May 19th, 2011 by VicenteBaosMD in Opinion, Research
Tags: Diario Medico, emotionally driven, Evidence Based Medicine, Irrational, medication choices, prescribing habits, prescription patterns, Spain
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I recently stumbled upon a very interesting editorial opinion in the ‘European Journal of Clinical Pharmacology’: ‘The use of drugs is not as rational as we believe…but it can’t be! The emotional roots of prescribing’, authored by Albert Figueras, from Fundació Institut Català de Farmacologia (Catalonia Institute of Pharmacology Foundation at Vall d’Hebron Hospital, in Barcelona).
Since more than 40 years ago when Archie Cochrane said that “there must be solid scientific evidence behind any statement, decision and prescription made by medical staff”, and all the way until today’s WHO promotion of rational medicine utilization, both developing and industrialised countries have been striving to increase sound knowledge about prescription and thus spread the kind of rational thinking necessary to foster evidence-based medicine in drug use.
Keeping your skills up to date has never been an easy task but nowadays we have newsletters and other Internet tools that can grant any MD state-of-the-art knowledge on any subject he or she may need, accessible anywhere and for any medical speciality. Nevertheless, drug use in the “real world” is far from this high quality. Not only in Spain: it has been noted in France, Greece and other countries that, despite widespread knowledge of risk factors that may cause gastrointestinal toxicity in patients under nonsteroidal anti-inflammatory drugs (NSAID) treatment, there is a massive use of proton-pump inhibitors in individuals that show no significant risk.
Changing well-established drugs for newer, less-known products is not consistent with the need of a well-grounded comparative evaluation. We are not raising concern on the influence of gifts or invitations from pharmaceutical companies. Many doctors really want to make rational decisions… but can’t. Read more »
*This blog post was originally published at Diario Medico*
May 17th, 2011 by Peggy Polaneczky, M.D. in News, Research
Tags: Attraction, Bad Reporting, Birth Control, Contraception, Fertility, Lemurs, OB/GYN, Obstetrics And Gynecology, Sexual Medicine, Sexuality, Wall Street Journal, Women's Health, WSJ
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In an article filled with speculation, misinformation and broad sweeping generalizations, the Wall Street Journal does its damned best to make the birth control pill seem to be the worst thing to have happened to modern civilization, implying that by interfering with ovulation, the pill impairs our natural ability to choose a mate, causes women to choose less masculine partners and then stray from them, and makes us pick genetically similar rather than dissimilar mates.
Women on the pill no longer experience a greater desire for traditionally masculine men during ovulation….Researchers speculate that women with less-masculine partners may become less interested in their partner when they come off birth control, contributing to relationship dissatisfaction…That could prompt some women to stray, research suggests. Psychologist Steven Gangestad and his team at the University of New Mexico showed in a 2010 study that women with less-masculine partners reported an increased attraction for other men during their fertile phase.
“Less masculine” men. What the heck does that mean? Less hairy? Less into sports? Less violent? Not into Nascar or big trucks?
How about more likely to engage in conversation? More likely to care about their partner’s satisfaction in bed than their own? More likely to accept a woman having a career? Read more »
*This blog post was originally published at The Blog That Ate Manhattan*
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 13th, 2011 by RyanDuBosar in News, Research
Tags: Colonoscopy, Competency, Gastroenterology, Mayo Clinic, Medical Education, More Training, Procedures
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Much more practice is needed than gastroenterological professional societies currently recommend, concluded Mayo Clinic researchers in Rochester, Minn.
Current recommendations are that 140 procedures should be done before attempting to assess competency, but with no set recommendations on how to assess it, wrote the author of the research. But it takes an average of 275 procedures for a gastroenterology fellow to reach minimal cognitive and motor competency.
Now, the American Society for Gastrointestinal Endoscopy is rewriting its colonoscopy training guidelines to reflect the need for more procedures and emphasize the use of objective, measurable tests in assessing the competency of trainees. Read more »
*This blog post was originally published at ACP Internist*
May 11th, 2011 by PJSkerrett in Health Tips, Research
Tags: Cardiology, DASH diet, Health, Healthy Eating, Heart, Heart Health, High Blood Pressure, Low-Salt, Salt
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A paper in a recent edition of Journal of the American Medical Association (JAMA) offers the contradictory conclusion that taking in less salt—a key goal of U.S. health and dietary recommendations—is bad for you. But before you roll your eyes and groan about flip-flops in science, know that this study isn’t the kind of work on which you or anyone should base dietary decisions.
In this study of 3,681 men and women from Belgium, Bulgaria, Italy, Poland, Romania and Russia whose health was followed for eight years, participants with the lowest sodium excretion (which is a good measure of sodium intake) were 56% more likely to have died from cardiovascular disease than those with the highest sodium excretion. Among the nearly 2,100 participants with normal blood pressure at the study’s start, sodium excretion (sodium intake) had no effect on the development of high blood pressure.
These are startling findings. If true, they would undercut major programs by the U.S. government to reduce Americans’ intake of salt—the main source of sodium—from prepared and processed foods and at home. Read more »
*This blog post was originally published at Harvard Health Blog*
