There will be no edition of the Newsletter of the Doctor Thursday 25 and Friday, May 26, 2006. Our next edition will be published Monday, May 29
The daily figure: 2 diabetes may be implicated in the death of 225,000 Americans per year
On 24 May this year
1543: Death of Nicolas Copernicus
1798: Philippe Pinel , author of the Treatise on medico-philosophical insanity or mania, free the insane from their chains at the Bicêtre hospital
1844: sending the first telegram in Morse
1898: Birth of Helen Taussig, American pediatric cardiologist, the first woman professor at Johns Hopkins. Known for the operation Blalock-Taussig ² ²
1899: Birth of the writer Henri Michaux
1883: inauguration of the Brooklyn Bridge
1941: birth of Bob Dylan
1974: Death of Duke Ellington
Website of the Day : Contraception Online
http://www.contraceptiononline.org/
Quote of the Day: "Love: a term that has no meaning if defined." John Ralston Saul
Titles publishing
1. Temperature rises in Germany
2. Open letter in the Times against the NHS to support patamédecines
3. The legacy of Dr. Lee Jong-wook
4. A panel of UK expert for injecting rooms for heroin addicts
5. The German health care again fever
6. Sequencing the human genome: the last
deciphered chromosome 7. A new treatment for atrial fibrillation
8. Respiratory problems and cleaning
9. Screening colonoscopy in very elderly: is it quiet! (JAMA)
10. Obesity in Teens: depending on whether you are rich or poor (JAMA)
1. The temperature rises in Germany
The increasing bureaucratization and control measures of physicians, as we noted earlier provoked a strong discontent of the German practitioners. Last Friday, half of general practices were closed, while 20,000 doctors marched in Berlin. On the other hand, the conflict over medical fees in hospitals is stagnating.
2. Open letter in the Times against the NHS to support patamédecines
A series of British doctors leading publishing date, the Times ( http://www.timesonline.co.uk/article/0, 0.2 to 2,191,985. html) an open letter to leaders of the NHS, to request that trusts (local management units) of the national health system no longer take care therapies have not proven their effectiveness, such as homeopathy or acupuncture. And this at a time when one expects a speech in Geneva of Prince Charles to the World Health Assembly, for the treatment to which he continues to promote.
The letter included two critical initiatives: a guide to homeopathy for patients funded by the government and a report commissioned by Prince Charles, suggesting greater access to alternative therapies in particular to make vast savings.
3. The legacy of Dr. Lee Jong-wook
Shortly after his arrival at the head of the WHO in 2003, says the BBC, Dr Lee Jong-wook, died of a stroke on Monday morning was the fight against HIV a top priority. He has launched the Three by Five. The intention was to put 3 million HIV-positive individuals in the poorest parts of the world on ARVs by the end of 2005. It is estimated that is far below that goal, which brought the leaders of the WHO to submit a public apology. Consensus is not to blame Lee Jong-wook for this failure. "There is no room for satisfaction in our fight against HIV. We must maintain pressure to ensure that prevention, treatment and care is coordinated and operational, "wrote Lee Jong-wook in the last speech he would have had to vote on Monday afternoon before the fifty-ninth World Health Assembly health.
4. A panel of UK expert for injecting rooms for heroin addicts
A British panel of independent experts recommended special rooms where addicts can safely inject their product, reports the BBC. Such an initiative is already in Australia. This would reduce, according to these experts, the risks of contracting various diseases, as well as overdoses. As expected, the Home Office (interior ministry) predicted it, increased activities of drug dealers and drug-related crimes if they opened such injection chambers.
5. The German health care again fever
Three years after a major reform of health care, Medicare German plunges back into the red. After the surplus of 1.7 billion euros in 2005 would be a deficit of one billion euros for the current year, reported the German weekly Focus. In this context it is a little dark to see the conflict between doctors and government in Germany. "The German doctors are currently fighting against the federal government because of the guardianship and custody of their financial activity. The tightening accounting results in a reversal of doctors when exceed the targets. This struggle has been ours for the past ten years and we've got the disappearance of this way of behaving of government in our country. But this disappearance is always precarious and requires from us great attention. Moreover, the German doctors, mainly third-party payers, realize that by their capitation system, 30% of the activity they provide they are not paid. That's a stone in the garden of those who would pay third-leading generalized in an obvious way the guardianship of the good doctor's work provisions of funds, "published on this bulletin UNOF the (union's branch French medical generalist CSMF).
6. Sequencing the human genome: the last chromosome deciphered
Researchers at the Sanger Institute in England, succeeded in sequencing the last chromosome in the human genome, including Liberation reported. And to clarify that the "chromosome 1" contains nearly twice as many genes as the average of other chromosomes and accounts for only 8% of the genetic code of man.
7. A new treatment for atrial fibrillation
focal administration of acetylcholine in the atrioventricular node may represent a new therapy for atrial fibrillation in which the ventricular rate is controlled through the use of an implantable drug delivery system, conclude Sigg et al , authors of a study published in Circulation (2006; 113:2383)
( http://circ.ahajournals.org/cgi/content/abstract/113/20/2383?etoc ).
8. Respiratory problems and cleaning
Zock et al conducted a study to be published in the European Respiratory Journal, to see if asthma and bronchitis worsened among professional cleaners, because of contact with various cleaning products. They conclude that some products used in this context can affect the respiratory health of professional cleaners. It is unclear, they add, if their non-business use in homes may also have similar effects.
9. Screening colonoscopy in very elderly: is it quiet! (JAMA)
Although the prevalence of cancer increases with age, screening colonoscopy in people very old (80 years) results only 15% gain in life expectancy achieved in younger patients. We must therefore carefully weigh the pros and cons before making a screening colonoscopy for these patients, Lin et al conclude, authors of a study published today in JAMA (2006; 295:2357)
( http:/ / jama.ama-assn.org/cgi/content/abstract/295/20/2357? ETOC).
10. Obesity in Teens: depending on whether you are rich or poor (JAMA)
The tendency to obesity is increasing among young people 15 to 17 living below the official poverty compared to other kids their age. This is not the case for adolescents 12 to 14 years. In addition, Miech et al conclude, the authors of a study published in JAMA (2006; 295:2385)
( http://jama.ama-assn.org/cgi/content/abstract/295/20/2385 ? ETOC ), physical inactivity, the making of soft drinks and skipping breakfast are potential targets for prevention programs in this regard, they note yet.
Information to also check the site MediPlanet
1. Saudis shun U.S. hospitals
2. Recommendations good clinical practice in cases of medical liability: a weapon or a shield? (Text of KCE)
3. Suicide, the choice of weapons
4. For UNAMEC, Belgium has missed the boat of the revolution in cardiology of guardians coronary (Press UNAMEC)
1. Saudis shun U.S. hospitals
For a number of U.S. hospitals is a fiscal disaster. A program that worked for many years and which brought the rich Saudis seek care in U.S. hospitals has been closed. This decision is a consequence the degradation of the climate between the U.S. and Saudi Arabia since September 11, 2001.
2. Recommendations for good clinical practice in cases of medical liability: a weapon or a shield? (text KCE)
Recommendations of good clinical practice are tools that compile an ever increasing amount of medical information. They are published by scientific bodies and sometimes by public services and provide a decision support for physicians and patients. At the legal level, they can also be used in case of medical liability lawsuits. It is clear from the analysis Legal Center Federal Health Care (KCE) that the recommendations of good practice should be considered as the possible translation of what constitutes proper medical conduct.
To question the responsibility of a physician in our legal system, the patient must prove that it has erred. The use of good practice recommendations in this goal is a double-edged sword. If a physician deviates from a recommendation of good practice, one can imagine that his responsibility is called into question if he can not justify its deviation in the particular case is judged. Recommendations for good practice in such cases can be used by patients as evidence of lack of diligence on the part of the physician. Conversely, a doctor may rely on the fact that he followed a recommendation to properly defend themselves.
If recommendations of good practice are used to determine the legal care of a physician, their legal weight should be equal to their scientific quality. A recommendation of quality must be scientifically justified, reproducible and applicable, specific, flexible and expressed in clear and understandable language. In addition, its quality should ideally be confirmed by external validation, as in the BICAM (Belgian Centre for Evidence-Based Medicine) and must be maintained. If several recommendations exist for a given clinical situation, we can thus establish a hierarchy between them according to their quality. The KCE
argues in his report that physicians who correctly apply a recommendation of good quality are protected to the maximum, if questioned their responsibility, because they have followed this recommendation. Recommendations for good practice can be used as a defense by doctors when questioned their responsibility.
The full text of these recommendations is available on the website of KCE: www.centredexpertise.fgov.be (under "publications") as reference KCE reports vol 26B: "Medico-legal recommendations for good medical practice."
(full text of the Federal Centre of Expertise of health care, commonly referred to as its Flemish name of Kenniscentrum)
3. Suicide, the choice of weapons
The methods chosen by the candidates for suicide vary not only according to sex, but also between countries. This is shown in an international comparative study presented Monday at meeting of the American Psychiatric Association in Toronto. Thus
Swedish women opt preferably for drugs, while those in Taiwan choose hanging or pesticides. And the USA, they are divided between the poisoning (mainly drug overdoses) and firearms.
One of the findings of the authors is that up to 44 years, suicide rates are similar in the three countries mentioned above. After there is a peak between 45 and 64 years in USA and Sweden, with a decrease thereafter, while the suicide rate began to rise from 65 years in Taiwan.
4. For UNAMEC, Belgium has missed the boat of the revolution in cardiology of guardians coronary (Press UNAMEC)
From May 16 to 19 held a congress in Paris Cardiology worthwhile. One theme that was presented, is the growing success of the new generation of guardians Coronary Drug Eluting Stents called. Doctors and researchers around the world can exchange knowledge and experiences on this new type of guardian who is indisputably a major therapeutic advance in the treatment of patients with coronary problems. Drug
Eluting Stents, a therapeutic advance
Drug Eluting Stent
A (DES) is a small prosthesis consists of a wire coated with a drug substance that gradually diffuses an active substance which prevents the formation of scar tissue. The Guardian opens the blocked vessel and then kept open thus preventing restenosis (the ship that becomes blocked again) after the procedure. Scientific data now available show that in fact, through the use of such stents, a significant decrease of restenosis has been registered, why use this new generation of tutors is in most cases recommended.
With this new technology, this intervention is limited in time and does not require lengthy hospitalization. It generally allows patients to resume rapidly their professional and social activities under the best conditions and lead a normal life.
Therefore, the significant benefits of this new generation of guardians (DES) are definitely part of the armamentarium available to modern cardiology.
The Belgian private patient the best care available
On the occasion of EuroPCR, which takes place in a few days in Paris, UNAMEC, the Professional Association of Manufacturers, importers and distributors of medical equipment, again draws attention to the fact that Belgium could completely miss the boat.
Indeed, in Belgium, because of limited reimbursement system, the placement of a guardian is the exception rather than the rule. This means that the Belgian patient has no access to the most effective therapeutic methods and is disadvantaged compared to patients from other European countries where tutors are available to a wider group of patients.
so ago about a year, tutors were able to enjoy during a time of political attention, when it was learned that the Prime Minister, following heart problems, has benefited from the placement of a guardian. A few days after surgery, the Prime Minister has returned to work and is "living proof" of the importance of tutors in the treatment of patients with coronary problems.
Whoever has hoped that any patient with this disease could now have easier access to tutors, was wrong. In reality, this new generation of guardians is still not available to approximately 23,000 patients, which the medical point of view, should be treated with tutors.
Currently, Belgium, diabetic patients, considered a risk group, are the only ones who can receive a refund when sufficient investment Drug Eluting Stent with a. Elsewhere in Europe, the group at risk is defined much more broadly. Belgium, a country nearly the lowest penetration of this new technology in Europe.
figures illustrate this unquestionably ethical problem. Indeed, Belgium has a penetration rate 30%, Germany 39%, France 52% Netherlands 65% Spain 67%, UK 70%, 80% of Austria and Switzerland no less than 86%. The European average is 52%. (*)
UNAMEC appeals to all political leaders to urgently expand Belgian reimbursement guardians of all patients affected by this type of implantation. All cardiac patients were Belgian, undoubtedly, the right to access to available therapies are most effective.
UNAMEC is the Professional Association of Manufacturers, importers and distributors of medical devices is recognized that groups and businesses that produce and distribute medical devices, which include companies that have developed and produce including coronary guardians.
to Monitor Released May 23, 2006
Royal Decree amending the Royal Decree of 25 April 2002 on the attachment and liquidation of the budget financial resources of hospitals (p. 26326) amending the Royal Decree
Royal Decree of 3 July 1996 to implement the law on compulsory insurance and health care benefits, coordinated July 14, 1994 (p. 26211)
Royal Decree amending the Royal Decree of 15 July 2002 on the implementation of Chapter III bis of Title III of the Act on compulsory health insurance and benefits, coordinated July 14, 1994 (p. 26213)
French Community Commission of Brussels-Capital Region: Decree consent to the cooperation agreement of 2 September 2002 between the Federal State, Communities, the Joint Community Commission, the French Community Commission and the Regions for a policy of comprehensive and integrated drug (p. 26224)
French Community Commission of Region Brussels-Capital: Decree consent to the Cooperation Agreement between the Federal State, the Flemish Community, the Flemish Region, the French Community, Walloon Region, speaking Community, the Brussels-Capital Region, the Joint Community Commission and the French Community Commission, establishing a National Commission for the Rights of the Children, concluded at Brussels, 19 September 2005 (p. 26227)
Royal Decree amending the Royal Decree of 16 February 1987 appointing the president, vice-president and members of the Joint National Medical Hospitals (p. 26,229)
Staff. Appointment (p. 26229)
Staff. Appointment (p. 26230)
Staff. Appointment (p. 26,230)
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