July 18th, 2011 by John Mandrola, M.D. in Opinion, Research
1 Comment »
What should I have told the doctor who recently asked me about dronedarone (Multaq)?
“Supposedly, it’s [Multaq] just like Amiodarone, but without the side effects?” he asked.
Gosh…Should I, or shouldn’t I?
I took a big cleansing breath, reminding myself to stay civil, as at least Sanofi-Aventis, the makers of Multaq, sponsor a cycling team. Then I gave him my long answer:
I started with the fact that Multaq barely made it through the approval process. One of the original studies with Multaq (ANDROMEDA), a randomized trial of Multaq in patients with severe heart failure, showed that patients who took the drug were twice as likely to die.
Multaq eventually won approval for use in patients without significant heart failure and mild forms of AF, based on the results of the ATHENA trial—which randomized 4628 patients with non-permanent AF to either standard therapy or standard therapy plus Multaq. The ATHENA investigators didn’t exactly say that Multaq works, rather they claimed that it reduced a composite of hospitalizations and death.
This started the marketing machine in motion, the likes of which I have not ever witnessed. Read more »
*This blog post was originally published at Dr John M*
June 24th, 2011 by Bongi in True Stories
No Comments »
It affected me. Not just it, but the fact that it didn’t seem to affect my colleague.
I was a lowly fourth year medical student, delivering babies for all I was worth. Looking back, I realize I enjoyed it. The whole ‘joy of a baby coming into the world’ really gave me joy that a baby was coming into the world. Call me sentimental but I saw each birth as beautiful. Somehow I could look past the meconeum and the amniotic fluid and the episiotomies and see what was actually going on. It was a happy time for the mother (mostly). It was the beginning of hopes and dreams. It was a new start for the baby (obviously) and for the mother, and in a sense, each new birth may have signified a potential new start for me.
She was excited about her new baby, but there was a cloud over her entire admission. The reason she had come in to the hospital was because she hadn’t felt the baby kicking for the last 24 hours and she was worried. Quite soon we were worried, too. Read more »
*This blog post was originally published at other things amanzi*
June 2nd, 2011 by RyanDuBosar in News, Research
No Comments »
The World Health Organization (WHO) says graphic health warnings on tobacco packages are a powerful “best buy” in decreasing tobacco use and its many health consequences.
The Centers for Disease Control and Prevention outlined the research in the MMWR.
The World Health Organization (WHO) created a treaty for tobacco product labels that many countries have ratified. Among other requirements, these warnings are expected to appear on at least 30%, and ideally 50% or more, of the package’s principal display areas, and preferably use pictures.
To assess how cigarette package labels impact quitting smoking, researchers used data from the Global Adult Tobacco Survey (GATS) in 14 countries from 2008 to 2010 that had ratified WHO’s tobacco control treaty. Current smokers of manufactured cigarettes were asked whether they had noticed health warnings on a cigarette package in the previous 30 days, and whether the label led them to think about quitting smoking.
Among men in 12 of the countries and women in seven countries, more than 90% of smokers reported noticing a package warning in the previous 30 days. Read more »
*This blog post was originally published at ACP Internist*
May 10th, 2011 by RyanDuBosar in News
No Comments »
About 9% of infants are given dietary botanical supplements or teas as young as 1 month old, prompting government researchers to warn physicians to look for side effects and other health risks.
Supplement use is common. Parents use them to help with fussiness, digestion, colic, and relaxation. Parents like them because there’s no prescription required, they’re traditional to many cultures, and they’re marketed as “natural.”
But, caution the authors of a paper that appeared in the journal Pediatrics, such supplements’ purity and potency are unregulated, they can interact with prescription medicines, they may contain heavy metals or other contaminants, and they may not adapt well to a newborn’s metabolism and body weight.
Supplement use is also common as a cause of emergency room visits. And they’re linked to seizures and death.
Researchers from the Food and Drug Administration and the Centers for Disease Control and Prevention used data from the Infant Feeding Practices Study II, a longitudinal survey of 2,653 women studied from late pregnancy through the first year of the child’s life. The sample was drawn from a nationally distributed consumer opinion panel of healthy adult mothers with healthy term or near-term infants.
*This blog post was originally published at ACP Internist*
May 1st, 2011 by Shadowfax in Health Policy, Opinion
No Comments »
One interesting comment I have seen come up over and over is the idea that end-of-life costs are the thing that is spiralling out of control and that if we could somehow find a way to curb the costs of futile care, then that would somehow solve the health care inflation crisis. Andrew Sullivan endorsed such an idea the other day, a “Modest Proposal,” which is not nearly as radical or amusing as Swift’s. And indeed, there is a modicum of sense in the idea.
Estimates are that spending in the last six months of a person’s life account for 30-50% of their overall health care costs, and that the spending in the last year of a person’s life accounts for 25% of overall medicare spending. So — simple solution, right? cut down on the futile care, and we’re good to go.
Only problem — as a doctor, I sometimes have a hard time telling when someone is in their last DAY of life, let alone last year. Read more »
*This blog post was originally published at Movin' Meat*
