"The Book of Woe" is an account of the compiling of the fifth edition of the "Diagnostic and Statistical Manual of Mental Disorders." The DSM was first published in 1952, and in the years since it has been subject to epochal revisions in which the foundations of the mental health professions have been reconceived and revamped. The DSM-5, plans for which were begun as early as 1999, is set to be published this month. The process of assembling it has been anything but smooth, as "The Book of Woe" relates.

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The Geneva memorial honours the physician as warrior in the eradication of smallpox. On a Pfizer campus in Pennsylvania, a twin statue tells a different story, positioning Big Pharma as the hero. Neither monument, however, recalls the many casualties of smallpox, and this says a great deal about what we choose to remember.

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But don't worry, Wall Street. Pharma isn't going to deliver disappointing earnings just because it has little or no new drugs coming online and has failed at the very reason for its existence. Here are six new Pharma marketing initiatives that are guaranteed to keep investor expectations high along with our insurance premiums. The secret? Recycling old and discredited drugs and marketing diseases to sell the few new ones.

1) Repurposing Ritalin

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Do you believe there is such a thing as a "quarter-life crisis"? I'm turning 25 next week, but I am so sick of waiting for my life to begin.

OK, background story: I decided very early in high school I wanted to be a nurse. I loved the idea of traveling and thought that nursing could translate across borders. So the life plan was simple: graduate from nursing school with a BSN, work two years as a staff nurse on a general medicine floor to get experience, then work abroad for Doctors Without Borders, return home and go to graduate school for my nurse practitioner degree, get married ... (you get the trend).

Well, Phases 1 and 2 have been accomplished. I'm currently working as a staff nurse at a busy city hospital and in September 2013 I'll have been working there for exactly two years. So September is the big month, time for me to move on, do something or go somewhere new.

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Only now are these nurses beginning to come to grips with what they endured — and are still enduring as they continue to care for survivors. They are angry, sad and tired. A few confess they would have trouble caring for the surviving suspect, 19-year-old Dzhokhar Tsarnaev, if he were at their hospital and they were assigned his room.

And they are thankful. They tick off the list of their hospital colleagues for praise: from the security officers who guarded the doors to the ER crews who mopped up trails of blood. The doctors and — especially — the other nurses.

Nurses from Massachusetts General Hospital, which treated 22 of the 187 victims the first day, candidly recounted their experiences in interviews with The Associated Press. Here are their memories:

THEY WERE SCREAMING

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It had the dosages, the time of day each should be taken and a check mark when her folks, who live 10 miles away, assured her the pills had been swallowed.

"I work full time so it was very challenging," said D'Auria, 63, of West Nyack.

Now she has an app for that. With a tap or two on her iPhone, D'Auria can access a "pillbox" program that keeps it all organized for her and other relatives who share in the caregiving and subscribe to the app.

"I love the feature that others can see this," D'Auria said. "I'm usually the one who takes care of this, but if I get stuck, they're all up to date."

From GPS devices and computer programs that help relatives track a wandering Alzheimer's patient to iPad apps that help an autistic child communicate, a growing number of tools for the smartphone, the tablet and the laptop are catering to beleaguered caregivers. With the baby boom generation getting older, the market for such technology is expected to increase.

The pillbox program is just one feature of a $3.99 app called Balance that was launched last month by the National Alzheimer Center, a division of the Hebrew Home at Riverdale in the Bronx.

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Researchers surveyed 196 parents of children 18 months or younger in a Seattle county with vaccination rates below the national average: 126 of these parents followed the national recommendations on childhood-vaccination from the U.S. Centers for Disease Control and Prevention (CDC), while 70 delayed vaccination, partially vaccinated or didn't vaccinate their child at all.

While both were informed by friends and family, peer influence in the vaccination "naysayer" group was a much bigger factor than in vaccine "conforming" circles, researchers found. Advice from social networks "blew any other variable out of the water” for vaccine doubters, Emily Brunson, who conducted the research as an anthropology graduate student at the University of Washington, told Time magazine. It “was more important in terms of predicting what parents decide to do than any other factor, including parents’ own opinions," she added.

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“Before 2010, we were buying the most expensive ARVs in the world. Now we are a country where the ARVs are the cheapest in the world... It means we can increase the number of people on treatment,” Motsoaledi said.

As reported by Agence France-Presse:

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Levitt published thirty-four papers on flatus. He identified the three sulfur gases responsible for flatus odor. He showed that it is mainly trapped methane gas, not dietary fiber or fat, that makes the floater float. Most memorably, to this mind anyway, he invented the flatus-trapping Mylar “pantaloon.”

“Even now,” he says of his flatus work, “it overshadows everything else I do.” Levitt and I are sitting in a conference room upstairs from his lab at the Minneapolis VA Medical Center. Levitt has a goofy, lopsided smile and a pale complexion. I couldn’t recall, while writing this, whether his hair was gray, so I typed his identifiers into Google Images. A photograph of a can of baked beans came up.

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The test detects proteins in the blood that have been strongly linked with the degenerative disease, such as amyloid and APOE. Most notably, researchers say, proteins related to inflammation seem to be suggestive of the disease and have added to the promise of the test.

The University of Nottingham is now developing a test to perform in clinics, but it could be a decade before its ready to be used on patients.

"Our findings are exciting because they show that it is technically possible to distinguish between healthy people and those with Alzheimer's using a blood test. As blood tests are a fast and easy way of aiding diagnosis, we are really encouraged by these findings and the potential they hold for the future," Kevin Morgan, a professor at University of Nottingham involved in the study, told the BBC.

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Via Reuters:

The child's story is the first account of an infant achieving a so-called functional cure, a rare event in which a person achieves remission without the need for drugs and standard blood tests show no signs that the virus is making copies of itself.

More testing needs to be done to see if the treatment would have the same effect on other children, but the results could change the way high-risk babies are treated and possibly lead to a cure for children with HIV, the virus that causes AIDS.

The only other well-documented case of a cure in the world involved a middle-aged man with leukemia who received a bone-marrow transplant from a donor genetically resistant to HIV infection. The so-called Berlin patient, Timothy Brown, went through a costly and elaborate treatment (which also involved the destruction of his immune system). The Mississippi baby, by contrast, was treated with a cocktail of widely available drugs already used to treat HIV infection in infants.

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Take one case detailed to medical sociologist Lori Freedman by the doctor involved. A woman 16 weeks pregnant with twins was diagnosed with a molar pregnancy, which can lead to cancer, and "didn't want to carry the pregnancy further." She went to the hospital with vaginal bleeding, but unluckily for her, it was a Catholic one. There, the ethics committee decided that a uterine evacuation was tantamount to abortion, because there was a slim chance one of the fetuses would survive.

According to another doctor who witnessed the situation, "The clergy who made the decision Googled molar pregnancy."

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The shortage of the Johnson & Johnson injectable medication, made under contract by Ben Venue Laboratories, has continued on and off for a few years. It's resulted in rationing, with some patients with ovarian and other cancers getting less-effective care, and disrupted studies testing Doxil against possible new treatments.

The Food and Drug Administration says it's approved a generic version, called doxorubicin, made by Sun Pharma Global FZE. Last February, the FDA authorized temporary importation from India of a brand-name version, called Lipodox, also made by Sun Pharma. It's a subsidiary of an Indian drugmaker.

Meanwhile, J&J continues to seek a contract manufacturer to replace Ben Venue.

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Smartphones, like Swiss Army knives and SkyMall watches, have a few nifty features and plenty of useless ones. Who needs a checkbook when you’ve got Square, a toolkit when you’ve got iHandy Level, or a baby sitter when you’ve got Fruit Ninja? Encyclopedias, gazetteers, even boredom itself now seems obsolete.

Are dermatologists next? A slew of skin cancer-detection apps — with names like SkinVision, SpotCheck, and Mole Detective 2 — allow smartphone users to photograph and “analyze” their worrisome blemishes, offering diagnoses such as “problematic,” “high risk,” and “looks okay.” The free or low-cost apps base their findings on algorithms, rather than human expertise, and return results instantly. “Costs far less than an insurance copay, won’t leave a scar, and may save your life!” promises one advertisement. “The survival rate of melanoma is a dismal 15% at stage four,” warns another.

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My spouse refuses to see the doctor!

I am very worried and frustrated about my spouse's health. But every time I bring up seeing a doctor or getting help or anything he gets defensive and angry and tells me I'm bitching at him or patronizes me by saying it's not a big deal or he'll consider what I'm saying. But he never does. I have been with him for 13 years, we have two young children, ages 7 and 3, and I told him that I thought it was selfish and inconsiderate of him not to think about how we would feel if we lost him. This only upset him and he has shut down in speaking about it now.

Reason for my concern is legitimate. He smokes three to four packs a day, he has high blood pressure (he always has and the only reason I know this is I made him go to the E.R. twice in our relationship and both times, high blood pressure) and he is a heavy drinker. He's recently not as bad as he used to be; he was a raging alcoholic for about eight years and now is at about three to four glasses of vodka or mixed drinks a day. On weekends it's more. 

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A new report in the Annals of Oncology this week reveals that in two thirds of breast cancer studies, side effects were downplayed – including serious ones. And, as Reuters reports, it's a field-wide problem in the health care industry: Last fall, cardiology journal editors warned authors to "watch their language" in reporting, and pediatrics researchers warned of "spin and boasting" in their journals.

Aside from the ethical issues of publishing misleading information, the habit of rushing to make it all seem better has serious consequences. Because the sunnyside talk doesn't stop at the journals. It trickles over to doctors, who then minimize what a patient's real experience is going to be like.

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The law, however, has done more to inconvenience chronic cold sufferers than curb methamphetamine abuse. Regulating pseudoephedrine didn’t end meth production. It simply changed the game. So long as Americans are willing to take drugs to improve performance in an increasingly exhausting work culture, those without access to legal amphetamines like Adderall will use what is available. Just as some college kids take Adderall to study, some Americans who don't have access to psychiatrists will use meth to increase productivity.

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I’ve thought about that question many times in the years since then, and my answer today is an even more resonant, “Yes.” It isn't that I'm so eager to die, but I can't help thinking about how destructive our fear of death is -- how it compels us to live, even when "living" may be little more than breathing; how we have made living, just to be alive, the unqualified objective. For me, that’s quite simply not enough. No, that’s not right. It isn’t “simple” at all. But I do have a concrete plan to end my life when I decide it’s time – and the tools to implement it. Will I have the courage to do it?

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