NewburyportNews.com, Newburyport, MA

February 7, 2013

Good news, bad news

As I See It
Robert Campbell

---- — Comedians say the only way to open up such a topic is to ask, “What do you want to hear first?” I’m not so inclined. My nature is such that facts will dictate the direction news should take, but there is always that “zinger” that throws facts out the window and invites in something out of left field to deflate the facts.

A Pentagon program for the study of alternative fuels enlisted the Navy to put our Pacific fleet on a $12 million cocktail of biofuels this past summer, to prove that warships can operate on fuel made from algae or even chicken fat. That’s the good news! The bad news is that it costs $27/gallon compared with $3.50/gallon for conventional military fuel. It was back in 2000 that the Navy started to look for alternatives to petroleum. Various companies have come forward eager to “eat at the trough” of military expenditures, remembering the $7,600 coffeemaker the Pentagon authorized years ago. The House of Representatives, controlled by Republicans, has approved measures to kill the Pentagon funding on the biofuel program, while a Democratic Senate committee has vowed to preserve the program. Save your bacon fat, people, you may yet be able to cash in to keep the Navy afloat on a greasy sea.

In the language of distillery production (e.g., whiskey) the term “Angels share” is that applied to the 4 percent of the alcohol (ethanol) that escapes into the air from a barrel of aging booze. That share is causing problems for residents of the whiskey region around Louisville, Ky., home of several of the largest bourbon distilleries. It seems a black fungus, identified as baudoinia, germinates from the ethanol and blackens homes, cars, fire hydrants and stop signs, to name a few. So what’s the problem, say the distilleries. “We were here over a hundred years before the surrounding homes.” The problem has existed in Scotland for many decades; the same for Spain and Portugal, but no one has died from the unsightly fungus. Let’s drink up and await the court’s verdict! This could well turn out to be good booze, bad booze!

In the early days of WWII, Dr. Alexander Fleming made a quick, government-authorized trip from Great Britain to the U.S. His purpose: to enlist one or more manufacturers to make a pharmaceutical product that had the ability to kill germs caused by accidents or, in the immediate sense of the times, warfare. Two companies responded: Chas. Pfizer & Co. and American Cyanamid, who agreed to make penicillin by deep tank fermentation. Enough penicillin was ready by 1944 to save thousands of lives on the beaches of Normandy and the shores of Pacific Islands. Thus, the Age of Antibiotics was ushered in. Good news!

But, wait, presently 80 percent of the antibiotics sold in the U.S. goes into feed for chickens, pigs, cattle to stimulate growth and control bacteria. Yet, the producers of meat and poultry are under no obligation to report how they use the drugs and thus the relationship between antibiotic use in animals and antibiotic-resistant infections in people has created a “Frankenstein” dilemma. Routine infections of humans are resistant to penicillin, causing thousands of deaths year after year. Regulatory responsibility is distorted because the FDA regulates drugs, but the Department of Agriculture, which controls use in animals, is strongly opposed to any ban on antibiotics. Regulation will be difficult; it’s a real conundrum. We have created a monster, unknowingly. That’s the bad news!

The most effective therapy in the treatment of childhood asthma, and currently the only therapy, are glucocorticoids used broadly in inhalers. Good news for children! But, a recent study published in the New England Journal of Medicine found that the drug slows the growth rate of children that lasts into adulthood. Bad news, indeed! Questions are being asked in the medical field about curtailing the use of glucocorticoids. The author of the new study, H. William Kelly, is strongly opposed to this action, citing the drug as the only therapy that can decrease the risk of dying. His answer to those opposing the drug is to start young children on lower doses. This may alleviate the problem, but only time will tell. Good news? Maybe not!

If ever a codicil, or supplement, were to be applied to a good news-bad news situation, it’s the case of the New England Compounding Center. Their compounded drugs, to alleviate back pain, resulted in an alarming number of mistakes that killed 39 in 2012 and continues to be a risk for thousands more, all due to the contamination of methyl prednisolone by a fungus. Medical companies and pathologists across the U.S. have been requested to review all cases of deaths back to January 2012, where shipments of drugs from NECC were made.

Besides seeking the source of contamination, legal aspects will add up to hundreds of millions of dollars, which will affect physicians, hospitals, clinics and those who in any way were involved in the debacle. NECC declared bankruptcy on Dec. 21. It will take years to unravel, but for those thousands whose health has been adversely affected, there is no hope for monetary or health recovery.

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Robert D. Campbell, an essayist who lives in Newburyport, believes that a sense of humor is essential.