The potential regulation – for endocrine disruptors – is also a threat for a vast array of economic interests. Watch the result of Stephane Horel’s 18-month investigation…
A countdown has begun in Brussels. Europe is considering a ban on endocrine disruptors, ubiquitous chemicals that hijack children’s hormonal systems and impair their health. But the potential regulation is a threat for a vast array of economic interests. The future generations mandate an astute baby to lead a behind the scenes investigation of European democracy where industry, scientists and NGOs fight for influence.
The result of Stephane Horel‘s 18-month investigation, Endocrination exposes the indulgence and sensitivity of the European institutions towards corporate influence. Attack of independent researchers, instrumentalisation of science, conflicts of interest: the film also lifts the veil on the various strategies used by the chemical and pesticides lobbies, borrowed from the tobacco industry’s tool-box, to short-circuit the forthcoming regulation.
American physicians are increasingly unhappy with their once-vaunted profession, and that malaise is bad for their patients
“I wouldn’t do it again, and it has nothing to do with the money. I get too little respect from patients, physician colleagues, and administrators, despite good clinical judgment, hard work, and compassion for my patients. Working up patients in the ER these days involves shotguning multiple unnecessary tests (everybody gets a CT!) despite the fact that we know they don’t need them, and being aware of the wastefulness of it all really sucks the love out of what you do. I feel like a pawn in a moneymaking game for hospital administrators. There are so many other ways I could have made my living and been more fulfilled. The sad part is we chose medicine because we thought it was worthwhile and noble, but from what I have seen in my short career, it is a charade.”
From a nationally recognized expert, an exposé of the worst excesses of our zeal for medical testing
After the criteria used to define osteoporosis were altered, seven million American women were turned into patients—literally overnight. The proliferation of fetal monitoring in the 1970s was associated with a 66 percent increase in the number of women told they needed emergency C-sections, but it did not affect how often babies needed intensive care—or the frequency of infant death. The introduction of prostate cancer screening resulted in over a million additional American men being told they have prostate cancer, and while studies disagree on the question of whether a few have been helped—there’s no disagreement that most have been treated for a disease that was never going to bother them. As a society consumed by technological advances and scientific breakthroughs, we have narrowed the definition of normal and increasingly are turning more and more people into patients. Diagnoses of a great many conditions, including high blood pressure, osteoporosis, diabetes, and even cancer, have skyrocketed over the last few decades, while the number of deaths from those diseases has been largely unaffected.
Drawing on twenty-five years of medical practice and research, Dr. H. Gilbert Welch and his colleagues, Dr. Lisa M. Schwartz and Dr. Steven Woloshin, have studied the effects of screenings and presumed preventative measures for disease and “pre-disease.” Welch argues that while many Americans believe that more diagnosis is always better, the medical, social, and economic ramifications of unnecessary diagnoses are in fact seriously detrimental. Unnecessary surgeries, medication side effects, debilitating anxiety, and the overwhelming price tag on health care are only a few of the potential harms of overdiagnosis.
Through the stories of his patients and colleagues, and drawing from popular media, Dr. Welch illustrates how overdiagnosis occurs and the pitfalls of routine tests in healthy individuals. We are introduced to patients such as Michael, who had a slight pain in his back. Despite soon feeling fine, a questionable abnormal chest X-ray led to a sophisticated scan that detected a tiny clot in his lung. Because it could not be explained, his doctors suggested that it could be a sign of cancer. Michael did not have cancer, but he now sees a psychiatrist to deal with his anxiety about cancer.
According to Dr. Welch, a complex web of factors has created the phenomenon of overdiagnosis: the popular media promotes fear of disease and perpetuates the myth that early, aggressive treatment is always best; in an attempt to avoid lawsuits, doctors have begun to leave no test undone, no abnormality—no matter how incidental—overlooked; and, inevitably, profits are being made from screenings, a wide array of medical procedures, and, of course, pharmaceuticals.
Examining the social, medical, and economic ramifications of a health care system that unnecessarily diagnoses and treats patients, Welch makes a reasoned call for change that would save us from countless unneeded surgeries, debilitating anxiety, and exorbitant costs. Read book reviews.
This Tuesday 9th of September : join our free social media event taking place at each Full Moon – via #EAv – and give a boost to your social networking!
The Harvest Moon
There are native American names for the full moons that you can find here, here or here.
September month full moon was named Harvest Moon because many of the native American’s tribes’ staple foods were ready to be harvested around this time. It was sometimes named the Corn Moon because it marked when corn was supposed to be harvested.
This is the full moon nearest the autumnal equinox (about September 23) when the angle of the moon’s orbit relative to the Earth’s horizon is at its minimum, causing the full moon to rise above the horizon much faster than usual. Since the difference of the moon’s rising time on successive nights barely varies, the moon appears to rise at nearly the same hour for several nights in succession. Because the harvest moon, like any full moon, must rise near the hour of sunset, harvest workers in the Northern Hemisphere may be aided by bright moonlight after sunset on several successive evenings. A similar effect is observed in corresponding southern latitudes around March 21…
#FullMoonEngageMe Social Media Event N°5 Schedule
The event will start on Tuesday 9th of September at 18:00 UTC and will last until Monday the 15th in HERE.
Please read our FAQs and use the comment section to ask any question about the event.
You can join – for FREE – Empire Avenue at anytime – before and after any FullMoon EngageMe Social Media Event. You can use this link – with no strings attached – to get some extra “eaves” at start ! See you soon 😉
DES daughters in France: experts’ points of view on the various genital, uterine and obstetric pathologies, and in utero DES exposure
Background Compensation of diethylstilbestrol exposure depends on the judicial system. In France, girls having been exposed to diethylstilbestrol are currently being compensated, and each exposure victim is being evaluated. Fifty-nine expert evaluations were studied to determine the causal relation between exposure to diethylstilbestrol and the pathologies attributable to diethylstilbestrol.
Methods The following were taken into consideration: age at the first signs of the pathology; age of the sufferer at the time of evaluation; the pathologies grouped into five categories: fertility disorders – cancers – mishaps during pregnancy – psychosomatic complaints – pathologies of “3rd generation DES victims”; submission of proof of DES exposure; the degree of causality determined (direct, indirect, ruled out).
61% of the cases related to fertility disorders,
28.8% to cancer pathologies (clear-cell adenocarcinoma),
18.6% to mishaps during pregnancy,
8.5% to disorders resulting from preterm delivery,
and 3.4% to psychosomatic disorders.
Some cases involved a combination of two types of complaints. Indirect causality was determined in 47.1% of the cases involving primary sterility, in 66.7% involving secondary sterility, and in 5 out of 6 cases of total sterility. There is direct causality between in utero diethylstilbestrol exposure and vaginal or cervical clear cell adenocarcinoma. Causality is indirect in the case of disorders linked to prematurity in third generation victims.
Conclusion Causality was determined by the experts on the basis of scientific criteria which attribute the presenting pathologies to diethylstilbestrol exposure. When other risk factors come into play, or when exposure is indirect (third generation), this causality is diminished.
Sources DES daughters in France: experts’ points of view on the various genital, uterine and obstetric pathologies, and in utero DES exposure, Med Sci Law, PMID: PubMed 24534146, 2014 Feb 17.
The fund, which has helped more than 55,000 cancer patients since it was set up four years ago, will be increased from £200 million a year to £280 million a year for the next two years to improve access to drugs currently deemed too expensive.
The increase in funding means two new cancer drugs will be made available and many more patients with rare conditions will benefit from life-extending drugs recommended by their doctor.
Hunt demands shake-up to stop NICE blocking life-extending drugs for cancer: Health Secretary will also announce 40% increase in resources to pay for treatments, DailyMail, 27 August 2014.
Cancer drugs fund subject to ‘value for money’ assessment for first time, The Telegraph, 28 Aug 2014.
The threat to human health posed by overdiagnosis and the waste of resources on unnecessary care
In 2002 the BMJ published a theme issue called “Too Much Medicine?” with articles on the medicalisation of birth, sex, and death, among other aspects of ordinary life. Its opening editorial wondered whether doctors could become pioneers of de-medicalisation, handing back power to patients, resisting disease mongering, and demanding fairer global distribution of effective treatments.
A decade later, as data on overuse and overdiagnosis mount the BMJ announces its Too Much Medicine campaign aiming to highlight the threat to human health posed by overdiagnosis and the waste of resources on unnecessary care.
There is growing evidence that many people are overdiagnosed and overtreated for a wide range of conditions, such as prostate and thyroid cancers, asthma, and chronic kidney disease.
Through the campaign, the journal plans to work with others to increase awareness of the benefits and harms of treatments and technologies and develop ways to wind back medical excess, safely and fairly. This editorial by Fiona Godlee, editor in chief of The BMJ and overdiagnosis researcher Ray Moynihan, senior research fellow at Bond University, Australia, explains more about the campaign:
Dr Godlee said: “Like the evidence based medicine and quality and safety movements of previous decades, combatting excess is a contemporary manifestation of a much older desire to avoid doing harm when we try to help or heal.
Making such efforts even more necessary are the growing concerns about escalating healthcare spending and the threats to health from climate change. Winding back unnecessary tests and treatments, unhelpful labels and diagnoses won’t only benefit those who directly avoid harm, it can also help us create a more sustainable future.”
The BMJ was a partner in the international scientific conference, Preventing Overdiagnosis, held in September 2013 in Hanover, New Hampshire. The conference brought together the research and researchers, advanced the science of the problem and its solutions, and developed ways to better communicate about this modern epidemic.
Prenatal antidepressant exposure associated with risk for attention-deficit hyperactivity disorder
The study – “Prenatal antidepressant exposure is associated with risk for attention-deficit hyperactivity disorder but not autism spectrum disorder in a large health system” – suggests a potential link between women taking antidepressants during pregnancy and an increased risk of ADHD, but not ASDs, in their children. The limitation to this type of study is that factors other than the antidepressants, such as the depression itself, or genetic factors increasing both depression and ADHD risk, might be causing the effect seen.
The researchers used various methods to take this into account, but acknowledge that other factors could still be having an effect. While the link with ADHD remained significant after taking maternal depression into account, it did not remain significant after taking into account measures of how severe the woman’s illness was.
Other limitations to the study include the following:
It could only assess what prescriptions the mothers received, and not whether they took them.
It could not directly assess how severe a woman’s illness was; they had to rely on data that was routinely collected on the types of treatment she was receiving and her previous diagnoses. This is unlikely to capture severity as well as a more direct assessment could.
If children or mothers were diagnosed or treated outside of the healthcare grouping being assessed, this information would not be available to the researchers, and this could affect results.
It is important to know that no one factor is likely to cause ADHD or ASD. These conditions are complex, and we are not yet entirely sure what causes the majority of cases. Both genetic and non-genetic (known as “environmental”) factors are thought to potentially play a part.
Medications are used sparingly in pregnancy to reduce any risk of harm to the developing foetus. However, if a woman’s condition could have serious consequences if untreated, then the woman and their doctor may decide that the benefits outweigh the harms.
Antidepressant use in pregnancy linked to ADHD, NHS Choices, Mental Health, August 27 2014.
Prenatal antidepressant exposure is associated with risk for attention-deficit hyperactivity disorder but not autism spectrum disorder in a large health system, Nature, Molecular Psychiatry , doi:10.1038/mp.2014.90, 26 August 2014.
Pregnant women who take anti-depressants ‘could raise their child’s risk of ADHD‘, DailyMail, health/article-2734926, 26 August 2014.