Medical progress

The problem is that many doctors are extremely reluctant to drop treatments that seem to work in clinical practice, even when clinical trials show that these treatments are really placebos. This problem is not confined to antidepressants. As we shall see in Chapter 5, it is a problem that has slowed medical progress in other areas as well. 

The Declaration of Geneva of the World Medical Association binds the physician with the words the health of my patient will be my first consideration, and the International Code of Medical Ethics declares that medical progress is based on research, which ultimately must rest in part on experimentation involving human subjects. In medical research on human subjects, considerations related to the well being of the human subject should take precedence over the interests of science and society. ... 

Francois C, Hance AJ. Medical progress HIV drug resistance. N Engl J Med 2004 350 1023-35. 

Gilman S. Medical progress imaging the brain. NEngl]Med 1998 338 812-20, 889-98. 

Belmaker RH. Medical progress bipolar disorder. N Engl] Med 2004 351 476-86. 

BaUantyne JC, Mao J. Medical progress opioid therapy for chronic pain. N Engl ] Med 20(B 349 1943-53. 

Medical progress is based on research which ultimately must rest in part on experimentation involving human subjects. 

The present predictive state of pharmacological science is such that the therapeutic or even pharmacologic value of an innovation usually cannot be foretold at the time of its discovery. Thus, a certain amount of innovative activity may never yield real breakthroughs, while certain innovations that may appear scientifically trivial can turn out to be useful contributions to medical progress. 

Until 1937, when the United States ruled that marijuana was an illegal substance, cannabis was an accepted, if often ineffective, medication. The following are excerpts from medical journals and pharmacopoeias that show some of the far-fetched afflictions for which cannabis was prescribed—and also how much medical progress has been made in the last century. 

Baulieu, E.E. (1985) In Abortion Medical Progress and Social Implications. Ciba Foundation Symposium 115, (Porter, R. and O Connor, M., eds.) pp. 192-210. Pitman Press, London. 

Would the medical use of embryonic stem cells have brutalizing effects on our society that would outweigh the good of medical progress Would our reverence for life erode a little more each time an unborn human embryo is used to extend the life and attractiveness of an adult ... 

In contrast to the important advances in biochemistry, medical progress in the cannabinoid field has been rather limited, possibly due to the legal situation. However, at least one new synthetic cannabinoid (HU-211) is in clinical trials (see below). We shall review the advances made since 1987 with emphasis on novel uses, on synthetic compounds which are being developed as drugs, on new synthetic leads and on chemical tools for further biochemical and pharmacological investigations. 

The life story of Canadian Lieutenant Eddie Baker demonstrates a heartwarming example of progress. Baker was blinded in WWI by sniper fire. After the war, he devoted himself to improving the fives of blinded veterans. He raised the funds used to start the Canadian National Institute for the Blind (CNIB) and, later, was involved in the development of eye banks. The downstream effect of his efforts was the first cornea transplant in Canada, performed in 1956 on a WWI veteran, 40 years after he was blinded by gas (Wilton, 1996). While this is wonderfijl medical progress, it cannot undo the fact that there is still no antidote against SM. 

Hemetig, F.M., Cieslak, T.J., Eitzen, E.M. (2002b). Medical progress biological and chemical terrorism erratum. J. Pediatr. 141 743-6. 

Further, the industry and advertising/promotion advocates contend that in the modern age there is an inherent need for pharmaceutical companies to communicate information about their research and new products. The public demands information about health care products everyone wants to know about medical progress. Investment capital for new biotechnology companies is dependent on understanding the potential value and research progress of new products. Health care providers need to know, on a continuing basis, what kinds of advances are being made in their specialty. 

Thadhani R, Pascual M, Bonventre JV Medical progress-acute renal failure. N Engl J Med 334 1448-1460,1996... 

Suerbaum S, Michetti P. Medical progress Helicobacter pylori infection. (Review Article). N Engl J Med 2002 347 1175-86. 

Dutton DB. 1988. Worse than the Disease Pitfalls of Medical Progress. Cambridge University Press Cambridge 87. 

This section therefore concentrates on the financial aspects of pharmaceutical medicine. This may be an unattractive subject to the idealists. But Churchill once said Democracy is the worst form of government, except for all those other forms that have been tried from time to time (House of Commons, 11 November 1947). Perhaps we should replace the words democracy and government with the terms private enterprise and medical progress, respectively. 

Smythe, M.A. Shah, P.P. Spiteri, T.L., et al. Pharmaceutical care in medical progressive care patients. Ann. Phar-macother. 1998, 32, 294-299. 

McClennan et al. conducted a prospective 2-month intervention study to determine clinical outcomes associated with pharmacist interventions at a tertiary referral cancer institute in Australia. Clinical pharmacists documented clinical interventions and relevant patient information which were assessed by an independent pharmacist. Members of the healthcare team reviewed and discussed medical progress notes to determine outcomes. Of 674 total interventions that were documented during the study, outcomes were assessed for 10% of the interventions reported 90% of the interventions led to documented clinical benefit. Pharmacist interventions most frequently consisted of initiating changes in drug therapy associated with antiemetic, antimicrobial, and analgesic agents. 

Despite timely and appropriate reversal of the enticing insult... many patients develop the syndrome. Mortality is proportional to the number and depth of system dysfunction and the mortality of MODS after (for example) repair of ruptured abdominal aortic aneurysm is little changed despite three decades of medical progress. 

R. R. Edeman and S. Warach Medical progress Magnetic resonance imaging. New England Journal of Medicine, First of two parts 328,708 (1993) Second of two parts 328,785 (1993). 

Jankovic J. Medical progress Tourette s syndrome. N Engl J Med 2001 345 1184-1192. 

Wolfe MM, Lichenstein DR, Singh G. Medical progress Gastrointestinal toxicity of nonsteroidal anti-inflammatory drugs. N Engl J Med 1999 340 1888-1899. 

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