Health Scan: When docs write an Rx

Health Scan When docs w

By JUDY SIEGEL-ITZKOVICH
The number of prescriptions that doctors write is decided not only by the condition of their patients and health fund guidelines but also - says a new Ben-Gurion University study - according to their moods. Prof. Thelma Kushnir, a medical psychologist in the Beersheba university, revealed this at the recent 14th international conference of the Israel National Institute for Health Policy Research. She wanted to know whether doctors changed their professional behavior when angry, stressed or suffering from chronic fatigue. She sent an anonymous questionnaire to 188 primary physicians in the community (family doctors, general practitioners and pediatricians) that included the same question in four versions: On a day in which you feel good, bad, tired or stressed, how much do you talk to patients, give precriptions, send them to lab or diagnostic tests and refer them to a specialist? The doctors were asked to rank their answers on a one-to-seven scale. The questionnaire also measured the level of their mental and physical condition by giving answers to 14 more queries. Kushnir found that a good or bad mood affected all five doctor behaviors. When doctors felt well, they spoke more to patients, wrote fewer prescriptions, ordered fewer tests and issued fewer referrals. When they were in a bad mood, they did the opposite, she found from the self-reported answers. The more the physicians were exhausted and upset, the more extreme their behaviors. Thus, one could conclude that the health funds are better off, at least economically, when keeping their physicians happy, but the study doesn't reach conclusions whether patients get better or worse medical care when their physicians are upset. HOW THE BODY KEEPS TIME Without wearing a watch on its wrist, the human biological system somehow knows that it is supposed to operate on a 24-hour cycle. Nobody could explain this until Hebrew University discovered that a tiny molecule holds the clue to the mystery. Human as well as most living organisms possess a circadian (24-hour) life rhythm that is generated from an internal "clock" located in the brain that regulates many bodily functions, including the sleep-wake cycle and eating. Although the evidence for their existence is obvious, and they have been studied for more than 150 years, only recently the mechanisms that generate these rhythms have begun to be unraveled. Dr. Sebastian Kadener, a researcher at HU's Alexander Silberman Institute of Life Sciences, and student Uri Weissbein are participating in a collaborative study that has found that tiny molecules known as miRNAs are central constituents of the circadian clock. It was recently published in Genes and Development and highlighted in Nature Review Neuroscience . Their discovery holds wide-ranging implications for future therapeutic treatment to deal with sleep deprivation and other common disorders connected with this daily cycle. The sleep-wake cycle, the most characterized manifestation of the circadian clock, is generated thanks to specialized neurons found both in humans and fruitflies. This mechanism is almost identical in both the bugs and mammals. These neurons have the amazing ability to count time very accurately using a complex process of gene activation and repression that results in a tightly controlled process taking exactly 24 hours. The researchers have shown that the very tiny miRNA molecules are necessary for the circadian rhythms to function and demonstrate that one specific miRNA (called bantam) recognizes and regulates the translation of the gene clock. This is the first example of a defined miRNA-gene regulation in the central clock. NEW SANITIZER CLEANS UP The Health Ministry has declared that washing one's hands regularly with soap and water eliminates pathogens such as H1N1 flu virus and that no commercial alcohol gel is needed - except for medical staffers and others who have to sanitize their hands frequently. But now, the Yissum Research Development Company Ltd. - the technology transfer arm of the Hebrew University - claims one of its professors has developed an antiviral hand sanitizer named EtoClean that has been found to be "a highly effective against the swine flu virus." Developed by Prof. Elka Touitou of the HU School of Pharmacy, the product is being developed by Novel Therapeutic Technologies, a Yissum spin-off company. Results of tests conducted on clinically isolated H1N1 virus from patients "demonstrated that the innovative composition completely inactivates the swine flu virus within 15 seconds of exposure," said Yissum.The tests were carried out according to the American Society for Testing and Materials protocol in a FDA-certified laboratory in the US. EtoClean appears to "completely inactivate the swine flu virus almost immediately, while most hand sanitizers available on the market today were not tested specifically for swine flu," said Yaacov Michlin," Yissum's president and CEO. The new product is claimed to show microbicidal and antiviral properties effective for sanitizing a variety of surfaces, foods and skin. It also is said to contain ingredients generally regarded as safe for use and environmentally friendly. In addition, the product "inactivates also many non-enveloped viruses, such as the hepatitis and noroviruses, which are not susceptible to regular alcohol based sanitizers. Hand sanitizers have grown into a $200-million-a-year industry in the US alone.