May 10th, 2011 by Michael Kirsch, M.D. in Health Tips, Research
Tags: Cardiology, Contraindicated, Dangerous Combination, FDA, Gastroenterology, Plavix, PPI, Prilosec, Purple Pill
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When the medical press seizes a story, it can become an obsession. Any physician who is reading any journal is aware of the reported interaction between clopidrogel (Plavix) and proton pump inhibitor (PPI) drugs, including Prilosec and her cousins. PPI medicines are not exotic elixirs known only to medical professionals. They are known to any person with a working TV set or who still reads a newspaper, since ads for these drugs are omnipresent. Just google ‘purple pill’ and begin your entrance into the PPI Chamber of Advertising.
PPI medicines are highly effective for peptic ulcers and gastroesophageal reflux, although I suspect that most patients on these medications do not have any true indication for them. (Disclosure: I’ve pulled the PPI trigger too quickly on many patients who do clearly require acid blocking medicines.) PPI medicines are prescribed to hospitalized patients almost by reflex, and are often administered by the intravenous route, even when patients can swallow pills adequately.
Medical studies in 2009 reported that PPI medications appeared to make Plavix less effective. Since thousands of patients are on both of these medicines, this drug interaction could affect a large cohort of patients. Plavix serves to keep coronary stents open and to prevent heart attacks and strokes. Clearly, any force that could diminish Plavix’s potency could have serious ramifications for patients. But, is it really true? Read more »
*This blog post was originally published at MD Whistleblower*
May 10th, 2011 by Medgadget in Research
Tags: Artificial Pancreas, Blood Sugar Levels, Diabetes, Endocrinology, Overnight Control, Type 1 Diabetes
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A team led by researchers from University of Cambridge showed that closed loop insulin delivery was effective in controlling overnight blood glucose levels in patients with type 1 diabetes. The system took readings every fifteen minutes and automatically titrated a proper amount of insulin.
University of Cambridge researcher Dr Roman Hovorka led two studies to evaluate the performance of the artificial pancreas in 10 men and 14 women, aged 18 to 65, who had used an insulin pump for at least three months. Read more »
*This blog post was originally published at Medgadget*
May 10th, 2011 by admin in Health Tips, Research
Tags: Calcium, Calcium Supplements, Cardiology, Geriatrics, Harmful, Heart Attack, Myocardial Infarction, Osteoporosis, Safety, Science and Medicine, Supplements
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Calcium is good for us, right? Milk products are great sources of calcium, and we’re told to emphasize milk products in our diets. Don’t (or can’t) eat enough dairy? Calcium supplements are very popular, especially among women seeking to minimize their risk of osteoporosis. Osteoporosis prevention and treatment guidelines recommend calcium and vitamin D as an important measure in preserving bone density and reducing the risk of fractures. For those who don’t like dairy products, even products like orange juice and Vitamin Water are fortified with calcium. The general perception seemed to be that calcium consumption was a good thing – the more, the better. Until recently.
In a pattern similar to that I described with folic acid, there’s new safety signals from trials with calcium supplements that are raising concerns. Two studies published in the past two years suggest that calcium supplements are associated with a significantly increased risk of heart attacks. Could the risks of calcium supplements outweigh any benefits they offer? Read more »
*This blog post was originally published at Science-Based Medicine*
May 9th, 2011 by RyanDuBosar in News, Research
Tags: Angioplasty, Cardiology, Death Rate, Gender Disparities, Heart Attack, Hospital Medicine, MI, Mortality, Women's Health
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One-third (33.5%) of female heart attack patients receive surgery or angioplasty compared to nearly half (45.6%) of men, and among heart attack patients receiving an intervention such as coronary bypass surgery or angioplasty, women had a 30% higher death rate compared to men, reports HealthGrades.
The findings are based on an analysis of more than 5 million Medicare patient records from 2007 to 2009 and focused on 16 of the most common procedures and diagnoses among women.
The most noticeable disparities were in cardiovascular care. Heart disease is the #1 killer of women in America, surpassing all forms of cancer combined, the company said in a press release. Read more »
*This blog post was originally published at ACP Internist*
May 9th, 2011 by DrWes in Health Policy, Research
Tags: Data, Hospitals, P4P, Pay For Performance, Performance Measures, Quality Assurance, standard deviation
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Quality measures. Patient satisfaction surveys. With our new health care reform law, these “performance measures” are the new black in health care.
Hospitals are currently spending, conservatively, tens of millions of dollars to bolster these “performance measures” in hopes of securing a refund of a mere 1% of payments that CMS will soon withhold from them in the name of “assuring” quality improvement.
But what if, nationwide, there wasn’t a big difference in these measures between hospitals? What happens then? Might payments then be made on political grounds?
Performance measures have been collected for some time now in anticipation of this new payment initiative by the government, so data exist to evaluate. In fact, Kaiser Health News was nice enough to aggregate the findings from our government’s Hospital Compare website for my review.
So I calculated the mean, median and standard deviation of the results of all of this data collected across 50 states and 2 territories and found very little difference in measures collected between states: Read more »
*This blog post was originally published at Dr. Wes*
When the medical press seizes a story, it can become an obsession. Any physician who is reading any journal is aware of the reported interaction between clopidrogel (Plavix) and proton pump inhibitor (PPI) drugs, including Prilosec and her cousins. PPI medicines are not exotic elixirs known only to medical professionals. They are known to any person with a working TV set or who still reads a newspaper, since ads for these drugs are omnipresent. Just google ‘purple pill’ and begin your entrance into the PPI Chamber of Advertising.
