Inhaled insulin, statins, flu, and the plague.

Health and medicine explained.
Oct. 3 2005 6:38 AM

Your Health This Month

Inhaled insulin, statins, flu, and the plague.

Statins revisited: They help after heart attacks, too.

State of the science: Statins, the medications that block the body's production of cholesterol, seem to have no end of valuable properties. Besides their usual job—cutting down coronary artery disease and heart attacks—they also appear to decrease the chance of getting certain kinds of cancer and strokes. Recent research, which examined more than 90,000 U.S. veterans, suggests that elderly patients taking statins are at decreased risk for broken bones. An even more striking finding emerged this month from research involving over 170,000 patients studied immediately after a heart attack. Conducted by Gregg C. Fonarow of UCLA's Division of Cardiology and his colleagues, the study makes a strong case that early use of statins following a heart attack substantially decreases the risk of death or serious complications.

Advertisement

Question: Interestingly, we really have no idea why these beneficial effects occur. The studies that uncovered them were following up on incidental observations in other studies or on rabbit and rat experiments that showed similar protections for animals at risk for heart attacks.

The flu vaccine: Not so good for the elderly.

State of the Science: The most recent outbreak of the avian flu (H5N1) in Indonesia has probably involved over 40 people, of whom six have died. Out of the six, perhaps two or three acquired the disease from infected people rather than birds. Sooner or later, it is likely that this virus will acquire the ability to infect human beings more efficiently. We need a vaccine. There's a problem, though: Recent research by Lone Simonsen and his colleagues at the National Institute of Allergy and Infectious Diseases casts some doubt on the protection that the current influenza vaccine gives to the elderly, who are most at risk of a bad outcome from flu.

Simonsen's group looked at mortality trends that could be attributed to an exceptionally virulent strain of human flu (H3N2) that emerged in 1968. If immunization helps prevent serious disease in elderly people infected with influenza, then the flu death rate should fall as the percentage of older people who are immunized rises. Simonsen's complex statistical modeling boils down to this finding: Even though immunization rates increased from 15 percent to 65 percent during the period under study, there was no substantial effect on influenza-related mortality.

Caveat: The authors of this study are careful to point out that their results are somewhat at odds with some earlier studies, which suggested greater value for elderly people who are immunized. As a doctor, I don't want to risk carrying flu to my patients, and I'm in the age range for which this shot has traditionally been recommended. So despite the serious questions raised by this study, I'm sure I will yet again take my flu shot this year. But it will not surprise me if future research shows that older people need a different vaccine than young adults—perhaps a more concentrated one.

Inhaled insulin: No more shots?

State of the Science: As all science-minded schoolchildren should know, in 1921 the Canadian scientists Frederick Banting, Charles Best, J.J.R. MacLeod, and J.B. Collip developed insulin, the first treatment for diabetes. Insulin was a miracle drug, capable of transforming an almost uniformly fatal disease into a survivable illness with good quality of life. But as any diabetic will tell you, its failing is that it must be injected. Other methods of giving insulin—oral administration, nasal sprays, others—have been tried, but none have worked.

TODAY IN SLATE

Doublex

Crying Rape

False rape accusations exist, and they are a serious problem.

Scotland Learns That Breaking Up a Country Is Hard to Do

Are You Attending the People’s Climate March? Nine Reasons You Should.

The Music Industry Is Ignoring Some of the Best Black Women Singing R&B

How Will You Carry Around Your Huge New iPhone? Apple Pants!

Medical Examiner

The Most Terrifying Thing About Ebola 

The disease threatens humanity by preying on humanity.

Television

The Other Huxtable Effect

Thirty years ago, The Cosby Show gave us one of TV’s great feminists.

There’s a Way to Keep Ex-Cons Out of Prison That Pays for Itself. Why Don’t More States Use It?

Colorado Is Ground Zero for the Fight Over Female Voters

Behold
Sept. 19 2014 11:33 AM An Up-Close Look at the U.S.–Mexico Border
  News & Politics
Foreigners
Sept. 19 2014 1:56 PM Scotland’s Attack on the Status Quo Expect more political earthquakes across Europe.
  Business
Moneybox
Sept. 19 2014 12:09 PM How Accelerators Have Changed Startup Funding
  Life
Inside Higher Ed
Sept. 19 2014 1:34 PM Empty Seats, Fewer Donors? College football isn’t attracting the audience it used to.
  Double X
The XX Factor
Sept. 19 2014 1:11 PM Why Men Never Remember Anything
  Slate Plus
Slate Picks
Sept. 19 2014 12:00 PM What Happened at Slate This Week? The Slatest editor tells us to read well-informed skepticism, media criticism, and more.
  Arts
Brow Beat
Sept. 19 2014 1:39 PM Shonda Rhimes Is Not an “Angry Black Woman,” New York Times. Neither Are Her Characters.
  Technology
Future Tense
Sept. 19 2014 12:38 PM Forward, March! Nine leading climate scientists urge you to attend the People’s Climate March.
  Health & Science
Medical Examiner
Sept. 19 2014 12:13 PM The Most Terrifying Thing About Ebola  The disease threatens humanity by preying on humanity.
  Sports
Sports Nut
Sept. 18 2014 11:42 AM Grandmaster Clash One of the most amazing feats in chess history just happened, and no one noticed.