In 2003 in the BMJ, Wald and Law and a supporting editorial by then editor Richard Smith, proposed that 80% of heart attacks and strokes could be prevented by widespread use of a six drug polypill. The six ingredients were a statin, three low-dose antihypertensives (a thiazide, an ACE inhibitor and a beta blocker), folic acid, and aspirin. Although there was a lot of derision at that time and there has ...

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Most parents and all pediatricians are aware of the 1998 study published in The Lancet by Dr. Andrew Wakefield that mentioned a causal link between measles, mumps, rubella (MMR) vaccine and the increased incidence of childhood  autism.  It shook the medical community and created an international movement of parents questioning the extensive combination of immunizations that are given to children.  Could these immunizations be the cause of the increase in ...

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by John Horton When the FDA was created in 1906, not even Nostradamus could have predicted the medical advances that would come to extend and improve our lives: childhood vaccines, insulin, and the use of lasers in surgery were all unimaginable a century ago. While many future advances are beyond our imaginations’ reach, it seems certain that the advances in biologics -- medicines made from living organisms -- will stand out as ...

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There is a lot of press about a study recently published in the New England Journal of Medicine that shows that adding tiotropium (Spiriva) to an inhaled steroid might have benefit in asthmatic patients. This study is creating a lot of buzz due to recent concerns of ICS/LABA safety and might prompt doctors and patients to start switching (some already have before this study came out). However, this ...

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Part 3 of a series.  Please read part 1, DTC advertising, and its history with the FDA, and part 2, Economic and commercial impact of DTC advertising. In the first two parts of this article, we explored the historical and legal contexts of direct-to-consumer (DTC) advertising, the effects of these ads on prescribing behavior, and the economic incentives to advertise. In this final installment, we will examine what ...

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New medicines are like new fashions in clothing. They are introduced with great fanfare. Most turn out to seem fairly ordinary after a few years. Some are quickly forgotten or discarded and make us say: “What was I thinking?” Evaluating a new drug is difficult, for the pharmaceutical and scientific communities as well as for us clinicians. It often takes years of general use before a drug can really prove its ...

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As a primary care doctor, I have figured out many tricks for helping patients save money on prescriptions. Some of them I am sure you have never heard of, and others , well -- you might have, but they bear repeating. All of the prices quoted here are from Costco, unless otherwise specified. 1. Price compare between pharmacies. Can't stress enough the potential differences in medicine prices between pharmacies. Generic medicine prices vary more than ...

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What’s happened to psychiatry over the last 15 to 20 years? That’s a big subject, discussed in many recent and excellent books. One of those books is by Daniel Carlat, author of Unhinged: The Trouble with Psychiatry – A Doctor’s Revelations about a Profession in Crisis. One of the problems Carlat readily acknowledges is that psychiatry is excessively focused on psychopharmaceuticals at the ...

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With the darker days upon us, it may be tempting to try to fight fatigue with energy drinks. Ever wonder what’s really in them and what they might be doing to you? I just came across an article in the November issue of the Mayo Clinic Proceedings that broke it down nicely. Here’s the summary. Caffeine.  No brainer. Interestingly, it is on the list of substances banned by the International Olympic Committee (which is ...

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Antibiotics for viral infections are a big pet peeve of mine. No. Make that a huge pet peeve. Some doctors prescribe antibiotics for coughs and stuffy noses because the patients want them. If you’re one of those patients who think that antibiotics make your coughs go away, or clear up your stuffy noses, or somehow make your sinus headaches vanish, or if you’re a doctor who prescribes antibiotics for these symptoms, ...

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