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PubMed2005

Scientific drug information in newspapers: sensationalism and low quality. The example of therapeutic use of cannabinoids.

OBJECTIVE: We aimed to analyse the quality of newspaper articles (NAs) concerning the therapeutic use of cannabis published in Spanish newspapers. METHODS: A preliminary questionnaire of the Index of Scientific Quality was used [scores ranged from 0 (no misleading) to 14 (misinformation in each item)]. RESULTS: Of the 29 NAs analysed, 16 (55.2%) were scored as 4 or lower, and 6 (20.7%) scored 7 or higher. Up to 23 NAs (79.3%) did not manage the knowledge related to cannabinoids; 20 (69%) gave a sensationalist message; 11 (37.9%) were able to wrongly influence clinical decision taking; and 8 (27.6%) misled medical concepts. CONCLUSION: The leading medical journals could play an especially relevant role while preparing their press releases if they specify study limitations and context.

Biomedical Research↗

PubMed2004

State of the art of current modalities for the diagnosis of breast lesions.

With the availability of numerous diagnostic techniques comes the possible risk of the unjustified use of such techniques and a lack of rational clinical application. Clearly, errors of this nature would affect the diagnostic accuracy and therefore reduce the possibilities for treatment. It is not uncommon for women and also for general practitioners to be misinformed about which is the most suitable technique or rather, which is the best combination of the various techniques. For this reason, inappropriate tests are often requested or, conversely, there is failure to request tests which would in fact make a useful contribution to safeguarding the patient's health. This work has the following aims: (a) to set out precisely the real diagnostic contribution of each method, both radiological and otherwise, and suggest methods of application and indications consistent with the state of the art, and (b) to suggest the most effective and rational combinations of the various techniques and organisation of diagnostic activities.

Biopsy, Needle↗

PubMed2000

[Placebo].

BACKGROUND: The placebo reaction is a widely known phenomenon but the way it develops is not fully understood. This fact has given rise to numerous misinformed opinions on this subject. PLACEBO ANALGESIA: More research has been done in the field of placebo analgesia, where the involvement of the endogenous opioid systems was discovered some twenty years ago. Recently there have been some new discoveries concerning the role of expectancy and drug conditioning in experimentally induced placebo analgesia. PLACEBO REACTION: The placebo reaction is very impressive not only following drug administration, but also after surgical operations. In many cases, it is extremely difficult to decide whether a therapeutic success is due to a given medical intervention or to a placebo response. The use of placebo controlled clinical studies remains an ethically charged issue.

English Abstract↗

PubMed2003

What is true community-acquired urinary tract infection? Comparison of pathogens identified in urine from routine outpatient specimens and from community clinics in a prospective study.

In order to identify the true nature of community-acquired urinary tract infections, the uropathogens isolated from 100 patients with urinary tract infection included in a prospective study conducted in community clinics were compared to 244 isolates from outpatient urine specimens routinely submitted to the laboratory. Significant differences in both the spectrum of bacteria and their antibiograms were found between the two groups. Laboratory data analysis of uropathogens from outpatient urine specimens may not reflect the true bacteriology of urinary tract infections acquired in the community. Hence, surveys based on laboratory data alone may overestimate resistance rates, leading to misinformed choices being made when treatment is empirical.

Anti-Bacterial Agents↗

PubMed2005

A case for informed consent? Indoor UV tanning facility operator's provision of health risks information (United States).

OBJECTIVE: Indoor UV tanning is associated with skin cancer. This study describes consumer health risks information provided by indoor UV tanning facility operators in four states (Colorado, Illinois, Texas, and Wisconsin) with varying operator training, regulations, enforcement and penalties. METHODS: Using a cross-sectional survey study design, 100 randomly selected licensed indoor UV tanning facilities from each state were surveyed anonymously by telephone. Facility operators were questioned regarding the provision of information on potential adverse effects of indoor UV exposure. RESULTS: Of 628 licensed indoor UV tanning facilities contacted, 400 facilities were surveyed. Most (87%) advised patrons of the potential risk of sunburn from indoor tanning. Less than half of facility operators in Colorado, Texas and Wisconsin informed patrons about the risk of skin cancer (42, 43 and 48%, respectively) compared with 81% of Illinois operators. Likewise, more operators in Illinois reported the risk of premature aging (79%) compared with other states (41% Colorado, 43% Texas and 51% Wisconsin). CONCLUSIONS: Tanning facility operators frequently misinformed patrons of indoor UV exposure risks. The provision of informed consent by indoor tanning facility operators needs improved adaptation by the tanning industry as a standard for customer service.

Aging, Premature↗

PubMed2000

Cerebellar Ataxia.

There is nothing more discouraging than for a patient to be given a specific diagnosis, then to be told that there is nothing that can be done. Physicians are equally disheartened to see exponential progress being made in the understanding of the pathophysiology of a complex disorder but few direct benefits resulting for their patients. Over the past 5 years, molecular genetic research has completely revolutionized the way in which the progressive cerebellar ataxias are classified and diagnosed, but it has yet to produce effective gene-based, neuroprotective, or neurorestorative therapies. The treatment of cerebellar ataxia remains primarily a neurorehabilitation challenge, employing physical, occupational, speech, and swallowing therapy; adaptive equipment; driver safety training; and nutritional counseling. Modest additional gains are seen with the use of medications that can improve imbalance, incoordination, or dysarthria (amantadine, buspirone, acetazolamide); cerebellar tremor (clonazepam, propranolol); and cerebellar or central vestibular nystagmus (gabapentin, baclofen, clonazepam). Many of the progressive cerebellar syndromes have associated features involving other neurologic systems (eg, spasticity, dystonia or rigidity, resting or rubral tremor, chorea, motor unit weakness or fatigue, autonomic dysfunction, peripheral or posterior column sensory loss, neuropathic pain or cramping, double vision, vision and hearing loss, dementia, and bowel, bladder, and sexual dysfunction), which can impede the treatment of the ataxic symptoms or can worsen with the use of certain drugs. Treatment of the associated features themselves may in turn worsen the ataxia either directly (as side effects of medication) or indirectly (eg, relaxation of lower limb spasticity that was acting as a stabilizer for an ataxic gait). Secondary complications of progressive ataxia can include deconditioning or immobility, weight loss or gain, skin breakdown, recurrent pulmonary and urinary tract infections, aspiration, occult respiratory failure, and obstructive sleep apnea, all of which can be life threatening. Depression in the patient and family members is common. Although no cures exist for most of the causes of cerebellar ataxia and there are as yet no proven ways to protect neurons from premature cell death or to restore neuronal populations that have been lost, symptomatic treatment can greatly improve the quality of life of these patients and prevent complications that could hasten death. Supportive interventions should always be offered-- education about the disease itself, genetic counseling, individual and family counseling, referral to support groups and advocacy groups, and guidance to online resources. Misinformation, fear, depression, hopelessness, isolation, and financial and interpersonal stress can often cause more harm to the patient and caregiver than the ataxia itself.

Journal Article↗

PubMed2006

Initial treatment of Parkinson's disease.

Initial treatment of early idiopathic Parkinson's disease (PD) begins with diagnosis based on clinical evaluation supplemented by laboratory studies and brain imaging to exclude causes of secondary parkinsonism. In most cases, testing is normal and the diagnosis of PD rests on clinical criteria. In patients with mild symptoms and signs, the diagnosis of PD may not initially be apparent, and follow-up evaluation is needed to arrive at a diagnosis. Once the diagnosis is made, pharmacologic treatment may not be the first step. First, patient education is essential, especially because PD is a high-profile disease for which information and misinformation are readily available to patients and families. Counseling concerning prognosis, future symptoms, future disability, and treatment must be provided. Questions from patients concerning diet, lifestyle, and exercise are especially common at this point. The decision of when to initiate treatment is the next major consideration. Much controversy but relatively little light has been brought to bear on this issue. L-dopa was the first major antiparkinson medication to be introduced and remains the "gold standard" of treatment. Next in efficacy are the dopamine agonists (DAs). A debate has raged concerning whether initial dopaminergic treatment should be with L-dopa or DAs. Physicians have been concerned about forestalling the appearance of dyskinesias and motor fluctuations, whereas patients have incorrectly understood that L-dopa and possibly other antiparkinson drugs have a finite duration of usefulness, making it important to defer treatment for as long as possible. This has created "L-dopa phobia," which may stand in the way of useful treatment. In spite of this controversy, there is uniform agreement that the appropriate time to treat is when the patient is beginning to be disabled. This varies from patient to patient and depends on age, employment status, nature of job, level of physical activity, concern about appearance, and other factors. The choice of a specific drug is sometimes dictated by the patient's symptoms. For example, L-dopa is preferable for severe akinesia, an anticholinergic may be useful when tremor is the most prominent symptom (especially in those aged younger than 70 years), and DAs may be indicated for younger patients, more prone to dyskinesias and fluctuations, with relatively mild symptoms. It is also important to manage non-motor symptoms in patients with early PD. Anxiety and depression are particularly common at this stage and may be presenting symptoms of PD. Where appropriate, counseling and/or treatment with anxiolytics and antidepressants should be considered.

Journal Article↗

PubMed1979

The inappropriateness of conventional cephalometrics.

1. Cephalometric conventions today may have little basis in either biology or biometrics. 2. There is no theory of cephalometrics, only conventions which involve landmarks and straight lines only. These fail to capture the curving of form and its changes, exclude proper measures of size for bent structures, and misrepresent growth, portraying it as vector displacement rather than a generalized distortion. 3. Conventional cephalometric procedures misinform by fabrication of misleading geometric quantities, by camouflage, particularly of remodeling, by confusion about what is happening (analysis of rotations, treating shape separately from size, and registering angles on landmarks as vertices), and by subtraction as a representation of growth. 4. We suggest that the present systems offer little real hope of improvement sufficient to meet our needs in craniofacial growth research. We call attention to three possible techniques to be included in future cephalometric conventions: (1) tangents and curvatures, (2) Blum's medial axis ("skeleton"), and (3) biorthogonal grids.

Biometry↗

PubMed1996

Where to look first for suggestibility in young children.

Preschoolers' suggestibility following exposure to biased information has often been interpreted as indicating that memory traces have been genuinely altered. However, young children may not recognize that the purpose and relevance of questions in experiments on suggestibility is to determine whether they can ignore misinformation in remembering the original details of stories. Instead, children may be prompted to regard the original story details as trivial by experimenters who are perceived as having portrayed these details as unimportant or irrelevant in that they themselves did not bother to get these right. Under such conditions, children may interpret the biased information to mean that a biased alternative was an acceptable, or even a preferred, test choice when compared to the original details. We report the results of an investigation with 3- to 5-year-olds in which children heard a story followed the next day by either biased, unbiased, or no information. The children were able to identify the original story details 6 days later when the questions were phrased in an explicit manner that referred to the time of the information to be recalled.

Attention↗

PubMed1992

Genetics of affective disorders.

Studies of the mode of inheritance of affective disorders have been reviewed. The overall picture which emerges does not seem to involve specific modes of inheritance. Linkage studies based on the single gene hypothesis, support X-linkage for a bipolar variant, as well as possible linkage to chromosomes 6 and 11. The more recent approach of linkage studies using large numbers of RFLP markers scattered throughout the genome looks promising, though it may still give rise to misinformation. Several confounding factors have been suggested such as genetic and phenotypic heterogeneity, as well as the lack of well defined diagnostic criteria.

Bipolar Disorder↗

PubMed1987

Radiation-induced forward and reverse specific locus mutations and dominant cataract mutations in treated strain BALB/c and DBA/2 male mice.

Strain BALB/c and DBA/2 mice were chosen to investigate the effects of genetic background on the radiation-induced mutation rate since they exhibit differences in their radiation sensitivity. Males were exposed to 3 + 3-Gy X-irradiation and mated to untreated specific locus Test-stock females. Offspring resulting from treated spermatogonia were screened for induced specific locus forward and reverse mutations and dominant cataract mutations. Since BALB/c mice are homozygous brown and albino, specific locus forward mutations could be screened at 5 of the 7 specific loci (a, d, se, p, s), while reverse mutations could be screened at the b and c loci. Strain DBA/2 is homozygous non-agouti, brown and dilute. Therefore, specific locus forward mutations could be screened at 4 loci (c, se, p, s) and reverse mutations were screened at the a, b and d loci. Results indicate no effect of genetic background on the sensitivity to mutation induction of specific locus forward mutations, while for the dominant cataract alleles strain DBA/2 exhibited a higher mutation rate than either strain BALB/c or similarly treated (101/El X C3H/El)F1 mice. If, by confirmation, these differences should be demonstrated to be real, it is interesting that strain DBA/2 should exhibit a greater sensitivity to radiation-induced dominant mutations. First, strain DBA/2 was chosen as radiation resistant or repair competent. The observation that DBA/2 exhibited a higher sensitivity to radiation-induced mutation may indicate a role for repair, albeit misrepair, in the mutation process. Second, that the effect of genotype was only observed for the mutation rate to dominant cataract alleles may reflect a difference in the spectrum of DNA alterations which result in dominant or recessive alleles. A dominant allele is more likely misinformation, such that as heterozygote it interferes with the wild-type allele. By comparison, a recessive allele may result from any DNA alteration leading to the loss of a functional gene product. One reverse mutation at each of the a and d loci was recovered in the present experiments. The similarities of the present results for radiation-induced reverse mutations with the extensive data on the spontaneous reverse mutation rates are interesting. Reverse mutations were recovered only at the a and d loci. Further, the reverse mutations recovered at the a locus were to alternate alleles (at, Aw or Asy) while true reverse mutations were apparently recovered at the d locus.

Abnormalities, Radiation-Induced↗

PubMedDate not supplied

Myopia--a treatable "disease"?

The authors cite various information and misinformation regarding proposed treatments (atropinization, contact lenses, orthokeratology, wearing glasses, not wearing glasses) for the progression of myopia. They conclude that there is insufficient evidence to support the more vigorous approaches to treatment of myopia, and provide some useful explantations for patients and their parents who question the ophthalmologist's decision to treat conservatively.

Accommodation, Ocular↗

PubMed1986

Risk management in chemical safety: some general observations relating to the state of the art.

Risk management for chemical safety begins with judgement and produces arbitrary regulations. In between, technical risk assessment has value in clarifying the behaviour of particular chemical risk systems. Risk quantification can be useful in some cases and quite misleading in others. In no case can it alone be the decisive factor. In the public's perception, chemicals are feared most for potential insidious exposure in the general environment. Risk management then must deal with high system uncertainty and information heavily influenced by value judgements. The technical contribution to risk assessment is reduced, in real terms, as the decision-making scenario expands with its increasing exposure to system 'noise', interference and misinformation. Improved communication in the system requires the use of simplified language. The suitability of risk estimation methodologies must be assessed in terms of general comprehensibility in the management for chemical safety will remain, perhaps always, more of an art than a science, concerned with an interplay of information that can be 'rationalised' with other information that defies such rationalisation.

Communication↗

PubMed1983

What young men know about testicular cancer.

A survey to asess what young men know about testicular cancer and to determine awareness and practice of testicular self-examination (TSE) was conducted among 266 male graduate and undergraduate students at the State University of New York at Buffalo. Findings indicate that the majority of young men were either uninformed or misinformed about their risk of getting testicular cancer and about the symptoms of testicular cancer. Only 16% of respondents had heard of TSE before the survey, and only a small percentage of these individuals reported doing TSE on a routine basis. The findings from this study point out the need for increased public education directed at symptom recognition, especially at the high school and post-high school levels.

Adolescent↗

PubMed1980

Hippocampal rhythmic slow activity (RSA; theta): a critical analysis of selected studies and discussion of possible species-differences.

The literature concerning the correlates of hippocampal RSA (theta) has seen a wealth of hypotheses generated from seemingly contradictory data. Two possible reasons for this are examined here. (1) An analysis of the maximum published RSA amplitudes in over 70 papers shows that there is enormous variation in how effective various research groups have been in tapping the hippocampal RSA generator zones. It is suggested that this variation is a major source of 'contradictory data'. The enormous variability is probably due to the fact that the laminar structure of the hippocampus, and the location of two seemingly independent 180 degrees out-of-phase RSA generators, results in very disparate signals being recorded by electrodes of different configurations. Electrodes which are not optimally placed result in records which may provide misinformation as to whether or not the hippocampus is in the RSA 'mode'. The results of studies with less than adequate records must therefore be viewed with great caution. (2) An explanation often evoked to account for much of the controversy is that of species differences. This idea is examined and it is suggested that there are probably not major species differences in that all of the species appropriately examined thus far have neural systems capable of producing both an atropine-sensitive and an atropine-resistant form of RSA. All species (with the exception of primates) also show relations of RSA to ongoing motor behavior. However, there are definitely species differences in the neural mechanisms underlying the production of atropine-sensitive, immobility-related RSA. Although all species appear to be capable of producing immobility-related RSA some do so only rarely (e.g. rats), while others do so frequently, particularly in response to sensory stimulation (e.g. rabbits, cats, guinea pigs). Therefore, the answer to the question as to whether there are species differences in the occurrence of RSA may be yes, or not, depending upon how specifically the question is posed.

Animals↗

PubMed1993

Contracts: problems and prospects.

This article focuses on the important role played by contract prices in the new NHS. The power of prices to both inform and misinform the allocation of resources is highlighted. Orthopaedic surgery is used as a case study to indicate not only the obstacles to prices leading to improvements in efficiency but also the substantial scope for the prices set to convey valuable information on relative costs. Whether the purchaser-provider split will lead to an improved use of scarce resources will depend on several factors. One of the most important of which will be the development of sophisticated contracts embodying accurate price information.

Aged↗

PubMed1990

The psychosocial impact of HIV infection--what clinicians can do to help.

The psychosocial impact of infection with human immunodeficiency virus (HIV) can be viewed from three perspectives: (1) the issues focused by acquired immunodeficiency syndrome (AIDS), (2) the persons affected, and (3) the emotions encountered. Among the many issues faced by AIDS patients, their families, and their caregivers are impending death, dependency, disfigurement, physical and emotional isolation, contagiousness, secrecy, changes in lifestyle, financial responsibility, discrimination, and burnout. Although these issues are not unique to AIDS patients, they are accentuated because more of them are likely to occur. Some ways that clinicians can help mitigate the impact of these issues are by correcting misinformation that patients and caregivers may have, improving the coordination of community services and support groups, encouraging patients to maintain control over their lives and establish a network of support contacts, being alert to repressed patient/caregiver reactions, understanding the therapeutic value of humor, and encouraging the expression of deep emotions such as grief, guilt, and anger.

Acquired Immunodeficiency Syndrome↗

PubMed1986

Infection control and the pregnant health care worker.

Health care workers may be exposed to a variety of infectious agents in the workplace. The pregnant health care worker presents additional concerns because of the potential risk of infection to the developing fetus. Health care workers often misunderstand the basic elements of infection transmission. The result of this misinformation is that personnel are most often concerned about the agents that are least transmissible. To develop an infection control program that is rational and workable, the infection control practitioner must have a thorough understanding of the mechanisms of disease transmission. With this foundation, an infection control program for the pregnant health care worker will rarely involve transfer to alternative assignments or work restriction based on pregnancy alone. The approach outlined in this article stresses a more generic approach to infection control by isolating the disease and not the employee.

Acquired Immunodeficiency Syndrome↗