Now we have the mobile lawyer

From EMedConcepts, a physician took this picture of a “mobile lawyer van” parked outside the emergency room. When security chased the van away, it moved across the street where it stayed for the rest of the day. Unbelievable.

Does diet soda increase the risk of cancer?

Just noticed this headline as I was drinking my diet soda. I’ll have to see the actual study myself to come to any conclusion, but here are the salient points from Reuters:

A team at Tata Memorial Hospital in India found a strong correlation between the rise in per capita consumption of carbonated soft drinks in the past 50 years and a documented increase in rates of esophageal …

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Warts and duct tape

Just saw a patient with warts on her hands and remembered there was a small study that was released comparing duct tape and cryotherapy. I quickly Googled it and here’s the data:

In the study, researchers randomly assigned 51 patients, aged 3 and 22, to receive either a maximum of six cryotherapy treatments or two months of “duct tape therapy.”

Duct tape therapy consisted of a nurse …

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Comeback for laparoscopic colectomy

A laparoscopic approach to colon cancer was initially explored in the early 1990’s, but then abandoned due to questions regarding the efficacy for achieving appropriate resection. A recent study from the NEJM, did a controlled trial which concluded similar rates of cancer recurrance between open and laparoscopic resection.

Here is an excerpt from the accompanying editorial:

Approximately 250,000 colonic resections are performed each year in …

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Should statin cholesterol drugs be over the counter?

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.

Osteoporosis and homocysteine

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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Zocor OTC in the United Kingdom

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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Echinacea doesn’t work for colds

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.

Here’s a novel idea to "treat" viral infections

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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Physicians provide more than $5 billion in uncompensated care

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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D-Dimer in pulmonary embolus diagnosis

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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Herbal viagra frauds

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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A case for defensive medicine

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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Progress in smoking cessation

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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FDA rejects emergency contraception against its own advice

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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Deceiving a physician, then suing him

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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How to prevent blood clots when going on airplanes

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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Importing drugs gaining momentum

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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Physicians still prescribing new blood-pressure medication

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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