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The "Shock Doctrine" applied to the Catalan sanitat

DEMPEUS per la salut pública
En defensa del Sistema Nacional de Salut amb tot el seu caràcter assolit: públic, universal, de qualitat, integral, solidarity and of fairness guaranteed. 02/03/2011 GMT 1

The "shock doctrine" applied to the Catalan health

collective @ 11:28

Naomi Klein in Shock Doctrine , tells us many things. The latest statements by the Minister Ruiz made us think about this doctrine.

retalls sanitat Of the seven measures announced by the Minister to reduce spending and comply with the goal of cutting 10% of budget The most aggressive is the elimination of programs to reduce waiting lists and announced that non-urgent patients may wait over 6 months (how long) to be operated. But is not the only measure to report, the end of the model involve many local grievances for rural Catalonia and it is not clear that means less spending and together with the extent of incentives for efficiency brings us to model only area that has implemented in the Madrid of the PP government with all the shortcomings that we have been reporting on this blog in recent months.
The new health care model promoted by the CiU is intended for public health to worsen significantly in the country, taking advantage of the economic crisis, the benefit of private healthcare. In this regard we recommend the article by Martinez Angels Gender, crisis, violence and health which compares the consequences and measures taken in the crisis of 29 with the current crisis. crisis-salud


Discuss Boi Ruiz's statements to the NOW: "Health give more money to hospitals more productive," also to Europa Press, "Los fading presupuestarios the Catalan Health will make its Listas Crecer 3% of non-urgent waiting, according Boi Ruiz, "El Pais" remove Health the right to be operated at a maximum of 180 days "and" La Vanguardia " CC.OO. Health reports that will eliminate the programs in order to reduce the waiting Listas .

And then the article NOW, we have chosen because it lists the seven measures proposed by the Minister Boi Ruiz.

THE NEW MODEL HEALTH

Minister of Health, Boi Ruiz announced yesterday unions and employers plan cuts in health, which goes through the end of the proximity model and encourage centers more productive.'s plan cuts slows 60% of investments
LARA BONILLA - BARCELONA - 01/03/2011
Boi a foment action plan to ensure sustainability of the health system with 850 million less than budget or which is the same, 10% less than last year. To do so, the Minister of Health, Ruiz Boi, was presented yesterday to the sector during the Council meeting Catalan Health, a seven-point plan which hopes to reduce between 20% and 25% administrative spending , 20% more spending on equipment and between 8% and 11% spending on health services and pharmacy.
Structure administrative
S'aprimarà the top 10% of senior managers
The first to fall were the managers of the Hospital. One person centralize management, which previously delivered three people. But this is only the beginning. The aim of the Department of Health is to reduce 10% of the health system managers and end the duplication of charges and excessive bureaucracy. All in all, estimated that the structure is reduced by 20%. With this simplification, the Department of Health expects to save between 20% and 25% of the budget in this area.
retallada-xhup Catalog
benefits will not be accepted without drug benefits or funding
This is to negotiate with Madrid. The government wants to increase its power to influence decisions and will not accept any new provision in the health care available and no new drug that is accompanied by a budget. Reorder
services
The end of the proximity model: Not all hospitals will all
It can not be guaranteed that patients will have all services close to home. This was one of the obsessions of the previous coalition government, which gave many regional centers and clinics with new technologies to prevent displacements. Now is reorganized according to performance centers and critical mass. Just some extra services, such concerted activities to reduce waiting lists, and review the catalog of 14 surgical procedures to guarantee six months of waiting. Patients with urgent conditions should not expect more. Also be reduced by 2% rates of consultation with schools. Incentives for efficiency
el-roto-sanidad-3
Improved productivity costs and outcomes
is one of the most innovative measures. Health encourage and recognize the work of hospitals and health centers more productive, which reward you with a budget higher than other schools do not get as good results. These reward efficiency. New technologies

optimization of new technologies and research
Remove the recipe on paper and electronics as well as promote the use of new technologies throughout the health system to reduce costs. The use of email replaced, in some cases, the conventional consultation.
Investment Program
stopped 60% of the works and new services
Health reviewed not only investments but also screened la posada en marxa de nous equipaments i serveis. Només pot garantir un 40% de les noves inversions. La resta o s'aturaran temporalment o no es faran. El departament ho concretarà d'acord amb el territori i vol que siguin les entitats municipalistes les que decideixin les inversions prioritàries.
Més capacitat de decisió
Enfortir la confiança entre gestors i professionals
Es dotarà de capacitat els centres perquè puguin participar en els processos de decisió. Una mesura amb la qual esperen guanyar-se la confiança del sector i reforçar l'autonomia dels professionals. La majoria de mesures per contenir la despesa es volen pactar centre per centre.
Font: ARA.cat
marketed as a treatment for epileptic seizures, was later shown that this treatment was ineffective. Then used in a trial of a new antihistamine in the treatment of allergy. After a while, found that had no effect. However, in each of these tests that were conducted showed that itself was quite effective as a sedative. Finally, after many rounds, the final destination of the drug was to treat nausea, anxiety, insomnia and morning vomiting of pregnant women. Three years later, in 1957, thalidomide became the drug of choice to help pregnant women. Its use spread quickly the following year and was introduced in several countries in Europe, Africa, America and Australia.
The fury of the new drug was evident, advertising left no room for doubt "was completely safe for pregnant women" and the company's success was apparent Gruenenthal Chemie.

However, a year before being marketed internationally (1956), the first child was born with the effects of thalidomide. Of course back then did not have any suspects. Although the malformations are rare, can occur without any specific cause. It was not until four and half years later that isolated event when an Australian obstetrician, William McBride, he realized that something was wrong. Detected within a very short time, almost identical malformations in three newborn babies. It was not normal, such anomalies are a few for each decade, but not in three babies at the same time. The frequency is out of the ordinary and there is clear evidence that there was more than a cause spontaneous.
  1. What that obstetrician diagnosed in babies was focomielia. A rare congenital condition in which there is a lack of development of all or part of legs and arms. But also other abnormalities appeared less rare in other infants, deafness, blindness, internal malformations of organs ...



    After detecting these abnormalities McBride sent its comments to the Lancet, a prestigious medical journal. However, its publication was delayed a few months "for lack of space in the magazine. But he was not the only one who found that things were going very badly. Obstetricians in all countries where thalidomide was introduced as alterations observed as rare as the focomielia was appearing frequently. At first they did not know what he was, raised environmental explanations, infections, x-rays, toxic substances, etc. It was not until on November 11, 1961 when another physician, Dr. Lenz became clear that the culprit of all these malformations was thalidomide. 5 days after its discovery, when he felt he was completely safe for the research he had done, he telephoned the company Gruenenthal Chemie. It took days of intense discussions with company representatives, authorities and experts before the drug was withdrawn, mostly by how the press would react. Chemie Gruenenthal continued to deny the teratogenic (causing malformations) of thalidomide. But increasingly, the suspicion grew that not exactly denied by honest ignorance, but in order to weaken the charges against the company.
  2. Meanwhile, throughout this period of time, more than 15,000 newborns worldwide suffered from the drug, of which fewer than 5,000 survive today. It did not take in the events referred to as "The Thalidomide catastrophe" and the name of the drug became the paradigm of the pharmaceutical act more despicable.

    After the event, many countries gradually began to enact laws to control drugs and the requirement that they be subjected to drug tests and tested in animals, as well as clinical trials before marketing people. also began the era of financial compensation to all affected families in all countries where the drug was distributed. He turned to look closely Chemie Gruenenthal evidence presented at the time the German authorities to be approved as a drug and that was when it was discovered all the irregularities they had committed. It took the company to court and forced to whom it was rewarded financially to the victims. The drug had been billed as "totally safe" became one of the most teratogenic drugs which have been known, sufficient intake of a single dose to produce serious birth defects and 40% of the victims died before their first year. Still, it is prescribing in some countries as a treatment for leprosy and some cancers.
  3. About:
    The History of Thalidomide
Meneame
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From that small mistakes in medical websites will spread to the halls of medicine ...
  1. "
    2. 29 Responses "The Catastrophe the Thalidomide "

Jokin
says August 24, 2006 at 5:39 PM Great review the issue of thalidomide, we all know but few know exactly where it came However, the last sentence is not quite right: Still, it is prescribing in some countries as a treatment for leprosy and some cancers.
I would not say "yet", which connotes little interest in the consequences or what the patient may suffer treatment ... After many years when production ceased, has recently begun to be used again in cases of leprosy and certain tumors (eg multiple myeloma) in which other treatments have been ineffective, and where the person (whether man or woman) is not of childbearing age or take measures to prevent offspring (by written contract and signed).
is not a drug of first, second or third choice, but it is another tool to consider.
When all else fails, what one would not cure a cancer?
omalaled says August 24, 2006 at 5:38 PM Thank you for your comment on my blog.

respect to thalidomide, it is one thing he knew from personal experience. I remember as a child several boys and girls with their conseciencias when he was less than 5 years.

    Now, I have two suckers, but the truth is that the bombardment of questions to the gynecologist during pregnancy was fierce whenever prescribed something. Is it safe? How many years have you used? How many years have you prescribing?.
  1. And although we said that prescription drugs were safe, never we trust 100%.
    Still, most exciting is the "nose" of the perpetrators, saying things they know are not true. Anyway ... these things are happening? Cheers
    Misslucifer :)

    says:
    August 24, 2006 at 9:25 PM
    Wow, I had no idea. It's terrible. I remember the movie Constant Gardener, uf ...
    2. Anonymous says:
  2. August 25, 2006 at 7:48 a.m. I have read that thalidomide is used in cats do not know if will have some other veterinary use. a link that shows different effects between humans and animals of various medications. is curious that a chicken can die from eating marzipan (almond is) and dogs, cats and horses will feel bad chocolate.
    RD
    says

    :-)
    August 25, 2006 at 1:22 a.m.
  3. Noooo ... Maybe that's why I never decided to be a pharmacist or doctor ... A lot of responsibility.
    Leonardo ... from Colombia
    says
    August 25, 2006 at 4:33 a.m.
    I remember that in an episode of House's use as a treatment ... was Damned? ...
  4. In my country ... and suppose that many of lationamerica all lasted longer, it is known (and it sounds pedantic true) that this area tend to send the drugs banned in other countries ...
    pipistrellum
    says
    August 25, 2006 at 7:34 a.m. According
  5. 've read there are two forms of thalidomide with an identical chemical composition. Good and bad. Glucose can rotate polarized light to the left (levosa) or right (dextrose), the usual. Has different optical anisotropy. Both have the same chemical composition, but have a different 3D shape. This may not have any effect, change the properties of a chemical or even make something happen from a medication to a poison, as the case of thalidomide. During the production of thalidomide produce a chiral half and half of another. Could be separated, but into the body some molecules will be converted in the form teratogenic. (Curiosity teratogenic = generating monsters, monstrous Terabyte = Byte) A curious but important fact is that the same molecule can smell like lemon or orange just by changing the chiral form, a mirror is another. All told this on the first link, if anyone wants more information. I recommend the article is very interesting
    link me what happened
    chemist in the jabber room.
    A preguntilla, not if you will. When I look at a food ingredient, dextrose and almost always indicates a very rare case Levosa?
    That has some reason? The process improves the body or is that normal glucose produced / manufactured is dextrose?
  6. Marcos says
    August 25, 2006 at 8:39 a.m.
    Hello!
    First of all I would like to congratulate its Shora indispensable blog. Let me add something about the sugars pipistrelum said.
    I think you're a confusion of terms, let's see, glucose or dextrose (a synonym) is a natural simple sugar which is also a component of sucrose with fructose. The correct terms to speak of the stereoisomers are left-handed and right-handed forms, substances that have the property of rotating the plane of polarized light to the left or right.
    A greeting. Greetings
  7. pipistrellum
    says
    "What I am getting at now Is That The Same Some Substances with chemical formula rotate polarized light to the right, plow dextro-rotary, as, for instance, What is Known as dextrose. Others rotate it to the left, plow levo-rotary, as the Substance Called levose. Both themes are of glucose. Substances Which There Are So Give the Same chemical reactions Which Can Only Be Distinguished by Their Being left or right rotary. "
    Treiral_

    says
  8. August 25, 2006 at 1:59 PM
    Very good article, very interesting too ... Greetings!
    Shora



    says
    9. August 25, 2006 at 2:00 PM
  9. Omalaled: Indeed, as a pregnant woman have to take fewer drugs, better. Of course, vitamin supplements, iron and folic acid are essential. Although they are not drug as such, but an extra supply of something that is taken daily. Hopefully stuff does not happen again and that controls on drugs that were created to prevent it from happening. Jokin : You're right, I should have qualified the "yet." When I put it was recalling that leprosy is found mainly in developing countries and treatment with thalidomide is not controlled as it should. So children have appeared in areas focomielia lepers.
    Shora
    says
  10. August 25, 2006 at 2:16 PM
    Miss: Our generation usually do not know what happened, I know because I do medicine, but if you ask any of my brothers or friends know nothing of thalidomide. Pipis: Uis, a page of veganism. With skewed reasoning of why animals should not be used in biomedical research laboratory. The case that concerns us, thalidomide, no comment on anything that was rigged results in animal testing, what things xD As for left-handed and right-handed forms and has answered Marcos. By the way, thanks for the congratulations
    As for the English link you mentioned at the end, when it comes to levosa is specifying with glucose when it is left-handed. It is rare to be called so, normally set as L-glucose (L-glucose).

  11. pipistrellum
    says August 25, 2006 at 3:08 PM and I realized the type of site, but I found it interesting the different effects produce chemicals in humans and animals. That part did not seem wrong.
    certainly know why that glucose is almost always right-handed? I find it curious.
    Noralba
    12. says
  12. August 25, 2006 at 5:20 PM Very interesting article, did not know exactly as had been the story. As for the new use of thalidomide believe that now is again legal in Spain and has nothing wrong. All drugs have side effects and are contraindicated in certain circumstances, what is important is to understand the potential impacts and take them properly. As a curiosity many other antiepileptic drugs are teratogenic untilizados in neurology and no one raises her hands to her head because they are marketed. I'd also say that not necessarily Most drugs are bad for Professionals & Researchers, although it is true that in many cases are contraindicated because they do not know the effects on pregnant women not because they know they hurt.
    Shora
    says :)
    August 25, 2006 at 7:40 PM
    13. Pipistrellum:
  13. I think this panel will enlighten my answer about that :
    http://www.phdcomics.com/comics/archive.php?comicid=749 xDD Nah, seriously. The D-glucose is the only biologically active that can be used metabolically because the enzymes recognize. Why did he have to be that and not the other? No idea, some way had to choose to opt for one evolution
    Noralba. With thalidomide had been carried no hands to the head if they are not just right had prescribed to pregnant women and to say nothing of teratogenicity. While the report clearly and controlled drugs, yet have many side effects that may be beneficial, as you say. What happens with thalidomide is leading the "fame" and that behind for the affected families is something that will never change.

    14. pipistrellum
  14. says August 26, 2006 at 9:18 a.m.
    That was the question I had, if the l-glucose in the body functioning well.
    me not clear whether the teratogenic effects are part of life or temporary. If a person ever takes thalidomide children siguietes children you have will be defoma?
    pipistrellum
  15. says
    August 26, 2006 at 8:16 PM More than anything, I was saying if left sequels in the gonads or something. Oi For many years a radiologist who had a few children with defects, and could not have more because they ran a high risk of having another child like. But I see no
    lei for a daughter of Adolfo Suarez that chemotherapy given during pregnancy and she was very scared but the doctors what they said not to worry and the baby went well.
    In principle, the placenta protects many things, but not if they used any particular drug that did not pass through the placenta or the other to prevent the pass.
    also heard a case in which a pregnant operated, but they got that anesthesia affects only the mother.
    Shora :P
    says
  16. August 26, 2006 at 24:49
    are temporary. The drugs are metabolized and excreted in urine over time. There are drugs that endure longer than others, but, to my knowledge, there is none that is permanently in the body (well, removing the high radiation radiopharmaceuticals can be some radiation, but the drugs themselves are removed). Therefore, a decrease from a certain amount, the drug has no appreciable effect. What produces is teratogenic thalidomide itself to intervene in the training of members in the fetus to reach the mother's blood (although not quite know how.) If the drug is gone, the teratogenic effects as well. Apparently teratogenic effects last between 6-7 months.
    valentina says:
  17. August 27, 2006 at 11:25 a.m.
    Hello ... at age 22 had lupus, and between medication Furtado received ... THALIDOMIDE dieorn I imagine, was about to get married and my first dream was to become a mother .... soon I got pregnant, and without thalidomide (sold as candies me from a big bottle bllancos transparent) in Cordoba, Argentina professor Dr. Garzon, a dermatologist. Ezekiel was born healthy and I have 4 children, but it is a crime ... .. still used ??????????? The fear I felt at every ultrasound, not like now, it was terrible, her arms look !!!!!! should embrace it denunciarse.un
    Shora
    :-)
    says
    August 27, 2006 at 7:54 PM
    Pipistrellum: Radiation is not the same than drugs. Considerable radiation alters the DNA itself can lead to cell mutations that cause gonadal malformations in offspring genetic. Anyway, this is avoided by using lead shielding, beam steering, etc..
  18. Drugs that alter the DNA that I know of are only those used in chemotherapy. Although drugs and disappear over time and have no effect, mutation remains.
    Thalidomide acts by altering the DNA of gonadal cells, if so influence before pregnancy, not during pregnancy. Valentina : Sorry, had to be tough. When will you prescribed thalidomide warned before the possible effects on the child if you get pregnant?
    Ahynara
    says
    September 2, 2006 at 11:21 a.m.
  19. guess in Portugal is the prescription of Thalidomide and Spain. Here is only used in cases of multiple myeloma as a last alternative, informed consent must sign a billet of 10 page, which includes a section where he says he should not become pregnant, and for fertile women who are committed to follow a tt º contraception, with a strict medical monitoring.
    pipistrellum
    says

    November 26, 2006 at 7:04 a.m.
    Kramer has yogurts also have
  20. lactic acid enantiomeric versions
    Shora
    says
    November 26, 2006 at 2:42 PM
    Pipistrellum:
    jejeje, lactobacillus, I have an outstanding issue with this organism.
  21. karlos
    says
    January 25, 2007 at 4:45 PM
  22. I just found your blog engaging and I love ...
    would like to clarify one thing, all drugs, all are poison, depends on the dose that can cure, administration and what they are used. The talimodia for example, help in some cases of cutaneous lupus, and many doctors are hesitant to prescribe it in some cases by bureaucratic obstacles, and the suspicion (normal) of pacientes.Que a woman of 70 years and nun asked every 15 days a pregnancy test, no less peculiar. But if prohibit all drugs at some time have been a possibility of teratogenicity, we are left with the "soda?. The downside is that Shora said that in many developing countries, development is not reported and no control pregnancies, and I know that recently there were few cases in Brazil. A hug
    Shora
  23. says
    January 25, 2007 at 8:50 PM karlos: Thalidomide is now used same for ... as you say, cutaneous lupus, recurrent ulcers resistant to conventional therapy Leprosy, a specific type of porphyria, and some types of tumors. With strict medical control nothing happens, the bad thing is when using chaotically. And of course you have is the wake of malformations back, it's hard to forget. And doctors rather than risk, tend to safest.
    I'm glad you like the blog
  24. meneame.net
    says October 13, 2007 at 1:50 a.m.
    The disaster of thalidomide ... Interesting article
    physician reveals the effects catastrophic drug thalidomide, used at the end of the 50 early 60's for the treatment of nausea, vomiting, anxiety, insomnia in pregnant women ....
    miracles
    says
    November 1, 2007 at 10:14 PM
  25. I limit myself to Argentina and Brazil. then use this damn medication that affected my life.
    I am a victim of the trials. Who takes care of us. Who cares what we feel. We are not mentally retarded people are maimed by scientists. Heal or sick soul?? What is more important?? is known that Most of us have to depend on. will cure diseases for people living freely. Luckily I can be free to think and express myself and now thanks to this device I can, perhaps wondering if I missed something in life? Perhaps the most beautiful to fondle my children? or walk this earth as all, aware of thalidomide kill maim destroy.
    Newsletter Public Health »Blog Archive» Health recognizes that thalidomide was sold in Spain
    says :)
    November 11, 2007 at 8:48 PM
    26. [...] The Thalidomide catastrophe [...]
  26. nilton says
    December 7, 2007 at 10:47 PM
    thalidomide should not ever exist again
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