Patients, Medicine, Science & Trust

Treating lab tests or people? Chasing our good HDL cholesterol

2011-05-31T15:01:00.000-04:00

Adults with high blood cholesterol levels have been shown to suffer increased chances of having a heart attack or stroke. Various advisory committees have recommended that patients should make efforts to reduce their blood cholesterol levels. Photo William JonesHowever, there are two types of cholesterol, low density and high density, with the former getting nicknamed ‘bad’ cholesterol (or

Peeling the onion of financial conflicts of interest - Publishing research

2009-12-06T08:51:00.000-05:00

Financial conflicts of interest in research bias towards results, conclusions and recommendations that favour the interests of the sources of the money. Even though those receiving the money or financial support for their projects {Photo Credit - Darwin Bell} always claim theywere not biased, abundant hard evidence shows just the contrary. Knowing this, health sciences journals have played a

The sacred and overly screened female breast - new recommendations rightly recommend discontinuing screening mammograms in younger women.

2009-12-01T13:00:00.000-05:00

The United States Preventive Task Force recently released its latest guidance on screening healthy women for breast cancer. To general astonishment the Task Force recommended that mass screening for breast cancer in healthy women between the ages of 40 ad 40 be stopped, along with efforts to teach women to regularly palpate their own breasts, searching for lumps and bumps. Image Ductal

Swine flu in the nursing home...Should patients with chronic dementia get aggressive care?

2009-10-20T13:53:00.002-04:00

This situation will surely arise during the current influenza season. In the Nursing Home where I work about 20% of the residents have a long standing dementia. Most are unable to recognize me although I will see each of them about every 4 weeks for one reason or another. Many have family members they do not recognize (although the bedside walls are often covered with family photographs).

Pop’s up again...

2009-07-08T09:09:00.006-04:00

I’ve had a year. Well almost a year since the last post. Here goes again. A brief explanation involves describing a move to this Island off the coast of Maine and New Brunswick http://www.flickr.com/photos/bubbalouie ~ about 2,000 permanent residents along the 15 or so miles of coastline on the East side of the island (there is no road on the West side), living in 3 or 4 villages (numbers

Censoring Science and scientists - The Insite Example

2008-09-18T11:04:00.011-04:00

Censoring Science and scientists - The Insite Example(Insite, Canada's only facility for supervised injections of illicit drugs)Censored is a powerful and friendless word with few public advocates. When Galileo, perhaps the most famous censored scientist, published his proof that the universe is heliocentric not geocentric (that the earth was not the centre of the universe but rather revolved

Screening for hypercholesterolemia - new guideline recommends screening of all children and drug therapy for those older than seven. Wise?

2008-07-30T17:08:00.003-04:00

Pediatricians and family physicians alarmed by the growing prevalence of obesity in children in their waiting rooms and increasingly frustrated by their lack of success in encouraging parents to try to get their child(ren) to lose weight and exercise more may welcome the recommendations of the Committee on Nutrition of the American Academy of Pediatrics.<1> The recommendations reverse previous

Type 2 Diabetes - Time to relax: Two clinical trials show no benefit and some risk of tight control of blood sugar

2008-06-16T09:21:00.005-04:00

What your doctor is reading or should beTwo clinical trials published earlier this month show that aggressive control of blood sugar not only failed to yield benefits, it made things worse - higher death rates and more myocardial infarctions and strokes in the group with tight control of their blood sugars, compared with the control group managed conventionally. The ‘ADVANCE’ trial, sponsored by

The irritating imprecision of medicine - will network analysis help?

2008-06-10T09:06:00.008-04:00

A friend of mine thought about buying a car the other day and went to the dealer to inspect new models. He’s interested in reliability of the car as he travels a long distance usually on back roads visiting customers and trying to make sales.“The best model” the dealer said, “is this one. It rarely breaks down, in fact over 10 years only 16% have to be replaced or have major repairs.”“That’s one

Type 1 Diabetes - Ongoing clinical trials of immune suppressant therapy

2008-04-16T15:39:00.004-04:00

What your doctor is reading or should be.April 16, 2008(photo courtesy of nicointhebus (Nicolas Monnot)The recent onset of diabetes in the child of friends of ours led me to the registry of clinical trials. There are 68 studies in the registry recruiting children for studies on type 1 diabetes in children. Our friends, whose son is 8, had already contacted an investigator for one of the trials

Wyeth v. Levine: Should the FDA be held responsible for adverse events?

2008-04-08T16:44:00.003-04:00

Diana Levine, a musician, went to the hospital with severe nausea associated with a migraine headache. She was given Phenergan, a Wyeth drug, by intramuscular injection. When the nausea persisted, the drug was administered by IV push into a vein. Unfortunately some of the drug made contact with arteries in the arm, resulting in arterial damage (a known risk), gangrene and eventual amputation.

US FDA sets standards for medical journals and peer review

2008-02-28T15:34:00.004-05:00

Photo Credit vaneska~tHOmz's In seeking to define standards for ‘good reprint practices’ by pharmaceutical companies seeking to provide copies of journal articles to doctors the FDA has had to grapple with the quality of articles and of journals. That they have failed is hardly a surprise, but that they even tried is quite astonishing given their intimate knowledge of the hundreds (if not

Diabetes cured? - Rosiglitazone trials raise new questions.

2008-02-21T09:12:00.009-05:00

What your doctor is reading, or should be. Today, diabetes in adults is common. Yet, when Banting, Best and others in 1922 showed the effects of a crude extract of pancreatic tissue on the blood sugar of a 14 year old boy the disease was uncommon. <1> Only those who had extremely high blood sugars, usually discovered in childhood with what we would now call Type I diabetes, were diagnosed with

Chronic Knee pain from osteoarthritis and what to do about it - Topical ibuprophen.

2008-02-18T15:52:00.004-05:00

About 1 in 3 adults over the age of 50 have chronic pains in the knees. Most are caused by osteoarthritis, essentially a wearing out of the joint, most likely due to age, prior injuries, obesity or other overuse (work or weight bearing), and in part to one’s genes. If you want to know if you have osteoarthritis a good source is the US National Institutes of Health. They have a patient friendly

Ovarian Cancer

2008-01-28T11:36:00.000-05:00

What your doctor is reading - or should beJanuary 28, 2008Ovarian CancerCancer of the ovaries occurs in about 1 in 50 women over the age of 50 or so. While not that common, the disease is troublesome because it is difficult to diagnosis early and most forms of ovarian cancer are highly malignant, spreading quickly. Thus there has been an interest in detecting the causes of ovarian cancer and

So many small clinical trials, so little information

2008-01-25T14:46:00.000-05:00

January 25, 2008Editors get a lot of manuscripts reporting relatively small clinical trials, in the range of a few hundred study subjects. Such studies can never evaluate clinically meaningful outcomes because like death or hospitalization because these events are rare and require large trials in order to collect enough events for statistical testing. The smallish trials usually measure indirect

Why do pharmaceutical companies keep screwing up?

2008-01-21T09:29:00.002-05:00

Perhaps it’s because they are trying too hard. Or lying to hard. But probably it’s because it is really difficult to bring new compounds to market, costs a lot of shareholder money and is very high risk for failure. It must be similar to designing a new commercial aircraft, or even bringing out a new car model that might or might not be market successful. The difference between a pharmaceutical

What’s a drug company gonna do?

2008-01-18T11:48:00.000-05:00

I feel sorry for the big pharmaceutical companies. They are picked on by pretty much everyone that is not on their payroll, and even some that are. Take Pfizer and GSK and other drug companies for example, accused of deliberately hiding results from clinical trials that had results showing their antidepressants weren’t what they’re cracked up to be. Most of us, if we had to show the world the

Equator - Enhancing the Quality and Transparency of Health Research

2008-01-10T14:15:00.001-05:00

Even General Motors’ design engineers know that to design a new car they must take into account every part that is essential for the vehicle. Further they must be intimately aware and take into account all national and state regulations that govern automobile design, construction and assembly. They have a check list. This is important because of the human and economic costs that result if