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Sunday, May 28, 2006

Creating Health Risk

I often wonder what is behind articles like this, especially since there are so many of them every day. Maybe the core issue is that medical education is so poor at this time, aspiring physician's have gained no insight in to how to evaluate what is happening to a person with a health concern where nothing in their vocabulary fits. I am certain that either you or some one you know has been told "we don't know what s wrong".

I guess I am fortunate that I learned how to sort out what goes on physiologically and nutritionally in people, so at least I can offer them some information they can use to work on getting well.

Alopecia is a condition that leads to hair loss. Sometimes it is seen as an auto-immune problem. I knew someone who had a bout of this as a child. It left him without eyelashes and hair.

Somewhere, though, a doctor missed something. Maybe the status of the thymus, the adrenals, or thyroid. Go to the correct source of information and you might find a relationship to a cause of the problem. Then you can do something about it.

And you can do something for HIV, AIDS, or Alzheimer's if you go to resources outside the mainstream protocols. Especially if you are not subject to an organizational psychologist who is setting up a mechanism to further an agenda that certain people can't get help to be well.

Too often this happens today, and I think the following article shows there is something a foot to ingrain the process in people so they take the brunt of a failed health care / medical system.


According to an article on May 26 in HealthDay News, people are more likely to seek tests for conditions they believe to be severe but treatable, but are unlikely to do the same for illnesses they view as severe and untreatable, such as Alzheimer's disease, cancer and HIV/AIDS, a study finds.

"If people think they have no control, they may not seek information about their health status even if they are at risk for a serious disease. In fact, they may go out of their way to actively avoid any information," researcher Erica Dawson, an assistant professor of organizational behavior and fellow of the Center for Customer Insights at the Yale School of Management in New Haven, Conn., said in a prepared statement.

In one experiment, the researchers told two groups of participants that they were at risk for alopecia areata, which can cause hair loss but poses no overall health threat. One group was told the condition was severe and untreatable, while the other group was told it was treatable.

People who were told the condition was untreatable were less likely to request a conclusive genetic test, less likely to volunteer to take part in a future study about the disease, and avoided looking at an informational brochure about the disease in private.

The results may actually under-represent the degree to which people avoid information when confronted with a serious health problem, the researchers said.

The study may help doctors and other health care workers predict when people may be likely to avoid testing and to provide them with appropriate counseling.

"Caregivers should discuss treatment options not only with patients who have been positively diagnosed, but also with those who have considered, but not yet consented to, diagnostic testing," Dawson said.

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Now after reading this you might want to visit, and look at Skewed and Dirty Medicine links as well. Ivan Fraser's work is another good source of information

Sunday, May 14, 2006


From and article in the London daily Mail, May 12, 2006

There are growing concerns about the safety of medicines, after it emerged that some are prescribed without their full effects being known.

Over 250,000 patients are admitted to hospital each year because of adverse rections to drugs - and doctors estimate 10,000 patients a year died from them. Children, pregnant women & the elderly are particuarly vulnerable to the dangers, which include sudden death, respiratory failure & heart attacks.

and now you are supposed to believe that by avoiding one of the main concerns of drug management - ALLERGY - is fine to be overlooked according to the new greed guidelines from Big Pharma.

It used to be that if a person showed signs of allergy to a prescribed pharmaceutical, it was stopped immediately. It was stopped to prevent anaphylactic shock which leads to death.

Technique Eases Patient Allergy to Plavix

FRIDAY, May 12 (HealthDay News) -- A new method developed by U.S. researchers can help patients overcome an allergy to a common anti-clotting drug, clopidogrel (brand name Plavix).

Doctors often prescribe the drug to help prevent new blockages inside coronary stents, but about two out of every 100 patients who receive clopidogrel develop an allergic reaction marked by rash, itching, hives, or swelling of the tongue and airway. Some patients develop an anaphylactic reaction and go into shock.

"Allergic reactions can be quite frightening to patients and physicians, and can lead to discontinuation of the medication. We showed we could successfully and safely desensitize patients who had just recently had a drug-eluting stent placed. That's a critical population to manage," Dr. Nicolas E. Walker, a cardiology fellow at the University of Iowa in Iowa City, said in a prepared statement.

The desensitization protocol was used on eight patients. While being monitored in the cardiac ICU, the patients were first given a small dose of clopidogrel mixed into a drinkable solution. Every 15 minutes over the next few hours, the patients received an additional, higher dose of the drug. This continued until they were able to tolerate the target dose of 75 milligrams of clopidogrel. In total, the patients received nine doses totaling 150 milligrams of the drug.

Antihistamines and other anti-allergy medicines were used to treat patients who developed allergy symptoms during the desensitization process. All eight patients completed the process and were able to safely take a daily 75 milligram dose of clopidogrel at home without suffering allergic reactions.

Patients who suffer the most severe reaction -- anaphylactic shock -- to clopidogrel were not included in this study.

The findings were presented Thursday at a meeting of the Society for Cardiovascular Angiography and Interventions in Chicago.

The U.S. National Library of Medicine has more about clopidogrel.

so how about them apples, eh?

Thursday, May 04, 2006

Doctors Object to Gathering of Drug Data

Doctors Object to Gathering of Drug Data

Although virtually unknown to consumers, the information has long been considered the most potent weapon in pharmaceutical sales — computerized dossiers showing which physicians are prescribing what drugs. Armed with such data, a drug sales representative can pressure a doctor to write more prescriptions for a name-brand medicine or fewer orders for a competitor's drug.

But now a rebellion is under way by some doctors, who consider the data-gathering an intrusion that feeds overzealous sales practices among the nation's estimated 90,000 drug company representatives. Public officials are also weighing in. A vote on a state bill to clamp down on the practice is scheduled for today in New Hampshire, and similar bills have been introduced in other states, including Arizona and West Virginia.

To appease the doctors and try to stave off the state restrictions, the American Medical Association will soon give individual physicians the choice of declaring their prescription records off limits to drug sales representatives. The new measure is viewed as a self-policing move that the drug industry and the A.M.A., which has lucrative contracts with data-mining companies, hope will keep states from banning sales of prescription data altogether.

If the A.M.A effort succeeds, "legislators will turn their attention elsewhere, and the industry can hang on to one of its most valuable data sources," according to an article this week in the industry trade magazine Pharmaceutical Executive, which was co-written by an A.M.A. official and an executive with the leading vendor of prescription data. Even many critics concede that patients' privacy is apparently not an issue, because the tracking systems identify only the prescribing doctors, not patients. But many doctors find the use of the data by sales representatives an intrusion into the way they practice medicine.

"These doctors were outraged that people came into their office and talked to them about how many times they prescribed a particular drug," said Dr. John C. Lewin, the chief executive of the state medical association in California, one of the states where complaints about the current system arose.

The California group is beginning its own program under which doctors who do not opt out under the A.M.A. system will get comparisons of their prescribing patterns in 17 classes of drugs from the data companies, said Dr. Lewin, who added that the program was being started as a pilot effort that he hoped would be extended statewide.

Among the doctors who raised an early complaint about the system was Dr. Brad Drexler, an obstetrician in Healdsburg, Calif., who said he was surprised four years ago when pharmaceutical representatives began thanking him for writing prescriptions — the first time he realized that the drug representatives had information he assumed was private.

"I think it adds to the potential that physicians could be targeted one way or another for perks," said Dr. Drexler, alluding to the practice by drug companies of deciding which doctors to reward with the gifts, meals and other perks that sales representatives have dangled over the years, or to gauge which physicians might be worthy of signing up as paid speakers or consultants.

"It's the most powerful tool a drug rep has, for sure," said Jamie Reidy, a former drug salesman who was fired last year by Eli Lilly & Company after writing "Hard Sell," a humorous exposé of the pharmaceutical industry. Mr. Reidy said the pharmaceutical representatives received updated prescription data every two weeks. The information also sometimes characterizes each physician's prescribing patterns, Mr. Reidy said.

For example, "early prescribers" — also known among drug representatives as "cowboys," according to Mr. Reidy — are those doctors who start prescribing a drug as soon as it comes to market. If you are a drug sales representative, "you go to see that doctor in the first week," Mr. Reidy said.

Although the drug representatives are told not to share the prescribing details with doctors, some nonetheless have confronted doctors with the data. A representative might become frustrated, for example, if after providing numerous lunches to a doctor's staff, the data show that the doctor is not writing prescriptions for the company's drug.

"It just creates a weird atmosphere," Mr. Reidy said.

State Representative Cindy Rosenwald of New Hampshire, lead sponsor of her state's bill, said she was motivated partly by high Medicaid drug costs, which she said she believed had been driven up by the pharmaceutical industry's success in coaxing doctors to prescribe expensive brand-name drugs.

"To me this is a money issue," Ms. Rosenwald said. "When I look at our state's budget, the fastest-growing part of the Medicaid program here in New Hampshire is for prescription drugs. It's an enormous cost for a small state like New Hampshire."

Ms. Rosenwald's legislation has been adopted by the New Hampshire House and is tentatively set for a Senate vote this afternoon.

She said she did not believe the A.M.A.'s self-policing measure would provide enough protection, partly because even if doctors specify that their prescription records not be available to drug sales representatives, the information would still be sold to drug companies for other marketing and research purposes. The drug companies, she said, would be on their honor not to share the data with their sales staffs. A Gallup Poll commissioned by the A.M.A. in 2004 found that two-thirds of doctors surveyed were opposed to the release of such data to pharmaceutical representatives, and that 77 percent felt that an opt-out program would alleviate concerns about the release of data. Nearly a quarter of the doctors were not even aware that the pharmaceutical industry had access to such information.

That same year, the American College of Physicians requested that the A.M.A. prohibit the release or sale of doctors' prescribing information. The college represents internists and related medical subspecialties, while the A.M.A. is a broader trade group whose members include all doctors, including surgeons.

Dr. Dean Abramson, an Iowa physician, is among the doctors who plan to opt out under the new A.M.A. process, which will involve a sign-up registry that goes into use on July 1. His opposition began nearly a decade ago, he recalled, when a representative from TAP Pharmaceutical Products let slip during a sales call that Dr. Abramson wrote more prescriptions for Prevacid, a treatment for acid reflux, than any other doctor in the state.

"I was pretty surprised that they kept that data, and I was not happy at all," Dr. Abramson said. "I said, 'Why is that data even kept?' She didn't really give me an answer."

Since then, Dr. Abramson has become something of an activist against the lunches and gifts that the pharmaceutical industry dispenses to doctors. His gastroenterology group in Cedar Rapids, Iowa, accepts neither, he said.

The leading compiler and vendor of prescription data is IMS Health, a publicly traded company based in Fairfield, Conn., that had revenue last year of $1.75 billion. IMS and its competitors gather the data through contracts with retail pharmacy chains and companies that manage drug plans for insurers, then sell it to pharmaceutical companies.

IMS and its competitors — the main ones are Verispan, Dendrite International and a Dutch company, Wolters Kluwer — also pay the A.M.A. for access to its repository of information on approximately one million doctors who are graduates of American medical schools, as well as foreign medical school graduates licensed in the United States.

The A.M.A., which calls this repository Masterfile, begins collecting the information when a doctor enters medical school. Over doctors' careers, additional material includes information on their board certifications, types of practice and disciplinary records. The Masterfile information is among data that companies like IMS use in developing physician profiles.

In an interview, IMS officials said they believed that state efforts to curtail their activities were misguided. "Limiting the access to our data will not stop pharmaceutical marketing," said Robert J. Hunkler, whose job with the company includes serving as a liaison with the medical profession. Mr. Hunkler also says that the data his company collects is valuable for medical research and is sometimes shared free with researchers.

Mr. Hunkler was a co-author of the Pharmaceutical Executive article describing the new A.M.A. program. The other writer was Robert A. Musacchio, the A.M.A.'s senior vice president for publishing and business services. While Mr. Musacchio declined to disclose the exact value of its Masterfile contracts with the four main data companies, he said that the organization made $40 million a year selling information, which also includes mailing lists and a service through which hospitals can check the credentials of doctors. Mr. Musacchio said that doctors had always been able to put a "no contact" status on their Masterfile record, meaning their name would not be licensed for marketing by mail, telephone or fax.

The A.M.A.'s new registry, administered partly through a Web site, will enable doctors listed in its Masterfile to indicate that they do not want their prescribing data shared with pharmaceutical sales representatives. The decision will remain in force for three years.

And yet, even those doctors' prescription information will still be collected and transmitted to drug companies, whose other uses of the data include tallying bonuses paid to pharmaceutical representatives, which are based on sales. "What we've always stressed is that physicians have rights and they can always tell pharmaceutical representatives that they don't want to be called upon," said Mr. Musacchio. But he said the organization had always made clear to the pharmaceutical industry that its representatives should never "badger or embarrass or harass" physicians.

"They sometimes try to get their point across a little too strongly," he said.

Copyright 2006 The New York Times Company
4 May 2006

Wednesday, May 03, 2006

The FDA Attacks Again! Both vitamin purveyors and consumers could be the losers.

Our thanks go to the Vitamin Lawyer for his update on the recent CODEX meeting in Ottawa, Canada. You'll read (and see I hope) the FDA under control of BIG PHARMA as it fails to support your right to health care supplements and your right to know what they can do for your health. For more information on this topic, and to see the BIG PICTURE go to IAHF

Ottawa – 05/02/06 - The thirty-fourth session of the Codex Alimentarius committee on food labeling (CCFL), held at the Congress Center in the Canadian capitol, is witnessing the continuation of bickering among various delegates,with each nation or block seeking advantage over the others.

Both vitamin purveyors and consumers could be the losers.

In recent years the Codex process has been criticized by the international agency’s parent organizations, the World Health Organization and the Food and Agriculture Organization for failing to contribute to better health. WHO and FAO have mandated the Codex Commission to implement the WHO/FAO Global Strategy on Diet, Physical Activity and Health. The GS puts good nutrition, including dietary supplements, in the forefront of efforts to improve world health. The Commission has, in its turn, mandated the CCFL, and other Codex Committees, to take steps within their terms of reference to implement the Strategy.

While the representatives of many nations paid lip-service to the Strategy, when it came time to take action, calls for specific action from states such as South Africa and non-governmental organizations (NGOs) such as the National Health Federation were marginalized or ignored.

As observers, to assess the impact of the agency on the world health crisis, we and
other NGO observers, were dismayed to see a coordinated attack on natural health lead by the otherwise rival US and EU delegations. This impacted both nutrition issues and organic issues.

When one NGO (NHF) asked to have a reference to the use of nutrition for optimal health added to the committee recommendations for implementation of the Global Strategy, the US delegation (controlled by the FDA) demanded that such language not be allowed. The Chair of the meeting complied.

When South Africa made 11 specific proposals, including the significant proposal that dietary supplements be encouraged as foods, not treated toxins, as had been the standard Codex anti-nutrient approach prior to the Global Strategy mandate, the well-constructed proposals, vigorously supported by the pro-health NGOs, were ignored by the Chair. South Africa had to insist that the proposals be included in the minutes of the meeting. These proposals can be seen at: South Africa raising the banner that "Dietary Supplements are Foods, not Toxins" (drugs) was a very significant step to supporting health freedom of choice.

While this may seem to be dry bureaucratic infighting, the impact of the World Food Code, in our growing globalized food marketplace, cannot be under estimated. We are particularly concerned that cheap, safe, advanced natural approaches to optimal health will be ignored, in favor of expensive and dangerous pharmaceutical interventions that developing countries and under insured people in the developed world cannot afford, thereby denying billions of people access to the improved diet that the Global Strategy says is essential to their health and very survival.

While “business as usual” predominated, with a dangerous assault on the integrity of organic agriculture along with the marginalization of the Global Strategy, the good news is that various states and NGOs are allying themselves with the Global Strategy and demanding that the Codex system make a real effort to implement rules for better diet for better health. The pro-health lobby did attain a consensus that WHO/FAO would review all comments and make further recommendations to the Codex Commission meeting scheduled for the WHO headquarters in Geneva this July. At that time the Commission will have to commit itself to implementing the Global Strategy without delay or prevarication.

Ralph Fucetola JD