HDTenEightyP/NetNews huggingface dataset:
From: george@ibmpcug.co.uk (Michael Veltman)
Newsgroups: sci.med,connect.audit
Subject: Re: Relationship
Date: 9 Apr 92 00:00:56 GMT
Organization: The IBM PC User Group, UK.

Dear Kim,

Yes, the doctor patient relationship does seem to be changing.

Part of it is that its getting harder and harder to find a good generalist
these days as people expect more specialist level knowledge from their 
generalist (ie., family doctor), and specialist knowledge seems to know
no bounds.

Just keeping up with say, internal medicine is difficult enough, and there
are few good general physicians (ie., specialist physicians); these people
do not even profess to know any paediatrics, obstetrics or surgery (ie.,
they are not family doctors).  So with this senario, which is likely to 
get worse, its not suprising to see a decline in the family doctor.  

Please don't get me wrong, I think that we need the generalist, its just
hard to find a good one, and I am sure it will be harder and harder to
do so in the future.

Also, there are now more and more issues with funding, as you rightly 
point out.  As the ability of medicine to deliver progressively increases,
so too does the cost and therefore so too do the number of ways of 
covering these costs.  Again, I can only see this situation as getting
more and more difficult to deal with.  The big problem here is that
the populace are being put into a position of trying to buy medicine
or insurance without really knowing what they will need.  Its alot
harder than insuring a car, and there are plenty of pitfalls with
cars from not reading the fine print.

Just a couple of thoughts on the above,

Yours,

Michael

-- 
Automatic Disclaimer:
The views expressed above are those of the author alone and may not
represent the views of the IBM PC User Group.
-- 
The above opinion is not that of the IBMPCUG.
In fact, it may not be my opinion, either.

Michael Veltman         George@ibmpcug.co.uk 
Newsgroups: sci.med
From: dyer@spdcc.com (Steve Dyer)
Subject: Re: Effects of Prozac et al.
Organization: S.P. Dyer Computer Consulting, Cambridge MA
Date: Fri, 17 Apr 1992 13:38:42 GMT

In article <34621@ttidca.TTI.COM> hollombe@polymath.tti.com (The Polymath) writes:
>}... I eventually stopped
>}after about three months because of the sexual side effects:
>}can you imagine going 3 months without an orgasm?  About 25%
>}of people given the drug experience delayed orgasm or outright
>}anorgasmia ...
>Same thing happened to me.  As I read the PDR, the percentage is more like
>1.7%, but that's at the psychotherapeutic dose.

The PDR figures are based on pre-marketing data, and probably reflect
gross underreporting.  The prevalence of sexual side-effects was
only noticed when the drug was widely used.  Subsequent studies
seem to indicate an incidence of 15-30%.  If you look at the product
data for sertraline (Zoloft), a new, chemically unrelated antidepressant
which also acts as a serotonin reuptake inhibitor, you'll see figures
much more in line with what I mention.  That's because investigators
were alerted to the problem and knew what to ask.

>Interestingly, apart from the above, it had no other detectable effect.

Although a week is usually not long enough to judge a drug's
antidepressant effects, side effects generally appear sooner.

-- 
Steve Dyer
dyer@ursa-major.spdcc.com aka {ima,harvard,rayssd,linus,m2c}!spdcc!dyer
From: dsr@chickpea.mitre.org (Douglas S. Rand)
Newsgroups: sci.med
Subject: Re: Saline solution; was: Re: O2 a "prescription-only" drug?  Why?
Date: 16 Apr 92 17:59:32 GMT
Article-I.D.: chickpea.DSR.92Apr16125932
	<1992Apr16.055006.9578@athena.cs.uga.edu>
Organization: The MITRE Corporation

In article <1992Apr16.055006.9578@athena.cs.uga.edu> mcovingt@athena.cs.uga.edu (Michael A. Covington) writes:

   ...

   There are a number of formulas for saline solution for washing out one's
   nose; some contain glycerin, baking soda, etc., as well as salt.
   What are people's recommendations?  It's the middle of pollen season here...

I've had good luck with just a pinch of salt in boiled water.  I
suppose buffering it with some baking soda might make it less
irritating,  but you just blow it out anyway.  Works for me.


--
Douglas S. Rand 
Internet:   <dsrand@mitre.org>
Snail:	    MITRE, Burlington Road, Bedford, MA 
Disclaimer: MITRE might agree with me - then again...
Amateur Radio: KC1KJ
From: Robin.Salmansohn@f715.n273.z1.fidonet.org (Robin Salmansohn)
Newsgroups: sci.med
Subject: Girl stopped growing... :(
Date: 11 Apr 92 13:17:53 GMT
Organization: FidoNet node 1:273/715 - Ophiophile Maximus, Blue Bell PA

>from: schli@cs.tu-berlin.de (Wolfram Schlickenrieder)

 WS>        [I'm sorry for the subject, but I can 
 WS> neither come up with the
 WS>        correct word, nor can I find any of my 
 WS> dictionaries... I guess
 WS>        it's not much of a problem, is it!?! :) ]
 
Assuming that her growth remains this way, perhaps it is Turners Syndrome.


 

--  
Uucp: ...{gatech,ames,rutgers}!ncar!asuvax!stjhmc!273!715!Robin.Salmansohn
Internet: Robin.Salmansohn@f715.n273.z1.fidonet.org
From: fgz@ddxrus.enet.dec.com (Federico Genoese-Zerbi)
Newsgroups: sci.med
Subject: O2 a "prescription-only" drug?  Why?
Date: 10 Apr 92 19:45:58 GMT
Article-I.D.: ddxrus.1992Apr10.154558
Reply-To: fgz@ddxrus.enet.dec.com (Federico Genoese-Zerbi)
Organization: Digital Equipment Corporation





After a long postponment, I decided that I was involved in enough
activities that could give rise to situation where prompt and
effective Oxygen administration would save a life (boating,
diving) that it would be stupid not to carry it and be trained in
its use.

I signed up for an O2 administration course, given by the folks
who operate the Hyperbaric Medicine Center of the University of
New Hampshire and finished off the module fine.  Imagine my surprise
when I found out that in Massachusetts you need a prescription to
buy the stuff....

Now I understand that there are some dangers inherent in the use of
Oxygen, and people who should not be given oxygen at 100% except
along some clear guidelines, but compared to some of the other stuff
available over the counter, this is one innocuous substance.

So what's the scoop?  Is this just another notch in the dagger of the
"war on drugs"?

F.

P.S. I can get O2 cylinders refilled in NH, and it's not
illegal to carry them back to MA....go figure.
From: kurts@hpnmdla.sr.hp.com (Kurt Strain)
Date: Tue, 7 Apr 1992 16:21:58 GMT
Subject: Re: Suicide prevention; what next?
Organization: Milky Way Galaxy
From: suhre@meltami.dsd.trw.com (Maurice E. Suhre)
Subject: Re: Effects of Prozac et al.
Organization: TRW, INC.
Date: Wed, 15 Apr 1992 19:06:10 GMT

In article <1992Apr14.183413.5052@ac.dal.ca> fairbro@ac.dal.ca writes:
>I would like to hear from people who have been treated for depression with 
>drugs like Prozac, from what I've read it takes about 2-6 weeks for these
>anti-depressants to take effect. Do you just wake up one day and feel great 
>or do you just realize that your not depressed any more? Or is it more gradual
>so that you can start to feel yourself improve day after day?

When I started Prozac, my psychiatrist told me that it might take a
month to see results, if at all.  It would be a question of which
neurotransmitter was in trouble and there was no way to culture the
brain and see what was wrong.

It turned out I felt good in just 2 or 3 days.  I can't be sure what the
day to day progress was, but I would expect you would see a more gradual
progress.

Usual admonitions about one anecdote doesn't really prove anything.

-- 
Maurice Suhre
suhre@trwrb.dsd.trw.com
From: jean@hpfcso.FC.HP.COM (Jean Jasinski)
Date: Wed, 8 Apr 1992 17:03:34 GMT
Subject: Re: MRI
Organization: Hewlett-Packard, Fort Collins, CO, USA
Newsgroups: sci.med

I would not down play the claustrophic effect at all.  My husband
who is NOT claustrophic and had had one MRI in the last year, did
indeed "freak" when he went to have a second MRI.  The difference
might be that the first MRI was on his knee and the second was
on his brain.  (They put a wire mesh cage over his head this time!)
He is fairly tall (6'3") and small boned (190 lb) and he didn't even 
get all the way in the tube before he lost it.  He had to reschedule 
the MRI for another time when he could be premedicated with Valium.  
However, this time the radiologists were so far behind (2 hours), 
the Valium wore off but he was able to withstand the tube the second 
time.  Perhaps the valium hadn't completely worn off, and perhaps the
3 days of psyching was enough, and perhaps his continually replaying
Rush's 2112 in his head did the trick.  But it was also a different
machine with better ventilation and a mirror so he could see out
the other end of the tube.  

MRI's take some time (minimum 45 minutes), and possibly longer depending
on how many contrasts they do.  The reason they were so far behind
the day my husband has his valium-induced MRI was that the previous
patient had been in and out of the tube for 3-1/2 hours due to the
doctors ordering more tests based on the results.

The MRI technician told my husband that about 20% of the patients who
claim not to be claustrophic do indeed have a problem.  Those (like me)
who are professed claustrophics are scheduled to be medicated the first
time.  So if you think you might have a problem, tell them when you
schedule your appointment and be aware that you will have to be there
an hour early to be medicated and cannot drive yourself home.

Jean Jasinski
Newsgroups: sci.med
From: dyer@spdcc.com (Steve Dyer)
Subject: Re: Antihistamines, colds, and pills.
Organization: S.P. Dyer Computer Consulting, Cambridge MA
Date: Tue, 14 Apr 1992 04:47:04 GMT

In article <3428@daily-planet.concordia.ca> gpkatch@alcor.concordia.ca (Gary Katch) writes:
>This morning my girlfriend looked in my medicine cabinet, and found my
>Seldane (terfenadine) tablets, which I keep for for controlling my cat
>allergies on social visits.  She complained about having a runny nose
>all night and decided to take one.  I protested because I know it is an
>antihistamine, which is specifically for allergic reactions, and not
>mild colds.  But she said she often takes [chlorhexadrine?] during colds
>and it helps.  I am guessing that there is a decongestant in that stuff
>if it is a cold remedy.

The received wisdom from the medical profession is that antihistamines
aren't useful for colds.  However, most of them have a good deal of
anticholinergic activity and tend to dry up secretions, and so may help
a runny nose somewhat, which is the reason for their use in colds.
I think the other antihistamine your girlfriend used was probably
chlorpheniramine.

>I got angry because I think she is much too quick to pop pills for
>things;  I have known her to take expired or friends' prescriptions at
>times.  She is also taking some presciption migraine medication at the
>moment, I think called sandomigrin [sp?].  I have been unable to find
>this last in a drug encyclopedia.

My Merck Index gives this as pizotyline, a rather unusual serotonin
blocking drug which is not approved in the US.  It greatly resembles
the anti-serotonin antihistamine cyproheptadine (Periactin).  Although
it's sold for migraine prophylaxis, it is itself a potent antihistamine.
My educated guess is that the kind of drug interaction you might expect
if you mixed this with another antihistamine would be excessive
sedation or excessive dry mouth or other anticholinergic effects.  Of
course, the terfenadine shouldn't add to the sedation.  If she's not
experiencing any side effects, I wouldn't worry.  But it's a good idea
for her to ask her doctor explicitly.  You could make the point that
there's no need to take another antihistamine if she's already taking
one (even if she doesn't realize it.)

>Now, am I being overly cautious, or is she treating over-the-counter
>drugs with too little respect?   She dismissed my concerns saying that
>these medicines can't do any harm even if they do no good.  Also, she
>claims her doctor would have warned her about mixing other drugs with
>the migraine pills.

Well, I think you should take a Valium(tm).  Sheesh.  Or do what I do,
and simply inform her haughtily that antihistamines haven't been shown
to be more effective than placebos in treating colds.  You have to work
on the tone.  Icy superiority is more effective than anger.

-- 
Steve Dyer
dyer@ursa-major.spdcc.com aka {ima,harvard,rayssd,linus,m2c}!spdcc!dyer
Newsgroups: sci.med
From: tsf@CS.CMU.EDU (Timothy Freeman)
Subject: Re: Dentists & Doctors slaves to people with AIDS?
Date: Mon, 06 Apr 92 22:22:46 GMT
Organization: School of Computer Science, Carnegie Mellon University
	<1992Mar26.202945.14010@phlpa.UUCP>
	<TSF.92Apr1140132@U.ERGO.CS.CMU.EDU>
	<1992Apr03.011522.18030@phlpa.UUCP>
Originator: tsf@U.ERGO.CS.CMU.EDU

In article <1992Apr03.011522.18030@phlpa.UUCP> scott@phlpa.UUCP (Scott Scheingold) writes:

   In article <TSF.92Apr1140132@U.ERGO.CS.CMU.EDU> tsf@CS.CMU.EDU (Timothy Freeman) writes:

   We must
   realize that education about this deadly disease is a start. The
   risks are minimal. 

Agreed.

   ... I KNEW there where risks when I entered
   the First Aid Acadamy. I chose to accept them. All of the above must
   say something about my morals, Tim. ...

Right.  It says that you want to be of service to people, which is a
good thing.  The issue we're discussing here is whether it is good to
coerce others to be of service to you, which is entirely different (right?).

   >If you want to do it by coercion (remember the $10K fine that started
   >this conversation), why do you want to punish the AIDS-phobic
   >potential patients less than the AIDS-phobic doctors?  

   Tim I don't want to 'punnish' anyone. There are things that must be
   punnished. 
   The doctor has a resopnsibility to patinets. I do not want to see 
   patients punnished more than doctors. There are losts of doctors that
   will see AIDS patients. But It is not me who punnishes the patients
   by wanting the doctor loose his licence or pay huge fines. It is 
   the doctor who brings this upon himself and his patients. Not me.

If you say "the government should fine those misbehaving doctors", and
indeed the government does, you are responsible to some extent because
if no one wanted the fines, they wouldn't happen.  Whether you
personally carry out the punishment is irrelevant; the important
decision for you to make is whether you wish to contribute to causing
the punishment to happen.

We're trying to decide here whether the fines are a good thing to
have, and to do that we have to compare two different government
policies.  Saying that "the doctor brings it upon himself" means that
you are considering the government's policy as being completely fixed.
We can't have the government's policy both be completely fixed and
subject to debate, so the discussion has to stop here.

   If you feel
   that the doctor is wrong why do you feel that this doctor should
   not be punnished in some form. 

Not all errors need to be punished.  Often the natural consequences of
a mistaken belief are more than enough punishment for holding the
belief, and additional punishment from outside is pointless.  The
dentist did lose one patient by turning away the person with AIDS, and
assuming that the risk assessments people have been stating here are
right, he lost money when doing that even if we take into account his
small risk of being infected.

I am learning a lot about your morals here, Scott.  This is what I
wanted from this conversation.

Thanks,
Tim 
Xref: sparky sci.med:8383 sci.electronics:8113
From: chap@art-sy.detroit.mi.us (j chapman flack)
Newsgroups: sci.med,sci.electronics
Subject: Input section of an EKG
Summary: Could you describe it please?
Date: 7 Apr 92 02:10:53 GMT
Reply-To: chap@art-sy.detroit.mi.us (j chapman flack)
Distribution: usa
Organization: Appropriate Roles for Technology

I'm looking for information on the input section of a simple
electrocardiograph.

What's the minimum number of electrodes needed to outline a basic rhythm
and any obvious anomalies like an extra systole?  Where on the (human) body 
should those electrodes be placed?  Is the detected signal a voltage,
and whatever it is, what magnitude are we talking about?  What should
the input section's impedance be, and what kind of filtering needs to be
done to eliminate unrelated signals?

Thanks!
-- 
Chap Flack                         Their tanks will rust.  Our songs will last.
chap@art-sy.detroit.mi.us                                    -MIKHS 0EODWPAKHS

Nothing I say represents Appropriate Roles for Technology unless I say it does.
Newsgroups: sci.med
From: geb@dsl.pitt.edu (gordon e. banks)
Newsgroups: sci.med
Subject: Re: Question on long term use of Amitryptiline
Date: 9 Apr 92 17:23:30 GMT
Organization: Decision Systems Laboratory, Univ. of Pittsburgh, PA.

In article <9309@ncrwat.Waterloo.NCR.COM> brd@images1.Waterloo.NCR.COM (Barry Drodge) writes:
>does any one know what the possible effects of long term use of
>Amitryptiline are?  By long term I mean in the five to ten year range, with
>a dosage of 75mg per day for the first five years tapering to 10mg over the nect
>five years.
>
I've never seen any long term side effects from amitryptiline.
I think it is very safe.
-- 
----------------------------------------------------------------------------
Gordon Banks  N3JXP      | "I have given you an argument; I am not obliged
geb@cadre.dsl.pitt.edu   |  to supply you with an understanding." -S.Johnson
----------------------------------------------------------------------------
From: debs@ccwf.cc.utexas.edu (Deborah Summa)
Newsgroups: sci.med
Subject: Re: Is balloon angioplasty safe?
Date: 10 Apr 92 02:35:03 GMT
Reply-To: debs@ccwf.cc.utexas.edu (Deborah Summa)
Originator: debs@louie.cc.utexas.edu

>It is fine to have an open newsgroup. However, I think that lay people
>should think twice before offering medical advice. The problem is
>that the lay people on this group can say any outlandish thing they
>want to. As a professional, I cannot, because any of you can
>legitimately sue me if I actually offer you advice. I responded to
>this lady privately, with information that I know to be true, which
>did not constitute "advice."
>
> -km


Hurray!  

I've noticed Ken Mitchum takes a lot of flack on this bboard, at least
lately -- I, for one, am glad he sticks with us though:) I find his
opinions informed and balanced, and his participation is certainly a big
reason i read this board.  I find it hard to imagine anyone could possibly
even consider suing someone over advice or opinions offered over the net,
let alone actually do so legitimately.  Is it really coming to this??
These days nothing surprises me...

I think the proliferation of somewhat questionable 'advice' arises at least in
part from the frustration ordinary people feel when trying to communicate with
those within the medical establishment.  Unfortunately, today's
hectic society rarely permits one the luxury of sufficient time
with the physician in order to ask appropriate questions regarding
whatever the situation is.  Another problem we've all encountered at
one time or another is the physician who feels s/he's God and who as
a consequence doesn't really listen to or talk with the patient. (To
be fair,  let's also consider the frustration a physician must feel
when a patient cannot or will not report all appropriate symptoms or
behaviors, or worse still, one that lies about what they've been
doing or taking, etc.) While a large segment of society is comfortable 
being 'taken care of', there are those of us who do appreciate an 
explanation as to what's going on (or suspected of going on) and why
a particular course of treatment is or is not being recommended. 
(On the other hand, many people are alarmists when it comes to their
health;  it's no doubt hard to judge how much one can/should say 
without jeopardizing someone's mental state too.)
To a certain extent it's  useful and informative 
to solicit opinions or experiences from those on 
the net, although i think most of us realize any actual advice or 
so-called factual information so received has to be weighed carefully.  
After all, everyone's different and every disease is different, and while
medical science has come a long way, there is still a fine art involved
in clinical practice.

Just my 2-cents...

	-deb s.

PS:  Now having said all that, thanks to those who took the time to
     reply to my recent queries:)
Newsgroups: sci.med
From: M20614@mwvm.mitre.org (Hugh Pritchard)
Subject: Re: Fertility drugs
Organization: The MITRE Corporation, McLean VA 22102
Date: Fri, 3 Apr 1992 14:03:49 GMT

In article <1992Apr02.172153.22517@Veritas.COM>
joshua@Veritas.COM (Joshua Levy) writes:
 
>I think you have it backwards.  Increased fertiltiy sounds like a minor
>side effect for a drug which increases libido.  Is this Clomid stuff
>available OTC?  :-)
 
No, sorry.  (-:  Clomid (clomiphene citrate) is available by prescription
only.  It's indicated to spur female ovulation and to treat some kinds of
male infertility.
 
Clomiphene citrate works by goading the pituitary into producing FSH
(follicle-stimulating hormone) and LH (luteinizing hormone).  In males,
FSH tells the testacles to produce sperm (spermatogenesis), and LH tells
the testacles to produce testosterone -- hence the increased libido.
 
Why not dream about obtaining Pergonal (menotropins), which is straight
FSH plus LH?  (I understand that the Italian drug company which developed
Pergonal gets it from urine collected at a convent -- the nuns are happy
to contribute in some way to the happiness of others.)
 
**  Hugh Pritchard,  hapritch@mitre.org,  703/883-6616
From: ccat@netcom.com (Chris Beaumont)
Subject: Re: Selling Organs
Date: Sat, 11 Apr 92 16:29:37 GMT
Organization: Netcom - Online Communication Services  (408 241-9760 guest) 

..
I just think it's important to point out that the reason I 
posted the info on organ selling in China was simply because I empathize
with the plight of the Chinese students and dissidents 
(who, you might remember, had literally thousands disappear into
the "prison system" in China following the Tienamien square events)
who are being exploited in an altogether distasteful way..to put
it mildly...(remember the official Chinese govt. line is that these
events never happened..so witnesses were not very welcome..)
...
After MFN was renewed, I thought that the ignorance of the American
media of these events was appaling. Since the thread was brought
up here.. I just wanted to comment on it. Sorry if I offended anyones
sensitivities but the Chinese situation is a matter of public record.
How would you like to be shot for your kidney?

I carry an organ donor card and I AM sebnsitive to the need for more
voluntary organ donation.

-- 
--
Chris Beaumont
PO Box 170156,San Francisco,CA. 94117
ccat@netcom.com
From: h2co@odin.cc.pdx.edu (Candace O'Connor)
Newsgroups: sci.med
Subject: Re: Taxol RFI
Keywords: Thanks; Cancer Info #
Date: 8 Apr 92 18:44:11 GMT
Article-I.D.: pdxgate.5285
Distribution: usa
Organization: Portland State University, Computing Services

Recently I posted an RFI about Taxol.  I want to thank the person who
responded to my post almost immediately.  I think s/he was from Texas,
but I accidentally deleted the email.  So I hope you see my thank you
here.

For anyone out there who might be interested, you can reach the NCI
information system by dialing 1-800-4-CANCER.  After pushing a few
buttons to ask to speak to a person, you may be on hold for a long
time (I was) but it might be worth it to wait (it was for me).  You
can request various information bulletins.  You can also do a search 
for ongoing clinical trials that may be appropriate for your cancer.
To get the most out of the system, it helps to know medical history
(exactly what kind(s) of cancer(s) are present now and were present
in the past, surgical history, radiation, chemical, and hormonal
therapy history, stage of cancer).  They keep an up-to-date data base
on NCI (that's National Cancer Institute) approved trials.  

Candace O'Connor
Biology Department

h2co@odin.cc.pdx.edu