News News News
RADIATION EXPOSURE RISKS
A New England Journal of Medicine review published in the November 29th, 2007 issue suggests that 1.5% to 2% of cancers may be a result of diagnostic CT scans.
The number of CTís ordered in the U.S. has increased by 95% since 1980, and the x ray dosage delivered is many times that of plain film-type x-rays.
Although the actual amount of short and long term damage caused by radiation exposure is controversial, it is clear that in each case, there is a measurable risk. The strong magnetic fields of MRI scans also affect our biology, as do the powerful sound waves used in ultrasound scans.
It behooves both the patient and the physician to decide if the value of any diagnostic test justifies the risk involved, and our general rule at Acupuncture Associates is that if a test will not alter your treatment, it is probably not indicated.
For example, I see many patients with back pain or headaches who are not candidates for surgery, and yet have been put through painful or risky procedures that have no impact on whether or how their condition can be treated.
Many of these tests are extraordinarily expensive, and one factor in their overuse is the profits they generate and the preference of payment plans for procedures over results.
A calculator to help patients and physicians understand the radiation dose delivered by imaging procedures is available here.
UNITED HEALTH CARE CEO SETTLES STOCK BACKDATING CHARGES BY SEC
UnitedHealth Groupís former CEO and board chair, William McGuire, M.D., has paid 468 million dollars to settle charges against him that he benefited from an illegal scheme to manipulate the price of options he was awarded by the company. He also agreed to repay 448 million to the company as well as forgo 200 million that he earlier gave back when he resigned in November 2006.
The present CEO, Stephen Hemsley surrendered 190 million dollars, and other executives are also involved in the settlement.
It is no surprise, given how our "justice" system works, that patients and shareholders are not part of the settlement.
Dr. McGuire still has 800 million dollars in stock options whose fate remains to be determined.
The amazing amounts of money involved signify just how profitable it is to control the money stream in medicine. These excesses have been made possible by government manipulation of what politicians refer to as a "free market" when it is as far from a free market as possible.
Since "regulation" is always the solution by politicians, the rhetoric that free market "excesses" are the reason for the high cost of medical care in the U.S. is frequently heard from our elected system lords, and repeated by various media representatives and organized medicine "experts".
In reality, if a real free market were allowed, many of the problems that we currently face would be eliminated. However, further elimination of free market forces and greater volumes of money will be funneled to fat cats like Dr. McGuire when "universal health care" is unleashed upon the American medical system. (AMA News January 7, 2008 p. 18)
ANTIDEPRESSANTS LIKELY MORE VALUABLE FOR COMPANIES THAN PATIENTS
A review of published and non-published research at the University of Hull in the U.K. suggests that the benefits of pharmaceutical antidepressants has been exaggerated as a result of the fact that studies that show no benefit or negative effects are not published.
Since most studies are paid for by pharmaceutical companies, and all medical journals are heavily dependent on the advertising support from these very same sources, only research favorable to company profits tend to be promoted.
Lead researcher Professor Irving Kirsch at the University said: "The difference in improvement between patients taking placebos and patients taking anti-depressants is not very great."
Significant side effects and interactions with other drugs are strong reasons to reconsider the widespread practice in the U.S. of prescribing these drugs for almost any reason.
CAUTION WITH CALCIUM
Calcium supplementation significantly increased the risk of heart attack, sudden death, angina or chest pain among healthy post menopausal women, compared with those taking a placebo, in a secondary analysis of a 5 year osteoporosis study. (Am. J. Med. 2006;1119:777-85).
Dr. Rita Redberg, a cardiologist at the University of California, San Francisco, noted that risk increased despite the fact that HDL/LDL ratios improved in all participants: "It shows that just improving cholesterol does not reduce the risk of a heart attack".
One hypothesis for the findings proposed by Dr. Redberg is that "women lose calcium from their bones as they get older and it ends up in their arteries and the lining of their vessel walls, leading to accelerated atherosclerosis." (Family Practice News Feb.1, 2008 p. 1)
NO SCREENING FOR CAROTID ARTERY NARROWING
The U.S. Preventive Services Taskforce has concluded that routine "carotid artery stenosis" screening with ultrasound is too risky and false positive rates are too high.
The risk of surgery is also considerable, with increased rates of stroke and other cognitive changes, as well as the usual risks which accompany hospitalization.
Angiography, another method of screening, also increases the risk of stroke. (Cortland Forum Feb. 2008 p. 12)
VITAMIN C REDUCES POST FRACTURE PAIN
In a study of 2137 patients with wrist fractures in the Netherlands, 500 mg of vitamin C daily reduced the development of chronic pain at one year post injury by 80%.
Injuries of all sorts can result in a syndrome known as chronic regional pain syndrome (CRPS) which is poorly treated by standard Western medicine.
From 2001 to 2004, patients were randomized to receive placebo or Vitamin C in various doses for 49 days.
At one year, 10% of the placebo patients had CRPS and chronic pain, compared with 2% who took 500 mg. of vitamin C for 7 weeks after the injury.
The rate was 4% for those who took 200 mg, and 1500 mg did not provide any benefit beyond 500 mg. (The Journal of Family Practice Feb. 2008 p. 86)
Fine combing of wet hair is four
times more effective at eliminating head lice than using chemical products (57%
cure rate versus 13%). (BMJ Journal).
CURCUMIN & CANCER Curcumin, found in turmeric, has been found to block a key biological
pathway needed for the development of melanoma and other cancers, according to
researchers from the University of Texas M.D.Anderson Cancer Center. The study
is the latest to suggest that curcumin has potent anticancer powers.
Considerable research is being carried out worldwide into the antioxidant,
anti-inflammatory and anti-carcinogenic properties of curcumin. (M.D.Anderson
News Release 7/20/05).
CURCUMIN & CANCER
Curcumin, found in turmeric, has been found to block a key biological pathway needed for the development of melanoma and other cancers, according to researchers from the University of Texas M.D.Anderson Cancer Center.
The study is the latest to suggest that curcumin has potent anticancer powers. Considerable research is being carried out worldwide into the antioxidant, anti-inflammatory and anti-carcinogenic properties of curcumin. (M.D.Anderson News Release 7/20/05).
WATCH FOR RELAPSE OF DEPRESSION IF CHANGING ANTIDEPRESSANT BRANDS
A survey of patients who relapsed and were previously stable and responsive to their antidepressant drugs at the University of Toronto found that the only factor in common was a change from a brand-name antidepressant to a generic, or from their original generic to another generic without the patientís knowledge.
Patients refilling their prescriptions should always check to see if another brand has been substituted, and if a drug seems to stop working as well as it has in the past, both physicians and patients should double check to make sure that substitution has not been provided. (The Journal of Family Practice, Feb. 2008 p. 109)
ACUPUNCTURE HELPS COUNTER AIDS DRUGS SIDE-EFFECTS
In a study of 50 HIV-infected adults (half with full-blown AIDS) taking HIV medicines, all initially complained of at least two digestive side-effects: gas (80%), bloating (40%), cramps (50%), appetite loss (50%) and loss of weight (10%).
All participants received six weeks of acupuncture - the first three weeks at acupuncture points designed to treat digestive symptoms and the last three weeks at non-points near actual points not indicated for digestive disorders.
After the first three weeks of treatment only 60% still complained of two or more digestive symptoms, and although both types of acupuncture appeared to benefit symptoms, the "true" acupuncture was more effective in controlling loss of appetite, abdominal cramps and bloating. (3rd IAS Conference on HIV Pathogenesis and Treatment, Rio de Janeiro, Brazil, July 24-27, 2005)
ANTIBIOTIC INEFFECTIVE FOR KIDSí CONJUNCTIVITIS
Around one in eight British schoolchildren have at least one episode of acute bacterial conjunctivitis each year and many are treated with a local antibiotic, commonly chloramphenicol eye drops.
A new study, however, which compared chloramphenicol eye drops with placebo eye drops, found no difference in outcome (clinical cure at day seven and six-week follow-up) between the two.
They conclude "Most children presenting with acute infective conjunctivitis in primary care will get better by themselves and do not need treatment with an antibiotic". (The Lancet 2005; 366:37-43).
ECHINACEA APPEARS TO BE INEFFECTIVE
A major study has cast doubt on the ability of Echinacea angustifolia to either prevent or to alleviate the symptoms of the common cold.
The study, which was funded by the US National Center for Complementary and Alternative Medicine, tested three laboratory-made preparations made at the three different strengths that are most represented in the worldwide literature on echinacea for the common cold.
Four hundred and thirty-seven healthy, young-adult volunteers were assigned at random to receive either one of the echinacea preparations or a placebo. There were seven subgroups among the volunteers that received various combinations of echinacea and/or a placebo, in two phases: a preventative phase (seven days) and a treatment phase.
On the seventh day, the already treated volunteers were exposed to a nasal mist containing common-cold virus. Then, they were isolated for five days and monitored for the appearance and severity of cold symptoms.
The research team found that taking echinacea had no clinical or significant effects on whether volunteers became infected with a cold or, in those who developed colds, on how severe their symptoms were or how long those symptoms lasted. (Journal of the American Medical Association. 2003 290(21):2824-2830).
MORE DOUBT CAST ON HOMEOPATHY
A major meta-analysis of existing homoeopathy trials has concluded that there is no evidence that homoeopathy is more effective than placebo.
The Swiss study authors compared 110 homoeopathy trials with the same number of orthodox medicine trials and concluded that "There was weak evidence for a specific effect of homeopathic remedies, but strong evidence for specific effects of conventional interventions". (The Lancet 2005; 366:726-732).
"What Were They Thinking?" Department
SENATORS PROPOSE "HEALTH LITERACY ACT OF 2007"
Senators Norm Coleman (R. Minn.) and Tom Harkin (D. Iowa) have become convinced that a lack of "health literacy" is what is ailing America. Their solution is a bureaucracy to funnel some more money away from actual care or useful training into a "federal-level health literacy implementation center to gather and disseminate resources and best practices. It would also sponsor demonstration projects, coordinate research, assist other federal agencies, and set national health literacy strategies and goals." 1
Of course, the AMA sees this as a "welcome sign of progress", as they will certainly benefit from the cashflow generated by the all encompassing goals for this "implementation center". With a mandate so broad and vague, a budget the size of the National Institutes of Health could easily be manifested by our elected representatives and spread around to their favorite fat cats.
Leaving aside for the moment the fact that most of the expense and inefficiency to be found in our medical system is the result of the ineptitude of government policies in the first place; can there be anyone outside Washington who believes that another bureaucracy is an answer for patient confusion?
Patients are often confused because their doctors are confused. Much of the information which they themselves receive is contradictory, irrelevant, or distorted by marketing propaganda. Complex problems require complex analysis and an ongoing therapeutic relationship. This takes time and effort on both the patient and physicianís part, and a check box for a procedure code in an electronic health record is not a substitute.
I created a low cost demonstration project to improve physician patient communications and presented it with two magicians at a Las Vegas magic school in 2005, introducing techniques that are proven to be both effective and teachable. This project could be expanded at very little cost. The Coleman-Harkin bill, in contrast, creates a massive rathole for taxpayer dollars with no evidence or track record to support its grandiose vision.
And, if a federal level boondoggle "implementation center" is not expensive enough or intrusive enough for overburdened citizens and physicians, the AMA News editorial details how "in addition, it would establish state based resource centers to identify and understand local health literacy challenges, coordinate public and private efforts to deliver services, and provide technical and policy assistance to state and local governments." 2
Unfortunately, no matter who is the nominative party of power is in Washington, endless funds seem slated for yet more theoretical and fossilized concepts of this sort, and experimental "centers" to correct the problems that such thinking and programs have already created.
1. Editorial, AMA News January 28, 2008 p 25