July 13th, 2011 by Matthew Mintz, M.D. in Opinion
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Both Germany and France have now suspended the marketing of Actos (pioglitazone) due to concerns of a link between Actos and bladder cancer. Though we have known about bladder cancer concerns for some time, these recent concerns about the bladder cancer link stem from a recent report analyzing the FDA’s Adverse Event Reporting System (AERS), which found that 93 cases of cancer were recorded between 2004 and 2009 in patients treated with antidiabetic drugs, of which 31 patients were treated with pioglitazone, representing a statistically significant increased risk of bladder cancer (ROR 4.30, 95% confidence interval, 2.82-6.52; P less than 0.0001).
Interestingly, the FDA announced that it was going to look into the link between Actos and bladder cancer only a few days before it made its final decision on what to do with Avandia (as if they didn’t know about the Actos cancer risk before the July 2010 advisory board).
Despite the many things you have heard about Avandia, back in July 2010, the FDA decided to severely restrict the use of Avandia for three reasons: Read more »
*This blog post was originally published at ACP Internist*
June 8th, 2011 by John Mandrola, M.D. in Health Tips
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When cyclists find out that I am a heart doctor, they most frequently ask about cholesterol numbers.
“…My cholesterol is this…What do you think?”
“…My doctor wants me to take a statin…But I read that these drugs might lower my functional threshold power 2.014 watts/40km.”
All this focus on numbers saddens me. Remember, I am a forest guy, not a tree guy. What’s more, as a doctor that revels in the adrenaline rush of ablating rogue circuits with technology that would impress even a twenty-something, I find questions about biochemistry dreary–like eating quinoa.
I wish folks would ask me about how to terminate AF with a catheter, or how an (evidenced-based) ICD saved a mom’s life, or perhaps even this: “Do you do heart surgery?”
But more often than not people want to know about cholesterol.
Okay. It just so happens that this week brought some very interesting news concerning the treatment of abnormal cholesterol lab values. News that big-picture docs have to like. Read more »
*This blog post was originally published at Dr John M*
June 2nd, 2011 by John Mandrola, M.D. in Health Tips, Research
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It is hardly news to say that we need better means to predict who will die of heart disease. No matter how much you may hear about medical errors, hospital acquired infections, or even distracted driving, it’s still heart disease that kills the most of us.
The inflammation that begins narrowing our arteries starts when we are young. It percolates quietly, stealth-like for years. The young usually skate by unscathed. But all the cookies, beers, chips, inactivity and work stress adds up. The tension of life squeezes our arteries, daring them to crack or fissure. This cataclysm is one of the ways that middle age may introduce herself.
A friend, or colleague, or sibling dies suddenly of heart problems. Those of us that our “masters-aged” have likely felt these sensations of sadness, and then the reality that they may be next.
“I should probably come in and get a check-up,” is something I hear frequently in the doctor’s lounge after such a tragedy.
I agree. When you are old enough to use reading glasses it is time to think about what lurks inside your heart’s blood vessels.
But herein lies the catch. Read more »
*This blog post was originally published at Dr John M*
April 25th, 2011 by PeterWehrwein in News, Research
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Baseball fans have the Baseball Prospectus annual. Political junkies can get their fix from Nate Silver’s 538 blog.
For those of us with geeky interest in health and medicine statistics, graphs, and charts, the Health, United States, 2010 report from the National Center for Health Statistics is that kind of treat. The 41 charts and graphs and 148 trend tables in the 2010 report (it’s dated 2010 but was released earlier this year) could keep me happily occupied for hours.
One graph that really caught my eye shows the percentage of Americans that take a statin. Statins are prescribed mainly to lower “bad” LDL cholesterol, but they may have other benefits, too. The statins include atorvastatin (sold as Lipitor), rosuvastatin (sold as Crestor), and simvastatin (sold as Zocor but also available as a generic ).
Here is the graph I am talking about:
Many Americans take statins. No surprise there. But half of men, ages to 65 to 74, and 39% of women, ages 75 and older—that’s pretty stunning. Read more »
*This blog post was originally published at Harvard Health Blog*
April 12th, 2011 by Peggy Polaneczky, M.D. in Health Tips, Research
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This is the study that doesn’t end…
The longterm follow up extends…
Some people started studying hormones in menopause,
And they’ll continue publishing more data just because…
(repeat)
In yet another paper in a major journal, we hear once more from the investigators of the Women’s Health Initiative. This time it’s the long term outcomes of women who took estrogen alone, now seven years out from stopping their hormones. What new information can we learn from this extensive analysis of new data?
Nothing.
Really.
The WHI’s been telling us the same thing about ERT (Estrogen replacement therapy) and HRT (Combination estrogen/progestin therapy) since 2002, and all each subsequent study does is reinforce and expand on that initial data. Unfortunately, it will probably take a few more papers before some folks accept the results of this important study, which, though flawed, continues to inform the practice of menopausal medicine.
Allow me to summarize what we know - Read more »
*This blog post was originally published at The Blog That Ate Manhattan*
