June 3rd, 2010 by Steve Novella, M.D. in Better Health Network, Opinion, Quackery Exposed, Research
Tags: Acupuncture, Adenosine Triphosphate, Analgesic Effect, Ancient Superstition, ATP, Block Pain Signals, CAM, Complementary And Alternative Medicine, Eastern Medicine, Evidence Based Medicine, Inhibit Prostaglandins, Mechanism, Modulating Pain, Nana Goldman, Nature Neuroscience, New therapies, New treatment, Opiate Receptors, Pain Relief, Pre-Scientific Superstition, Propaganda, SBM, Science Based Medicine, Science-Based Evidence, Science-Based World, Western Medicine, WHO, World Health Organization
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The development of drugs and other treatments for specific symptoms or conditions relies heavily on either serendipity (the chance finding of a beneficial effect) or on an understanding of underlying mechanisms.
In pain, for example, there are limited ways in which we can block pain signals –- such as activating opiate receptors, or inhibiting prostaglandins. There are only so many ways in which you can interact with these systems. The discovery of a novel mechanism of modulating pain is therefore most welcome, and has the potential of leading to entirely new treatments that may have a better side effect profile than existing treatments and also have an additive clinical effect.
A recent study by Nana Goldman et. al., published in Nature Neuroscience, adds to our understanding of pain relief by identifying the role of adenosine in reducing pain activity in the peripheral nervous system. The researchers, in a nice series of experiments, demonstrated that producing a local painful stimulus in mice causes the local release of ATP (adenosine triphosphate) that peaks at about 30 minutes. This correlates with a decreased pain response in the mice. Further, if drugs are given that prolong the effect of adenosine, the analgesic effect itself is prolonged. Read more »
*This blog post was originally published at Science-Based Medicine*
June 2nd, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion, Research, True Stories
Tags: California, Cost Of Providing Primary Care, Family Medicine, General Medicine, Grossly Underestimated The Cost, Healthcare Economics, Internal Medicine, Medicare, No Insurance Accepted, Patients' Perception, Pay What It's Worth To You, Pay-What-You-Can Program, Primary Care Appointment, Primary Care Visit, uninsured, Value To Patients
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How much is a primary care appointment worth? Not much, it appears.
Physicians in California decided to embark on an innovative idea, asking patients to simply pay them what they thought the visit was worth. Here’s how it worked:
On the day of the events, no insurance was accepted. Care was provided only to the uninsured, who were asked to pay what they could afford. Laboratory tests were provided at cost, and patients who needed additional services were referred to various public resources. Practices also handed out lists of generic medications available for reduced prices at large, discount pharmacies.
Physicians who accept Medicare are not allowed to include Medicare beneficiaries in any pay-what-you-can program.
Although patients did value the visit, they grossly underestimated its cost. Read more »
*This blog post was originally published at KevinMD.com*
June 2nd, 2010 by GarySchwitzer in Better Health Network, Health Policy, News, Opinion, Research
Tags: Atrial Fibrillation, CureTogether.com, Dave Hage, E-Patients, Family Medicine, Gary Schwitzer, General Medicine, Health Data Rights, Health Journalism, Healthcare Conflicts of Interest, Healthcare Social Media, HealthNewsReview.org, Internal Medicine, John Fauber, Milwaukee Journal-Sentinel, Minneapolis Star Tribune, Multaq, Natasha Singer, New York Times, Online Health Communities, Online Health Conversations, Over-Used Procedures, PatientsLikeMe.com, Personal Health Data, Primary Care, Side Effects, Social Health Media, Social Media Sites, Social Networking, Social Networks, Too Much Medicine, Under-Proven Ailments, When Patients Meet Online
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A couple of health journalism gems you shouldn’t miss just because they were published over the holiday weekend:
Natasha Singer of the New York Times had an important piece, “When Patients Meet Online, Are There Side Effects?,” about privacy concerns when social networking sites like CureTogether.com and PatientsLikeMe.com offer online communities for patients and collect members’ health data for research purposes.
John Fauber of the Milwaukee Journal-Sentinel published another in his “Side Effects” series on conflicts of interest in healthcare. This one was about doctors vouching for the drug Multaq for treating atrial fibrillation without ever having seen all of the data.
The Minneapolis Star Tribune began a “Too Much Medicine” series. Health editor Dave Hage informs that they’ve been working on this project for nearly a year with plans for a few more installments in coming months, each covering different ailments and procedures that are over-used or under-proven. (Unfortunately, I think the series is only available in the print editions.)
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
June 1st, 2010 by Peggy Polaneczky, M.D. in Better Health Network, News, Opinion, Research
Tags: Art, Assisted Reproductive Technology, Autism, Autistic Children, Fertility Treatment, In Vitro Fertilization, Infertility, International Meeting for Autism Research, IVF, Obstetrics And Gynecology, Pediatrics
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In the latest media barrage on autism, fertility treatment has come into question as a possible cause for this increasingly common developmental disorder. The reason is two research abstracts recently presented at the International Meeting for Autism Research in Philadelphia.
One study assessed the history of IVF (in vitro fertilization) among 574 children evaluated at a special center for autism in Israel. The researchers found that 10% of the group diagnosed as autistic had had IVF, compared to a background rate in the overall population which they quote as 3.5%. Not surprisingly, maternal age was higher in the IVF group and the rate of prematurity was higher in the autistic children.
The second study was a look into a pre-existing database — the Nurse’s Health Study — which collects data from a cohort of nurses over time. The researchers compared the reproductive history reported by women who also reported having a child with autism and compared it to that of women who did not report having an autistic child. Of those with autistic children, 48% reported infertility with 34% having used ovulation inducing drugs, compared with 33% and 24%, respectively, in women without autistic children, a difference that was statistically significant when controlled for maternal age and self-reported pregnancy complications.
A Time article getting a lot of media play calls the results of the second study “some of the strongest evidence to date” linking autism to fertility treatment. Unfortunately, that’s just not true. Read more »
*This blog post was originally published at The Blog that Ate Manhattan*
June 1st, 2010 by KevinMD in Better Health Network, Health Policy, Opinion, Research
Tags: Ambulance Accidents, Ambulance Crashes, Ambulance Drivers, Ambulance Service, Annals of Emergency Medicine, Bleeding, Choking, Dangerous, Difficulty Breathing, Dr. Jesse Hines, Dr. Zachary Meisel, Emergency Medical Technicians, Emergency Medicine, Emergency Physicians, EMT, Endanger Lives, ER Doctors, Fast Transport Speed, Head Injury, Heart Attack, High-Speed Rescue Vehicles, Life-Threatening, Lights Flashing, Medical Transport Speed, Medics, Minutes Don't Count, Paramedics, Pedestrians, Save Lives, Sirens Blaring, Slate, Speeding Ambulances, Stroke, Survival, Time Sensitive, Trauma Patients, Uninvolved Motorists
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How fast should an ambulance go? The stereotypical speeding ambulance with lights flashing and sirens blaring is the image that most conjure up. But recent data suggests that transport speed may be overstated.
In a fascinating piece from Slate, emergency physicians Zachary F. Meisel and Jesse M. Pines examine that very question. They cite a recent study from the Annals of Emergency Medicine, which concluded that a fast transport speed didn’t necessarily save lives. Read more »
*This blog post was originally published at KevinMD.com*
