ABCDE HEALTH SCIENCE tuesday, august 24, 2010 &


CONSUMER REPORTS


Hold it!


Medication isn’t likely to be the best solution for bladder control. E2


COSMOLOGY


Are we living in a black hole? Scientist puts a new spin on the universe. E3


52 million INSURING YOUR HEALTH


An aid to research New law ends penalty for joining a clinical trial. E4


Americans 12 and older who have taken prescription drugs for nonmedical reasons. These substances can be as addictive as heroin. AnyBODY, E2.


‘superbug’ the latest Meet


Resistant to antibiotics and alcohol wipes, C. diff bacteria are a growing threat


by Laura Ungar Special to The Washington Post


As intravenous antibiotics dripped into his arm, David Carmody seemed to be recovering nicely from a bad blad- der infection. But then out of the blue things got worse as he lay in bed at a rehabili- tation center: He felt weaker and began suf- fering uncontrollable diarrhea. A battery of tests re- vealed an entirely new, and serious, problem: Clostridium difficile (or C. diff), a virulent form of bacteria that doctors worry has become a new “super bug” — in- creasingly common in


hospitals and with growing resistance to antibiotics and virulence among those afflicted. “I hadn’t heard of C. diff. But there it


was, eating its way through me,” said Carmody, a 55-year-old government re- tiree from Anne Arundel County, whose multiple sclerosis requires him to use a wheelchair. He recovered after more than a week of heavy-duty antibi- otics that still work against C. diff, but “it scared me,” he said. The C. diff strain sickens about 3 mil- lion Americans a year, usually attack- ing people who, like Carmody, have been on antibiotics or in hospitals or


other health-care facilities. It can cause severe diarrhea and inflamma- tion of the colon. It is deadly in up to one in 40 cases, particularly when it strikes the elderly and infirm, and contributes to 15,000 to 30,000 deaths annually, according to the Centers for Disease Control and Pre- vention.


Research shows that FOR THE WASHINGTON POST


David Carmody says it was scary to become infected.


JAMES A. PARCELL


the C. diff bacterium rivals the better- known MRSA, or methicillin-resistant Staphylococcus au- reus, as a source of hospital-acquired in- fection resistant to var- ious drugs. A recent study found 25 percent more C. diff than MRSA in 28 communi- ty hospitals in Vir-


ginia, North Carolina, South Carolina and Georgia. Becky Miller, an infectious-disease


physician at Duke University Medical Center who presented that research at a recent conference, says she be- lieves those statistics reflect what’s happening at hospitals across the country and not just in those states. The findings bolster research pub- lished in 2008 in the American Jour- nal of Infection Control showing that C. diff rates had skyrocketed to 13 per 1,000 hospitalized patients, up to 20


infection continued on E4 E K


THE GREEN LANTERN


No dead trees All things considered, e-readers are doing the environment a favor. E3


DM VA


DOUG KAPUSTIN FOR THE WASHINGTON POST


Jen Driscoll didn’t learn the reason for her son Adam’s problems until he was 4.


MEDICAL MYSTERIES


Her baby was quiet. Too quiet.


Specialists saw no problem, but a mother’s persistence resulted in rare diagnosis


by Sandra G. Boodman Special to The Washington Post


Adults who encountered Adam Dris- coll as a baby tended to be impressed by his quiet, easygoing nature. He seemed happy, cried little and, by the age of 6 weeks, even slept through the night. But his mother, Jen, though grateful for Ad- am’s placidity — a marked contrast to his rambunctious older brother — viewed his undemanding behavior with an uneasiness that grew as he did. A former day-care provider who


worked in a genetics lab at the Univer- sity of Delaware, Driscoll knew that sib- lings’ personalities and development varied considerably. But she worried that Adam’s behavior reflected some- thing more ominous: His muscle tone was poor, and he was stumped by things that seemed almost instinctive to other children, such as playing with toys. Driscoll repeatedly mentioned her concerns to her pediatrician, who brushed them off. “She told me, ‘He’ll be fine.’ ” It was years before Driscoll, who en- countered similar reactions from other specialists, learned the real reason for her son’s difficulties, which by then were evident in many aspects of his life. “He’s very typical in that he presented symptoms as a newborn” but a diagnosis was not made for several years, said Car- ole Samango-Sprouse, an associate clin- ical professor of pediatrics at George Washington University who is evaluat- ing Adam, now 7. “This is a disorder that can be easily


identified or ruled out” but too often isn’t, she said, because doctors are unfa- miliar with the diagnosis or because they worry about labeling a child. As a result, the problem may go untreated for


mystery continued on E5 CLOSTRIDIUM DIFFICILE BACTERIA; GETTY IMAGES


Trying to tackle Alzheimer’s early


With new diagnostic tools, researchers hope to quell a looming surge of patients


by Aaron James Special to The Washington Post “We have a tsunami coming at us,


and we’re sitting in a rowboat,” says neurologist Richard Mayeux of New York’s Columbia University. The surge that worries Mayeux is Alzheimer’s disease: In 2050, 13.5 mil- lion Americans may have it, at an an- nual health-care cost of more than $1 trillion, according to the Alzheimer’s Association. “Alzheimer’s could bankrupt Medi- care and Medicaid,” says Howard Fillit of the Alzheimer’s Drug Discovery


on washingtonpost.com


Telling their own stories, patients with dementia describe


what it’s like to forget. See the video at washingtonpost.com/health.


Foundation. The impending epidemic, combined with emerging technologies, is driving a transformation in the fight against the disease: Instead of beginning treat- ment after symptoms appear, the idea is to detect and respond to the disease in the earliest, previously undetectable stages, before it can irretrievably rav- age the brain. Researchers say that, based on current estimates of life ex- pectancy, delaying the onset of Alzhei- mer’s by an average of five years could reduce the number of patients by half. “People take Lipitor because it low- ers the risk of heart disease. We want to find the same thing for Alzheimer’s,” Mayeux says. The new approach is made possible by recently developed methods to de- tect and measure Alzheimer’s biomark-


alzheimer’s continued on E5


Physicist floats fresh ideas to keep boats on an even keel


by Justin Mullins New Scientist


It is 7 a.m. on a cloudy Monday morn- ing on the river Thames in West Lon- don. At the Imperial College Boat Club, the men’s rowing eight are about to take to the water in an unusual boat. The placement of rowers in a boat —


its “rig” — conventionally has the oars arranged alternately to the left and right. In this boat, however, the order is seemingly random: the first two to the left, the next four to the right and the fi- nal two to the left. The crew is testing a rig suggested by


John Barrow, a mathematical physicist at the University of Cambridge. Accord- ing to Barrow’s calculations, this con- figuration should outperform the stan-


dard rig in one very important way. So this morning’s paddle, at New Scien- tist’s suggestion, is a rough test of whether his calculations have the ring of truth. The force generated by an oar being pulled through water has been well studied by rowing coaches. Though the size and direction of this force varies throughout the stroke, it can always be resolved into two components: one that pushes the boat forward and another that pushes it to the side. Obviously, any sideways motion of the boat is wasted energy, and the ideal rig would elimi- nate this. But what should this rig be? This is just the kind of symmetry problem that mathematicians find irre- sistible, which is perhaps why it came


rowing continued on E6


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