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Medical Madness

MDs go on strike, death rate drops
The June 10, 2000 issue of the British Medical Journal reports that on March 9, 2000, doctors in the Israel Medical Association began sanctions to reduce their contact with patients (in other words, a strike) in order to protest a new four-year wage contract for doctors.
Since going on strike, the death rate in Israel has dropped considerably according to a survey of Israeli Burial Societies. "The number of funerals we have performed has fallen drastically," said Hananya Shahor, Director of Jerusalem's Kehilat Yerushalayim Burial Society. "This month, there were only 93 funerals compared with 153 in may 1999, 133 in the same months in 1998, and 139 in May 1997."
Meir Adler, who manages the Shamgar Funeral Parlour says, "there definitely is a connection between the doctors' sanctions and fewer deaths. We saw the same thing in 1983 (when the doctors applied sanctions for four and a half months)".
There is one town in Israel where the death rate has remained constant, the town of Netanya. Netanya has only one hospital and the doctors there signed a no-strike clause with their contract. The doctors in Netanya have not participated in the country-wide sanctions.
A similar situation also occurred in the United States. According to Robert Mendelsohn, M.D., In his book Confessions of a Medical Heretic, (1979) in Los Angeles County, California in 1976 the doctors went on a work slowdown to protest soaring malpractice insurance premiums.
There was an 18% drop in the death rate. When the strike ended, the death rate went back to where it had been before the strike.
In retrospect, that may not have been the best argument they could
have made about high malpractice insurance rates.



Adverse Drug Events proliferate
A study to measure the occurrence and preventability of Adverse Drug Events (ADEs) in the July 5, 1995 issue of the Journal of the American Medical Association found that slightly more than 6% of adults admitted to the study hospitals surgical units suffered from an ADE of some kind.
Reported incidents were classified by two independent reviewers as ADEs or potential ADEs as well as for severity and preventability
Over a six month period, the study found that out of 4,031 patients admitted, 247 of them experienced ADEs and 194 of the cases were identified as potential ADEs..
1% of the cases were fatal (none preventable), 12% were life-threatening (42% preventable), 30% were serious (also 42% preventable) and 57% were significant. (28% preventable).
Mistakes that resulted in ADEs happened most often when ordering the drug, 56% and giving the drug, 34%. Transcription and dispensing errors made up the remaining 10%.
Reviewing statistics for 1995 reveals ADEs cause:
• $76.6 billion in medical bills.
• 106,000 – 199,000 deaths.
• 8.8 million hospitalizations.
Statistical data reveals:
• Fatalities due to adverse reactions are greater than those of high-risk sexual behavior, firearms, and motor vehicle injuries – combined.
• Medication errors are the second most frequent and second most expensive malpractice claim.
• Most complications are dose-dependent. Therefore, 70-80 percent of these complications are predictable and preventable.



Steroid therapy continues despite known dangers
The July 15, 1998 issue of the Journal of Clinical Investigation, reports that medical doctors continue to prescribe prolonged steroid therapy for millions of Americans despite the fact that research has proven it can lead to serious bone loss (osteoporosis) that weakens the bones.
The study was conducted at the University of Arkansas for Medical Sciences in conjunction with the Central Arkansas Veterans Healthcare System. The researchers said, "Basically, our findings revealed that when animals or humans take high doses of steroids, not only fewer bone-forming cells are made, but they are dying prematurely."
The lead author of the study, Dr. Robert Weinstein says, "Our study shows that steroid-induced osteoporosis arises from changes in the number of bone cells available to maintain bone, causing eventual fractures and, also, collapse of large joints. No bone is spared from the steroid-induced bone loss, but the effects are more dramatic in the spine and in the hip. Unlike common age-and gender-related types of osteoporosis, this form of the disease occurs at any age, even in children. Not infrequently, patients that took steroids for many years end up in a wheelchair."
The researchers pointed out that medicine has known about the long term effects of steroid use for 60 years yet continue to use them more and more often.
Why? Doctors seem to be ignorant of the dangers. Weinstein says. "A recent survey of physicians showed that most underestimated the risk of [steroid]-induced osteoporosis in men and women. Only 25% ranked osteoporosis as one of the top three side effects of high-dose [steroid] therapy in a 45 year-old premenopausal woman and 8% ranked it as one of the top three side effects in a 45 year-old man."



Prozac: Drug producer hides suicidal reactions
The May 9, 2000 edition of the Boston Globe reports that Eli Lilly and Co. has known for years that Prozac, its best selling drug on the market could cause suicidal reactions in a significant number of patients. Although Lilly has downplayed the danger in the past, the patent for a "new" Prozac promises that the new version will not produce "its more significant side effects," suicidal thoughts and self mutilation.
A review of the company's internal documents, government applications and patents made some interesting findings:
–In 1990, Lilly scientists were pressured by Lilly executives to alter records on physician experiences with Prozac. Mentions of suicide attempts were changed to "overdose" and suicidal thoughts to "depression."
–The German equivalent of the US FDA refused to approve Prozac because Lilly's own studies showed that previously non-suicidal patients who took Prozac were five times more likely to attempt or commit suicide than those on older anti-depressants and three times more likely than those taking placebos.

Lilly has long maintained that an insignificant number of people who take Prozac have attempted or committed suicide and has been very active in trying to discredit researchers who continually prove them wrong.
Dr. David Healy, director of the North Wales Department of Psychological Medicine at the University of Wales is an expert on the brain's serotonin system that Prozac affects. Using his and Lilly's own research he estimates that "probably 50,000 people have committed suicide on Prozac since its launch, over and above the number who would have done so if left untreated."
By way of commentary, 50,000 people (a number Lilly sees as insignificant) are dead over the years as a direct result of using Prozac and the company is still selling it? World-wide last year (1999) Eli Lilly & Co. earned $10 billion in revenue. Prozac was responsible for more than 25% of that income.

Hundreds Of Infant Deaths Occur Every Year From Drug Reactions
The November 2002 issue of the journal Pediatrics reports that an average of 243 infant deaths occur each year from prescription drugs, biological products and other therapeutic agents.
The study involved case reviews of more than 500,000 adverse drug events (ADEs) occurring from November 1997 through December 2000. The study was performed by researchers at George Washington University and the University of Maryland. 7,111 of the ADEs reviewed involved children under the age of two.
The Authors found that in the 7,111 cases:
• “only 17 drugs or biological products were a suspect in 54% of all serious and fatal adverse events in drugs administered directly.”
• The drug palivizumab, used in high-risk pediatric patients, accounted for 28% of the adverse events.
• Four drugs accounted for 38% of the reported deaths: palivizumab (15%), nitric oxide (11%), indomethacin (10%) and cisapride (3%). Even though widely used for gastroesophageal reflux in children, Cisapride was not approved for use in infants by the FDA. It was withdrawn from the U.S. market in 2000 because it was found to cause cardiac arrhythmia and sudden death.
• In 24% of all the adverse events, exposure to the drug was from the mother during pregnancy, delivery or breast-feeding.
• 31% of the deaths occurred in the first month of life and 50% between day two and the 12th month. The authors say drug reactions in children are more likely “because young children have immature detoxification mechanisms and because doses must be individually adjusted for a much wider range of body size and weight.”



Cold And Cough Medications May Be Deadly To Infants
The January 12, 2007 issue of the Morbidity and Mortality Weekly Report from the U.S. Centers for Disease Control and Prevention (CDC) says that the deaths of three infants between 1 and 6 months of age were attributed to the use of common, over-the-counter cold and cough
medications.
Normal therapeutic dosing of the drug pseudoephedrine in children between 2 and 12 years old produces blood levels of the drug ranging from 180 to 500 ng/ml. In the autopsies of the three dead infants, blood levels of pseudoephedrine ranged from 4700 to 7100 ng/ml.
Dr. A. Srinivasan and colleagues at the CDC report that between 2004 and 2005, about 1500 children under the age of two were taken to U.S. emergency rooms to be treated for adverse drug reactions to cold and cough medications.
In a related editorial, the CDC says that in controlled trials, cold and cough medications were no more effective than a placebo in children younger than two years of age. In 2006, the American College of Chest Physicians advised doctors to refrain from recommending cough medications for kids in this age group. They suggested instead that parents use saline nose drops or a cool-mist humidifier to soften mucus and then clearing the congestion out with a rubber suction bulb.



Dramatic Rise In Asthma Risk With Antibiotic Use
A study in the November 14, 2007 issue of the journal Chest reports that giving children antibiotics in the first year of life may significantly increase their risk of contracting asthma before age 7.
A prescription database of more than 13,000 children was examined. Researchers compared the occurrence of asthma with a number of risk factors such as antibiotic use, gender, maternal asthma history, living location, income, the presence of pets in the home and the number of brothers and sisters at the sage of seven.
Children who were given antibiotics for non-respiratory tract infections in the first year of life doubled the likelihood they would develop asthma at the age of seven than those children who were not given antibiotics. In fact, the more antibiotics they received, the greater their risk of
developing asthma.
Interestingly, the presence of a dog in the house decreased the risk of developing asthma even in children who received multiple antibiotic treatments.
"Dogs bring germs into the home, and it is thought that this exposure is required for the infant's immune system to develop normally. Other research has shown that the presence of a dog in early life protects against the development of asthma," said lead researcher Anita Kozyrskyj.
Commentary: This study reinforces our belief that a good dog goes a long way. Adopt one today.



Preventable Medical Error Death Estimates Double
On July 27, 2004 the news service HealthDayNews reported that the estimated number of people in the United States who die each year from preventable medical errors in hospitals has more than doubled from previous estimates of 98,000 per year to more than 195,000. The previous estimate came from the Institute of Medicine (IOM) in 1999 The current report was produced by HealthGrades, Inc., a health quality ratings company. IOM representatives confirmed the new estimates saying their 1999 estimates were always considered to be on the conservative side.
In the study, 37 million Medicare patient hospital records from 2000 to 2002 were reviewed. The data showed there were about 1.14 million “safetyrelated incidents” associated with 323,993 deaths. 81% of those deaths were specifically attributable to an incident. One in every four Medicare patients who experienced an incident died.
The report also found that 60% of all “safety-related incidents” were the result of “failure to rescue” (that is, the failure to diagnose and treat a condition that developed in the hospital), bedsores and post-operative sepsis and infection.
According to the authors, during the time frame of the study, 2000 to 2002, the 575,000 preventable deaths that occurred cost American consumers an extra $19 billion.
Lead author, Dr. Samantha Collier said, “The magnitude of this is significant. We need to address this and we need to have support from the medical community.” “I think it’s a safe bet to say that we’ve maybe gotten a little complacent about patient safety in the medical community, and this is just re-sparking and refueling debate around how to address this,” she said. “Hopefully, it is creating a sense of urgency.”



U.S. Leads The World In Medical Errors


The November 3, 2005 issue of the internet journal Health Affairs reports that patients in the United States reported higher rates of medical errors and more disorganized doctor visits than people in other countries around the world.
The study was a phone survey of patients who had experienced some kind of serious health issue that required “intense” medical treatment or hospitalization.
Thirty-four percent of U.S. patients reported that they received the wrong medication, improper treatment or incorrect or delayed test results during the last two years.
Thirty percent of patients in Canada reported similar results along with 27 percent of Australian patients, twenty-five percent in New Zealand, 23 percent in Germany and 22 percent in Britain.



Many medical procedures unproven, untested
The American Medical Association estimates that 40-60% of the 2.1 billion prescriptions written last year were prescribed to treat conditions for which they were not approved or, in many cases, were not even tested.
Writing prescriptions for conditions the drug has not been approved or tested for is called “off-labeling” described by some as controversial at best, dangerous at worst. An example?200,000 children with Attention Deficit Disorder (ADD) are being prescribed clonidine, an adult high blood pressure drug.
Dr. Richard Greene, director of the Agency for Health Care Policy and Research (AHCPR) says, “The public is shocked when they learn that there isn't a shred of evidence for a lot of medical therapies. They just can't believe their doctor is doing things that they couldn't back up.”

Birth trauma during medically assisted deliveries dangerous to newborns
In a landmark study published in Developmental Medicine and Child Neurology in 1969, Dr. Abraham Towbin reports that “during the final extraction of the fetus, mechanical stress imposed by [obstetricians] –even the application of standard orthodox procedures –may prove intolerable to the fetus.”
The most common cause of this damage is excessive traction and twisting of the infant’s neck when using the head as a lever to extract the infant from the birth canal, damaging spinal structures, the spinal cord and brain stem. Survival of the infant depends on brain stem functions such as respiration, heart activity and reflex actions.
Unfortunately, such damage often goes undiagnosed and unreported since many doctors are unaware of the significance of birth trauma spinal cord and brain stem injury. Routine examination of spinal structures are not normally done during autopsies of newborns.


Towbin, of the Harvard Medical School and the Department of Pathology (Neonatology) of St. Margaret’s Hospital in Boston, reports that spinal damage can occur in numerous ways. Rupture and tearing of the covering of the brain and spinal cord (Meninges), tearing of the spinal nerve roots and laceration, swelling and compression of the spinal cord and brain stem are common. While heart function may or may not
be normal in such cases, respiratory depression soon after birth is a cardinal sign of brain stem injury.
By way of commentary on this article, chiropractors correct the misalignments (subluxations) that occur during even routine deliveries. If your child, or any you know, experienced a difficult delivery, it is imperative that their spines be checked by a chiropractor for subluxation. Chiropractic correction of spinal problems should begin as soon as they occur.




Needle Biopsy Linked To Spread Of Breast Cancer


The June 2004 Archives of Surgery reports that having breast cancer tissue biopsied with a needle seems to increase the chance that the disease will spread to the lymph nodes in the armpit known as sentinel nodes.
The research was done by Dr. Nora Hansen of the John Wayne Cancer Institute at Saint John’s Health Center in Santa Monica, California. She studied 663 women with proven breast cancer. About half of the cancers were biopsied with a needle while the remainder had the tumor removed and then checked for cancer cells.
Women who had the needle biopsy were 50% more likely to have cancer in the sentinel nodes. The researchers felt that this was “due in part to the mechanical disruption of the tumor by the needle.”



Elective C-Sections Increase Infant Deaths
A new study in the September 2006 issue of the journal Birth reports a higher risk of deaths in babies born by cesarean section to mothers who have no medical reason to have the procedure done.
Lead researcher Dr. Marion MacDorman of the National Center for Health Statistics at the Centers for Disease Control in Hyattsville, Maryland says that rates of c-sections have increased steadily in the United States. In 1996 14.6 percent of all first-time births were c-sections.
In 2004 the rate increased to 20.6 percent. A greater risk of death among infants born by c-section has been noted since 1989, when data on c-sections began being gathered. Researchers have always assumed that this was because these babies were more likely to die from other causes. To find out if c-sections have a contributing effect on infant deaths, the researchers looked at the records of 5.8 million births between 1998 and 2001 that were considered to be at “no risk” for a c-section. “No risk” means a single baby, full-term, in a head down position with no other medical risk factors involved.
The authors had previously noted a 49 percent increase in c-section rates between 1996 and 2001 among women in the “no risk” category.
The risk of death in the first 28 days of life was 1.77 deaths per 1,000 live births among the “no risk” women who had c-sections and 0.62 deaths per 1,000 live births in “no risk” women who delivered vaginally.
The researchers could find no clear explanation for the difference, even after analyzing the various causes of infant death.


Commentary: While the researchers couldn’t account for the increase in c-section deaths, damage to infants’ spines and nervous system structures during the medically assisted delivery process has been well documented in the literature and reported previously in this publication.
And with the number of deaths nearly 300 percent higher in “no risk”, elective c-sections, doctors continue to perform the procedures.
A November 2002 report from the Centers for Disease Control and Prevention (CDC) found that c-sections were on the increase for two reasons. One, because they make it convenient for doctors to schedule births (the doctors also mentioned that normal deliveries are more time-consuming and they get paid more for a C-section). Two, because of the risk of legal action if something goes wrong (an admittedly small chance).
Shameful, disgusting, heartbreaking: We’ll let you pick the word to describe the situation. Personally, we pick all three with many more easily coming to mind.



Health care "system" responsible for 98,000 deaths every year
A study reported in November, 1999 by the Institute of Health finds that upwards of 98,000 Americans die from medical mistakes every year. The institute calls the errors "stunning" and says there are ways to prevent many of them from even occurring in the first place.
According to the report, the problem lies with the health care "system" in general and not so much with the individual practitioners who actually make the mistakes while administering the care directly to the patients who die as a result.
The report cited such "systemic" problems as poor handwriting, too many drugs whose names sound alike and are easily confused, the inability to decipher orders and fill prescriptions properly as reasons for the deaths.
William Richardson, chairman of the panel that compiled the report wrote "these stunningly high rates of medical errors . . . Are simply unacceptable in a medical, disease care system that promises first to 'do no harm.' "
By way of commentary, let's put these numbers in perspective. 98,000 preventable deaths from the health care "system" is about four times the number of people who die from automobile accidents involving alcohol every year (approximately 20,000, all preventable as well). While we don't wish to minimize the importance of groups like Mothers Against Drunk Drivers (MADD), we look forward to the day when groups like Mothers Against the Health Care System will form.

Research: Antibiotics not needed for ear infections
Research reported in the November 26, 1997 issue of the Journal of the American Medical Association concludes that routinely treating children's ear infections with antibiotics is medically unwarranted.
The research indicates that using antibiotics is unnecessary not only because of the danger of developing antibioticresistant organisms but also because many children will recover from ear infections on their own.
Every year, doctors write more than 23 million prescriptions for antibiotics to treat ear infections.



Antibiotic overuse: doctors blame parental pressure
The February 1999 issue of the journal Pediatrics reports on a study that finds parental pressure is the main reason doctors give when pressed for reasons why they prescribe antibiotics to children in inappropriate situations.
610 pediatricians, all members of the American Academy of Pediatrics from around the country were surveyed. One in three of the surveyed doctors said they often or occasionally prescribed antibiotics they believed to be unnecessary to appease the parents.
Antibiotic overuse is a major health problem. in 1980, 4.2 million prescriptions were written for amoxicillin, most commonly used for ear infections. by 1992, the number of prescriptions increased by 194% to 12.4 million. The use of cephalosporin antibiotics grew 687% during that same time. The problem with antibiotic overuse, the researchers note,
is that doctors continue to prescribe antibiotics for viral problems such as colds and flu that they know the drugs are ineffective against.



100,000 die each year from
Adverse Drug Reactions

The April 15, 1998 issue of The Journal of the American Medical Association reports that Adverse Drug Reactions (ADRs) in hospitals may cause more than 100,000 deaths in the U.S. every year. This does not include ADR deaths outside hospitals such as those at home or in nursing homes.
The study, performed at the University of Toronto, found that 2,216,000 hospital patients experienced a serious ADR resulting in 106,000 deaths. This figure accounts for nearly 5% of all causes of recorded death in 1994. This makes Adverse Drug Reactions the fourth leading cause of death in the United States.
According to the U.S. Substance Abuse and Mental Health Administration, 5,212 Americans die each year from illegal drugs such as heroin and cocaine. This means that in the United States alone, properly prescribed and dispensed legal drugs kill 20 times the number of people that illegal drugs do.



Dramatic Rise In Asthma Risk With Antibiotic Use
A study in the November 14, 2007 issue of the journal Chest reports that giving children antibiotics in the first year of life may significantly increase their risk of contracting asthma before age 7.
A prescription database of more than 13,000 children was examined. Researchers compared the occurrence of asthma with a number of risk factors such as antibiotic use, gender, maternal asthma history, living location, income, the presence of pets in the home and the number of brothers and sisters at the sage of seven.
Children who were given antibiotics for non-respiratory tract infections in the first year of life doubled the likelihood they would develop asthma at the age of seven than those children who were not given antibiotics. In fact, the more antibiotics they received, the greater their risk of
developing asthma.
Interestingly, the presence of a dog in the house decreased the risk of developing asthma even in children who received multiple antibiotic treatments.
"Dogs bring germs into the home, and it is thought that this exposure is required for the infant's immune system to develop normally. Other research has shown that the presence of a dog in early life protects against the development of asthma," said lead researcher Anita Kozyrskyj.
Commentary: This study reinforces our belief that a good dog goes a long way. Adopt one today.



FDA: Antidepressants May Increase Suicidal Behavior
The July 9, 2005 issue of the British Medical Journal reports that the US Food and Drug Administration (FDA) has issued a warning that patients treated with antidepressants should be closely monitored for
signs of deepening depression and “increased suicidal thinking or behavior.”
The FDA simultaneously posted new information that a “higher than expected rate of suicide attempts were observed” among patients taking the drug duloxetine, marketed in the US as Cymbalta.
A February 2005 study reported in the British Medical Journal showed that adults taking selective serotonin reuptake inhibitors (SSRIs) were twice as likely to attempt suicide as patients taking a placebo. After that study the FDA initiated a review of all SSRI antidepressants and asked manufacturers to provide all their data from any placebo controlled studies involving the drugs. The warning states “adults being treated with any type of antidepressant medication, particularly those being treated for depression, should be watched closely for worsening of depression and for increased suicidal thinking or behavior.”
The warning is not, however, limited to the approved uses of the drugs. Studies of women taking Cymbalta for Stress Urinary Incontinence (SUI) found the risk of suicide attempts was twice that of the same age group of women in the general population. Cymbalta is not approved for use in the treatment of SUI.

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