22 MEDICINE GOOD AND BAD

Question 1

Who is Albert Schatz?

Answer 1

Albert Schatz was a microbiologist who discovered streptomycin, the first drug effective against Gram-negative bacteria

Schatz lived from 1920 to 2005 and came from a poor farming family in Connecticut.

Question 2

What significant antibiotic did Albert Schatz discover?

Answer 2

Streptomycin

It was effective against Gram-negative bacteria, including the one responsible for tuberculosis.

Question 3

What was the role of Selman Waksman in Schatz’s discovery?

Answer 3

Waksman took charge of the clinical trials for streptomycin and claimed credit for the discovery

He required Schatz to sign an agreement ceding patent rights to Rutgers University.

Question 4

What recognition did Albert Schatz receive for his contributions?

Answer 4

He was awarded a portion of the royalties and credit as co-discoverer after suing Waksman and Rutgers

However, he faced professional setbacks as a result of the lawsuit.

Question 5

What was the life expectancy for American males in 1900?

Answer 5

46 years

By the end of the century, it rose to 74 years.

Question 6

What was the average life expectancy for women in the United States by the end of the twentieth century?

Answer 6

80 years

It improved from 48 years in 1900.

Question 7

What was one major cause of death in 1900?

Answer 7

Infectious diseases

They accounted for nearly half of all deaths during that time.

Question 8

What is the current leading cause of death compared to 1900?

Answer 8

Heart disease and cancer are now leading causes of death

Infectious diseases have significantly decreased as causes of death.

Question 9

What major factor did Thomas McKeown attribute to the decline in death rates?

Answer 9

Improved sanitation and diet

He suggested that medicine accounted for only about 20% of the improvements in life expectancy.

Question 10

True or False: Vaccinations have been credited with saving more lives than antibiotics in the twentieth century.

Answer 10

True

According to Nobel laureate Max Perutz.

Question 11

What was the childhood mortality rate in 1950?

Answer 11

216 children in every thousand died before the age of five

Today, it is just 38.9 early childhood deaths in a thousand.

Question 12

What is a significant issue regarding life expectancy data today?

Answer 12

Disparities in life expectancy based on socioeconomic status

For example, life expectancy can differ greatly even within the same city.

Question 13

Fill in the blank: In the early 1960s, Thomas McKeown noted that deaths from tuberculosis had declined without effective treatments, suggesting that _______ accounted for much of the improvement.

Answer 13

sanitation and diet

Question 14

What is the current life expectancy in Hong Kong?

Answer 14

84.3 years

It is the highest in the world.

Question 15

What is the average global life expectancy as of today?

Answer 15

70.5 years for men and 75.6 years for women

This marks significant improvement from historical figures.

Question 16

What major public health intervention drastically reduced diphtheria cases in America from about 200,000 in 1921 to just 3 by the early 1980s?

Answer 16

Vaccination

Other diseases like whooping cough and measles also saw significant reductions.

Question 17

True or False: Most of the improvements in life expectancy over the last century can be attributed solely to advancements in medicine.

Answer 17

False

Many improvements are linked to better sanitation, diet, and lifestyle changes.

Question 18

What happens to life expectancy in London for every two stops traveled eastward on the District Line?

Answer 18

It drops reliably by one year.

Question 19

In St. Louis, Missouri, how does life expectancy change with a twenty-minute drive from Clayton to Jeff-Vander-Lou?

Answer 19

It drops by one year for every minute of the journey.

Question 20

What is the impact of wealth on life expectancy?

Answer 20

Being rich significantly increases life expectancy; wealthy individuals can expect to live into their late eighties.

Question 21

How much earlier can a poor person expect to die compared to a wealthy person with an equivalent lifestyle?

Answer 21

Between ten and fifteen years sooner.

Question 22

How does being American affect life expectancy compared to other industrialized nations?

Answer 22

Americans have a higher risk of dying compared to their peers in other industrialized countries.

Question 23

What is the likelihood of a randomly selected American aged forty-five to fifty-four dying compared to someone in Sweden?

Answer 23

More than twice as likely.

Question 24

How does childhood mortality in the United States compare to other wealthy nations?

Answer 24

Children in the U.S. are 70 percent more likely to die in childhood.

Question 25

What is the general standing of the U.S. in medical well-being measures among wealthy countries?

Answer 25

The U.S. is at or near the bottom for almost every measure.

Question 26

How much does the U.S. spend on health care per person compared to other developed nations?

Answer 26

Two and a half times more.

Question 27

What rank does the U.S. hold in global life expectancy?

Answer 27

Thirty-first.

Question 28

What unhealthy lifestyle factors contribute to lower life expectancy in the U.S.?

Answer 28

Oversized food portions, physical inactivity, and stress.

Question 29

How do traffic death rates in the U.S. compare to other countries?

Answer 29

11 traffic deaths per 100,000 people, compared to lower rates in the UK, Sweden, and Japan.

Question 30

What is the average cost of an angiogram in the U.S. compared to Canada?

Answer 30

$914 in the U.S. vs. $35 in Canada.

Question 31

What is the average cost of insulin in the U.S. compared to Europe?

Answer 31

About six times as much.

Question 32

What is the five-year survival rate for colon cancer in the U.S. compared to South Korea and Australia?

Answer 32

64.9 percent in the U.S., 71.8 percent in South Korea, 70.6 percent in Australia.

Question 33

What complicates cancer survival rates in the U.S.?

Answer 33

Ethnic disparities in survival rates.

Question 34

What is overtreatment in the context of modern medicine?

Answer 34

Focusing on preventing problems through excessive testing and screening.

Question 35

How many women given an all-clear after a breast cancer screening actually had tumors?

Answer 35

Between 20 and 30 percent.

Question 36

What is the effectiveness of breast cancer screening in saving lives?

Answer 36

Saves one life in every thousand women screened.

Question 37

What is the reliability of the PSA test for prostate cancer?

Answer 37

Hardly more effective than a coin toss.

Question 38

What percentage of men experience impotence or incontinence after prostate treatments?

Answer 38

Between 20 and 70 percent.

Question 39

What is the estimated amount wasted on unnecessary precautionary maneuvers in U.S. health care annually?

Answer 39

$765 billion.

Question 40

What is the primary motivation behind overtreatment according to some doctors?

Answer 40

Fear of litigation and maximizing income.

Question 41

What is the criticism of the pharmaceutical industry regarding doctors?

Answer 41

Doctors often receive money or gifts to promote drugs.

Question 42

What was the finding regarding the drug atenolol in a 2004 study?

Answer 42

It reduced blood pressure but did not reduce heart attacks or fatalities.

Question 43

What did Purdue Pharma pay in fines for marketing OxyContin with fraudulent claims?

Answer 43

$600 million.

Question 44

What is the main conclusion about U.S. health care spending?

Answer 44

Higher spending does not necessarily result in better outcomes.

Question 45

What did Purdue Pharma pay in fines for fraudulent claims about OxyContin?

Answer 45

$600 million ## Footnote Purdue Pharma was fined for marketing the opioid OxyContin with fraudulent claims.

Question 46

How much did Merck pay in fines for issues with Vioxx?

Answer 46

$950 million ## Footnote Merck failed to disclose problems with its anti-inflammatory drug Vioxx, which was withdrawn from sale.

Question 47

What is the record penalty paid by GlaxoSmithKline?

Answer 47

$3 billion ## Footnote This penalty was for various transgressions in their drug marketing practices.

Question 48

What does Marcia Angell suggest about the fines paid by drug companies?

Answer 48

They are just the cost of doing business ## Footnote Fines often do not offset the huge profits made by companies before legal action.

Question 49

What is a major issue with drug development?

Answer 49

It is inherently hit-or-miss ## Footnote Drug development often fails to yield successful results despite diligent research.

Question 50

Why might animals not be good surrogates for human drug testing?

Answer 50

They have different metabolisms and respond differently to stimuli ## Footnote Animals can contract different diseases and may not accurately represent human responses.

Question 51

What is a problem with testing drugs on genetically engineered mice for Alzheimer's?

Answer 51

The drugs worsened dementia in humans ## Footnote Mice must be engineered to develop Alzheimer’s, leading to misleading results in drug effectiveness.

Question 52

What are confounding variables in clinical trials?

Answer 52

Other medical conditions or medications that complicate results ## Footnote Excluding participants with these variables limits the applicability of trial results.

Question 53

What percentage of hospital admissions in the U.K. are due to drug side effects?

Answer 53

6.5 percent ## Footnote Many admissions are often due to side effects from drugs taken in combination.

Question 54

What does taking low-dose aspirin daily help prevent?

Answer 54

Heart attacks ## Footnote However, there are risks associated, such as major gastrointestinal bleeding.

Question 55

What was found about low-dose aspirin's effectiveness for those weighing 154 pounds or more?

Answer 55

It is not effective in reducing cardiac or cancer risk ## Footnote This finding indicates that many may take aspirin without any benefit while facing risks.

Question 56

What did a 2013 study find about common medical practices?

Answer 56

146 practices had no benefit or were inferior to those they replaced ## Footnote This highlights the need for continual evaluation of medical standards.

Question 57

What did a similar study in Australia find regarding medical practices?

Answer 57

156 practices are probably unsafe or ineffective ## Footnote This suggests that not all established practices are beneficial.

Question 58

What can significantly affect medical outcomes besides medical science?

Answer 58

Compassion ## Footnote A study showed better outcomes in patients treated by compassionate doctors.

Question 59

What is the significance of empathy and common sense in medicine?

Answer 59

They can be as important as advanced technology ## Footnote Everyday attributes may influence patient outcomes significantly.

Question 60

Who developed a technique to distinguish between Gram-negative and Gram-positive bacteria?

Answer 60

Hans Christian Gram ## Footnote The Gram staining technique was developed in 1884.

Question 61

What does the 'Gram' in Gram-negative and Gram-positive refer to?

Answer 61

Hans Christian Gram ## Footnote It is not related to weights and measures, but to the bacteriologist's name.

Question 62

What distinguishes Gram-negative from Gram-positive bacteria?

Answer 62

The thickness of their cell walls ## Footnote This difference affects how easily they are penetrated by antibodies.