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.

Sunday, January 25, 2009


FDA approves first human embryonic stem cell study.

On the front page of its Business Day section, the New York Times (1/23, B1, Pollack) reports, "In a research milestone, the federal government will allow the world's first test in people of a therapy derived from human embryonic stem cells." The approval is expected "to be announced Friday by Geron, the biotechnology company that first applied to the Food and Drug Administration (FDA) to conduct the trial last March." Agency officials stated that "political considerations had no role in the decision." Still, "others said they suspected it was more than a coincidence that approval was granted right after the new administration took office." In the past, "the Bush administration restricted federal financing for research on embryonic stem cells because creation of the cells entails the destruction of human embryos."


Doc D:  Misleading article.  These are human embryonic stem cells that come from adult differentiated cells (like skin cells) that have been stimulated to “un-differentiate” into embryonic-type cells.  The key thing is that they are not taken from human embryos…which was what the whole moral argument was about.  President Bush told researchers to find a way to get stem cells without using embryos, and they did.  Can’t tell that from the article, can you?


The magnitude of distortion we get exposed to in the name of “news” continues to shock me.


Survey finds more Americans do without prescriptions.

The New York Times (1/23, Rabin) reports, "One in seven Americans under age 65 went without prescribed medicines in 2007 as drug costs spiraled upward in the United States, a nonprofit research group said on Thursday." That figure "is up substantially since 2003, when one in 10 people under 65 went without a prescription drug because they couldn't afford it, according to the Center for Studying Health System Change in Washington, D.C." Laurie E. Felland, a senior health researcher at the center and lead author of the study, said the current figure "may be even higher because of the recent economic downturn." She added that the people "who were least able to afford medicine were often those who needed it most: uninsured, working-age adults suffering from at least one chronic medical condition." Almost two-thirds of them in the survey "said they had gone without filling a prescription." The study also "one in 10 working-age Americans with employer-sponsored coverage went without a prescription medication in 2007, up from 8.7 percent in 2003."


Doc D:  We need more information here.  I would say that at least 10 percent of the medicines we take, we don’t need (maybe 20 percent).  So, it makes a difference whether you are taking Zantac because you have heartburn from overeating in the evening, or taking digoxin for heart failure.  I’m OK with people not being able to afford a prescription in the first example:  their doctor should get them to stop eating six tacos a night.  In the second example, it’s critical that we make sure they can afford the drug.  How many people are in the “don’t need it” category, and how many are in the “have to have it” category?  Of course, both categories of patients think they need the drugs.


Obama team puts new ICD-10, other rules on hold.

Modern Healthcare (1/22, Lubell) reports that the Department of Health and Human Services' (HHS) "implementation of ICD-10 and several other rules issued last week could potentially be delayed, as the White House proceeds with a review of any new or pending regulations issued under the Bush administration." … White House Chief of Staff Rahm Emanuel released a memorandum that "put a hold on all regulations that have either not been published or those that have not yet taken legal effect." …including HHS' final rule for transitioning to the International Classification of Diseases, 10th Revision," he added.

Doc D:   So now the politicians are going to get into defining what is or isn’t a disease.   The International Classification of Diseases and Related Health Problems is commonly referred to as the ICD.  ICD-9 is the old version and will be superseded by version 10.  The document is used world-wide to code diagnoses, and is the basis for understanding between the sub-sectors of the healthcare industry—between doctors; between doctors and hospitals; among doctors hospitals, and insurance companies.  I can understand reviewing Medicare regulations of the previous administration, but this is a “dictionary” of disease.  Important document, and apparently it needs review for political correctness.


Researchers criticize policies prohibiting smokers from employment.

In the Los Angeles Times (1/21) Booster Shots blog, Shari Roan wrote that "becoming more common is the practice of barring smokers from employment." This practice, however, "is unfair and may have unintended consequences that do more harm than good," according to an essay published Jan. 21 in the journal Tobacco Control. Co-author Dr. Michael Siegel noted that although "policies prohibiting the hiring of smokers have become much more popular in the past year," the "widespread adoption of such policies may make smokers nearly unemployable." As a result, they may "lose their health insurance," which would "affect their health and that of their families." Dr. Siegel and co-author Brian Houle, of the University of Washington, also contend that "refusing to hire smokers is discriminatory and may lead to the adoption of other selective employment practices." Meanwhile, tobacco-control advocates remain "divided over the merits of barring smokers from the workplace." Dr. Siegel stated that some advocates fear being "branded as 'traitors to the cause'" for "speaking out against the employment bans."


Doc D:  It’s interesting that the anti-tobacco advocates are at odds with each other.  I read an article a few months ago that one environmental organization broke into another’s officers in protest of their activities, disrupting files and writing slogans.  In the past, wars have been fought over minor points of difference in religious dogma.  So it seems clear to me we are equally prone to “religious” conflict, whether spiritual or secular.   As humans, we have a tough time accommodating anybody’s opinion of how things should be but our own.



Medical quote of the Day:

Smoking … is a shocking thing, blowing smoke out of out mouths, into other people’s mouths, eyes and noses, and having the same thing done to us. –Samuel Johnson [1709-1784]


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.



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