David Thrower

(97) Vaccine Autoimmune Project for Research and Education (VAP) VAP's co-founder Ray Gallup and Dr. Yazbak examine the most recent United States Department of Education statistics and reveal that the 1 in 150 estimate is outdated by five years. They report that the present prevalence of ASD may be as high as 1 in 67.

(98) Biological Evidence of Significant Vaccine Related Side-effects Resulting in Neurodevelopmental Disorders. Presentation to the Vaccine Safety Committee of the Institute of Medicine, The National Academies of Science, February 9, 2004. Jeff Bradstreet MD, ICDRC, 321-953-0278

(99) Gastrointestinal comorbidity, autistic regression and Measles-containing vaccines: positive re-challenge and biological gradient Andrew J. Wakefield, FRCS FRCPath; Carol Stott, PhD; and Kirsten Limb, BSc A.J. Wakefield, C. Stott, K. Limb / Medical Veritas 3 (2006) 796–802

(100) Mercury & Autism Comprehensive research into the autism mercury poisoning connection. Autism: A Unique Type of Mercury Poisoning. See Table A: Summary Comparison of Characteristics of Autism & Mercury Poisoning. Sallie Bernard, Albert Enayati, B.S.Teresa Binstock Heidi Roger Lyn Redwood, R.N., M.S.N., C.R.N.P. Woody McGinnis, M.D. Contact: (201) 444-7306 by ARC Research

(101) Katie Wright, Autism Debate Strains a Family and Its Charity New York Times

(102) Autism Every Day Film with Katie Wright at Sundance Film Festival

(103) Book Review :Louder Than Words By Jenny McCarthy on TACANOW

(104) Jenny Mccarthy Interview in People Magazine, author of Louder than Words, on New York Times Best Seller List. number 5 on 10/15/07

(105) Robert F Kennedy Jr. Home Web Site

(106) Iowa Health Fredom Coalition, First State to Ban Mercury in Vaccines.

(107) Deadly Immunity, originally published on Salon.com June 16, 2005
by Robert F Kennedy Jr

(108) Cases in Vaccine Court — Legal Battles over Vaccines and Autism Stephen D. Sugarman, J.D. NEJM, Volume 357:1275-1277 September 27, 2007 Number 13

Books:

Louder Than Words, By Jenny McCarthy, on the New York Times Best Seller List No. 5,
Non-Fiction HardCover 10/15/07.(103)

Vaccines, Autism and Childhood Disorders: Crucial Data That Could Save Your Child's Life (Paperback) by Neil Z. Miller (Author), Bernard Rimland (Foreword)

What Your Doctor May Not Tell You About Children's Vaccinations (Paperback) by Stephanie Cave MD(Author), Deborah Mitchell

A Shot in the Dark (Paperback) by H. Coulter (Author)

How to Raise a Healthy Child in Spite of Your Doctor (Mass Market Paperback) by Robert S. Mendelsohn MD

Evidence of Harm: Mercury in Vaccines and the Autism Epidemic: A Medical Controversy (Paperback) by David Kirby

Vaccines: Are They Really Safe and Effective (Paperback) by Neil Z. Miller

Vaccinations: A Thoughtful Parent's Guide: How to Make Safe, Sensible Decisions about the Risks, Benefits, and Alternatives (Paperback) by Aviva Jill Romm

Vaccine Guide: Risks and Benefits for Children and Adults (Paperback) by Randall Neustaedt

References for Autism

1
http://specialchildren.about.com/od/autismandvaccines/i/vaccines.htm
Do Vaccines Cause Autism

2 http://www.autismwebsite.com/practitioners/danus.html
DEFEAT AUTISM NOW! (DAN!) Physician Referral List: Implementing the Defeat Autism Now!

3 http://www.nationalautismassociation.org/pdf/IOM-Bradstreet.pdf

Biological Evidence of Significant Vaccine Related Side-effects Resulting in Neurodevelopmental Disorders. Presentation to the Vaccine Safety Committee of the Institute of Medicine,
The National Academies of Science, February 9, 2004.
Jeff Bradstreet MD, ICDRC, 321-953-0278

3A http://www.whale.to/a/deth.pdf
Molecular Aspects of Thimerosal-induced Autism
Richard C. Deth, Ph.D. Professor of Pharmacology Northeastern University Boston, Massachusetts

4 http://en.wikipedia.org/wiki/Richard_Deth
Deth's research has uncovered evidence thimerosal creates deficits in the D4 receptor-mediated phospholipids methylation essential for detoxification and sustaining attention to tasks. The research provides the first scientific link between attention deficits and autism. Deth has identified the metabolic process, called methylation, whereby thimerosal can cause the brain damage associated with autism.

5 http://www.sciencenews.org/articles/20041113/bob8.aspAn enzyme critical to methylation, methionine synthase, uses an active form of vitamin B12 to complete its chemical function, according to Deth. Thimerosal interferes with the conversion of dietary forms of B12 into the active form and so impedes DNA methylation and disrupts some normal gene actions.

6 http://en.wikipedia.org/wiki/Mercury_poisoning Mercury Poisoning

(7) http://www.epa.gov/mercury/ EPA mercury Site

(8) http://www.atsdr.cdc.gov/substances/mercury/index.html
HHS agency for Toxic Substances

(9) http://www.mass.gov/dep/toxics/stypes/hgres.htm
Mass Dept of Environmental Protection

(10) http://www.dhs.ca.gov/ps/dcdc/izgroup/shared/mercury_law.htm
California Mercury Law

(11)http://www.autismtoday.com/articles/Bush%20To%20Veto%20Ban%20On%20Mercury%20In%20Vaccines.asp

Bush will VETO similar Mercury Law

12 http://www.polioeradication.org/content/publications/OPVCessationFrameworkEnglish.pdf
WHO Cessation of Oral (live) polio vaccine..policy paper.

13 http://www.polioeradication.org/content/fixed/opvcessation/opvcessation.asp Oral Polio Vaccine Cessation
14 http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5010a1.htmvaccinia smallpox CDC info

(15)
http://en.wikipedia.org/wiki/Swine_flu Swine Flu Vaccination

(16) http://www.haverford.edu/biology/edwards/disease/viral_essays/warnervirus.htm The Sky is Falling: An Analysis of the Swine Flu Affair of 1976, by Joel Warner

(17) http://www.monitor.net/monitor/free2/dpt.html The Tainted History of the DPT Vaccine by Harold Stearley

(18) http://vaccineawakening.blogspot.com/2007/06/at-risk-truth-about-vaccines-lawsuits.html At Risk: Truth About Vaccines, Lawsuits & Shortages Barbara Loe Fisher

(19) http://en.wikipedia.org/wiki/Vaccine_court Office of Special Masters of the U.S. Court of Federal Claims,

20) http://www.hrsa.gov/vaccinecompensation/table.htm Vaccine Injury Table outlining which vaccine related injuries are to be compensated.

21
http://www.uscfc.uscourts.gov/OSM/Autism/Autism%20Update%20-%20September%2028,%202007.pdf Current status of 4900—claims for vaccine injuries resulting in autism spectrum disorder before US Court of Federal Claims, Special masters Patricia Campbell Smith, Denise Vowel and George L Hastings Jr. Ruling is expected after Jan 15, 2008.

22) ftp://autism.uscfc.uscourts.gov/autism/index.html . Audio and written transcripts of this first test case. the Cedillo Case No. 98-916V are available at this page:

23 http://www.ccandh.com/default.asp. Homer legal web site. news and links relating to vaccine litigation.

24 http://www.ccandh.com/decisions.asp Homer legal website; This page contains a listing of federal vaccine court decisions with summary and full pdf file of transcripts.

25 http://www.cbo.gov/ftpdocs/86xx/doc8641/09-20-ConradLTpresenceinIraq.pdf
The Possible Costs to the United States of Maintaining a Long-Term Military Presence in Iraq September 2007

26 http://www.thoughtfulhouse.org/supporting_research.htm#measles
references pertaining to measles MMR vaccine and autism. The vaccine strain of measles virus has been found in 85% of samples taken from the guts of children with regressive autism, according to Dr. Stephen Walker of the Wake Forest University School of Medicine.The study replicates findings made by Dr. Andrew Wakefield, a gastroenterologist, in 1998, and by Prof. John O’Leary, a pathologist, in 2002.

27) http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=11950955

Mol Pathol. 2002 April; 55(2): 84–90. Potential viral pathogenic mechanism for new variant inflammatory bowel disease V Uhlmann,1* C M Martin,2* O Sheils,2 L Pilkington,1 I Silva,1 A Killalea,1 S B Murch,3 J Walker-Smith,4 M Thomson,4 A J Wakefield,4 and J J O'Leary1

Results: Seventy five of 91 patients with a histologically confirmed diagnosis of ileal lymphonodular hyperplasia and enterocolitis were positive for measles virus in their intestinal tissue compared with five of 70 control patients. Measles virus was identified within the follicular dendritic cells and some lymphocytes in foci of reactive follicular hyperplasia. The copy number of measles virus ranged from one to 300 000 copies/ng total RNA. onclusions: The data confirm an association between the presence of measles virus and gut pathology in children with developmental disorder.

28 http://www.nature.com/mp/journal/v7/n2s/pdf/4001179a.pdf

VACCINES AND AUTISM Detection of measles virus in children with ileo-colonic
lymphoid nodular hyperplasia, enterocolitis and developmental disorder
Molecular Psychiatry (2002) 7, S47–S48. Martin CM, Uhlmann V, Killalea A, Sheils O, O'Leary JJ.
29 http://en.wikipedia.org/wiki/MMR_vaccine
wikipedia MMR vaccine

30 http://www.nature.com/mp/journal/v7/n2s/pdf/4001181a.pdf
VACCINES AND AUTISM MMR vaccine and autism: a review of the evidence for a causal association Molecular Psychiatry (2002) 7, S51–S52 CDC finds NO causal association F DeStefano National Center on Birth Defects and Developmental Disabilities, CDC

31 http://www.medscape.com/viewarticle/545428

New Data refutes Measles Virus from Vaccine in Children with Autism

32
http://pediatrics.aappublications.org/cgi/content/full/118/1/e139

PEDIATRICS Vol. 118 No. 1 July 2006, pp. e139-e150
Pervasive Developmental Disorders in Montreal, Quebec, Canada: Prevalence and Links With Immunizations Eric Fombonne, MDa, Rita Zakarian, MEda, Andrew Bennett, PhD, CPsychb, Linyan Meng, MSca and Diane McLean-Heywood, MAb The findings ruled out an association between pervasive developmental disorder and either high levels of ethylmercury exposure comparable with those experienced in the United States in the 1990s or 1- or 2-dose measles-mumps-rubella vaccinations.

33 http://www.cispimmunize.org/fam/autism/a_wake.html
The "Wakefield" Studies: Studies Hypothesizing That MMR Causes Autism Dr. Paul Offit, M.D., FAAP, Chief of Infectious Diseases and Director of the Vaccine Education Center at Children's Hospital of Philadelphia. Those who claim that MMR causes autism often cite two papers by Andrew Wakefield and colleagues. This section summarizes those studies and lists their critical flaws.Conclusion; autism is not caused by thimerosol vaccines

34 http://www.immunize.org/index.htm
Web site which states that Autism not caused by vaccines, funded by CDC

(35) http://www.ama-assn.org/ama/pub/category/13697.html
The relationship between the MMR vaccine and autism
From The Vaccine Education Center Newsletter
AMA page denying link between thimerosol vaccines and autism

(36)http://www.safeminds.org/pressroom/vaccine-study.html
VACCINE STUDY IN NEW ENGLAND JOURNAL OF MEDICINE WRONG IN CONCLUDING MERCURY EXPOSURES ARE HARMLESS, STATES SAFEMIN"Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years," appearing in the New England Journal of Medicine (NEJM, 9/27/07 issue), DS

A Sept 2007 NEJM article speaks against the notion that thimerisol containing vaccines cause neurological problems.

(37) http://content.nejm.org/cgi/content/abstract/357/13/1281
Volume 357:1281-1292 September 27, 2007 Number 13
Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years

38 http://www.safeminds.org/pressroom/ehp0114-a00412.pdf

VOLUME 114 | NUMBER 7 | July 2006 • Environmental Health Perspectives
diagram of autism epidemic rise

39 http://www.youtube.com/watch?v=sJIXEyXE4Vk
BioMedMom

40 http://www.safeminds.org/mercury/
Critical Issues, Mercury from Safe Minds.org
41 http://www.vaccinationnews.com/DailyNews/October2001/WhatDocMayNotTell.htm
Link to Stephanie Cave Book, What Your Doctor May Not Tell You About Children's Vaccinations, by Stephanie Cave, M.D., F.A.A.F.P and Deborah Mitchell.

42 http://www.youtube.com/watch?v=aDY7mst7ytg&mode=related&search=Megson%20Autism%20Vaccines

Dr. Mark Geier Speaks at Mercury-Free Vaccines Rally

43
http://www.youtube.com/watch?v=i6yIncJnx4U&mode=related&search=
Dr. Mary Megson Speaks on Autism Epidemic and Vaccines
44
http://www.youtube.com/watch?v=GHMWDBJzh7s&mode=related&search=Megson%20Autism%20Vaccines
Boyd Haley, PhD Speaks at Mercury-Free Vaccines Rally Urinary Porphyrin Profile

45
http://www.youtube.com/watch?v=85tgwh3HpsM&mode=related&search=
Mercury toxicity video How Mercury Kills the Brain ~ Autism

46 http://www.mothering.com/sections/experts/tenpenny-archive.html#doctor-fears Sherri J. Tenpenny, D.O. Vaccinations, Alternative Medicine

47 http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&list_uids=17885929
J Toxicol Environ Health A. 2007 Oct;70(20):1723-30. A prospective study of mercury toxicity biomarkers in autistic spectrum disorders. Geier DA, Geier MR.

48 http://www.mercury-freedrugs.org/docs/07930_PR_UrineTestingConfirmsAutismIsMercuryPoisoningb.pdf

This study utilized urinary porphyrin profile analysis (UPPA) to assess body-burden and physiological effects of mercury in children diagnosed with ASDs.

49 http://www.youtube.com/results?search_query=signs+of+autism&search=Search Signs of Autism U-Tube

50 http://www.autismwebsite.com/krigsman/
Video:Current Concepts in the Treatment of Autistic Spectrum Associated Enterocolitis, Arthur Krigsman, M.D.Presented at DAN conference 2004. next meeting appearance National Autism Association November 9-11, 2007, Atlanta

52 http://www.thoughtfulhouse.org/bio_akrigsman.htm
Arthur Krigsman MD Web Site, pediatric gasteroenterologist

53 http://en.wikipedia.org/wiki/Arthur_Krigsman
Arthur Krigsman MD Gasteroenterologist

54 http://www.greatplainslaboratory.com/home.htm Great Plains Lab web site

55 http://www.greatplainslaboratory.com/bookstore/autism.asp#biologicalTretments
Biological Treatment of Autism by William Shaw PhD

56 http://www.autism101manual.com/ The Official Autism 101 Manual is the most comprehensive book on Autism"

57 http://www.huffingtonpost.com/robert-f-kennedy-jr/attack-on-mothers_b_52894.html?view=screen
Robert F. Kennedy Jr Attack on Mothers The poisonous public attacks on Katie Wright this week--for revealing that her autistic son Christian (grandson of NBC Chair Bob Wright), has recovered significant function after chelation treatments to remove mercury -- surprised many observers unfamiliar with the acrimonious debate over the mercury-based vaccine preservative Thimerosal. But the patronizing attacks on the mothers of autistic children who have organized to oppose this brain-killing poison is one of the most persistent tactics employed by those defending Thimerosal against the barrage of scientific evidence linking it to the epidemic of pediatric neurological disorders, including autism. Mothers of autistics are routinely dismissed as irrational, hysterical, or as a newspaper editor told me last week, "desperate to find the reason for their children's illnesses," and therefore, overwrought and disconnected.

59 http://www.youtube.com/watch?v=QWG-SWQ3vSs&mode=related&search= Christian and MAkena Non verbal aggressive little guy has turned into a wonderful healthy little boy with the help of the specific carbohydrate diet, vitamins, supplements, chelation therapy, ABA, Occupational and Speech therapy.

60 http://www.mothering.com/articles/growing_child/vaccines/biochemistry.html Interview with Stephanie Cave MD

61 http://www.mothering.com/sections/experts/tenpenny-archive.html#doctor-fears
Sherry Tenpenny. In 1987, the World Health Organization advocated the combined administration of Vitamin A with the measles vaccine. When a dose of 100,000 IU of Vitamin A is given with the vaccine, lower rates of side effects occur, and antibodies still develop. Therefore, be sure to give your child is given Vitamin A on the day s/he receives the vaccine. I would also suggest giving powdered Vitamin C (10mg per pound), for 3 days before, the day of, and for 5 days after any vaccine.
If you chose to vaccinate, I recommend that you wait until your child is at least 6 months of age, preferably older. Do only one vaccine at a time, at least a month apart

62 http://jeffreydach.com/2007/05/06/jeffreydachdrdachvaccinehpv.aspx
Guard Your Daughters from Gardasil

63 http://en.wikipedia.org/wiki/Ignaz_Semmelweis Ignaz Semmelweiss

64
http://www.jameslindlibrary.org/trial_records/17th_18th_Century/lind/lind_1753_commentary.html James Lind and the story of Scurvy

65
http://www.drpasswater.com/nutrition_library/homocysteine.html
Kilmer McCully MD and the discovery of the Homocytseine cause for heart disease

66
http://www.medicalantiques.com/medical/Scarifications_and_Bleeder_Medical_Antiques.htm

(67) http://www.ima.org.il/imaj/ar99nov11.pdf
Wakefield AJ and Montgomery SM. Autism, viral infection and measles mumps rubella vaccination. Israeli Medical Association Journal 1999;1:183-187

(68)

http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&list_uids=17885929
J Toxicol Environ Health A. 2007 Oct;70(20):1723-30. A prospective study of mercury toxicity biomarkers in autistic spectrum disorders. Geier DA, Geier MR.

(69)
http://www.mercury-freedrugs.org/docs/07930_PR_UrineTestingConfirmsAutismIsMercuryPoisoningb.pdf

Press Release Contact: September 30, 2007 WASHINGTON, DC – A new peer-reviewed scientific/medical case study confirms that many children with autistic spectrum disorders (ASDs) suffer from mercury poisoning. The new study, “A Prospective Study of Mercury Toxicity Biomarkers in Autistic Spectrum Disorders” by Mr. David A. Geier and Dr. Mark R. Geier has been published in the most recent issue of the Journal of Toxicology and Environmental Health, Part A (volume 70, issue 20, pgs 1723-1730).

70) http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=9756729&ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
Uhlmann V., Martin C, Shiels, Wakefield AJ, O’Leary JJ. Possible viral pathogenesis of a novel paediatric inflammatory bowel disease. Molecular Pathology 2002;55:84-90
71) http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=12849883&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
Singh VK, Lin SX, Yang VC. Serological association of measles virus and human herpesvirus-6 with brain autoantibodies in autism. Clin Immunol Immunopathol. 1998;89:105-8.
===

72) http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&list_uids=12849883&query_hl=43
Singh VK, Jensen RL, Elevated levels of measles antibodies in children with autism, Pediatric Neurology, 2003;28:292-294.
----

73)
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=12145534&ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
Abnormal measles-mumps-rubella antibodies and CNS autoimmunity in children with autism. Singh VK, Lin SX, Newell E, Nelson C.Department of Biology and Biotechnology Center, Utah State University, Logan, Utah 84322, USA. singhvk@cc.usu.edu, J Biomed Sci. 2002 Jul-Aug;9(4):359-64.

74) Wakefield, A.J., et al.Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children Lancet 351: 637-641, 1998.
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=9500320&dopt=Abstract%20

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Uhlmann, V., et al. Potential viral pathogenic mechanism for new variant inflammatory bowel disease. Journal of Clinical Pathology: Molecular Pathology 55:1-6, 2002. http://jcp.bmj.com/cgi/data/55/1/DC1/1

76) http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=10376617&ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
Taylor, B., et al. Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association. Lancet 353:2026-2029,1999.

77)
http://www.immunize.org/autism/offit_article.pdf
VACCINES AND AUTISM IMMUNIZE, Paul A. Offit, MD, Director, Vaccine Education Center, Children’s Hospital of Philadelphia

78) http://jama.ama-assn.org/cgi/content/full/285/9/1183
Dales, L., et al. Time trends in autism and in MMR immunization coverage in California. JAMA 285:1183-1185, 2001

79)
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Lancet. 2000 Oct 7;356(9237):1273.Response to the MMR question.Taylor B, Miller E, Farrington CP.
80) http://bmj.com/cgi/content/full/322/7284/460?view=full&pmid=11222420
Kaye, J.A., et al. Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time trend analysis. Brit Med J 322:460-463, 2001.

81)
Taylor, B., et al. Measles, mumps, and rubella vaccination and bowel problems or developmental regression in children with autism: population study. Brit Med J 324:393-396, 2002.

82)
Adrien, J., et al. Blind ratings of early symptoms of autism based upon family home movies. J Am Acad Child Adolesc Psychiatry 32:617-626, 1993.

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83)Adrien, J., et al. Early symptoms in autism from family home movies: evaluation and comparison between 1st and 2nd year of life using I.B.S.E. scale. Acta Paedopsychiatrica 55:71-75, 1992.

84)http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=2037548&dopt=AbstractPlus
Adrien, J., et al. Autism and family home movies: preliminary findings. J Autism Devel Disorders 21:43-49, 1991.

85) http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=8050980&dopt=AbstractPlus Osterling, J., et al. Early recognition of children with autism: a study of first birthday home videotapes. J Autism Devel Disorders 24:247-257, 1994.

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Mars, A.E., et al. Symptoms of pervasive developmental disordeers as observed in prediagnostic home videos of infants and toddlers. J Pediatr 132:500-504, 1998.

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Teitelbaum, P., et al. Movement analysis in infancy may be useful for the early diagnosis of autism.Proc Natl Acad Sci USA 95:13982-13987, 1998.

Jefferson T, Price D, Demicheli V, Bianco E. Unintended events following immunization with MMR: a systematic review. Vaccine 2003; 21: 3954-3960

Demicheli V, Jefferson T, Rivetti A, Price D. Vaccines for measles, mumps and rubella in children (Review). The Cochrane Collaboration 2005

Balzola F, Daniela C, Repici A, Barbon V, Sapino A, Barbera C, Calvo PL, Gandione M, Rigardetto R, Rizzetto M. Autistic enterocolitis: confirmation of a new inflammatory bowel disease in an Italian cohort of patients. Gastroenterology. 2005;128:Suppl.2;A-303

Balzola F., Barbon V.,Repici A., Rizzetto M., Clauser D., Gandione M., Sapino A., Panenteric IBD-Like Disease in a Patient with Regressive

Autism Shown for the First Time by the Wireless Capsule Enteroscopy: Another Piece in the Jigsaw of this Gut-Brain Syndrome? American Journal of Gastroenterology. 2005;100:979

González L., López K., Martínez M., Navarro D., Negrón L., Rodríguez R., Villalobos D., Flores L., Sabrá A. Endoscopic and Histological

Characteristics of the Digestive Mucosa in Autistic Children with Gastrointestinal Symptoms. Preliminary Report. G.E.N. Suplemento Especial de Pediatría-Nº 1, 2005; pp41-47.

http://www.informedchoice.info/MMR.html autism articles
http://pediatrics.aappublications.org/cgi/content/full/107/5/e84

PEDIATRICS Vol. 107 No. 5 May 2001, p. e84 ELECTRONIC ARTICLE:Measles-Mumps-Rubella Vaccine and Autistic Spectrum Disorder: Report From the New Challenges in Childhood Immunizations Conference Convened in Oak Brook, Illinois, June 12-13, 2000 Neal A. Halsey, MD, Susan L. Hyman, MD, and the Conference Writing Panel Conclusions.

Although the possible association with MMR vaccine has received much public and political attention and there are many who have derived their own conclusions based on personal experiences, the available evidence does not support the hypothesis that MMR vaccine causes autism or associated disorders or IBD. Separate administration of measles, mumps, and rubella vaccines to children provides no benefit over administration of the combination MMR vaccine and would result in delayed or missed immunizations.

http://www.vaccinetruth.org/measles_in_the_brain.htm

http://www.vaproject.org/thrower/mmr-briefing-20070430.pdf

Regressive Autism, Ileal-Lymphoid Nodular Hyperplasia, Measles Virus and MMR Vaccine Summary of Published Studies Offering Evidence for Linkages By David Thrower

http://www.vaproject.org/

Va

Roger Federer, Ranked Number One

The number one ranked tennis player, Roger Federer, swept the Australian Open, Wimbledon and the U.S. Open in all three years, 2004, 2006 and 2007.(1)(2)

What is Roger's Secret Weapon?

Of course, Roger Federer is a gifted athlete, but could he have a secret weapon that gives him an edge on the tennis court? You might be surprised to know that Roger Federer makes use of gadget called a BEMER. This is a portable pulsed magnetic field device which speeds healing of muscle and tendons after tough tennis matches. According to the BEMER web site, Roger and many other athletes have been using a portable pulsed magnetic therapy unit regularly. (3)

Horse Racing and Pulsed Magnetic Wave Devices

This type of therapy for sports injuries is nothing new. There is big money in Horse Racing, and trainers give their horses pulsed magnetic therapy to gain an edge on the track. Benefits include faster recovery time from sports injuries, improved blood flow, improved nerve regeneration, and faster wound and fracture healing. (4-11)

Dan Clark MD and the BioEnergetic Medicine Conference

I learned about Roger Federer using the BEMER at Dan Clark’s BioEnergetic Medicine Conference in Orlando. (15)

Robert O Becker, M.D., The Body Electric

Electromagnetic radiation as a therapeutic device wasn’t accepted by mainstream medicine until 1985 when Robert O Becker, M.D. discovered that non-united bone fractures heal with pulsed EMF electrical stimulation. This is now standard practice in all hospitals. Becker’s books, The Body Electric in 1985, and Cross Currents in 1990, broke new ground, and the 3 decades of research since then have shown pulsed EMF to be effective for non-united bone fractures, relief of musculo-skeletal pain, migraine headaches, low back pain, depression, wound healing, improvement in blood flow and nerve regeneration, to mention a few. Becker discovered that weak electric currents recruit stem cells which differentiate into the body part requiring healing. Becker also discovered a second nervous system in the body which corresponds to the Chinese acupuncture meridians. (9-14)(63-71).

Electromagnetic Waves are the Basis of the Chemical Bond

Although modern science began with Newton’s laws of mechanics in 1687, Michael Faraday’s principles of electromagnetic induction were discovered only recently in 1831. Since then, Einstein and quantum mechanics further changed our understanding of matter, energy, and the universe. Paradoxically, the electron and all electromagnetic energy are both particle and wave, and the electron’s wave function derived from quantum mechanics is the basis of the chemical bond, first described by Linus Pauling. The chemical bond is now understood as sharing electrons (electromagnetic energy wave forms) between two atoms or molecules. (16)(17)(18-21A)

Electro-Magnetic Energy Use in Diagnosis

We have been using electromagnetic energy for medical diagnosis since the beginning of modern medicine. For example, the Electrocardiogram (EKG) and Electroencephalogram (EEG) both record electrical activity from body parts. The CAT scanner makes an image by passing electromagnetic radiation through a body part. The MRI scanner makes an image by pulsing electromagnetic energy through the body and then “listening” for the emitted energy signal. The mass spectrograph, a primitive form of MRI machine is used daily in the hospital lab for routine blood testing.

Electromagnetic Energy is Essential for Life

When we bask in the sun, and our skin makes vitamin D from sun light, this is electromagnetic radiation driving a bio-chemical reaction in our body. Photosynthesis is another example of absorption of electromagnetic radiation to form carbon bonds in plants. As a matter of fact, all biochemistry can be explained as electrical interactions between outer shell electrons. Electromagnetic energy is a basic part of the biochemistry of life.

BEMER and ONDAMED

One elementary problem with pulsed electro magnetic therapy as a treatment is: how do we determine the exact pulse frequency to be used? The BEMER device steps through a series of pre-set frequencies. Another device called the Ondamed uses a more sophisticated method of diagnosis before applying the treatment. (22) The operator scans though a frequency range while palpating the radial pulse. When the pulse becomes palpably stronger, this indicates a vascular autonomic response (VAS), and that’s the frequency used for treatment. (23). Our understanding of pulsed magnetic field treatment is still in its infancy, and the next few decades will see more research and refinement of technique, and greater acceptance into mainstream medicine.

Presenters at the Meeting:

Shari Lieberman

Dr. Shari Lieberman presented three cases of plantar fasciitis treated with the Ondamed device, all with prompt recovery.(24) (25). Dr. Lieberman is currently compiling additional Ondamed cases of trigeminal neuralgia, reflex sympathetic dystrophy, bell’s palsy, and others.

Poly-MVA

Dr. Shari Lieberman also presented Poly-MVA case studies. Poly MVA is a non-toxic nutritional supplement containing palladium which has been used as cancer treatment. Dr. Lieberman presented cases of clinical improvement with Poly MVA. These cases included multiple myeloma, lung cancer, and prostate cancer. (30, 30A-D).

Merrill Garnett

Merrill Garnett, the inventor of Poly MVA, is a brilliant researcher and author of the book, First Pulse, which describes the electrical pulsations inside every cell, and how Poly MVA manipulates these electrical pulsations to cause the death of cancer cells without injuring normal cells. Garnett’s life-long search for an anti-cancer agent culminated in his discovery of Poly MVA. One hundred years from now, it is likely that history books will place Garnett in the same company with Faraday, Einstein, and Becker (31)(32)(33)(34)(35).

Patricia Kane PhD

Patricia and Ed Kane of the Haverford Wellness Center, Havertown, PA presented their treatment protocol and case studies. They use IV phospholipid therapy for ALS, Stroke, Environmental illness, Hypercoagulation, Parkinson's, Cardiovascular Disease, Hepatitis C and Autism. This is the original IV phospholipid formulation from Natterman in Germany, and they showed case photos before and after treatment which were simply amazing, and by far the most impressive at the meeting. (26-29)

Ed Kane, cell membrane phospholipid bilayers, the key to health.

Above diagram shows the bi-layer nature of the cell membrane.

Phospholipids are long chain carbon molecules which form microscopic tuning forks which can oscillate and resonate at set electromagnetic frequencies. (see diagram below)

Above diagram is magnified version of membrane bi-layer showing molecular structure of the phospholipid "tuning fork" composed of two long carbon chains joined at the top. Note one chain has a cis double bond which results in a 37 degree bend which vibrates back and forth.

These phospholipid bilayers are not only located at the outer cell membrane, they are also present as folded layers throughout the cell cytoplasm providing surfaces for all biochemical reactions to take place. Energy absorption by these bilayers speeds up biochemical reactions at the membrane surfaces.

(Below diagram is an electron micrograph inside a cell showing a mitochondria which has an oval shape. The vertical rows of lines inside the oval are membrane bilayers where energy production takes place. The membrane bilayers are made of tuning fork phospholipids which absorb and emit electromagnetic energy)

Sangeeta Pati, M.D.

Sangeeta Pati, M.D. discussed bio-identical hormones, reviewing the medical literature which demonstrates that bio-identical hormones are safe and do not increase risk of breast cancer as shown in the French Cohort study. In addition, bio-identical hormones are protective and reduce risk of heart disease as shown in a recent NEJM coronary calcium score study. On the other hand, the synthetic progestins are the bad guys which should be avoided. (36-39). Don’t miss Dr. Sangeeta Pati explaining bio-identical hormone therapy in a video interview on the Wellness Hour.

Eldred Taylor MD

Eldred Taylor MD discussed adrenal fatigue diagnosis with salivary cortisol testing, and treatment with cortisol or phosphatidyl serine. Dr. Taylor left his OB/Gyne practice because the field had degenerated to the point where the only information he needed was the patient’s age. (40) (41) Women younger than 50 get birth control pills and SSRI anti-depressants. Women older than 50 get synthetic HRT and SSRI antidepressants. Sadly, conventional medical practice has come down to that.

Adrenal Fatigue:

Adrenal Fatigue: Chronic daily stress eventually causes exhaustion, and this means reduced adrenal production of cortisol, which is the definition of adrenal fatigue. I had a recent phone conversation with an old time friend who is also an endocrinologist. She informed me that adrenal fatigue simply doesn’t exist as a real medical diagnosis. Mainstream medicine doesn’t believe in it. The adrenal gland is normal, functioning at 100%, or nonfunctional (Addison’s’ Disease), with nothing in between. For these doubting mainstream docs, Dr. Taylor presented a review of the medical literature showing that adrenal fatigue is indeed caused by cortisol deficiency which can be measured with salivary testing, and the condition can be cured with bio-identical natural cortisol. (43-55)

Russell Jaffe MD

Russell Jaffe MD discussed how vitamin and nutritional deficiencies are prevalent and cause chronic diseases such as cardiovascular disease, cancer, and osteoporosis.(56)(57) Russell Jaffe is the founder of Perque, a unique vitamin an nutritional supplement company which is miles ahead of the competition. We use the Perque Vitamin C because it is 100% L-ascorbate, fully buffered with no fillers, and is the superior product. Russ has solved a number of nutritional supplement problems. His choline citrate solves the magnesium uptake block issue. His glucosamine joint product provides more rapid pain relief, his bioflavonoids provide more pain relief, and a new fiber which is better tolerated. Russ also has a new adrenal stress product containing Relora which was unveiled at the meeting, and the samples I tried were incredible. Russ has continued to improve the Perque line everytime and visit their booth. For example, Strontium is now included in the Bone Guard supplement for osteoporosis prevention. (58)(59)

Always the showman, Dr. Jaffe made the closing comments at the meeting describing how Louis Pasteur triumphed over his rival Bechamp with superior marketing, rather than with superior technology.

Did you find this newsletter interesting?
Feel free to email this to a friend with the button on the bar at the bottom of the page.

Regards,

Jeffrey Dach, M.D.
4700 Sheridan, Suite T.
Hollywood Florida, 33021
954 983 1443
www.drdach.com

References

(1) Roger Federer Web Site
http://www.rogerfederer.com/en/index.cfm

(2) Roger Federer http://en.wikipedia.org/wiki/Roger_Federer

(3) list of athletes using BEMER
http://www.bemerclinics.com.au/public/html/sports.html

(4) http://www.horsemagneticpulser.com/HMPstory.pdf
History of Pulsed Magnetic Fields for Treatment of Horses
(PDF / Adobe Acrobat). horsemagneticpulser.com.

(5) http://www.debmar.com/equine/
Pulsed Magnetic Fields for Treatment of Horses. Debmar Equine.

(6) http://www.tgselectronics.com.au/vetpmft.html
Australian Pulsed Magnetic Fields for Treatment of Horses. TSG Electronics Australia.

(7) http://www.equi-stimlegsaver.com/history.htm
Horses and pulsed magnetic fields

(8) http://en.wikipedia.org/wiki/List_of_historical_horses
List of famous race horses:

(9) http://www.curatronic.com/pdf/PEMF%20therapeutic%20uses.pdf
Therapeutic Uses of Pulsed EMF review article 2003

(10) http://www.ursi.org/RSBissues/RSBdecember2003.pdf
Therapeutic Uses of Pulsed EMF review article 2003

(11) http://www.earthpulse.net/Becker.htm
Robert O. Becker Research Bibliography

(12) Becker’s The Body Electric Description on Wikipedia
http://en.wikipedia.org/wiki/The_Body_Electric

(13) http://www.harpercollins.com/books/9780688069711/The_Body_Electric/excerpt.aspx

The Body Electric Electromagnetism And The Foundation Of Life © 1985 By Robert Becker, Gary Selden

Described as “the greatest scientific work of the 20th century, with the POSSIBLE exception of Einstein's "Collected Works on Relativity". Yes, Becker is that good.”

(14)
http://www.amazon.com/gp/reader/0874776090/ref=sib_dp_pt/104-6967425-7603934#reader-link

CrossCurrents by Robert O Becker © 1990

(15) http://www.bioenergeticseminars.com/
Daniel Clark, MD, The 11th Annual International Congress Of BioEnergetic Medicine

(16)
http://en.wikipedia.org/wiki/Isaac_Newton
Issac Newton

(17)
http://en.wikipedia.org/wiki/Michael_Faraday
Michael Faraday

(18)
http://hyperphysics.phy-astr.gsu.edu/hbase/mod1.html
Light- Particle/ Wave duality

(19) Matter and Energy
http://web.jjay.cuny.edu/~acarpi/NSC/index.htm

(20) http://en.wikipedia.org/wiki/Matter
definition of matter

(21)
http://en.wikipedia.org/wiki/Energy
definition of energy

(21A)
http://osulibrary.oregonstate.edu/specialcollections/coll/pauling/bond/narrative/page46.html
Linus Pauling and the Chemical Bond

(22) http://www.ondamed.net/
Ondamed Web Site

(23) http://www.iaam.nl/_fundamental/00080000.htm
The Biophysics of the Vascular Autonomic Signal and Healing, John M. Ackerman, M.D., Research of orthopedic surgeon, Joseph H. Navach, M.D.

(24) http://www.drshari.net/
Shari Lieberman

(25) http://www.ondamed.net/news_detail_us.php
Shari Lieberman joins Ondamed research team.

(26) http://www.bodybio.com/index.htm
Ed and Patricia Kane (BodyBio)

(27) http://www.bodybio.com/main/products/detoxxbook.htm Detoxx Book

(28) http://www.haverfordwellness.com/
Haverford Wellness Patricia Kane

28A) http://explorepub.com/articles/nutrition1.html
Essential Fatty Acids, Lorenzo's Oil and Beyond, by Patricia Kane, Ph.D., Millville, New Jersey, U.S.A. (Explore Issue: Volume 7, Number 6)

(29) PhosChol
http://www.phoschol.com/physicians/

(30) PolyMVA
http://www.polymva.com/

(30A)
http://www.facr.org/pdf/Case-studies-for-prostate-8-05.pdf
Poly MVA for treating Prostate Cancer, a report of three cases by Shari Lieberman PhD and James Forsyth M.D.

(30B) http://www.polymva.com/pdf/MultipleMyeloma-final-revision.pdf
Poly MVA in treatment of Multiple Myeloma by Shari Lieberman

(30C)
http://www.liebertonline.com/doi/abs/10.1089/act.2006.12.77
Poly-MVA for Treating Non–Small-Cell Lung Cancer: A Case Study of an Integrative Approach by Lieberman and Forsythe

(30D) http://www.townsendletter.com/FebMar_2003/polymva0203.htm
The Medical Journalist Report of Innovative Biologics: Cancer Remission Rates Increase from Use of the Safe and Effective Lipoic Acid Palladium Complex Poly-MVA
by Morton Walker, DPM From the Townsend Letter for Doctors & Patients
February/March 2003

(31) Foundation for the Advancement of Cancer Research
http://www.facr.org/

(32) http://www.polymvasurvivors.com/testimonial_colon.html
Poly-Mva Survivors web site

(33) http://www.electrogenetics.net/
Merrill Garnett Web Site

(34) First Pulse Book by Merrill Garnett, describes how Poly MVA Works
http://www.firstpulseprojects.com/Publications.html

(35) http://www.firstpulseprojects.com/firstpulsereview.html
review of First Pulse by Brian Thomas Carroll

http://www.explorepub.com/articles/summaries/13_1_garnett.html

The Fire in the Genes 2004 by Merrill Garnett, USA
(Explore Issue: Volume 13, Number 1)

(36) http://www.sajune.com/page4.html
Sangeeta Pati, M.D. SaJune Spa and Medical Center Orlando
http://www.sajune.com/

(37) http://www.wellnesshour.com/features/hormone_replacement/pati_sangeeta.html
Sangeeta Pati MD Video Interview on the Wellness Hour with Randy Alvarez

(37A) http://www.youtube.com/watch?v=hxOvbBI-FRQ
Sangeeta Pati, MD Video Interview on the Wellness Hour with Randy Alvarez on U-Tube

(38) http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=12626212&query_hl=3&itool=pubmed_docsum

French Cohort Study showing no increased risk of breast cancer from bio-o\\identical hormones.

(39) http://content.nejm.org/cgi/content/short/356/25/2591
NEJM study which shows that estrogen therapy prevents heart disease.
Estrogen Therapy and Coronary-Artery Calcification
NEJM Volume 356:2591-2602 June 21, 2007 Number 25
JoAnn E. Manson, M.D. et al.

(40) http://getoutoflinenow.com/
Eldred Taylor Web site

(41)
http://www.alibris.com/search/search.cfm?qwork=8699964&wauth=Eldred&matches=19&qsort=r&cm_re=works*listing*title

The Book:Are Your Hormones Making You Sick? By Eldred and Ava Taylor

(42)
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&list_uids=6316831

Salivary cortisol: a better measure of adrenal cortical function than serum cortisol. Ann Clin Biochem. 1983 Nov;20 (Pt 6):329-35. Vining RF, McGinley RA, Maksvytis JJ, Ho KY.

(43)
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&list_uids=2828410

Salivary cortisol measurement: a practical approach to assess pituitary-adrenal function.
J Clin Endocrinol Metab. 1988 Feb;66(2):343-8.
Laudat MH, Cerdas S, Fournier C, Guiban D, Guilhaume B, Luton JP.

(44) http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=11164057&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

J Psychosom Res. 2000 Nov;49(5):335-42. Salivary cortisol patterns in vital exhaustion.Nicolson NA, van Diest R.

(45) http://bjp.rcpsych.org/cgi/content/full/184/2/136

Br J Psychiatry. 2004 Feb;184:136-41. Salivary cortisol response to awakening in chronic fatigue syndrome.Roberts AD, Wessely S, Chalder T, Papadopoulos A, Cleare AJ. (FULL TEXT)

(46) http://jcem.endojournals.org/cgi/content/full/86/8/3545
Hypothalamo-Pituitary-Adrenal Axis Dysfunction in Chronic Fatigue Syndrome, and the Effects of Low-Dose Hydrocortisone Therapy. The Journal of Clinical Endocrinology & Metabolism Vol. 86, No. 8 3545-3554 A. J. Cleare, J. Miell, E. Heap, S. Sookdeo, L. Young, G. S. Malhi and V. O’Keane (FULL TEXT)

(47) http://www.annalsnyas.org/cgi/content/abstract/1057/1/466
Stress-Induced Hypocortisolemia Diagnosed as Psychiatric Disorders Responsive to Hydrocortisone Replacement, SUZIE E. SCHUDER Ann. N.Y. Acad. Sci. 1057: 466–478 (2005).

(48) http://edrv.endojournals.org/cgi/content/full/24/2/236
Endocrine Reviews 24 (2): 236-252, 2003, The Neuroendocrinology of Chronic Fatigue Syndrome Anthony J. Cleare

(49) http://www.adrenalfatigue.org/
Adrenal Fatigue by James L Wilson D.C., N.D., Ph.D. The 21st Century Syndrome

(50) http://www.drpressman.com/Library/UseAdrenalCorticalExtracts.htm
The Use Of Adrenal Cortical Extracts In Adrenal Fatigue
By James L. Wilson DC, ND, PhD

(51) http://www.amazon.com/gp/product/0398066213/ref=cm_cr_dp_orig_subj/104-6967425-7603934
Safe Uses of Cortisol (Cortisone, Hydrocortisone) by William McK., M.D. Jefferies (Author)

(53) http://crobm.iadrjournals.org/cgi/content/full/13/2/197
Crit Rev Oral Biol Med 13(2):197-212 (2002)
THE DIAGNOSTIC APPLICATIONS OF SALIVA— A REVIEW, The Monitoring of Hormone Levels, Eliaz Kaufman,*Ira B. Lamster

(54)
http://www.biodia.com/TechnicalCharts/SALIVARY_REFERENCES.pdf

references on salivary hormone testing

(55) http://coastherbal.com/web_standard/adrenal_stress.html
Adrenal stress and salivary cortisol article in The Standard

(56) http://jama.ama-assn.org/cgi/content/full/287/23/3116
Vitamins for Chronic Disease Prevention in Adults, Scientific Review ,
Kathleen M. Fairfield, MD,DrPH; Robert H. Fletcher, MD,MSc, JAMA. 2002;287:3116-3126.

(57)
http://jeffreydach.com/2007/07/08/americas-healthcare-system-found-critically-ill-by-russell-jaffe-md.aspx

SICKO, America’s healthcare system found ‘critically ill’
by Russell Jaffe MD PhD, July 4, 2007

(58) http://www.perque.com/
Perque, Russell Jaffe MD PhD, 2 of his LifeGuard Multivitamins have more nutritional value than 100 Centrum Silver, or 100 Theragram vitamins.

(59) http://www.perque.com/pdfs/DrGuyersOctNewsletter.pdf
Interview with Russell Jaffe MD

BOOKS

(60) http://www.amazon.com/Bioelectromagnetic-Healing-Rationale-its-Use/dp/0964107058/ref=pd_sim_b_3/104-6967425-7603934?ie=UTF8&qid=1190392414&sr=1-1
Bioelectromagnetic Healing: A Rationale for its Use by Thomas Valone © 2003

(61)

http://www.amazon.com/Energy-Medicine-Scientific-James-Oschman/dp/0443062617/ref=pd_sim_b_3/104-6967425-7603934?ie=UTF8&qid=1190392414&sr=1-1
Energy Medicine: The Scientific Basis by James L. Oschman © 2000

(62) http://en.wikipedia.org/wiki/Bioelectromagnetics
Bioelectromagnetics

(63)
http://ajp.psychiatryonline.org/cgi/content/full/163/1/88
A Randomized, Controlled Trial of Sequential Bilateral Repetitive Transcranial Magnetic Stimulation for Treatment-Resistant Depression, Am J Psychiatry 163:88-94, January 2006

(64) https://www.advancesintherapy.com/frame.asp?https://www.advancesintherapy.com/detail.aspx?ID=229
Impulse magnetic-field therapy for migraine and other headaches: a double-blind, placebo-controlled study. Adv Ther. 2001 May-Jun;18(3):101-9
Pelka RB, Jaenicke C, Gruenwald J. Seventy-six percent of active-treatment patients experienced clear or very clear relief of their complaints.

(65)
http://www.thefreelibrary.com/Pulsed+microamperage+stimulation:+a+controlled+study+of+healing+of+...-a014944034

Pulsed microamperage stimulation: a controlled study of healing of surgically induced wounds in Yucatan pigs

(66)
http://www.thefreelibrary.com/Chronic+dermal+ulcer+healing+enhanced+with+monophasic+pulsed+...-a011704104 Chronic dermal ulcer healing enhanced with monophasic pulsed electrical stimulation

(67) http://www.industryinet.com/~ruby/electpropcells.html
Electrical Properties of Cells and Tissues

(68)
http://www.biomedcentral.com/1471-2121/7/37
Nanoelectropulse-driven membrane perturbation and small molecule permeabilization
Gundersen BMC, Cell Biology 2006, P Thomas Vernier, Yinghua Sun and Martin A

Electric pulses produce membrane disturbances that are associated with phospholipid rearrangements and the influx of small molecules from the medium into the cytoplasm. Cellular responses are consistent with a nanopore-facilitated, electrophoretic mechanism for the PS externalization observed after exposure of cells to electric fields.

(69)
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=16545779
Biochem Biophys Res Commun. 2006 May 5; 343(2): 351–360.
Nanosecond pulsed electric fields cause melanomas to self-destruct.
Richard Nuccitelli, Uwe Pliquett, Xinhua Chen, Wentia Ford, R. James Swanson, Stephen J. Beebe, Juergen F. Kolb, and Karl H. Schoenbach

(70)
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17714104&ordinalpos=21&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
Prospective, randomized, single-blind, sham treatment-controlled study of the safety and efficacy of an electromagnetic field device for the treatment of chronic low back pain: a pilot study.
Harden RN, Remble TA, Houle TT, Long JF, Markov MS, Gallizzi MA. Pain Pract. 2007 Sep;7(3):248-55.
This study demonstrates that TEMF may be an effective and safe modality for the treatment of chronic low back pain disorders.

(71)
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17632344&ordinalpos=53&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Pulsed magnetic fields accelerate cutaneous wound healing in rats.
Strauch B, Patel MK, Navarro JA, Berdichevsky M, Yu HL, Pilla AA.

Plast Reconstr Surg. 2007 Aug;120(2):425-30.
The authors successfully demonstrated that exposing wounds to pulsed magnetic fields of very specific configurations accelerated early wound healing in this animal model, as evidenced by significantly increased wound tensile strength at 21 days after wounding.

(72) http://www.baar.com/beckerbk.htm
"The Body Electric" tells the fascinating story of our bioelectric selves. Robert O. Becker, a pioneer in the field of regeneration and its relationship to electrical currents in living things, challenges the established mechanistic understanding of the body. He found clues to the healing process in the long-discarded theory of the 18th century vitalists that electricity is vital to the life process. But as exciting as Becker's discoveries are, pointing to the day when human limbs, spinal cords, and organs may be regenerated after they have been damaged, equally fascinating is the story of Becker's struggle to do such original work. As his understanding of the effects of electrical forces led him to alert the public to their possible effects on the environment, the establishment erected an even higher wall of resistance. "The Body Electric" also explores new pathways in our understanding of evolution, acupuncture, psychic phenomena, and cancer, all within the framework of Dr. Becker's colorful and controversial career.

(73) http://en.wikipedia.org/wiki/The_Body_Electric
The Body Electric: Electromagnetism and the Foundation of Life is a book by Robert Becker and Gary Selden.

(74) http://www.rexresearch.com/becker/becker1.htm
Cross Currents, Dr. Robert O. Becker,

(75) http://www.horsemagneticpulser.com/HMPstory.pdf
THE STORY OF THE DEVELOPMENT OF THE EXPERIMENTAL
HORSE MAGNETIC PULSER By Gary Wade, Physicist 6/03/2007

(76) List of famous race horses:
http://en.wikipedia.org/wiki/List_of_historical_horses

Abercrombie
Adios
Adios Butler, famous harness-racer
Affirmed, last horse to win the U.S. Triple Crown (1978)
Albatross
All Along
Alydar, finished second to Affirmed in all three Triple Crown races, and one of the great sires in North American history
Aristides, winner of the first Kentucky Derby
Arkle, reckoned the greatest steeplechaser of all time
Arko
Assault, U.S. Triple Crown winner (1946)
Barbaro, 2006 Kentucky Derby winner
Best Mate, 2002, 2003 and 2004 Cheltenham Gold Cup winner, often given title 'Greatest Steeplechaser' since Arkle, and an equal to him
Carbine, two-time winner of the Melbourne Cup
Cigar, a great champion in the 1990s
Citation, U.S. Triple Crown winner (1948)
Dan Patch, America's greatest pacer
Dance Smartly, Breeders' Cup champion
Dawn Run, great racemare and the only horse ever to complete Champion Hurdle, Cheltenham Gold Cup double
Desert Orchid, won King George four times and Cheltenham Gold Cup, beautiful grey
Exterminator exceedingly popular, "iron horse" of American racing history
Funny Cide, first New York bred and first gelding since Clyde Van Dusen to win the Kentucky Derby
Genuine Risk, the second filly to win the Kentucky Derby (1980)
Gloaming
John Henry, grand old man of racing
Kelso, only five-time winner of U.S. Horse of the Year
Kindergarten, weighted more than Phar Lap in the Melbourne Cup
Kingston Town
Kissin George
La Troienne, most important broodmare of the Twentieth Century
Lottery, UK
Makybe Diva, won Melbourne Cup three successive times
Man o' War, often considered America's greatest racehorse; won 20 of 21 career starts
Might and Power
Montrose
Nijinsky II, last horse to win the English Triple Crown (1970)
Northerly
Northern Dancer
Precious Bunny
Phar Lap, New Zealand/Australia's most famed racehorse; won 37 of 51 career starts
Red Rum, only horse in the history of the Aintree Grand National to win the race three times (he also came second on two other occasions)
Ruffian, the great filly champion who won every race she started until her final (and fatal) race
Seattle Slew, U.S. Triple Crown winner (1977)
Seabiscuit
Secretariat, U.S. Triple Crown winner (1973)
Shergar, the kidnapped winner of the 1981 Epsom Derby
Silky Sullivan, arguably the fastest closer of all time
Smarty Jones
Spectacular Bid
War Admiral
Winning Colors, the third (and currently last) filly to win the Kentucky Derby (1988)

Sept 4, 2007
To Robert GAllo

Dear Bob,

To advance the idea that "the Human Retrovirus," HTLV-1 causes leukemia in Humans at a rate of 0.06% or as Gallo told me on the phone 4%, or as some textbooks say, 5% constitutes causality, is like saying:

"I have 20,000 birds. 10,000 of these birds moult once a year. The other 10,000 moult 3 times a year. Now, 5 of the 10,000 birds that moult once a year died by hitting their head into utility poles.

However, 15 of the 10,000 birds that moult 3 times a year died by hitting their head into utility poles. Therefore, among these 15 birds, their moulting 3 times a year CAUSED them to hit utility poles and die. Moulting 3 times annually
--> hitting utility poles --> death."

Of course, this is purely hypothetical, because I'm not aware of any controlled studies on HTLV-I and ATL that demonstrate causality.

Andy Maniotis

What is Aspirin? The most common chemical name for this organic compound is acetylsalicylic acid (ASA). There are at least 32 other names for it, mostly trade names [1]. It was first synthesized by Carl R. Gerhardt in 1853 [2]. The major therapeutic use of ASA in providing relief from the pain of rheumatoid arthritis was recognized by Felix Hoffman, an employee of Bayer AG, in 1897, who administered ASA to his father, who tolerated ASA much better than other salicylates already in use. ASA was not "invented" in 1897 as in the book The Aspirin Wars [3] ("Wars", p7 and cover). First trademarked in 1899 by Bayer AG [4], Leverkusen, Germany, the name Aspirin? became a generic term for ASA in the manner of kleenex and frigidaire. For most of a century aspirin has been the preferred treatment for arthritis pain, and has been used for headache, fever, and, in the last decade, prevention of heart attacks. It has been called the most successful drug in history. A decade ago 1 in 5 Americans took aspirin every day (Wars, cover).


Not until the 1970s was the mode of action of aspirin worked out! Sir John Vane was awarded the Nobel Prize for uncovering the mode of action of ASA [5]. ASA inhibits the enzyme cyclooxygenase, preventing the cells of the body from making certain prostaglandins that cause inflammation, and other ones that cause the clumping of blood platelets to form clots. The clots, or thromboses, are responsible for "ischemic events", which are the local anemias, or blood shortages, caused by blockage of arteries. When these are coronary arteries, the blockages are called "heart attacks" of the myocardial infarction (MI) type. The common slogan "aspirin thins the blood" is not strictly true; aspirin prevents clot formation by platelets.

The ASA content of a standard aspirin tablet is 325 mg. Extra-strength or arthritis-strength tablets contain 500 mg. For other uses tablets containing 160 and 81 mg are available. Enteric-coated aspirin tablets resist the acidic environment of the stomach; the aspirin is absorbed in the alkaline small intestine. You would not expect "fast, fast , FAST relief of headache" with these, but some studies showed that stomach erosions and ulcers were less frequent [6]. "Buffered" aspirin is no faster than plain aspirin (Wars, p164) and only slightly less irritating, if at all (www.mayohealth.org).

Because it may be important for preventing heart attacks, a Bufferin? tablet, besides 325 mg of ASA, has an actual alkali content of 158 mg of calcium carbonate, 63 mg of magnesium oxide and 34 mg of magnesium carbonate; the latter pair provide a total of 48 mg of magnesium. Bayer Aspirin with Stomach Guard is the same.

Primary vs. Secondary Prevention of Heart Attacks

One must be skeptical about any recommendation for or against aspirin that does not distinguish between primary and secondary prevention. Primary means that people not at any particular risk of MI may prevent a fraction of potential MIs from occurring by taking small doses of aspirin for a long period. Any side effects of aspirin can be serious if a great number of people begin taking it at age 45-50 and continue for 30-40 years. Secondary prevention means that victims of MI or unstable angina, a high-risk group, may prevent a fraction of further cardiovascular problems by taking moderate doses of aspirin for a limited period. Any recommendation for or against aspirin that does not make the distinction can be disregarded as superficial.

Wars distinguished between primary prevention of first heart attacks and secondary prevention on p11 quite well, and described the U. S. Food and Drug Administration (FDA) decision to allow advertising for second heart attacks, but not for first heart attacks, due to an unusual number of strokes in the aspirin-using group in a large study on primary prevention, a prescient decision. But by p334 in Wars: "...aspirin is the drug of doctors' dreams. It is hugely effective. One aspirin a day, or every other day, will save hundreds of thousands of lives a year. It can be taken safely by more people than almost any other drug... It is likely to remain the only heart attack preventive sold in grocery stores for years to come."

Surrogate End Points in Clinical Trials: Are We Being Misled?

This is the title of an unusual paper by T. R. Fleming and D. L. DeMets in Annals of Internal Medicine 125, 605-613 (1996). Clinical trials are the standard scientific method for evaluating a new drug or a new use for an old drug. The true endpoint in most trials would be cure of a disease or condition, or, at least, reduction of symptoms, as indicated by longer lifespan of good quality. A surrogate endpoint is a laboratory measurement or a physical sign used as a convenient substitute for a clinically meaningful endpoint that measures survival directly. Changes induced by a therapy on a surrogate endpoint are supposed to reflect changes in a clinically real endpoint; but all too often, they do not.

Examples of surrogate endpoints are reduction of cholesterol level or blood pressure, two parameters easy to measure in the short term. A meta-analysis of 50 cholesterol-lowering interventions, including diet, resins and lovastatin, lowered cholesterol levels an average of 10%, but there was a 1% increase in overall mortality. A meta-analysis of trials of calcium channel blockers that really do lower blood pressure showed possibly harmful effects overall. In addition, two new antiarrythmia drugs approved by the FDA, encainide and flecainide, clearly suppressed arrythmias, probably as seen by electrocardiograms, as the surrogate endpoint. However, it was found that 3 times as many patients in the drug group died as in the placebo group.

In evaluating aspirin, it is, therefore, not enough to show reduction in the rate of MI or other undesirable vascular events; one must determine total death rates for a reasonable period of several years in order to find whether some toxic effect of aspirin is countering a positive effect on MI. On the other hand, one does not want to carry on for too many years since the ultimate death rates of treatment and placebo converge - to 100%.

Whisper Down the Alley

This is one name for a grade-school game in which someone in a classroom whispers a phrase of a few words to the nearest student, who whispers the same phrase (supposedly) to the next student. The output of the 30th or so student is compared with the input and all have a good laugh, since the two are never equal.

Adult scientists are not supposed to scramble the input - but some do.

A massive meta-analysis of 25 completed clinical trials of secondary prevention of MI was reported in the British Medical Journal (BMJ) in 1988 [7]. The title: "Secondary Prevention of Vascular Disease by Prolonged Antiplatelet Treatment" makes clear that most of the patients involved had already suffered from MI, transient ischemic attack, unstable angina, or minor stroke. "Antiplatelet Treatment" indicates that aspirin was not the only drug tested; these facts are, of course, confirmed in the text and tables, of which one of the key tables is reproduced here as Figure 2. Note that only 12 of the trials employed aspirin alone. Overall reduction in mortality was about 25%, mostly in the first 2 years of treatment. A special note was made that men aged 55-74 with no history of vascular disease for whom aspirin treatment was actually primary showed no difference in mortality.

This BMJ article was cited in Science, a publication of the American Association for the Advancement of Science, with reproduction of that same figure, as an excellent example of how to do a meta-analysis, along with an explanation of how to do one [8]. The secondary nature of the trials was indicated only by the word "recurrence" and the endpoint was implied to be only "heart attack", while the legend (in Figure 2) includes as endpoints MI, stroke, and other vascular death.

The Science article was cited by Dean Radin in the book The Conscious Universe as an example of the power of meta-analysis [9]. Now Radin wrote implying that only aspirin was involved, and only for heart attacks, and the secondary nature of the treatment was not mentioned at all, which led me to believe, when I read this, that I should have continued using aspirin myself after all.

Recommendations for You to Take Aspirin for Primary Prevention of Heart Attacks

In publications for the general public there are a number of sources of advice to take aspirin for primary prevention of heart attacks. Here are a few:

Consumer Reports (CR), with 5 million subscribers and 20 million readers, recommended that postmenopausal women, men over 35 with risk factors such as smoking cigarets, and possibly men over 45 without risk factorsall take aspirin. No dose level was given, although the study quoted was based on "one 'aspirin' tablet every other day", and the use of enteric coated aspirin was advised only if uncoated aspirin caused damage to the stomach. "The...study found that one aspirin tablet every other day cut the rate of initial heart attacks almost in half... The implications were stunning." But then CR was very cautious, noting that the clinical study they were citing showed significantly more hemorrhagic strokes (rupture of blood vessel in the brain), ulcers and allergic reactions, and that no benefit was observed in another trial on healthy male physicians in the UK [10]. While the studies used did not get proper citations, the first was certainly the Physicians Health Study in which 22,071 male physicians were studied for 5 years [11]. (This will be called PHS 89.)

Julian Whitaker, M. D., in his popular newsletter Health & Healing, properly referenced PHS 89, and recommended that everyone take aspirin for primary protection from MI, but at the rate of 162 mg every other day, or 81 mg every day, half the dose used in PHS 89. While the study involved only male physicians, Whitaker did not restrict his recommendations to males. Whitaker wrote that the usual side-effects of aspirin could be avoided by taking the low dose he recommended with a meal [12].

In the current issue of Life Extension Magazine the recommendation for taking 81 mg of aspirin per day with food is unequivocal: "A lot of people in alternative medicine criticize The Life Extension Foundation for recommending the daily use of low-dose aspirin, but The Foundation stands firm on the recommendations it made in 1983: most healthy people should take low-dose aspirin to specifically reduce their risk of heart attack. Aspirin may protect in ways that supplements do not." [13] Of the 34 references cited at the end of the article in such a way that one cannot tell which one backs each aspect of the article, just 9 are to peer-reviewed journals. PHS 89 is not cited, nor is any peer-reviewed paper that shows lower total mortality in low-risk subjects. The article is cleverly laid out with a large space taken up by art work so that it ends on the top half of its last page. The bottom half of the page is an advertisement for Life Extension Foundation's brand of aspirin. Does this fact make you skeptical?

Recommendations for You Not to Take Aspirin for Primary Prevention of Heart Attacks

From an anonymous author on a website www.internetwks.com/pauling/lie/mag.html:

"We have been told that all the aspirin studies that 'prove' an aspirin a day keeps a heart attack away -- were with buffered aspirin, i. e., with added magnesium. Our sources point out that it is unlikely that further studies using 'plain' aspirin will be undertaken because preliminary studies always show 'plain' aspirin does not show the same protective effect against heart attacks. So if you still believe what you read in the mass media, make sure that your daily aspirin is buffered! (Or much better yet, take a magnesium tablet instead!)"

"Possibly the largest collaborative study ever performed in medicine, this meta-analysis (BMJ 8 Jan 94) pooled the results of some 174 clinical trials from around the world, testing an aggregate of ll0,000 patients... The overview was designed to determine whether medium-dose aspirin (75 mg to 325 mg per day) ...could prevent...nonfatal heart attacks , strokes, or deaths in [mostly] high-risk patients... The researchers reckoned that this sort of therapy reduced the risk of [premature] death [a solid endpoint] from one of these causes by one-sixth... This isn't the case with low-risk patients; the study showed that among those taking aspirin as 'primary prevention', although heart attacks were reduced by a third, there was a 'non-significant' increase in nonfatal stokes. However, that increase was cited as 21 % (hardly a 'non-significant' increase in our view)... However, the study makes quite clear that for low-risk people of for those with so-called risk factors like high cholesterol, hypertension, or smoking, but without vascular disease, there is no evidence that this so-called preventive therapy does any good. In fact, the risks (particularly of hemorrage or stroke) may outweigh the benefits. Therefore, there is no scientific justification for your doctor's view that you should start taking aspirin just in case." Thus wrote the editors of the newsletter What Doctors Don't Tell You [14].

And from William Campbell Douglass, MD: "I'm sure you've heard about the study [PHS 89, Ref. 11] showing that an aspirin a day prevents heart attacks. In that study, men who took a daily aspirin had 47% [sic] fewer heart attacks than men who didn't. What you haven't heard, and what I'm sure the aspirin companies don't want you to know, is that the subjects in that study took buffered aspirin - aspirin mixed with magnesium. Numerous studies have proven that magnesium has a powerful protective effect on your heart. It dilates blood vessels...aids potassium absorption into your cells (preventing heartbeat irregularities)...acts as a natural blood thinner...and keeps your blood cells from clumping together [the anti-platelet effect]; indeed autopsies of heart attack victims almost always find a magnesium deficiency! ...Not only that, but recent studies link aspirin to macular degeneration - the #1 cause of blindness in people over the age of 55! But the biggest strike against aspirin may come from the very study touting its heart benefits. If you read the study's fine print, you'll find that even though the group taking aspirin had 47%fewer heart attacks, there wasno difference in the death rates of the two groups. That means that death from other causes was 47% higher in the aspirin group! So stop taking that daily aspirin! Stick to magnesium instead." [15]

Are these people crazy? Not entirely. Now we know enough to divide the original question that is the title of this article into two separate questions: on primary as distinct from secondary prevention of heart attacks. Let us go to the peer-reviewed literature to answer the first of the properly posed questions:

Should You Take Aspirin to Prevent a First Heart Attack?

In the Antiplatelet Trialists' Collaboration [7] reported in 1988 there were some low-risk men aged 55-74 for whom aspirin treatment was actually primary. The paper concludes with the opinon that the absolute benefits in primary prevention of MI were uncertain because they might be outweighed by a small increase in cerebral or other serious hemorrhagic disease. "Thus only for patients with an appropriate history of vascular disease is there at present clear evidence that antiplatelet treatment reduces the overall incidence of fatal or disabling vascular disease." This opinion recognizes that the real endpoint is life extension, not merely minimizing MIs.

Figure 3 is reproduced from PHG 89 [11]. This massive study on 22,071 physicians, half taking 325 mg of "aspirin" every other day, showed that total deaths in the aspirin group over the 5-year period of the study were 4% fewer total deaths than in the placebo group (P=0.64), thus the difference was not considered significant. A big reduction in fatal MIs of 69% (P=0.004) was countered by nearly equal increases in the totals for sudden death (P=0.09), stroke and other cardiovascular deaths. The reduction in MI was seen only in those aged Ú 50. Using the endpoint of life extension, not MI, there was hardly any benefit from taking aspirin. With respect to non-fatal bleeding of several types the aspirin group had a relative risk of 1.32 (P=0.00001). Furthermore, 48 in the aspirin group and 28 in the placebo group required blood transfusions (P=0.02, all 95% conf.). There really was a significant (P less than 0.00001) reduction in non-fatal MIs of 44%. But what did this mean in real benefit? It meant that in a 1-year period the chance of having a non-fatal MI was cut from 0.44 % to 0.25%.

There is no doubt that PHG 89 used Bufferin, not aspirin. Monthly calendar packs containg either Bufferin or placebo were provided by Bristol-Myers Products. Domenick Mellace of Bristol-Myers was acknowledged for his logistic support. Bristol-Myers contrived to have a 1.5 page advertisement placed just ahead of this paper in the journal, in which advertisement they were careful to advertise Bufferin only for secondary prevention as directed by the FDA. Is it possible that the reduction in MIs was due to the magnesium present in the Bufferin and not the ASA content?

By 1994 the Antiplatelet Trialists' Collaboration published a meta-analysis that was now up to 100,000 patients of whom 30,000 were in the low-risk catagory [16]. The doses were 75-325 mg of ASA per day, but the exact source of the ASA was not given. "There was no clear evidence on the balance of risks and benefits of antiplatelet therapy in primary prevention in low-risk subjects." In fact a graph was shown with "% free from a vascular event", including fatal, as the ordinate, and "years to first vascular event" as the abscissa. For low risk subjects after 4 years the treated group had 0.4% fewer events, that is, 4 per 1000. But this included all of the antiplatelet treatments, including 2 trials with drugs that were more effective than aspirin, so it is likely that aspirin was of no benefit in low-risk subjects.

Randomized clinical trials testing aspirin in 5011 elderly people, 58% of whom were women, mean age 72 years, followed for a mean of 4.2 years, showed that use of aspirin caused a 4-fold increase in hemorrhagic stroke (P=0.003) and a 1.6- to 1.8-fold increase in ischemic stroke [17].

Based on the Nurses' Health Study involving 79,319 women aged 34-59 years at the beginning, the role of aspirin in primary prevention of stroke was uncertain [18]. This was based on a questionaire, so the reduction, mostly in older women, of large-artery occlusive infarction by half (1 to 6 aspirin per week) or a doublng of the risk of hemorrhage (15 or more aspirin per week) might have included the use of a large fraction of buffered aspirin. This was not thought important. Total death rates were not included.

"No conventionally used prophylactic aspirin regimen seems free of the risk of peptic ulcer complications... Alka-Seltzer may be associated with higher risk (2 times) and enteric-coated aspirin with lower risk (0.5 times) compared with plain aspirin." [19] Users of aspirin for long periods to relieve arthritis pain have suffered so badly from side-effects that a multitude of alternates, such as ibuprofen and naproxen, were introduced.

And, most recently, reported in 1998, a study of about 5500 physicians in the UK on primary prevention of ischemic heart disease (which causes MIs) was carried out with 75 mg of aspirin daily in a controlled-release formulation for a median time of 7 years. The main effect of aspirin was a 32% reduction in non-fatal MI (less effective than PHG 89 which used double the dose), but there was an increase of 12% in fatal MI leading to an overall rise in death from all causes of 6%, which was not considered significant [20]. The absolute reduction in all MIs per year was 0.23%. Note that there is a 10% increase in overall death rate in the aspirin group in this study compared with the Bufferin group in PHG 89. Could this "non-significant" difference have been a lack o the beneficial effect of the magnesium in Bufferin? Another difference from PHG 89 is that the men in this study were recruited from the quintile considered to be at highest risk for MI based on heredity, smoking, blood pressure and obesity; but this is still a lower-risk group than the one composed of actual victims of MI.

If delaying death is the real end-point, not reduction in heart attacks per se, then it seems pointless to take aspirin for primary protection, with its certainty of obnoxious side-effects, which may include gastritis, peptic ulcer, other internal bleeding, hemorrhagic stroke, fatal MI, and sudden death, to which has been added wet macular degneration (in 1988) and twice the risk of cataracts (in 1998), in trade for a probable reduction of only 0.2% absolute per year in total (mostly non-fatal) MIs, especially when safer alternatives exist, such as magnesium.

Now it is time to ask the more difficult question...

Should You Take Aspirin to Prevent a Second Heart Attack?

Five earlier studies on secondary prevention of MI by ASA were reported from 1974-1980. There was said to be no beneficial effect overall [21]. One multicenter study, nevertheless, the earliest of this type I have seen, had positive results. A single daily dose of 300 mg of aspirin in a gelatine capsule or a similar-looking placebo was to be taken before breakfast to ensure rapid absorption by 1,239 men who had had a recent MI. The aspirin group showed a reduction in total mortality of 12% at 6 months, 25% in 1 year, and 28% at 2 years. The authors modestly acknowledged that the results were statistically inconclusive, but they were in the range of what was observed in later trials. The much larger size of the later trials was needed to obtain results that would be statistically solid [22].

Reported in 1988, the second International Study of Infarct Survival (ISIS-2) Collaborative Group in the UK determined the effect of aspirin vs. placebo in 17,187 people entering 417 hospitals after the onset of suspected acute MI. The aspirin used was clearly stated to be 162.5 mg in an enteric coated tablet given daily for 1 month. All-cause mortality was said to be similar to vascular mortality. After 5 weeks aspirin produced 23% fewer vascular deaths overall (P less than 0.00001), cut MIs from an absolute value of 2% to 1%, cut non-fatal stroke from 0.6% to 0.3%, and did not cause any increase in cerebral hemorrhages. Survival rates after 2 years were 81.7% in the aspirin group vs. 80.0 % on placebo [23].

In 1988 the Antiplatelet Trialists' Collaboration [7] on 29,000 patients, a majority with a history of transient ischemic attack, stroke, unstable angina, or MI, were treated by a variety of methods, including with ?300 mg ASA daily, which did not differ greatly in results from other drug regimens employed in the trials, as shown by this meta-analysis (see Figure 2). The authors thought that vascular mortality was reduced by 1/6, and non-vascular undesirable events by 1/3 in high-risk patients. By 1994, now up to 70,000 high-risk patients, the Antiplatelet Trialists' Collaboration [16] found similar results; but now the daily aspirin dose was 75-325 mg.

By 1998 ISIS-2 was still following 6,213 high-risk patients in the UK of the 17,187 originally in the trial. During the first 35 days of follow-up the use of aspirin during the first month reduced the death rate by 22%. Hence all of the survival benefit of an early, one-month course of oral aspirin (162.5 mg enteric coated, daily) seemed to accrue during the first month, with little further benefit between day 36 and the end of year 10, by when the death rate was down 1% relative to placebo [24].

This then was the background of the North of England Aspirin Guideline Development Group's recommendations to physicians: Aspirin should be used in patients with acute MI at 150 mg daily for one month, then 75 mg daily for several years. In patients with MI, anginas, stroke, or transient ischemic attack, aspirin should be used at 75 mg daily for several years. There was no evidence that higher doses were more effective [25]. The Group did not mention either buffer or enteric coating. The latter seems desirable to this writer.

So the answer for secondary protection from recurrence of several types of undesirable vascular conditions is: Yes, take aspirin in low doses, and not forever, in order to obtain a moderate (16-22%) protection from fatal MI. But is aspirin the best protection there is, either from the standpoint of effectiveness or freedom from side effects? Probably not.

What Else Could You Take to Prevent Heart Attacks?

Vitamin E for primary protection

The Nurses Health Study involved 87,245 female nurses aged 34-59 in 1980, who were free from diagnosed cardiovascular disease and cancer, and who completed dietary questionaires every two years up to eight years. Women who took vitamin E supplements containing, on average, 200 IU (International Units) for more than 2 years had 41% fewer instances of coronary disease of several types, and and overall mortality 13% lower than those who did not (P=0.05) [26]. The amount of vitamin E in multivitamin capsules at that time was typically ? 30 IU.

The Health Professionals Follow-up Study involving >40,000 males aged 40-75 in 1986 who were free of diagnosed coronary heart disease, diabetes, or hypercholestemia completed detailed dietary questionaires every two years until 1990. Men who took 100-250 IU of vitamin E as supplements for 2-10 years had 37% fewer instances of coronary disease of several types, including fatal (P=0.05). Higher doses of vitamin E were no more effective. By contrast, the intake of vitamin C and beta-carotene did not lower risk [27].

These results are far more impressive than the ones for aspirin, especially because side-effects were so minimal as not to be mentioned. And vitamin E could be bought at almost any grocery store.

Vitamin E for secondary protection

The Cambridge Heart Antioxidant Study [CHAOS (English humor?)] was a single-center, double-blind, placebo-controlled study with 2002 patients who had angiographically proven coronary atherosclerosis (fatty deposits). Doses of 400 or 800 IU of vitamin E were used in half, and the group was followed or a median of 510 days. Vitamin E gave a significant reduction in non-fatal MI of 77% (P=0.005); however, there was a non-significant excess (18%, P=0.61) of cardiovascular deaths in the combined Vitamin E groups. The lower dose of vitamin was better on both counts, including a lower death rate on 400 IU than on placebo. So here, too, vitamin E is far more effective than aspirin, and, again, side effects were negligible [28].

Magnesium for primary protection

The Caerphilly Heart Disease Study of men aged 45-59 years at the beginning of a 5-year period examined the relation of magnesium in the diet to the incidence of MIs, both fatal and non-fatal. Of the 627 men in the study 38 suffered MIs. The mean daily intake of magnesium in these was 12% lower than in men who did not have MIs. This is difference of about 38 mg per day, less than the amount in a Bufferin tablet [29]. The inverse relation of magnesium concentrations in drinking water to rate of heart attacks has been noted many times [30].

The usual recommendations for dietary supplements are to take 300-600 mg of magnesium in a compound (not the metal) daily with food [31]. The most common form in which to take magnesium is as the compound magnesium oxide, one of the alkalis in Bufferin; but equally persuasive is advice to take it as potassium magnesium aspartate for fast absorption [32]. Women at risk of osteoporosis are advised to take also about twice the mass of calcium [33]. But calcium, as well a vitamin D and phosphates, increase the amount of magnesium needed [34]. Mildred Seelig, MD, also wrote that the typical daily intake of magnesium in American college students was 250 mg, not ?385 mg recommended for a 140-lb woman, or ?500 mg for a 185-lb man. Unfortunately, I have not found a report on a large clinical study on primary protection using supplements in humans.

A prospective study of 10-year duration in 400 "high-risk" subjects (selected about as in Ref. 20), of whom 93.5% were male, living in Moradabad, India, was carried out by assigning half the group to a high-magnesium diet (1,142 mg per day vs. 418 mg in the control group from fruits, green vegetables, cereals and nuts) and tracking medical events.

The high-magnesium group had 35% fewer deaths from all causes (P value less than 0.001), and a 61% reduction of non-fatal cardiovascular events (P less than 0.001), including a 54% reduction in strokes [35]. Unfortunately, this report was marred by a number of arithmetical errors in the table of results. There was also a confounding factor in that the high-magnesium diet was also a high calcium diet (880 vs. 512 mg daily) and a high-potassium diet (3,080 vs. 548 mg daily). Since serum levels of magnesium and potassium were raised, and those of calcium were not, it is most likely that the magnesium and potassium were responsible for the differences in outcomes, which also included significant reductions in serum total cholesterol and glucose.

Use of magnesium supplements in many people is probably justified by inference based on their effectiveness on secondary prevention, the clinical experience of a number of physicians, the drinking water studies, and the above diet study. The diet study would support using potassium magnesium aspartate as the supplement most resembling the high-magnesium diet.

Magnesium for secondary protection

In a double-blind, placebo-controlled study involving 273 patients with suspected acute MI, 74 received placebo, while 130 received 1.2 g of magnesium as the chloride intravenously during 24 hours, followed by 0.3 g in the next 24 hours. Treatments were begun within 3 hours of hospital admission. During the first 4 weeks after treatment mortality was 7% in the magnesium group and 19% in the placebo group, a reduction of 63% (P=0.045). In the magnesium group 21% of the patients had arrhythmias that needed treatment vs. 47% in the placebo group, a reduction of 55% (P=0.004). No adverse effects of intravenous magnesium were observed [36].

Reported in 1992, the second Leicester Intravenous Magnesium Intervention Trial (LIMIT-2) on 2316 patients with suspected acute MI found a 24% reduction (P=0.05) in 28-day mortality from treatment with intravenous magnesium sulfate. Reported in 1995, the fourth International Study of Infarct Survival (ISIS-4) showed no benefit of similar treatment of 29,000 patients.

By 1996 the discrepancy was explained as follows: LIMIT-2 was double-blind and placebo controlled, and only 30% of the patients had received treatment for thrombosis (streptokinase) by the time magnesium was begun on average 3 hours after onset of symptoms. ISIS-4 was non-blinded, had no placebo, the alternate treatments being the drugs isosorbide mononitrate or captopril; and 70% of the patients had received treatment (which raises blood magnesium concentrations) for thrombosis (clotting in major blood vessel), and 94% had received aspirin by the time magnesium was begun on average 8 hours after onset of symptoms. It in interesting that captopril is a product of Bristol-Myers Squibb, the sponsor of ISIS-4, at a cost of about $10 million.

A study appeared simultaneously involving 194 patients considered unsuitable for treatment for thrombosis. In-hospital mortality was 4.2% in the magnesium group and 17.3% in controls, a reduction of 76% [37].

Where confounding treatments are absent, rapid treatment of patients suffering from MI with intravenous magnesium is of great benefit in secondary prevention, not only of MI, but of arrhythmias. The 3 studies not confounded showed, on average, a greater 4-week benefit than from aspirin, and LIMIT-2 showed that concurrent aspirin did not change the outcome. Side-effects of magnesium were minimal and could be avoided altogether.

The medical establishment has accepted the role of oral magnesium supplements in countering hypertension, MI, congestive heart failure, and arrhythmias [38].

Coenzyme Q10 for primary protection

Coenzyme Q10 is an oily organic compound, like vitamin E, and is found in every cell of the body. It has a number of functions, among which are preventing the oxidation of LDL, and transporting oxygen from hemoglobin into the parts of cells where ATP, the main source of cellular energy, can be formed. Sharing its status with magnesium, the value of oral coenzyme Q10 supplements for better health in a low-risk population has not been investigated in large-scale controlled experiments [39]. Its use in older people with some definite symptoms, such as congestive heart failure, is probably justified by inference based on its effectiveness on secondary prevention, and the clinical experience of a number of physicians. For details see the website of The International Coenzyme Q10 Association (wwwcsi.unian.it/coenzymeQ).

Coenzyme Q10 for secondary protection

The New York Heart Association (NYHA) has grouped heart failure into 4 classes of severity. A cardiac patient in class IV, the most serious, is unable to perform any physical act without discomfort, and symptoms of heart failure, including anginal pain, may be present even at rest. Cardiologists know that such patients are on a relentless downhill course to death in spite of all conventional therapy. In a study in which all patients in hospitals were in NYHA classes III and IV, and all received conventional therapy (bypass surgery, digitalis, diuretics, vasodilators), about 25% survived for 3 years. The 88 patients treated with Coenzyme Q10 had a 75% survival rate. Putting this finding in the same form as used above, the reduction in 3-year death rate was 67%! [40]

Congestive heart failure is always characterized by an energy depletion status correlated with lowered coenzyme Q10 levels. In a 1-year double-blind trial 641 patients of mean age 67 with chronic congestive heart failure (NYAS classes III and IV) were randomly assigned to receive either 2 mg/kg (?100 mg) daily of coenzyme Q10 or placebo. The number of patients who required hospitalization for worsening heart failure was 38% lower (P less than 0.001) in the Q10 group; the incidence of pulmonary edema was cut by 61%, and of cardiac asthma was cut by 51% (both P less than 0.001) [41]. A similar study on 2500 patients showed only 0.5% with side effects thought due to Q10.

Summing Up

Not only the medical adviser to Consumers Union, but also some health professionals who recommend aspirin, believe that there is a "high-risk" but not-yet-diagnosed population who should take aspirin for primary prevention of heart attack. You may check for yourself in the studies cited - often there is no such group. True, males greater than 50 years old are at higher risk than males or females lesss than 50, but those males greater than 50 are actually the low risk group in most of the large studies on health professionals. The study with the most favorable results in terms of reducing MIs, PHG 89, used Bufferin, which contains a significant amount of magnesium, not plain aspirin. This fact was lost on the author of The Medical Letter 42 (1072), 21 Feb 00, p18, who cited PHG 89 and did not believe that the later European studies were valid.

There is no consensus even among cardiologists that use of aspirin in the general population is advisable. For one, Prof. F. Verheught, Dept. Cardiology, University Hospital, Nijmegen, Netherlands, warned that use of aspirin for primary prevention was inadvisable because its use was investigated only in men, that the risk of non-fatal MI is less than 0.5% per year [and would be cut only by 0.2%], and that there was risk of gastric discomfort and bleeding? [42]. The studies on low-risk males were carried on for 5-7 years. Based on life-expectancies, advice to take aspirin beginning at age 50 would mean 30 years of exposure to its side-effects.

Vitamin E is both more effective and safer than aspirin, and its value in primary protection has been demonstrated in both men and women.

Magnesium intake is inversely correlated with incidence of cardiovascular problems, the effect being more pronounced in men than in women. Up to at least 1,100 mg daily along with up to 3,000 mg of potassium is strongly protective.

In secondary protection, aspirin has a limited but definite value, and does not have to be taken forever; most of the benefit is obtained in the first month. Based on available evidence, aspirin is preferred for the majority of stroke or myocardial infarction (heart attack) patients at risk of recurrences, according to The American Heart Association. But studies have shown that vitamin E, magnesium, and coenzyme Q10 each provide much greater benefits than aspirin with lesser side-effects. Not even the skeptical website www.quackwatch.com disagrees with this.

A skeptical outlook is of great value in evaluating medical claims of most types. Medical advice with no citations to peer-reviewed papers on well-controlled studies can be ignored. You should spot-check the original papers, but beware of the internet trap - you can get abstracts free, but it is more difficult or costly to obtain the full papers from websites. While all of the peer-reviewed papers in this field seem very honestly presented, some important facts often do not appear in the abstracts, and some studies were contrived to favor a pre-conceived result.

Acknowledgements: The following faculty at The University of the Sciences in Philadelphia provided help: Eric G. Boyce, Donna Gagnier, Daniel A Hussar, Jeannette McVeigh, and William A. Reinsmith, were of great help, but do not necessarily agree with the conclusions. Additonal aid was provided by Charles J.Kelley, Tom Miller and Mildred Seelig, MD.

----------------------------------------------------------------------

REFERENCES:

1. M. Windholz, Ed., The Merck Index, 9th ed., Merck & Co., Inc., Rahway, NJ, 1976, p114.

2. J. Fraser Mustard in Acetylsalicylic Acid: New Uses for an Old Drug, H. J. M. Barnett et al., Eds., Raven Press, NY, 1982, p1.

3. Charles C. Mann and Mark L. Plummer, The Aspirin Wars: Money, Medicine, and 100 Years of Rampant Competition, Alfred A. Knopf, NY, 1991 ("Wars").

4. John R. Vane and Regina M. Botting, Eds., Aspirin and Other Salicylates, Chapman & Hall Medical, London, 1992, p10.

5. Susan E. Feinman, Ed., Beneficial and Toxic Effects of Aspirin, CRC Press, Boca Raton, FL, 1993, p11.

6. John W. D. McDonald in Acetylsalicylic Acid: New Uses for an Old Drug, H. J. M. Barnett et al., Eds., Raven Press, NY, 1982, p89.

7. BMJ 88: Antiplatelet Trialists' Collaboration, British Medical Journal 296, 320-331 (1988).

8. "Meta-Analysis in the Breech", Science 249, 476-9 (1990).

9. Dean Radin, The Conscious Universe, Harper Edge, San Francisco, CA, 1997, pp55-6.

10. Consumer Reports, 10/88, pp616-8.

11. PHS 89: Steering Committee of the Physicians Health Study Research Group, The New England Journal of Medicine 321, 129-135 (1989).

12. Julian Whitaker, Health & Healing 6 (8), 8/96, pp1-3. (Dr. Whitaker is one of the most courageous advocates of new or alternate treatments for many conditions. He has risked life, liberty, and financial ruin in trying to protect other practitioners from the FDA and in campaigning for easy availability of supplements.)

13. JoAnn Knorr, "Aspirin, The Multi-Purpose Compound, Not Just for Headaches Anymore", Life Extension, 2/2000, pp50-55.

14. Lynne McTaggart, Ed., Medicine: What Works & What Doesn't, The Wallace Press, no location, 1995, pp52-54.

15. William Campbell Douglass, ?Health Breakthroughs?, Second Opinion, Atlanta GA, Fall, 1998, p4.

16. Antiplatelet Trialists' Collaboration, British Medical Journal 308, 81-106 (1994).

17. R. A. Kronmal et al., Stroke 29, 887-894 (1998).

18. H. Iso et al., Stroke 30, 1764-1771 (1999).

19. John Weil et al., British Medical Journal 310, 827-829 (1995).

20. T. W. Meade et al., The Lancet 351, 233-41 (1998).

21. M. Gent and C. J. Carter in Acetylsalicylic Acid: New Uses for an Old Drug, H. J. M. Barnett et al., Eds., Raven Press, NY, 1982, p251-2.

22. P. C. Elwood et al., "A Randomized Controlled Trial of Acetylsalicylic Acid in the Secondary Prevention of Mortality from Myocardial Infarction", British Medical Journal, Part 1, 436-440 (9 Mar 74).

23. ISIS-2, Lancet, 349-360 (13 Aug 88).

24. C. Baigent et al., for ISIS-2, British Medical Journal 316, 1337-1343 (1998).

25. M. Eccles, N. Fremantle and J. Mason, and the North of England Aspirin Guideline Development Group,British Medical Journal 316, 1303-1307 (1998).

26. M. J. Stampfer et al., "Vitamin E Consumption and the Risk of Coronary Disease in Women", The New England Journal of Medicine, 328, 1444-9 (1993).

27. E. B. Rimm et al., "Vitamin E Consumption and the Risk of Coronary Disease in Men", The New England Journal of Medicine, 328, 1450-96 (1993).

28. N. G. Stephens et al., "Randomised Controlled Trial of Vitamin E in Patients with Coronary Disease: Cambridge Heart Antioxidant Study (CHAOS)", Lancet 347, 781-6 (1996).

29. P. C. Elwood et al., "Dietary Magnesium and Prediction of Heart Disease", Lancet 340, 483 (22 Aug 92).

30. J. R. Purvis, MD and A . Mohaved, MD, Magnesium Disorders and Cardiovascular Diseases", Clinical Cardiology 5, 566-8 (1999).

31. Tom Miller, www.execpc.com, last update 23 Jul 99.

32. W. C. Douglass, "A Strong Case for Magnesium", Second Opinion, V (7), 1-3 (July, 95).

33. S. Lieberman and N. Bruning, The Real Vitamin & Mineral Book, Avery Publ. Grp., Garden City Park, NY, 1990, pp141-2.

34. Mildred S. Seelig, Magnesium Deficiency in the Pathogenesis of Disease, Plenum, NY, 1980, pp8,10,169.

35. R. B. Singh, "Effect of Dietary Magnesium Supplementation in the Prevention of Coronary Heart Disease and Sudden Cardiac Death", Magnesium & Trace Elements 9, 143-51 (1990).

36. H. S. Rasmussen et al., "Intravenous Magnesium in Acute Myocardial Infarction", Lancet, 234-5 (1 Feb 86).

37. G. F. Baxter, M. S. Sumeray and J. M. Walker, "Infarct Size and Magnesium: Insights into LIMIT-2 and ISIS-4 from Experimental Studies", Lancet 348, 1424-6 (1996).

38. David P Lauler, MD, "A Symposium: Magnesium Deficiency-Pathogenesis, Prevalence, and Strategies for Repletion", The American Journal of Cardiology 63 (14), 1-43G (1989).

39. K. Overvad et al., "Coenzyme Q10 in Health and Disease", Eur. J. Clin. Nutr. 53, 764-70 (1999).

40. Karl Folkers, "Contemporary Therapy with Vitamin B6, Vitamin B2, and Coenzyme Q10", Chemical & Engineering News, 55-6 (21 Apr 86); Karl Folkers, S. Vadhanavikit and Svend A. Mortensen, "Biochemical Rationale and Myocardial Tissue Data on the Effective Therapy of Cardiomyopathy with Coenzyme Q10", Proc. Natl. Acad. Sciences USA 82, 901-4 (1985).

41. C. Morisco, B. Trimarco and M. Condorelli, "Effect of Coenzyme Q10 Therapy in Patients with Congestive Heart Failure: A Long-Term Multicenter Randomized Study", Clincal Investigations 71 (8 Suppl.), S134-6 (1993).

42. Z. Kmietowicz, "Aspirin and Warfarin Best for Primary Prevention of Heart Attacks", British Medical Journal 316, 327 (1998).

Additional Note: In people under 55 years old to start taking aspirin at more than 1 per week for more than 10 years, the risk of getting cataracts goes up 2-5 fold.

Should You Take Aspirin to Prevent Heart Attack? by Joel M. Kauffman

Joel M. Kauffman (Emeritus)
Professor
Ph.D., Organic Chemistry
MIT, 1963

What is Aspirin? The most common chemical name for this organic compound is acetylsalicylic acid (ASA). There are at least 32 other names for it, mostly trade names [1]. It was first synthesized by Carl R. Gerhardt in 1853 [2]. The major therapeutic use of ASA in providing relief from the pain of rheumatoid arthritis was recognized by Felix Hoffman, an employee of Bayer AG, in 1897, who administered ASA to his father, who tolerated ASA much better than other salicylates already in use. ASA was not "invented" in 1897 as in the book The Aspirin Wars [3] ("Wars", p7 and cover). First trademarked in 1899 by Bayer AG [4], Leverkusen, Germany, the name Aspirin? became a generic term for ASA in the manner of kleenex and frigidaire. For most of a century aspirin has been the preferred treatment for arthritis pain, and has been used for headache, fever, and, in the last decade, prevention of heart attacks. It has been called the most successful drug in history. A decade ago 1 in 5 Americans took aspirin every day (Wars, cover).


Not until the 1970s was the mode of action of aspirin worked out! Sir John Vane was awarded the Nobel Prize for uncovering the mode of action of ASA [5]. ASA inhibits the enzyme cyclooxygenase, preventing the cells of the body from making certain prostaglandins that cause inflammation, and other ones that cause the clumping of blood platelets to form clots. The clots, or thromboses, are responsible for "ischemic events", which are the local anemias, or blood shortages, caused by blockage of arteries. When these are coronary arteries, the blockages are called "heart attacks" of the myocardial infarction (MI) type. The common slogan "aspirin thins the blood" is not strictly true; aspirin prevents clot formation by platelets.

The ASA content of a standard aspirin tablet is 325 mg. Extra-strength or arthritis-strength tablets contain 500 mg. For other uses tablets containing 160 and 81 mg are available. Enteric-coated aspirin tablets resist the acidic environment of the stomach; the aspirin is absorbed in the alkaline small intestine. You would not expect "fast, fast , FAST relief of headache" with these, but some studies showed that stomach erosions and ulcers were less frequent [6]. "Buffered" aspirin is no faster than plain aspirin (Wars, p164) and only slightly less irritating, if at all (www.mayohealth.org).

Because it may be important for preventing heart attacks, a Bufferin? tablet, besides 325 mg of ASA, has an actual alkali content of 158 mg of calcium carbonate, 63 mg of magnesium oxide and 34 mg of magnesium carbonate; the latter pair provide a total of 48 mg of magnesium. Bayer Aspirin with Stomach Guard is the same.

Primary vs. Secondary Prevention of Heart Attacks

One must be skeptical about any recommendation for or against aspirin that does not distinguish between primary and secondary prevention. Primary means that people not at any particular risk of MI may prevent a fraction of potential MIs from occurring by taking small doses of aspirin for a long period. Any side effects of aspirin can be serious if a great number of people begin taking it at age 45-50 and continue for 30-40 years. Secondary prevention means that victims of MI or unstable angina, a high-risk group, may prevent a fraction of further cardiovascular problems by taking moderate doses of aspirin for a limited period. Any recommendation for or against aspirin that does not make the distinction can be disregarded as superficial.

Wars distinguished between primary prevention of first heart attacks and secondary prevention on p11 quite well, and described the U. S. Food and Drug Administration (FDA) decision to allow advertising for second heart attacks, but not for first heart attacks, due to an unusual number of strokes in the aspirin-using group in a large study on primary prevention, a prescient decision. But by p334 in Wars: "...aspirin is the drug of doctors' dreams. It is hugely effective. One aspirin a day, or every other day, will save hundreds of thousands of lives a year. It can be taken safely by more people than almost any other drug... It is likely to remain the only heart attack preventive sold in grocery stores for years to come."

Surrogate End Points in Clinical Trials: Are We Being Misled?

This is the title of an unusual paper by T. R. Fleming and D. L. DeMets in Annals of Internal Medicine 125, 605-613 (1996). Clinical trials are the standard scientific method for evaluating a new drug or a new use for an old drug. The true endpoint in most trials would be cure of a disease or condition, or, at least, reduction of symptoms, as indicated by longer lifespan of good quality. A surrogate endpoint is a laboratory measurement or a physical sign used as a convenient substitute for a clinically meaningful endpoint that measures survival directly. Changes induced by a therapy on a surrogate endpoint are supposed to reflect changes in a clinically real endpoint; but all too often, they do not.

Examples of surrogate endpoints are reduction of cholesterol level or blood pressure, two parameters easy to measure in the short term. A meta-analysis of 50 cholesterol-lowering interventions, including diet, resins and lovastatin, lowered cholesterol levels an average of 10%, but there was a 1% increase in overall mortality. A meta-analysis of trials of calcium channel blockers that really do lower blood pressure showed possibly harmful effects overall. In addition, two new antiarrythmia drugs approved by the FDA, encainide and flecainide, clearly suppressed arrythmias, probably as seen by electrocardiograms, as the surrogate endpoint. However, it was found that 3 times as many patients in the drug group died as in the placebo group.

In evaluating aspirin, it is, therefore, not enough to show reduction in the rate of MI or other undesirable vascular events; one must determine total death rates for a reasonable period of several years in order to find whether some toxic effect of aspirin is countering a positive effect on MI. On the other hand, one does not want to carry on for too many years since the ultimate death rates of treatment and placebo converge - to 100%.

Whisper Down the Alley

This is one name for a grade-school game in which someone in a classroom whispers a phrase of a few words to the nearest student, who whispers the same phrase (supposedly) to the next student. The output of the 30th or so student is compared with the input and all have a good laugh, since the two are never equal.

Adult scientists are not supposed to scramble the input - but some do.

A massive meta-analysis of 25 completed clinical trials of secondary prevention of MI was reported in the British Medical Journal (BMJ) in 1988 [7]. The title: "Secondary Prevention of Vascular Disease by Prolonged Antiplatelet Treatment" makes clear that most of the patients involved had already suffered from MI, transient ischemic attack, unstable angina, or minor stroke. "Antiplatelet Treatment" indicates that aspirin was not the only drug tested; these facts are, of course, confirmed in the text and tables, of which one of the key tables is reproduced here as Figure 2. Note that only 12 of the trials employed aspirin alone. Overall reduction in mortality was about 25%, mostly in the first 2 years of treatment. A special note was made that men aged 55-74 with no history of vascular disease for whom aspirin treatment was actually primary showed no difference in mortality.

This BMJ article was cited in Science, a publication of the American Association for the Advancement of Science, with reproduction of that same figure, as an excellent example of how to do a meta-analysis, along with an explanation of how to do one [8]. The secondary nature of the trials was indicated only by the word "recurrence" and the endpoint was implied to be only "heart attack", while the legend (in Figure 2) includes as endpoints MI, stroke, and other vascular death.

The Science article was cited by Dean Radin in the book The Conscious Universe as an example of the power of meta-analysis [9]. Now Radin wrote implying that only aspirin was involved, and only for heart attacks, and the secondary nature of the treatment was not mentioned at all, which led me to believe, when I read this, that I should have continued using aspirin myself after all.

Recommendations for You to Take Aspirin for Primary Prevention of Heart Attacks

In publications for the general public there are a number of sources of advice to take aspirin for primary prevention of heart attacks. Here are a few:

Consumer Reports (CR), with 5 million subscribers and 20 million readers, recommended that postmenopausal women, men over 35 with risk factors such as smoking cigarets, and possibly men over 45 without risk factorsall take aspirin. No dose level was given, although the study quoted was based on "one 'aspirin' tablet every other day", and the use of enteric coated aspirin was advised only if uncoated aspirin caused damage to the stomach. "The...study found that one aspirin tablet every other day cut the rate of initial heart attacks almost in half... The implications were stunning." But then CR was very cautious, noting that the clinical study they were citing showed significantly more hemorrhagic strokes (rupture of blood vessel in the brain), ulcers and allergic reactions, and that no benefit was observed in another trial on healthy male physicians in the UK [10]. While the studies used did not get proper citations, the first was certainly the Physicians Health Study in which 22,071 male physicians were studied for 5 years [11]. (This will be called PHS 89.)

Julian Whitaker, M. D., in his popular newsletter Health & Healing, properly referenced PHS 89, and recommended that everyone take aspirin for primary protection from MI, but at the rate of 162 mg every other day, or 81 mg every day, half the dose used in PHS 89. While the study involved only male physicians, Whitaker did not restrict his recommendations to males. Whitaker wrote that the usual side-effects of aspirin could be avoided by taking the low dose he recommended with a meal [12].

In the current issue of Life Extension Magazine the recommendation for taking 81 mg of aspirin per day with food is unequivocal: "A lot of people in alternative medicine criticize The Life Extension Foundation for recommending the daily use of low-dose aspirin, but The Foundation stands firm on the recommendations it made in 1983: most healthy people should take low-dose aspirin to specifically reduce their risk of heart attack. Aspirin may protect in ways that supplements do not." [13] Of the 34 references cited at the end of the article in such a way that one cannot tell which one backs each aspect of the article, just 9 are to peer-reviewed journals. PHS 89 is not cited, nor is any peer-reviewed paper that shows lower total mortality in low-risk subjects. The article is cleverly laid out with a large space taken up by art work so that it ends on the top half of its last page. The bottom half of the page is an advertisement for Life Extension Foundation's brand of aspirin. Does this fact make you skeptical?

Recommendations for You Not to Take Aspirin for Primary Prevention of Heart Attacks

From an anonymous author on a website www.internetwks.com/pauling/lie/mag.html:

"We have been told that all the aspirin studies that 'prove' an aspirin a day keeps a heart attack away -- were with buffered aspirin, i. e., with added magnesium. Our sources point out that it is unlikely that further studies using 'plain' aspirin will be undertaken because preliminary studies always show 'plain' aspirin does not show the same protective effect against heart attacks. So if you still believe what you read in the mass media, make sure that your daily aspirin is buffered! (Or much better yet, take a magnesium tablet instead!)"

"Possibly the largest collaborative study ever performed in medicine, this meta-analysis (BMJ 8 Jan 94) pooled the results of some 174 clinical trials from around the world, testing an aggregate of ll0,000 patients... The overview was designed to determine whether medium-dose aspirin (75 mg to 325 mg per day) ...could prevent...nonfatal heart attacks , strokes, or deaths in [mostly] high-risk patients... The researchers reckoned that this sort of therapy reduced the risk of [premature] death [a solid endpoint] from one of these causes by one-sixth... This isn't the case with low-risk patients; the study showed that among those taking aspirin as 'primary prevention', although heart attacks were reduced by a third, there was a 'non-significant' increase in nonfatal stokes. However, that increase was cited as 21 % (hardly a 'non-significant' increase in our view)... However, the study makes quite clear that for low-risk people of for those with so-called risk factors like high cholesterol, hypertension, or smoking, but without vascular disease, there is no evidence that this so-called preventive therapy does any good. In fact, the risks (particularly of hemorrage or stroke) may outweigh the benefits. Therefore, there is no scientific justification for your doctor's view that you should start taking aspirin just in case." Thus wrote the editors of the newsletter What Doctors Don't Tell You [14].

And from William Campbell Douglass, MD: "I'm sure you've heard about the study [PHS 89, Ref. 11] showing that an aspirin a day prevents heart attacks. In that study, men who took a daily aspirin had 47% [sic] fewer heart attacks than men who didn't. What you haven't heard, and what I'm sure the aspirin companies don't want you to know, is that the subjects in that study took buffered aspirin - aspirin mixed with magnesium. Numerous studies have proven that magnesium has a powerful protective effect on your heart. It dilates blood vessels...aids potassium absorption into your cells (preventing heartbeat irregularities)...acts as a natural blood thinner...and keeps your blood cells from clumping together [the anti-platelet effect]; indeed autopsies of heart attack victims almost always find a magnesium deficiency! ...Not only that, but recent studies link aspirin to macular degeneration - the #1 cause of blindness in people over the age of 55! But the biggest strike against aspirin may come from the very study touting its heart benefits. If you read the study's fine print, you'll find that even though the group taking aspirin had 47%fewer heart attacks, there wasno difference in the death rates of the two groups. That means that death from other causes was 47% higher in the aspirin group! So stop taking that daily aspirin! Stick to magnesium instead." [15]

Are these people crazy? Not entirely. Now we know enough to divide the original question that is the title of this article into two separate questions: on primary as distinct from secondary prevention of heart attacks. Let us go to the peer-reviewed literature to answer the first of the properly posed questions:

Should You Take Aspirin to Prevent a First Heart Attack?

In the Antiplatelet Trialists' Collaboration [7] reported in 1988 there were some low-risk men aged 55-74 for whom aspirin treatment was actually primary. The paper concludes with the opinon that the absolute benefits in primary prevention of MI were uncertain because they might be outweighed by a small increase in cerebral or other serious hemorrhagic disease. "Thus only for patients with an appropriate history of vascular disease is there at present clear evidence that antiplatelet treatment reduces the overall incidence of fatal or disabling vascular disease." This opinion recognizes that the real endpoint is life extension, not merely minimizing MIs.

Figure 3 is reproduced from PHG 89 [11]. This massive study on 22,071 physicians, half taking 325 mg of "aspirin" every other day, showed that total deaths in the aspirin group over the 5-year period of the study were 4% fewer total deaths than in the placebo group (P=0.64), thus the difference was not considered significant. A big reduction in fatal MIs of 69% (P=0.004) was countered by nearly equal increases in the totals for sudden death (P=0.09), stroke and other cardiovascular deaths. The reduction in MI was seen only in those aged Ú 50. Using the endpoint of life extension, not MI, there was hardly any benefit from taking aspirin. With respect to non-fatal bleeding of several types the aspirin group had a relative risk of 1.32 (P=0.00001). Furthermore, 48 in the aspirin group and 28 in the placebo group required blood transfusions (P=0.02, all 95% conf.). There really was a significant (P less than 0.00001) reduction in non-fatal MIs of 44%. But what did this mean in real benefit? It meant that in a 1-year period the chance of having a non-fatal MI was cut from 0.44 % to 0.25%.

There is no doubt that PHG 89 used Bufferin, not aspirin. Monthly calendar packs containg either Bufferin or placebo were provided by Bristol-Myers Products. Domenick Mellace of Bristol-Myers was acknowledged for his logistic support. Bristol-Myers contrived to have a 1.5 page advertisement placed just ahead of this paper in the journal, in which advertisement they were careful to advertise Bufferin only for secondary prevention as directed by the FDA. Is it possible that the reduction in MIs was due to the magnesium present in the Bufferin and not the ASA content?

By 1994 the Antiplatelet Trialists' Collaboration published a meta-analysis that was now up to 100,000 patients of whom 30,000 were in the low-risk catagory [16]. The doses were 75-325 mg of ASA per day, but the exact source of the ASA was not given. "There was no clear evidence on the balance of risks and benefits of antiplatelet therapy in primary prevention in low-risk subjects." In fact a graph was shown with "% free from a vascular event", including fatal, as the ordinate, and "years to first vascular event" as the abscissa. For low risk subjects after 4 years the treated group had 0.4% fewer events, that is, 4 per 1000. But this included all of the antiplatelet treatments, including 2 trials with drugs that were more effective than aspirin, so it is likely that aspirin was of no benefit in low-risk subjects.

Randomized clinical trials testing aspirin in 5011 elderly people, 58% of whom were women, mean age 72 years, followed for a mean of 4.2 years, showed that use of aspirin caused a 4-fold increase in hemorrhagic stroke (P=0.003) and a 1.6- to 1.8-fold increase in ischemic stroke [17].

Based on the Nurses' Health Study involving 79,319 women aged 34-59 years at the beginning, the role of aspirin in primary prevention of stroke was uncertain [18]. This was based on a questionaire, so the reduction, mostly in older women, of large-artery occlusive infarction by half (1 to 6 aspirin per week) or a doublng of the risk of hemorrhage (15 or more aspirin per week) might have included the use of a large fraction of buffered aspirin. This was not thought important. Total death rates were not included.

"No conventionally used prophylactic aspirin regimen seems free of the risk of peptic ulcer complications... Alka-Seltzer may be associated with higher risk (2 times) and enteric-coated aspirin with lower risk (0.5 times) compared with plain aspirin." [19] Users of aspirin for long periods to relieve arthritis pain have suffered so badly from side-effects that a multitude of alternates, such as ibuprofen and naproxen, were introduced.

And, most recently, reported in 1998, a study of about 5500 physicians in the UK on primary prevention of ischemic heart disease (which causes MIs) was carried out with 75 mg of aspirin daily in a controlled-release formulation for a median time of 7 years. The main effect of aspirin was a 32% reduction in non-fatal MI (less effective than PHG 89 which used double the dose), but there was an increase of 12% in fatal MI leading to an overall rise in death from all causes of 6%, which was not considered significant [20]. The absolute reduction in all MIs per year was 0.23%. Note that there is a 10% increase in overall death rate in the aspirin group in this study compared with the Bufferin group in PHG 89. Could this "non-significant" difference have been a lack o the beneficial effect of the magnesium in Bufferin? Another difference from PHG 89 is that the men in this study were recruited from the quintile considered to be at highest risk for MI based on heredity, smoking, blood pressure and obesity; but this is still a lower-risk group than the one composed of actual victims of MI.

If delaying death is the real end-point, not reduction in heart attacks per se, then it seems pointless to take aspirin for primary protection, with its certainty of obnoxious side-effects, which may include gastritis, peptic ulcer, other internal bleeding, hemorrhagic stroke, fatal MI, and sudden death, to which has been added wet macular degneration (in 1988) and twice the risk of cataracts (in 1998), in trade for a probable reduction of only 0.2% absolute per year in total (mostly non-fatal) MIs, especially when safer alternatives exist, such as magnesium.

Now it is time to ask the more difficult question...

Should You Take Aspirin to Prevent a Second Heart Attack?

Five earlier studies on secondary prevention of MI by ASA were reported from 1974-1980. There was said to be no beneficial effect overall [21]. One multicenter study, nevertheless, the earliest of this type I have seen, had positive results. A single daily dose of 300 mg of aspirin in a gelatine capsule or a similar-looking placebo was to be taken before breakfast to ensure rapid absorption by 1,239 men who had had a recent MI. The aspirin group showed a reduction in total mortality of 12% at 6 months, 25% in 1 year, and 28% at 2 years. The authors modestly acknowledged that the results were statistically inconclusive, but they were in the range of what was observed in later trials. The much larger size of the later trials was needed to obtain results that would be statistically solid [22].

Reported in 1988, the second International Study of Infarct Survival (ISIS-2) Collaborative Group in the UK determined the effect of aspirin vs. placebo in 17,187 people entering 417 hospitals after the onset of suspected acute MI. The aspirin used was clearly stated to be 162.5 mg in an enteric coated tablet given daily for 1 month. All-cause mortality was said to be similar to vascular mortality. After 5 weeks aspirin produced 23% fewer vascular deaths overall (P less than 0.00001), cut MIs from an absolute value of 2% to 1%, cut non-fatal stroke from 0.6% to 0.3%, and did not cause any increase in cerebral hemorrhages. Survival rates after 2 years were 81.7% in the aspirin group vs. 80.0 % on placebo [23].

In 1988 the Antiplatelet Trialists' Collaboration [7] on 29,000 patients, a majority with a history of transient ischemic attack, stroke, unstable angina, or MI, were treated by a variety of methods, including with ?300 mg ASA daily, which did not differ greatly in results from other drug regimens employed in the trials, as shown by this meta-analysis (see Figure 2). The authors thought that vascular mortality was reduced by 1/6, and non-vascular undesirable events by 1/3 in high-risk patients. By 1994, now up to 70,000 high-risk patients, the Antiplatelet Trialists' Collaboration [16] found similar results; but now the daily aspirin dose was 75-325 mg.

By 1998 ISIS-2 was still following 6,213 high-risk patients in the UK of the 17,187 originally in the trial. During the first 35 days of follow-up the use of aspirin during the first month reduced the death rate by 22%. Hence all of the survival benefit of an early, one-month course of oral aspirin (162.5 mg enteric coated, daily) seemed to accrue during the first month, with little further benefit between day 36 and the end of year 10, by when the death rate was down 1% relative to placebo [24].

This then was the background of the North of England Aspirin Guideline Development Group's recommendations to physicians: Aspirin should be used in patients with acute MI at 150 mg daily for one month, then 75 mg daily for several years. In patients with MI, anginas, stroke, or transient ischemic attack, aspirin should be used at 75 mg daily for several years. There was no evidence that higher doses were more effective [25]. The Group did not mention either buffer or enteric coating. The latter seems desirable to this writer.

So the answer for secondary protection from recurrence of several types of undesirable vascular conditions is: Yes, take aspirin in low doses, and not forever, in order to obtain a moderate (16-22%) protection from fatal MI. But is aspirin the best protection there is, either from the standpoint of effectiveness or freedom from side effects? Probably not.

What Else Could You Take to Prevent Heart Attacks?

Vitamin E for primary protection

The Nurses Health Study involved 87,245 female nurses aged 34-59 in 1980, who were free from diagnosed cardiovascular disease and cancer, and who completed dietary questionaires every two years up to eight years. Women who took vitamin E supplements containing, on average, 200 IU (International Units) for more than 2 years had 41% fewer instances of coronary disease of several types, and and overall mortality 13% lower than those who did not (P=0.05) [26]. The amount of vitamin E in multivitamin capsules at that time was typically ? 30 IU.

The Health Professionals Follow-up Study involving >40,000 males aged 40-75 in 1986 who were free of diagnosed coronary heart disease, diabetes, or hypercholestemia completed detailed dietary questionaires every two years until 1990. Men who took 100-250 IU of vitamin E as supplements for 2-10 years had 37% fewer instances of coronary disease of several types, including fatal (P=0.05). Higher doses of vitamin E were no more effective. By contrast, the intake of vitamin C and beta-carotene did not lower risk [27].

These results are far more impressive than the ones for aspirin, especially because side-effects were so minimal as not to be mentioned. And vitamin E could be bought at almost any grocery store.

Vitamin E for secondary protection

The Cambridge Heart Antioxidant Study [CHAOS (English humor?)] was a single-center, double-blind, placebo-controlled study with 2002 patients who had angiographically proven coronary atherosclerosis (fatty deposits). Doses of 400 or 800 IU of vitamin E were used in half, and the group was followed or a median of 510 days. Vitamin E gave a significant reduction in non-fatal MI of 77% (P=0.005); however, there was a non-significant excess (18%, P=0.61) of cardiovascular deaths in the combined Vitamin E groups. The lower dose of vitamin was better on both counts, including a lower death rate on 400 IU than on placebo. So here, too, vitamin E is far more effective than aspirin, and, again, side effects were negligible [28].

Magnesium for primary protection

The Caerphilly Heart Disease Study of men aged 45-59 years at the beginning of a 5-year period examined the relation of magnesium in the diet to the incidence of MIs, both fatal and non-fatal. Of the 627 men in the study 38 suffered MIs. The mean daily intake of magnesium in these was 12% lower than in men who did not have MIs. This is difference of about 38 mg per day, less than the amount in a Bufferin tablet [29]. The inverse relation of magnesium concentrations in drinking water to rate of heart attacks has been noted many times [30].

The usual recommendations for dietary supplements are to take 300-600 mg of magnesium in a compound (not the metal) daily with food [31]. The most common form in which to take magnesium is as the compound magnesium oxide, one of the alkalis in Bufferin; but equally persuasive is advice to take it as potassium magnesium aspartate for fast absorption [32]. Women at risk of osteoporosis are advised to take also about twice the mass of calcium [33]. But calcium, as well a vitamin D and phosphates, increase the amount of magnesium needed [34]. Mildred Seelig, MD, also wrote that the typical daily intake of magnesium in American college students was 250 mg, not ?385 mg recommended for a 140-lb woman, or ?500 mg for a 185-lb man. Unfortunately, I have not found a report on a large clinical study on primary protection using supplements in humans.

A prospective study of 10-year duration in 400 "high-risk" subjects (selected about as in Ref. 20), of whom 93.5% were male, living in Moradabad, India, was carried out by assigning half the group to a high-magnesium diet (1,142 mg per day vs. 418 mg in the control group from fruits, green vegetables, cereals and nuts) and tracking medical events.

The high-magnesium group had 35% fewer deaths from all causes (P value less than 0.001), and a 61% reduction of non-fatal cardiovascular events (P less than 0.001), including a 54% reduction in strokes [35]. Unfortunately, this report was marred by a number of arithmetical errors in the table of results. There was also a confounding factor in that the high-magnesium diet was also a high calcium diet (880 vs. 512 mg daily) and a high-potassium diet (3,080 vs. 548 mg daily). Since serum levels of magnesium and potassium were raised, and those of calcium were not, it is most likely that the magnesium and potassium were responsible for the differences in outcomes, which also included significant reductions in serum total cholesterol and glucose.

Use of magnesium supplements in many people is probably justified by inference based on their effectiveness on secondary prevention, the clinical experience of a number of physicians, the drinking water studies, and the above diet study. The diet study would support using potassium magnesium aspartate as the supplement most resembling the high-magnesium diet.

Magnesium for secondary protection

In a double-blind, placebo-controlled study involving 273 patients with suspected acute MI, 74 received placebo, while 130 received 1.2 g of magnesium as the chloride intravenously during 24 hours, followed by 0.3 g in the next 24 hours. Treatments were begun within 3 hours of hospital admission. During the first 4 weeks after treatment mortality was 7% in the magnesium group and 19% in the placebo group, a reduction of 63% (P=0.045). In the magnesium group 21% of the patients had arrhythmias that needed treatment vs. 47% in the placebo group, a reduction of 55% (P=0.004). No adverse effects of intravenous magnesium were observed [36].

Reported in 1992, the second Leicester Intravenous Magnesium Intervention Trial (LIMIT-2) on 2316 patients with suspected acute MI found a 24% reduction (P=0.05) in 28-day mortality from treatment with intravenous magnesium sulfate. Reported in 1995, the fourth International Study of Infarct Survival (ISIS-4) showed no benefit of similar treatment of 29,000 patients.

By 1996 the discrepancy was explained as follows: LIMIT-2 was double-blind and placebo controlled, and only 30% of the patients had received treatment for thrombosis (streptokinase) by the time magnesium was begun on average 3 hours after onset of symptoms. ISIS-4 was non-blinded, had no placebo, the alternate treatments being the drugs isosorbide mononitrate or captopril; and 70% of the patients had received treatment (which raises blood magnesium concentrations) for thrombosis (clotting in major blood vessel), and 94% had received aspirin by the time magnesium was begun on average 8 hours after onset of symptoms. It in interesting that captopril is a product of Bristol-Myers Squibb, the sponsor of ISIS-4, at a cost of about $10 million.

A study appeared simultaneously involving 194 patients considered unsuitable for treatment for thrombosis. In-hospital mortality was 4.2% in the magnesium group and 17.3% in controls, a reduction of 76% [37].

Where confounding treatments are absent, rapid treatment of patients suffering from MI with intravenous magnesium is of great benefit in secondary prevention, not only of MI, but of arrhythmias. The 3 studies not confounded showed, on average, a greater 4-week benefit than from aspirin, and LIMIT-2 showed that concurrent aspirin did not change the outcome. Side-effects of magnesium were minimal and could be avoided altogether.

The medical establishment has accepted the role of oral magnesium supplements in countering hypertension, MI, congestive heart failure, and arrhythmias [38].

Coenzyme Q10 for primary protection

Coenzyme Q10 is an oily organic compound, like vitamin E, and is found in every cell of the body. It has a number of functions, among which are preventing the oxidation of LDL, and transporting oxygen from hemoglobin into the parts of cells where ATP, the main source of cellular energy, can be formed. Sharing its status with magnesium, the value of oral coenzyme Q10 supplements for better health in a low-risk population has not been investigated in large-scale controlled experiments [39]. Its use in older people with some definite symptoms, such as congestive heart failure, is probably justified by inference based on its effectiveness on secondary prevention, and the clinical experience of a number of physicians. For details see the website of The International Coenzyme Q10 Association (wwwcsi.unian.it/coenzymeQ).

Coenzyme Q10 for secondary protection

The New York Heart Association (NYHA) has grouped heart failure into 4 classes of severity. A cardiac patient in class IV, the most serious, is unable to perform any physical act without discomfort, and symptoms of heart failure, including anginal pain, may be present even at rest. Cardiologists know that such patients are on a relentless downhill course to death in spite of all conventional therapy. In a study in which all patients in hospitals were in NYHA classes III and IV, and all received conventional therapy (bypass surgery, digitalis, diuretics, vasodilators), about 25% survived for 3 years. The 88 patients treated with Coenzyme Q10 had a 75% survival rate. Putting this finding in the same form as used above, the reduction in 3-year death rate was 67%! [40]

Congestive heart failure is always characterized by an energy depletion status correlated with lowered coenzyme Q10 levels. In a 1-year double-blind trial 641 patients of mean age 67 with chronic congestive heart failure (NYAS classes III and IV) were randomly assigned to receive either 2 mg/kg (?100 mg) daily of coenzyme Q10 or placebo. The number of patients who required hospitalization for worsening heart failure was 38% lower (P less than 0.001) in the Q10 group; the incidence of pulmonary edema was cut by 61%, and of cardiac asthma was cut by 51% (both P less than 0.001) [41]. A similar study on 2500 patients showed only 0.5% with side effects thought due to Q10.

Summing Up

Not only the medical adviser to Consumers Union, but also some health professionals who recommend aspirin, believe that there is a "high-risk" but not-yet-diagnosed population who should take aspirin for primary prevention of heart attack. You may check for yourself in the studies cited - often there is no such group. True, males greater than 50 years old are at higher risk than males or females lesss than 50, but those males greater than 50 are actually the low risk group in most of the large studies on health professionals. The study with the most favorable results in terms of reducing MIs, PHG 89, used Bufferin, which contains a significant amount of magnesium, not plain aspirin. This fact was lost on the author of The Medical Letter 42 (1072), 21 Feb 00, p18, who cited PHG 89 and did not believe that the later European studies were valid.

There is no consensus even among cardiologists that use of aspirin in the general population is advisable. For one, Prof. F. Verheught, Dept. Cardiology, University Hospital, Nijmegen, Netherlands, warned that use of aspirin for primary prevention was inadvisable because its use was investigated only in men, that the risk of non-fatal MI is less than 0.5% per year [and would be cut only by 0.2%], and that there was risk of gastric discomfort and bleeding? [42]. The studies on low-risk males were carried on for 5-7 years. Based on life-expectancies, advice to take aspirin beginning at age 50 would mean 30 years of exposure to its side-effects.

Vitamin E is both more effective and safer than aspirin, and its value in primary protection has been demonstrated in both men and women.

Magnesium intake is inversely correlated with incidence of cardiovascular problems, the effect being more pronounced in men than in women. Up to at least 1,100 mg daily along with up to 3,000 mg of potassium is strongly protective.

In secondary protection, aspirin has a limited but definite value, and does not have to be taken forever; most of the benefit is obtained in the first month. Based on available evidence, aspirin is preferred for the majority of stroke or myocardial infarction (heart attack) patients at risk of recurrences, according to The American Heart Association. But studies have shown that vitamin E, magnesium, and coenzyme Q10 each provide much greater benefits than aspirin with lesser side-effects. Not even the skeptical website www.quackwatch.com disagrees with this.

A skeptical outlook is of great value in evaluating medical claims of most types. Medical advice with no citations to peer-reviewed papers on well-controlled studies can be ignored. You should spot-check the original papers, but beware of the internet trap - you can get abstracts free, but it is more difficult or costly to obtain the full papers from websites. While all of the peer-reviewed papers in this field seem very honestly presented, some important facts often do not appear in the abstracts, and some studies were contrived to favor a pre-conceived result.

Acknowledgements: The following faculty at The University of the Sciences in Philadelphia provided help: Eric G. Boyce, Donna Gagnier, Daniel A Hussar, Jeannette McVeigh, and William A. Reinsmith, were of great help, but do not necessarily agree with the conclusions. Additonal aid was provided by Charles J.Kelley, Tom Miller and Mildred Seelig, MD.

----------------------------------------------------------------------

REFERENCES:

1. M. Windholz, Ed., The Merck Index, 9th ed., Merck & Co., Inc., Rahway, NJ, 1976, p114.

2. J. Fraser Mustard in Acetylsalicylic Acid: New Uses for an Old Drug, H. J. M. Barnett et al., Eds., Raven Press, NY, 1982, p1.

3. Charles C. Mann and Mark L. Plummer, The Aspirin Wars: Money, Medicine, and 100 Years of Rampant Competition, Alfred A. Knopf, NY, 1991 ("Wars").

4. John R. Vane and Regina M. Botting, Eds., Aspirin and Other Salicylates, Chapman & Hall Medical, London, 1992, p10.

5. Susan E. Feinman, Ed., Beneficial and Toxic Effects of Aspirin, CRC Press, Boca Raton, FL, 1993, p11.

6. John W. D. McDonald in Acetylsalicylic Acid: New Uses for an Old Drug, H. J. M. Barnett et al., Eds., Raven Press, NY, 1982, p89.

7. BMJ 88: Antiplatelet Trialists' Collaboration, British Medical Journal 296, 320-331 (1988).

8. "Meta-Analysis in the Breech", Science 249, 476-9 (1990).

9. Dean Radin, The Conscious Universe, Harper Edge, San Francisco, CA, 1997, pp55-6.

10. Consumer Reports, 10/88, pp616-8.

11. PHS 89: Steering Committee of the Physicians Health Study Research Group, The New England Journal of Medicine 321, 129-135 (1989).

12. Julian Whitaker, Health & Healing 6 (8), 8/96, pp1-3. (Dr. Whitaker is one of the most courageous advocates of new or alternate treatments for many conditions. He has risked life, liberty, and financial ruin in trying to protect other practitioners from the FDA and in campaigning for easy availability of supplements.)

13. JoAnn Knorr, "Aspirin, The Multi-Purpose Compound, Not Just for Headaches Anymore", Life Extension, 2/2000, pp50-55.

14. Lynne McTaggart, Ed., Medicine: What Works & What Doesn't, The Wallace Press, no location, 1995, pp52-54.

15. William Campbell Douglass, ?Health Breakthroughs?, Second Opinion, Atlanta GA, Fall, 1998, p4.

16. Antiplatelet Trialists' Collaboration, British Medical Journal 308, 81-106 (1994).

17. R. A. Kronmal et al., Stroke 29, 887-894 (1998).

18. H. Iso et al., Stroke 30, 1764-1771 (1999).

19. John Weil et al., British Medical Journal 310, 827-829 (1995).

20. T. W. Meade et al., The Lancet 351, 233-41 (1998).

21. M. Gent and C. J. Carter in Acetylsalicylic Acid: New Uses for an Old Drug, H. J. M. Barnett et al., Eds., Raven Press, NY, 1982, p251-2.

22. P. C. Elwood et al., "A Randomized Controlled Trial of Acetylsalicylic Acid in the Secondary Prevention of Mortality from Myocardial Infarction", British Medical Journal, Part 1, 436-440 (9 Mar 74).

23. ISIS-2, Lancet, 349-360 (13 Aug 88).

24. C. Baigent et al., for ISIS-2, British Medical Journal 316, 1337-1343 (1998).

25. M. Eccles, N. Fremantle and J. Mason, and the North of England Aspirin Guideline Development Group,British Medical Journal 316, 1303-1307 (1998).

26. M. J. Stampfer et al., "Vitamin E Consumption and the Risk of Coronary Disease in Women", The New England Journal of Medicine, 328, 1444-9 (1993).

27. E. B. Rimm et al., "Vitamin E Consumption and the Risk of Coronary Disease in Men", The New England Journal of Medicine, 328, 1450-96 (1993).

28. N. G. Stephens et al., "Randomised Controlled Trial of Vitamin E in Patients with Coronary Disease: Cambridge Heart Antioxidant Study (CHAOS)", Lancet 347, 781-6 (1996).

29. P. C. Elwood et al., "Dietary Magnesium and Prediction of Heart Disease", Lancet 340, 483 (22 Aug 92).

30. J. R. Purvis, MD and A . Mohaved, MD, Magnesium Disorders and Cardiovascular Diseases", Clinical Cardiology 5, 566-8 (1999).

31. Tom Miller, www.execpc.com, last update 23 Jul 99.

32. W. C. Douglass, "A Strong Case for Magnesium", Second Opinion, V (7), 1-3 (July, 95).

33. S. Lieberman and N. Bruning, The Real Vitamin & Mineral Book, Avery Publ. Grp., Garden City Park, NY, 1990, pp141-2.

34. Mildred S. Seelig, Magnesium Deficiency in the Pathogenesis of Disease, Plenum, NY, 1980, pp8,10,169.

35. R. B. Singh, "Effect of Dietary Magnesium Supplementation in the Prevention of Coronary Heart Disease and Sudden Cardiac Death", Magnesium & Trace Elements 9, 143-51 (1990).

36. H. S. Rasmussen et al., "Intravenous Magnesium in Acute Myocardial Infarction", Lancet, 234-5 (1 Feb 86).

37. G. F. Baxter, M. S. Sumeray and J. M. Walker, "Infarct Size and Magnesium: Insights into LIMIT-2 and ISIS-4 from Experimental Studies", Lancet 348, 1424-6 (1996).

38. David P Lauler, MD, "A Symposium: Magnesium Deficiency-Pathogenesis, Prevalence, and Strategies for Repletion", The American Journal of Cardiology 63 (14), 1-43G (1989).

39. K. Overvad et al., "Coenzyme Q10 in Health and Disease", Eur. J. Clin. Nutr. 53, 764-70 (1999).

40. Karl Folkers, "Contemporary Therapy with Vitamin B6, Vitamin B2, and Coenzyme Q10", Chemical & Engineering News, 55-6 (21 Apr 86); Karl Folkers, S. Vadhanavikit and Svend A. Mortensen, "Biochemical Rationale and Myocardial Tissue Data on the Effective Therapy of Cardiomyopathy with Coenzyme Q10", Proc. Natl. Acad. Sciences USA 82, 901-4 (1985).

41. C. Morisco, B. Trimarco and M. Condorelli, "Effect of Coenzyme Q10 Therapy in Patients with Congestive Heart Failure: A Long-Term Multicenter Randomized Study", Clincal Investigations 71 (8 Suppl.), S134-6 (1993).

42. Z. Kmietowicz, "Aspirin and Warfarin Best for Primary Prevention of Heart Attacks", British Medical Journal 316, 327 (1998).

Additional Note: In people under 55 years old to start taking aspirin at more than 1 per week for more than 10 years, the risk of getting cataracts goes up 2-5 fold.

Should You Take Aspirin to Prevent Heart Attack? by Joel M. Kauffman

Joel M. Kauffman (Emeritus)
Professor
Ph.D., Organic Chemistry
MIT, 1963

Sept 3 2007, to: Robert Gallo

Dear Bob,

I've been away being filmed again on medical-scientific ethics in an hour-long interview to be dispersed amongst mainly the medical community. Sorry for the delay in responding.

During the interview with a scientist host who interviewed me, I mentioned about 1/3 way through the show, the concept that there are different layers of medical/scientific ethics. As you know all too well, it's not only about people people deliberately fudging data. I reviewed many of the issues involved in IRB's, testing of special groups, protected populations, prisoners, psychological testing, conflicts of interests, special needs of assent versus consent with child subjects, etc.

Then I shifted focus to a different layer of medical/scientific "ethos," where factual info that is not knowable often until years after protocols are placed into action can violate and should reverse what is thought about a disease or procedure. This is not necessarily a breach in ethics: it is called "advancement in medical science" (E.G. people don't treat yellow fever with mercury to the point their tongues turn black or exsanguinate them as did Benjamin Rush in Phily in 1773). This segment involved a treatment of epistemology and different concepts of causality. Such trials as the Fischl 1987 trial are good examples in light of what was found later at Concorde and Hamilton's Veterans Affairs AZT studies and of course many others who used high dose AZT, or which made healthy people sicker as shown by the VA study of Hamilton. I talked equally at length about the scientific impossibility of conducting a truly controlled clinical trial, and emphasized that medicine is perpetually on a learning curve, and collectively, failures and mass harm during such mass human experiments eventually lead to reform and more rational approaches, and even though the investigators directing the research most often are directing things for the welfare of patients, although it doesn't seem to frequently turn out that way. Medicine isn't science. AIDS science has arrived I believe, with reports like:

HAART-HIV TREATMENT RESPONSE AND PROGNOSIS IN EUROPE AND NORTH AMERICA IN THE FIRST DECADE OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY: A COLLABORATIVE ANALYSIS:

Methods: We analyzed data from 22217 treatment-naïve HIV-1-infected adults who had started HAART and were followed in one of 12 cohort studies. The probablility of reaching 500 or less HIV-1 RNA copies per mL by 6 months, and the change in CD4 cell counts, were analyzed for patients starting HAART in 1995-96, 1997, 1998, 1999, 2000, 2001, and 2002-03. The primary endpoints were the hazard ratios for AIDS and for death from all causes in the first year of HAART, which were estimated using Cox regression.

Interpretation: Virological response after starting HAART improved over calander years, but such improvement has not translated into a decrease in mortality.[The Antiretroviral Therapy (ART) cohort Collaboration-www.thelancet.com Vol 368, 451-58, August 5, 2006],

or even like your collaborator, Max Essex's group reported recently on nevirapine:

“Well over 875,000 women and infants have received a single dose of nevirapine. A single dose of nevirapine is the cornerstone of the regimen recommended by the World Health Organization (WHO) to prevent mother-to-child transmission among women without access to antiretroviral treatment and among those not meeting treatment criteria.

However, nevirapine resistance is detected (with the use of standard genotyping techniques) in 20 to 69% of women and 33 to 87% of infants after exposure to a single, peripartum dose of nevirapine. Among 60 women starting antiretroviral treatment within 6 months after receiving placebo or a single dose of nevirapine, no women in the placebo group and 41.7% in the nevirapine group had virologic failure (P<0.001). Women who had received a single dose of nevirapine had significantly higher rates of virologic failure on subsequent nevirapine-based antiretroviral treatment than did women who had received placebo. This apparently deleterious effect of a single dose of nevirapine was concentrated in women who initiated antiretroviral treatment within 6 months after receiving a single dose of nevirapine. We did not find that a previous single dose of nevirapine compromised the efficacy of subsequent nevirapine-based antiretroviral treatment in women who started antiretroviral treatment 6 months or more after delivery. Among the 30 HIV-infected infants, a single dose of nevirapine (one each to mother and infant) as compared with placebo was associated with significantly higher rates of virologic failure and smaller CD4+percentage increases in response to subsequent nevirapine-based antiretroviral treatment”

[Lockman S. et al., Response to Antiretroviral Therapy after a Single, Peripartum Dose of Nevirapine. The New England Journal of Medicine 356 january 11, 2007].

I believe Essex's interpretation wrong, but that's not at issue at this time, nor did I discuss this on film.

Finally, I believe that you'd be proud of me, that during a segment of the filming, I essentially repeated the issues that emerged with an over-zealous Dingell commission I've learned about from you recently. I discussed the Sharma case (where the typo errors in his grant involving the two proteins were reversed because of a typo, and also, the issue of Papovic and the ND (not determined) versus (not done) issue, and how this launched a ridiculous investigation that obscured the far more important underlying scientific issues, and how this in turn launched the events that damaged your credibility and how legal investigations, charges of misconduct, and changing the rules of scientific review to allow uninformed legal criminal considerations instead of having scientific discussions prevail, should be abolished (the issues involving Suk and his stem cells in Korea are other good examples of this as I'm sure you have become aware of regarding the issue of parthanogenesis he supposedly actually blindly stumbled upon with his stem cells-in other words he didn't really understand his own findings until after he was vilified, and the findings turn out to be simply the first evidence for human parthanogenetic development that have ever come to light).

In essence, and in good faith during the filming, I have pro-actively tried to correct the historical misperceptions involving your 5 years of investigation, and done so I hope articulately (I haven't seen it yet, but when it is out I will send it to you), with a motive in the back of my mind to try to convince you and others I am not trying to attack you or your conduct in any way shape or form. I really never was, but I assumed the Crewdson and Dingell stuff was the last word, which obviously, it wasn't.

I hope this shows you in real terms that I am sincere about correcting the historical mistakes.

Regarding the call tomorrow, I don't know the nature of it-you say it is 'serious" but you haven't responded to my last email(s) regarding the correction of the HTLV-1 stuff (number 4 on the list). I had agreed to incorporate the Kostaratos descriptions and not rely on the Adams descriptions, although they are essentially identical regarding this early period of your discovering HTLV-1 and 2 and how you believe it causes both cancer and neurological syndromes in (4%) of the victims who test positive.

You indicated in a previous email, that 4 of the 5 points have been settled and something as to the effect that you couldn't have stated them any better yourself.

So if you'd like to call tomorrow, or for me to call you, I'm completely at your disposal anytime. However, I'd love to tape it to protect both of us, and, taping would be helpful to me and my book so I can refer to exactly what you think, especially if you would like to discuss science, so that I won't get anything wrong again, and so I can prove it is from the horse's mouth to my "denialist" "flat-earthers," which was a term you did suggest appropriate during an interview you gave to Hockenberry in 1993 I believe it was. I'd need some time to tell my wife to set up her equipment, however, if you wanted to do this.

Note: I wouldn't of course ask you anything over the phone
(scientifically) that I wouldn't tell you about beforehand to allow you to think about any response before you answer. In other words, there are only a few difficult points that I could easily convey to you in a few minutes before we taped anything, and you have my word that I wouldn't spring any surprises on you, nor, as you were worried about before, I wouldn't tape anything, not a word, without your specific permission. I'd still like that visit someday to your office on my nickel. And besides, I still owe you a nickel about the endothelial cells.

Otherwise, if this is unsatisfactory for you, could we simply continue to communicate with email for the next several days, since I am absolutely strapped with the beginning of schoolm, teaching, and research and grants at the moment and have numerous student interruptions during both the morning and early afternoon?

Much obliged,

Andy Maniotis

Dear David and Anthony (and others),

I can retract historical info that is wrong (that he stole the virus from Montagnier, or impeded Montagnier's publication when he shepherded it through-although it was Robin Weiss's re-review of the work that got it in, that the press review with Heckler was before the peer review (Gallo's work had to have been in review because it came out a month after the press conference and it typically takes 3-12 months to get papers out in journals like science, etc.), but I can't change the way I feel that HTLV-and 2 were frauds.

Here's why.

If you believe Duesberg's stats it is 0.6% of an HTLV-1 testing positive population that will contract leukemia if they test HTLV-1 positive, or if you believe Gallo (see below) you get 4% leaving 96 HTLV-posives who don't get it. It is a fraud as a cancer researcher, or even a person that can tie their shoe, to see that this is not causality. But its in every medical and molecular biological textbook and we have to teach this shit!

Drop a pen 9,994 times and it floats upward 6 of those times-then I can say that gravity causes pens to float up (sometimes)? Or perhaps my machines didn't work so good 6 of those times? It's embarrassing! Or if you believe Gallo, 6 people of of 94 who test HTLV-1 positive will get leukemia. Therefore, I have discovered that Human retroviruses cause leukemia if 6 who test positive get leukemia but not the 94 who also test positive? I see 100 rain storms. 96 times I see birds flying but 4 times I don't and see birds sitting on branches instead, during the rain. I can now say that birds sitting on branches cause rainstorms? Sheesh!

Andy

---------------------------- -----------------------

Subject: Re: Maniotis Letter to Gallo, 4th version.
From: "Robert Gallo"
Date: Fri, August 31, 2007 3:33 pm
To: "Maniotis, Andrew J."

Andy,

In response to your long last letter I need to make a few clarifications.

1) Regarding Barre-Sinoussi: I do not want to sat I trained her, only that she was in my lab. for a few months to study lymphocyte culturing.

2)Regarding Robin Weiss: Certainly, I (we) never trained him. I needed him to help in tissue culture virus experiments in the mid-1970s, and he wished to come and did. Again, this was probably only for a few months.

3) I deeply resent your reference to me as calling you and others" Holocaust denialists". I do not believe I have ever used that phrase on anyone. You clearly have mixed me up with someone else, if indeed there is any truth in this at all. Really Andy, I do not know where you get your information, but if I were you I'd make a few adjustments.

4)Finally, you end with your concerns that we are not communicating as well, and you predict we may return to an adversarial relationship with censorship.... and only serve to block progress. In this regard I have a serious matter to discuss with you. In many respects more serious than anything before or anything we have ever discussed. It is important and urgent that we speak. In that I will be with some visiting friends this Labor Day weekend-let's try to talk on Tuesday. Please confirm.

Thank you. Bob

________________________________________

Maniotis, Andrew J. wrote:

Bob,

I have taken out a new website and posted on it. But I don't like the post I made regarding HTLV-1 and my apology for the way I stated this history. After reading Kontaratos's description of the early years of HTLV-1 again, and feeling that his material and not only Adam's material is a more appropriate description of that time period because at least there is a picture shown in his book with your quotes, and a better explanation of your resolve to prove the existence of a human cancer-causing retrovirus, that I should quote his work and not only Adam's description, which I will do as soon as possible.

Of course this is the hardest material for me to navigate, because I am so in tune with this science. But navigate through it I will.

However, you are wrong about:

"What is the point except to try to minimize our contributions?"

My statements or anything I wrote about HTLV-1,II are not about the
Japanese, or who discovered what first. Our conversations and emails and my reading of the materials you sent have convinced me (and others I might add), that there was no "misconduct" either between you and Montagnier or with respect to your research efforts and those of the Japanese. In fact you convinced me that you have been consistent and successful in your efforts, perhaps more than most of us, to proliferate your findings, and methods throughout the world in that you have consistently shown a willingness to send out materials, even though others haven't reciprocated as you indicated regarding the Japanese (and methods and train people like Barre-Sinoussi and Weiss in your own lab).

But these aren't the issues (at least from my perspective). The issue is the nature of the molecular signatures you and others have been tying to retroviruses and their effects (on cancer patients on AIDS patients and on:

"spastic paraparesis patients and now retermed HTLV-1 associated
myelopathy" patients."

I have many ideas about these things. I sent you two papers last spring regarding new approaches to testing for the pathogenicity of viruses by looking at chromatin, and our work on reversing cancers, without any reply from you, for example. I was reaching out, even to you who I know won't take the time to try to understand the science that I have developed that really began when I was in Folkman's group, and which I whole-heartedly believe, is the real issue(s) behind trying to reverse cancers.

Just so you know and to clarify my position, I was in error regarding the assumption that Crewdson, and others (even your supporters) were correct in their perceptions of your work and collaborations, which as far as I am concerned, and as as far as I've told the other "Holocaust denialists," as you like to call us (which is not very nice from a Greek immigrant's son's point of view who hid the Jews from the Nazi's and allowed the Russians time to prepare their defenses for 11 months while the Nazi's terrorized Greece-but not the Mani because we were too fierce), that I know and to the other "Holocaust denier's amazement," and also to the amazement of
other people who know you and like you like Mary Hendrix and Judah
Folkman, that you have done nothing but pursue your hypotheses, be they wrong or right, with admirable openness, and resolve as any one of us should.

As a senior scientist, I owed you open apologies for suggesting that your motives have been otherwise, which after this last posting on this new website, I believe will be sufficient (after I add Kontaratos's descriptions). You have no worries about the lose ends floating about the internet with respect to things I have said, written, or suggested: I will not be associated with any wrong information regarding the important historical events surrounding any hypotheses regarding cancer, and all of these things, no matter where they are have been, will be or have been changed to reflect what I said in the previous paragraph.

I wish we could continue to discuss these things as openly as we did a
week ago. I wish you'd see me as an asset to a modification of the
"HIV=AIDS" paradigm, but I know this probably will never happen, and
things will return to an adversarial and bitter exchange, with
characteristic silence, censorship, and other unfortunate behaviors that only serve to stall or block progress.

Regards, Papa Gallo,

Andy
____________________________________________________

On Thu, August 30, 2007 9:40 am, Robert Gallo wrote:

Andy,

This is becoming too time consuming. My schedule is filled , whereas you are doing a book. The problem here is simple to correct: you made
comments related to two bona fide discoveries. HTLV-1 and 2 have been
given (by me) to numerous labs all over the world. I do not know nor do you nor Adams (whoever he is) that the Japanese were about to make the same discovery. If true so what? What is the point except to try to minimize our contributions? The fact is we published 5 papers in peer reviewed journals in 1980-1981 before the first paper from Japan
appeared in late 1981, and yes, we presented data at international
meetings in 1979 ,e.g., Cold Spring Harbor meeting.

As to Duesberg's odd or at least misleading statistic of a 0.06%
incidence: according to Japanese and epid. studies of others, about 4%
of HTLV-1 infected people get this very specific CD4 T cell leukemia,
known as ATL or Adult T Cell Leukemia, occurring in young to middle
aged adults over a 70 year life span, and slightly more get the fatal
neurological disease, first known as tropical spastic paraparesis and
now retermed HTLV-1 associated myelopathy. This was first recognized as an HTLV-1 caused disease in Lyon, France by Gessain and deThe.

As to Adams quotes of me regarding any and all Duesberg phenomena.
including discoveries,I cannot vouch for accuracy. Surely I never said
Duesberg and Vogt "discovered" oncogenes in 1970 because a) I don't
recall date, and 2) the discoveries involved many groups contributing at many different fronts.

Finally, I do not understand your lumping Kontaratos with Adams.
Kontaratos had access to all files, interviewed me dozens of times,
and interviewed numerous co-workers and collaborators of mine before
even beginning to write. I do not recall even meeting Adams. If I did I sure do not recall. I do see that he is an HIV denialist which makes any and all of his views on me more than a little suspect. If you want my primary quotes go to my book, written in 89-90 and published in 91. It is all there and then some.

Andy, I am now really fed up with this. Make the correction and apology simply and fairly..

Thanks, Bob

______________________________________

Maniotis, Andrew J. wrote:

Bob,

RE: "Gallo's discoveries of HTLV-1 and 2 were frauds undertaken to get
funding for a cash strapped virus cancer program at NIH"."

I'm glad the other points are now rectified. For this forth point you'd like me to correct, I have had to do some reading and confering with my colleagues about this period, and about retroviruses. I think my unfortunate statement should be easy to correct. But before I post it, would you varify that the info in the attached document is correct as you remember it. There are some quotes of yours that I don't want to get wrong.

Thanks,

Andy

______________________________

On Mon, August 27, 2007 3:57 pm, Robert Gallo wrote:

Andy,

O.K., I'll wait to see the "final". Then I will send you a note to post.

Bob

_________________________________

Maniotis, Andrew J. wrote:

Bob,
You're right, it wasn't intentional-I was just stating what you said.
But yes, I'll correct it also.

andy

________________________________________

On Mon, August 27, 2007 1:28 pm, Robert Gallo wrote:

Andy,

Thank you for these clarifications. They are nearly precisely what I
would have asked for. However, in point #4, the current wording
corrects the misinformation about the virus cancer program, but seems
to leave standing the misinformation that my discoveries of HTLV-1 and
HTLV-2 were "frauds". I suspect that you simply overlooked that part
as you were correcting the other information. Nevertheless, this is
obviously the most important and serious part of #4, and I would
appreciate you also correcting that information..

Bob

_________________________

Maniotis, Andrew J. wrote:

Bob,

Here's the final revision you asked for. I hope it is now
satisfactory. I will post it upon receiving your approval.

andy

______________________________________

To:
Robert C. Gallo, MD
August 25, 2007
Director and Professor
Institute of Human Virology
University of Maryland
School of Medicine
725 W. Lombard Street
Suite S307

In order to clarify my previous letter, my statements were conveyed
on this public science forum to acknowledge that you had sent me various documents, and a new book you have drawn my attention to, "Dissecting a Discovery," by Nikolas Kontaratos. According to these documents and the book, and my own belief that what you have told me personally makes sense for various reasons, there is little doubt in my mind that, contrary to what the many damaging reports and investigations have portrayed in the media, in books, in various journals, and in other publicly-available records, there could have been no misconduct in the Gallo-Montagnier collaboration.

Regarding your collaborative relationship(s) with the Montagnier lab,
and specifically, the complex specific details about techniques and the molecular signatures both groups associated with 48 AIDS patients and an ARC patient, the following specific statements are questionable in their account of the facts, since they have been contradicted now by these other sources I have listed and which you sent to me. I strongly believe, and I hope that my willingness to make these corrections demonstrates, that an accurate history of this period amidst the confusion of financial, social, and political issues of that time is absolutely critical in order better
assess scientific issues. These inaccuracies include:

1) "The Dingell Commission and others concluded Gallo committed
fraud."

Mr. Dingell himself disavowed the report against Gallo. Also the
HSS's Office of Research Integrity ruling concluded there was no
misconduct.

2) That "Gallo hijacked the virus from Montagnier." This would be
impossible because you shepherded Barre-Sinoussi's 1983 paper.

3) That "Gallo suppressed Montagnier's work". The opposite was true
and Luc Montagnier would confirm this if anyone asked him. This would
also be unlikely since the 1983 paper was shepherded through.

4) That "Gallo's discoveries of HTLV-1 and 2 were frauds undertaken
to get funding for a cash strapped virus cancer program at NIH". The truth is that Gallo did not work in the virus cancer program, and the program was never strapped for funds.

5) That "Gallo's work was not peer reviewed before being published".

The truth is that the work was reviewed, but did not appear before HSS
Secretary Heckler's press conference, but did appear a month later.

As I stated before, I will endeavor to correct these perceptions and
statements not only because I regret passing along this information,
but because it is the right thing to do in order to get to the truth
regarding the molecular signature of the isolates.

Sincerely,

Andrew Maniotis, Ph.D.
Program Director in the Cell and Developmental Biology of Cancer
Departments of Pathology, and Bioengineering,
University of Illinois at Chicago, Chicago, IL 60607

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SICKO, America’s healthcare system found ‘critically ill’
by Russell Jaffe MD PhD, July 4, 2007
__________________________________________

As we celebrate our 231st anniversary of freedom in America, let us remind ourselves that this means freedom from "taxation without representation", and freedom from odious oppression of opaque external authority.

SICKO, the Michael Moore documentary on America’s healthcare system, calls attention to the health insurance industry, which represents an opaque taxing authority which succeeds in collecting our dollars as monthly premiums, yet fails in the delivery of caring, competent, and compassionate healthcare to all of our citizens.

Transparency Is Our Ally

Opacity interferes with making wise, informed choices about our health. Further, if we applied what we already know about promoting health as a proactive priority, substantial saving of lives and resources can be quantified. Similar conclusions have been reached by a variety of experts. Indeed, almost every major study of America’s healthcare system has concluded that we could hardly do worse in terms of how much well-being is yielded for the resources currently expended.

America’s health report card: 2006-2026

America ranks 15th to 37th out of 153 nations studied in all measures of health. We spend two to three times more per citizen than other developed countries. This year, over $2 trillion dollars, one in six dollars of our whole economy, are allocated to healthcare, over 90 cents of each dollar on disease treatment. The remaining nine cents of each healthcare dollar are devoted to research and development of tomorrow’s remedies.

Mechanistic Viewpoint is NOT Prevention

Our national remain priorities remain focused on a mechanistic rather than functional or integrative assumptions about the human body. These research priorities were established a generation ago. We are again in need of a fundamental evaluation of the relation between our health care needs, regulatory priorities, and resources allocated. The convergence between these three could be better.

We preach prevention and yet we devote only one percent, about a penny of each healthcare dollar, to actual prevention programs.

Prevention Saves Dollars and Reduces Cost of Health Care

Many proven preventive programs save $3-4 by the fourth year for each $1 spent in the first year. This is a healthy return on investment (ROI). America has increased our share of national wealth devoted to sick care from 4.6% in 1960 to almost 17% in 2008 and 20% in 2020 (projected) if current trends continue. For example, in Japan, healthcare costs per worker contribute about $100 to the cost of the vehicle. Healthcare is a right of all citizens in Japan. In the US, typical cost per vehicle for healthcare is over $1500. Healthcare remains a privilege in America.

Medical Information Doubles every Four Years

While information doubles in medicine in less than four years, our healthcare institutions evolve and change with decade or longer time frames. This means the gap between knowledge and practice widens daily. Information technologies exist to help bridge this widening gap. It is time to make such information technologies national priorities for our healthcare system.

Herioc Medical Interventions in Last Six Months of Life

We expend half of a typical Medicare beneficiaries lifetime healthcare resources during the last six months of the individual’s life, often at great cost to quality of that life. When physical, mental, emotional, and spiritual aspects are included many people prefer to end their life in comfort, at home, with loved ones around them even if this means sacrifice of a short time that could be added by heroic medical interventions. We deserve to be birthed with reverence and die with dignity.

Healthcare Technology Enabling or Disabling?

We are awash in technology throughout healthcare that can enable better care. Examples include electronic medical records, electronic prescribing, informed dispensing of medications including simple instructions.

Technology may be harmful when it intrudes upon the therapeutic relationship between healthcare professionals and people in need. Technology can enable or disable the human healing responses.

Adverse Effects of Drugs and Procedures

Adverse effects of properly administered conventional medical therapies cost 100,000 – 250,000 lives and $200-$400 Bn annually. Don Berwick and colleagues champion a ‘Save 100,000 lives’ campaign which can save lives and resources. However, these programs to reduce medical errors have low priority. The issue is not enough of a "hot button" for political constituencies to take action.

Diabetes and Obesity

Diabetes and obesity are increasing rapidly, currently estimated to be 6% of the population, and projected to reach 10% in a few years. How do we reverse this trend? By being more active physically and mentally, and by eating more nutritious whole foods, by eating in harmony with our nature, we can reverse this alarming trend towards increasing diabetes and obesity in our population.

Incentives for Bad Health or Incentives Good Health ?

The problem is, we give our people incentives for bad habits of ill health. From foods, to attitudes, to activity, our priorities have been appearance and convenience, rather than healthfulness. We know quite well how to give people incentives for the habits of good health. When we offer these incentives, enough people will choose good health to serve as examples to others. We can do better with health incentives and preventive medicine. The only question is when?

Russell Jaffe, MD PhD

Biography

Dr. Jaffe received his MD degree from the Boston University School of Medicine in 1972. He completed his residency training in Clinical Pathology at the National Institutes of Health, where he was on the permanent staff as a practicing molecular biologist and molecular pathologist. In addition, he has studied extensively in the area of nutrition. He was asked by Norm Shealey to be the founding chairman of the Scientific Committee of the American Holistic Medical Association. He was the first Course Director of "Oriental Medical Strategies in Western Medical Practice." This was the first program recognized by N Y State for licensure certification based on being a diplomate of this training program. Most graduates of this program are now instructors in Oriental Medicine and Acupuncture training programs throughout the world. In 1984, Dr. Jaffe developed the lymphocyte response assays (LRA) by ELISA/ACT tests. These tests enable physicians to examine the responses of patients' immune systems to challenges. Delayed allergy for up to 436 common substances can be ruled in or ruled out in terms of delayed hypersensitivity by functional LRA by ELISA/ACT or MELISA tests.

Russell Jaffe MD PHD
Nutrition for Optimal Health Association
P.O. Box 380 Winnetka, IL 60093
http://www.nutrition4health.org/
Phone: 847-60HEALTH
(847-604-3258)