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Help For Inhaling Medications

Cambridge Consultants and India’s Sun Pharma Advanced Research Company (SPARC) have developed a new dry powder inhaler. According to the companies, the device delivers an even, consistent drug dose deep into the lungs regardless of how strong the inhalation is performed by the patient.

From the press release:

The device employs a novel de-agglomeration engine to separate the drug from the lactose ‘carrier’ particles. Based on a highly efficient airway design, the patented drug separation mechanism has successfully completed clinical trials and demonstrated that it is capable of delivering significantly more of the drug to the deep lung than traditional inhalers. In practice, this will minimise side effects from drug build-up in the back of the throat, reduce non-systemic load and wastage, and means almost 50% less active drug needs pre-loading into the device in comparison to a standard inhaler. Read more »

*This blog post was originally published at Medgadget*

Lung Cancer CT Scan Marketing Spreads Across The Country

Last week, after the National Lung Screening Trial results were released, David Sampson, American Cancer Society director of medical and scientific communications, wrote that “our greatest fear was that forces with an economic interest in the test would sidestep the scientific process and use the release of the data to start promoting CT scans. Frankly, even we are surprised how quickly that has happened.”

And, yes, the marketing has even hit fly-over country in the Twin Cities, with this ad appearing in the Sunday Minneapolis Star Tribune in the “A” section:

scan.jpg

Of course, no where in the ad will you read about the potential harms of such scans, the false positive rate, what happens when you get a false positive (unnecessary followup testing and perhaps unnecessary treatment), and more costs. And nowhere in the ad will you read that 300 heavy smokers had to be scanned in order for just one to get a benefit of extending his life. But six clinics in this chain are standing by to take your money and do your scan.

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

How Much Pesticide Is In That Cigarette?

I had a fascinating discussion with an ex-tobacco farming expert. He’s an expert because he used to grow tobacco, but not anymore. If you’re a smoker, or user of any tobacco leaf product, what he said should shock you. I take that back — you’re a smoker: “shocked” is never going to happen to you.

What did he say that was so striking? I’m not a farmer, so it became a little difficult to understand all the science behind the conversation. Needless to say, he said they used to farm vegetables and tobacco side by side. He said something about potato farming being timed with tobacco crops, and when the potato market went south he got out of the tobacco farming business for good and went with just vegetables. Now he’s a full-time vegetable farmer.

While he was a tobacco farmer, how did he run his tobacco farm? Like I said, he grew vegetables and tobacco side-by-side. He used different pesticides for the vegetables than he did for the tobacco farming. He farmed based on the concept that people who ate vegetables were looking for a healthy food. So he used pesticides in their lowest recommended concentration and applied them at the longest recommended time frame between applications and used the safest formulations available. None of his chemicals carried the skull-and-crossbones warning. And what about the tobacco farming? Read more »

*This blog post was originally published at The Happy Hospitalist*

Screening For Lung Cancer: New Findings And Continued Controversy

Lung cancer screening has been an area of considerable controversy. Before today, there had been no evidence that screening patients for lung cancer, either with a CT scan or chest x-ray, saved lives.

For years, doctors have been waiting for the results of the large, randomized National Lung Screening Trial (NLST), conducted by the National Cancer Institute.

[Yesterday] it was announced that the trial was stopped early, with a bold, positive finding:

All participants had a history of at least 30 pack-years, and were either current or former smokers without signs, symptoms, or a history of lung cancer.

As of Oct. 20, 2010, the researchers saw a total of 354 deaths from lung cancer in the CT group, compared with 442 in the chest x-ray group.

That amounts to a 20.3% reduction in lung cancer mortality — a finding that the study’s independent data and safety monitoring board decided was statistically significant enough to halt the trial and declare a benefit.

Previously, only breast, colon, and cervical cancer has had the evidence back up its screening recommendations. It’s still early in the game, but it appears that lung cancer may be following in that same path. That said, there are a variety of concerns before opening up the floodgates to screening chest CTs. Read more »

*This blog post was originally published at KevinMD.com*

A Poem About An Ending

She coughs
and heaves a breathless goodbye
into the bedside phone.

Her lungs
damp, bloated, sacked honeycomb
wheeze with vanishing bees.

The room
of sensors and startling noise
has not air to float upon.

Morphine
slakes a thirst for breathable sky
and calms the panic within.

The shame
of living, of death smiling,
savoring smoke and ash.

Eyes closed
she imagines her son, boy,
man, precious evermore.

Flowers.
Beautiful white, red, and black
from a husband who waits.

Starstuff
spinning in galaxies far,
with summer lightning bugs.

And then
it is upon her, the moment,
dreaded, practiced, boundless.

We run
through soft sands lit by moonlight,
now tumbling under waves.

All that matters
doesn’t.
And all that happens
matters.

The absence of pain and hunger
the end of struggle and story
mark an indifferent,
yet decent,
finish.

*This blog post was originally published at The Examining Room of Dr. Charles*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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