52 Books a Year: #51 - Blood

Posted by Brian Wed, 30 Dec 2009 18:08:00 GMT

Blood: An Epic History of Medicine and Commerce
By Douglass Starr

4/5

This was the last of my wife’s popular medical books that she picked up at the library book sale this summer. I ended up reading all of them before she read any. Chronicling the development of blood transfusions from ancient times through today, Blood tells an interesting story. Early transfusion methods and ideas look crude and odd in modern times. For example, early experiments involved transfusing blood from farm animals into patients in an attempt to change their personalities. Needless to say, this didn’t work.

The primary focus in Blood is on two subjects. First, Starr details the rise of the blood industry, mostly beginning with work done during World War II. This was focused on battlefield transfusions and led to the development of technology to separate plasma and to handle blood and its derivative products in bulk. From here the industry exploded, with a number of new blood derivatives entering the market, stretching the number of people who could be treated for each unit of blood given. These developments also led to blood products being combined in large vats of thousands of units, each from a different person, which led to the focus of the rest of the book.

Today the safety of blood transfusions is excellent. It is very rare for anybody to get sick from a blood transfusion, but that wasn’t the case until the 90’s. Before this tens of thousands of Americans contracted hepatitis from transfusions, many because of the large vats used to make derivative products. If one unit of the tens of thousands contains hepatitis the whole vat will be contaminated. This was a known issue for the industry, but there were no tests initially. When tests became available the industry deemed it not cost effective to test every unit. The turning point came when AIDS came on the scene. The clotting that hemophiliacs use is derived from blood products that are pooled into tens of thousands of units. By the 1980s standard hemophiliac treatment involved many injections on a regular basis of this clotting factor, which led to as many as fifty percent of hemophiliacs in some areas contracting AIDS. To compound the problem the industry refused to admit their was a problem, leading to many lawsuits. The details of the industry’s indecision were exposed in court.

Blood leaves the reader with a bad taste in their mouth. Many in the blood industry turned their back on those who were being treated by their products. They either refused to admit their was a problem or decided they couldn’t do anything about it. Many knew that it would effect the bottom line and chose to do nothing. If you are interested in how the blood industry developed, then Blood is an excellent read.

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52 Books a Year: #49 - The Antibiotic Paradox

Posted by Brian Mon, 28 Dec 2009 18:44:00 GMT

The Antibiotic Paradox: How the Misuse of Antibiotics Destroys Their Curative Powers
By Stuart B. Levy, M.D.

4/5

When penicillin was first made available to the public it was touted in the press as a miracle drug that would end disease, leading to it being used to treat many illnesses that it had no real power to cure. Even today many still go to the doctor demanding an antibiotic to treat a cold because they do not understand that antibiotics only treat bacterial diseases, not viral. Stuart Levy explores this misuse of antibiotics in The Antibiotic Paradox.

So what is the paradox exactly? The problem is that the more you use antibiotics the more useless they become. An antibiotic does not kill every bacteria it comes in contact with. Those that are left usually have some form of resistance that can be transferred to other bacteria. In effect the use of an antibiotic selects for ever greater resistance to that antibiotic. It gets worse though. Even though we have approximately 100 antibiotics to choose from many of them have similar enough chemical compositions that resistance to one will also confer some level of resistance to another.

This paradox is a problem even with responsible use of antibiotics and Levy makes clear that proper use of antibiotics should not be stopped. His problem is with unnecessary and incorrect use of antibiotics. The patient who demands antibiotics unnecessarily can cause resistance that effects all. The person who pops a few pills when he feels a little run down is selecting for resistance in his own body for no reason. The overuse of antibiotics in livestock as a growth promoter limits the types that can be used in people because resistance has already been selected for. The explosion in unnecessary usage of antibiotic products in the home paradoxically can make your home less safe.

Levy has crafted an excellent exploration of the consequences of the abuse of antibiotics in society. As the only drugs whose abuse can actually cause more disease in society, he pushes for regulation that splits them into their own class of drugs with regulation that recognizes the unique role they play. Along with Infection: The Uninvited Universe, give The Antibiotic Paradox to a hypochondriac friend near you.

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52 Books a Year: #47 - Infection: The Uninvited Universe

Posted by Brian Sat, 26 Dec 2009 18:37:00 GMT

Infection: The Uninvited Universe
By Gerald N. Callahan

5/5

Absolutely fantastic. This is one the few non-fiction books that I have read this year that I would recommend to anybody. In Infection, Gerald Callahan describes how infection is what makes us human. From the helpful bacterial flora in our intestines to disease changing the course of history, infection shapes us and the world we live in.

The book is divided into three parts. The first covers good germs and is the most fascinating portion of the book. Starting from before birth, where bacteria in the birth canal (Lactobacilli) help prevent premature delivery. Proteins from breast milk serve as fertilizer for bacteria to populate the child’s intestines, an essential part of health. From here we learn about parasitic worms being used to treat diseases and the possible role of bacteria in mental health. The big point is that bacteria are not always the enemy and that extreme cleanliness can actually be to the detriment of your health. The last two sections of the book cover the role of bacteria in shaping the world as we know it and some diseases that could alter the course of history. These sections are also interesting, but not as much as the first.

Callahan’s writing is excellent. He mixes in stories from his own family and how bacteria shaped them. He strikes a nice balance between medical and popular that will appeal to a wide audience while still being informative. I highly recommend picking this up. It will help you rethink how you view the bacteria surrounding us.

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