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The daily figure (2-12-2005)
According to the American Pharmacists Association, 11% hospitalizations and approximately 125,000 deaths annually in the U.S. are due to poor adherence to medication regimens
Website of the Day (2-12-2005)
DrugAbuse.com
http://www.drugabuse . com /
The quote Day
Other times, other care. Racine ( Mithridates )
Tensions between management and employees to WHO (2-12-2005)
WHO is not that these institutions are expected to cite in the news because of internal social conflict. Yet this is the case today, as reported in the International Journal of Medicine. "So on a cold winter day in Switzerland, some 700 employees did not hesitate yesterday to stop work for one hour and scroll around the premises the organization in protest against a long series of decisions made by management, according to the protesters who are against the interests not only of employees but the entire institution, including Jim wrote. The decision to deny employees who smoke, even if they indulge in their vice and outside work, is one of the decisions complained of management. Having a child at age 40 and over .... (2-12-2005) release focuses on late pregnancy, the topic on December 1 during the Days of National College of Obstetricians and Gynecologists French. More and more women give birth after 40 years: the number of birth after that age has tripled in 25 years. And more and more women want a child after that age. Now first of all, fertility declines with age: if a woman has 9 out of 10 chance of having a child at age 30, this probability falls to 6.5 in ten to 40 years. And in vitro fertilization does not improve the chances of fertility. We must therefore warn women who want a child at this age "the biggest problem to a later age is not pregnant." Moreover, the risk of miscarriage is greater than 30% at 40 years and spent more than 50% after 45 years. The risk of having a child with Down syndrome is 1 / 110 to 40 and 1 / 28 to 45. The rate of twins is also higher after 40 years. And mortality in childbirth is 35 per 100,000 after 45 years. In short, while women 40 and older are comfortable with themselves, even if past the risk of miscarriage Q1 and excluded the risk of trisomy 21 by prenatal screening, then these pregnancies are much like other , increased surveillance of these pregnancies "late" is needed. While avoiding blame the candidates late in pregnancy to have their privileged career. "It is society that pushes it," said Dr. Michel Tournaire, department head at St. Vincent de Paul Hospital in Paris. "Nothing is done to help working women" retorted Dr. Joel Bellaisch Allart, fertility specialist at hospital Sevre. EB-M
My rant of the day (2-12-2005)
The Committee to Review the rules of prescription PPIs met on November 29. According to Roland
Lemye, mutuals have proposed not to change these Kafkaesque rules but to clarify the site of the Inami and increase the use of IT so that doctors find it better. In any case, mutuals do not want to increase the workload of their doctors advice.
No, this is not simply a "clarification" that we want! Besides, who would be able to clarify rules that persons or gastroenterologists or general practitioners or medical officers have understood? If nobody understood, everyone will go its own interpretation and it may take a long time in committee. Meanwhile, nobody knows over how to prescribe it but patients needs, they are definitely there and it is not clarification but they need care.
No, we do not want multiple forms and changing faster than the wind! It is impossible to take those tons of books at home. We do not want more of the unique solution of having to download the many different forms for the same molecule at the site of the Inami because it is impossible to connect the patient's home! Moreover, it occurred to me to be denied by an MC, the page ad hoc Monitor, Inami uploaded to the site!
No, we do not want the pretext that mutual have them, the right to demand less work for their CD, this idiot and overworked they do not want free home!
If this work seems impossible for them to MC, they remained in office with a (e) Secretary to provision a computer permanently connected to the Internet, they have the honesty not to peddle such work impossible patient's home, no secretary and no Internet connection.
Is not it came time to make a serious assessment of what costs the Bf in operating costs (without this it done by gratos MG)? How MC, secretaries of mutual material computer, computer scientists, manufacturers websites, how many tons of paper (obsolete so fast and so quickly thrown away), how many heated rooms (at the current price of oil that is thinner) since the inception unique Belgian BF in the world? Grace made a review of this enormous cost plus the lost time of unpaid doctor, added to the suffering of all patients who have not had the courage to take steps on their incomprehensible. Or who have been denied essential medication to relieve their pain because of lack of understanding of rules that were beyond the understanding practitioner and physician advice!
Remember, gentlemen Policies, adding to the cost price of all meetings, commissions, employees responsible to meet each medical developments to change the rules they must first understand retry before trying to change it. All for the price of a perpetual delay from one administration to the inertia so heavy that medicine will soon be Belgian known for always having a length behind medical discoveries.
So please, in a word, as in percent: Stop!
Quick, an assessment of the cost of Bf and his report expected before any new rules Kafkaesque!
And until that balance, hang the last regulatory PPI will have at least succeeded in doing is unique in Belgium, unanimously against it, whether in North or South, whether in mutual or in field practitioners.
The MG masked
Miss HIV (continued) (2-12-2005)
The newspaper Liberation publishes the results of the beauty pageant for HIV positive women in Russia we were talking in one of our previous letters. It's a very pretty young woman of 24 years Izambayeva Svetlana, who won the first prize: an MP3 player. The modesty of the prize won clearly proves that it's not greed that motivated but as she says in her interview, the will to fight against prejudice against HIV. Prejudices and stereotypes that make despite their participation in said contest, the other two winners chose not to appear before the cameras.
EB-M
2080: Alert flies (2-12-2005)
The United Kingdom could fall prey to fly in 2080 if we are to believe the Journal of Applied Ecology and reflected the opinion that a team from the University of Southampton. Hotter it gets, the better and faster the flies breed. These insects are known, are vectors of many bacteria. Flies not only directly affect humans, but are also responsible for significant reductions in the potential production of meat and protein expected from intensive farming. All types of flies can carry bacterial infections can be transmitted to other agencies. Diseases transmitted by flies include salmonella, smallpox, mastitis, colibacillosis and rhinitis. Flies are in man probably responsible for the transmission of Helicobacter pylori. It was found that the bacteria can survive for 30 hours in houseflies. Thus, we think it is possible that flies or other insects can transmit the germ indirectly via food or drinking water.
The proliferation of these insects (which always based on Journal of Applied Economy could reach 250% for a temperature rise of 2 to 3 °) would have an obvious impact on people's health.
EB-M
Price dietetics (2-12-2005)
The 'Price of Food', awarded by Kellogg's in association with the two associations of dietitians (and UPDLF VVVD ) and to support and encourage the profession of dietician (on) and highlight the importance of research in nutrition-related news, has been awarded this year for the 17th time. The first prize goes to Ikram Gharrafa the Katholieke Hogeschool Sint-Lieven for his excellent thesis which is an adaptation of Moroccan recipes traditional to the specific needs of diabetic patients.
The second prize was won by Corine Deben Institute Arthur Haulot to create a file for teaching children with celiac disease and their families. Kim Magerotte Institut Paul Lambin received the third prize for his work in education diet for patients with gestational diabetes.
face transplant in France (2-12-2005)
A 38-year-old received this weekend at the University Hospital of Amiens partial face transplant, removed from a deceased donor, reports The Figaro. The operation was conducted between Sunday and Monday night by teams of Professors Jean-Michel Dubernard and Bernard Devauchelle. Professor Benedict Lengelé specialist in microsurgery and reconstructive plastic surgery, Clinical Associate at the Cliniques Universitaires Saint-Luc and professor of anatomy at the Faculty of Medicine at UCL in Brussels, attended this first.
Requisitions: A legal opinion authorized (2-12-2005)
Meganck Dr. Michel asked me to Anrys (Absym) a legal opinion concerning the threat of requisition in Hainaut. Here
lawyer's response:
" Article 9 of Royal Decree 78 postulates several conditions for a requisition.
1) The Medical Board should have identified the need for care. Regarding Hainaut, there must have been a very old debate (1979?)
2) In case of deficiency, the Commission calls for initiative or at the request of the Governor to the collaboration of organizations and practitioners interested to supplement the care.
3) The Governor fixed in the application of the Medical Commission a deadline for a response.
4) At the expiration of the period, The health inspector must see for a minute if child care does not work.
5) In this case, the Governor chaired a meeting of the Provincial Commission determines who needs to fill.
health inspector takes any steps to organize or complete care according to identified needs as stated above.
II. In these measurements "requisition", he must observe the general principles of equality before the public service, non-discrimination.
III. Under Article 38, § 1, 3, is punished with eight days to 3 months imprisonment and / or 26 to 2,000 francs fine practitioner, who, being requisitioned under Article 9, § 3, does not perform its obligations without just cause or without having been replaced.
That is to say that the penalty is only possible if the measure was taken to the deadline set by the Governor in the request by the latter organizations concerned, ie said in § 1, circles and representative organizations. "
bypass after PTCA in freefall (2-12-2005)
Cardiologists send a much smaller number of patients for emergency bypass surgery after angioplasty, despite the increasing number of PTCA performed in patients at high risk. This was found researchers from the Mayo Clinic, who reviewed data from more than 23 000 patients undergoing PTCA between 1979 (that is to say in the era before stenting) 2003. Between these two dates, the percentage of emergency CABG decreased from 3 to 0.3%.
Barrett's esophagus: 2% of our population (2-12-2005)
According to a study Ronkainen et al, conducted in northern Sweden and published in Gastroenterology, the prevalence of Barrett's esophagus is about 2% in the overall population, which represents some 3 million people in the U.S. in particular. It occurs about two times higher among people with reflux symptoms than those who do not. We know the character of this precancerous lesion, which frequently leads to cancer of the esophagus, one of those who are clearly increasing in our societies.
Campaign in December of the Belgian Centre for Guide Dogs (2-12-2005)
The Belgian Centre for Dogs Guide (CBCG) yesterday launched a national campaign for greater recognition and better funding for centers for guide dogs. A larger number of dogs would make a greater number of blind and partially sighted people of their forced isolation.
A guide dog is, for many of the approximately 10 000 blind and 100 000 severely visually impaired, access to greater mobility and a better social life. Thirty
guide dogs are trained at the most every year in our country. It is largely insufficient. Therefore, from 1 December, in collaboration launches CBCG Pearle Opticians with a national campaign to improve the recognition and funding for training center for guide dogs.
" At the moment, public funds are grossly insufficient to cover minimum needs. There is moreover no statutory standard in dog training guide. Blind people thus have no guarantee of quality. Finally, the legislation on road traffic ignores guide dogs in public "said Adeline Valkenborg, president of CBCG.
This is due mainly to financing conditions particularly poor training centers. The authorities only pay € 4,000 to the user. For comparison, the Netherlands, the authorities intervene in the fee at a rate of 18 000 €. The CBCG calculated that the training of a dog, which lasts two years, and supervision of his master blind or partially sighted cost at least 15,000 €.
To substantiate the book's claims CBCG and raise additional funds, the CBCG calls to exchange an old pair of glasses in a store Pearle of the country during the month of December. The eyeglasses collected will be symbolically handed over to the competent political authorities in January, at the same time that the book claims CBCG. CBCG intends to make the authorities and the population more responsive to the mobility problems of blind and visually impaired.
Meanwhile, Pearle CBCG to provide $ 5 € for each pair exchanged. The stores also sell Pearle small cleaning sets of glasses for the benefit of CBCG. It is also possible to make donations to the bank account 750-9458821-24 of CBCG.
AIDS Pandemic: a diagnosis made impeccably (1-12-2005)
" We are facing a crisis. Today, in the third decade of the pandemic of AIDS, the end of the tunnel is not in sight. Since 1981, more than 28 million people died of AIDS. Every day we deplore 14 000 new infections and 8,200 deaths from AIDS. It is estimated that the United States approximately one million people are currently living with HIV. Overall they are 40 million people are infected with HIV, including 5 million people infected in 2005 alone. The devastation caused by AIDS have exceeded even the most pessimistic forecasts of the early '80s. However, no statistics, so alarming as it is, may not appropriately reflect the human suffering and hardship that these figures represent . It is in these terms perfectly adapted to the reality of the problem that is expressed on the site of the American Psychiatric Association, Francine Cournos, Chair of AIDS of the APA, who offered his homepage audit committee for the day from 1 December.
Sex for money is increasingly successful in the United Kingdom (1-12-2005)
Two studies of Ward et al (London), conducted among 11 000 British adults, the one in 1990 and the other ten years later and published in Sexually Transmitted Infections newspaper show that the number of men paying women for sex has doubled in this interval from about one in twenty to one in ten, reports the BBC. The authors attribute this development to the growth in divorce rates, sex tourism is booming and the increased availability of commercial sexual offers. There are more men willing to pay to have sex and more women looking for this type of work. All this obviously contributes to the spread of STDs, even if it is not the first factor. Today there are 58,000 British HIV positive, while in 2004 alone there reported 104 155 new cases of chlamydia.
increased risk behaviors among gay Scottish (1-12-2005)
A study of Hart and Williamson conducted on the male homosexual population in Scotland and published Sexually Transmitted Infections (Sex Transm Inf 2005; 81: 367 ) shows that risk behaviors have increased in this group between 1999 and 2002. Men are more confident about the similarity of their status in relation to HIV, while there was no increase the number of tests on the subject, or even more than mutual discussions on the subject; For authors, there is a cultural shift in perception and a failure of HIV prevention efforts public. Note that it seems that Scotland is not really an exception in this regard.
The POZ parties, benefits and risks (1-12-2005)
The phenomenon of parties for gay men with HIV (POZ parties) has been developing for a number of years, particularly USA. Serosorting (séroassortiment) find Clatter et al, authors of a study published in Sexually Transmitted Infections ( 2005; 81: 373), can reduce the rate of new HIV infections, which is beneficial to both organizers of these meetings that the participants . High rates of anal sex in these encounters result in a continuous and substantial risk of STDs. In addition, unprotected sex with infected partners and partners of unknown HIV status outside of these parties raised concerns increased dissemination of HIV superinfections.
World Aids Day (1-12-2005)
Do we still actually remember that December 1st is World AIDS Day?
UNAIDS, WHO and UNFPA (United Nations Fund for Population)
endorsed today's announcement by the EU to intensify the fight against HIV and AIDS, particularly in the third world countries. The joint report by UNAIDS / WHO shows how the intensive programs of struggle against HIV have been successful in limiting infection in some countries such as Haiti, Kenya and Zimbabwe. But we must not forget that there were 5 million new infections in 2005. The combat is very far from being won!
Antiretroviral therapy in the developing world: results comparable to those obtained in the U.S. (NEJM) (1/12/2005)
The one-year survival without antiretroviral therapy, adults and Haitian children suffering from AIDS is one year. Data for survival on ART in the developing world are, cons, limited in a context of high frequency of co-infections by the tropical or BK, as well as lesser opportunities for therapeutic monitoring. Therefore
Severe et al, conducted a study effectiveness of antiretroviral therapy on 1004 patients with AIDS consecutive Haitian and never received any such treatment before (N Engl J Med 2005; 353: 2325). Their conclusion is that the results of such treatment are quite comparable to that obtained in the United States.
" These results support international efforts to bring antiretroviral treatment available to AIDS patients in the Third World , therefore underline the study's authors.
NICE is Not so nice (1-12-2005)
Pearson and Rawlins described in the JAMA this day (2005; 294: 2618) how the National Institute for Health and Clinical Excellence (NICE) could possibly serve as a model for USA. This institution aims to establish criteria for the adoption of new medical technologies and the management of certain diseases.
We would add for our part, what the authors are unaware that the NICE is also an institution which has just declared, as we recently pointed out (see MDL No. 92, November 28, 2005), that doctors had the right to refuse treatments for diseases that people "self-inflicted , such as those related to smoking, alcoholism and obesity.
ASA in patients at low cardiovascular risk (1-12-2005)
Contrary to what happens to the risk of myocardial infarction, stroke, death from vascular disease in high risk patients suffering from vascular occlusive disorders, the effects of low-dose aspirin are not very clear with regard to patients at low risk, recall Patrono et al, authors published in the New England Journal of Medicine ( N Engl J Med 2005; 353: 23,373).
A meta-analysis of five primary prevention trials has shown that aspirin reduces the risk of heart attack by about 30%, but had little tangible effect on the risk of stroke. The aspirin component of the Women's Health Study showed, for cons, the rather surprising results (compared to previous studies, primarily conducted on men) among 40 000 apparently healthy women with a reduced risk of stroke by 17%, but little substantive result The risk of myocardial infarction. In secondary prevention trials, for cons, the results are comparable in both sexes.
The benefits of aspirin exceed the risk of bleeding in most patients with proven arterial disease, but the risk / benefit is marginal in populations at low risk.
The lack of primary prevention trials including elderly patients makes difficult the assessment of risk / benefit ratio.
Patrono et al stress the need to improve in any case the strategy based on SOA or another Effective antiplatelet therapy in patients at high risk, many patients do not receive the potential beneficiaries. " It takes considerable effort to improve statistics on the subject ."
But we need more randomized trials testing this strategy in certain groups of patients, eg diabetics with no history of vascular disease or in subjects over 70 years.
After Katrina: doctors again on the gap, but few patients (1-12-2005)
Infrastructure Medical Part of the State of Mississippi's hardest hit by Hurricane Katrina recover gradually, 80% of doctors returning to work and 60% of hospitals and private practices are again operational. If physicians are overwhelmingly to the call, patients will continue to be singularly lacking, says Modern Physician.
Too many males at night here ... (1-12-2005)
... lizards anyway. According to an article published in Science and future, an imbalance in the sex ratio towards males is deleterious to the species. It is a study published in PNAS by researchers at the CNRS who says, after observing two populations of lizards. When the males are too large numbers, the number of couplings increases and individuals become males significantly more aggressive. This aggression results in increased mortality in females with reproductive diminished. It seems that the balance of sex ratio male / female should be preserved to save some cash with the need to remove the excess males.
EB-M
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