Reblogged from godlessnurse:

As last night unfolded, I knew I would eventually blog about it. After a long holiday weekend, James and I were doing a bit of leisurely shore line fishing. While we were packing up, James exited his truck and BAM! He immediately felt a sharp pain in his back. This isn’t the first time, but it had been a little while since such a severe flare-up. With this, we promptly went home and applied all the home remedies we knew. Heat, rest, ibuprofen. James’ back was no better in the morning. After dealing with it …

Never say “pain meds” on the phone in an Emergency Call for a on call Physician in California.

It's a Emergency Call Device Sign (Photo credit: Rantz)

I underwent the same back pain emergency in Marseille, France I related here.

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It made me laugh a lot. Transmitted by my cousin who held it from a Facebook friend so I didn’t resist to share.

You can find a lot more of such humorous or inspirational sentences on the face book page of Fatima Parker who is an Author, a regular guest speaker on self-esteem, healthy living and size acceptance, on Radio,Television & print Media, in the Middle East, Africa,the UK, the USA & on-line Media. She has dedicated her life to helping women and children with issues of self-confidence and self-esteem that are fundamental to friendships, work, love relationships, ambitions, goals, and good health. She struggle against the discrimination undergone by the persons who are stricken by obesity or are suffering from a problem of size. She is the president of the International size acceptance association in the UK.

Here is the link to the association’s website:

http://www.size-acceptance.org/uk/

http://www.size-acceptance.org/

Image via Wikipedia

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Patient Recognition Month Poster (Photo credit: Army Medicine)

President of the Conseil National de l’Ordre des Médecins, the French national board for private practice physicians, has said in a recent interview on the topic of breath cancer screening: “one would better have too much chemotherapy than not enough”. This statement from a French health policy stake holder could hint that France is not enough mobilized against the issue of over treatment, unnecessary treatment and non pertinent treatment (although other stake holders are aware of the problem as shown in the document, issued by the former National Physician Adviser of one of the greatest health insurance scheme of France, entitled “Pertinence des actes par delà la polémique” cited in the work consulted list below).

Yet the pertinence of a treatment is a very relevant issue that health insurance companies have to deal with, be they private or public. A great amount of literature has already been released treating of the subject and health insurance policy makers are more and more concerned in the hope to cut some spending and improve the quality of care all in a same move by addressing the issue of overuse of medical care.

Unfortunately, to distinguish which procedure is really needed from which is non relevant requires, when it comes to a single patient, a high level of medical expertise and skill all along associated with a very high responsibility in case of misjudgment . That’s the reason why the better way for the health care benefits manager to solve the problem is to ask for a second medical opinion. And that’s how an almost patient is transformed in a non patient at all. Using such a procedure a benefit manager glorifies himself having avoided to a dozen of his insured the bistoury of their surgeon.

If a surgeon appears to show a high trend to operate although there is no particular need, the benefit manager enlist him in a “do not use” list. Four procedures are now under high scrutiny in the US: Stents for Stable Angina, Complex spinal fusion for stenosis, Hysterectomy for uterine fibroids, and Knee arthroscopy for osteoarthritis.

Surgeons are not automatically guilty of a willing of harm their patient but the bias can be resumed as follows: “when all you have is a hammer, everything looks like a nail”.

But surgeons are not alone exposed the trend of over treating. Pharmaceutical firms try systematically to open new market shares either by widening the indication of an old molecule with large and expansive multicenter studies or by widening the field of extension of a common disease which was not very known by the public and the health care providers until the drug maker undertakes a nation wide disease mongering campaign. And as Richard Lehman notes in his Blog post of February 20^th2012, pharmaceutical companies are ready to put a lot of money to do that: “It took 60 centres in 11 countries to recruit 227 subjects for that PRIMO trial of paracalcitol (“Zemplar,” Abbott). This is not at all unusual in trials run by pharmaceutical companies on products still under patent, when the prize might be a large extension of indication.” Unfortunately for the company, the results of this large multicenter study were negative while a more modest less funded study showed that amoxicillin shorten by only three days the course of  acute rhino sinusitis versus placebo.

And my conclusion will be: in medicine “the more the better” is a maxim that has to be pronounced cautiously.

Works consulted:

1) Keep your docs off ‘do not use’ lists

http://www.hospitalimpact.org/index.php/2012/02/20/keep_your_docs_off_a_do_not_usea_lists

2) Four surgeries to think about avoiding.

http://www.oldstuff4saleshop.com/?p=6050

http://www.oldstuff4saleshop.com/?p=6054

http://www.oldstuff4saleshop.com/?p=6056

http://www.oldstuff4saleshop.com/?p=6058

3) White Coat, Black Hat: Adventures on the Dark Side of Medicine.

http://www.malaprops.com/book/9780807061428

4) Take patients away from the overtreaters.

http://www.kevinmd.com/blog/2012/02/patients-overtreaters.html

5) Quant aux chimiothérapies, il vaut mieux en faire un peu trop que pas assez ! affirme le docteur Legmann, Président du CNOM.

http://docteurdu16.blogspot.com/2012/02/quant-aux-chimiotherapies-il-vaut-mieux.html

6) The Treatment Trap: How the Overuse of Medical Care Is Wrecking Your Health and What You Can Do to Prevent It.

http://www.treatmenttrap.org/

http://www.amazon.com/Treatment-Trap-Overuse-Medical-Wrecking/dp/1566638429

7) Amoxicillin for Acute Rhinosinusitis; a Randomized Controlled Trial

http://jama.ama-assn.org/content/307/7/685.abstract

8) Vitamin D Therapy and Cardiac Structure and Function in Patients With Chronic Kidney Disease; the PRIMO Randomized Controlled Trial

http://jama.ama-assn.org/content/307/7/674.abstract

9) Richard Lehman’s journal review – 20 February 2012 by BMJ Group

JAMA  15 Feb 2012  Vol 306

http://blogs.bmj.com/bmj/2012/02/20/richard-lehmans-journal-review-20-february-2012/

10) Fait-on trop de dépistage du cancer du sein ?

http://www.conseil-national.medecin.fr/sites/default/files/cn_bulletin/medecin21_web.pdf

11) Pertinence des actes par delà la polémique; le regard de l’assurance maladie.

http://www.fhp.3cfr.com/fhp_circulaires/invitforumissions.pdf

www.fhp.3cfr.com/fhp_circulaires/APERRIN.ppt

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Reblogged from cometscorners:

Have just seen this and thought we would make you aware also – I am disgusted!! And here is this mornings response to it as seen in my Facebook newsfeed: I believe the ad has now been pulled after much outrage and complaint!!

The pit bull puppy and the McDonald’s Ad Campaign

Fortunately, in France, thank to the action of the cometscorners blogger, we have not assisted to the broadcast of such a shameful advertising campaign. To distrust a breed with regard to dogs or a race with regard to humans proceeds from the same misjudgment. Individual characteristics should always prevail on breed or race characteristics.

“Images represented by TandemStock.com“

via “Ruff Water” – Los Angeles, CA – Seth Casteel – Featured Photographer.

Such a commitment for a simple piece of plastic will always astonish me. They live their life fully with no half measure, especially when it comes to toys and swimming pools.

Credit for these amazing pictures:

http://photobotos.com/

see more at their post here:

http://photobotos.com/2012/02/17/ruff-water-los-angeles-ca-seth-casteel-featured-photographer/

More pictures available here:

http://www.facebook.com/LittleFriendsPhoto

http://www.amazon.com/gp/search/ref=as_li_qf_sp_sr_il_tl?ie=UTF8&keywords=seth%20casteel&tag=photo01ba-20&index=aps&linkCode=as2&camp=1789&creative=9325

How certain men can risk their life to rescue a dog while others don’t even understand how one can think even to adopt one?

In fact adopting and rescuing belong not at all to the same context.
From my point of view, a man decides in a few minutes if he can rescue a living being be it member of his family or not, a pet or a human.

Genetically, from the cavern ages we, men, are programmed to protect the clan from dangers from outside when men lived in the wilderness. And I think, at least in some of us, those old reflex are still present.

As far as I am concerned, the same situation occurred one year in winter (month of February) when one of my cockers crossed a river chasing his ball and trapped his ears (which cockers have very very long as it is well known) in the brambles of the other bank of the river. Evaluating rapidly the situation (he would rapidly drown) I put my self  in the same dress code like the man in the picture (only in under-wears) and I dived  for a quick rescue.

I must have keep the gene of the protector of the clan.

But you should know it can be very dangerous; each year men die doing those sort of things for rescuing an animal (on average seven death per year  in the UK).

Bentley the rescued and Malcom his master who saved him.

Congrats Malcom!

Source of documentation:

http://www.bbc.co.uk/news/magazine-17013243

http://www.dailymail.co.uk/news/article-2101257/Dog-owner-inched-ice-save-pet-explains-reckless-act.html

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The ethical code of journalism as well as literature code of honor banish heavily plagiarism as it is an important, wide-spread, well known malpractice. Journalists and writers are not alone; Scientists also put plagiarism in the top list of deadly sins. A great amount of texts has been written up today on how to handle this matter. But beside we have to keep in mind that scientists love to meticulously write a multitude of sophisticated rules (i.e.guidelines). Then they write papers on how to respect these rules (check lists of items). Then even more papers are published on who didn’t respect these rules and the various pattern of disrespect (retraction notices). Then back again to the beginning for adding some precisions or extensions to the initial rules and then the virtuous circle start again. One of those numerous written rules, which scientists affectionate, is the rule regulating the plagiarism. In scientific publication plagiarism is one of the highest sin in the scale of misconduct and dishonesty. Specific soft wares are run by editors on the pre-publication materials in order to reduce the risk of plagiarism before editing an article. Plagiarism includes a sub-category: self-plagiarism. What do scientific researchers mean when putting next one to another such apparently contradictory and opposed two terms? That’s what I will try to explicit below, if possible with simple words. Self-plagiarism occurs when a scientist publishes two or more different articles based on the same set of data (even if he added a few new units in one of the paper, the principal core of the data is the same in the two papers) and the same research question (or a very light difference between the research questions in the two papers). Why is self-plagiarism dangerous for the community (and hence considered as a sin)? There are four main reasons: First, scientific publication stem from the unpaid work of volunteers (i.e. the scientific readers of the submitted paper intended to issue an approved version) and consequently self-plagiarism lead to unnecessary overload of work for this readers; Second, meta analysis now uses sophisticated statistical tools which will be biased if two different articles based on the same set of data for the same outcome are included (thus giving twice more weight to the results than they deserve in term of evidence); Third, academic evaluation based on the number of publication will be deceived when counting two-time the same work; And four there will be automatically a moral infringement with regard to the reader because each article is assumed to be original. Another scientific misconduct very near from self-plagiarism is the salami-slice publication. A searcher is culprit of salami-slice publication when he publishes in two episodes a work that would have been published in one (analyses and results are simple enough for one single paper) without warning the reader in none of the two publications. Now you have no excuse if you are caught in self-plagiarism misconduct or if you salami-slice your papers.

Image via Wikipedia

Works consulted (but not plagiarized) to write this post:

Kassirer JP, Angell M. Redundant Publication: A Reminder. N Engl J Med. 1995 Aug;333(7):449-450. Available from:http://dx.doi.org/10.1056/NEJM199508173330709.

http://ori.hhs.gov/sites/default/files/plagiarism.pdf

http://ori.hhs.gov/plagiarism-15

http://ori.hhs.gov/plagiarism-13

http://ori.hhs.gov/avoiding-plagiarism-self-plagiarism-and-other-questionable-writing-practices-guide-ethical-writing

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Image via Wikipedia

Whitney Houston - Concert in Central Park / Good Morning America 2009 - Manhattan NYC (Photo credit: asterix611)

That the question each and every medical doctors in the world should ask themselves.

The least that it can be said is that the two artists were not helped by their medical entourage nor friendship circle.

Certainly they were deeply unhappy and isolated in the middle of celebrity and superficial relationship or greedy managers.

It remembers me a maxim my cousin shared few days ago on Facebook: “there is no way to happiness, happiness is the way”. And definitely the worst way to happiness is to take medicine mixed with alcohol, even worst anaesthetic drug, all the more when they are prescribed or administered by a Hollywood rogue Doc.

Doctor Alon Steinberg, a cardiology expert, gives us his opinion on the CNN channel.
But I understand that it would be very difficult, in private practice in Hollywood to say “no” at an international pop or movie super star! And in another hand superstars know to use their fame to get their pills!
Pharmacies and prescription records are investigated “Doctor shopping” being suspected in the Whitney Houston case.

Videos consulted on CNN:

ac-whitney-houston-death-investigation.cnn

ac-marquez-celebrity-drug-investigations.cnn

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Reblogged from Gds44's Blog:

The death rattle of Democracy – Tea Party Nation. Posted by Judson Phillips Watching a Democracy die is not a pleasant experience.  The only thing worse is watching one die and having most people not even realize a Democracy just died.  Which Democracy died?  Greece, of course.  Greece is a cautionary tale for America and every other nation in the world.  Perhaps the question we have to ask, is Greece even a nation any more?  The obvious reaction to that question is, of course it is.  The Greek flag …

Although I do not share the same ideas of this right-wing American party, I found interesting their analysis of the Greek’s debt default in payment. This financial crisis entails the loss of the sovereignty of the Greek people and hence is endangering their democracy. The author of this text, Judson Phillips is the leader of the Tea Party Nation. With regard to the American political landscape, the Tea Party Nation is a USA ultra reformist party believing in the return to the fundamental values of their Constitution especially the second Amendment which allows all citizen to bear and possess weapons in the aim to defend the democracy in case of governmental abuse. Their point of view does not reflect my own personal position but contributes to bring some arguments in the discussion with regard to the topic of the European debt problem.

To balance the discussion, below is represented the point of view of a left-wing Greek party, the KKE, with regard to the situation of Greece:

• National Sovereignty and the Sovereignty of the People: Video from the KKE (cedarlounge.wordpress.com)

Image via Wikipedia

I have selected for the benefit of my readers some articles issued by The Lancet, a prestigious medical journal, focusing on the consequences of the Greek economic and political crisis on Health Services. Greece is in Europe; nevertheless this country seems abandoned by the Europeans. After the world war two in Europe, starting from ruins, a welfare system was reconstructed. Nowadays it seems like we assist exactly to the reverse: Europe, starting from a well build welfare system is being ruined. In both cases only the will of human beings is at work. After World war two those men in charge were the former resistance fighters while now they are bankers and traders. Even perhaps the latter could be the grand sons of the formers. With their Marshall plan the USA helped Europe in the past. But now it seems that no one would stand up for that purpose.

Greece’s financial crisis dries up drug supply:

Eva Karamanoli; www.thelancet.com Vol 379 January 28, 2012

Resume: The pharmacies run short of medicine as important as Parkinson treatment or Epilepsy treatment. International pharmaceutical laboratories hesitate to deliver their product to Greece because of the lowering that government imposed to the price of medicines in the context of health budgets cuts. Patients have to pay in cash pharmacist before holding medicine because social security funds take months to reimburse; if not wholesalers cannot deliver the drug to the pharmacist.

Health effects of financial crisis: omens of a Greek tragedy:

Alexander Kentikelenis, Marina Karanikolos, Irene Papanicolas, Sanjay Basu, Martin McKee, David Stuckler; www.thelancet.com Vol 378 October 22, 2011

Resume: The rate of suicides has grown during the crisis, as well of the rate of HIV or Sexual Transmissible Infections (secondary to an increase of drug users and prostitution). Criminality rates have also increased (homicide and theft). Primary care practitioner consultations have not been implemented although they were needed while rate of admission in public hospitals has increased.

Increased suicidality amid economic crisis in Greece

Marina Economou, Michael Madianos, Christos Theleritis, Lily E Peppou, Costas N Stefanis; www.thelancet.com Vol 378 October 22, 2011

Resume: The suicide rate has increased by 40% since the beginning of the crisis. It is highly associated with the economic distress in the surveyed population.

IMF and European co-workers attack public health in Greece

Konstantinos Triantafyllou, Chryssi Angeletopoulou ; www.thelancet.com Vol 378 October 22, 2011

Resume: At the demand of the International Monetary Fund and the European Central bank, health care spending cuts will lead Greece to lose 26 000 public health workers (of whom up to 9100 doctors). According to the author the inevitable consequence will be the worsening of the health of the population as it has been already observed in all the countries previously “aided” by the IMF in the world. But this latest fact is contested by the IMF.

Debt crisis strains Greece’s ailing health system

Eva Karamanoli; www.thelancet.com Vol 378 July 23, 2011

Resume: In order to cut spending, clinics will be merged and a special body of primary care will be created to alleviate the public hospital’s burden. Indeed, in one hand public hospitals are lacking or in short supply of elementary material such as gloves, IVs, gazes or medicines and the patients undergoes long waiting times while in the other hand people use public hospitals instead of private practices not to have to advance the money because Social security reimbursements have to be waited for months.

To say it short, the overall situation is: Health insurance fund owes money to health providers who themselves owes money to wholesalers who owes money to pharmaceutical industry. The health services strongly have to be rebooted in Greece.

Greek academic psychiatry and neurology before the firing squad?

Thomas Paparrigopoulos, Ioannis Liappas; www.thelancet.com Vol 378 July 23, 2011

The most important psychiatric hospital in Greece whose chiefs of departments are also keys opinion leaders in their speciality experience a 30 % budget cut. Greek academic psychiatrists are now an endangered specie which need urgently to be preserved.

Works consulted (in the same order):

http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673612601299.pdf

http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673611615560.pdf

http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673611616383.pdf

http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673611616395.pdf

http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673611611525.pdf

http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673611611586.pdf

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• Greeks Reeling From Health Care Cutbacks – Suzanne Daley via NYTimes.com (underpaidgenius.com)
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• The Greek Tragedy – Chaos Beckons (thepressnet.com)