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End of expectation that individual doctor knows best and best medical care emerges from open discussion of patient symptoms, concerns, and exam and consideration of the options, some of which may involve lifestyle changes not drugs
Radio
1. Even in car, hear about medical miracles that can change your life. Unending assault on consumer ears through various media.
Public Relations
There are financial ties between many of the supposedly most trusted medical experts and the medical industry
Medical 'news' or advertising masquerading as news
Studies on real news shows, funded by drug companies are presented as objective
Inadequate medical coverage and research on news -- medical news not hard news so less fact-checking
Lazy reporters -- accept biased reports as facts
XI. Chapter 11: Follow the Money -- Supply-side medical care
More care and more intervention means more money, but is not necessarily better medicine and better for the patient
Supply-side medicine means medicine has primary interest of improving financial health of hospital
XII. Chapter 12: Biomedicine limits
A. Scandal of using technology simply because 'you can' -- near-automatic use of medical technologies, such as cardiac catheterization, less because they are needed than because they are available
XIII. Chapter 13: What research shows about staying healthy.
Case study of the selling of Fosomax
1.Studies in respected peer-reviewed medical Journal of American Medicine promise the moon -- say Fosamax works
2. Randomized clinical trials of Fosamax published in medical journals show dramatic reductions in the relative risk of hip fracture for women with osteoporosis. JAMA in 1998 says women with an average age of 68 and a T score of - 2.5 or less (bone density score that means osteoporosis) who took Fosamax for four years were 56% less likely to suffer a hip fracture than women in the control group.
How many hip fractures were really prevented? With no drug therapy at all, women with osteoporosis had a 99.5% chance of making it through each year without a hip fracture
Creation' of illness in media, medical journals, and advertising
Also, osteoporosis drugs work on outer part...
This increases the score on bone density test but does not necessarily contribute proportionately to fracture resistance. Statistics look good, but drugs don't change much.
Prevention better
Walking statistically better way of reducing hip fractures
XIV. Chapter 14: Solutions
Value of preventative medicine -- medicine should not be a commodity
System not working -- currently costs America 500 billion a year
Remember that America spends more on medicine than any other industrialized nation and still not healthiest and not every American is covered by insurance
America spends more on high-tech neonatology than other Western countries but has a higher infant-mortality rate because of inattention to low-tech prenatal care.
Gap is widening between the scientific evidence that impartial experts
Paxil example -- based on nine clinical studies on adolescents
No more effective than placebos
Increases the frequency suicidal thoughts and attempts)
Solution of drug company
Created task force of the American College of Neuropsychopharmacolgy which approved drug under review although 9 of the 10 task force members had financial ties to pharmaceutical industry
FDA epidemiologist in charge of analyzing all the antidepressant studies involving children concluded Paxil dangerous but barred from testifying at government hearing
Use of preventative, non-drug methods to treat depression like physical exercise, therapy better, especially in young people
Endovascular Technologies example (subsidiary of Guidant, the company that manufactures defibrillators)
Manufactured a $10,000 device to repair aortic aneurysms -- malfunctioned in a third of the 7600 patients in study
Company underreported number to FDA, and this never checked. Guidant later disclosed 2628 new malfunctions, resulting in 12 deaths.
Company still in business although $92 million poorer after criminal and civil payments to victims and regulatory officials.
Conclusion
Stay healthy! Preventative medicine is best
Need to return to relationship of trust between doctors and patients.
Media and money should not control quality of medicine
Treatment of osteoporosis revolves around specific calcium and vitamin D medication programs but first and foremost in importance is the institution of regular, healthy and appropriately strenuous exercise. This helps to strengthen both muscle support for fragile bones and improves ambulatory abilities to the end of helping to reduce the likelihood of accidents. Additionally, a lifestyle of activity can have decidedly positive preventative properties as well, serving as one of
Osteoporosis In a healthy adult the skeleton is maintained through a process of complementary bone resorption and deposition (Das & Crockett, 2013). The two cell types responsible for this process are the multinucleated osteoclasts derived from the blood and resident osteoblasts. In the course of normal living the skeleton will develop localized, stress-induced microfractures, which trigger resident osteocytes to signal for help from the osteoclasts. The osteoclasts arrive and begin to
Osteoporosis Pathophysiology: Osteoporosis Presentation of the disease Osteoporosis is a disease in which the body fails to regenerate enough bone to replace the bone mass that is lost when the body reabsorbs the tissue as part of the natural cycle of bone regeneration. "Bone is living tissue, which is constantly being absorbed and replaced" (Osteoporosis, 2011, Mayo Clinic: Definition). "When you're young, your body makes new bone faster than it breaks down old
More than half of all men who undergo a hip fracture go from the hospital to a nursing home, and 79% of those who endure for one year still live in nursing homes or transitional care facilities. Osteoporosis is a major threat to more than 2 million men in the United States. In spite of these facts, as per a 1996 Gallup Poll, many men still view osteoporosis as a
Osteoporosis is a disease in which bones become fragile and are, therefore, more likely to break (NOF, 2004). Thus, the common perception that bones are inert structures, like wooden beams, is incorrect. For, a bone is actually a living tissue, which is constantly being remodeled. After age 35, however, on the average a little more bone is lost each year than is gained during this remodeling. Between 40 and 50,
This study was a "randomized population-based open trial." The group in this study (287 women) received cholecalciferol 800 IU plus calcium 1,000 mg for 3 years. The women were all between the ages of 66 to 71 years. The "control group" (306 women) received nothing, no vitamins or calcium. The authors of this article assert in a "working hypothesis" that "daily vitamin D and calcium supplementation have a positive effect