December 16th, 2010 by DrWes in Better Health Network, News, Opinion
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In a desperate attempt to reach an even number it seems, hospital defibrillators were added to ECRI.org’s “Top 10 Health Technology Hazards” list of devices that threaten to kill or maim patients:
The Top 10 Health Technology Hazards list is updated each year based upon the prevalence and severity of incidents reported to ECRI Institute by healthcare facilities nationwide; information found in the Institute’s medical device problem reporting databases; and the judgment, analysis, and expertise of the organization’s multidisciplinary staff. Many of the items on this year’s list are well-recognized hazards with numerous reported incidents over the years.
If one honestly looks at the number of lives saved versus the number of deaths from defibrillators, I wonder how many of this highly-esteemed group of “multidisciplinary staff” of the ECRI might reconsider. Clearly, most of them have never been in a code situation.
– WesMusings of a cardiologist and cardiac electrophysiologist.
Hat tip: Wall Street Journal Health Blog
*This blog post was originally published at Dr. Wes*
December 15th, 2010 by Glenn Laffel, M.D., Ph.D. in Better Health Network, Health Tips, News, Research
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It’s beginning to look like chocolate, especially dark chocolate, really and truly is a heart healthy snack, though only if it’s consumed in small quantities.
A delectable taste of this news came last spring, in the form of a study by German scientists which appeared in the European Heart Journal. It was a retrospective study of nearly 20,000 people, and it showed that folks in the highest quartile for chocolate consumption (meaning they consumed 7.5 grams of chocolate per day — the equivalent of 2 to 3 small squares of a Hershey bar), had lower blood pressure, a 27 percent lower risk of heart attack, and a 48 percent lower risk of stroke than those in the lowest quartile (about 1.7 grams per day).
Now, a new study in the journal Cardiovascular Pharmacology has lent credence to those findings by suggesting a mechanism through which chocolate reduces blood pressure. In the study, Ingrid Persson and colleagues at Linkoping University showed that dark chocolate inhibits the activity of the angiotensin-converting enzyme (ACE). This enzyme helps regulate fluids and salt metabolism in the body. It is the target of many well-known antihypertensive drugs including captopril, lisinopril and enalopril. Read more »
*This blog post was originally published at Pizaazz*
December 15th, 2010 by admin in Health Tips
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This is a guest post from Dr. Mary Lynn McPherson.
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Rescuing Patients On Darvon Or Darvocet With Zero Tolerance For Pain
On November 19, 2010 the Food and Drug Administration (FDA) called for a halt in the use of the popular opioid pain relievers Darvocet and Darvon. These products contain the opioid propoxyphene, and it has been used to treat mild to moderate pain for over 50 years. However, concerns have long been raised about the effectiveness of this drug, and the risk of death (accidental and suicide). Darvon and Darvocet were banned in Britain in 2005, followed by the European Union in 2009. Over the past 30 years, the FDA has received numerous petitions to take these drugs off the U.S. market.
Research has shown that Darvon and Darvocet are no more effective for treating moderate pain than over the counter drugs like acetaminophen, aspirin or ibuprofen. Unfortunately, Darvon and Darvocet cause a lot more side effects such as dizziness, drowsiness, nausea and vomiting, hallucinations and constipation (all pretty typical of opioids used to treat pain). But, the side effects don’t stop there. The data is in, and it’s not a pretty picture. A recent study requested by the FDA showed that when used at the recommended doses, Darvon and Darvocet cause significant changes in the electrical activity of the heart, which can lead to a fatal irregularity in your heartbeat, even after only short-term use.
Among those advocating for the removal of these drugs from the market were pharmacists. The American Society of Health-System Pharmacists approved a policy in 2007 advocating for the withdrawal of Darvon and Darvocet from the U.S. market, and recently testified at the FDA Advisory Committee to this effect. As an often overlooked member of the medical team, pharmacists have a vital role to play in providing safe and effective treatments. We serve as the last line of defense against improper or unwise prescribing of drugs — especially those for pain. We are drug experts, and we can help patients and doctors switch from Darvon or Darvocet to safer and more effective treatments. Read more »
December 12th, 2010 by John Mandrola, M.D. in Better Health Network, Opinion, True Stories
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The human heart resides in a lighltless 98.6-degree chest cavity. Its contracting muscles are further cushioned by the well-lubricated glistening smooth pericardial sac. One wouldn’t think that the heart could sense the time of year. The heart’s rhythm should remain independent of the holiday season. But then there is December in the EP lab. They are as busy as the malls.
Is it the depressing weather? Or the short days? Or a post-Thanksgiving hangover? It’s hard to say, but every year for as many as I can remember, the EP lab rocks in November and December. And with the advent of deductible health plans, this holiday phenomenon has only intensified.
The I-90 of the heart, the AV node, seems to give out more in the holidays. I’ll never forget the Saturday in December many years ago when I did five “urgent” pacemakers — and neither will the pacemaker rep. Read more »
*This blog post was originally published at Dr John M*
November 30th, 2010 by Elaine Schattner, M.D. in Better Health Network, Health Policy, News, Opinion, Research
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Over the long weekend I caught up on some reading. One article* stands out. It’s on informed consent, and the stunning disconnect between physicians’ and patients’ understanding of a procedure’s value.
The study, published in the Sept 7th Annals of Internal Medicine, used survey methods to evaluate 153 cardiology patients’ understanding of the potential benefit of percutaneous coronary intervention (PCI or angioplasty). The investigators, at Baystate Medical Center in Massachusetts, compared patients’ responses to those of cardiologists who obtained consent and who performed the procedure. As outlined in the article’s introduction, PCI reduces heart attacks in patients with acute coronary syndrome — a more unstable situation than is chronic stable angina, in which case PCI relieves pain and improves quality of life but has no benefit in terms of recurrent myocardial infarction (MI) or survival.
The main result was that, after discussing the procedure with a cardiologist and signing the form, 88 percent of the patients, who almost all had chronic stable angina, believed that PCI would reduce their personal risk for having a heart attack. Only 17 percent of the cardiologists, who completed surveys about these particular patients and the potential benefit of PCI for patients facing similar scenarios, indicated that PCI would reduce the likelihood of MI.
This striking difference in patients’ and doctors’ perceptions is all the more significant because 96 percent of the patients “felt that they knew why they might undergo PCI, and more than half stated that they were actively involved in the decision-making.” Read more »
*This blog post was originally published at Medical Lessons*
