Grand Rounds 11
Dr. Charles gives you the weekly best of the medical blogosphere.

Update:
Nick gives the upcoming hosting schedule.

Study: Celebrex Safer on Heart Than Vioxx
"A new study finds that Celebrex, the first in a family of stomach-friendly painkillers called cox-2 inhibitors, is safer for the heart than Vioxx, a similar drug that has been linked to cardiovascular problems."

This is a case-control study from the Annals of Internal Medicine. Those who used Vioxx had a 2.72 times higher risk of an MI than those who ...

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The Disparate Consensus on Health Care for All
The need for universal coverage is clear. The debate on how to implement it continues.

Portrayal of Doctors in Movies Serves as Public Opinion Gauge
Glenn Flores, M.D. watches a lot of movies.

Harvard Health Letter Picks 2004's Top 10 Health Stories
Nice list of the most talked about this year.

ADD Grows Up
"ADD medications are becoming a fad, and Caplan says the seductive marketing campaigns are designed mainly to sell drugs to people "” whether they need them or not.

'Doctors these days feel pretty besieged. And a lot of them are gonna say, 'I'm not gonna fight with my patients. They come in, they want something I think is trivial, I don't believe it's gonna ...

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Ten troublesome trends in TV health news
"A 2002 Gallup poll showed that many Americans consider television their most important source of news and information on health. It also showed that television is one of the least trusted sources of such news and information. I studied each of the 840 health news stories that appeared between February and May 2003 on four television stations (KARE, KSTP, KMSP, ...

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Cash-only doctors: The future of medicine?
"'Instead of paying $600 to $700 per month for insurance with a $10 co-pay when you visit a doctor's office, why not pay $150 per month for catastrophic coverage with a $2,000 deductible?' he asked. Then use some of the money saved ---- $450 to $550 per month ---- to pay cash for regular physician office visits and tests."

Exploring the feasibility of ...

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X-ray snafu cost my life
Not communicating an X-ray result leads to a lawsuit. Never assume that "no news is good news". Always followup on lab and X-ray tests.

Is It Botox, or Is It Bogus?
"It sounds like someone was cooking up some Botox in their kitchen or basement and got it wrong . . ."

Following up the story mentioned here a few days ago.

Some hospital ERs begin guaranteeing quick service
"Anyone who has spent half the night in an emergency room will welcome a trend that has some hospitals guaranteeing patients will be seen in 33 minutes or less."

Apologies for the extended downtime today. If it happens too often, I may be shopping for a new server to host the blog.

I have had a great response to the recent case discussions. However, there has been some concern regarding patient privacy. A couple of points to clarify. First, all identifying information has been removed, and the presentation changed. For instance, a "65-year old man shoveling ...

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Experts Fear Medicare Won't Work for Nursing Home Patients
"A wide range of experts on long-term care express serious concern that the new Medicare law will be unworkable for most of the 1.5 million Americans who live in nursing homes.

Nursing home residents take large numbers of prescription drugs, an average of eight a day. But many have physical disabilities and brain disorders that impair their memory ...

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More tests, less acumen reshaping medicine
"More non-essential tests are being ordered by doctors because of that fear, according to Dr. Kopjas.

'Do doctors over-order tests? Absolutely,' he said. 'Look at what happens in the ER (emergency room) and how many CAT scans are ordered there.'

The effect of not being able to rely on clinical acumen is discouraging for medical professionals, according to Dr. Kopjas.

'There ...

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Opinion: Market-driven medicine
"While it is morally and ethically a necessity to take care of those who are without adequate resources, those able should accept first-dollar responsibility for their medical costs by contributing to HSAs (health savings accounts) and purchasing high-deductible insurance. If you control where you buy care, you are more likely to see a market-driven economy resulting in reduced medical costs. Most important, take personal responsibility for ...

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FDA panel questions safety of female sex-dysfunction drug
"A federal advisory panel voted unanimously yesterday that the first drug to enhance the sex drive of women should not be approved because there is not enough information about its long-term safety."

Not surprising in the wake of Vioxx and hormone replacement therapy. Expect the FDA to increasingly act on the side of caution.

Consumer Reports - Best Buy Drugs
"Visitors to the Consumer Reports Best Buy Drugs website will be able to view the latest findings about the comparative effectiveness and cost-effectiveness of many widely used prescription drugs. We will tell you what you need to know when you talk to your doctor about switching to more cost-effective medications."

I'm looking forward to this and curious how they're going to implement ...

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40 Percent in U.S. Use Prescription Drugs
"The annual report on Americans' health found that just over 44 percent of all Americans take at least one prescription drug, and 16.5 percent take at least three . . .

Prescription drugs, which make up about one-tenth of the total medical bill, were the fastest growing expenditure."

Put two and two together, and it's small wonder why health costs are ...

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'Blog' No. 1 word of the year
"Merriam-Webster Inc. said on Tuesday that blog, defined as 'a Web site that contains an online personal journal with reflections, comments and often hyperlinks,' was one of the most looked-up words on its Internet sites this year."

A testament to the surging popularity of the blog format. My blog was started in May 2004, and now has grown to 10,000 unique ...

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Reefer madness hits the Supreme Court
Chris Rangel writes about the current issue of medical marijuana that the Supreme Court is pondering.

Here is what the Mayo Clinic writes about the medical applications of marijuana.

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