Associated Press:
Some of the world's biggest drug companies are working behind the scenes to convince regulators to let older cholesterol-lowering drugs be sold without a prescription in low doses, as Britain has just done.

While doctors say the drugs are safe, less than one-half of Americans who could benefit take them, mostly those at highest risk of heart disease, other complications and death, experts say. Most of the ...

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Loopy fish

Loopy fish, who designed this website, has commented on his design of the Kevin, M.D. blog template as well as the usability of the recently improved Blogger. Check out his very interesting blog of eclectic interests.

Today's NEJM released studies from the Netherlands and from the Framingham Study concluding that elevated homocysteine levels being a predictive risk factor for osteoporosis.

Here are comments from the accompanying editorial:
Whether it is a culprit or a bystander, homocysteine can now be added to the growing list of risk factors for fractures. Its use might increase the predictive power of an assessment based not ...

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The UK is the first country to allow statins to be sold over-the-counter. It's inevitable that statins will be OTC in the United States when the US patent for Zocor expires in 2006. With the success of OTC Claritin and Prilosec, pushing medications to OTC status will allow drug companies to continue reaping profits after patent expiration.

Risks of elevated liver enzymes, muscle aches, as well as ...

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There has been conflicting data regarding the efficacy of Echinacea for the common cold. Another study came out suggesting it doesn't work:

After exposing 48 healthy adults to a virus that causes the common cold, U.S. investigators found that people who took Echinacea were no less likely to develop colds than people who took an inactive placebo pill.

AMNews:
Cold kits stifle pleas for antibiotics

Minnesota physicians may have found a way to satisfy patients who hate to take no for an answer where antibiotics are concerned, researchers announced Feb. 29 at the International Conference on Emerging Infectious Diseases.

Patients with upper respiratory illnesses or acute bronchitis were provided boxes filled with over-the-counter pain relievers, decongestants, cough syrup and lozenges, powdered chicken soup and a teabag ...

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The ACP released a paper today focusing on uncompensated care for the uninsured. This paper coincides with Cover the Uninsured Week taking place from May 10-16:
In 2001, for instance, the American health care system provided close to $99 billion in care to uninsured patients, $35 billion of which was uncompensated.

Hospitals provided $24 billion of that care while physicians volunteered about $5.1 billion in uncompensated care, including ...

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I recently saw a case of a young lady for shortness of breath. No other medical issues, only medication was oral contraceptives. No family history of blood clots. Chest X-ray clear, no desaturations on room air. My pre-test probability for pulmonary embolus was quite low, however she was concerned and asked to be "checked for a blood clot". With such a low index of suspicion, ...

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Reuters:
"Herbal" Viagra and other so-called natural alternatives for treating impotence advertised on the Internet and in men's magazines are often contaminated with real drugs and could kill those who take them, researchers said on Monday.

"These are being marketed as being safe and natural products," said Dr. Neil Fleshner of Princess Margaret Hospital in Toronto, Canada. "It is plausible that deaths have occurred or could occur."


Like ...

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AMNews:
A family sued their infant's pediatrician, an emergency department physician and an on-call pediatrician at the hospital for not ordering a CT scan. To the doctors, the 11-month-old boy appeared normal and in no need of the test.

But after the infant had more serious injuries resulting from an incident at his babysitter's home a couple of weeks later, the parents faulted the physicians for not ordering ...

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AMNews:
Smoking cessation success reported

Training nurses and medical assistants who register patients at primary care facilities to use specific, guideline-based methods to encourage smoking cessation increases the likelihood that patients will successfully quit, according to a study published in the April 21 Journal of the National Cancer Institute.

Researchers tested the effectiveness of guidelines developed by the Agency for Healthcare Research and Quality in a randomized, controlled ...

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Boston Globe:
The Food and Drug Administration yesterday rejected over-the-counter sale of the emergency contraceptive Plan B, saying that the distributor had not proven that young teens can take the drug safely without a doctor's guidance.

The decision was an unusual repudiation of the the lopsided recommendation of the agency's own expert advisory panel, which voted 23-4 late last year in favor of the switch and 27-0 that ...

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AMNews:
In what's believed to be the first lawsuit of its kind, a Texas patient who presented a fake ID and the patient's father were allowed to go forward with a civil lawsuit against a physician who gave the girl an abortion without contacting her parents.

Cherise Mosley Hughes first came into the clinic where Houston general practice physician Douglas Karpen, DO, works in the summer of 2000. She ...

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I'm flying soon, and thought this would be a relevant article to share.

Prescriber's Letter:
Practical Tips for Avoiding "Economy Class Syndrome"

What Is Economy Class Syndrome?

Economy class syndrome is a condition that can happen after sitting in a cramped space, such as the economy class section of an airplane. This can lead to blood clots in the legs and sometimes the ...

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Boston Globe:
2 chains urge OK for drug imports
CVS, Walgreens add to growing support

The nation's two largest chain drugstores, CVS and Walgreens, launched a challenge to the nation's drug manufacturers yesterday by calling on the Bush administration to develop a legal, safe channel for Americans to buy imported drugs.

CVS Corp.'s Tom Ryan, chairman and chief executive of the Rhode Island company, led the way ...

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AMNews:
Doctors prefer prescribing newer blood pressure drugs

Physicians are more likely to prescribe newer anti-hypertensives than their less expensive predecessors recommended by the Joint National Commission on High Blood Pressure Treatment, according to a study published in the December Journal of General Internal Medicine.

Researchers at the University of Michigan surveyed 1,700 primary care physicians, finding that most believed diuretics were less effective and that beta-blockers had ...

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Although the United States spends more on health care than any other industrialized country (the United States spent $4,887 per capita on health care in 2001, compared to $2,792 in Canada, $2,513 in Australia and $1,992 in Britain) - totalling more than 1.4 trillion dollars, there continues to be a sizable portion without health insurance. This is simply unacceptable. Next week is "Cover the unisured week" to ...

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The Prescriber's Newsletter cites a study that comments on the use of antibiotics for ear infections. Using the statistical variable, Number Needed to Treat (NNT) and Number Needed to Harm (NNH) helps put data into perspective:

The number needed to treat is 15...you have to give antibiotics to 15 kids for ONE to benefit.

But you must also consider the number needed to harm...only 12. Treating ...

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This past Sunday, 60 Minutes did a piece on the emergence of drug-resistant bacteria. One of the major contributing factors is the overprescription of antibiotics for non-bacterial infections:

While we can't stop the bacteria from trying to outwit antibiotics, health officials say a dramatic cut in their use could help reverse the tide. That means doctors will have to stop writing, and patients will have to stop demanding, ...

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AMNews:
Final data from WHI's estrogen-only arm published

Estrogen-only hormone therapy for postmenopausal women does not affect coronary heart disease but increases the risk of stroke by 39% while decreasing the risk of hip fracture by 39%, according to a study published in the April 7 Journal of the American Medical Association.

Therapy was also associated with an increased risk of breast cancer, although this was not statistically ...

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