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INFORMATION TECHNOLOGY MALFUNCTIONS AT VETERAN’S MEDICAL CENTERS
The VA medical centers have been pioneers at adopting electronic medical record systems, which they began using 10 years ago. They use one of the most robust and well-tested systems available. A recent software update in August of 2008 demostrates how vulnerable these systems are to creating medical errors.
After the “upgrade”, records began to scramble together, displaying one patient’s records with another patient’s name. In addition, physician orders to stop medications were not displayed as they formerly were, resulting in some patients receiving drugs that had been discontinued.
Although advocates of computerized records promote them as a means to reduce medical error, different errors are created with programming, data entry problems, operator error, and software and hardware malfunctions. Bland assurances that the 20 billion dollars the U.S. will spend on computerization will magically correct widespread problems with our medical system are not supported by reality. (JAMA March 4, 2009 p. 919)
GRAPEFRUIT FLAVONOID BLOCKS VIRUS REPLICATION
Naringin, a bitter component of grapefruit and some other citrus fruit, metabolizes in the body into naringenin. This substance has been found to lower cholesterol by 17% in human trials (Clin Nutr. 2003;22(6): 561-568) Because hepatitis C is bound to very low density lipoprotein, researchers wondered if naringenin would also inhibit the release of viral particles from cells. If so, the viral life cycle might be interrupted.
In a preliminary study of liver cells, the grapefruit derived compound indeed seems to inhibit viral release, suggesting that hepatitis C might be controlled by a combination of grapefruit flavonoids and antiviral drugs. (Nahmias Y.,et.al. Hepatology doi:10.1002./hep.2297 Jan 7, 2008)
BEWARE HENNA TATTOOS
Black henna tattoos, widely used in Asia and the Middle East, may give rise to contact dermatitis and even the potential for lifelong reactions. Black henna contains the dye phenylenediamine (PPD), which is added in high concentrations to darken henna and to speed up drying time. When PPD is used in hair dyes it normally requires a warning about possible skin irritation.
It is also suggested that PPD can induce cross-allergy leaving people with potentially lifelong reaction to local anesthetics, sunscreen, cosmetics and black-dyed clothing. (Onder M. Temporary holiday "tattoos" may cause lifelong allergic contact dermatitis when henna is mixed with PPD. Australasian Journal of Dermatology 2000; 41: 168-71)
MORE BAD NEWS FOR PREMARIN®
A new study has found that estrogen-only hormone pills increase the risk of women developing blood clots (mostly in the legs) but not as much as estrogen-progestin pills which have been linked to a doubling of the risk of blood clots, as well as increased risk of heart attack and breast cancer in 2002.
In a study of nearly 11,000 women aged 50 to 79 with hysterectomies, those who took estrogen only pills were found to be 32% more likely to develop blood clots compared to placebo. Women who had previously suffered blood clots were at the highest risk. This data reflects use of horse derived estrogens and synthetic progesterone and may not apply to women who take bioidentical hormones. (Curb JD et al. Venous Thrombosis and Conjugated Equine Estrogen in Women Without a Uterus. Arch Intern Med. 2006;166:772-780)
HYPE AND HERCEPTIN: WHY CAN’T PEOPLE (AND THE MEDIA) TELL THE TRUTH?
In 2005, the New England Journal of Medicine published a study that suggested that herceptin would reduce the recurrence of certain cancers. The media and the medical establishment were quick to exaggerate the results: “Breast Cancer Recurrence Cut in Half” claimed The New York Times on April 26, 2005; “Docs See Huge Gain Vs. Breast Cancer” announced the New York Daily News October 20, 2005.
Jo Anne Zujewsky of the National Cancer Institute gushed, “In 1991, I didn’t know… we would cure breast cancer… in 2005, I’m convinced we have.” Gabriel Hortobagyi of the MD Anderson Cancer center stated “This observation suggests a dramatic and perhaps permanent perturbation of the natural history of the disease, and may even be a cure.”
But when the results are analyzed truthfully, it is evident that the use of herceptin in the NEJM study reduced breast cancer related death by a very modest 0.6 per cent. It is possible that this difference is due to chance alone, suggesting that adding Herceptin to chemotherapy confers no meaningful survival advantage.
In addition, Herceptin produces heart damage in 4.1 per cent of early stage breast cancer patients. Hortobayi was a paid consultant to Genentech, Herceptin’s US distributor. (New Scientist March 4, 2006 p. 22)
ANTI-ARTHRITIS ANT EXTRACT
Chinese scientists have analyzed extracts from a species of Chinese medicinal ant (Polyrhacis lamellidens) traditionally used to treat rheumatoid arthritis.
The researchers identified two new polyketides in the extracts, compounds which have previously been found in plants, fungi and bacteria and which have shown promise in other studies for fighting arthritis, bacterial infections, and a variety of other diseases. (Bicyclic polyketide lactones from Chinese medicinal ants, Polyrhacis lamellidens. J Nat Prod. 2008 Apr;71(4):724-7. Epub 2008 Feb 26)
HERB EXTRACTS INCREASE EFFECT OF CHEMOTHERAPY DRUGS
Extracts of two herbs used in Ayurvedic medicine have been shown to be selectively cytotoxic against human cancer cells. Phyllanthus emblica (bahera - emblic myrobalan or Indian gooseberry) and Terminalia bellerica (amla - belliric myrobalan) extracts also increased the growth inhibitory effects of the chemotherapeutic drugs doxorubicin and cisplatin on lung and liver cancer cell lines.
This means that the drugs, which have harmful side effects, can be administered at lower doses, thus minimizing their systemic cytotoxicity while enhancing therapeutic efficacy. (Synergistic growth inhibitory effects of Phyllanthus emblica and Terminalia bellerica extracts with conventional cytotoxic agents: doxorubicin and cisplatin against human hepatocellular carcinoma and lung cancer cells. World J Gastroenterol. 2008 Mar 14;14(10):1491-7)
The fact that the USA (with about 4% of the world’s population) consumes around 30% of the world’s resources is showing in the shocking rise in US obesity, revealed to be even greater than thought due to poor data collection. Figures have mostly been compiled by telephone interviews in which women often understate their weight and men overstate their height, thus skewing body mass index statistics by up to 50%.
If figures are taken from the more accurate (face-to-face weighing and measuring) 2002 National Health and Nutrition Examination Survey, 28.7% of adult American men and 34.5% of women are now clinically obese. This shows a rise from 16% and 21.5% in 1988.
Since the obesity statistics do not include people who are classified as just overweight, the overall extend of weight related problems is even higher. “These are the first unbiased estimates of trends in the obesity in the US states and the results are staggering,” said lead researcher Majid Ezzati. (Ezzati M et al. Trends in national and state-level obesity in the USA after correction for self-report bias: analysis of health surveys. J. R. Soc. Med. 2006 99: 250-257)
THE IMPORTANCE OF GUM HEALTH
There is mounting evidence that gum and mouth disease is associated with more widespread disease in the body, according to speakers at a conference sponsored by the American Dental Association and the American Medical Association.
Over 80% of Americans suffer some form of periodontal disease, mostly gingivitis. It is thought that oral disease can trigger other disorders, either because oral bacteria enter the bloodstream causing inflammation of other body tissue, or because oral infections trigger an inflammatory immune response.
Research presented at the conference indicated an association between moderate to serious dental disease and premature delivery (at least double the risk). Untreated periodontal disease may also exacerbate diabetes and cardiovascular disease. (Feb. 23, 2006, presentations, Oral and Systemic Health; Exploring the Connection)
NEUROPATHY FROM DENTURE CREAM
Excessive zinc intake can cause a copper deficiency, resulting in severe neurologic symptoms as well as skin rash, anemia and immune system disorders. Neurologists have studied four patients who developed nerve disorders as a result of using denture cream, which contains high levels of zinc.
Zinc concentrations ranging from 17,000 to 34,000 µg/g were identified in Fixodent and Poli-Grip denture creams. Serum zinc levels improved in three patients following cessation of denture cream use. Copper supplementation resulted in mild neurologic improvement in two patients who also stopped using denture cream. (http://www.neurology.org/cgi/content/abstract/71/9/639)
RISE IN PRETERM BIRTHS
Research carried out in Denmark discovered a 22% rise in preterm deliveries between 1995 and 2004, with a 51% increase among low risk women. Assisted conceptions, multiple pregnancies and elective deliveries also increased during this time and were associated with early birth.
Preterm deliveries account for three quarters of neonatal deaths and most neonatal intensive care admissions, whilst one in four early babies (born before 25 weeks) may suffer physical or mental disabilities. The reasons for the preterm births are not known but may include smoking, early and late life pregnancies, sexually transmitted diseases and obesity, as well as earlier ultrasound for dating and screening. (Langhoff-Roos J et al. Spontaneous preterm delivery in primiparous women at low risk in Denmark: population based study. BMJ 2006 332: 937-939)
MUSHROOM HELPS COUNTER CANCER
Phellinus linteus, a mushroom used in Asian medicine (Sang-Hwang in Korean) can boost the effects of chemotherapy in destroying prostate cancer cells. The rare mushroom grows on mulberry trees in the wild and nowadays is cultivated. (Phellinus linteus sensitizes apoptosis induced by doxorubicin in prostate cancer. British Journal of Cancer 95, 282_288)
GINSENG & CANCER
A study of nearly 1,500 breast cancer patients in Shanghai found that having taken ginseng regularly before their diagnosis resulted in a significantly reduced chance of dying from the cancer or other causes, and that taking it before and after diagnosis was associated with improved quality of life.
The researchers conclude that regular use of ginseng at 1.3 grams per day may bring significant benefits for cancer patients. (Association of Ginseng Use with Survival and Quality of Life among Breast Cancer Patients. The American Journal of Epidemiology, Vol. 163, April 1, 2006, pp. 645-53)
"Is Anyone Thinking?" Department
100 YEARS OF SUBSERVIENCE
“If you love wealth more than liberty, the tranquility of servitude better than the animating contest of freedom, depart from us in peace. We ask not your counsel nor your arms. Crouch down and lick the hand that feeds you. May your chains rest lightly upon you and may posterity forget that you were our countrymen.”—Samuel Adams
The editorial below, from the May 5th, 1906 edition of the Journal of the American Medical Association, reveals how long physicians have tolerated the dictates of a controlled market.
Apologists for industrialized medicine often cite the “failure of the free market” when they propose centralized controls of medical thought and action, but this is a canard (a deliberately misleading fabrication).
The consolidation of economic power by a small number of government favored fat cats is responsible for the continued failure of our medical system to meet the needs of patients and practitioners, and its establishment stretches back farther than most realize.
Under the guise of “reform”, another monumental power grab by the greedy is in process.
LIFE INSURANCE EXAMINATION FEES
"Whether it is because gold has depreciated in value, owing to the increase in its production, or whether it is because of good times resulting from good crops and other good things that tend to prosperity, we do not know, and it does not matter; but, whatever the cause, the prices of all the necessities and luxuries of life—except a few articles whose cost of production has lessened by improved machinery—have enormously increased during the last few years.
This is common knowledge. Likewise it is well known that the shoemaker, the bricklayer, the carpenter and artisans of all kinds, as well as the hod-carrier and the day laborer, are receiving from 25 to 100 per cent. higher wages than they did ten or fifteen years ago.
The lawyer is not hesitating to charge for preparing a brief double what he charged ten years ago—and he gets it. Even the preachers' salaries are better than they used to be. The doctor is the only breadwinner whose fees have remained stationary.
Where fifty cents for office consultation and a dollar for a visit were the average fees, say, fifteen years ago, the same high remuneration still prevails. This is especially true in smaller towns. In the larger cities the better men and the specialists have not hesitated to charge more as the incomes of their patients increased, but the fees of the average practitioners remain the same.
Of course, no one is to blame but those who have been contented to put up with these absurd conditions; it is the doctor's, and not the patient's, fault. It is the same old story; if we do not look after our own interests we can not expect others to do it for us.
Our object now, however, is not to discuss the fee question in its general aspects, important though this question is, but to call attention to the subject as it relates to the examination for life insurance. As many of our readers know to their cost, some old-line companies have recently cut their fees from $5.00 to $3.00, and this without consulting those who did the work—at least not until after the cut had been made.
And then the majority of those to whom the new terms were tendered meekly submitted. But what else could they do? They reasoned, undoubtedly, that if they refused to submit some other physician in the same town would accept, and, therefore, that it was better to have the reduced fee than none at all.
But did they reason rightly when that reasoning forced them to the conclusion that another physician would take the pittance they were offered if they did not? This is the question to be considered. In the past, when the medical profession was poorly organized, probably they would have been right. Then each physician organization and thus are in a position unitedly to demand their rights—justice.
From the fact that these companies moved in the matter at the same time, took exactly the same action, and even used the same verbiage in their circular letters in some instances, it looks very much as though they were united and acted in conformity with a plan mutually agreed on.
These wealthy organizations, without consulting those directly interested, said to their medical examiners – “We have reduced your fees 40 per cent.; accept this reduction or we will get some other physician to examine for us."
They thought their proposition would be accepted, and we regret to say that they were right in too many instances.
The question arises: Are we now sufficiently united to resist successfully such arbitrary dictation on the part of a combination of wealthy corporations, or shall we continue to submit and to take the pittance that is offered?
We certainly believe that we are sufficiently united; at least in most localities, and that we should not submit. As we have recorded from week to week in our news columns, several county societies have already taken action and have refused to accept this new rate.
In some instances, every physician in the county has signed an agreement not to examine for the old-line companies for less than the fee received in the past. As one put it, "If we accept this 40 per cent. reduction now, how soon will there be another similar cut?"
We publish in our "Correspondence" columns a protest and a plea on this subject from Dr. J. N. McCormack. Having traveled over the country and having come in close touch with the medical profession, he knows the conditions and the sentiments of the profession, and he believed that a united resistance should be made everywhere.
From the numerous letters we have received we believe that he is right and that action should be taken immediately in every county society in the country.
While we are giving attention to the question as it relates to old-line companies, we should not forget that the prevailing conditions as they relate to the industrial companies and fraternal insurance orders are still worse, one dollar and even less being the usual examination fee for this work.
It is absurd, and a reflection on the good common sense of the members of our profession, that we should have put up with this for so long, and, while we are discussing the question as it relates to the old—line companies, let us not forget to take in the industrial and fraternal phase of the question.
The time has come to act."