Aaron Rothstein's review In the Wall Street Journal of the new book Rabid by Bill Wasik and Monica Murphy, provides another example of a wonderful unintended consequence example. The dreaded disease rabies has within it a peptide that through evolutionary changes has found a way to easily enter into the human brain. Researchers, according to Mr. Rothstein, are working on using that transmission facility to work as a delivery mechanism to get Alzheimer's treatments into patient's brains.
This development reminds me of the discussion in my book regarding the medication thalidomide. After proving to be a scorch on pregnant mothers using it to relieve morning sickness, the disease now turns out to have beneficial effects on certain ailments.
Expressions like "Making a silk purse out of a pigs ear," are very descriptive of the ability of scientist to make something good out of something harmful.
In late May the United States Preventive Services Task Force issued a recommendation that caught many men and their doctors by surprise. The panel recommended that prostate specific antigen blood test (PSA tests) should not be conducted. This topsy-turvy recommendation to not pursue information that a man might have prostate cancer flies in the face of most peoples approach to being healthy. Get tested for everything possible and be as proactive as possible.
The unintended consequence which drives this recommendation is the finding that for every 1000 men who might avoid death as a result of the screening 3000 other men would die from complications caused by follow-up exams and treatment for prostate cancer. The dilemma is particularly acute when one hears from men whose PSA test found a rapid growing cancer and whose lives were saved as a result. These people do exist. Their testimony is not being balanced by the three other people, for each person whose voices heard, whose lives were lost as a result of treatment.
Fortunately this outcome has arisen prior to the onset of Obama care. Otherwise, people would suspect that a death panel had made the decision. Of course, in our world of self-interest and media manipulation, many voices are working to overcome the panel's recommendation. Hard to believe that people won't listen to a task force comprised of some of the best minds in the field.
The fast-paced world that we live in makes it difficult for people to have a full breakfast in the morning. Instead people grab a cup of coffee at Starbucks or wait to have an early lunch. Sometimes we tell ourselves that this is a good strategy for holding down weight, or we say that we don't have time to shop and buy the supplies required for a breakfast meal.
Among the unintended consequences of not eating breakfast are the results of a new study published in the American Journal of Clinical Nutrition which was conducted over a 16 year time span on nearly 30,000 men. men who did not eat breakfast at a significantly higher risk of developing Type 2 diabetes. This type of diabetes is referred to as adult onset diabetes and is associated with a higher cardiovascular and stroke risk. That statement doesn't seem to motivate people to take steps to avoid the problem, such as eating breakfast. Another way of describing the problem is to say that people with Type 2 diabetes have a 10% lower life expectancy. it would be a shame if that happened to someone because they didn't get up early in the morning to have a bowel of cereal.
American diets have moved to embrace seafood but especially salmon. My book talks about the unintended consequences that come from fish farming and that is a negative consequence. The recent issue of Neurology provides us with a positive unintended consequence from this transition.
a paper by Dr. Scarmeas reports a positive association between the consumption of omega-3 ( Salmon is a spectacular provider of it) and a significantly lower level of beta amyloid blood levels. So what you ask. The presence of these plaques in the brain are associated with the onset of mental problems associated with aging and there seems to be an additional association with Alzheimer's.
Smoked salmon, salmon with sushi, salmon patties, broiled or baked salmon, all these seem to be a relatively painless way, or should I say a tasteful way, of putting up a first level defense against experiencing mental declines as one ages. Some unintended consequences are beneficial this is an especially delicious one.
Once again Matt Ridley of The Wall Street Journal has written an article, Standards of Living Make Great Wonder Drugs, that is among the best pieces of journalism this past year. This time he reports on how the decline in death rates from illnesses such as TB do not seem to correlate well with the introduction of streptomycin, the antibiotic which Is the official "cure." Instead he notes that the improvement in housing which occurred commensurate with the improvement in economic conditions can be given much of the credit.
The unintended consequence of people no longer sharing beds with strangers, as was the case in earlier decades, has been a disruption of the linkage between the illness and new victims. Economic progress has fostered the creation of motels and hotels.
Exercise, and by that I mean walking, running, swimming, etc., is fun and a wonderful social activity. There is little that we do that has as many unintended consequences as does exercise. The newest unintended consequences is discussed in the April 24th issue of Neurology which discusses the statistically significant reduction in the risk of Alzheimer's disease among people who are physically active.
That research found benefits from day to day activities not normally classified as exercise. A big craze in offices today is a standing desk. Advocates of standing desks argued that It forces the body to remain toned throughout the day rather than allowing a person to slouch in their seat. There are other surreptitious ways to sneak in a little exercise every day. Among these are turning off the TV, walking between stores in the mall rather than driving, and walking upstairs rather than taking the elevator.
The unintended consequence of being young is a feeling of immortality. That sense of oneself fades slowly which is my only explanation for why people, knowing the evidence as clearly as we do know it today, smoke cigarettes, fail to engage in adequate exercise, and consume excessive quantities of food and alcohol.
Hearing the expressions "laughter is the best medicine" and "walk on the sunny side of the street" for years, We can now rest easy because research has now demonstrated the truth behind these upbeat propositions. A short article by Anahad O'Connor in The New York Times' Science section details the results of an 8,000 person study which revealed the unintended consequence of a person being more pleased with their life: a lower heart attack risk. Perhaps this is not too surprising. After all, we also have expressions like: "he died of a broken heart." This finding together with what we know about cholesterol and diet can contribute to a reduction in deaths from heart attacks.
This study builds on the work of Dr. Lester Breslow who died April 14 of this year. Dr. Breslow performed the studies which proved that a healthy lifestyle, eating,drinking, and sleeping in the right proportion, contributes to a person's longevity. Put together this unintended consequence suggests that walking around with a smile on one's face after a good nights sleep and having a moderate amount to eat and drink is the way for people to live a longer lifespan.
If you are like me and count yourself among the millions of people who must be careful about sunlight and its relationship to skin cancer, you know that dermatologist strongly recommend the use of sunscreen. Cosmetic companies have moved into this market segment and are competing amongst themselves offering higher levels of SPF protection designed to reduce ultraviolet radiation. Additives providing SPF protection are now found in moisturizers and sunscreens. Since most skin cancers take a long time to develop, empirical evidence to support this trend may be a long time in coming, but this probably falls into the category of better to be safe than sorry.
An article in The New York Times by C Claiborne Ray, “A Face in the Sun,” discusses the unintended consequence of daily application of sunscreens. He notes in response to a reader's question that sunscreens by putting a barrier between a person's skin and the sun reduces the individual’s production of vitamin D. Vitamin D is an important substance which for most people is synthesized from sunlight by their bodies. It is useful to avoid bone softening, osteomalacia, and is thought to be associated with lower mortality rates amongst women.
This unintended consequence may be overcome by consuming a diet rich in vitamin D, such as milk, yogurt, fatty fish such as salmon, or whole eggs. Like other unintended consequences, sunscreen provides benefits but also produces problems; fortunately this problem is one which can be defeated.
A recent joint study Involving dentist and cardiologist has reversed a long held belief that there was a relationship between gum disease and the incidence of heart attacks and possibly strokes. The new work evaluated hundreds of previous studies and combine their data sets to reach the new conclusion.
The unintended consequence of the mistaken identification of gum disease as a heart attack risk factor was that thousands of people took better care of their teeth by improving their dental hygiene. They experienced a positive benefit in having healthier keys and those who interact with them experience the positive benefit of a reduction in halitosis. It's nice to know that all unintended consequences are not negative.
We've all been sitting in the dentist's chair when they bring out a heavy lead apron and tell us it's time for us to get our teeth x-rayed. The science behind investigative dental x-rays is to stop decay before it causes irreparable harm to the tooth (please forgive the simplistic interpretation). Many dentists urge patience to get their teeth x-rayed every year. Americans probably have had her teeth today than at any time in history.
The unintended consequence of achieving these white shiny smiles is a higher incidence of meningiomas a noncancerous brain tumor. In a study conducted by Yale University and Brigham and Women's Hospital in Boston, dental patients had significantly higher risk if they agreed to bitewing x-rays than did patients who refused such prophylactic care. In fact, compared to patients who had never had these x-rays there appear to have been a doubling in risk.
The apparent incentives in this situation work against the patient. A dentist who disregards potential risk from x-rays for his patients has higher income than does a similar dentist who is careful to administer only the minimum necessary number and amount of x-rays. That suggests that to limit the impact of this unintended consequence that individuals need to proactively monitor and control what happens to them at the dentist office.
Readers interested in learning more can read the article published today, 4/10/12 in the journal Cancer.