Here are a few things from around the web that I've been meaning to blog about:

1. Larry Kramer slams Obama in a speech at an ACT UP / Healthgap demonstration in New York. A choice quote:

President after President have treated us so badly. Ronald Reagan. George Bush the first. Bill Clinton. George Bush the second. Barack Obama. They have all treated us like... shit. Like little pieces of shit that they can step on with their heels and grind into the ground. Obama is treating us just like that. Like little pieces of shit he can grind into the dirt with his heel to make us go away. I wish you could see that. I wish you could see what he is doing to us for for what it is. He is manipulating us into invisibility. He HAS manipulated us into invisibility. Our people in Washington live in a never-never cloud cuckoo-land, thinking that this man likes us, not responding as, little by little, he take bits and pieces of us away. That is how they control us. Can't you see that? Why can't our people in Washington see that? They give them a dinner as they take away another right.

2. DC-based Fuk!t has signed up our favorite twink Brent Corrigan for a safe-sex PSA. This would be all well and good, but the asshole director (an MD - no surprise there!) gave perhaps the most condescending interview with The Advocate I've ever read RE: Corrigan's previous bareback porn movies. Just listen to this pathologizing, fucked up response to whether the doc believes Corrigan was "taken advantage of" when doing bareback porn when he was 17:

"Oh, I would say that he was taken advantage of pretty clearly. No 17-year-old knows what they're doing (laughs). He knew what he was doing as well as any 17-year-old brain knows what it's doing. He definitely was taken advantage of, I don't have any question about that... which is why he's grown considerably. He's an amazingly mature individual for someone who's been through what he's been through."

And that, my friends, is why Terry Gerace, MD, is my asshole of the day! Typical doctor bullshit.

3. Canada's highest court has ruled that an HIV-negative man is not placed at "significant risk of serious bodily harm" if they fuck a HIV-positive bottom. The court ruled in 1998 in R. v. Cuerrier that HIV-positive people must disclose their status before engaging in sex that carries a "significant risk" of transmission. Topping can't be used to prosecute that anymore. It's a step, but far from enough.

4. In other news, the Michigan judge hearing a case against an HIV-positive man being charged with bioterrorism for biting his neighbor during an incident he describes as a hate crime has refused to drop the outrageous bioterrorism charge.

I was overwhelmed by the turnout last Friday night for the forum in Chicago, "What is justice for the black gay man?" I'm not particularly good at estimating crowd size, but the room was very spacious and it was standing room only. In attendance was a regular who's-who of Black gay men and their allies in Chicago, including a few local politicians and government officials. In this regard, I want to applaud the organizers of the event for bringing together a fabulous group of Black gay men and their allies for a discussion devoted to some rather difficult topics.

I was excited to hear the panelists, of course -- particularly E Patrick Johnson and Keith Boykin, both of which have done some pretty groundbreaking work in their respective fields for advocating for LGBT issues broadly and for Black gay men specifically. Johnson's performance work, "Pouring Tea," I particularly love for the way it brings to life an extremely diverse set of experiences of Black gay (or otherwise same-gender-loving) men living and thriving in the South. Keith's critical work on the down low was also I think an incredibly important invervention into the stigmatizing discourses around this issue that became hyperbolic when writers like J. L. King (who went on Oprah to spread his pathologizing understanding of the phenomena) and Benoit Denizet-Lewis, who wrote a grossly distorted piece for the New York Times. Denizet-Lewis has actually made something of a career of pathologizing gay men, which probably explains mainstream media's love for his alleged "exposes."

So needless to say, I was eager to hear these thinker's thoughts about how best to advocate for and understand the experiences of Black gay men. I expected to hear about social justice rooted in a denial of access to social benefits, racism, pathologizing discourses about Black MSM's sexualities and behaviors, an HIV epidemic that is crippling agencies working with these populations and disproportionately infecting Black men, and an interwoven network of stigmas that makes daily life for these communities trying at best, and unbearable at worst. Alongside these problems, I also wanted to hear about the ways in which many Black gay men are surviving and even thriving despite these obstacles.

I didn't really hear either of these things. Instead, I was shocked and nearly appalled when it became clear that justice for the speakers was primarily about "loving yourself" and "being true to who you are." Indeed, the problem that was posited as the most trying for Black gay men was their own internalized racism and homophobia, a kind of pathologizing and psychologizing approach to social injustice that I found utterly baffling. No, it wasn't pervasive systems of racism, homophobia, sissyphobia, and pozphobia that are systematically embedded in social institutions and cultures that should be the focus of social justice movements -- but rather the internal psyches and emotions of Black gay men themselves.

This is not far from the latest self-help craze for Oprah to latch onto, "The Secret," which proposes that to succeed in life we merely need to imagine ourselves as successful, wish for that to be true, and think positively. If we aren't rich, then it's our fault for not wanting to be rich. If we don't have health care, then it's our fault for not wanting to become insured. This isn't just offensive, it's downright manipulative for the way that it seduces people into believing that the onus of achieving loosely defined "success" in life falls entirely on individuals. Nevermind the vast libraries of scholarship that illustrate the ways in which various forms of social inequality make achieving these markers of success difficult if not impossible for many social groups -- particularly those born into poverty but also those marked by certain socially ascribed characteristics such as race, gender, and sexuality. Under this individualistic / rational framework, you are a free agent whose choices in life are the only factor that will influence whether or not you grow up to be a CEO or a garbage collector. As a sociologist, this is the kind of ignorant, distorted, and highly conservative perspective on the world that erases the foundations for a politics of social justice.

I'd call attention here to two comments from the audience after the short presentations by the panelists that I think help illustrate the underlying politics (or lack thereof) in their comments. First, there was a question from a self-identified "successful" Black gay men near the front of the room who noted that he loved himself, his life, and his partner just fine -- but his self-love, well-paying job, and house didn't translate into his ability to formally marry his partner of many years. Thus, I read him as trying to point out the ridiculousness of the panelists' claims about what justice should mean for Black gay men -- it cannot be framed just in the terms of psedo-scientific self-help jargon, but rather must first and foremost recognize the structural and social injustices that make that self-love difficult to achieve. The self-love is the OUTCOME of justice, not the root CAUSE.

Second, a man near me later stood up to ask why it was that the panelists were defining homophobia as a kind of psychological problem, rather than as a pervasive social system of power relations that is embedded in institutions and cultures. Heterosexism, he posited, would perhaps be a better way to situate the claims for justice that could foment a Black gay politics. "No, no" the panelists said (I'm paraphrasing), "I don't think that's how we understand homophobia." But it was clear that this was EXACTLY how they were positing homophobia and more broadly the social justice politics that should stem from that form of social inequality -- as I hope is made clear by my (distilled) description of their talks above.

Don't get me wrong, I hope that Black gay men are happy. That's a good thing. But you just don't build a social justice politics based on psychological concepts like internalized homophobia and depression. That's the building blocks for a public health intervention, which increasingly are supplanting actual social justice movements for gay men in general -- Black, white, or otherwise. It's perhaps not a coincidence that these efforts are funded by state agencies that perpetuate these very injustices. The disease or problem in this model becomes not the system and the dramatic injustices it enables, but the various medical problems experiences by minority groups like "self-destructive behaviors" and "low self-esteem." It is precisely though this pathologizing reconfiguration that political movements become neutered and inequality gets perpetuated, reproduced, and made more insidious because these injustices come backed by medical authorities with so-called "evidence."

Let's take care not to fall victim to these alluring models for social change. They may make us feel warm and cuddly, but that isn't going to mean a damn when said happy person gets denied health insurance because he's HIV-positive. Or when he gets fired from his job because a co-worker saw him kissing his boyfriend at a local nightclub. Let's see how happy they are after that.

If you've ever gotten into a debate over healthcare with conservatives, you're very likely to butt heads over a key central issue: Who's going to pay for all this care? I wanted to take a moment to reflect on this question, and in particular consider the idea that these outcomes -- health, life, or death -- are incommensurable. That is, you cannot simply translate these outcomes into a monetary metric. In short, 100 lives does not equal $100.

I was recently trying to explain this concept as it relates to healthcare to my students, and I used the following example: "So if I said to each of you, I'm going to die unless you all give me ten dollars, most of you would probably say that this is reasonable and you'd be willing to shell out the dough. But what if that cost goes up to $100? $1000? At some point, you're probably going to say, 'Trevor, I like you very much, but I just can't afford that. Very sorry. Best of luck!'" They all got a laugh out of that, but I think it illustrates the idea that you simply cannot translate one life into some sort of monetary value. This is most strangely illustrated when driving across the country and notice that killing a road worker is valued differently in different states. Here in Michigan, for instance:

Other states have laws that value road workers' lives differently. To say that this is perplexing is a bit of an understatement. Why $7500 and not $10000? When it comes to healthcare, this has been most explicitly debated in regards to things like preventative care. Take for instance the recent debate over mammograms. The U.S. Preventive Services Task Force updated its guidelines to suggest that women in their 40s should not have mammograms, because of the risk for false positives: "While roughly 15 percent of women in their 40s detect breast cancer through mammography, many other women experience false positives, anxiety, and unnecessary biopsies as a result of the test, according to data."

Here what we have is a kind of valuation of two outcomes: 15% of women detecting cancer, and a less specific group of "many women" who experience "false positives, anxiety, and unnecessary biopsies" because of the test. This Task Force has made a decision that the latter outcome is too costly to merit the former. Put plainly by the chief medical officer for the American Cancer Society quoted in the article: "With its new recommendations, the [task force] is essentially telling women that mammography at age 40 to 49 saves lives; just not enough of them."

How do you decide what is right and wrong in this scenario? Should all women over 40 get mammograms? Notably, these are just recommendations for care -- there is no mandate behind this guideline that would necessarily prevent a 42 year old woman from receiving a mammogram should she ask. But her doctor may reasonably say that the test is costly (not just financially, but also in terms of medical risks) and statistically her risk of detection is low, and therefore strongly suggest she not get the test. Some doctors may even outright refuse her the test based on the guidelines.

Here we creep up on an even more controversial debate within healthcare: Who controls healthcare decisions -- patients or doctors? With the recent growth of advertising for pharmaceuticals, it's clear that we are moving to a patient-centered approach to healthcare. You diagnose yourself before going to the doctor, and then show up demanding a prescription for Zoloft because you saw a television ad describing symptoms that you then relay to the doctor. We expect doctors to make informed decisions about the various treatments they prescribe, but when faced with a very demanding patient may err on the side of caution.

At the same time, patients with greater access to medical knowledge and resources are much better able to demand the care they think they need -- while patients with lesser degrees of access are unable to do so. Somewhere down the line, you and I are paying for that patient's Zoloft prescription -- whether we like it or not. We're also not paying for countless medications and treatments for patients who either have no access to care or are not as able to demand that care. Thus, there is a socially stratified (by race, class, geography, education, etc) access to treatment based on different levels of access to both services and to knowledge.

I am not enviable with those tasked with legislating these kinds of irrational rationalities (irrational in their incommensurability, rational in their formalized, calculated nature). We not only need to take care to carefully think through how we attach value to health outcomes that are invaluable, but also to consider how these valuations are likely to be socially stratified in their outcomes. Women over 40 might well be good candidates for mammograms, but how many women in the 40s will actually wind up getting that care? And how much are people collectively willing to pay for those mammograms? How much more are we all willing to pay to ensure that any woman who wants that mammogram can get it? $100 a year? $1000? At the end of the day, these are the questions that make healthcare reform downright maddening. There is no right answer. Precisely because there cannot be.

Michigan journalist and HIV-positive activist Todd Heywood has an outrageous and upsetting story posted on his site detailing the kinds of struggles he faced recently when trying to get access to post-exposure prophylaxis treatment for a sexual abuse victim:

I accompanied a 2[0-something] who had been the victim of a sexual assault to the hospital on Nov. 21. His experience, and mine with the Sexual Assault Nurse Examiner Justine, was more than acceptable. However, the victim requested a prescription for post exposure prophylaxis- which is a combination of antiretroviral medications taken over a 28 day time period to prevent infection with HIV. Because this was a stranger sexual assault, the HIV status of the assailant was unknown.

This victim and I spent four hours in the E.R. to receive a prescription which should have taken no more than an hour. Sadly, the E. R. Dept. Supervising doctor was unwilling to prescribe the medications, as is recommended by the Centers for Disease Control and Prevention in Atlanta for NonOccupational Post Exposure Prophylaxis (nPEP). In fact, this doctor, a Dr. Moreno was rude, uninformed, and provided several falsehoods to the victim in denying him access to necessary medications.

The CDC has a 24 hour hotline for doctors / clinicians to call if they are unsure of what drugs are appropriate to prescribe in a given situation. The issue of time is signficant here: The drugs are more effective the sooner you start them, and after 72 hours that effectiveness drops dramatically. So getting access quickly is key -- and ease of acesss is also key. This patient had an advocate there for him willing to fight for him, which seems largely to be the reason he ended up getting access -- FINALLY:

Dr. Moreno left the patient to talk with the Risk Management person, a Mr. Cole. And also provided a tablet with CDC guidelines of PEP in occupational exposure situations- which was not the case in a sexual assault, as you can imagine. Right there in paragraph two of the occupational exposure guidelines by the CDC was an 800 number staffed by CDC experts on PEP. Did your doctor find this number and call it?

No, that was left to me. The doctor from the CDC, upon presentation of the clinical facts- 22-year-old, unprotected, nonconsensual same sex activity in a high prevalency area (defined as have a 1% or higher incidence, which Ingham county has)- nPEP was indicated as an immediate treatment.

Dr. Moreno was given the name and telephone number of this CDC expert, and within minutes, the story changed.

The sad truth here is that doctors are grossly ignorant about these issues, and instead of owning up to their own ignorance, they tend to veil their ignorance under the guise of medical authority -- reacting not helpfully, but angrily. "How dare you challenge my authority! I know what's best." But they don't. And instead of getting the information they need, they deny care to patients. It's disgusting.

I recently had an experience VERY similar to this one. Incidentally, Todd recently interviewed me for an upcoming story on the matter. Look for more on that soon!

And scientists are completely baffled:

A new AIDS vaccine tested on more than 16,000 volunteers in Thailand has protected a significant minority against infection, the first time any vaccine against the disease has even partly succeeded in a clinical trial.

Scientists said they were delighted but puzzled by the result. The vaccine -- a combination of two genetically engineered vaccines, neither of which had worked before in humans -- protected too few people to be declared an unqualified success. And the researchers do not know why it worked.

"I don't want to use a word like 'breakthrough,' but I don't think there's any doubt that this is a very important result," said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, which is one of the trial's backers.

"For more than 20 years now, vaccine trials have essentially been failures," he went on. "Now it's like we were groping down an unlit path, and a door has been opened. We can start asking some very important questions."

[snip]

Col. Jerome H. Kim, a physician who is manager of the army's H.I.V. vaccine program, said half the 16,402 volunteers were given six doses of two vaccines in 2006 and half were given placebos. They then got regular tests for the AIDS virus for three years. Of those who got placebos, 74 became infected, while only 51 of those who got the vaccines did.

Although the difference was small, Dr. Kim said it was statistically significant and meant the vaccine was 31.2 percent effective.

So what we're looking at here is a 30% effectiveness rate. How bizarre. Adding confusion is the fact that those who did become infected with the vaccine did not have lower viral loads than those who became infected with the placebo, something that is generally expected with vaccine trials:

The most confusing aspect of the trial, Dr. Kim said, was that everyone who did become infected developed roughly the same amount of virus in their blood whether they got the vaccine or a placebo.

Normally, any vaccine that gives only partial protection -- a mismatched flu shot, for example -- at least lowers the viral load.

That suggests that RV 144 does not produce neutralizing antibodies, as most vaccines do, Dr. Fauci said. Antibodies are long Y-shaped proteins formed by the body that clump onto invading viruses, blocking the surface spikes with which they attach to cells and flagging them for destruction.

Instead, he theorized, it might produce "binding antibodies," which latch onto and empower effector cells, a type of white blood cell attacking the virus.

Obviously, this trial is not the Holy Grail. But it is indeed interesting and compelling new data that will have an obvious effect on future trials. Combining two failed vaccine candidates was a HIGHLY controversial idea, but it appears to have paid off -- at least in some small fashion.

Always good to start the day with a good laugh!

The AIDS Vaccine Advocacy Coalition has published a report with information regarding the forthcoming results from a controversial Thai HIV Vaccine trial. The trial is a Phase III trial which means it tests effectiveness and safety (for more info on this go here), and the largest of its kind ever. The hugely expensive trial triggered divisive debate in the scientific community, because it involved two vaccine candidates that had minimal / no results in previous trials. Here's the basic 411 on the report's info:

In September 2009 results will be released from an AIDS vaccine phase III trial in Thailand. This test-of-concept trial is the largest AIDS vaccine trial ever conducted. The study, known as RV 144, began in 2003 and enrolled more than 16,000 HIV-negative Thai men and women between the ages of 18 and 30.

[snip]

In late September, the first announcement of data will focus on the general findings: whether there was any evidence of vaccine impact on HIV infection and/or viral load. More detailed information on the findings will be released at the annual AIDS Vaccine Conference in Paris (October 19-22). Regardless of the content of these two announcements, in-depth analysis of the findings will continue well beyond October.

As the report notes, there may be several outcomes here:

Any clinical trial may show no effect, but if there is a positive result, it will be one or both of the following:

1) The vaccine strategy reduces risk of HIV infection;
2) The vaccine strategy reduces viral load in participants who receive the experimental vaccine regimen and go on to become infected.

Even a modest indication of either of these benefits will be exciting news for the field. It would be the first time that an AIDS vaccine shows an impact on either risk of infection or viral load.

The report is available in English (PDF) and Thai (PDF).

Dr. Peter Kilmarch (Chief, Epidemiology Branch, Division of HIV/AIDS Prevention, CDC) gave a presentation today on one of CHAMP's amazing StrategyLab conference calls. I didn't make the call, but I did check out the Powerpoint slides the Kilmarch sent out to support his talk, "Assessing the Effect of Antiretroviral Therapy on Risk of Sexual Transmission of HIV." Very useful and interesting compilation of data here. I'm not sure if the slides are public, so I won't republish them here, but I did want to highlight this slide on the hypothetical potential for ARV + Universal testing to dramatically impact the epidemic in South Africa:

Granted, this is highly hypothetical scenario (based on this modelling study) -- requiring a number of assumed phenomenon to be implemented without problem. But the entire set of slides highlights the potential for a combination of testing and treatment to be used as a powerful set of prevention techniques. I've said it once, I'll say it again: these are tried and true tools in our prevention knapsack -- and they seem to rely much less on the needs of behavioral change messages that I believe are often stigmatizing and highly problematic. Though certainly testing / treatment program implementations can come with their own set of problems (treatment adherence, questions over when to begin ARV treatment, etc.)

What we need to make this feasible is certainly generic equivalents -- ASAP. And certainly a rethinking of the "old school" approaches to prevention.

Andrew Sullivan considers why The Right's blogosphere has been relatively quiet about Vermont's democratic move to install same-sex marriage...

The NY Times reflects on Iowa and Vermont's newfound same-sex marriage rights, and looks to the future of marriage equality...

Gay porn icon Jack Wrangler is dead.

CNN covers the trend towards locking teenagers away for life in prison without parole...

Pam Spaulding recounts her experience at Equality North Carolina's Day of Actiong (their annual LGBT lobby day) with Mandy Carter, and I sigh and miss my home...

A new DNA test is much better at finding advanced cervical cancer than the traditional pap smear...

A new ad campaign bets that gay men are the key to reviving NYC's ailing tourism industry...

And that's all for this morning! Off to the gym, and then lunch with the lovely Heather Love, who's visiting Michigan from Penn to do a few lectures on her new project interrogating Erving Goffman's 1963 classic study, Stigma. She's helping us think about the development of a conference for 2010 or 2011 on the 20th anniversary of queer theory.

Thank goodness:

President Obama signed an executive order Monday repealing a Bush-era policy that limited federal tax dollars for embryonic stem cell research.

Obama's move overturns an order signed by President Bush in 2001 that barred the National Institutes of Health from funding research on embryonic stem cells beyond using 60 cell lines that existed at that time.

Obama also signed a presidential memorandum establishing greater independence for federal science policies and programs.

"In recent years, when it comes to stem cell research, rather than furthering discovery, our government has forced what I believe is a false choice between sound science and moral values," Obama said at the White House.

"In this case, I believe the two are not inconsistent. As a person of faith, I believe we are called to care for each other and work to ease human suffering. I believe we have been given the capacity and will to pursue this research -- and the humanity and conscience to do so responsibly."

Coupled with his repeal of the Global Gag Rule, we're on our way to evidence-based policy.

If you're in San Francisco, you might drop by the memorial for Martin Delaney -- an AIDS drug activist who pressured the FDA to revamp the way they tested and brought new drugs to market. He founded Project Inform in 1985, a national patient advocacy organization. He died last month from complications of liver cancer at the age of 63.

Here are the details via Project Inform on his memorial:

Memorial and celebration of Martin Delaney's life and work

Saturday, March 14, 2009, 4:30pm
Eureka Valley Recreation Center
100 Collingwood @ 18th Street
Castro District, San Francisco

You are invited to attend the civic memorial and celebration of life for Martin Delaney. Feel free to stop by and meet others who knew this great activist. No RSVP necessary. The Memorial will be followed at approximately 6pm with a reception and refreshments.

Public transportation is strongly encouraged since parking near the Rec Center may be difficult to find. The MUNI Castro Station is a convenient two-block walk to the Rec Center (lines K, L and M). MUNI bus lines 24 and 33 stop one block away at Castro and 18th Streets. Also, the F Market trolley stops in the Castro.

Martin requested that donations be made to Project Inform in his honor.

For more information, email Project Inform or contact Henry Lucero at 415.558.8669 x211.

Image via BBC

Let's hope for the best! A trial has just kicked off aimed at testing the hypothesis that splicing out patient's T-Cells' CCR5 receptors (where HIV binds to the cell) may lead to host immunity. Not only would this provide immunity to those who are HIV-negative, but would in theory also cure people who are HIV-positive. The procedure involves removing T-cells from patients, genetically modifying them outside the body, and the injecting them back into the patient. Here's the news report:

Recruiting for the trial began Tuesday, and the first people to receive the experimental treatment will be HIV patients with drug-resistance problems.

"We do have good treatments for HIV. That has been one of the most successful stories of the last 20 years in medicine," said Pablo Tebas, an infectious disease expert at the University of Pennsylvania.

"However, over time, if the medications are not taken properly, individuals develop resistance to the HIV treatments, so they tend to have more limited therapeutic options."

Since the discovery that a small portion of people who are exposed to HIV do not get infected, scientists have been working to discover the secret to those people's resistance and how to make others resistant as well.

It turns out that most people have a gene called CCR5, which makes them vulnerable to HIV infections. The naturally resistant people have mutant CCR5 genes that inhibit HIV.

Previously, scientists found that by cutting the CCR5 gene out of white blood cells involved in the immune response known as T-cells, they could protect a tube full of human cells from the virus. The gene editing technique relies on proteins called zinc finger nucleases that can delete any gene from a living cell.

In theory, zinc finger nucleases could give that immunity to anyone.

The procedure is simple: Take some healthy T-cells out of an HIV patient, clip out their CCR5 genes, grow more of these clipped T-cells in a dish, and then put them back in the patient.

"In this first study we will re-infuse approximately 10 billion of these cells back into the participants, and we will see if it is safe and if those cells inhibit HIV replication in vivo," said Tebas. "We know they do in the test tube."

(Via Joe. My. God.)

Holy canoli!:

In what is being heralded as a "first-ever procedure," surgeons removed a healthy kidney through a donor's vagina, the Johns Hopkins Medical Center has announced.

Although the procedure has been previously done to extract cancerous and nonfunctioning kidneys that threatened a patient's health, the January 29 surgery was the first time it was done for donation purposes, the center said in a news release issued Monday.

"The kidney was successfully removed and transplanted into the donor's niece, and both patients are doing fine," Dr. Robert Montgomery, chief of transplant surgery at Johns Hopkins, said in the release.

The surgery is considered less invasive and could pave the way for an increase in organ donations, it added.

"Removing the kidney through a natural opening should hasten the patient's recovery and provide a better cosmetic result," Montgomery said.

Pretty effing cool!

I awoke my second night during my Christmas vacation in North Carolina to a horrible burning sensation in my left hand. Not quite the same as the "pins and needles" you feel when a limb falls asleep, more like a singing pain mixed with a dose of strange numbness. I rolled over to a different position, thinking that my circulation had simply been obstructed (I owe my bad circulation to my mother), but to no avail. The pain persisted. I finally found a comfortable position to lie in, and managed to fall back asleep.

But the next night, the pain returned. It continued throughout my holiday, progressively getting worse and preventing me from sleeping a full night without waking up. Sometimes it was mild -- an annoying, lingering feeling that just barely prevented my slumber. Sometimes it was agonizing, causing me to double over with tears welling up in my eyes. What was happening to me? Arthritis? I'm only 25 for fuck's sake! I asked my family members, but they all regarded me with suspicion as I may have a habit of hyberbole from time to time. But this was no exaggeration: I was in pain.

It didn't take me long to suspect that the culprit was likely carpal tunnels syndrome. I'm a computer addict -- and have been since I was very young. I think I published my first website when I was thirteen ("No Doubt Emporium," a fan site dedicated to the band). A quick read of the Wikipedia entry regarding the problem confirmed my suspicion:

Many people that have carpal tunnel syndrome have gradually increasing symptoms over time. The first symptoms of CTS may appear when sleeping and typically include numbness and paresthesia (a burning and tingling sensation) in the thumb, index, and middle fingers, although some patients may experience symptoms in the palm as well.[3] These symptoms appear at night because we tend to bend our wrists when we sleep, which further compresses the carpal tunnel.

The pain I had been experiencing was this "paresthesia." I decided not to see a doctor, as I believed I had found the problem's source and a potential remedy for the time being. I went to the pharmacy the next day and I bought the lovely wrist brace you see in the photo above. It's god-awful ugly, but relatively comfortable. And best of all: my symptoms are gone. No more waking up at night to searing pain in my hand. Just pleasant sleep. Thank God for that. Now if I can just find a Bedazzler for cheap on Ebay and pimp this brace out...

If I've learned anything from this ordeal, it's that our bodies can be terribly uncooperative. I'm 25 and will likely wear this brace to sleep for many years to come -- perhaps until I die if I never have a surgical intervention. I imagine rolling over and wrapping my arm around my lover in a daze while the sun is rising, only to hear his screams of terror when this brace lands with a thud on his side. Very sexy. Ugh.

This is so exciting!!!:

The Bristol University statement said a segment of trachea, roughly three inches long, was taken from a 51-year-old donor who had died of a cerebral hemorrhage. Using a new technique developed in Padua University, the trachea was stripped of its donor’s cells over a six-week period “so that no donor cells remained,” the statement said.

At the same time, at Bristol University, stem cells removed from Ms. Castillo’s bone marrow, were grown into “a large population” and used to “seed” the donated windpipe using a new technique developed in Milan to incubate cells.

Four days after the seeding, the graft was used to replace Ms. Castillo’s damaged windpipe.

Normally after transplants there is a high risk of rejection because the recipient’s immune system reacts against the foreign organ. Most transplant patients, thus, use immunosuppressant drugs to prevent rejection.

Expect this to be the first in a series of big news stories on these kinds of therapies. They will start with these kinds of tissue / minor organ replacement, but ultimately this is headed towards replacing major organs like the heart and repairing damage previously thought irreversible to the brain.

Very exciting news for folks affected by multiple sclerosis:

Researchers at the University of Cambridge said Thursday they have found that a drug originally developed to treat leukaemia can halt and even reverse the debilitating effects of multiple sclerosis (MS).

In trials, alemtuzumab reduced the number of attacks in sufferers and also helped them recover lost functions, apparently allowing damaged brain tissue to repair so that individuals were less disabled than at the start of the study.

[snip]

In the trial, 334 patients diagnosed with early-stage relapsing-remitting MS who had not previously been treated were given alemtuzumab or interferon beta-1a, one of the most effective licensed therapies for similar MS cases.

After three years, alemtuzumab was found to reduce the number of attacks the patients suffered by 74 percent over the other treatment, and reduce the risk of sustained accumulation of disability by 71 percent over interferon beta-1a.

Many individuals who took alemtuzumab also recovered some of their lost functions, becoming less disabled by the end, while the disabilities of the other patients worsened, the study in the New England Journal of Medicine said.

A new study out of England and Germany points to another genetic variation that may predispose some to baldness. The common trope has for years been to check your mother's father and see if he's bald. If not, you're in good shape. But this has never actually been 100% accurate. The new link they've found is actually not on the X chromosome (where the previously discovered one was) -- but on chromosome 20, which everyone has two copies of (one from mum, one from pop):

New genetic links to male pattern baldness have been discovered by researchers in England and Germany.

It's the second genetic connection to the kind of hair loss that many men -- and women -- experience as they grow older, said Felix F. Brockschmidt, a postdoctoral fellow at the University of Bonn and one of the authors of a report published online Oct. 12 in the journal Nature Genetics.

"The first gene known until now is on the X chromosome," Brockschmidt said. "It is the most important for alopecia [hair loss]. We are sure that this new locus we found is the second most important."

The discovery could open the way for genetic tests to single out men most likely to lose hair as they age, Brockschmidt said. "Screening for the X chromosome locus and also for this new one can possibly show the risk of male pattern baldness," he said.

[snip]

That test looks at variants of a gene governing receptors for androgens, which are male hormones. That gene location, on the X chromosome, was identified only a few years ago. A man has only one copy of the X chromosome, inherited from his mother. The new gene locus is on chromosome 20. Men and women alike have two copies of chromosome 20, inherited from both father and mother.

[snip]

"If you don't have the genes, there is a negative predictive value of 96 percent," he said. "If you do have the genes, there is a positive predictive value of about 14 percent."

This is my GREATEST. FEAR. EVER. I mean, don't get me wrong. Some guys look hot bald. But I've shaved my head before. It's.... lumpy. Ugh. And mole-y! Eek!!! My mom's dad has a full head of great thick silver hair. I've got my fingers crossed!

Time Magazine has a report on several new studies that indicates men experience a loss of fertility as they age -- just like women do -- and that older paternal age is associated with risks such as bipolar disorder. This of course flies in the face of common attitudes towards fertility that see infertility primarily as a woman's problem. Apparently as much as a 50% of infertility may be due to men, not women:

Not only do men become less fecund as they age, but their fertility begins to decline relatively early — around age 24, six years or so before women's. Historically, infertility has been seen as a female issue, as has the increased risk of Down syndrome and other birth defects, but studies now also link higher rates of autism, schizophrenia and Down syndrome in children born to older fathers. A recent paper by researchers at Sweden's Karolinska Institute found that the risk of bipolar disorder in children increased with paternal age, particularly in children born to men age 55 or older.

It used to be that "if you had hair on your chest, it was your wife's problem," says Barry Behr, an associate professor of obstetrics and gynecology at the Stanford Medical School and director of Stanford's in vitro fertilization laboratory. Even now, he said, though about half of infertility cases are caused by male factors, such as low sperm count or motility, there are many more tests to evaluate a woman's fertility than a man's.

You can find the Swedish study on bipolar disorder here, and the French study on age and pregnancy rates here.

And PS: isn't that photo of a microscope sold in Japan AMAZING? Thanks to Gizmodo for that. Notice not just the happy sperm, but also the DEAD sperm on the box. How amazing!

For many years now, there has been a mobilization against vaccinating small children based on shaky evidence of a link between the MMR (measles, mumps, and rubella) vaccine and autism. A new study out of Columbia University refutes that claim:

The theory was created in 1998, when British researcher Andrew Wakefield published studies that suggested the measles vaccine caused gastrointestinal problems and that those GI problems led to autism.

W. Ian Lipkin of Columbia University in New York, who co-authored the most recent study, said Wakefield theorized that the virus used in the vaccine grew in the intestinal tract, leading to inflammation that made the bowel porous. That allowed material to seep from the bowel into the blood, Wakefield's theory surmised, affecting the nervous system and causing autism.

In Wednesday's study, the researchers replicated key parts of Wakefield's original study to determine whether the vaccine causes autism and GI problems, said Mady Hornig, a study co-author. Irish pathologist John O'Leary, co-author of Wakefield's studies that supported the autism link, also is a co-author of the new study.

O'Leary and the other researchers looked for evidence of the measles vaccine in children's intestines after they had been vaccinated and sought to determine whether their GI problems and autism symptoms occurred before or after they were vaccinated.

They analyzed samples taken from 38 children with bowel disorders, 25 of whom also had autism. The investigators found only one child in each group had trace amounts of the measles virus in their samples.

The samples were analyzed at Columbia and at a laboratory of the Centers for Disease Control and Prevention, as well as at O'Leary's lab -- the same one Wakefield used for his original studies.

The conclusion: "no evidence" linked the vaccine to either autism or GI disorders, Lipkin said.

Now hopefully we can have some sanity on this issue. Autism as you may know is a politically hot issue, with various celebrities lobbying (Jenny McCarthy, etc) for more awareness. Unfortunately, the guidelines for diagnosing autism have been expanding, so it's perhaps no wonder that more children have been diagnosed in the past 20 years. I find it somewhat similar to ADD (attention deficit disorder), an extremely vague and every-expanding category of "disease" that parents have rushed to treat with drugs not terribly different from cocaine. It's effectively the medicalization of our young people, and it makes me deeply uncomfortable.

Fuzeon maker Roche has pulled out of HIV drug research:

Swiss pharmaceutical company Roche Holding AG will suspend its HIV research because none of its pending medicines represent significant improvement over existing drugs, a company spokeswoman said on Friday.

"Research scientists currently working in HIV will be reassigned to other activities," Linda Dyson, a spokeswoman in Roche's U.S. office in New Jersey, said in an e-mail.

Dyson confirmed an e-mail sent on Wednesday to some activists informing them of the decision. In that e-mail, the company said it "decided to refocus our resources within virology on diseases in which we can deliver substantial improvements over existing medications."

Dyson declined to specify how much Roche has been investing in HIV research.

Apparently, Joe @ Joe. My. God. believes that activists are not upset about this, because "the company has been unwilling to discount their products in the manner of other big pharma companies." I work on HIV prevention, so the treatment side of things is not my specialty. But it seems to me that you want as many eyes and brains on this thing as possible...