JAMA NOTES

JAMA: 23-30 April 2019 Vol 321 Number 16 Page 1575

HEALTH AGENCIES UPDATE

Free App to Help Patients Ask Appropriate Questions

No Specific Author noted

 In Today’s world, there seems to be a program/application for everything.  This one, found on the above page, quotes a man named Jeff Brady who is a director in the agency AHQR (Agency For Healthcare Research and Quality), as following…….  By asking appropriate questions in this application, patients can help reduce the chance of missed diagnoses, identify the right tests that are needed and avoid unnecessary hospital stays.

According to the article, this agency has produced the application called “Question Builder”.  On it one can ask questions and input data that is then focused.  Allegedly this then gives the participant a better- more useful bit of information so that that person can utilize the face time with the physician more efficiently.  According to this article, many different devices can be used to access the application.

JAMA NOTES

JAMA 16 April 2019 Volume 321 Number 15 page 1449

NEWS FROM THE FOOD AND DRUG ADMINISTRATION

Agreement To Regulate Cell Based Meat Products

Feyza Sancar PhD

On this page of FDA NEWS is an article written by a Feyza Sancar PhD. She informs us of the joining together of the FDA (Food And Drug Administration) and the USDA-FISIS (US Department of Agriculture Safety and Inspection Service) to work together to regulate Cell Based Meat Products. These are new products that will supplement the supply of meat-based foods. It appears that the FDA will be in charge of collecting ,managing and developing the cell groups. They will also probably be in charge of ensuring the safety of these products. After the harvesting of the cells, the USDA-FISIS will have the job of inspection. packaging and further issues.

Last verse of Kipling’s poem IF”

If you can talk with crowds and keep your virtue,

Or walk with Kings — nor lose the common touch,

If neither foes nor loving friends can hurt you,

If all men count with you, but none too much;

If you can fill the unforgiving minute

With sixty seconds worth of distance run,

Yours is the Earth and everything that’s in it,

And __ which is more,____you’ll be a Man, my son!

JAMA NOTES

9 April 2019 Volume 321 Number 14 pages 1338 – 1340

MESH IMPLANTS FOR WOMEN: SCANDAL OR STANDARD OF CARE?

by Rita Rubin

Ms Rubin is a writer for the Journal of the American Medical Association . This article appears on the JAMA page discussing Medical News and Perspectives. It concerns the widespread use of surgical interventions for the problem of stress urinary incontinence in women , also abbreviated as ‘SUI”. The surgical treatment of various problems using a mesh, has evidently been around for decades, not only for female issues. It is believed that this approach has been used for abdominal hernias since the 1950’s, for prolapses of the pelvic organs since the 70’s and in the 90’s via vaginal approach, for female urinary issues. This is what Ms Rubin discusses.

Comments by Dr. M.

This article caught my interest because the topic has been in the news lately particularly on the problems with the abdominal hernia. The company of Johnson and Johnson is alleged to have paid billions of dollars because of the use of the trans vaginal mesh and a company by the name of Endo International is alleged to have spent billions already litigating this problem.

I had hoped that this article would help to answer the questions raised but unfortunately it did not. There have been many successes and yet many failures. Some surgeons have stopped using this material. For the female afflicted with this issue life can be miserable. The only conclusion I reached at the end of this piece was that there is no one answer. Like ALWAYS treatment and decisions have to be made individually case by case. That has not changed and full disclosure of the risks and benefits should be SOP(Standard Operating Procedure). But then………what’s new?

2nd Verse of Kipling’s poem “IF”

If you can dream- and not make dreams your master;

If you can think- and not make thoughts your aim;

If you can meet with Triumph and Disaster

And treat those two impostors just the same;

If you can bear to hear the truth you’ve spoken

Twisted by knaves to make a trap for fools,

Or watch the things you gave your life to,broken,

And stoop and build’em up with worn-out tools:

This is a sharing of the poem by Rudyard Kipling.It was of course written many years before of sensitivity to gender equality so one must translate all reference to man, men, and son, to encompass females also. At least, that is how I am interpreting it today. Since it is several verses long, I will only do one at a time……so-o-o stay tuned.

IF

by Rudyard Kipling

If you can keep your head when all about you

Are losing theirs and blaming it on you,

If you can trust yourself when all men doubt you,

But make allowance for their doubting too;

If you can wait and not be tired by waiting,

Or being lied about, don’t deal in lies,

Or being hated, don’t give way to hating,

And yet don’t look too good, nor talk too wise:

?

Maybe there are enough youth in the world

Suppose instead……there was a Fountain of Smart ?

Definition of a Lottery Player :….. a person who is bad at math

2 April 2019 Volume 321 Number 13 page 1306

AN EPINEPHRINE PREFILLED SYRINGE (SYMJEPI) FOR ANAPHYLAXIS

Reprint from the The Medical Letter on Drugs and Therapeutics of February 25 2019; 61 (1566):25-26.

Disclaimer: It is not my usual pattern to give the name of a specific product. I do so at this time because of the thought, that the knowledge that work is being done in this area, could be useful to any serious allergy sufferer. This is NOT an advertisement nor an endorsement for this specific product. It is mentioned here for information purposes only!

SYMKEPI. Is the name of a new preparation that has won recent FDA approval for use to treat anaphylaxis. Like the “EpiPen” it requires that the substance be injected from a syringe by hand. Allegedly it will cost less than the “EpiPen”. If you or someone you know need this type of help, please discuss these new products with your medical provider.

Better get a receipt from the IRS when you do something good.

Heaven might be just like that agency.