May 4th, 2011 by Peggy Polaneczky, M.D. in Health Tips, Research
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Two studies published in this weeks’ British Medical Journal, one from the US and the other from the UK, report that users of drosperinone containing oral contraceptives (Yaz, Yasmin and their generics) have increased relative risks for non-fatal blood clots compared with users of pills containing levonorgestrel.
While neither study is perfect, and indeed have some very major limitations, they add to a growing body of evidence that pills containing drosperinone may impart higher risks for blood clots than older pills. Yaz is not alone in this regard – other studies have suggested that pills containing the newer progestins gestodene and desogestrel also impart slightly high clot risks than the so-called first and second generation pills containing the older progestins norethindrone and levonorgestrel.
I won’t go into the studies’ limitations here, but will say that trying to get our hands around comparative data on clot risks between various pills is an extraordinarily difficult process given that the diagnosis of blood clots is not always straightforward (or correct), pill choices are not randomized and fraught with prescribing bias, and confounding risk factors for clotting are numerous and difficult to control for. I wish folks would stop trying to answer these questions on the quick and cheap using claims and pharmacy databases without requiring chart review and strict diagnostic criteria. But that’s the way these studies are being done, and that’s the data I am being forced to contend with in my practice, so let’s talk about it. Read more »
*This blog post was originally published at The Blog That Ate Manhattan*
April 12th, 2011 by Peggy Polaneczky, M.D. in Health Tips, Research
1 Comment »
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*
April 5th, 2011 by Peggy Polaneczky, M.D. in Humor, Opinion
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No, not the shoes. The British TV series.
Martin is surgeon, whose glittering career comes crashing down around him when he develops a phobia which prevents him conducting operations. He makes a life changing decision to retrain as a GP, and applies for a vacant post in the sleepy Cornish hamlet of Portwenn, where he spent childhood holidays.
Doc Martin is as grumpy, short-tempered and brilliant as House, and while he has no cadre of residents to torture, he does have a town full of varied and wonderful characters to annoy him. And of course, there’s a love interest.
We’ve barely started watching, and already there have been these memorable lines –
Patient – Am I your first official patient?
Doc Martin – You are indeed. Collect a thousand loyalty points and you get a free coffin. Read more »
*This blog post was originally published at The Blog That Ate Manhattan*
March 25th, 2011 by Peggy Polaneczky, M.D. in Opinion, True Stories
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A Well Blog post series in the NY Times, written by Peter Bach, MD, an attending physician at Memorial Sloan-Kettering Cancer Center in NYC, chronicle’s his experiences with his wife’s diagnosis and treatment for breast cancer.
As painful as it was to read of Bach’s wife’s breast cancer diagnosis and treatment, I found reading the comments section on the first few posts to be equally difficult. The comments ranged from supportive to downright vitriolic, as patients took the opportunity to vent at doctors and a medical system that they perceive gave Bach’s wife better access to treatment than theirs. The bitterness that comes through these comments is astonishing, but should not be. Read more »
*This blog post was originally published at The Blog That Ate Manhattan*
March 11th, 2011 by Peggy Polaneczky, M.D. in Better Health Network, Opinion
1 Comment »
If ever a medical device company crossed a line with their marketing, this one has. Essure, which makes a sterilization device for women, is trying to scare men away from vasectomy in order to drive women to use their device.
“We made men watch footage of an actual vasectomy,” says the female voiceover — and then they proceed to show men’s reactions to watching a surgical procedure, with “That’s frickin’ gross, man” being the most memorable quote. The final tagline: “You can only wait so long for him to man up.” Yeah, and to be sure he doesn’t, they’ve created this ad.
The ad is slimy, harmful, obnoxious, and just plain stupid. A couple’s decision as to which sterilization procedure is best for them should be one informed by real information, not frat-boy marketing.
How dare they? The FDA should pull this ad — now.
**********
Addendum: I just emailed the FDA at BadAd@fda.hhs.gov. Feel free to copy my message below and send your own email:
To the FDA,
I find this ad for Essure both inflammatory and unethical. I am incensed at the impact this ad could have on couples’ informed choices about sterilization. I ask that you mandate that the company who makes Essure immediately pull this ad, both from the Web and from any media outlet where it’s playing.
Thank you for your attention to this matter.
*This blog post was originally published at The Blog That Ate Manhattan*
Two studies published in this weeks’ British Medical Journal, one from the US and the other from the UK, report that users of drosperinone containing oral contraceptives (Yaz, Yasmin and their generics) have increased relative risks for non-fatal blood clots compared with users of pills containing levonorgestrel.
