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News of black grass developing resistance to glyphosate herbicide takes nine months to percolate

4 Jan

In December, one day before Christmas Eve, Helena Horton reported evidence from a study showing that black grass – a native annual weed – is developing resistance to glyphosate in the field. Glyphosate is currently approved for use as a herbicide in the EU until 2022 but is banned or restricted in many countries listed here.

Nine months earlier the paper had been published in the New Phytologist, Evolutionary epidemiology predicts the emergence of glyphosate resistance in a major agricultural weed (March 19th) followed on June 20th by an interesting commentary on the study which said:

“Although resistance to herbicides initially did not appear to evolve as rapidly as did cases of insecticide resistance (Gressel & Segel, 1978), over 240 weeds are now resistant to a variety of herbicides following c.70 years of herbicide use (Heap, 2019).

“Currently, there are c.41 weed species that have evolved resistance to glyphosate (Heap, 2019). Strikingly, what we have learned about glyphosate resistance evolution from these species all stems from studying the weeds after they become problematic to the farmer. This means that we are most often considering glyphosate resistance evolution in a reactive, rather than proactive fashion”.

Farming UK reported on the research paper in June, quoting the lead author, Dr David Comont, a weed ecologist from Rothamsted Research, who said the work provides an early-warning to the UK farming industry that over-reliance on glyphosate is likely to lead to resistance:

“We found evidence that a number of blackgrass populations are responding to glyphosate use, by evolving reduced sensitivity to this herbicide in the field. Crucially, our results show this happening before high levels of resistance have evolved, whilst there is still time to delay or prevent this resistance”

The Telegraph reported on the research published in New Phytologist, on an article in ZSL Science (Zoological Society of London) and referred to a study in the journal Nature.

It repeated ZSL’s warnings that the UK’s food security is being put at risk by herbicide-resistant black-grass and its call for a ban on overuse of weed killer: “Black grass out-competes wheat for soil nutrients and reduces the number of wheat plants where it grows – and it is likely to spread further across the UK. This would increase the prices of bread and biscuits, and there would be less animal feed available so could also affect how much meat costs”.

Worldwide, there are 253 herbicide-resistant weeds, so the global impact of further resistance could be enormous. Nature’s study recommends urgent national-scale planning to combat resistance and the provision of incentives for increasing yields through food-production systems rather than herbicides. Dr Varah, the lead author, added that farmers need to implement more truly integrated pest management strategies – including diverse crop rotations and strict field hygiene measures.

 

 

 

 

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How many people have heard of an NHS ‘yellow card’ on which suspected side-effects should be reported?

23 Oct

Dr Mark Porter is a part-time partner in a busy rural NHS GP practice in the Cotswolds. He spends the rest of his time writing about medical matters in his weekly column and delivering his Radio 4 series Inside Health. He was awarded an MBE for services to medicine in 2005

In the Times recently, he asked, ‘How safe are your medicines?’ and informs all that In the UK a form anyone can use to report suspected side-effects is called ‘the yellow card’.

Last year there was a fall in the number of cards received and Dr Porter asked if drugs really are causing fewer problems or if ‘we have taken our eye off the ball’.

In 2018 the monitoring authority – the Medicines and Healthcare Products Regulatory Agency (MHRA) – received 42,500 yellow cards, down from 44,000 the previous year.

Most patients have never heard of yellow cards, or assume that their doctor will report problems for them but healthcare professionals are stretched and may not link the side-effect to a drug.

New drugs are more risky because they may have been tested on only a few thousand people before gaining a licence, and even then often only for short periods.

It was the MHRA, with the help of yellow cards, that warned people taking the cholesterol-lowering drug simvastatin on which this site reported in 2012. It also warned against taking the anticoagulant warfarin with grapefruit juice because it interfered with the way the drugs were metabolised, increasing the risk of side-effects such as muscle aches and bleeding.

Dr Porter emphasises the importance of reporting side-effects experienced whilst taking a new drug (identified by a black triangle on the patient leaflet), even if you think it may be a coincidence because it’s often a pattern of such “coincidences” that produces a signal.

An online yellow card can be filled in at yellowcard.mhra.gov.uk to report problems or incidents with medicines, vaccines, herbal or homeopathic remedies, medical devices (from pacemakers to blood glucose monitors).

A printable Yellow Card form for members of the public is available at Member Of Public Yellow Card Reporting Form (December 2018) (379kb .pdf); for healthcare professionals a printable Yellow Card form may be downloaded from Healthcare Professional Yellow Card Reporting Form (February 2017) (110kb .pdf).

Patients who do not use computers will have to ask friends, family or a carer to do this for them.

 

 

 

 

 

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MMR: why not allow the single vaccine option, in use elsewhere and widely accepted in ‘60s & ‘70s Britain?

30 Apr

 

As Dr Michael Jarmulowicz (FRCPath, MBBS) wrote in the BMJ:

“What I find puzzling is the adamant refusal of the authorities to facilitate the availability of the single measles vaccine, to the point that the Department of Health has banned its use within the NHS. How does this fit with the growing acceptance of patient autonomy and patient
choice? . . .

“Other countries with equivalent medical and ethical standards make them freely available.”

Other countries with equivalent medical and ethical standards do indeed make single vaccines freely available – indeed, Japan, a country with an excellent child health record, completely stopped using the MMR vaccine in 1993 after 1.8 million children had been given two types of MMR and a record number developed non-viral meningitis and other adverse reactions

The Merck measles, mumps and rubella (MMR) vaccine is a mixture of live weakened viruses of the three diseases. The first dose is generally given to children around 9 to 15 months of age and a second dose at 15 months to 6 years of age, with at least 4 weeks between the doses, according to PubMed (US government document – though the country’s National Center for Biotechnology Information (Centers for Disease Control and Prevention) states that the vaccine is only licensed for use in children who are 12 months old.

The scientific argument for immunising infants against measles is to establish a good herd immunity, protecting unvaccinated babies, children and adults who could not be given the vaccination.

Doctors and parents are urged to acquire and carefully read the information leaflets relating to whatever vaccine they are considering and an online search of medical journals finds material which would make a thoughtful parent pause before agreeing to have their baby injected with the MMR vaccine.

The World Health Organisation (a UN affiliated body) reports that Live Attenuated Vaccines (LAVs) raise some general safety and stability concerns and lists six. A snapshot of the measles section follows:

Mass measles immunization campaigns – reporting and investigating adverse events following Immunization – notes that seizure risk is age-dependent, and lower for children over six years, who are unlikely to have febrile seizures. Allergies (especially to gelatine) and general illhealth is a contraindication to vaccination with MMR vaccine.

The most common programme error is an infection as a result of non-sterile injection. The infection can manifest as a local reaction (e.g., suppuration, abscess), systemic effect (e.g., sepsis or toxic shock syndrome), or blood-borne virus infection (e.g., HIV, hepatitis B).

Establishing a profitable monopoly

In the U.S. more than a million dollars has been paid in compensation over the last ten years to parents alleging their children were harmed by the MMR jab, Merck and Co USA. Despite this, the manufacturers of Mumpsvax (Jeryl Lynn strain) announced in January 2010 that it would no longer provide mumps vaccines as single doses. The single dose rubella vaccine has also been halted. Single measles vaccines and a combined measles/rubella vaccine are still available.

Prolonged legal action in its tenth year against Merck, the manufacturers of the MMR vaccine.

The Wall St Journal and many other news outlets have reported that Stephen A. Krahling and Joan A. Wlochowski, former Merck virologists, filed a lawsuit in 2010, accusing the drug maker of falsifying data about its mumps vaccine. The case has not yet been settled nine years later and the virologists complain that the company is not making some documents available to the court.

Single vaccines are used privately in Britain

Although separate vaccines for measles, mumps and rubella are now unlicensed in Britain, it is not illegal for doctors and clinics to import the vaccines as long as they inform the Medicines Control Agency (MCA) that they are bringing the vaccine into the country.

Dr Richard Halvorsen, a GP with over 20 years’ experience and the author of OK Vaccines: Making the Right Choice for Your Child (2017), has written widely on the subject. He runs an immunisation service in Britain that offers parents a choice of buying single and small combination vaccines which includes the single measles and measles/rubella vaccines.

Should not all parents have the right to request the single vaccines for measles, mumps and rubella under the NHS system?

 

 

 

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Report research results separately to ensure new medicines are safe and effective for both sexes

19 Mar

“Women are not small men,” said Jeanine Roeters van Lennep. of the Erasmus Medical Centre in Rotterdam (right):

“There are biological differences in hormones and body composition. Women have smaller kidneys so it’s more difficult to clear medication. They have a different fat and water composition.”

A study published in February showed that trials were more likely to report results for women separately if they had a female lead author, with only one in three papers reporting results separately. The Lancet, which published that research, is one of the few major journals that tell researchers to analyse separately.

Research on drugs withdrawn from the market published by the United States General Accounting Office found that eight out of ten drugs withdrawn from the market between 1997 and 2001, after approval in the US, turned out to have higher health risks for women.

One example was Posicor, which was approved for the treatment of hypertension and angina and slowed or stopped the heart rate in otherwise healthy people, especially elderly women, and interacted with 26 different drugs.

Cholesterol-lowering statins are Britain’s most commonly prescribed medicine but in 45 trials Dr van Lennep analysed, 82% of those studied were men and only five trials made data available on men and women separately. This meant that there was not enough data to show statins prevented heart attacks, strokes and deaths in women with an acceptable number of side-effects, unlike for men.

She said it was probable that statins did work for women, with previous studies suggesting a similar benefit for both sexes, and is not advising women prescribed them to stop. However, she argues, doctors cannot be certain because of sexism which is largely unconscious:

“It’s shocking. Men forget to do sex-specific analysis, to be really polite about it. If 50% of the population is female you can’t just say it’s an optional extra. It’s a blind spot because right now the triallists are generally men. I don’t think it’s malice that they don’t want to perform this analysis; they just really don’t think about it . . . We think journals should make it compulsory to report results for men and women separately.”

A Times article summarises the problem: doctors argue that an absence of women in clinical trials and failure to report results by sex have resulted in an evidence gap that is likely to be hampering treatment. They insist that medical journals should force researchers to report results for men and women separately to be sure that new medicines are safe and effective for both sexes.

 

 

 

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Medic’s warning: prescribed medication caused a 50% increase in emergency admissions & nearly 100,000 hospitalisations a year in England

10 Feb

 

An article by Dr Mark Porter (December 2018) opens, “The first thing I do when faced with a poorly patient is to look at their medication to see if it could be responsible. You would be surprised how often it is”. Polypharmacy is rife: 1 in 18 of the population is taking ten medicines or more and potent pharmaceuticals carry risks as well as benefits. Millions of people are taking medication such as blood pressure pills and statins to prevent problems they may never have.

The really important message that reducing your risk of heart disease is best done by an improved diet and lifestyle is getting ‘crowded out’

Repeated campaigns have advocated mass medication – for example the February 2014 drive by the National Institute for Health and Care Excellence (the ‘health watchdog’) saying that the vast majority of men aged over 50 and most women over the age of 60 should take the drugs to guard against strokes and heart disease – though studies have suggested that up to one in five patients taking statins suffers some kind of ill-effect, including muscle aches, memory disturbance, cataracts and diabetes.

The Times reported on February 1st that a study published in the Lancet says all men over 60 and women over 75 are at high enough risk of cardiovascular problems to be eligible for the drugs. Professor Colin Baigent from Oxford University, a ‘co-investigator’, says “The risk of heart attacks and strokes increases markedly with age, and yet statins are not utilised as widely in older people as they should be”.

Dr Porter writes: “it is not illegal drug use in older people that concerns me most. I am embarrassed to report that prescribed medication exacts a far bigger toll on the nation’s health. Since 2008 there has been a 50% increase in the number of emergency admissions to hospitals for adverse drug events caused by medicines. In England alone such reactions are responsible for nearly 100,000 hospitalisations a year”.

He explains that anti-inflammatories such as ibuprofen and naproxen can work wonders for aches and pains from arthritic joints, but they have worrying side-effects and don’t mix well with many drugs commonly prescribed to treat high blood pressure (BP). They can damage the lining of the stomach, causing life-threatening bleeds (responsible for thousands of admissions every year) and can lead to kidney failure (on their own and when taken with BP drugs).

More subtle reactions impairing the quality of life are far more common and much easier to miss. Dr Porter gives a few examples from an ‘endless list’:

  • Blood pressure and heart pills that cause coughs (e.g. ramipril) and erectile dysfunction.
  • The prostate drug tamsulosin that can make you light-headed and increase the risk of falling.
  • Statins that cause aches and pains and reduce mobility.
  • Sleeping tablets that lead to addiction.
  • Cramp pills (quinine) that can cause heart problems.

He gave a striking case history:

“An elderly man with “early dementia” and diabetes was admitted to a residential home on our patch, where the staff reported that their new resident just sat in the corner all day looking vacant. His drug chart revealed he was taking an old-fashioned treatment for diabetes (gliclazide) that was pushing his blood sugars too low. It was stopped and two weeks later he was a new man and back in his own home. It is a lesson I have never forgotten”.

In October, an analysis in the British Medical Journal cautioned against any expansion in prescribing. One of its authors, Dr John D Abramson, clinical lecturer in primary care, from Harvard Medical School, last night said: “I think we have become victims of the drug companies. All the research is funded by them, and the really important message – that reducing your risk of heart disease is best done by an improved diet and lifestyle – is getting crowded out.”

 

 

 

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Over 159 American cities oppose section 9101 of the Federal Farm Bill blocking local pesticide controls

15 Dec

More than 150 U.S. cities and counties have created “organic-first” policies and in some cases banned the use of specific chemicals that may harm people or the environment.

PR Newswire refers to a letter sent by local officials to Congresswoman Nancy Pelosi    noting that research has increasingly connected some pesticides with Parkinson’s disease and honey bee die-offs, A rapidly growing body of evidence links pesticides to a wide range of diseases and conditions including Parkinson’s disease, diabetes, leukemia, lymphoma, lupus, rheumatoid arthritis, dementia, reproductive dysfunction, Alzheimer’s disease, and variety of cancers including breast, colon, prostate and lung cancer.

Recognizing these risks, many communities have passed progressive policies to restrict the use of pesticides and protect our residents before any harm comes to them.

Some local officials in Irvine have opted to go further than federal or state laws and have restricted pesticide use on public land such as parks, sports fields and landscaped central road reservations. The city now uses organic products with ingredients such as corn gluten meal and oil from soybeans, lemongrass or rosemary.

Detailed information and photograph (above) may be seen in https://ocweekly.com/how-irvine-became-socals-first-non-toxic-city-7317638/

However, though the bill has attracted attention by legalizing hemp, bolstering farmers markets and rejecting stricter limits on food stamps pushed by House Republicans, California’s Orange County Register reports that a four-page provision (Section 9101) tucked away in the 748 page 2018 federal farm bill could block local governments in the United States from making their own rules about pesticides, ‘effectively neutering’ local control over pesticides, blocking cities, counties and school districts from restricting the use of on playgrounds and parks.

Felicity Arbuthnot draws attention to a report by the Environmental Working Group, commenting: “It truly says it all when government attempts to force people to eat cancer causing poison and feed it to their families and friends”. The EWG report records that:

  • the National League of Cities and
  • the League of California Cities, sent letters of opposition to congressional leaders.
  • The National Association of Counties – representing all 3,069 U.S. counties – and
  • a diverse coalition of over 170 organizations dedicated to public health urged Congress to reject the rider.
  • The National Audubon Society and
  • the American Academy of Pediatrics also sent letters.
  • A lettersigned by over 60 local officials in 39 communities from 15 different states, urged the conference committee to reach an agreement on a final 2018 farm bill that does not include this rider.

Despite all these representations, on 12th December, the U.S. House of Representatives passed the 2018 Farm Bill by a vote of 369 to 47. The next step to permanent legalization is the President’s signature.

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Will any British city follow Irvine’s lead? 

In 2017 Horticulture Week reported Edinburgh City Council’s decision to pursue an herbicide-reduction policy at the end of 2016 followed a year-long trial of alternatives to chemicals run by the council’s parks department. An online search revealed that similar moves have been proposed and discussed by councils in Dundee, Bristol and Belfast.

Today, the Times reported that Dublin city council is to use alternatives as part of a move towards a “herbicide and pesticide-free city” in the spring.  In 2015 Kaethe Burt-O’Dea (above) started a campaign to stop Dublin City Council from using a weedkiller. She is seen above near the community garden started up more than 10 years ago as a place for the street’s residents to compost their organic waste.

 

 

 

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Biomedical research: the gender dimension

1 Aug

Dr Elizabeth Pollitzer, Director of Portia, recently wrote to the Financial Times.

Portia was established by a group of female scientists working at Imperial College, to respond to government concerns about under-representation of women in Science, Engineering and Technology.

Portia’s mission is to help women and men have the same opportunities for engagement and advancement in science, across all science disciplines, and to further the understanding and appreciation of the gender dimension in science knowledge making.

Dr Pollitzer responded to Anjana Ahuja’s article: “Britain must stop inflating the biomedical bubble” (July 17, probable paywall) which highlighted the issue of the failure of biomedical industry to translate the huge investment in research into improvements in the quality of medicine.

She pointed out that in 2014, following problems in replicating early pre-clinical studies and differences in efficacy and adverse effects of drugs in women and men, the US National Institutes of Health called for gender to be taken into account in study design and data analysis.

Between 1997 and 2000, ten prescription drugs were withdrawn from the market in the US; eight were judged to be more dangerous for women than for men.

Dr Pollitzer continued:

“Gene expression, immune response and how drugs are metabolised have been shown to differ between women and men. Taking into account these basic biological differences would improve the rigour, transparency and generalisability of pre-clinical research findings.

“Biomedical research has historically relied on experiments that used significantly more males than females as subjects (cells, tissues, animals, people) creating bias in fundamental knowledge of disease processes”.

She ends by saying that this research bias has an impact on how disease outcomes and responses to treatment are determined, resulting potentially in poorer quality of results for women.

Elizabeth Pollitzer has 20 years’ experience teaching and researching in the Department of Computing at Imperial College, University of London. Her original training was in Biophysics. She now applies this scientific background to promoting effective strategies for gender equality in Science, Engineering and Technology.

 

 

 

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