Litigation in the US

Every time we come to elections, you probably notice how attorneys are suddenly being debated. The GOP claims they are the spawn of the Devil. Their sole purpose in life is to put all businesses into an early grave. The theme is simple. Every mistake can be evidence of negligence and, without tort reform, we will all suffer. The Democrats sing the song that attorneys are the only thing standing between consumers and predatory businesses. This highlights two quite separate but important problems. First, we have become a very litigious society. If anything goes wrong and we have the money (or are insured), the first reaction to any loss is to blame others and sue them. Consequently, we have one of the most active court systems in the world. Second, there’s a real shortage of adequate laws to protect consumers. This encourages everyone to sue using the law of tort and there we get into long-running cases where attorneys make a lot of money.

Let’s move over to New Jersey where a case has just finished against Roche for their acne treatment. Three claims were heard together. They alleged the drug had caused serious ulcerative colitis. You probably read about this because several Hollywood celebrities were involved as plaintiff and witnesses. The result was a 2 to 1 win for Roche with two of the claims being dismissed by the jury. In reporting this, we can gloss over the fact there are some three-thousand similar claims outstanding. There’s a bandwagon effect. Once word goes around that there’s one claim, other plaintiffs suddenly appear. No matter what the merits of these claims, there are some instructive lessons from other countries.

In Europe, only a qualified dermatologist can prescribe this drug, and he or she is directly responsible for monitoring the progress of the treatment. Patients are usually required to attend the clinic or hospital once a month for a check-up. This ensures a lower risk the drug will be abused by the patients. There’s evidence US patients want the cure now and not tomorrow, so they decide to increase the dosage or extend the period of treatment. Without proper supervision, the drug can therefore cause more damage. The fact there are warnings in the literature given out with every prescription is not helpful. Few people ever read them from start to finish. In New Zealand, there’s very clear research evidence showing low dosages are safe and effective. Such evidence is unlikely to affect the behavior of our teens who are determined to have perfect skin no matter what the cost. [...]

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Can you dig it?

According to The Mock Turtles, people dig it when they turn on a light, see how big and strong you’ve grown, and recognize you’ve taken to standing on your own. This is confirmation, as if we needed it, that men who stand out from the crowd are dug (or should that be digged?). We admire the loner, the one who does his own thing not caring whether anyone else is following or not. The only issue is whether you prove to be a force for good or evil. The maverick can have a slightly poor rep in some circles. So, when it comes to fashion, where do you stand on hair (other than in the barber’s shop, of course)? Some men actively embrace it, shaving their heads and standing out proud for all to see. Although they’re all getting a little old now, so there are other explanations for the loss of hair, men like Andre Agassi, Bruce Willis, Samuel Jackson and Homer Simpson have made a feature of their baldness from the early days of their celebrity. They challenged expectations and proved anyone with confidence can remain a celebrity and command respect.

This should be a lesson for us all. No one would criticize Mike Tyson. . . Well, that’s actually a little unfair since he had a habit of using critics as punchbags when he was in the fight game. It’s rather the same for Steve Austin who could knock you stone cold if you even hinted a thought about the lack of hair. For us mere mortals, all we need to be is good at what we do and most people around us will value us and ignore the lack of hair. So wimpy little guys like Michael Stipe are praised just because they can sing in tune, and no one said too many bad things about Demi Moore when she shaved her hair off in G.I Jane, or Natalie Portman who managed to make baldness cool in V for Vendetta. It all just goes to show you can live a successful life without hair on your head. [...]

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Natural alternatives

Over the centuries, men have been plagued by the steady drop of their hair. Let’s not make any sexist mistake here. In many ways, men are just as vain as women, particularly when it comes to displaying a full head of hair. Indeed, at various times through the ages, facial hair has been fashionable with sometimes extravagant beards considered a statement of superior strength and abilities. When you put the two together, actually seeing the face behind was a challenge, often making it difficult to get a precise grasp on whether the truth was spoken. Hence the special respect accorded to those with the ability to be barefaced liars. Except all this could be lost if hair was less than forthcoming. So men have experimented with every possible substance, hoping to discover the one magic ingredient that will restore them to their full glory. Sadly, there’s never been any scope for the placebo effect. When it comes to many illnesses of the body, a strong enough belief in the effectiveness of the “cure” will often produce the cure. But hairs are a law unto themselves. If it’s their time to fall, there’s nothing in nature that can do anything about it.

Except the myths have persisted. One of the more extraordinary is the power of the red pepper to kick-start healthy growth. Now let’s be very clear about this. There are some varieties of pepper that burn the skin when you handle them with unprotected hands. Those who work in the restaurant trade have a deep respect for some of these fierce spices, using broad-bladed knives for chopping and scooping up the results. The real danger lies in the seeds, of course. If you want to cook with them and are afraid of the results, the only “safe” course of action is to remove the seeds, wearing gloves of course.

Anyway, the myth says that if you cut open a red pepper and rub it over your scalp, this will encourage the roots of your hair to start growing again. The deranged who suggest this treatment justify this by pointing to the violence of the allergic reaction on the scalp. This is an attack on your body. The autoimmune system is triggered and sends its troops to your scalp to defend the skin. The roots of your hair are just under the surface of the skin and, as the blood supply is improved and healing antibodies are delivered, this can only be good for your hair. Well, medical science as practiced in the ERs can testify this treatment causes great pain, often lasting for days, and has been known to damage the roots of hair. So do not be tempted to try this, whether at home or more likely in the bar where your drunken “friends” are encouraging you to try it. [...]

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New marketing rules

Although it may feel as though we’ve had the internet forever, it’s only been a real force from about 1999 onwards. Now, it’s hard to imagine life without it. When you add in all the hand-held technology that allows us to talk to each other, tweet and sms while we are on the move, the full extent of the revolution becomes obvious. With GPS technology also built into the mobile devices, advertisers can see exactly where we are. If we want to know a good place to eat, it’s easy to ask for guidance. As by magic, a list of eateries comes back, usually accompanied by customer reviews so we have a better idea of which are the most reliable. Through an analysis of our searches, Google and the other companies also have a detailed profile of our interests. As and when they want, these companies will be able to sell targeted lists to marketers. With Google also buying into the hardware side and able to sell Android across all interfaces, it may not be long before we can expect a continuous series of suggestions on where to eat or shop as we drive or walk through a town or city.

Except not all this technology is considered appropriate by some of the regulators. Take Twitter as an example. It’s possible to collect large numbers of followers. Suppose a pharmaceutical company buys into a big list of followers and tweets the launch of a new drug. Wait, a company did this recently with one of the erectile dysfunction drugs. The European regulators were outraged. There’s an absolute ban on the direct promotion of medication to the public. It’s only legal to send marketing messages to healthcare professionals. Worse, the tweet was made in the UK and the local regulator has a rule only messages that are “factual and balanced” can be sent out to the healthcare professionals. A message hyping a launch is not balanced. So on both counts, the manufacturer was named and shamed.

It would be the same result in the US. The FDA has detailed regulations requiring drug manufacturers not only to describe the benefits of the drug, but also to list the adverse side effects. In most cases, this list will exceed the message length on Twitter. A new dilemma on the use of Facebook has also just emerged. Until recently, a drug company has been able to run an informational page with the wall closed to comments. Facebook has now changed the rules and these pages must now allow unedited comments on the wall. If the manufacturer refuses, the pages must close. This creates a big dilemma. Does a manufacturer run the risk of angry patients detailing all their bad experiences when using the drug? It makes control of the brand image very difficult. [...]

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Nexium and changes to your diet

As indicated in other articles, it should not be an option to do nothing if you are affected by heartburn. Even though the more painful aspects of the leakage of stomach acid into the esophagus can be controlled by the use of drugs, it’s always better to find the natural way, if one is available. Not only does this save the cost of medication, but also builds the strength of the body in being able to defend itself from disease. In this case, there are two broad sets of changes that should be made. The first surrounds the type of food you eat. Being practical, the body immediately knows what to do if you eat some rice. But if you eat some processed food full of stabilizers and other chemicals, the body is unsure which of its many enzymes to deploy to extract the energy from the food. To hedge its bets, it orders more acid. If nothing else, this additional acid will dissolve the food more rapidly. What happens after that will be trial and error. So here are a few simple rules for you to follow.

It takes longer to digest food with a high fat content. This leaves food in the stomach for longer and the risk of acid flowing up into esophagus increases. This means you should reduce the overall amount of fat you eat and, in particular, seriously cut back on fried food. Now come the things to avoid. Chocolate, anything based on tomato, acidic fruits and drinks, mint, coffee, and alcohol. All these loosen the muscle separating the esophagus from the stomach and encourage reflux, i.e. the acid flowing out.

Now come the physical changes. You must get into the habit of eating less. The more food there is in the stomach, the more food has to queue up in the esophagus. This keeps the sphincter open and allows the reflux. Equally, as food is pressing into the stomach, it squeezes the liquid out. This pressure is reduced if you keep vertical as you eat and do not lie down soon after eating. Going to bed shortly after eating is a bad idea. If it’s unavoidable, prop yourself up so that the acid will not simply run out of your stomach, but has to move against gravity. You should allow space for the stomach to expand. This means wearing loose clothing. If you are wearing a belt, loosen it. There’s always more pressure on the stomach musculature if you are obese. Loosing weight will help reduce the heartburn. After eating, you may find it helps to chew gum. This helps your mouth produce more saliva which, in turn, helps wash the food down into the stomach. If you have not already done so, quit smoking. The nicotine damages the sphincter. [...]

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