equipocesca

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.

• Multicasuality of falls and the role of drugs. Gérvas J, Gorricho J. BIT. 2013; 21: 1-8. Download whole article here.

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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.

• Health and politics: a not so innocent relationship. Gérvas J. Aten Primaria. 2008;40:277-84. Download whole article here.

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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.

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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.

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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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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: 665. Download full article here.

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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 endpoints and there are alarming results on the possible risks.
Increasing consumption responds to the success of awareness raising campaigns. TDS is a clear example of disease mongering.

• Medicalization of aging and the testosterone deficiency syndrome. Gérvas, J., Gavilán, E., Gorricho, J. BIT Navarra. 2012;20 (4):1-8. Download article here.

See also a “letter” about the same topic published by the authors in BMJ:

• Marketing, not evidence based arguments has probably increased testosterone prescribing. Gorricho, J., Gavilán, E., Gérvas, J. BMJ 2012; 345: e6905 doi: 10.1136/bmj.e6905 (Published 17 October 2012). Download letter here.

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