News News News
THOSE WHO FORGET THE PAST ARE CONDEMNED TO REPEAT IT
When Medicare was first proposed back in 1966, the projection was for inflation-adjusted annual costs to rise to $12 billion by 1990. The actual cost in 1990 was $107 billion. Anyone who believes the lies we are hearing about how a centralized medical bureaucracy will save money and improve care should study the history of every system that has been proposed to “improve” the age old relationship between physicians and patients.
In every case, the motivation has been to co-opt the economic value of medical treatment and hijack it for the benefit of government favored fat cats. History repeats itself with the present efforts to completely socialize our medical system. A truly bad system is about to become much worse.
The difference today is that we are dealing with probable multi-trillion-dollar miscalculations of the cost for “reform”. In the midst of the worst economic crisis since the Great Depression, and with the nation encumbered with the biggest debts in the history of the world, the national healthcare bill could easily push America over the edge.
UNEXPECTED RISK FOR ADHD DRUGS
The US Food and Drug Administration (FDA) has “urged caution” in interpreting the results of a new case-control study that shows that stimulant medications, specifically methylphenidate, are associated with a 600 to 700 per cent increased risk for sudden death in children and adolescents. The study is published online June 15 in the American Journal of Psychiatry. (http://www.medscape.com/viewarticle/704421)
ENCOURAGING NEWS ON SOYA & BREAST CANCER
There has been concern about whether the consumption of soya products is safe for postmenopausal women. Experiments on monkeys appear to show that isoflavones, estrogen-like compounds in soya, do not stimulate cell growth or other markers for cancer risk in breast tissue. In fact females with higher levels of estrogen may gain a protective effect from higher doses of soy isoflavones. (Wood CE et al. Dietary Soy Isoflavones Inhibit Estrogen Effects in the Postmenopausal Breast. Cancer Res 2006 66: 1241-1249)
SOYA PROTECTS AGAINST FRACTURES
Consumption of soya foods has been found to be associated with a significantly reduced risk of bone fracture in women, especially in the early years following menopause. A study of over 24,000 postmenopausal Chinese women averaging 60 years of age found that women with the highest consumption of soya were around 35% less likely to suffer bone fractures compared to women with the lowest consumption. (Zhang X et al. Prospective Cohort Study of Soy Food Consumption and Risk of Bone Fracture Among Postmenopausal Women. Arch Intern Med. 2005;165:1890-1895)
ASSISTED REPRODUCTION & PLACENTA PREVIA
Assisted reproduction techniques (ART) such as IVF have been found to be linked to a higher risk of placenta previa, according to a study of over 800,000 Norwegian pregnancies between 1988 and 2002.
The risk of placenta previa was found to be more than five times greater in women who conceived with ART compared to natural conception, and three times greater for women who conceived with ART following a previous natural conception.
Placenta previa is potentially life-threatening and raises the risk of hemorrhage in late pregnancy and the need for Caesarean section. (Increased risk of placenta previa in pregnancies following IVF/ICSI; a comparison of ART and non-ART pregnancies in the same mother. Hum. Reprod., September 2006; 21: 2353 – 2358)
BLOOD CHOLESTEROL LEVELS CAN BE CONTROLLED WITH DIET
An anti-cholesterol diet has been found to be as effective as medicinal statins in lowering high cholesterol. The diet, which was followed by 55 participants for one year, was rich in almonds, oatmeal, fish, soya, lean meat, fruit and vegetables. (Jenkins DJA et al. Assessment of the longer-term effects of a dietary portfolio of cholesterol-lowering foods in hypercholesterolemia. Am J Clin Nutr 2006 83: 582-591)
PROSTATE CANCER & LIFESTYLE CHANGE
Rising prostate-specific antigen (PSA) levels after surgery or radiotherapy for prostate cancer is an indicator of recurrent cancer. Hormonal therapy at this stage can probably only extend survival time slightly and has significant side effects.
A study of a small group of men with recurrent prostate cancer was conducted to see if a change to a plant-based diet (increased whole grains, cruciferous and leafy green vegetables, beans and legumes, and fruit, and a decrease in meat, dairy products and refined carbohydrates) combined with stress management training (including meditation, yoga and tai chi) could reduce the rate of PSA increase.
After six months, four out of ten men had actually reduced their PSA levels and nine showed a reduction in the rate of PSA increase. The median time it took for the men’s PSA levels to double increased from 11.9 months at pre-study to 112.3 months. (Potential Attenuation of Disease Progression in Recurrent Prostate Cancer With Plant-Based Diet and Stress Reduction. Integr Cancer Ther 2006 5: 206_213)
KEEP MOVING, KEEP ON LIVING
A study of 302 physically functioning older adults (70-82 years) was designed to compare daily activity and rate of mortality over a six-year period. Apart from climbing stairs and walking for fitness, self-reported activities showed no effect on mortality rate.
However when an objective test was applied (comparing the rate of breakdown of a stable isotope taken in water) it was found that those who expended the most energy in physical activity were 67% less likely to die during the study period. (Daily Activity Energy Expenditure and Mortality Among Older Adults. JAMA. 2006;296:171-179)
FDA ADVISES AGAINST ZINC CONTAINING NASAL SPRAYS, GELS
The FDA’s Center for Drug Evaluation and Research said that it has directly received more than 130 reports of patients losing the sense of smell after using Zicam Cold Remedy Nasal Gel, Zicam Cold Remedy Nasal Swabs, and Zicam Cold Remedy Swabs, Kid’s Size.
The agency has requested a recall of all of these products and advised consumers not to use them. The FDA also stated that the company that manufactures these remedies appears to have more than 800 more reports related to loss of sense of smell associated with the products.
Loss of the sense of smell can be permanent as well as potentially life threatening when people cannot detect gas leaks, rotting food, or smoke from a fire. The FDA also states that the loss of the sense of smell can occur with the first dose. (Family Practice News July 1. 2009 p. 8)
ACUPUNCTURE & RHEUMATOID ARTHRITIS
A small study has demonstrated that acupuncture, and particularly electro-acupuncture, appears to be effective in reducing joint pain, stiffness and swelling in rheumatoid arthritis (RA). 36 patients, average age 58, suffering from RA that was unresponsive to other therapies, were assigned to three groups and received either electro-acupuncture, traditional acupuncture or ‘placebo acupuncture’.
All received twenty treatments over ten weeks. The points used in the first two groups were Yangchi SJ-4, Waiguan SJ-5, Yangxi L.I.-5, Wangu SI-4, Dazhui DU-14 and Quchi L.I.-11. A total of 29 patients completed the study and most of the drop-outs (because of inefficacy) were in the placebo group.
In both the acupuncture groups the number of tender joints and physician’s global scores were significantly reduced. (Efficacy of Traditional Chinese Acupuncture in the Treatment of Rheumatoid Arthritis (RA): A Double-blind Controlled Pilot Study. American College of Rheumatology Annual Scientific Meeting, November 2006)
ANOTHER DANGER OF TELEVISION VIEWING
Viewing a stressful soccer match more than doubles the risk of an acute cardiovascular event. A German study carried out during the 2006 World Cup, which was hosted by Germany, found that there were significant increases in cardiac emergencies on days when the host nation was playing. According to the authors, it is not the outcome of a game that triggers stress-induced coronary events, but rather the intense strain and excitement experienced during the viewing of a dramatic match, such as one with a penalty shoot-out. (Cardiovascular events during World Cup soccer. N Engl J Med. 2008 Jan 31;358(5):475-83)
RESIDENTS IN SUNNY CLIMATES STILL DEFICIENT IN VITAMIN D
87% of children in New Mexico were found to have less than ideal levels of Vitamin D in a study from the University of New Mexico Hospital. These children were aged 2-16 years old and suffered no limitations on their ability to play outside. The findings suggest that the modern lifestyle, even among children living in sunny regions, may be contributing to a deficiency of this important hormone. (Family Practice News July 1, 2009, p 43)
VITAMIN D AND CANCER
A serum 25-hydroxy Vitamin D level greater than 30 ng/ml is associated with at least a 50% lower risk of breast cancer in a meta-analysis of three observational studies. Dr. Cedric Garland reported these findings at the 2008 meeting of the American Association for Cancer Research. Dr. Edward Gorham, another researcher involved in the study, stated “We’re confident that we can prevent half of the breast cancer in women in the United States, if we could raise serum vitamin D levels to 32 ng/ml.” (Family Practice News July 2008 p.32) On page 34 of the same issue, details of a study presented at the same meeting suggested that calcium and Vitamin D increases the production of a protein that is involved in the destruction of malignant cells in the colon.
REDUCING FRUCTOSE AND FRUCTANS MAY BENEFIT IRRITABLE BOWEL SYNDROME
Eliminating fruits and vegetables which contain fructose and short chain carbohydrates known as fructans resulted in a “marked and sustained global improvement in gastrointestinal sysmptoms” in a study published in the July 2008 issue of Clinical Gastroenterology and Hepatology. A later challenge with a fructose/fructan drink “significantly increased” IBS symptoms. Unfortunately, the diet is quite restrictive, requiring the patient eliminate apples, pears, watermelon, onions, leeks, asparagus, artichokes, breads and pasta, stone fruits, legumes, lentils, cabbage and Brussels sprouts.
ANOTHER DUMB IDEA: EXERCISING WHILE YOU WORK
No doubt one thing Americans need is more exercise. However, with levels of unemployment continuing to rise, businesses are asking their remaining workers to take on extra work, leaving less time for activities outside the office.
The solution is obvious to the engineers at Steelcase: A combination treadmill and desk. For those who cannot fathom how jogging while trying to do your job will make America more competitive , we can only hope that the engineers will add an intravenous module for their Steelcase Walkstation so employees won’t have to leave the office to eat.
To that end, a competitor, TrekDesk, adds a cup holder. As the TrekDesk folks put it, “chairs are the enemy”.
(http://www.trekdesk.com/ and http://www.steelcase.com/na/walkstation_products.aspx?f=30670)
Ed. note: Shouldn't the fellow on the left be the one exercising?
"Is Anyone Thinking?" Department
WHAT HAPPENED TO PROFESSIONALISM?
Choosing Expediency over Character
With all the sensationalism surrounding the events of the past month, very little has been said about the colossal failure of professional ethics and even common sense in this situation.
No matter how much money a doctor is paid, or who is paying him, the responsibility to safeguard a patient's health and wellbeing is a priority common to all medical traditions.
The ultimate safeguard for patients is the character of the person they choose to rely upon for their care. In our "medicine as a business" model of health care, doctors are technicians, chosen less for their ability to relieve suffering than their skill at generating cash flow. A submissive capability to "work well with others" and accept "standardized care" guidelines is more valued than the ability to advocate for individualized treatment.
As the country debates the direction of our medical system, it is important to consider if our priorities have somehow become corrupted. Our system for choosing the students who become physicians and nurses places too little emphasis on individual character and strong ethical conviction. During training, the emphasis is on the needs of the institution rather than the capability and welfare of the practitioner.
It is impossible to imagine how anyone with even a particle of medical knowledge would think that anesthesia is a treatment for insomnia. Reading the cocktail of drugs prescribed to Mr. Jackson in the evening before his death is striking for the outrageous arrogance of the prescriber.
Even if a physician is so ignorant that they haven't a clue of appropriate treatment, if that physician had just a smidgen of good character, the patient would still be protected. Sadly, this was not true in this case.
Doctors are certainly human, and on occasions submit to criminal motivation in their non professional lives, but willful infliction of harm on a patient is another matter altogether.
One wonders why the family, or friends, or business associates, did not object to this bizarre perversion of treatment: Why there were no questions why a "cardiologist" was treating insomnia or why administration of anesthesia in a non surgical setting was acceptable.
The victim of these ministrations was also poorly served by the surgeons who provided his plastic surgery, and once again, the professionalism which is disappearing from the modern practice of medicine might have prevented that travesty.
Ultimately, patients must bear some responsiblity for their choices of doctors and treatments. But, the failure to support and maintain professionalism in medicine reflects an alarming trend that not only threatens rich celebrities, but all of us.