Faculty Bibliography

Torture and ill-treatment are reportedly widespread in Mexico. Little is known, however, about the quality of forensic investigations and documentation of evidence of these human rights violations. To determine the integrity of the documentation and the presence, quality, and frequency of both physical and psychological evaluations, analyses were conducted on 103 medical evaluations identified in 33 cases of alleged torture and/or ill-treatment that the Mexican National Commission for Human Rights (CNDH) investigated between January 2000 and July 2002. Findings suggest that forensic medical evaluations in CNDH cases have been conducted promptly after alleged occurrences of torture and/or ill-treatment, and the results of such evaluations have often been introduced as evidence in legal investigations. Inadequate documentation in most forensic medical evaluations reinforces the need for effective training, monitoring, and accountability strategies.

Meanwhile, the drug salespeople brought free lunches as well as flashy product samples to my office, trying to entice me and my patients with the latest and greatest. It was tempting to believe that the new pill would work -- we both wanted it to. It was easy to forget last year's pill, which was probably just as good and, having gone generic, a whole lot cheaper. But Mr. B was growing more and more cynical, not believing any pill could help his hip pain. On the rare day when his symptoms eased and he felt well, he would claim that medications had nothing to do with it. Mr. B would not consider hip surgery -- he was afraid of complications -- though he finally did agree to see an arthritis specialist. This doctor prescribed a yellow pill, the latest once-a- day medicine that was supposed to be easier on the stomach than other drugs. Taking it for a two-week trial, Mr. B reported that his stomach was fine, but he still limped noticeably. At his request, I sent him to a second arthritis expert, who switched him to a green pill, which didn't work even as well as the yellow one. The second arthritis expert recommended surgery, but Mr. B still refused it. In my office, the yellow pill competed with the green one for space in my sample closet. Both manufacturers clearly thought that I would end up prescribing the drug. All the drug salespeople seemed to know how much of their product I prescribed. They brought clumps of samples for various conditions all at once, probably believing if I gave out their green pill for arthritis, I would also start prescribing their red pill for sinus infections

Siegel discusses a recent experience having dinner at a restaurant sponsored by a drug company.

The largest study ever of high blood pressure has found that older diuretic drugs, or water pills, are as effective, if not more, than newer, costlier drugs..

A baby girl born infected with the West Nile virus in Syracuse a month ago is the world's first documented case in which the virus was transmitted in the womb, health officials said yesterday. ''It's very possible that West Nile virus was the cause of the baby's neurological deficit, but with only one case it's impossible to really determine cause and effect,'' Dr. Lyle Petersen, a West Nile expert at the Centers for Disease Control and Prevention, said at a news conference. In the case of West Nile, though, a lab worker had previously been infected with a different, but closely related virus. Still, the earlier infection did not protect against West Nile infection, though it may have modified the severity of the worker's illness

'It's very possible that West Nile virus was the cause of the baby's neurological deficit, but with only one case it's impossible to really determine cause and effect,' Lyle Petersen, a West Nile expert at the Centers for Disease Control and Prevention, said at a news conference

To reduce the risk of infection by the mosquito-borne virus, [Lyle Petersen] and other health officials urged pregnant women to wear protective clothing and to use insect repellents containing DEET during the mosquito season. The virus is still being transmitted in some Southern states

The study found that a diuretic, chlorthalidone, was more effective in preventing fatal and nonfatal heart attacks than were three other classes of drugs: amlodipine (sold as Norvasc), a calcium channel blocker; lisinopril (Zestril and Prinivil), an ACE inhibitor; and doxazonsin (Cardura), an alpha-adrenergic blocker. Diuretic use for hypertension costs about $25 a year, compared with about $250 for an ACE inhibitor and $500 for a calcium channel blocker, according to Dr. Paul Whelton, a leader of the study who is also professor of epidemiology at Tulane University. Compared with participants who took the diuretic, the ACE inhibitor group had, on average, about a 2 mm mercury higher systolic blood pressure, which is the top number in the blood pressure reading. Blacks in the group had a 4 mm mercury higher systolic blood pressure

The new study found that a diuretic, chlorthalidone, was more effective in preventing fatal and nonfatal heart attacks than were three other classes of drugs: amlodipine (sold as Norvasc), a calcium channel blocker; lisinopril (Zestril and Prinivil), an ACE inhibitor; and doxazonsin (Cardura), an alpha-adrenergic blocker. ''There were tremendous efforts to prevent doctors from using diuretics,'' Dr. Marvin Moser of Yale, an expert in hypertension, said in an interview. He said that the new findings vindicated experts who recommended the use of diuretics in the face of vast promotional efforts by some experts and manufacturers to sell more expensive patented drugs. Precisely how diuretics reduce high blood pressure is not known, despite their use for more than half a century. Although the new study showed the superiority of diuretics over other classes of drugs, it did not explain whether the findings were from positive effects of the diuretics or negative effects of the other classes, said Dr. Michael H. Alderman, a hypertension expert at Albert Einstein Medical School

The new study found that a diuretic, chlorthalidone, was more effective in preventing fatal and non-fatal heart attacks than were three other classes of drugs: amlodipine (sold as Norvasc), a calcium channel blocker; lisinopril (Zestril and Prinivil), an ACE inhibitor; and doxazonsin (Cardura), an alpha-adrenergic blocker. The market for blood pressure-lowering drugs is huge. High blood pressure affects 50 million Americans, and 24 million of them spend $15.5 billion a year for blood pressure-lowering drugs. The remainder do not know they have hypertension or do not take drugs for it. The prevalence of hypertension increases with age; more than half of people over age 60 have hypertension. Diuretic use for hypertension costs about $25 a year, compared with about $250 for an ACE inhibitor and $500 for a calcium channel blocker, according to Dr. Paul Whelton, a leader of the study who is also professor of epidemiology at Tulane University. 'There were tremendous efforts to prevent doctors from using diuretics,' Dr. Marvin Moser of Yale, an expert in hypertension, said in an interview. He said that the new findings vindicate experts who recommended use of diuretics in the face of vast promotional efforts by some experts and manufacturers to sell more expensive patented drugs