September 2007

Table of Contents
Generic vs Brand Name I: The Taste Test
Generic vs Brand Name II: The Sleep Test
Generic vs Brand Name III: The FDA Test
Obesity Found To Be A Communicable Disorder - Really!!
Are Prescription Medicines for Treating Alzheimer's Worth It?
Intensive Care or Palliative Care. Sometimes It's Not an Easy Choice


Generic vs Brand Name I: The Taste Test
Sixty three children were fed five identical foods and drinks either in packaging having MacDonald's logos or similar packaging without the logos. For each pair of foods, the children were asked to point to the one that tasted better. Children significantly preferred four of the five foods and drinks that they thought were from MacDonald's. The taste preference was greatest in children whose homes had more TV sets.


Generic vs Brand Name II: The Sleep Test
Tryptophan is a sleep inducing food element. A study published in the American Journal of Nutrition showed that drinking milk, common lore notwithstanding, decreases the amount of tryptophan that gets into the brain. On the other hand, foods high in carbohydrate stimulate the release of insulin, which eases tryptophan's entry into the brain. If you really believe that milk works for you, it will (see MacDonald's test, above). Otherwise, try a Twinkie.


Generic vs Brand Name III: The FDA Test
A myth encouraged by the drug industry has it that generics are in some way not as good as brand name drugs. In fact, generic manufacturers must prove to the FDA that their drug delivers the same amount of active ingredient in the same time frame as does the brand name drug. The generic must have the same quality, strength (100%), purity and stability as the brand name drug. The manufacturing standards required of generics are identical to those required of brand name drugs, and FDA inspectors use the identical criteria while inspecting their facilities. In fact, 50% of generic drugs are produced by brand-name firms, which frequently make copies of their own or other brand name drugs and sell them as generics.


Obesity Found To Be A Communicable Disorder - Really!!
Researchers analyzed data from twelve thousand participants in the Framingham Health Study from 1971 to 2003. They found that a person's having friendship with a an individual who became obese during the study period was significantly associated with the person's developing obesity himself. (Read on before you decide the "himself" is sexist.). This correlation extended to a friend of a friend of a friend. An increase in weight correlated 100% for male to male friendships (!), only 38% for female to female friends (not statistically significant), and not at all for opposite-sex friendships. Overall, obesity in a friend was a stronger predictor than obesity in a sibling or a spouse. Obesity in a neighbor had no predictive value. If this study's findings can be replicated (which I doubt), maybe you'll need to change your friends, not your diet.


Are Prescription Medicines for Treating Alzheimer's Worth It?
The short answer is probably not. In numerous studies, patients taking these medications had a very small benefits on cognitive tests (just enough to get approved by the pharmaceutically funded FDA) but had no improvement in their ability to carry out day-to-day self-care tasks. - Neurology Jul 2007 69:459-69



Intensive Care or Palliative Care. Sometimes It's Not an Easy Choice
It is sometimes wrenching for doctors, patients and families to accept that a patient's illness is not curable and that active treatment is no longer needed. Thus the old nurse's joke: Why do they put nails in coffins? To make sure the doctors don't restart the chemotherapy. Palliative care is defined as active care of patients whose disease is not responsive to curative treatment. This can involve control of pain or other symptoms as well as psychological, social and spiritual support. The goal of palliative care is for patients and their families to achieve the best possible quality of life in the face of serious illness.


In a study of 130 patients in a medical intensive care unit (ICU), consultation with a palliative care specialist cut the average length of time seriously ill patients spent on the unit from two weeks to one week with no change in mortality. This does not mean patients should be prematurely hurried off the ICU. But sometimes a sensitive outside consultant can help doctors and families make more humane and reasonable decisions about treatment options for very seriously ill patients.

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