Misdiagnosis in the U.S. Infographic

Frightening Statistics, Consequences of Diagnostic Errors


Current calculations have determined that one out of every twenty patients in the U.S. is given a totally inaccurate medical diagnosis. Sadly, these faulty diagnoses can result in permanent injury, death, delayed treatments, increased medical costs, as well as pain and suffering.

Sources and more information

L’invité d’i matin février 2006: le docteur Nicole Delepine

Ma liberté de soigner ; témoignage

Nicole Delépine est sur i-télé afin de parler de son livre : “Ma liberté de soigner“. Vidéo publiée le 4 juin 2012 par Nicole Delepine.


A la fois témoignage bouleversant sur son vécu auprès d’enfants malades du cancer et réquisitoire aurgumenté contre un système de plus en plus totalitaire qui rejette les fondamentaux de la médecine d’Hippocrate, l’ouvrage du docteur Nicole Delépine est surtout un vibrant plaidoyer pour la liberté thérapeutique.

Plus d’informations:
  • Le site du docteur Nicole Delépine.

Many doctors misunderstand how people may abuse prescription pain drugs in the U.S.

Primary Care Physicians and Prescription Opioid Abuse: A National Survey

This post content is published by Johns Hopkins Bloomberg School of Public HealthTogether we’re Protecting Health, Saving Lives—Millions at a Time.

image of doctor working-with-prescriptions
LACK OF UNDERSTANDING MAY LEAD TO CONTINUED OVERPRESCRIBING OF ADDICTIVE PRESCRIPTION PAIN PILLS. A doctor check his patients’ paperwork by World Bank Photo Collection.

Many primary care physicians – the top prescribers of prescription pain pills in the United States – don’t understand basic facts about how people may abuse the drugs or how addictive different formulations of the medications can be, new Johns Hopkins Bloomberg School of Public Health research suggests.

This lack of understanding may be contributing to the ongoing epidemic of prescription opioid abuse and addiction in the U.S.

Reporting online June 23 in the Clinical Journal of Pain, the researchers found that nearly half of the internists, family physicians and general practitioners surveyed incorrectly thought that abuse-deterrent pills – such as those formulated with physical barriers to prevent their being crushed and snorted or injected – were actually less addictive than their standard counterparts. In fact, the pills are equally addictive.

Physicians and patients may mistakenly view these medicines as safe in one form and dangerous in another, but these products are addictive no matter how you take them,” says study leader G. Caleb Alexander, MD, MS, an associate professor in the Bloomberg School’s Department of Epidemiology and co-director of the school’s Center for Drug Safety and Effectiveness. “If doctors and patients fail to understand this, they may believe opioids are safer than is actually the case and prescribe them more readily than they should.

He adds: “Opioids serve an important role in the treatment of some patients. However, our findings highlight the importance of patient and provider education regarding what abuse-deterrent products can and cannot do. When it comes to the opioid epidemic, we must be cautious about overreliance on technological fixes for what is first and foremost a problem of overprescribing.”

Another finding from the new research: One-third of the doctors erroneously said they believed that most prescription drug abuse is by means other than swallowing the pills as intended. Numerous studies have shown that the most common route by which drugs of abuse are administered is ingestion, followed by snorting and injection, with the percentage of those ingesting the drugs ranging from 64 percent to 97 percent, depending on the population studied. Certain medications are more likely than others to be snorted or injected.

Prescription drug abuse is the nation’s fastest growing drug problem, according to a report released by the White House in 2011. According to the U.S. Centers for Disease Control and Prevention, prescription drug overdose death rates in the United States have more than tripled since 1990 and have never been higher. The clinical use of prescription opioids nearly doubled between 2000 and 2010. By 2009, prescription drugs surpassed motor vehicle crashes as a leading cause of unintentional death, with more people dying from prescription opioids than cocaine and heroin combined.

Doctors continue to overestimate the effectiveness of prescription pain medications and underestimate their risks, and that’s why we are facing such a public health crisis,” Alexander says.

For the study, Alexander and his colleagues conducted a nationally representative survey of 1,000 primary care physicians between February and May 2014 examining their knowledge, attitudes and beliefs regarding prescription drug abuse. They focused not only on opioid abuse and diversion (the use of prescription drugs for recreational purposes), but also their support for clinical and regulatory interventions that may reduce opioid-related injuries and deaths.

The researchers found that all respondents believed that prescription drug abuse was at least a small problem in their communities, with more than half reporting it was a “big problem.” While there was disconnect in physicians’ understanding of some elements of abuse and addiction, the researchers found large support for a variety of measures that could reduce prescription opioid abuse.

Nearly nine out of 10 physicians said they “strongly supported” requiring patients to get opioids from a single prescriber and/or pharmacy, something that would cut down on the number of patients who go from doctor to doctor to get more pain pills than one doctor would prescribe.

Two-thirds of doctors strongly supported the use of patient contracts, where patients agree to properly use their pain medication and not give or sell it to others. More than one-half strongly supported the use of urine testing for chronic opioid users to make sure patients are taking their medication and not diverting it and are not taking drugs they are not prescribed.

Alexander says he is heartened by the numbers, but believes some physicians may be overstating their support for such measures, as they would be time-consuming to implement and, in the case of urine testing, are already recommended by some guidelines yet typically underused.

Despite the high levels of support, there are many barriers to implementation and there may be reluctance to translate these changes into real-world practice,” he says. “But for the sake of making a dent in an epidemic of injuries and deaths, we have to find ways to make changes. Too many lives are at stake to stick with the status quo.

Primary Care Physicians and Prescription Opioid Abuse: A National Survey” was written by Catherine S. Hwang, MSPH; Lydia W. Turner, MHS; Stefan P. Kruszewski, MD; Andrew Kolodny, MD; and G. Caleb Alexander, MD, MS.

The research was supported by the Robert Wood Johnson Public Health Law Research Program and the Lipitz Public Health Policy Award from the Johns Hopkins Bloomberg School of Public Health.

Prenatal diethylstilbestrol exposure and performance on college entrance examinations

DES exposure and written tests performance

writing-test
No differences in test performance were seen among exposed daughters. Among sons, test scores were marginally higher among the exposed, probably due to chance. Written test image by Melanie Holtsman.

1992 Study Abstract

The fetal rodent brain is permanently altered by exposure to sex hormones. Long-term effects of prenatal sex hormones on the human brain are far less clear.

In order to explore such effects, we studied a measure of cognitive function among young adults who had been exposed in utero to a powerful synthetic estrogen. In a randomized clinical trial conducted at the University of Chicago in 1950-1952, 1646 pregnant women were randomly assigned to receive either high doses of Diethylstilbestrol or placebo.

Women in this study gave birth to 1653 liveborn infants, of whom 1603 (820 sons and 783 daughters) survived to their fifteenth birthday. College entrance examination scores were obtained for 42% of these offspring. No differences in test performance were seen among exposed daughters. Among sons, test scores were marginally higher among the exposed, probably due to chance.

Sources
  • Prenatal diethylstilbestrol exposure and performance on college entrance examinations, Wilcox AJ, Maxey J, Herbst AL, NCBI PMID: 1398561, Horm Behav. 1992 Sep;26(3):433-9. Full study.
More DES DiEthylStilbestrol Resources

European Parliament EDCs Roundtable

EDCs Roundtable European Parliament, June 30th 2015

European Parliament, Endocrine Disrupting Chemicals and Future Generations: Time for the EU to Take Action
June 30th 2015 (15:00-18:00, room ASP 5E2)

This post content is published by PAN Europe – Sustainable Agriculture; eliminate dependency on chemical pesticides and to support safe sustainable pest control methods as well as healthier products.

PAN Europe takes the initiative to organize an event in the European Parliament to bring MEPs and scientists together to discuss the issue of EDCs and the delay in their regulation.
Background Information

Exposure to Endocrine Disrupting Chemicals (EDCs) is an issue of concern, globally, due to the negative impacts on humans and wildlife. Exposure to these chemicals, especially during pre-natal and post-natal stages has been linked to the development of endocrine diseases and disorders of the thyroid, immune, digestive, cardiovascular, reproductive and metabolic systems (including childhood obesity and diabetes). The World Health Organization report on EDCs, published in 2013 highlights that “exposure to EDCs and their effects on human and wildlife are a global problem that will require global solutions“. It also calls for an improvement of the methods used in the risk assessment of chemicals and in the evaluation of EDC exposure and health effects.

In Europe, the Pesticide Regulation approved by the European Parliament in 2009, adapted the precautionary principle approach and banned the use of endocrine disrupting substances (EDCs) in these products. In parallel, it called for the COM to present the criteria to identify EDCs by December 2013. The task was first given to the Environment Directory of the COM (DG ENV) to identify “horizontal” criteria that could also be applied in the other Chemical Regulations (Biocides, REACH, Cosmetics and Medical Devices). Following the work of endocrinology experts, DG ENV had the draft criteria ready in 2013 but they were never approved. Instead, the COM commanded for an impact assessment, gave the lead to DG SANTE and decided to miss the deadline. The impact assessment will be done on more options that the ones proposed from the endocrinologists and adapted in the draft criteria of DG ENV, including elements of traditional risk assessment that will miss to detect these chemicals. Not only we haven’t progressed but we have also gone backwards, since we are discussing again what was already approved by the European Parliament and the European Council back in 2009. The “necessity” of an impact assessment has been highly criticised by the general public, politicians and scientists for being a fruit of the industry “lobbying”. Not only the COM is delaying the regulation of these harmful chemicals but it may also select the wrong criteria that will fail to protect the health of our children and the future generations.

Purpose of the Event

The event, hosted by MEP Nicola Caputo and organized together with PAN Europe, aims to bring the science back in the European Parliament and give the opportunity to MEPs and participants to ask questions directly to scientific experts about EDCs and help accelerating the process of their correct regulation in the EU. We have invited professors and expert scientists in the field of endocrine disrupting research (from WHO, EEA, KEMI, Endocrine Society panels) to present the state of the science of endocrine disruptors and the criteria needed to identify these substances. The leading DGs on EDCs will be present to explain the current regulatory procedures on EDCs (criteria and impact assessment) as well as EFSA, the responsible agency for the peer review of the risk assessment of pesticides and other food residues. We will use as a reference the regulation of endocrine disrupting pesticides and biocides, but the event will cover EDCs used in all sectors for example in chemical and cosmetic industry. The MEPs and all the participants will have the chance to discuss EDCs openly with the scientists and the responsible civil servants.

Considering that exposure to EDCs is an issue of concern that has been brought to light due to the recent advances in technology and research, Pesticide Action Network Europe highlights that a collaborative action of all sectors is needed to protect our future generations. This is in line with the objectives of the new Commission:Innovation by applying the most recent advances in endocrinology, animal testing and the monitoring of environmental exposure. This will create jobs in the research and industry sectors, which will provide sustainable growth, by allowing the development without prejudicing the health of the future generations and the environmental resources.

Agenda
Chairing: MEP Nicola Caputo (S&D), Henrik Sundberg (KEMI, Sweden)

15:00-15:15
General introduction: MEP Nicola Caputo
Bringing back EDCs in the European Parliament: Angeliki Lysimachou (PAN Europe)

15:15-16:10
EDCs: What are they and why should we be concerned?
Human exposure to potential EDCs, semi-persistent chemicals and current-use pesticides in particular.
Prof. Åke Bergman (The Academic Center Swetox, Sweden)

EDCs and male reproductive health – why are we concerned?
Prof. Jorma Toppari (University of Turku, Finland)

Cost of inaction and endocrine disruptors what do we know?
Ing-Marie Olsson (KEMI, Sweden)

Discussion
16:10-17:00
EDCs and risk assessment

Endocrine disruptors: a panoply of health effects. When is enough enough?
Prof. Ana Soto (Tufts University, Boston)

Thyroid hormone disruption, brain development and IQ loss.

Prof. Barbara Demeneix (Muséum Nationale d’histoire Naturelle/CNRS,
expert OECD, Paris)

EFSA’s work on the assessment of endocrine active substances
Hubert Deluyker (EFSA)

Discussion: Why are EDCs different than other toxic chemicals? Are current EU “safe” limits really that “safe”?

17:00-18:00
Regulation of endocrine disrupting pesticides/biocides-update, roadmap and impact assessment.
The debate about regulating endocrine disrupters
Prof. Andreas Kortenkamp (Brunel University, London)

The impact assessment for defining criteria on endocrine disruptors in the context of the plant protection products and biocidal products regulations
Michael Flueh (DG SANTE)

The regulation of endocrine disruptors within REACH
Bjorn Hansen (DG ENVI)

Panel (including speakers): Georg Streck (DG Growth), Benjamin Musall (DG Trade),Jorge Costa-David (DG EMPL)

Discussion: Why the COM decided to miss the EDC criteria deadline? Will the impact assessment protect human health and wildlife from the effects of EDCs? Is it based on scientific evidence?

If you wish to participate please contact angeliki.

Do you have the next antibiotic?

Is the Next Antibiotic Just Sitting on a Shelf?

superbugs-cartoon
Katie McKissick @beatricebiology is a former high school biology teacher turned science writer and cartoonist.

The Community for Open Antimicrobial Drug Discovery (CO-ADD) was set up by scientists at the University of Queensland in Brisbane, Australia, in response to the growing problem of antimicrobial resistance.

Prenatal diethylstilbestrol exposure and reproductive hormones in premenopausal women

Reproductive hormone levels in DES-exposed premenopausal women

menopause-lane
In this 2015 study, prenatal DES exposure was associated with variation in concentrations of FSH, estradiol and inhibin B among women of late reproductive age.

2015 Study Abstract

Diethylstilbestrol (DES), a synthetic estrogen widely prescribed to pregnant women in the mid-1900s, is a potent endocrine disruptor. Prenatal DES exposure has been associated with reproductive disorders in women, but little is known about its effects on endogenous hormones.

We assessed the association between prenatal DES exposure and reproductive hormones among participants from the Harvard Study of Moods and Cycles (HSMC), a longitudinal study of premenopausal women aged 36-45 years from Massachusetts (1995-1999). Prenatal DES exposure was reported at baseline (43 DES exposed and 782 unexposed). Early follicular-phase concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol were measured at baseline and every 6 months during 36 months of follow-up. Inhibin B concentrations were measured through 18 months. We used multivariable logistic and repeated-measures linear regression to estimate odds ratios (OR) and percent differences in mean hormone values (β), respectively, comparing DES exposed with unexposed women, adjusted for potential confounders.

DES-exposed women had lower mean concentrations of estradiol (pg/ml) (β=-15.6%, 95% confidence interval (CI): -26.5%, -3.2%) and inhibin B (pg/ml) (β=-20.3%, CI: -35.1%, -2.3%), and higher mean concentrations of FSH (IU/I) (β=12.2%, CI: -1.5%, 27.9%) and LH (IU/I) (β=10.4%, CI: -7.2%, 31.3%), than unexposed women. ORs for the association of DES with maximum FSH>10 IU/I and minimum inhibin B<45 pg/ml – indicators of low ovarian reserve – were 1.90 (CI: 0.86, 4.22) and 4.00 (CI: 0.88-18.1), respectively.

Prenatal DES exposure was associated with variation in concentrations of FSH, estradiol and inhibin B among women of late reproductive age.

Sources
  • Prenatal diethylstilbestrol exposure and reproductive hormones in premenopausal women, Wise LA, Troisi R, Hatch EE, Titus LJ, Rothman KJ, Harlow BL, J Dev Orig Health Dis. 2015 Jun;6(3):208-16. doi: 10.1017/S2040174415000082. NCBI PMID: 25698132, Epub 2015 Feb 20. full study.
More DES DiEthylStilbestrol Resources

La Grande Invasion (des produits chimiques dans notre quotidien)

Notre quotidien le plus banal est farci de produits chimiques

Documentaire de Stéphane Horel, France 5 (2010).

Plus d’information
  • Notre quotidien le plus banal est farci de produits chimiques. Incrustés dans les plastiques, les détergents et les grille-pains, nichés dans les aliments, les boîtes de conserve, les jouets, les shampooings, ils sont invisibles et partout à la fois, y compris dans nos corps. La société de consommation et la magie pétrochimique se baladent dans nos petits intérieurs sous des noms strictement inconnus et parfaitement barbares. Phtalates, retardateurs de flammes bromés, parabens, bisphénol-A ont pour fâcheux inconvénient de cambrioler notre intimité hormonale : ce sont des perturbateurs endocriniens. Pour les scientifiques reconnus qui interviennent dans ce documentaire, cette imprégnation chimique n’est pas étrangère au développement des maladies dites modernes – du cancer du sein à l’obésité. Le constat, plutôt grave, n’empêche pas le film de prendre le parti du second degré. Oscillant entre humour grinçant et poésie, des animations en papiers collés montrent les destins parallèles des humains et des animaux de laboratoire. Allégories de la frénésie du progrès, des archives commerciales des années 1950-60 où l’on danse au milieu des réfrigérateurs deux portes, l’air radieux, racontent l’histoire d’amour de l’homme moderne avec le confort plastique et l’abondance électroménagère.
  • La Grande Invasion documentaire et articles/critiques.
  • Compilation de vidéos sur les produits chimiques et pesticides sur YouTube.

The Full Hay Moon 15th #FullMoonEngageMe #SocialMedia Event on #EmpireAvenue #SocialNetworking

July 1-5 2015, join our free social media event taking place at each Full Moon.

image of full hay moon
Between the 1st and the 5th of July 2015, join our free social media event taking place at each Full Moon – via #EAv – and give a boost to your social networking! Full Hay Moon image via Clifton Beard.

The Full Hay Moon

July‘s full moon is sometimes referred to as the Hay Moon, after the July hay harvest.
It is also called Blood Moon, or Thunder Moon – because thunderstorms are so frequent during this month – or the Buck Moon – because male deer, which shed their antlers every year, begin to regrow them in July.

15th #FullMoonEngageMe Schedule

Our free event will start on Wednesday the 1st of July 2015 at +/- 07:00 UTC and will last until Sunday the 5th at +/- 24:00 in HERE.

What is this about?

Our 1st #FullMoonEngageMe event launched in May 2014… Grab a unique opportunity to super charge your social networking by meeting and connecting with top social media engagers on Empire Avenue and beyond. Time for some “serious buzz” and serious FUN!

Take a look at some highlights from our previous (14th) event:










Confused?

See you soon 😉

Environmental Estrogens and Obesity, Body Weight following DES Exposure

Environmental Estrogens and Obesity

Control-and-DES-treated-Mice image
Representative photograph of control and DES-treated mouse at ~ 6months of age. Image via NCBI.  Complex events including exposure to environmental chemicals during development may be contributing to the obesity epidemic.

2010 Study Abstract

Many chemicals in the environment, in particular those with estrogenic activity, can disrupt the programming of endocrine signaling pathways that are established during development and result in adverse consequences that may not be apparent until much later in life. Most recently, obesity and diabetes join the growing list of adverse consequences that have been associated with developmental exposure to environmental estrogens during critical stages of differentiation. These diseases are quickly becoming significant public health issues and are fast reaching epidemic proportions worldwide.

In this review, we summarize the literature from experimental animal studies documenting an association of environmental estrogens and the development of obesity, and further describe an animal model of exposure to diethylstilbestrol (DES) that has proven useful in studying mechanisms involved in abnormal programming of various differentiating estrogen- target tissues.  Other examples of environmental estrogens including the phytoestrogen genistein and the environmental contaminant Bisphenol A (BPA) are also discussed. Together, these data suggest new targets (i.e., adipocyte differentiation and molecular mechanisms involved in weight homeostasis) for abnormal programming by estrogenic chemicals, and provide evidence that support the scientific hypothesis termed “the developmental origins of adult disease”.

The proposal of an association of environmental estrogens with obesity and diabetes expands the focus on the diseases from intervention/treatment to include prevention/avoidance of chemical modifiers especially during critical windows of development.

Summary and Conclusions

The data included in this review supports the idea that brief exposure, early in development to environmental chemicals with estrogenic activity, increases body weight gain with age and alters markers predictive of obesity in experimental animals. Epidemiology studies support the findings in experimental animals and show a link between exposure to environmental chemicals (such as PCBs, DDE, and persistent organic pollutants) and the development of obesity. Furthermore, the use of soy-based infant formula containing the estrogenic component genistein has been positively associated with obesity later in life.

Using the DES animal model as an important research tool to study “obesogens”, the mechanisms involved in altered weight homeostasis (direct and /or endocrine feedback loops, i.e., ghrelin, leptin, etc.) by environmental estrogens can be elucidated. In addition, hopefully this animal model may shed light on areas of prevention. Public health risks can no longer be based on the assumption than overweight and obesity are just personal choices involving the quantity and kind of foods we eat combined with inactivity, but rather that complex events including exposure to environmental chemicals during development may be contributing to the obesity epidemic.

Sources
  • Environmental Estrogens and Obesity, Retha R. Newbold, Elizabeth Padilla-Banks, and Wendy N. Jefferson, NCBI PMCID: PMC2682588, 2010 May 25.
More DES DiEthylStilbestrol Resources