May 17th, 2011 by Toni Brayer, M.D. in Health Tips, Research
Tags: Contraindication, Heart Attack, Ibuprofen, MI, Motrin, Myocardial Infarction, NSAIDs, Over-The-Counter Medications
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New information published in Circulation advises against using any nonsteroidal anti-inflammatory drugs (NSAIDs) in patients who have had a prior heart attack. These over-the-counter drugs are commonly used like Advil, Aleeve, Diclofenac, Ibuprofen. Using NSAIDs for even as little as one week was associated with a 45% increase for death or recurrent myocardial infarction (MI). The researchers could not identify a period that seemed to be safe, no matter how short.
The study used the Danish National Patient Registry and identified 83,675 patients who had a first MI between 1997 and 2006. The average age was 68 years and 65% were men. All the NSAIDs (except Naprosyn) used during the observation period were associated with an increased risk for death or new heart attack. Diclofenac (brand name Voltaren) was the worst.
Readers should not go away thinking NSAIDs cause heart attacks. This study looked at patients who had already had an MI. But for those patients, the over-the-counter pain relievers should be avoided. Many patients with heart disease also have arthritis or other pain syndromes. We need to come up with safe treatments for pain or use “safer” NSAIDs like low dose Naprosyn or Ibuprofen only when the benefit is weighed with the risk.
Just because something is sold without a prescription does not mean it is without risk. Tell your doctor every medication you take.
*This blog post was originally published at EverythingHealth*
May 16th, 2011 by Mark Crislip, M.D. in Health Tips, Quackery Exposed
Tags: Delusions, Delusions Of Parasitism, Energy Medicine, Infectious Disease, Morgellon's, Naturopathy, Parasites, Psychiatry, Science and Medicine
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I saw a patient recently for parasites.
I get a sinking feeling when I see that diagnosis on the schedule, as it rarely means a real parasite. The great Pacific NW is mostly parasite free, so either it is a traveler or someone with delusions of parasitism.
The latter comes in two forms: the classic form and Morgellons. Neither are likely to lead to a meaningful patient-doctor interaction, since it usually means conflict between my assessment of the problem and the patients assessment of the problem. There is rarely a middle ground upon which to meet. The most memorable case of delusions of parasitism I have seen was a patient who I saw in clinic who, while we talked, ate a raw garlic clove about every minute.
“Why the garlic?” I asked.
“To keep the parasites at bay,” he told me.
I asked him to describe the parasite. He told me they floated in the air, fell on his skin, and then burrowed in. Then he later plucked them out of his nose.
At this point he took out a large bottle that rattled as he shook it.
“I keep them in here,” he said as he screwed off the lid and dumped about 3 cups with of dried boogers on the exam table.
To my credit I neither screamed nor vomited, although for a year I could not eat garlic. It was during this time I was attacked by a vampire, and joined the ranks of the undead. Read more »
*This blog post was originally published at Science-Based Medicine*
May 15th, 2011 by Berci in Health Tips, News
Tags: App, Application, Exercise, Fitness, Health, Health 2.0, Medicine, Medicine 2.0, Technology, Tweet Fit, TweetFit, Twitter, Web 2.0
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Tweet_Fit is an amazing idea that is similar in nature to Kickbee. Here are the details:
Developed by a UK design student, the connected gym accessory attaches to the end of a standard dumbbell and sends updates to your Twitter account when you start and stop your workout. Take it offline and it guides you through the perfect curl. Tweet_Fit’s designer points out that it offers a novel way for trainers to keep track of their clients, and can be used to spur healthy competition between friends.
*This blog post was originally published at ScienceRoll*
May 14th, 2011 by StevenWilkinsMPH in Health Tips, Opinion
Tags: Doctor-Patient Communication, Medication Errors, Medications, Non-compliance, Patient Experience, Pharmaceuticals
2 Comments »
Lots of smart people over the years have been trying to figure out why people stop taking their medications within the first 12 months. Within the first 12-months of starting a new prescription, patient compliance rates drop to less than 50%. This rate is even lower for people with multiple chronic conditions taking one or more prescription medications.
If these medications are so important to patients, why do they just stop taking them? It defies common sense. Sure issues like medication cost, forgetfulness, lack of symptoms, and psychosocial issues like depression play a role in patient non-compliance. But there also something else going on…or in this case not going on.
The problem is that doctors and patients simply don’t talk much about new medications once prescribed. Here’s what I mean. Let’s say that at a routine check-up a physician tells a patient that he/she wants to put them on a medication to help them control their cholesterol. The doctor spends about 50 seconds telling the patient about the medication. The patient nods their head takes the prescription and boom…the visit is over. Read more »
*This blog post was originally published at Mind The Gap*
May 13th, 2011 by Glenn Laffel, M.D., Ph.D. in Health Policy, Health Tips
Tags: Commentary, Facebook, Online Identity, Online Persona, Physicians, Professionalism, Providers, Social Media, Twitter
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Like everybody else, physicians are expanding their online personal identities. At the same time, they are trying to comply with codes of conduct that help consumers trust them and their profession.
There’s no problem so long as the personal online activities of physicians don’t jeopardize their obligations as professionals, which means that there is a problem, unfortunately.
In a recent study for example, 17% of all blogs authored by health professionals were found to include personally identifiable information about patients. Scores of physicians have been reprimanded for posting similar information on Twitter and Facebook, posting lewd pictures of themselves online, tweeting about late night escapades which ended hours before they performed surgery, and other unsavory behaviors.
As I mentioned Monday, medical students and younger physicians who grew up with the Internet have to be particularly careful, since they had established personal online identities before accepting the professional responsibilities that came with their medical degree. Read more »
*This blog post was originally published at Pizaazz*
New information published in Circulation advises against using any nonsteroidal anti-inflammatory drugs (NSAIDs) in patients who have had a prior heart attack. These over-the-counter drugs are commonly used like Advil, Aleeve, Diclofenac, Ibuprofen. Using NSAIDs for even as little as one week was associated with a 45% increase for death or recurrent myocardial infarction (MI). The researchers could not identify a period that seemed to be safe, no matter how short.
Readers should not go away thinking NSAIDs cause heart attacks. This study looked at patients who had already had an MI. But for those patients, the over-the-counter pain relievers should be avoided. Many patients with heart disease also have arthritis or other pain syndromes. We need to come up with safe treatments for pain or use “safer” NSAIDs like low dose Naprosyn or Ibuprofen only when the benefit is weighed with the risk.
