Drawing the Line between Health and Disease: Who and How to Define Disease?

New way to define disease is needed to reduce overdiagnosis

Abstract

A new process is needed for defining diseases that takes account of the potential risks of overdiagnosis and overtreatment as well as the benefits of appropriate diagnosis and care, researchers, policymakers, and consumer groups agreed at an international congress this week.

“The problem at the moment is that we don’t have an internationally agreed process,”

said Paul Glasziou, professor of evidence based practice at Bond University, Robina, Queensland.

“Disease definitions are developed on a very ad hoc basis, often by guideline panels making recommendations about tests and treatments who, along the way, incidentally change the definition of a disease,”

he told the Preventing Overdiagnosis conference, co-sponsored by The BMJ and held on 20-22 September in Barcelona.

“We have a clear, internationally agreed process on what evidence is needed to recommend a particular treatment. But there has been a neglect of the fundamental issue that comes before that, which is the definition of disease.”

… continue reading on The BMJ 2016;354:i5082, 21 September 2016. Image Sergio Terrasa at #PODC2016.

Le Distilbène en 2016 (2/4)

Conséquences pour les mères, les filles et les fils DES

Vidéo publiée le 1er septembre 2016 par l’ Association Réseau DES FRANCE DISTILBENE.

En 2016, quelles sont les conséquences du DES pour les mères, filles et fils exposés?

Guide Pratique

Suite à l’étude Distilbène 3 générations qu’elle a initiée en 2013, l’association Réseau D.E.S. France a publié, fin 2015, un guide pratique pour les professionnels de la santé, synthétisant les données actuelles de la science. Deux versions sont à télécharger:

Le Distilbène DES, en savoir plus

Outdoor air pollution and human infertility

Outdoor air pollution and reproduction, 2016

Abstract

Air pollution is a current research priority because of its adverse effects on human health, including on fertility.

However, the mechanisms through which air pollution impairs fertility remain unclear.

In this article, we perform a systematic review to evaluate currently available evidence on the impact of air pollution on fertility in humans.

Several studies have assessed the impact of air pollutants on the general population, and have found reduced fertility rates and increased risk of miscarriage.

Outdoor air pollution and human infertility: a systematic review, Fertility and Sterility, Volume 106, Issue 4, Pages 897–904, September 15, 2016.

Image: Environmental Research Group, King’s College London, London Air Quality Network.

In subfertile patients, women exposed to higher concentrations of air pollutants while undergoing IVF showed lower live birth rates and higher rates of miscarriage.

After exposure to similar levels of air pollutants, comparable results have been found regardless of the mode of conception (IVF versus spontaneous conception), suggesting that infertile women are not more susceptible to the effects of pollutants than the general population.

In addition, previous studies have not observed impaired embryo quality after exposure to air pollution, although evidence for this question is sparse.

Victoire de Julien Le Cossec, Petit-Fils Distilbène

Procès DES 3ème génération : UCB Pharma et Zurich Insurance condamnés

Aujourd’hui, c’est la victoire de Julien, victime 3eme génération du Distilbène.
C’est la reconnaissance de la justice sur la responsabilité du laboratoire UCB Pharma d’avoir commercialisé sciemment le Distilbène pour son profit et l’assurance La Zurich de les avoir couvert.

Pour la justice française, UCB Pharma a commis une imprudence par défaut de vigilance, pour avoir maintenu, sans précaution ni mise en garde un produit dont la réelle efficacité et l’innocuité se trouvaient bien antérieurement mises en doute.

C’est aussi la victoire de Ma famille, je pense bien sûr à ma mère, à mon fils cadet Arthur et à mon époux Loïc, à toutes celles et ceux qui nous ont accompagnés dans ce long périple de David contre Goliath: nos amis, notre avocate, tous nos médecins qui nous ont entourés…
Et c’est enfin aussi la victoire de toutes les victimes DES 2ème et 3eme génération.

Depuis le début, UCB Pharma avait décidé de boycotter l’expertise du Dr Bataille afin de la faire invalider. Le tribunal a, au contraire, repris à son compte ces conclusions. Les juges ont en effet retenu dans leur jugement qu’il existait des présomptions graves, précises et concordantes permettant… d’établir un lien de causalité certain entre l’exposition au DES de Sylvie Le Cossec et l’état neurologique présenté par Julien.

Cette reconnaissance de la justice sur La responsabilité du laboratoire UCB Pharma va nous permettre d’avancer vers une forme d’apaisement pour franchir les prochaines étapes, construire le projet de vie de Julien mais ce qui est sûr, c’est que cette souffrance que j’ai en moi provoqué par le Distilbène restera à vie et cela n’enlèvera en rien le handicap de Julien. Et c’est ce que le laboratoire UCB Pharma et son assureur La Zurich doivent maintenant assumer.

Enfin, je voudrais remercier les médias et vous tous qui nous avez suivi sur cette page FB depuis le début de ce combat pour relayer l’information de l’affaire Distilbène et pour votre soutien humain.

Mille Merci X
Je vous embrasse.

Sylvie Le Cossec
Sources: DES, mon fils n aura jamais son bac, 2 hours ago, 29.09.2016.

Le Distilbène DES, en savoir plus

Could your deodorant cause breast cancer?

Aluminium salts could be environmental breast carcinogens

Abstract

Aluminium salts, present in many industrial products of frequent use like antiperspirants, anti-acid drugs, food additives and vaccines, have been incriminated in contributing to the rise in breast cancer incidence in Western societies. However, current experimental evidence supporting this hypothesis is limited. For example, no experimental evidence that aluminium promotes tumorigenesis in cultured mammary epithelial cells exists.

Aluminium chloride promotes tumorigenesis and metastasis in normal murine mammary gland epithelial cells, wiley, 7 September 2016.

We report here that long-term exposure to concentrations of aluminium—in the form of aluminium chloride (AlCl3)—in the range of those measured in the human breast, transform normal murine mammary gland (NMuMG) epithelial cells in vitro as revealed by the soft agar assay. Subcutaneous injections into three different mouse strains with decreasing immunodeficiency, namely, NOD SCID gamma (NSG), NOD SCID or nude mice, revealed that untreated NMuMG cells form tumors and metastasize, to a limited extent, in the highly immunodeficient and natural killer (NK) cell deficient NSG strain, but not in the less permissive and NK cell competent NOD SCID or nude strains. In contrast, NMuMG cells transformed in vitro by AlCl3 form large tumors and metastasize in all three mouse models. These effects correlate with a mutagenic activity of AlCl3.

We should avoid all deodorants containing aluminium salts.

Our findings demonstrate for the first time that concentrations of aluminium in the range of those measured in the human breast fully transform cultured mammary epithelial cells, thus enabling them to form tumors and metastasize in well-established mouse cancer models. Our observations provide experimental evidence that aluminium salts could be environmental breast carcinogens.

Le Distilbène en 2016 (1/4)

Téléchargez le guide pratique pour le suivi médical

Vidéo publiée le 1er septembre 2016 par l’ Association Réseau DES FRANCE DISTILBENE.

En 2016, quelles connaissances scientifiques des conséquences du DES?

Guide Pratique

Suite à l’étude Distilbène 3 générations qu’elle a initiée en 2013, l’association Réseau D.E.S. France a publié, fin 2015, un guide pratique pour les professionnels de la santé, synthétisant les données actuelles de la science. Deux versions sont à télécharger:

Le Distilbène DES, en savoir plus

Outdoor air pollution and sperm quality

Outdoor air pollution and reproduction, 2016

Abstract

Exposure to air pollution has been clearly associated with a range of adverse health effects, including reproductive toxicity, but its effects on male semen quality are still unclear.

We performed a systematic review (up to June 2016) to assess the impact of air pollutants on sperm quality. We included 17 semi-ecological, panel, and cohort studies, assessing outdoor air pollutants, such as PM2.5, PM10, NOx, SO2, and O3, and their effects on DNA fragmentation, sperm count, sperm motility, and sperm morphology.

Outdoor air pollution and sperm quality, Fertility and Sterility, Volume 106, Issue 4, Pages 880–896, September 15, 2016.

London Air Pollution View from Hackney, zongo.

Thirteen studies assessed air pollution exposure measured environmentally, and six used biomarkers of air pollution exposure (two did both).

We rated the studies using the Newcastle-Ottawa Scale and assessed with the exposure method. Taking into account these factors and the number of studies finding significant results (positive or negative), the evidence supporting an effect of air pollution on DNA fragmentation is weak but suggestive, on sperm motility is limited and probably inexistent, on lower sperm count is inconclusive, and on sperm morphology is very suggestive. Because of the diversity of air pollutants and sperm parameters, and the studies’ designs, we were unable to perform a meta-analysis.

In summary, most studies concluded that outdoor air pollution affects at least one of the four semen quality parameters included in the review. However, results lack consistency, and furthermore, studies were not comparable. Studies using standardized air pollution and semen measures are required to obtain more reliable conclusions.

The Doctor Who Gave Up Drugs

Season 1, Episode 2, 22 September 2016

Two-part social experiment in which Dr Chris van Tulleken takes over part of a GP surgery and stops patients’ prescription pills.

The Doctor Who Gave Up Drugs

Season 1, Episode 1, 15 September 2016

Two-part social experiment in which Dr Chris van Tulleken takes over part of a GP surgery and stops patients’ prescription pills.

Diethylstilbestrol Tablets Compounded

DES, Veterinary Products, CareFirst Specialty Pharmacy, USA

des_diethylstilbestrol_tablets
DES is still sold under different names.

DES was sold under many names including Distilbène®, Stilbetin®, Stilboestrol-Borne®, Benzestrol®, Chlorotrianisene®, Estrobene® and Estrosyn® to name just a few.

Many different companies manufactured and marketed this drug under more than 200 different brand names.

These Diethylstilbestrol tablets are marketed by CareFirst Specialty Pharmacy, USA.

DES Drugs Pictures
More DES DiEthylStilbestrol Resources