22 MEDICINE GOOD AND BAD Flashcards
Who is Albert Schatz?
Albert Schatz was a microbiologist who discovered streptomycin, the first drug effective against Gram-negative bacteria
Schatz lived from 1920 to 2005 and came from a poor farming family in Connecticut.
What significant antibiotic did Albert Schatz discover?
Streptomycin
It was effective against Gram-negative bacteria, including the one responsible for tuberculosis.
What was the role of Selman Waksman in Schatz’s discovery?
Waksman took charge of the clinical trials for streptomycin and claimed credit for the discovery
He required Schatz to sign an agreement ceding patent rights to Rutgers University.
What recognition did Albert Schatz receive for his contributions?
He was awarded a portion of the royalties and credit as co-discoverer after suing Waksman and Rutgers
However, he faced professional setbacks as a result of the lawsuit.
What was the life expectancy for American males in 1900?
46 years
By the end of the century, it rose to 74 years.
What was the average life expectancy for women in the United States by the end of the twentieth century?
80 years
It improved from 48 years in 1900.
What was one major cause of death in 1900?
Infectious diseases
They accounted for nearly half of all deaths during that time.
What is the current leading cause of death compared to 1900?
Heart disease and cancer are now leading causes of death
Infectious diseases have significantly decreased as causes of death.
What major factor did Thomas McKeown attribute to the decline in death rates?
Improved sanitation and diet
He suggested that medicine accounted for only about 20% of the improvements in life expectancy.
True or False: Vaccinations have been credited with saving more lives than antibiotics in the twentieth century.
True
According to Nobel laureate Max Perutz.
What was the childhood mortality rate in 1950?
216 children in every thousand died before the age of five
Today, it is just 38.9 early childhood deaths in a thousand.
What is a significant issue regarding life expectancy data today?
Disparities in life expectancy based on socioeconomic status
For example, life expectancy can differ greatly even within the same city.
Fill in the blank: In the early 1960s, Thomas McKeown noted that deaths from tuberculosis had declined without effective treatments, suggesting that _______ accounted for much of the improvement.
sanitation and diet
What is the current life expectancy in Hong Kong?
84.3 years
It is the highest in the world.
What is the average global life expectancy as of today?
70.5 years for men and 75.6 years for women
This marks significant improvement from historical figures.
What major public health intervention drastically reduced diphtheria cases in America from about 200,000 in 1921 to just 3 by the early 1980s?
Vaccination
Other diseases like whooping cough and measles also saw significant reductions.
True or False: Most of the improvements in life expectancy over the last century can be attributed solely to advancements in medicine.
False
Many improvements are linked to better sanitation, diet, and lifestyle changes.
What happens to life expectancy in London for every two stops traveled eastward on the District Line?
It drops reliably by one year.
In St. Louis, Missouri, how does life expectancy change with a twenty-minute drive from Clayton to Jeff-Vander-Lou?
It drops by one year for every minute of the journey.
What is the impact of wealth on life expectancy?
Being rich significantly increases life expectancy; wealthy individuals can expect to live into their late eighties.
How much earlier can a poor person expect to die compared to a wealthy person with an equivalent lifestyle?
Between ten and fifteen years sooner.
How does being American affect life expectancy compared to other industrialized nations?
Americans have a higher risk of dying compared to their peers in other industrialized countries.
What is the likelihood of a randomly selected American aged forty-five to fifty-four dying compared to someone in Sweden?
More than twice as likely.
How does childhood mortality in the United States compare to other wealthy nations?
Children in the U.S. are 70 percent more likely to die in childhood.
What is the general standing of the U.S. in medical well-being measures among wealthy countries?
The U.S. is at or near the bottom for almost every measure.
How much does the U.S. spend on health care per person compared to other developed nations?
Two and a half times more.
What rank does the U.S. hold in global life expectancy?
Thirty-first.
What unhealthy lifestyle factors contribute to lower life expectancy in the U.S.?
Oversized food portions, physical inactivity, and stress.
How do traffic death rates in the U.S. compare to other countries?
11 traffic deaths per 100,000 people, compared to lower rates in the UK, Sweden, and Japan.
What is the average cost of an angiogram in the U.S. compared to Canada?
$914 in the U.S. vs. $35 in Canada.
What is the average cost of insulin in the U.S. compared to Europe?
About six times as much.
What is the five-year survival rate for colon cancer in the U.S. compared to South Korea and Australia?
64.9 percent in the U.S., 71.8 percent in South Korea, 70.6 percent in Australia.
What complicates cancer survival rates in the U.S.?
Ethnic disparities in survival rates.
What is overtreatment in the context of modern medicine?
Focusing on preventing problems through excessive testing and screening.
How many women given an all-clear after a breast cancer screening actually had tumors?
Between 20 and 30 percent.
What is the effectiveness of breast cancer screening in saving lives?
Saves one life in every thousand women screened.
What is the reliability of the PSA test for prostate cancer?
Hardly more effective than a coin toss.
What percentage of men experience impotence or incontinence after prostate treatments?
Between 20 and 70 percent.
What is the estimated amount wasted on unnecessary precautionary maneuvers in U.S. health care annually?
$765 billion.
What is the primary motivation behind overtreatment according to some doctors?
Fear of litigation and maximizing income.
What is the criticism of the pharmaceutical industry regarding doctors?
Doctors often receive money or gifts to promote drugs.
What was the finding regarding the drug atenolol in a 2004 study?
It reduced blood pressure but did not reduce heart attacks or fatalities.
What did Purdue Pharma pay in fines for marketing OxyContin with fraudulent claims?
$600 million.
What is the main conclusion about U.S. health care spending?
Higher spending does not necessarily result in better outcomes.
What did Purdue Pharma pay in fines for fraudulent claims about OxyContin?
$600 million
Purdue Pharma was fined for marketing the opioid OxyContin with fraudulent claims.
How much did Merck pay in fines for issues with Vioxx?
$950 million
Merck failed to disclose problems with its anti-inflammatory drug Vioxx, which was withdrawn from sale.
What is the record penalty paid by GlaxoSmithKline?
$3 billion
This penalty was for various transgressions in their drug marketing practices.
What does Marcia Angell suggest about the fines paid by drug companies?
They are just the cost of doing business
Fines often do not offset the huge profits made by companies before legal action.
What is a major issue with drug development?
It is inherently hit-or-miss
Drug development often fails to yield successful results despite diligent research.
Why might animals not be good surrogates for human drug testing?
They have different metabolisms and respond differently to stimuli
Animals can contract different diseases and may not accurately represent human responses.
What is a problem with testing drugs on genetically engineered mice for Alzheimer’s?
The drugs worsened dementia in humans
Mice must be engineered to develop Alzheimer’s, leading to misleading results in drug effectiveness.
What are confounding variables in clinical trials?
Other medical conditions or medications that complicate results
Excluding participants with these variables limits the applicability of trial results.
What percentage of hospital admissions in the U.K. are due to drug side effects?
6.5 percent
Many admissions are often due to side effects from drugs taken in combination.
What does taking low-dose aspirin daily help prevent?
Heart attacks
However, there are risks associated, such as major gastrointestinal bleeding.
What was found about low-dose aspirin’s effectiveness for those weighing 154 pounds or more?
It is not effective in reducing cardiac or cancer risk
This finding indicates that many may take aspirin without any benefit while facing risks.
What did a 2013 study find about common medical practices?
146 practices had no benefit or were inferior to those they replaced
This highlights the need for continual evaluation of medical standards.
What did a similar study in Australia find regarding medical practices?
156 practices are probably unsafe or ineffective
This suggests that not all established practices are beneficial.
What can significantly affect medical outcomes besides medical science?
Compassion
A study showed better outcomes in patients treated by compassionate doctors.
What is the significance of empathy and common sense in medicine?
They can be as important as advanced technology
Everyday attributes may influence patient outcomes significantly.
Who developed a technique to distinguish between Gram-negative and Gram-positive bacteria?
Hans Christian Gram
The Gram staining technique was developed in 1884.
What does the ‘Gram’ in Gram-negative and Gram-positive refer to?
Hans Christian Gram
It is not related to weights and measures, but to the bacteriologist’s name.
What distinguishes Gram-negative from Gram-positive bacteria?
The thickness of their cell walls
This difference affects how easily they are penetrated by antibodies.
