Tilefish, which has a particularly high average mercury content

“Pregnant women who eat a lot of seafood have smarter babies than moms who don’t.” That short sentence contradicts a good deal of received wisdom. For decades, concerns about mercury levels in fish have convinced millions of women to avoid seafood while they’re pregnant. But a study published in the “Lancet” (a British medical journal) in 2007 suggests otherwise.

The results of the study were shocking: of 14,541 babies born near Bristol, England, those whose mothers ate “more than 340 grams of seafood a week” had kids with significantly higher I.Q.’s. (The test was performed on women who were pregnant in the early nineties, and the childrens’ I.Q.’s were tested over a decade later.) This contradicted the results of an earlier test: in the early 1980′s, a Danish scientist suggested that mercury levels might affect their babies’ attention spans.

What other food warnings would you like to see reconsidered? Does MSG really cause headaches? Do people who are lactose intolerant really need to avoid cheese?? Are “carbs” really worse for your figure than fats??? We eagerly await the next round of studies!

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Constant fatigue. Missed parties. Postponed exams. Precipitously falling grades. Feeling “out of the loop” with your friends. And isolation. These are a few of the ways that the scourge of high school and college students, known as “mono” or the “kissing disease,” can put a major damper on your (social) life.

Mono is called the kissing disease for two key reasons- it is transmitted through saliva and mucus and is most common in people 10 to 35 years old (with its peak incidence occurring in the 15 to 17 years old demographic). While only 50 people out of 100,000 of the general population contracts mono each year, the infection strikes as many as 2 out of 1,000 teens and twenty-somethings, especially those in high school, college, and the military. While mono is not usually considered a serious illness, it can take (what feels like) forever for an infected individual to fully recover from a bout with the infection.

Especially in adolescents and young adults, the disease is characterized by extreme and persistent fatigue, fever and sore throat along with several other possible signs and symptoms. It is primarily diagnosed by observation of symptoms, but suspicion can be confirmed by several diagnostic tests.

Caused by the Epstein-Barr virus (EBV), a member of the much-loved herpes virus family, mono has a long incubation period (30 to 50 days from the time you’re exposed to the virus) before an infected person begins to manifest symptoms. Of course, this increases the likelihood that an infected person will unwittingly spread the virus to others. I shudder to think about the collateral damage potential posed by one unknowingly infected teen and a basement game of spin the bottle.

Mono can be transmitted in other ways, such as sipping from the same straw or glass as an infected person — or even being close when the person coughs or sneezes. Most depressingly, some people remain infectious for up to a year after contracting the virus. This represents a literal kiss of death for the responsible and unattached young person, who must put a halt to all steamy make-out sessions until they get the green light from their doctor. For the teen and twenty-something set, that is easier said than done….

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Choice-supported bias is the tendency to give positive qualities to an option we’ve chosen, simply because we’ve chosen it. It is an example of cognitive dissonance, a psychological theory that describes the uncomfortable feeling caused by holding two contradictory ideas simultaneously. Cognitive dissonance theory holds that people have a motivational drive to reduce psychological dissonance by changing their attitudes, beliefs, and behaviors, or by justifying or rationalizing them. “Dissonance” occurs when a person perceives a logical inconsistency in their beliefs, which compels them to minimize the discrepancy through a variety of ego defense mechanisms, such as choice-supported bias.

Choice-supported bias describes the human tendency to believe that one’s past decisions were better than they actually were. People adopt a smug attitude about their choices for a number of reasons, all of which defend the ego against the threat of regret. When we make a choice, it becomes a part of our identity and is incorporated into our self image. Upon recalling a past decision, people often distort their memories to make their choices appear superior to the alternatives that existed at the time. As a result, we can rest on our laurels and feel positive about ourselves and have less regret for bad decisions. This might explain why older people tend more towards this bias than younger individuals.

Choice-supported bias is facilitated by the following three factors:

1. We can only know the details of the choices we have made. Thus, potential alternative outcomes remain abstract or distant in our mind and therefore ripe for self-serving manipulation.

2. The “it’s too late anyway” line of reasoning. This occurs when an individual quells their thoughts about past alternatives by telling themselves “it’s too late anyway”.

3. It supports our belief that we learn and grow from the choices they have made. Thus, we can self-soothe our fragile psyches by telling ourselves that our past decisions made us wiser. However, this line of reasoning fails to account for the fact that we are only learning from the choices we have made and not from the choices we didn’t make. Just because a choice led to a good outcome doesn’t mean that the other one wouldn’t have led to an equal or better one.

However, it would be wrong to conclude that choice-supported bias is an entirely negative phenomenon. Like all ego defensive strategies, it can help people better focus on the here and now by staving off fruitless and crippling regret about the past.

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Accutane (also known as Isotretinoin) is a potent medication used to treat moderate to severe acne, and has proven to be remarkably effective in improving even the worst breakouts (take my word for it- I have seen it perform miracles). However, because of its host of prohibitive side effects, dermatologists tend to only prescribe it as a drug of last resort.

On the milder end of the side effects spectrum, a person beginning a course of Accutane can expect to experience a nasty acne flare-up (coupled with EXTREME dryness of the skin, hair, lips and mucous membranes) in the first 1-3 months that they are taking the drug. Having witnessed this acne flare-up/dryness combo firsthand, I will put it bluntly: Accutane will (temporarily) make you look like you have a horrendous flesh-eating disease. However, once you have suffered this trial by fire, your skin will positively glow with radiance- it is truly astonishing to behold.

On the serious side, Accutane is a teratogen and is highly likely to cause birth defects if taken during pregnancy. A few of the more common birth defects that this drug has caused include: hearing and visual impairment; missing or malformed earlobes; facial dysmorphism; cleft palates; and mental retardation. In the U.S. more than 2,000 women have become pregnant while taking the drug between 1982 and 2003, with most pregnancies ending in abortion or miscarriage. However, about 160 babies with birth defects were born.

Consequently, the mandatory iPLEDGE program was enacted in 2005, the largest and arguably most complex risk-management program ever undertaken by the FDA in an attempt to ensure that female patients do not become pregnant while taking Accutane. As of March 2006, only prescribers registered and activated in iPLEDGE are able to prescribe it, and only patients registered and qualified in iPLEDGE will be able to have the drug dispensed to them. Inexplicably, men must also register for the iPLEDGE program. Well, at least they aren’t required to take a pregnancy test….

In addition, female patients cannot obtain or fill their first prescription unless they undergo an initial screening and two negative blood or urine pregnancy tests with documented results verified by the prescriber and entered into the iPLEDGE password-protected system. Female patients also must pledge to use two forms of contraception for one month before, during, and after completing Accutane therapy. Each month thereafter, the patient must have a negative pregnancy test result, and this result as well as verification of the two methods of contraception being used must entered by the prescriber into the iPLEDGE system.

Unsurprisingly, dermatologists are not iPLEDGE’s biggest fans. Most complain that it is inordinately onerous, structurally flawed and poorly organized. The net effect, say dermatologists, is a bottleneck in office operations, delays in patient care, and, ultimately, barriers to delivery of a drug that has proved the only effective therapy for many patients with severe, recalcitrant acne.

Only time will tell whether the iPLEDGE campaign will successfully deter pregnancy amongst Accutane users. However, the FDA cannot be accused of not giving it the old college try….

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Gender identity disorder (GID) is the formal diagnosis used by mental health professionals to describe persons who experience significant gender dysphoria (discontent with the biological sex they were born with). It is a psychiatric classification and describes the attributes related to transsexuality, transgender identity and transvestism. In the United States, the American Psychiatric Association permits a diagnosis of gender identity disorder if four diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, 4thEdition, Text-Revised (DSM-IV-TR) are met.

The criteria for GID are: Long-standing and strong identification with another gender; Long-standing disquiet about the sex assigned or a sense of incongruity in the gender-assigned role of that sex; The diagnosis is not made if the individual also has physical intersex characteristics; and Significant clinical discomfort or impairment at work, social situations, or other important life areas.

Many transgender people and researchers have criticized the classification of GID as a mental disorder for several reasons, including evidence from recent studies about the brains of transsexual people. The treatment for this disorder consists primarily of physical modifications to bring the body into harmony with one’s perception of mental (psychological, emotional) gender identity, rather than vice versa. But critics of GID argue that gender variations are normal occurrences in nature, not a mental disorder. A recently published paper in the International Journal of Transgenderism stated that, of the international organizations surveyed whose concern is the welfare of transgender people, 56 percent felt that the diagnosis should be excluded from the next version of the DSM.

So why not remove it from the DSM? In the survey, the primary reason cited was that, without the diagnosis, transgender health care would not be covered by insurance reimbursement in most countries. Most except the United States, of course, where transgender care is generally not covered by health insurance, diagnosis or not. Thus, many transgender people who are lobbying to get their health insurance companies to help them defray the cost of extremely expensive sex reassignment surgeries. Thus, transgender people truly find themselves caught between principle and pragmatism.

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Persistent or recurrent pain experienced before, during or after sexual intercourse is known as dyspareunia. Although this problem can affect men, it disproportionately affects women. The symptom is reported almost exclusively by women, although the problem can also occur in men. Women with dyspareunia experience varying degrees of pain and discomfort in the vagina, clitoris or labia during intercourse. Dyspareunia can be triggered by numerous physical and psychological causes, many of which are treatable. Despite the fact that it is rarely discussed in polite circles, dyspareunia is a common condition that affects up to one-fifth of women at some point in their lives.

A medical evaluation of dyspareunia focuses initially on physical causes, which must be ruled out before psychogenic or emotional causes are entertained. In the majority of instances of dyspareunia, there is an original physical cause. Vaginal pain may be associated with a range of physical factors, including: insufficient lubrication; injury, trauma or irritation; inflammation, infection or skin disorder; and side effects to birth control products; vaginusmus (involuntary spasms of the muscles of the vaginal wall); and vestibulitis (unexplained stinging or burning around the opening of your vagina).

Sometimes, it can be difficult to tell whether psychological factors are associated with dyspareunia. Initial pain can lead to fear of recurring pain, making it difficult to relax, which can lead to more pain. Thus, in virtually all cases of dyspareunia, psychological factors are implicated either directly (as the cause) or indirectly (as a concomitant of the sexual discomfort). Psychological assessment must include a complete developmental history, with particular attention to the sexual values and messages of the client’s immediate family and their religious persuasion and beliefs, as well as a careful psychosexual history. Often, poor self-esteem and body image are implicated, and the dyspareunic patient often has a history of overt or subtle sexual abuse. In these cases, individual and couples counseling are indicated.

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Like most Diseases of Affluence, obesity is the result of the interplay between genetic and environmental factors. Polymorphisms in various genes controlling appetite and metabolism predispose to obesity when sufficient calories are present. As of 2006 more than 41 of these sites have been linked to the development of obesity when a favorable environment is present. The percentage of obesity that can be attributed to genetics varies, depending on the population examined.

Strangely, obesity rates vary considerably in the United States amongst different ethnic groups, which many social scientists attribute to institutionalized socioeconomic oppression of certain minority groups (such as African-Americans and Latinos), who can only afford cheap, heavily processed and pre-packaged food high in fat and calories. However, while socio-economic conditions undoubtedly play a role in rising obesity rates, many scientists believe that poverty doesn’t account for the whole story.

A hotly contested alternative theory purporting to explain obesity amongst certain ethnic groups thrifty gene hypothesis postulates that certain ethnic groups may be more prone to obesity in an equivalent environment. Their ability to take advantage of rare periods of abundance by storing energy as fat would be advantageous during times of varying food availability, and individuals with greater adipose reserves would be more likely survive famine. This tendency to store fat, however, would be maladaptive in societies with stable food supplies.

Some experts don’t agree entirely with the “thrifty gene” theory – saying that poverty, stress due to racism, and poor nutrition (especially during pregnancy) also result in children being born predisposed to diabetes. Most experts agree that genetics alone does not determine the risk factor of obesity; but research does suggest that “thrifty genes” predispose people to hold on to food (sugars), making them more likely to develop type II diabetes. It is also common for indigenous groups to be poorer and have less access to healthy foods than the general population, so it is difficult to separate genetic from environmental factors.

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