Thursday, December 10, 2009

Sunday, December 06, 2009

Bacteriophage Therapy History (Part 3)


Use of phage therapy in the USA declined drastically with the advent of antibiotic therapy. But this was not the case in Eastern Europe. The Eliava Institute, founded in 1923 in Tbilisi, Georgia, by Giorgi Eliava, continues to this day to research phage therapy. In fact, there is a Phage Therapy Center to this day in the Republic of Georgia that takes patients for phage therapy treatment.

There are hundreds of published research reports on phage therapy. A large number of these are to be found in non-English journals published in the former Soviet Union and Poland. Stefan Slopek, of the Laboratory of Bacteriophages, Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, published a series of papers in the 1980's, on the effectiveness of phage therapy against infection with several different bacterial pathogens including multi-drug resistant bacteria. A review of the work was published by Slopek in 1987. Slopek reported that of 550 patients treated with phage therapy, "positive results were found in 508 cases (92.4%)". Most of these cases were infections with drug resistant bacteria.

More recently, at the same Institute in Poland, Gorski reported that "1307 patients with suppurative bacterial infections caused by multidrug-resistant bacteria of different species were treated with specific bacteriophages (BP)". And that, "BP therapy was highly effective; full recovery was noted in 1123 cases (85.9%)".

Reports concerning phage therapy of staphylococcal infections of the lung, sepsis in newborns, urinary tract infections, infections of surgical wounds, and eye infections have been published. Unfortunately, in many cases the trials were not completed in a manner to allow rigorous evaluation of the results.

Research on phage therapy does continue in the USA. In fact, rather than using the whole phage virus which can be attacked by the human immune system and in some cases by the bacteria themselves, a phage lysin can be used to attack the bacterial cell wall.

More information about phage therapy can be found at this Evergreen International Phage Biology Meeting website. An extensive list of the phage therapy literature can be found here.

Saturday, December 05, 2009

Bacteriophage - Therapy History (Part 2)


Bacteriophages are viruses that can infect and destroy bacteria. This fact was actually used, prior to the discovery and widespread use of antibiotics, to treat certain infections.

Who discovered bacteriophages is the subject of debate. Most credit Frederick Twort (1915), an English bacteriologist, and Felix d'Herelle (1917), a French-Canadian microbiologist with the independent discovery of bacteriophages.

Frederick Twort
Felix D'Herelle

But in 1896 another British bacteriologist, Ernest Hankin, observed that water from the Ganges river in India had a marked inhibitory effect against Vibrio cholerae. Furthermore, he observed that the substance was susceptible to heat and could pass through a fine porcelain filter. The first phage was not visualized until 1939 by Helmut Ruska using an electron microscope.

D'Herelle used phages to treat dysentary and was probably the first to use phages therapeutically. In one experiment, he purified a phage preparation and ingested it himself to insure its safety. The next day he gave the preparation to a 12 year old boy suffering from severe dysentary. The boy's symptoms ceased after a single dose of the phage and he fully recovered from the dysentary.

The first published report of using phage as a therapeutic treatment was in 1921 by Bruynoghe and Maisin who used phage therapy to treat staphylococcal skin disease. Felix D'Herelle eventually started a commercial laboratory in Paris to produce phage preparation marketed to treat 5 different bacterial infections. The company later became L'Oreal.

In the USA in the 1940's the Eli Lilly Company manufactured phage preparations for human use. These preparations were specific for staphylococci, streptococci, E. coli and several other bacteria. It was a subject of debate of how effective these phage preparations were in treating infections.

Unfortunately (and fortunately) the large scale production of penicillin also occurred in the 1940's and commercial production of phages ceased in most of the world.

Friday, December 04, 2009

Bacteriophage (Part 1)

What are bacteriophage? Bacteriophages (or phages) are viruses that infect bacteria rather than eukaryotic cells. The word bacteriophage comes from "bacteria" and "to eat" because many phages literally destroy the bacteria they infect.

Bacteriophage T4 is a classic example of phage virus. It infects the E. coli bacterium. Below is a diagram of a T4 phage and an actual electron micrograph of the phage.
The T4 phage looks alot like the lunar lander doesn't it? The "legs" of the T4 phage allow for attachment to the E. coli host bacterium and the phage "tail" is hollow to allow for the injection of the phage DNA into the bacterium. You can see an animation of the T4 phage infecting a bacterium here.

Viruses have two different types of life cycles called lytic and lysogenic. The lytic life cycle is the more common type of life cycle used by viruses and it results in the destruction of the bacterium or cell. The below excellent diagram, from the U. of Delaware, shows the lytic life cycle of a T4 phage.
Basically, the bacterium is infected, the phage takes over the metabolic machinery of the bacterium, reproduces itself and destroys the bacterial host cell thus releasing more virus available to infect new host cells.

The lysogenic cycle is different and is pictured below.
In this phage "life style", the phage DNA is actually incorporated into the bacterial genome. This newly integrated phage DNA is referred to as a prophage. The advantage of this life cycle is that every time the bacterium divides, the DNA of the prophage is replicated along with the bacterial genome. At some time in the future, the prophage can be induced to enter the lytic phase where new phages are reproduced and the bacterial cell is destroyed, releasing the phage virions.

So phages are good because they infect and destroy bacteria. Well not so fast. Phages are also known to increase the disease-causing capability (virulence) of some bacteria. For instance, the toxin produce by Vibrio cholerae bacterium diarrhea and rapid dehydration of the infected person, is due to infection of the bacterium with CTX phage. The toxin which causes cholera is actually encoded by the phage genome and not the bacterial genome. It is possible that phage infection of bacteria could be responsible for the evolution of more virulent bacteria. Other toxins reported to be encoded by phages include shigalike toxin in some pathogenic E. coli strains, botulinum toxin, diptheria toxin and erythrogenic toxin. This is serious business because it may be possible for phage to transfer virulence genes from disease-causing bacteria to unrelated bacteria which normally do not cause disease. You can read more about this phenomenon here.

Thursday, December 03, 2009

On Homosexuality, Civil Rights and Christian Judgement

It all started a few weeks ago with a letter to the editor of the Adirondack Daily Enterprise written by a very brave soul. The letter concerned gay marriage as a civil right. The letter generated 85 comments on the ADK website. What is surprising to me is the number of comments supporting the letter writer. I was not so surprised by the comments made by local homophobes.

A few days ago another letter to the editor was published in the ADK. This letter was written by a local bible-thumper and stated that homosexuals are sinners. As you might imagine (or maybe not) the letter has so far generated over 140 comments. The discussion rapidly devolved into whether what the bible says is worth the paper it is printed on. Interesting reading.

Sunday, November 29, 2009

Many Cancer Treatments Not Cost Effective

There is an article in today's Washington Post with some information that I expect many people do not want to hear. The bottom line is that treatment for most cancers is ineffective and very expensive.
At the moment, there is a giant disconnect between patients, the cost of care and the clinical benefit of the treatment -- a disconnect that has caused us to lose perspective. When it comes to cancer care, we're not getting what we pay for.
But we are talking about someone's life! Yeah, well maybe spending thousands of dollars a month on ineffective cancer treatments might make you feel like you are doing something rather than nothing, but all that is really happening is....well, nothing.

How did we get to where we are in cancer treatment? In spite of the billions of dollars spent on the "war on cancer" we actually have no "evidence-based medicine" on which treatments are effective. Accepting this situation means, I guess, that maybe we will have "rationing" and "death panels" in some areas of medicine where treatments are just not effective. Maybe more time and money need to be put into counseling patients about their untreatable conditions rather than tens of thousands of dollars on the hope of a miracle cure.

Speaking of "death panels" read this. There is sometimes a limit on what an emergency room can do for you.

Wednesday, November 25, 2009

Monday, November 23, 2009

Share the Sacrifice Act

With all the talk of deficits it is about time someone proposes a tax to pay for the ongoing war in Afghanistan. I'm sure all the deficit hawks will vote to support such a bill. A graduated surtax on individuals and corporations would actually pay for the war which currently costs over 60 billion dollars per year. Another billion dollars a year would be needed for every 1000 additional troops that are sent to Afghanistan.

The bill exempts those who served in Iraq or Afghanistan since the 2001 as well as families who have lost an immediate relative in the fighting. Families making between 30-150 thousand dollars per year would incur an additional 1% tax. Those that make between 150-250 thousand would pay more and those making over 250 thousand even more.

It's about time we start paying for these wars that we have been fighting for almost nine years now. Going to war and cutting taxes at the same time was not a reasonable policy. Let's see how much Americans support the war in Afghanistan when the cost actually comes out of their pockets every year. After all, we don't want to leave huge deficits for our children.

Saturday, November 21, 2009

Imprecatory Prayer


I thought I knew something about religion but imprecatory prayer is a new one on me. I blame the nuns at my catholic school for not teaching us about praying for someone to die.

I've seen the occasional parked car with a bumper sticker that reads "pray for Obama". But the tiny type in the corner of the sticker that cites Psalm 109:8 didn't really mean much to me. What does Psalm 109:8 say?
109:8 Let his days be few; [and] let another take his office
Ok, fair enough. You are praying to god that President Obama is not re-elected. But what does Psalm 109:7 say?
109:7 When he shall be judged, let him be condemned: and let his prayer become sin
Let him be condemned how though? Well, read Psalm 109:9.
109:9 Let his children be fatherless, and his wife a widow
That line doesn't need much interpretation. So good christians are actually praying to god for President Obama to die. Well, Barack Obama seems to be a pretty healthy guy in spite of his smoking. It appears unlikely that he will succumb to some disease in the near future. So praying for his death means what? And, it's not enough that someone is praying for President Obama's children to be fatherless and his wife a widow. Check out Psalm 109:10.
Let his children be continually vagabonds, and beg: let them seek [their bread] also out of their desolate places.
This is good Old Testament violence and revenge at it's best. But for those "good christians" that buy into this crap, I suggest you turn to the New Testament and read Matthew 7:1-2.
Judge not, that ye be not judged.

For with what judgment ye judge, ye shall be judged: and with what measure ye mete, it shall be measured to you again.

Debating Whether to Debate

This morning the US Senate is debating whether to debate the health care reform bill. We're number 1!!!

Thursday, November 19, 2009

Hoffman Claims ACORN Stole NY-23 Election

Doug Hoffman is rapidly become the North Country version of Glenn Beck. Here is his latest:
Recent developments leave me to wonder who is scheming behind closed doors, twisting arms and stealing elections from the voters of NY-23.

I'm sure you are as dismayed as I am to learn of the mischief that took place in Oswego and neighboring counties. We know this would not be the first time for the ACORN faithful to tamper with democracy.
That's not all:
P.S. I ran a different kind of campaign, one where Conservatives, Republicans, Libertarians, Tea Party and 9/12 activists rallied around. ACORN, the unions and Democratic Party were scared, and that's why they tampered with the ballots of voters in NY-23. Will you please contribute today so we can show them that fair elections are the Will of the People? Thank you.

Those are serious allegations. I hope Doug has more proof than what he's shown so far. BTW, Doug also claims he was "forced" to concede the election.

Als, Doug and his tenther, teabagger friends also believe that ACORN stole the last Presidential election, so it's not surprising that ACORN would steal the election from Doug Hoffman.

Wednesday, November 18, 2009

Murphy Explains His Health Care Vote

A couple of weeks ago I emailed Rep. Scott Murphy concerning his vote against the House health care bill. Here is his reply, likely a "form response", to me and the many other Democrats that probably sent emails similar to mine. It appears that Murphy is more concerned about local paper mills and medical device manufacturers (what medical device manufacturer?) than actual health care reform.
Thank you for taking the time to contact me about your support for the House health care bill, H.R. 3692, The American Affordable Health Care Act. Your input is important to me and helps me to better represent the people of New York's 20th district.

Over the last six months, I have traveled the 20th congressional district listening to constituents at over 100 events and Congress-On-Your-Corner meetings. During this time, no topic was discussed as often, or with as much passion as health care reform. These discussions were critical and reinforced my desire to reform our health care system.

I was pleased to see that H.R. 3962 took a number of important steps toward achieving these goals. For example, the bill would eliminate lifetime caps on insurance benefits and the pre-existing condition exclusion. It would create a health insurance exchange to force insurance companies to compete on a level playing field, and it offers a public option to give people access to a no-profit insurance choice.

However, in order to achieve this goal, we must be willing to address the flaws in the current system that have led to skyrocketing costs, bankrupt families, and windfall profits for insurance companies. That is why I have focused my attention on efforts to contain costs by eliminating waste, fraud and abuse; create a system based on healthy outcomes by incentivizing doctors to make Americans healthier; and drive competition in the insurance market to provide more choice and drive down costs.

However, after months of listening to constituents and reviewing the legislation, it was my belief that H.R. 3962 did not go far enough to bring down cost to a level that would contribute to our economic recovery. Furthermore, I was deeply frustrated by the last minute addition of over $50 billion in taxes, which would negatively impact the two largest employers in the 20th district--medical device manufactures and paper mills. This is not an acceptable way to pay for real healthcare reform. For these reasons, I voted against the bill when it passed the house by a vote of 220 to 215 on November 7, 2009.

As the bill now moves to the United States Senate, I remain committed to the goal of health care reform that provides quality, affordable health care to all American families and leaves our nation stronger. I look forward to continuing this important discussion and working to ensure that the final legislation addresses the issues that I believe are critical for Upstate New York.

Thank you again for contacting me about this important issue. As a member of Congress, I have to make tough decisions every day, and hearing from you helps me to do my job well. To stay informed of my work, or to sign up for future updates, please visit my website at http://scottmurphy.house.gov. Also, please do not hesitate to contact my office again if I can be of any further assistance.

Sunday, November 15, 2009

A Question About the War in Afghanistan

The following question was asked by former State Department official Matthew Hoh. "Do you want Americans fighting and dying for the Karzai regime?” Recently, our ambassidor to Afghanistan, Karl Eikenberry, appears to agree with Mr. Hoh.

I think these two guys have it right. Supporting the President of Afghanistan, who was likely fraudulently elected, is not the correct strategy. First, I no longer know who we are fighting in Afghanistan, is it the Taliban or Al Queda? It appears Al Queda terrorists are all hanging out in Pakistan, not Afghanistan. As for the Taliban, the Soviet Union couldn't defeat them (Mujahidee not Taliban; see comments) and I doubt we will either. At least in a war.

It's time to bring out troops home which will save lives and about a $100 billion dollars a year that our country sorely needs right now.

Friday, November 13, 2009

Yet Another Good Hard Laugh - John Stewart

I can't embed the video, but here is yet another John Stewart classic concerning Sean Hannity's apology for misrepresenting the Bachmann organized tea party.

Voice Your Opinion on the Public Option

Last month Majority Leader Harry Reid introduced a merged Senate health care bill -- a bill that includes a public option. And last weekend, the House of Representatives passed an historic health care reform bill that included a robust public option as well.

The question is no longer if we will have some sort of public option in the final health care reform bill, but instead what form it will take.

There are several interpretations of what a public option should look like, and I just shared my preferences with Senator Dick Durbin through his online public option poll at:

http://www.DickDurbin.com/PublicOptionPoll

Please click this link to voice your preferences for the public option included in the final health care reform bill:

http://www.DickDurbin.com/PublicOptionPoll

Wednesday, November 11, 2009

More Fox News Deception

The Daily Show With Jon StewartMon - Thurs 11p / 10c
Sean Hannity Uses Glenn Beck's Protest Footage
www.thedailyshow.com
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Making Health Care Better

A well thought out commentary on health care reform can be found in the Adirondack Daily Enterprise. A three-part commentary called "Health care reform is needed" is authored by Drs. Claud Roland Josh Schwartzberg. Part 1 can be found here and part 2 here. I assume part 3 will appear on Thursday.

The commentary fits in very nicely with an article published in the NYT Magazine last Sunday titled: "Making Health Care Better". Here is a taste of the article:
But there is one important way in which medicine never quite adopted the scientific method. The explosion of medical research over the last century has produced a dizzying number of treatments for different ailments. For someone with heart disease, there is bypass surgery, stenting or simply drugs and behavior changes. For a man with early-stage prostate cancer, there is surgery, radiation, proton-beam therapy or so-called watchful waiting. To enter mainstream use, any such treatment typically needs to clear a high bar. It will be subject to randomized trials, statistical-significance tests, the peer-review process of academic journals and the scrutiny of government regulators. Yet once a treatment enters the mainstream — once we know whether it works in certain situations — science is largely left behind. The next questions — when to use it and on which patients — become matters of judgment, not measurement. The decision is, once again, left to a doctor’s informed intuition.

Tuesday, November 10, 2009

Hoffmanization

Looks like Doug Hoffman will go down in history. Google "Hoffmanization". Use it in a sentence: How will she stand up against a stiff Hoffmanization? Hoffmanization isn't anywhere near as popular as Palinization yet and the word still doesn't show up in the Urban Dictionary.

Monday, November 09, 2009