nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
See here for more discussion.

Friday, November 21, 2008

HEALTH SCREENING, AND SOME GENDER RESULTS

Research indicates many health screens may be ineffective.

Forbes (11/6, Farrell) reports, "A new battery of health screens promises to detect dreaded diseases early so patients can put up a decent fight. In fact, they stoke fear and invite risk." Typically, "screens differ from diagnostic tests in that screens are aimed at patients who are not at unusually high risk, and exhibit no particularly alarming symptoms." The problem is that "plenty of screens don't really work that well. Many yield lots of false-positive results, which lead to unnecessary (and risky) treatments; others work, though not in time for patients to act, leaving them to a life of endless dread." In addition, "these screens can cost thousands of dollars, and many aren't covered by insurance." That is why "the United States Preventive Services Task Force, a government-backed group of healthcare professionals," studies and evaluates health screens. To date, the group has rated "64 potential screenings, and recommends that patients and doctors consider only 30 of those."

 

Doc D:  For us preventive medicine guys, the US Preventive Services Task Force produces the accepted guide to what-who-when for prevention screening.  Their website is here:  http://www.ahrq.gov/clinic/USpstfix.htm#pocket.  If you want to read the whole guide, you can find it on this page.  BUT, even better, there is an electronic search where you can put in age, gender, tobacco usage and sexual activity (just “yes” or “no,” you can’t answer “too little” or “unsat”…sorry), and it will construct a table of screening you should accomplish.  A great tool, here:  http://epss.ahrq.gov/ePSS/search.jsp.

 

On the other hand, some of the commercial advertising promotes testing that is potentially costly, and useless at best (harmful at worst).  Be sure to consult with your doctor first, before getting a genetic screen, or “environmental sensitivity” testing, etc.  Some of these are just rip-offs, some are quackery.  If you’ve already done one of these, well, it’s your life and your money.  Admittedly, some may be useful once proven—“virtual” colonoscopy, for example; this has a lot of appeal for people because they are squeamish about, or afraid of, the fiberoptic scope.  Here is the Task Force’s statement as of May 08:

 

“The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the service. Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined.”

 

But, don’t delay, waiting for some new technology to prove itself.  You could regret it.  And, some of the older techniques are as good or better.

 

Study indicates testosterone patch may increase sexual enjoyment among women.

The Wall Street Journal (11/6, Winstein, Byron) reports, "A female testosterone patch," called Intrinsa, "showed promise at boosting older women's enjoyment of sex," according to a study published in the New England Journal of Medicine. The patch "is designed to treat 'hypoactive sexual desire disorder,' meaning a lack of interest in sexual activity that leads to unhappiness." It "delivers a steady stream of testosterone, a hormone associated with sex drive in men and women." For the study of the patch's effectiveness on the disorder, researchers recruited an estimated 264 women to wear "Intrinsa patches, to be placed near the belly button and changed twice a week, and 277" women to wear placebo patches. The investigators found that those who wore Intrinsa patches "reported 4.6 satisfying episodes in the previous four weeks," at the end of six months. Meanwhile, those wearing "a fake patch" reported 3.2 satisfying episodes.

 

Doc D:  At first, I didn’t want to touch this with a ten foot pole.  But, you know?  Who am I to underestimate that extra 1.2 “satisfying episodes” per month for “older” women?  (although they make it sound much like enjoying the taste of a Big Mac).  Plus, don’t you just love the names that pharmaceutical companies come up with:  “Intrinsa”  I’ll bet they spend millions in research to pick the name that promotes the “association” they want with their product.  I mean, feel the power of “Intrinsa”…I’m not even female, and I’m ready to use it.

 

One serious comment.  Pharmacists can compound testosterone in a cream base for one-twentieth of the cost of the patches.  It’s absorbed thru the skin just like the patches.

 

Researchers say women have more varieties of hand bacteria than men.

Following a story covered by the AP yesterday, UPI (11/5) reports, "Not only do human hands harbor far greater numbers of bacteria than previously believed," but women also "have a greater diversity of microbes," according to a study published online in the Proceedings of the National Academy of Sciences.

        Noah Fierer, of the University of Colorado at Boulder, and colleagues, "scrutinized the palms of 51 undergraduate students for bacteria, just after the students had finished their academic exams," HealthDay (11/4, Gardner) added. "On average, each hand was home to about 150 different species of bacteria," and "overall, more than 4,700 bacterial species were identified on all hands," although "only five of which were common among all volunteers." Notably, about "17 percent of bacteria types were shared between right and left palms, while volunteers shared just 13 percent of bacteria species with each other, probably due to 'environmental' conditions, such as oil production, skin dryness, and what surfaces the hand had previously touched."

 

Doc D:  If this was publicly funded, I’m writing my Congressman.  I’m all for basic science research that teaches us new things about the fundamental nature of the universe.  But, if it fails that test, then it needs to pass the test of being useful.  So, what advice did you garner from this study:  don’t shake hands with women?  Our left and right hands need to share more for us to be healthy?

 

 

Medical quote of the Day:

 

If you live to the age of a hundred, you’ve got it made because very few people die past the age of a hundred.—George Burns

 

Doc D

Opinions are entirely my own.  Quotations from Kaiser Daily Health Policy Report ( © Kaiser Family Foundation), PND News Briefs – Texas Edition ( © 2008, Physician's News Digest, Inc.), AMA Morning Rounds (© U S News Custom Briefings), and other sources in the public domain.  As always, you may share this column, with appropriate attribution (here and in the text) included:  I just ask that you not forward my email address.  I don't care to argue with wacky strangers.

 

 

 

 

 

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