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Last week the UK’s chief drugs adviser, Professor David Nutt, was sacked by the Home Secretary Alan Johnson. One of the country’s leading experts on drugs Professor Nutt first joined the Advisory Council on the Misuse of Drugs (ACMD) over ten years ago, yet it was over the past 12 months that his relationship with the government had become strained.

It began with an article that Professor Nutt wrote in a scientific journal headlined “Equasy, an over-looked addiction with implications for the current debate on drug harms.” It was this paper that caused a storm, whereby sensational coverage blasted the Professor for suggesting that ecstasy and other illegal drug use could actually be safer than riding a horse and explaining his article he said: “This attitude raises the critical question of why society tolerates – indeed encourages – certain forms of potentially harmful behaviour but not others, such as drug use.”

After his comments, Jacqui Smith asked him to apologise. However the Professor continued in the summer producing a chart of the harm of illegal drugs, placing legal drugs such as alcohol and tobacco above LSD, ecstasy and cannabis and suggesting that a barrier was forming between legal and illegal substances with regards to classification. Nutt also suggested that the government’s policy of erring on the side of caution could cause more harm which was the final straw, and when the Professor was relieved of his duties.

Following the Professor’s sacking, one of his colleagues has resigned in protest, Dr. Les King; a drugs adviser with another adviser apparently soon to follow. With two charts, one from the Lancet and David Nutt’s own showing that classification is out of touch with harm caused by particular substances – supporters of a tougher stance on drugs say that it is dependant on society, and things aren’t as simple as classifying according to harm. However, we have to realise that not everyone who does drugs are bad people, or even not well off – smoking Marijuana certainly didn’t stop David Cameron successfully graduating from Oxford and being the favourite to be the next Prime Minister and it certainly didn’t stop Barack Obama becoming President; however, what would be of these people if they were affected by draconian government policy of 5 years in prison (with an unlimited fine) for possession?

Furthermore, the government showed how ridicoulous their drug policy is when they rushed through the ban of Psilocybin mushrooms at the end of the 2001-beginning of the 2005 government. Psilocybin mushrooms date back to a predicted million years and grow globally, and even before 2005 were legal in the United Kingdom and were sold in hundreds of shops and online and suddenly became a Class A drug in the same league as Heroin and Crystal Meth. It should be noted that nobody has ever died from the toxicity or physical effects of mushroom use, unlike the millions of people who do as a result of smoking tobacco or drinking alcohol. As well as this, the benefits of Psilocybin mushrooms are actually being investigated to help with a numerous amount of mental health conditions.

The government should start listening to scientists and experts instead of pandering to tabloid editors.

Drug harm chart from the Lancet medical journal, ordered in terms of harm and colour coded to how they're classified (Before Cannabis was Class B).

It's medicinal, I swear!

I feel bad. I went off about marijuana advocates Thursday in the Portland Mercury newsroom. It’s not like me, but there are a few issues that really get me Howard Dean-esque, and the marijuana legalization movement is one of them. So is mispronouncing the word “espresso” (do you see an X in there?) and slamming Kaimin reporters for doing their job.

For the record, so no one can argue that I hate marijuana or discount all the benefits of its use as hippie propaganda: I support the legalization of marijuana for medicinal and recreational purposes. Are we clear?

My issues aren’t with the movement’s goals, but with its methods. In Missoula, I wrote a Kaimin editorial opposing the passage of Initiative 2, which made marijuana offenses the lowest priority for law enforcement in Missoula County, Montana.

I agree with the initiative’s theory. It’s not an effective use of resources to have police, prosecutors, jailers, etc. processing low-level marijuana possession. It’s stupid. I get it.

But the Citizens for Responsible Crime Policy, the group that pushed I-2, made it a zero-sum argument: that cops don’t have enough resources to pursue violent criminals because they’re so busy with casual potheads. They used scare tactics to successfully convince Missoula that rapists and murderers would roam the streets of Missoula if the citizens didn’t pass Initiative 2.

When County Attorney Fred Van Valkenburg proposed amending the Initiative to make sure it didn’t apply to felony possessions, the kinds usually associated with large-scale drug deals, I-2 proponents turned vitriolic. Van Valkenburg said in his years of public service, he’d never encountered so much hatred as he did from pot advocates.

So, to make sure we got this straight: mean-spirited, fear mongering campaigners pushed to loosen restrictions on a drug often associated with rainbows and dancing bears.

Now, on medical marijuana: yes, it has benefits for terminal patients, and they should have access to it. But most “medical marijuana patients” are doing an excellent job at scamming the system. And why not? It’s easy, especially in California. Just ask Steve Lopez of the L.A. Times.

So let’s be honest: many people who buy and sell medical marijuana are smokers first and patients second. I’m sorry, but when your product starts catering to “the discerning connoisseur,” you’re no longer selling a medicine that helps people deal with pain. You’re pushing a pleasurable escape, like good Pinot Noir or professional baseball at its finest.

So please, drug advocates: be honest with your goals. State up front that you believe adult marijuana use should be decriminalized. You can cite this study in the British medical journal The Lancet, which says marijuana is one of the least harmful drugs a person can use. You can cite this study, which says marijuana does not have a significant long-term effect on memory. You can also cite this article that says governments can cushion their budgets with revenue from taxing marijuana sales. And you can cite this article that says marijuana is not a gateway drug.

All of this information (and there is certainly more out there) is more than enough to form a rational argument that shows recreational marijuana use is less harmful than alcohol consumption, has minimal long-term effects (especially if it’s not smoked), can be a boon to state coffers, and probably won’t irreparably corrupt the kids.

Now, stop trying to scare us with crime statistics. Stop trotting out old cancer patients and exploit their suffering for your right to get high. Just be straight with us.

Si parla molto di omega 3, ma pochi spiegano con precisione cosa siano realmente, che benefici forniscano al nostro organismo e dove si trovino.

Tecnicamente gli omega 3 sono acidi grassi polinstauri che, dal punto di vista chimico, hanno la caratteristica di possedere un doppio legame in posizione 3 (omega 3) o in posizione 6 (omega 6), della catena che li forma. Sono tecnicamente definiti EPA (acido eicosapentaenoico), e DHA (acido docosaesaenoico). Questi acidi hanno dei precursori, cioè delle sostanze che dopo l’introduzione nel nostro organismo vengono trasformati; nello specifico l’acido linoleico è il precursore dell’acido grasso omega 6, mentre l’acido linolenico è il precursore dell’aciso grasso omega 3. Gli omega 3 e 6 sono acidi grassi essenziali: con questo termine si intende che il nostro organismo non è in grado di sintetizzarli, e quindi l’introduzione atttraverso la dieta è assolutamente fondamentale. Per ciò che concerne le funzioni biologiche nell’organismo umano, si evidenzia dalle più recenti acquisizioni e studi scientifici, condotti su questo argomento, è possibile sostenere che, tra gli effetti protetivi degli omega 3 i più rilevanti sono sicuramente:

• azione antiaggregante piastrinica (effetto antitrombotico), cioè ridurrebbero la possibile formazione di coaguli nel sangue.
• controllo del livello plasmatico dei lipidi, soprattutto dei trigliceridi.
• controllo della pressione arteriosa, mantenendo fluide le membrane delle cellule, e dando elasticità alle pareti arteriose.

Gli effetti principali sono soprattutto legati alla protezione del cuore e del sistema circolatorio, aspetto positivo già evidenziato dagli studi epidemiologici iniziati intorno agli anni 70. In quegli anni furono studiati gli INUITS una popolazione eschimese che si cibava prevalentemente di pesce proveniente dalle coste della Groenlandia e del Giappone, già allora emerse molto chiaramente un’incidenza particolaremente bassa di malattia all’apparato cardiovascolare, correlata a quel tipo di alimentazione marittima.

Recentemente si stanno estentendo gli studi omega 3 anche nell’ambito della nutrizione neonatale, dove un’introduzione quantitativamente adeguata di questi acidi sarebbe importante per favorire lo sviluppo del bambino. Esistono inoltre, studi preliminari, dove si controlla l’applicazione degli omega 3 sul morbo di Crohn (patologia a carico dell’apparato intestinale): l’effetto studiato sarebbe legato all’attività antinfiammatoria di queste importanti sostanze. Per rimanere in tema di ricerche su questo argomento è importante ricordare che nel 1999 è stato pubblicato su “The Lancet” un’importante studio iniziato nel 1996 su 11324 pazienti colpiti da infarto miocardico, il quale ha dimostarto che, la somministrazione di un farmaco a base di acidi grassi polisaturi omega 3 ai pazienti colpiti da infarto riusciva a ridurre considerevolmente la mortalità legata a questa patologia.

In sintesi, queste ricerche hanno riscontrato che, la somministrazione quotidiana di un farmaco contenente un grammo di acido grasso omega 3 asscociata, ovviamente a un regime dietetico equilibrato (contenente un buon quantitativo di pesce), è importante per curare problemi di tipo cardiovascolare.

Per mantenere il benessere del nostro organismo cosa è più corretto fare?

E’ consigliabile seguire un’alimentazione varia ed equilibrata caratterizzata da armonia sia qualitativa che quantitativa tra i singoli nutrienti. Per favorire l’introduzione degli omega 3 è opportuno consumare dalle 2 alle 3 porzioni settimanli di pesce, la cui tipologia potrà variare tar le seguenti: sgombero, merluzzo, pesce spada, tonno, trota, sardine e aringa, altre fonti di omega 3 sono i cereali, le noci, i legumi e l’olio di lino. Per quanto riguarda le tipologie di cottura più indicate, perchè il pesce possa mantenere inalterate le sue benefiche proprietà, le migliori sono sicuramente: al forno, in umido o alla griglia.

Una considerazione da non sottovalutare mai è che un’attività di prevenzione rivolta alle malattie cardiovascolari deve primariamente concentrarsi sulla dieta equilibrata, e parallelamente sulla eliminazione dei fattori di rischio (fumo, obesità e sendentarietà). La società occidentale essendo caratterizzata da un consumo scarso di pesce è maggiormente esposta alle malattie cardiovascolari rispetto a tutte quelle popolazioni (ad esempio quelle orientali) che hanno abitudini alimentari diverse, ecco perchè l’indicazione ad un aumento del consumo di pesce è fondamentale. I composti farmacologici a base di omega 3 possono rappresentare un aiuto soprtattutto nei casi in cui l’alimentazione è particolarmente deficitaria, ma in linea di massima è possibile dire che, attraverso una dieta di tipo mediterraneo, caratterizzata dalla presenza di futta, verdura, pesce, olio extravergine di oliva ecc, la fonte di vitamine, sali minerali, proteine nobili e ovviamente omega 3 è assicurata.

www.benessere.com

Way back in August, the Lancet (For non-medical readers, the Lancet is one of the world’s leading medical journals, published in the United Kingdom) came out with this editorial (below) on health care reform in the US. Besides being incredibly uncritical (yes, even Brits have their “idea of Obama“), it is significant for demonstrating how people from other countries really don’t get the depth of dysfunction the US government has reached.

A few of us in PHM US decided to respond and sent in the letter that follows. It was way too late so they didn’t print it, which is why I am posting it here.

The Lancet, Volume 374, Issue 9687, Page 357, 1 August 2009
Remaking America’s health-care system

The momentum needed to repair the US health-care system has finally arrived. President Barack Obama, making it this year’s domestic priority, has argued that “America cannot afford not to reform” its health-care industry since the country will otherwise go “the General Motors way”. An affordable, accessible, and portable health-care system, it is argued, will not only benefit citizens but will also be the key to the country’s economic recovery—now with a record deficit of US$1·7 trillion.

The cost of the current US health system is astronomical—$2·5 trillion a year (the highest in the world)—comprising a fifth of the nation’s economy and roughly $6600 spending per person. A third of every US dollar spent on health is lost to bureaucracy. The resulting care is also far from being the world’s best: in fact it is ranked a modest 37th in the world by WHO. And America remains the only developed nation that has 46 million uninsured individuals—leading to an unfulfilled basic human right and 20 000 unnecessary deaths each year.

The current US health-care model is a fee-for-service system. It gives providers a financial incentive to order excessive tests and treatments without necessarily providing the best care to patients. The emphasis is on system overuse and not on primary care and prevention.

Another big problem is how the insured are insured. Most Americans (160 million) receive health-care coverage though their job via insurers chosen by their employers. Private insurers dominate the market and regulate pricing, reimbursements and premiums, and employers often negotiate deals with them that benefit the company and are not necessarily in employees’ best interests. The result is often underinsurance—policies that do not come close to covering all of an individual’s medical bills. Because of this shortfall, as many as half of personal US bankruptcies are due to medical debts.

This year’s deep recession has further aggravated the coverage problem, with an increasing unemployment rate (currently 9·7%) adding to the number of uninsured individuals. Unemployed people often do not have enough resources to maintain the same level of coverage even with the government’s help, or are either too rich to qualify for state-run Medicaid or too young to qualify for Medicare. And, even when people can afford insurance, an insurance company will deny coverage if there is a pre-existing medical condition.

Obama’s proposed health-care reform package is primarily intended to fulfil two aims: universal health coverage (mandated for individuals and employers) and the creation of a government-run public health insurance plan that will compete with private insurers. This means that insurance companies will be tightly regulated and are to offer a yet to be determined “essential benefit”. The new plan will also eliminate annual and lifetime insurers’ caps and ensure that out-of-pocket costs will not exceed individuals’ ability to pay. The proposal will also promote future comparative effectiveness research to control costs and improve patients’ care.

So far, Obama already has the necessary health players on his side: the pharmaceutical and hospital lobbies, who have promised a $230 billion 10-year cost-saving plan. And even the America’s Health Insurance Plans association has agreed to cover all individuals independent of their pre-existing conditions if the reform is accompanied by an individual health-coverage mandate. The American Medical Association has also backed the need for health-care reform. Existing polls show that American people are generally in favour of universal coverage and a government-run insurance plan.

The big obstacle for implementing reform of the American health-care system will be its price—an estimated $1 trillion over the next 10 years. The Senate’s Finance Committee has yet to agree on how and who is to pay. Half of that amount might be obtained by reducing payments to providers within the Medicare programme, but the rest requires new revenue sources. The burden might fall on families earning more than $350 000 annually. Or it could end up being the collective responsibility of all US citizens if workers’ salaries fall as a result of an employer’s requirement for broader insurance.

Passage of the US health-care reform bill this year is a must, even if it involves alterations and compromises. It is the appropriate political, economic, and moral act by the US Congress for the nation and it fulfils a promise by the President to American people. Yes, it can be done.

Lancet editors,

We were disappointed by The Lancet editorial of August 1, 2009, “Remaking America’s health-care system.” Although the editorial correctly identifies some of the ways the current system of finance and provision of medical care denies many Americans this “basic human right,” the rest of the piece fails to evaluate President Obama’s proposals, or the various draft bills in Congress, using the standards of the right to health. The editorial also distorts the role of large corporate interests – the health insurance, pharmaceutical, and hospital industries – in this debate, and the US political system in general.

Candidate Obama’s reform proposal was found to only partially meet human rights standards in a report by the National Economic and Social Rights Initiative and the National Health Law Program. All the legislation being developed now contains a mandate to obtain health insurance. This will result in a massive transfer of individual and public dollars to health insurance, hospitals and pharmaceutical corporations. That is how Obama has these “players on his side.”

There is legislation consistent with the right to health in the US Congress. HR676 and S703 would create a national health insurance system by expanding and improving the Medicare program to cover everyone. They are the most popular specific proposals, but the massive campaign donations given by the various health care industries, and the equation of policies to improve public welfare with socialism, make passage of these bills unlikely.

The Lancet has promoted the right to health in past Series and editorials. People living the US are just as entitled to this right as those in any other country. We constantly struggle here against the belief in US exceptionalism. We did not expect to find this belief shared by The Lancet.

When we are combating a massively funded campaign, pushing a toxic, addictive and carcinogenic drug, with a saturation media coverage down to 8 year old children, via Television, Radio, The Arts, Sporting Sponsorship, Facebook and New Media campaigns, and finally, School Based Alcohol Promotions, then Education is simply NOT enough.

Latest research published in the Lancet proves this. In ‘Knowledge of drinking guidelines does not equal sensible drinking‘, by Antony C Moss, Kyle R Dyer and Ian P Albery, in reviewing UK’s current approach to alcohol-related policy, prevention, and treatment – largely copied in Australia – is ineffective and uncoordinated. The .’..platforms for action were revision of policies for the pricing and promotion of alcohol, mandatory labelling, and revised sensible drinking guidelines. The focus on clear labelling and guidance carries with it the assumption that providing such information and facilitating its comprehension will reduce irresponsible drinking behaviour.’

They then blow these assumptions out of the water. They actually found a group in the UK who actually knew the UK’s drinking guidelines! No mean feat. Better than that, all of the test group had previously ‘received a structured curriculum incorporating specific education on alcohol and other drug misuse’. Then they surveyed their drinking habits:

41% were found to be at risk of alcohol dependence! 56% reported heavy and binge drinking, 78% consumed alcohol hazardously,  65% reported experiencing alcohol-related harms, and 24% reported at least one occasion where they were not able to stop drinking once started. More than half were not considering engaging in ’sensible drinking’.

Upon these people rest the future of the UK’s Hospitals and Medical Care. The test group are current Medical Students…

Nel 2008 sono morti poco meno di 9 milioni di bambini sotto i 5 anni. Di questi, quasi il 40% è morto di polmonite e diarrea.

La diarrea è la seconda causa di morte dei bambini sotto i 5 anni: ne muore quasi uno ogni 5 ogni anno, pari a circa 1,5 milioni.

La diarrea uccide più bambini di AIDS, malaria e morbillo messi assieme.

La diarrea si previene con vaccini contro il rotavirus e il morbillo, migliorando le condizioni igieniche, privilegiando l’allattamento materno con integrazione di vitamina A e migliorando la qualità dell’acqua.

La diarrea si cura tramite idratazione ed integrazione di zinco.

Da The Lancet.

Meer dan de helft van de baby’s die vandaag in de VS, West-Europa en Japan worden geboren zullen makkelijk honderd jaar worden. Dat blijkt uit een rapport van een groep Deense en Duitse wetenschappers van de universiteit van Rostock en het Duitse Max Planck Instituut voor demografisch onderzoek. Het rapport verschijnt vandaag in het medisch vakblad The Lancet. Aan de basis liggen betere leefomstandigheden, snellere diagnoses en betere behandeling van ziektes en hartkwalen. Ook de campagnes tegen roken brengen duidelijk vruchten op.

In de twintigste eeuw nam de levensverwachting in landen als de VS, het VK, Frankrijk, Duitsland, Canada en Japan met dertig jaar toe en deze trend zet nog een tijd door, schrijven de onderzoekers. Zonder de minste verbetering in levensomstandigheden zullen driekwart van de baby’s die vandaag worden geboren makkelijk 75 jaar worden.

De vergrijzing van de maatschappij zet de overheden voor enorme uitdagingen. Duitsland telt vandaag 29 gepensioneerden voor elke 100 werkende mensen. In 2056 zullen er dat 60 per 100 zijn. Ter vergelijking: in 1956 weren er dat amper 16 per honderd werkenden. Het gedurig verminderen van de arbeidstijd zal de levensverwachting nog verder doen stijgen, aldus het rapport. Mochten mensen in hun zestiger en zeventiger jaren gewoon doorwerken, dan zouden ze op vroegere leeftijd minder uren moeten presteren dan dat vandaag het geval is.

Die Lebenserwartung in den Industrieländern steigt rasant. Hält dieser Trend an, wird jedes zweite derzeit geborene Baby über hundert Jahre alt werden, prognostizieren Forscher. Auch die Gesundheit im hohen Alter wird sich demnach stark verbessern.

Frankfurt/Main – Im 20. Jahrhundert stieg die Lebenserwartung in den meisten Industrieländern um mehr als 30 Jahre. Selbst wenn diese Entwicklung stagnieren sollte, werden drei von vier derzeit geborenen Babys mindestens 75 Jahre alt. Dauert der Trend zum längeren Leben jedoch unvermindert an, werden die meisten seit dem Jahr 2000 geborenen Kinder sogar ihren 100. Geburtstag erleben, berichten deutsche und dänische Forscher im Fachblatt “The Lancet“.

“Ein sehr langes Leben ist nicht das Privileg von Generationen in der fernen Zukunft”, sagte Kaare Christensen vom dänischen Altersforschungszentrum. Eine hohe Lebenserwartung sei das Schicksal der meisten heute in entwickelten Ländern lebenden Menschen. Jedes zweite der im Jahr 2007 in Deutschland zur Welt gekommenen Babys wird nach Angaben der Forscher 102 Jahre alt, in Japan sogar 107 Jahre.

Eine Drosselung dieser Tendenz halten die Altersforscher der Universität Rostock und der Universität von Süddänemark in Odense für unwahrscheinlich. “Der lineare Anstieg der Lebenserwartung seit mehr als 165 Jahren deutet nicht auf ein Limit der menschlichen Lebensspanne hin”, schreiben sie. “Wenn sich die Lebenserwartung einer Grenze nähern würde, würde sich der Fortschritt vermutlich verlangsamen.”

Zudem vermuten die Forscher, dass die Menschen in Zukunft auch in sehr hohem Alter trotz Diabetes und Arthritis noch gesünder sind und sich eher selbst versorgen können als heutzutage. Dafür seien frühere Diagnosen und bessere medizinische Behandlungsmöglichkeiten verantwortlich.

Die Sterblichkeit in der Altersgruppe zwischen 80 und 90 Jahren sinkt in den Industrieländern. Während im Jahr 1950 nur jede siebte Frau und jeder achte Mann, der 80 Jahre alt wurde, auch den 90. Geburtstag noch erlebte, sind es inzwischen jede dritte Frau und jeder vierte Mann.

Dramatischer Wandel der Gesellschaft

Dennoch birgt die Entwicklung gesellschaftlichen Sprengstoff, wie Daten aus Deutschland zeigen. Im Jahr 1959 kamen auf 100 Bundesbürger zwischen 15 und 64 Jahren nur 16 ältere Senioren, im Jahr 2056 werden es 60 sein. Um die wirtschaftliche Belastung durch die alternde Bevölkerung zu senken, schlagen die Wissenschaftler eine Umverteilung der Arbeitslast vor.

“Die meisten Menschen könnten weniger Wochenstunden arbeiten als derzeit üblich, wenn sie dafür entsprechend mehr Jahre arbeiten würden”, schreiben die Forscher. Dies hätte auch einen gesundheitlichen Nutzen: Studien deuten darauf hin, dass eine kürzere Wochenarbeitszeit und eine längere Lebensarbeitszeit die Gesundheit im Alter sowie die Lebenserwartung begünstigen. Körperlich und geistig aktive Menschen bleiben länger fit.

Aber allen Prognosen zum Trotz: Der Rekord für das längste Leben ist seit zwölf Jahren ungebrochen. Damals starb die Französin Jeanne Calment im Alter von 122 Jahren.

Walter Willems, AP

Pemanasan global menimbulkan bencana besar bagi kesehatan. Negara di kawasan tropis paling rawan terkena dampaknya.

Kepedulian terhadap dampak kesehatan itu disuarakan belasan profesional yng tergabung dalam organisasi bidang kesehatan di dunia. Mereka menyatakan keprihatinannya, antara lain melalui publikasi dalam jurnal The Lancet dan British Medical Journal, baru-baru ini.

Keprihatinan itu diutarakan terkait Pertemuan Para Pihak Ke-15 (COP-15) Konferensi PBB tentang Perubahan Iklim (UNCCC) di Kopenhagen, Denmark, bulan Desember mendatang.

Dalam publikasi itu, para dokter dan profesi kesehatan lain berpandangan, kegagalan mencapai kesepakatan dalam negosiasi perubahan iklim di Kopenhagen akan mendatangkan bencana kesehatan global. Negara-negara tropis yang sebgian besar negara berkembang, dengan kondisi kesehatan yang sudah memprihatinkan, akan menerima akibat yang paling besar.

Berbagai penyakit

Menurut ahli kesehatan masyarakat dari Depkes Lingkungan Fakultas Kedokteran Masyarakat Universitas Indonesia, I Made Jaya, pekan lalu, pemanasan global merupakan akibat dari rangkaian fenomena yang saling kait, antara lain pertambahan penduduk, peningkatan, permintaan sumber daya alam, industrialisasi, konsumsi BBM, emisi, peningkatan suhu, mencairnya es, makin tingginya uap air, dan perubahan arah angin muson.

Dia mencontohkan, dengan pemanasan global, amplitudo suhu makin besar. Di siang hari, suhu dapat lebih panas dan lebih dingin di malam hari, tergantung daerahnya. Kondisi itu saja menyebabkan daya tahan tubuh rawan menurun sehingga manusia mudah terjangkit penyakit.

Hal yang lebih mengkhawatirkan, makin merebaknya penyakit akibat perubahan musim. “ Dulu, cacar air biasanya pada September dan Oktober. Masuk musim hujan, pertumbuhan jamur dan virus makin mudah. Namun, kini, sepanjang tahun terdapat kasus itu, “ ujarnya.

Kelangkaan sumber air akibat ketidakteraturan musim dan kegagalan manajemen air akan berpengaruh terhadap kelangkaan pangan dan penyakit kurang gizi. Agen penyakit juga gampang bermutasi. Hal ini, misalnya, terlihat dengan kemunculan kasus flu burung dan influenza A (H1N1). Virus corona, misalnya, bermutasi sehingga menyebabkan SARS.

Banyak kawasan menghangat sehingga parasit pembawa penyakit, seperti nyamuk, menyebar ke daerah baru yang tak siap dengan kedatangan pembawa penyakit itu.

Sumber  :

Pemanasan Global Timbulkan Bencana – Kompas, 24.09.2009

Här går Annika ut och säger vad hon menar..

Där hon kritiserar Jim Mann för att han skriver att “hennes kost” inte är bra.. och det är så typiskt.. bara för att han inte tycker som henne och hon får lite kritik så måste hon vända alla taggar utåt och ge sig på honom riktigt rejält…

Dessutom skriver hon så här om mammografin:

Det har också i media den senaste veckan påståtts att jag är motståndare till mammografi. Det är inte riktigt. Jag rekommenderar mammografi. Det är bara jag själv som inte upplever någon motivation att mammografera mig. Det känns viktigare för mig att ägna mig åt att arbeta för nyttigare kost för diabetiker och friska.

Hon har inte tid i 15-30 minuter att gå på mammografi.. för det är ungefär så lång tid det tar att göra den.. för att hennes arbete med nyttigare kost tar all hennes tid.. jag trodde att patienterna var viktigare än arbetet med kosten.. för har hon inte tid att gå på mammografi så har hon inte tid för sina patienter heller… fast hon kanske inte har några patienter… hon kanske har skrämt bort dem allihop..

Och nu är hon i blåsväder…
För det är ju så kul att Jim Mann på The Lancet har gått ut och skrivit det han har gjort.. och när Per Gunnar Holmgren (chefred. Dagens Medicin) säger:

En läkare ska förmedla råd baserade på vetenskap och beprövad erfarenhet – inte bara ”åsikter” och ”tro”

Då känns det faktiskt bra att jag skrev som jag gjorde..

För det kan faktisk medföra en anmälan till HSAN..

Om doktor Dahlqvist rekommenderar sin fettkost mot svininfluensan till sina egna patienter är det ett ärende för hälso- och sjukvårdens ansvarsnämnd.
- Det står i strid med vetenskap och beprövad erfarenhet, säger Lars-Erik Holm.

Och som vanligt är det vi patienter som kommer i kläm på ett eller annat sätt.. Undrar om Aftonbladet betalar “Fettdoktorn” något arvode för att hon skriver i tidningen.. risken är stor att det är så.. att hon får betalt för att föra ut livsfarliga råd och rön i en stor dagstidning..

Fast idag skriver Annika så här i sin blogg:

jag inte att belasta sjukvården om jag får influensan.
Jag kommer att stanna hemma isolerad tills jag är frisk igen.

Men hon skulle ju inte få influensan.. det säger hon ju själv.. vad är det här?? Litar hon inte på sin kost?? Och ändå vill hon att vi ska tro både på henne och på kosten…

Fortsättning följer… eller som de säger i Hollywood: to be continued…

Läs även andra bloggares åsikter om pysan, mammografi, Annika Dahlqvist, influensan, kost, The Lancet, kritik, “Fettdoktorn”, HSAN, kritik

A study in the UK medical journal The Lancet confirms what many have come to suspect: WHO ignores facts, logic and evidence when formulating its guidelines and recommendations.

An online study of WHO’s decision-making process from 2007 reveals that WHO uses a “distinctly non-transparent process” when issuing guidelines – guidelines that nevertheless appear consistently to correspond to the interests of the pharmaceutical companies that sit on WHO’s committees.

WHO’s tradition of ignoring scientific evidence and of making decisions that are “distinctly non-transparent” was continued this June when the UN public health watchdog declared a pandemic level 6 emergency over the “lethal” ”swine flu” in spite of the absence of evidence of any pandemic at all and a mere 500 deaths.

In July, WHO refused to publish the Minutes of a key meeting of its vaccine advisory board, packed with Baxter; Novartis, GSK and Sanofi and other pharma executives as “observers”, which “recommended” the “swine flu” vaccine — produced by Baxter, Novartis, GSK and Sanofi — to the globe.

WHO has also not publicised the ramifications of its International Health Regulations 2005 or its various national pandemic plans, which allow WHO in a “distinctly non-transparent” process to somehow take charge of every nation’s health and police services and even government in the event of WHO unilaterally declaring a pandemic level 6 emergency.

Dr Margaret Chan, Director General of WHO,  cancelled in June the requirement of governments to collect any data on the ”swine flu”, leaving her free to make statements about the “incredible speed” with which the flu spreads and its “virulence” without being hampered by mere facts and pedestrian reality.

The Lancet: WHO Ignored Evidence in Guidelines

NewsMax.com Wires
Wednesday, May 9, 2007

LONDON — When developing “evidence-based” guidelines, the World Health Organization routinely forgets one key ingredient: evidence. That is the verdict from a study published in The Lancet online Tuesday.

The medical journal’s criticism of WHO could shock many in the global health community, as one of WHO’s main jobs is to produce guidelines on everything from fighting the spread of bird flu and malaria control to enacting anti-tobacco legislation.

“This is a pretty seismic event,” Lancet editor Dr. Richard Horton, who was not involved in the research for the article. “It undermines the very purpose of WHO.”

The study was conducted by Dr. Andrew Oxman and Dr. Atle Fretheim, of the Norwegian Knowledge Centre for Health Services, and Dr. John Lavis at McMaster University in Canada. They interviewed senior WHO officials and analyzed various guidelines to determine how they were produced. What they found was a distinctly non-transparent process.

“It’s difficult to judge how much confidence you can have in WHO guidelines if you’re not told how they were developed,” Oxman said. “In that case, you’re left with blind trust.”

WHO issues about 200 sets of recommendations every year, acting as a public health arbiter to the global community by sifting through competing scientific theories and studies to put forth the best policies.

WHO’s Director of Research Policy Dr. Tikki Pang said that some of his WHO colleagues were shocked by The Lancet’s study, but he acknowledged the criticism had merit, and explained that time pressures and a lack of both information and money sometimes compromised WHO work.

“We know our credibility is at stake,” Pang said, “and we are now going to get our act together.”

WHO officials also noted that, in many cases, evidence simply did not exist. Data from developing countries are patchy at best, and in an outbreak, information changes as the crisis unfolds.

To address the problem, they said, WHO is trying to develop new ways to collect information in poor regions, and has proposed establishing a committee to oversee the issuance of all health guidelines.

The Lancet study – conducted in 2003-04 through analyzing WHO guidelines and questioning WHO officials – also found that the officials themselves were concerned about the agency’s methods.

One unnamed WHO director was quoted in the study as saying: “I would have liked to have had more evidence to base recommendations on.” Another said: “We never had the evidence base well-documented.”

Pang said that, while some guidelines might be suspect and based on just a few expert opinions, others were developed under rigorous study and so were more reliable.

For example, WHO’s recent advice on treating bird flu patients was developed under tight scrutiny.

Oxman also noted that WHO had its own quality-control process. When its 1999 guidelines for treating high blood pressure were criticized for, among other things, recommending expensive drugs over cheaper options without proven benefit, the agency issued its “guidelines for writing guidelines,” which led to a revision of its advice on hypertension.

“People are well-intended at WHO,” Oxman said. “The problem is that good intentions and plausible theories aren’t sufficient.”

It remains to be seen how WHO’s 193 member countries will react to The Lancet study, released just before WHO’s governing body – the World Health Assembly – meets next week at U.N. headquarters in Geneva to decide future health strategies.

“If countries do not have confidence in the technical competence of WHO, then its very existence is called into question,” said Horton, the journal’s editor. “This study shows that there is a systemic problem within the organization, that it refuses to put science first.”

WHO Director-General Dr. Margaret Chan, who took over the position this year, will be under pressure to respond to the study’s criticism.

“We need a strong WHO,” which in recent years “has seen its independence eroded and its trust diminished,” Horton said. “Now is a fabulous opportunity for WHO to reinvent itself as the technical agency it was always meant to be.”

© Reuters 2007. All rights reserved. Republication or redistribution of Reuters content, including by caching, framing or similar means, is expressly prohibited without the prior

Foto: Routers

La mitad de los fumadores de edad avanzada desarrolla una enfermedad obstructiva pulmonar crónica (Epoc), según pone de relieve un estudio realizado por un consorcio internacional en el que han participado el Centro de Investigación en Epidemiología Ambiental (Creal), el Instituto Municipal de Investigación Médica (Imim-Hospital del Mar) y el Hospital Clínic de Barcelona.

La investigación, publicada en el boletín médico ‘The Lancet’, ha permitido la elaboración de un índice de riesgo para calcular la mortalidad de pacientes con Epoc, cuyo uso permitirá a los médicos evaluar de forma más objetiva la gravedad de la enfermedad en cada caso, así como desarrollar tratamientos ajustados a cada persona.

El índice, que podría ser utilizado en los Centros de Atención Primaria (CAP), donde se trata a la mayoría de pacientes con Epoc, tiene en cuenta factores como la edad del paciente, su nivel de disnea –dificultad de respirar–, y predice la posibilidad de que muera en los próximos tres años.

La Epoc se encuentra entre las cinco causas principales de muerte en el mundo, ya que causa unos tres millones de fallecimientos anuales. La enfermedad llega a afectar a la mitad de los fumadores a lo largo de su vida, y se estima que en España mueren más de 18.000 personas al año por esta dolencia.

Unos 60 hombres de cada 100.000 mueren en España por esta razón, así como 17 de cada 100.000 mujeres, si bien estas cifras aumentan cada año debido a que España es uno de los países que tienen un mayor índice de tabaquismo entre adolescentes y en mujeres.

La Epoc se produce por la inflamación de los pulmones y en el resto del organismo produce ahogo, junto con una insuficiencia respiratoria progresiva, lo que representa uno de los principales problemas de los pacientes en su vida cotidiana.

Hasta el momento la mayoría de los pacientes recibían un tratamiento similar, fruto de la evaluación tradicional de la enfermedad, basada solo en la función pulmonar y que no predecía con precisión las condiciones clínicas ni la evolución progresiva de la enfermedad.

El uso del nuevo índice, “sencillo y práctico”, indica explícitamente el riesgo de muerte de un paciente concreto y contribuye a identificar cuáles podrían beneficiarse de un tratamiento más completo, que además del abandono del tabaquismo o del uso de fármacos por inhalación, puede incluir otros métodos no farmacológicos como la rehabilitación pulmonar y el ejercicio físico regular.

La investigación es el resultado de la colaboración entre investigadores de Suiza, Países Bajos, Estados Unidos y España, y ha sido posible por el análisis de datos de 232 pacientes suizos y 342 españoles tratados de esta patología en siete hospitales de Catalunya, uno del País Vasco y otro de Baleares.

Fuente: EuropaPress. El 50% de los fumadores sufrirá una enfermedad obstructiva pulmonar