Tuesday, January 24, 2006
No Trasylol For Me or My Patients, Please
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Trasylol (Aprotinin) is a very expensive drug used during many kinds of cardiac surgery to reduce blood loss. In today's print edition of the NEJM (but not online yet) is a very important article by Dennis Mangano (very, very smart anesthesiologist) which shows an "association between aprotinin and serious end-organ damage" including doubling the risk of renal failure requiring dialysis, a 55% increase in the risk of MI or heart failure, and a near doubling of the risk of stroke or encephalopathy. The good news is that there are alternative drugs which cost one tenth as much and are also very good at reducing the need for blood transfusion. More soon....
Monday, January 2, 2006
Baxter Moves Ahead With Generic Sevoflurane
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Baxter moves ahead with drug despite fight (Chicago Sun-Times):
"Unfazed by a continuing legal battle with Abbott Laboratories , Deerfield-based Baxter International will launch its generic inhaled anesthetic sevoflurane in the United States and Japan in the first half of this year."
[Via Yahoo Search: anesthesia]
Sunday, January 1, 2006
Prilosec and C.Diff?
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Reading a blog far afield of medicine, then to the Washington Post, I cam across an interesting nugget on C. Diff. The JAMA published an article on December 21, 2005 titled Use of Gastric AcidâSuppressive Agents and the Risk of Community-Acquired Clostridium difficileâAssociated Disease [abstract]. In two population-based case-control studies:
" The incidence of C difficile in patients diagnosed by their general practitioners in the General Practice Research Database increased from less than 1 case per 100 000 in 1994 to 22 per 100 000 in 2004. The adjusted rate ratio of C difficileâassociated disease with current use of proton pump inhibitors was 2.9 (95% confidence interval [CI], 2.4-3.4) and with H2-receptor antagonists the rate ratio was 2.0 (95% CI, 1.6-2.7). An elevated rate was also found with the use of nonsteroidal anti-inflammatory drugs (rate ratio, 1.3; 95% CI, 1.2-1.5). "
A teleconference is planned for January 18th to discuss these results as part of the new Author-in-the-room series.
Sunday, December 4, 2005
Sales of Impotence Drugs Fall, Defying Expectations - New York Times
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Sales of Impotence Drugs Fall, Defying Expectations - New York Times:
"Seven years after Pfizer made Viagra a cultural touchstone and commercial blockbuster, the market for impotence medicines appears to have fallen well short of what was once predicted."
[Via New York Times]
Sunday, November 20, 2005
Trial lawyers blocking avian flu bill
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ATLA blocking avian flu bill:
" The Washington Post's Jeffrey Birnbaum reports: "Legislation that would pour billions of dollars into the production of vaccines against avian flu and other pandemic diseases is threatened by the trial lawyers' lobby, which objects to proposed limits on lawsuits against drug manufacturers. "
All in the name of protecting patients, I'm sure.
[Via PointOfLaw Forum]
Sunday, October 9, 2005
The Cervical Cancer Vaccine
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The Well Timed Period offers some (well referenced) Q's and A's about the cervical cancer vaccine:
"Q: Why do we need to vaccinate the population at large?
Q: Why are the vaccine trials focused on preferentially vaccinating young women?
Q: Why are HPV 16 and 18 the target of Merck's vaccine?
Q: Are the researchers working on the HPV vaccine aware of potential barriers to its acceptance?
"
She concludes:
" The HPV vaccine is an extremely significant development because it offers tremendous possibility in helping reduce the incidence of abnormal Pap smears, cervical cancer, and genital warts in the United States as well as worldwide. "
Thursday, July 7, 2005
We are all Britons
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[Shape of Days]
Thursday, May 26, 2005
Face-Lift Played Major Part in Woman's Death
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Face-Lift Played Major Part in Woman's Death, City Finds - New York Times:
You may remember the story several weeks ago about an Irish citizen who died the morning after a face lift in a plastic surgeon's office in New York. I've kept a Google Alert on this subject and this popped up today:
" An investigation by the New York City Medical Examiner's Office has concluded that the death of a 42-year-old Irish woman earlier this year was caused in significant part by face-lift surgery she underwent in the Manhattan office of a doctor who has repeatedly been sued for malpractice. "
Not much (any) detail. Maybe more will come out soon.
[Via ]
Thursday, May 19, 2005
Neuromuscular blocker binders around the corner?
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Organon is working on the first of a new class of drugs called selective relaxant binding agents (SRBA). The first drug, called Org 25969, is about to enter phase three trials in the US. These drugs can supposedly reverse neuromuscular blockade at any depth of neuromuscular block by binding the neuromuscular blocker.
Though this news release and the Organon website are short on details, this site has the scoop:
"The novel concept of using a ring-shaped cyclodextrin to engulf a neuromuscular blocking drug is fascinating.2 Cyclodextrins are cyclic oligosaccharides which are recognised to encapsulate lipophilic molecules such as steroids. They are water soluble and well tolerated biologically. Org 25969 consists of eight such sugar molecules in a ring, the outside of which is hydrophilic, and the inside, hydrophobic. The size and shape of the ring is designed to produce a cavity into which a neuromuscular blocking drug such as rocuronium will tightly fit. Org 25969 is capable of forming a binary host – guest complex of high affinity with rocuronium, for two of its externally charged side-chains react with the quaternary nitrogen groups of the muscle relaxant. It is able to encapsulate all four steroidal rings of rocuronium within its lipophilic cavity. This encapsulation or chelation reverses the effect of rocuronium, by preventing its access to the nicotinic receptor and promoting its dissociation from it."
[via Medical News Today]
Saturday, April 2, 2005
DOJ Subpoenas Issued to Orthopedic Companies
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Via Medgadget: DOJ Subpoenas Issued to Orthopedic Companies:
" A press release by
Stryker
Stryker Corporation (NYSE: SYK - News) announced today that it has received a subpoena from the United States Department of Justice requesting documents for the period January 2002 through the present as follows: "any and all consulting contracts, professional service agreements, or remuneration agreements between Stryker Corporation and any orthopedic surgeon, orthopedic surgeon in training, or medical school graduate using or considering the surgical use of hip or knee joint replacement/reconstruction products manufactured or sold by Stryker Corporation."
Based on an initial conversation with a Department of Justice representative, the Company understands that similar requests have been or will be directed to other companies in the orthopaedics industry. Stryker intends to fully cooperate with the Department of Justice regarding this matter.
Something major is going on. Any ideas?"
Only the rampant attempts to influence orthopedic surgical residents and their attendings with dinners, trips to 'schools' to teach techniques, golf games, and on, and on.
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Dec Feb
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