Do they truly measure what they purport to measure? Are they accurate, reproducible, and can the data generated be concordantly interpreted by all users of the same data? Can the results be prospectively applied yielding desired outcomes? Advances in mammographic and other radiological technology are outpacing our ability to interpret and effectively use the data that it yields.

Horse-shaped shadows at a hundred yards may rightly be expected to be a horse in the U.S. However, misinterpreted microcellular appearance of diverse healthy tissues is resulting in excessive, aggressive, prophylactic intervention to mitigate potential breast cancer because at such diminutive microscopic levels the horses are actually too small to distinguish. As such, is the newest mammography valid, that is, does it actually measure what it purports to measure? Assure that your mammography test and results are valid, interpretable, and reproducible by both the team who performs it and if evaluated by another team of radiologists; ask how they validate their interpretations.

Contact us with questions and opinions.

Annually, we could all provide a complete medical history (update) and participate in a comprehensive physical examination, laboratory testing and personal habits/lifestyle documentation to fully assess our current health/disease status and disease risk status for the purpose of risk pool assignment to a single, nationally defined and managed, tiered insurance premium plan for national health care. Is such a program a right for citizens?

We have an obesity epidemic in the U.S, in all age groups. Obesity is generally caused by a combination of poor dietary and exercise habits. Dietary habits are developed via cultural introduction and availability of food resources. Our diverse culture presents a significant variety of foods. However, our media promotes style, and our entertainment venues regularly offer menus that are frequently not in our best health interests. . . . .

Aug 10, 2010 (CIDRAP News) – “The head of the World Health Organization (WHO) today declared the H1N1 influenza pandemic over, saying worldwide flu activity has returned to typical seasonal patterns and many people have immunity to the virus.

‘The world is no longer in phase 6 of influenza pandemic alert,’ said WHO Director-General Margaret Chan in a press briefing from Hong Kong. ‘We are now moving into the post-pandemic period. The H1N1 virus has largely run its course.’

But she cautioned that the virus has not gone away and bears continued watching, commenting, ‘We expect the H1N1 virus to take on the behavior of a seasonal influenza virus and continue to circulate for some years to come’.”

The WHO reported an initial expectation of over 1,000,000 post-exposure deaths, but fewer than 20,000 cases actually occurred. The markedly lower than projected numbers of deaths is evidence that the virus is not nearly as virulent as was initially anticipated. Hopefully, they’ll let the distributors of the vaccine know so they can stop flooding television with commercials about vaccination and the upcoming flu season.

Contact us with your questions and comments.

Did you know that the FDA has no explicit guidelines regarding when to allow a drug to come to the market, stay in the market versus be removed or to be allowed to return to the market? They simply try to assess benefit/risk ratio, frequently based upon work performed by the product manufacturer. Moreover, the FDA allows more severe side effects with medications applicable to more severe disease . . . . .

Lets consider the following:

· For age > 65 y/o, falls are the leading cause of fatal injury and responsible for approximately 2 million ER visits per year.

· Most falls are not truly accidents rather represent affects of physical deficits related to diminished vision, strength and/or balance.

· Ankle strength and range of motion accounts for approximately 50 percent of our balance.

· Hip strength accounts for approximately 20 percent of our balance.

· Numerous muscles of the trunk accounts for the remaining 30 percent of our balance.

· Decreased flexibility of musculature and ligaments away from the ankle also contributes to imbalance.

· Improved visual contrasts in the home and work environments, and keeping floors tidy (free from slip/trip hazards) lessens risk of injury.

Come on Baby-boomers, avoid the injuries. Contact us for additional recommendations.

I don’t know a single person who is unfamiliar with the phrase “ambulance chaser.” The term has long been applied to the unscrupulous practice of attorneys who advertise on/in all conceivable media to find potential clients amongst the injured and ill. Now pharmaceutical companies have joined the fray via direct marketing their products to commercial television audiences, disease mongering.

If all the commercials’ information were shared at the same rate of speech, you would see that they actually spend more time on disclaimers regarding side effects of the products compared to the purported benefits of the products. Even more disturbing is that if they concurrently manage to work their way into doctors’ offices, they would at least bring lunch, treats and samples to their audience. Whereas on television they make you pay with your time and cable/satellite bill to watch them.

While some people may be rightfully encouraged to seek needed help by this approach, most others are simply being coerced into using medicines not actually needed. Moreover, especially relative to the “ED” drugs, physicians seem be playing along with the popularity of the billion dollar markets that these drugs have created.

A person I recently met stated “I just hope that I don’t develop hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; chest pain; fainting; fast or irregular heartbeat; memory loss; numbness of an arm or leg; one-sided weakness; painful or prolonged erection; ringing in the ears; seizures; severe or persistent dizziness; sudden decrease or loss of hearing; sudden decrease or loss of vision in one or both eyes while waiting for my four hour erection to subside,” as he read the package insert. He didn’t, but thanks to “big pharma” he is part of the population with the fastest rising incidence of new STD cases, senior citizens.

The U.S. is challenged regarding the health of its population by its lack of definition of good national health. If the country were considered a corporation and taking care of its population’s health considered a corporate health program, the U.S. would be both reprimanded by NIOSH and cited regularly by OSHA for its substantively greater attention to corporate profits versus taking care of its employees’ well-being.

Discussion for national health care reform would then be better directed at the following:

The patient presents with recurrent pain about the outer aspect of the right elbow. He reports that the pain primarily occurs with forceful gripping and occurs with movements of his right upper extremity characterized as repetitive wrist extension and palm upwards rotation of his forearm (supination).

He reports that the symptoms are recurrent, associated primarily with periods of increased racquet sports activity and fitness training. He reports prior use of OTC and prescription NSAIDs, and receiving a number of local steroid injections.

On physical examination his right upper extremity appears normal, without focal redness or swelling. The soft tissue over the lateral epicondyle is mildly swollen and of a softer, fuller texture compared to that on the left. He demonstrates normal active range of motion at the elbow. He reports slight increase in pain over the lateral elbow (epicondyle) with resisted wrist extension and supination, with mildly decreased strength (pain limited) compared to the left.

Assessment

1. Lateral epicondylitis

Considerations

The diagnosis is not particularly challenging or uncommon. Of significance is that the label is only applicable for a limited period. Tendons attaching at the lateral epicondyle that are repeatedly inflamed may degenerate over time, epicondylitis transitioning to epicondylosis. As such, traditional oral anti-inflammatory treatment and local steroid injections will not be effective indefinitely. Moreover, excessive local steroid injections may hasten deterioration of the tissues.

Treatment

1. Educate the patient about the involved musculature, adjacent soft tissue and function.

2. The patient is to attempt to eliminate contributing causal/exacerbating activities as much as is possible.

3. We discussed his workout routine making adjustments to its content.

4. I recommended that he consider purchasing a lighter weight hybrid/composite tennis racquet and decrease backhand stroke frequency.

5. We discussed applying alternating heat, ice, mild friction massage and local electrical stimulation (TENS) to encourage local circulation with limited concurrent analgesic benefit.

6. I recommended twice a day application of a thin layer of topical DMSO overlaid with a balm composed of one or more of the following numerous substances: menthol, aloe, eucalyptus, cayenne, arnica, Emu oil, devil’s claw, c. indica (as allowed in his State); other agents are also applicable.

Presuming that the tissues have not already degenerated significantly and the patient can make appropriate lifestyle changes, I anticipate a positive response to the treatment plan over time. At follow-up we will address additional evaluation and treatment alternatives depending upon case status and how much of the plan he was able to fully engage.

Contact us with questions about this case and other issues of interest.

Humans are composed of approximately 55 to 75 percent water depending upon age, gender and percent body fat. Regular replacement of internal water is critical to our health. As such, one might state that the most important aspect of good healthcare is quality water consumption. When is the last time your favorite politician or clinician discussed water quality as an important issue in relation to your healthcare?