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#2988 05/29/00 12:37 PM
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Prevention is better than cure, so the saying goes. But sometimes no amount
of prevention helps and we are forced to visit those trained in the healing
arts. Like any profession, the world of medicine has its own jargon. If you
have come down with a bad case of medical jargonitis, help is near. Here is
AWAD's prescription: take this week's seven words and email me next week.


#2989 02/25/01 08:13 PM
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Sounds more helpful than the conventional "Take two aspirin and call me in the morning."


#2990 02/26/01 01:46 AM
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Oy. It depends on the words Anu serves up Bill. If they are those "fifteen consonant - two vowel" things then you know it will take a week to get over it.


#2991 03/07/01 03:04 AM
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Long ago, when a woman in labor was making little progress, sometimes a sternutant to cause sneezing would produce powerful contractions of the abdominal musculature, sometime being followed by more powerful regular contractions.
When pregnant women at term on British fighting ships at anchor had delayed onset of labor, sometimes cannons were fired, and apparently helped initiate labor. Children so born were called "sons of guns".
Many of the health spas long ago had minerals that acted as an aperient for those who suffered from constipation.
For patients who had ingested poison in a suicidal attempt, prompt administration of an emetic such as ipecac to make them vomit could be life saving.
Much can be learned about diseases of the heart and lungs by listening,called auscultation, originally by putting the ear against the chest wall. But this was inconvenient for the doctor, and unpleasant for the patient. Then it was discovered that a rod could be used to conduct sound to the doctor's ear. Later it was learned that a hollow tube worked even better.When rubber tubing became available the modern stethoscope was developed.
A doctor whose father could tell if wine casks were full, or only half full by tapping them, used this to detect when parts of the chest were filled with fluid, or solid with disease. This is called percussion.


#2992 03/10/01 06:22 PM
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If they are those "fifteen consonan" - two vowel" things then you know it will take a week to get over it.

And if more than one is mentioned in a discussion of your health the bill enlarges times the number of those words. used.$$$$$$$$$$$$$$$$$$$$$
wow



#2993 03/12/01 02:37 PM
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Is "medicine" the right word to describe the healing arts? The New England Journal of Medicine, for example, restricts its focus to traditional: the use of drugs and the creation of new orifices in the body (surgery) for the purpose of altering physiological processes and bodily function or structure. There are many healing disciplines that use less invasive and (dare I say) gentler methods. Is massage therapy medicine? Is nursing care medicine?

I suggest we use the terms "health care" or "healing professions" instead of medicine when referring to the collective health professions, or when appropriate, use the specific term that describes the discipline to which you refer, e.g., nursing, physical therapy, psychology. Restrict the term medicine to the practice that only MD's and DO's are licensed to provide.


#2994 03/12/01 05:18 PM
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Obviously "medicine" is used as a catch-all for many things other than just the use of medications, but it still suffices most of the time as an abstract term. "Health care" can be useful to include all of the many vital ancillary services. And I do not mean "ancillary" to be a put down. The people who keep hospitals clean are just as vital as the surgeons.


#2995 03/13/01 02:50 PM
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I think you misunderstood my point. I realize that lumping all disciplines together is not malicious, but, given the power of language to shape thinking, I'd like to see the non-medicine disciplines acknowledged when referring to all healing professions. To say "medicine," meaning nursing, PT, counseling, etc. is a misnomer that marginalizes the non-medical professions. Medicine has been defined as the application of drugs or the creation of openings in the body, e.g. incisions, for the purpose of altering physiology, pathology or body structure and function. Keeping to this definition acknowledges that many non-medical professionals also heal.





#2996 03/14/01 03:29 PM
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To make a comparison, generals are a necessary part of an army, but without the sergeants and privates, they would win no wars. This is not a put-down to the enlisted men, of whom I was one.


#2997 03/14/01 03:59 PM
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But Bill, i think most gereral would be happy about an "underground" army-- like the french underground-- but i sometime feel that the 5 star generals in medicine--the AMA and there ilk, don't like a lot of the alternate healers.

And while medicine has made wonderful advance in the past 100 years, clean water and good sewers have done more for human health almost any other medical advance.. Semiel (sp?) was able to cut mortality in "the laying in Hospital" with clean water and washed hands..

Vacines are the most important thing-- hurrah for Pasture! He saved the wine industry, and half the world!




#2998 03/14/01 08:41 PM
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Dear of troy: As I see it, the principal problem with the alternative medicine people is that they rely far too much on anecdotal data, and do not use properly controlled studies to validate their claims. Look at how hard it was to convince even doctors how hazardous smoking is. I knew far too many doctors who died of smoking. I even had one of them ask me bring him something that he could use to commit suicide with.I'm lucky that one of my friends was a chest surgeon, and told me about the numerous lung cancers he was seeing, back in the early 50's.

Puerperal Fever, infection, once prevalent in women after childbirth. In most cases puerperal fever occurred because aseptic techniques during delivery and occasionally during abortion and miscarriage were not used. Also called childbed fever, the infection in most instances was due to streptococci that entered the body during delivery. The efforts of the physicians Ignaz Philipp Semmelweis and Oliver Wendell Holmes brought about the adoption of rigid cleanliness and asepsis in maternal delivery procedures, and the mortality from puerperal fever was reduced more than 90 percent after their adoption.
In addition to the use of strict asepsis in obstetrical procedures, the availability of modern antiseptics has made puerperal fever a rarity.



"Puerperal Fever," Microsoft(R) Encarta(R) 98 Encyclopedia. (c) 1993-1997 Microsoft Corporation. All rights reserved.


#2999 03/15/01 05:33 PM
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wwh is correct. There are precious few controlled studies of alternative healing methods, e.g., herbal preparations, homeopathy. Some of these are in dire need of external validation via controlled studies. On the other hand, there are those who say that many "alternative" methods do not lend themselves to controlled, de-contextualized tests the way more traditional allopathic healing methods, e.g. drugs & surgery, do. A reasonable argument when you consider this is the reason why there are no placebo-controlled studies of, say, psychotherapy - because the treatment cannot be separated from its context without losing the effect.

An example is the therapeutic touch "controlled study" by a 9 year old girl that JAMA published a few years back. Its proponents claim that if there was a therapeutic touch effect, the experiment would have detected it. Its critics claim that reductionistic bias ensured that the experiment would achieve its desired result: to discredit therapeutic touch.

To return to the topic of words, "alternative" is out of favor as the proper adjective for describing non-allopathic healing modalities. "Complementary" is preferred, because most people use them alongside more traditional western methods. Another area ripe for research: How do these two very diffferent approaches to healing work together?


#3000 03/15/01 05:39 PM
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I can't quote Hippocrates accurately, but he said something like "Life is short, the Art is long, Experience fleeting, and Judgment difficult."
Look at how hard it is in spite of much study to evaluate the placebo effect accurately.


#3001 03/16/01 08:40 PM
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I read about a study done on theraputic touch in a nursing magazine-- In the early 90's

It was done at a university-- and the test subjects all had broken bones. They were told that there was a new UV light treatment for healing and all the subjects where young, reasonalbe healthy students.

During the study, they where directed to report to a test center (2 or 3 times a day)--once there they inserted the effected limb (arm or leg into an opening that was then carefully draped--(to protect their eyes from harmful damage from the "UV" light --allegedly)

Some of the test subjects recieved theraputic touch therapy-- (which does not always require direct touching of the skin) and some just sat there.

It was demonstrated that the students who recieved theraputic touch treatments A) had less pain (subjective) and B) healed faster (as shown by xray and-cat scan-- which was used to measure bone density--rather objective!)

I have no doubts that chemical compounds -- ranging from asprin to Zocor-- and lots inbetween can effect my body- and i have no doubt that my mental health effects my physical health-- the year of my divorce i had repeated episodes of high fever (once at high as 103!) with abdominal pain (and elevated white blood count) repeated test found nothing wrong. (the first guess was always gallbladder-- since i was a "classic" 4 F--fat, female, fourty, and fair-- I was kept over night once in emergency room-- since even asprin and cool baths were unable to bring down my fever.

After the divorce was settled, my health settled down too, and i haven't had another "episode"-- I have had colds, and other minor illnesses, but rarely have a fever over 100.

I feel sure that having some one "care for me" on an emotional level, a physical level, or "thereputically" helps me!

There was a study done at Harvard-- and it proved that bacteria growing in agar in petri dishes lived longer if someone prayed for its health! If bacteria do better when they are prayed for-- I am sure I will do better if some one prays for me! (and there are prayers needed-- one of our regulars needs prayers said for a family member--so stop and pray for the health of every regular contributor, and for all of the members of our families.. if it help harvard bacteria, I feel sure it will help them!)




#3002 03/30/01 01:02 AM
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Many of nursing' s contributions have been unrecognized (or even ridiculed) until the medical establishment condonces them.

From: http://www.agnesscott.edu/lriddle/women/nitegale.htm
Florence Nightingale is most remembered as a pioneer of nursing and a reformer of hospital sanitation methods. For most of her ninety years, Nightingale
pushed for reform of the British military health-care system and with that the profession of nursing started to gain the respect it deserved. Unknown to
many, however, was her use of new techniques of statistical analysis, such as during the Crimean War when she plotted the incidence of preventable deaths
in the military. She developed the "polar-area diagram" to dramatize the needless deaths caused by unsanitary conditions and the need for reform. With her analysis, Florence Nightingale revolutionized the idea that social phenomena could be objectively measured and subjected to mathematical analysis. She was an innovator in the collection, tabulation, interpretation, and graphical display of descriptive statistics.

During Nightingale's time at Scutari, she collected data and systematized record-keeping practices. Nightingale was able to use the data as a tool for improving city and military hospitals. Nightingale's calculations of the mortality rate showed that with an improvement of sanitary methods, deaths would decrease. In February, 1855, the mortality rate at the hospital was 42.7 percent of the cases treated (Cohen 131). When Nightingale's sanitary reform was implemented, the mortality rate declined. Nightingale took her statistical data and represented them graphically. She invented polar-area charts, where the statistic being represented is proportional to the area of a wedge in a circular diagram (Cohen 133).

As Nightingale demonstrated, statistics provided an organized way of learning and lead to improvements in medical and surgical practices. She also developed a Model Hospital Statistical Form for hospitals to collect and generate consistent data and statistics. She became a Fellow of the Royal Statistical Society in 1858 and an honorary member of the American Statistical Association in 1874. Karl Pearson acknowledged Nighingale as a
"prophetess" in the development of applied statistics.


#3003 10/03/01 01:01 PM
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Here is a URL to a very large medical dictionary

http://www.graylab.ac.uk/omd/index.html


#3004 10/05/01 03:47 PM
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It may be large, wwh, but not necessarily accurate or complete. There is no entry for clinical nurse specialist, although we are the 2nd largest group of advanced practice nurses in the US, and we've been around for 50 years. Moreover, the defintion of nurse practitioner is erroneous, paternalistic, and insulting.

"nurse practitioners: Nurses who are specially trained to assume an expanded
role in providing medical care under the supervision of a physician."


Someone at graylab needs to enter the 21st (or even the 20th) century.




#3005 10/05/01 04:49 PM
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Dear teresag: Methinks the lady complaineth a bit too much. I was not peddling the dictionary, but just citing it until you find us a better one. I hope you know me better than to think I put down nurse practitioners, after all my daughter's RN,PhD is comparable. And I would not expect to find information about the role of nurse practitioners in a dictionary.


#3006 10/05/01 05:34 PM
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Huh? It was the graylab dictionary that put down NP's, not you, wwh.
Does not the role define the term?

I prefer MedTerms.com's version:

"Nurse practitioner (NP): A registered nurse (RN) who has completed an
advanced training program in a medical specialty such as family practice,
pediatrics or internal medicine. An NP may function as a primary direct
healthcare provider and prescribe medications. Patients generally appear to be
just as happy -- and in some cases, happier -- to see a nurse practitioner as
their primary care doctor, according to a number of studies (British Medical
Journal 2000;320:1038-1048).

Some NPs fill other roles such as in research rather than in primary direct
patient care."

Only thing they left out is that numerous studies have shown NP's effectiveness
equals or exceeds that of MD's at lower cost. But I'll allow them that omission,
given their limited space.

So here's your suggestion for a better dictionary: http://www.MedTerms.com/Script/Main/hp.asp

Glad to be of help.





#3007 10/05/01 08:51 PM
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Patients generally appear to be just as happy -- and in some cases, happier -- to see a nurse practitioner as their primary care doctor, according to a number of studies.

surely you would agree to a stipulation that this sort of subjective opinion (however well-founded it may be) is not the sort of thing one expects to find in a dictionary!


#3008 10/05/01 09:08 PM
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Yes, I'll agree with that, tsuwm, but I don't expect to see falsehooods in a dictionary, either.

Specifically, I object to the statement "under the supervision of a physician." NP's are licensed independent practitioners, not required to practice under physician supervision in most states. Where "supervision" could be said to exist, it is in the form of collaborative practice agreements that give the NP the option of consulting with or referring to the physician, not direct supervision. (Any competent clinician would do that anyway when in doubt.) The supervising physician is not even required to be on-site. The agreements really exist to placate the physicians who view advanced practice nurses as competition.



#3009 10/07/01 10:30 PM
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Does the role of the Nurse Practitioner differ between the US (where I'm guessing most of you are from) and the UK (where the web site for the dictionary is)? (It's almost a rhetorical question, but an answer would still be appreciated.)

The position doesn't exist in Australia, although I'm sure many nurses would say they fill such a role, especially in inpatient settings.


#3010 10/07/01 11:55 PM
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http://www.nursepractitioner.org.uk/ indicates that NP's do not prescribe drugs in the UK, but they are otherwise similar in scope to US NP's.


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