Too much medicine. Less is more

13 Feb

Too much of a good thing is bad. Too much of good thing may not be wonderful. You can have too much of a good thing as food and alcohol and the excess of either can make you fat or drunk. In medicine, in general, the motto should be “maximum quality, minimum quantity”. Because more medical interventions, different patients-population expectations and the technology advances, medical activities are becoming dangerous. In this presentation we give a few examples and suggest some solutions.

  • Too much medicine. Less is more. Gérvas, J., Pérez Fernández, M. Vasco da Gama Movement Forum. Barcelona 7-8 Feb 2014. Download presentation or simple text.

Minimum data set in General Practice: definitions and coding

31 Jan

A minimum basic data set (MBDS) was designed and used in general practice. The most important purpose and need for establishing such a data set is to assist in the provision of patient care. MBDS is designed to meet common needs for many general practitioners. Minimum means that individual programmes or the GP are free to collect as much additional data as they may wish. The MBDS includes two kinds of data: permanent and dynamic/encounter items.

  • Minimum data set in General Practice: definitions and coding. Gérvas J, Pérez Fernández M. Fam Pract. 1992; 9: 349-52. Descargar artículo completo.

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. It has no sense to focus on osteoporosis and densitometry in postmenopausal females.

Health and politics: a not so innocent relationship

15 Oct

Democracy is associated with a better level of health, but not all democratic policies bring about the same health results, or the same alternatives as regards the organisation of services. In Spain there in an association between right-wing governments and less interest in primary health care.

Coercion is not justified in influenza vaccination

30 May

There are some countries (as Canada and the US) where mandatory influenza vaccine for health workers is a question in debate. There is good intention (to decrease influenza transmission) but has no scientific base, and has adverse effects in public health, as we consider in this paper.

  • Coercion is not justified in influenza vaccination. Gérvas J, Altisent R. Madrid, May, 2013. Download whole text here.

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 text here.

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. N Engl J Med. 2013; 368: 970. Download article here.
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