Rich Tucker and Benjamin Pugh take their shots.

Raising HDL

Now that Pfizer's torcetrapib was DOA, how can you raise HDL? Well, there's plain old exercise for starters:

A regular aerobic exercise program of at least two hours a week produced a small but significant increase in HDLs, according to a meta-analysis.

GruntDoc on the recent NY Times' piece on stroke and use of tPA:

It's a tour-de-force in obfuscation of fact, presentation of tragedy as preventable, and the presentation of TPA as an ignored wonder-drug, MRI should be the standard of care for new strokes, and frankly there's no redeeming value within.

Expansion of Massachusetts General Hospital is causing some worry:

Slavin is right that the people of Massachusetts expect much from the hospital: the best of care no matter how difficult the case, the training of physicians, and advances in medical research. But government, business, and consumers in the state can only afford so much. The long-term cost trends at MGH will be evident in a year or two, when ...

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The AMA and Sermo

The AMA decides to join to 21st century and partners with Web 2.0 upstart Sermo. Pharmalot shares some concerns about the deal.

Heart attacks, anxiety, depression and suicide often contribute to the high mortality rate in whistle-blowers. (via Health Care Renewal)

An ignorant DA is continuing with charges against diabetic Doug Burns, who was arrested during a hypoglycemic episode:

. . . the authorities pressing charges are publicly chastising Doug for negligence in his diabetes care, on the basis that he was temporarily on injections rather than his usual Animas pump at the time of the incident. This was because he had run out of infusion sets during recent ...

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Is potentially happening in the Czech Republic.

It's not single-payer and doesn't have a "doctor tax", so label me cautiously optimistic on Mr. Obama's proposal right now.

Kate Phillips, John McCormick, and Ezra Klein with the requisite analysis.

This pediatrician says no:

My advice is to forget about obtaining your kids' cholesterol level. More importantly, don't burden them with an explanation of the genesis of adult diseases, like atherosclerosis and its discontents. All a kid needs to know is that some things are "healthy" and some are not.
(via White Coat Notes)

Will there be enough primary care physicians to go around? At least I'll have some job security.

An observer at a recent GI conference notes the pharma influence:

The Shire Pharmaceuticals' booth offered weary physicians a park-like atmosphere complete with gently rolling grassy hills, stone paths, park benches, and free hot dogs. The Abbott booth contained a mini-movie theater. On every aisle, companies provided free slushies, gourmet espressos, coffee, tea, sweets, hot dogs, and fresh pretzels. They also offered beach towels, blankets, movies, free internet access, ...

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David Phillips rips major media, Steven Nissen and the NEJM in this scathing entry:

Like the yellow journalism that set us on a collision course to war with Spain in 1898, many journalists are sensationalizing Nissen's opinions to sell newspapers and/or magazines"”with little regard for those most likely to be impacted by the findings"”type 2 diabetes mellitus patients currently taking Avandia (and who might make unilateral decisions to stop taking ...

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Peter Rost further stirs the pot on Pfizer promoting the off-label use of Mirapex for restless leg syndrome (RLS). The thing is, Mirapex really is recommended as first-line treatment for RLS (via UptoDate):

Begin with pramipexole [Mirapex] (0.125 mg) or ropinirole (1.0 mg) approximately one hour before the usual time of symptom onset; the dose is titrated upward according to response. These drugs are effective and well ...

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Hilarious codes for things EMTs may encounter in the field. I like 20-301, "Overdose on normal dose of Ambien (also known as sleep)."

Brett Skinner: "Canada's public health insurance monopoly is failing and millions of Canadian patients wait so long for treatment that they are no better off than uninsured Americans."

Canada is planning a US-style war on drugs. Don't, says this op-ed:

Instead, there are signs -- such as the Conservative distaste for safe-injection sites that are a key component of the "harm-reduction strategy" -- that Ottawa is tilting toward a more aggressive, U.S.-style war on drugs. If that is the case, it would be an unfortunate mistake with predictable and very disappointing outcomes.

While Washington from time ...

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How you play golf can point to a variety of health problems:

You ride the golf cart. If a golf cart is essential, you probably need to improve your fitness . . .

Short drives. If your drives aren't going very far, it's often a sign of a flexibility problem in your lower body, particularly your hip muscles. . .

Accuracy problems. If the ball is consistently ...

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The WSJ jumps on the bandwagon against the NEJM, as discussed in the blogosphere last week:

At what cost do political machinations of the medical journals come? NEJM editors have long favored more drug regulation. But medical journals have also historically played a special role in helping to define medical practice standards. Even decisions they make on how prominently to place a study, let alone how they ...

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Edwin Leap thinks not:

Attention patients and families of patients, regulators, government officials, commentators, angry bloggers and reporters: I am the physician. That makes me the expert. I realize that we live in the age of polls, surveys, empowerment and self-help. I realize that the opinion of the masses generally matters more than the opinion of the educated. But as one of the educated, ...

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