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Multicasuality of falls and the role of drugs

17 Oct

Falls cause important morbidity and mortality in elderly people, but can occur at any age. They can be caused by various concurrent causes. Psychotropic agents such as benzodiazepines and other hipnotic drugs, antidepressants, antipsychotics and opioids have been associated with a higher incidence of falls. To avoid fractures the key question is to avoid falls. [...]

BRCA test, only for females of high familiar risk

22 May

BRCA genes are “normal” genes we all share in our cells. Some mutations of BRCA genes are associated with a higher incidence of breast and ovarian cancer. In this summary there is a few numbers to understand the problem. BRCA test, only for females of high familiar risk. Gérvas J. Madrid, 21st May 2013. Download [...]

Index case for the fungal meningitis outbreak, United States

13 May

Publications about the fungal meningitis outbreak (USA) do not address whether these injections were appropriate for low back pain. Physicians, patients, payers and regulators should question the role which overuse of injections for low back pain in the US played in this outbreak. Index case for the fungal meningitis outbreak, United States. Gérvas J, Kovacs FM. [...]

Trials of improve care for the elderly

7 Mar

Clinical randomized trials are experimental situations where some patients might received excellent care. What happens after the end of the trial? This a key ethical question should be answered in all proyects and programs of clinical trial.  Trials of improve care for the elderly. Gérvas, J., Pérez Fernández, M. N Engl J Med. 1996; 334: [...]

Medicalization of aging and the testosterone deficiency syndrome

16 Dec

Over the last few years it has been proposed that the simple fact of having testosterone below the normal levels, which occurs with the passage of time, provokes a constellation of disorders. Testosterone therapy in the management of TDS (testosterone deficiency syndrome) is not justified, because there is no clear benefit in the relevant primary [...]

Crying patients in general/family practice: incidence, reasons for encounter and health problems

16 Dec

Despite evidence demonstrating the benefits of understanding patients, there is a paucity of information about how physicians address psychological and social concerns of patients. Patients cried in 157 encounters out of a total of 18,627 giving an incidence rate of 8.4 per thousand. More frequent reasons for encounters were: feeling depressed (12.7%), social handicap (mainly [...]

Primary health care oriented systems, for whom, why and how

4 Jun

Health systems are social products, and as such they cannot being invented. They are expression of the final election between “freedom” and “equity”. Freedom means that each person may select and pay for the needed health services. Equity means solidarity, to help those in need even at the cost that are fit. Only the USA [...]