Thursday, June 7, 2007

At risk: vaccines - The Boston Globe

The Boston Globe

"Certainly there is plenty of evidence to refute the notion that vaccines cause autism. Fourteen epidemiological studies have shown that the risk of autism is the same whether children received the MMR vaccine or not, and five have shown that thimerosal-containing vaccines also do not cause autism. Further, although large quantities of mercury are clearly toxic to the brain, autism isn't a consequence of mercury poisoning; large, single-source mercury exposures in Minamata Bay and Iraq have caused seizures, mental retardation, and speech delay, but not autism.  

Finally, vaccine makers removed thimerosal from vaccines routinely given to young infants about six years ago; if thimerosal were a cause, the incidence of autism should have declined. Instead, the numbers have continued to increase. All of this evidence should have caused a quick dismissal of these cases. But it didn't, and now the courthas turned into a circus. The federal and civil litigation will likely take years to sort out."


[Via PointofLaw.com]


Thursday, March 8, 2007

Details On Why We Get Migraines

"A University of Iowa study may provide an explanation for why some people get migraine headaches while others do not. The researchers found that too much of a small protein called RAMP1 appears to "turn up the volume" of a nerve cell receptor's response to a neuropeptide thought to cause migraines.

"The neuropeptide is called CGRP (calcitonin gene-related peptide) and studies have shown that it plays a key role in migraine headaches. In particular, CGRP levels are elevated in the blood during migraine, and drugs that either reduce the levels of CGRP or block its action significantly reduce the pain of migraine headaches. Also, if CGRP is injected into people who are susceptible to migraines, they get a severe headache or a full migraine.

"We have shown that this RAMP protein is a key regulator for the action of CGRP," said Andrew Russo, Ph.D., UI professor of molecular physiology and biophysics. "Our study suggests that people who get migraines may have higher levels of RAMP1 than people who don't get migraines." "

The abstract is here.



Wednesday, March 7, 2007

Aspirin/NSAIDs For Colorectal Cancer Prevention Discouraged

"People who are at average risk for colorectal cancer, including those with a family history of the disease, should not take aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) to try to prevent the disease, according to a new recommendation from the U.S. Preventive Services Task Force. The recommendation is published in the March 6 issue of the Annals of Internal Medicine."

"USPSTF assessment: Overall, the USPSTF concluded that harms outweigh the benefits of aspirin and NSAID use for the prevention of colorectal cancer."

[AHRQ]



Friday, November 24, 2006

Anesthesia is safer than ever (even in France)

Anesthesiology--Survey of Anesthesia-related Mortality in France.

" Conclusion: In comparison with data from a previous nationwide study (1978-1982), the anesthesia-related mortality rate in France seems to be reduced 10-fold in 1999. Much remains to be done to improve compliance of physicians to standard practice and to improve the anesthetic system process."


Thursday, November 23, 2006

On Negotiations With Hospitals, Insurers, and Physicians

Contract Negotiations Between Insurers, Hospitals Increasingly Acrimonious

" The AP/Arizona Daily Star on Monday examined how contract negotiations between insurers and hospitals increasingly have "taken an ugly turn" as both sides work to control rising costs. Insurers "are under pressure to lower premiums to win business," while hospitals believe that insurers are "skimping on payments to boost their earnings," the AP/Daily Star reports."

The exact same can be said for negotiations between hospitals and physician groups and insurance companies and physician groups. It all reminds me of that scene in Star Wars where the good guys are stuck in a trash compactor after their escape from the brig--all attempts to stop the walls from moving from the inside fail. (what, you were expecting a reference to Greek mythology?)



Sunday, June 11, 2006

VA Physicians Data Apparently Also Lost

A laptop containing names, social security numbers, and dates of birth on 26 million veterans was stolen from a VA employee's home on May third. Though extremely concerning, I had no reason to think my data was on that laptop. After all, I'm not a Veteran. A letter arrived yesterday informing me that "[a]s a result of this incident, information identifiable with you was potentially exposed to others." I've worked at the Veterans Administration providing anesthesia care. I can only assume that the laptop contained more than just data on 'veterans and some spouses' but some physicians as well.

I must say I'm surprised by this breach of security. In my experience with the VA, their IT security policies were among the most rigorous and thorough.



Sunday, March 5, 2006

Vaccines, Mercury, and Autism--New Data

My smart wife tells me that this article is really big news: Early Downward Trends in Neurodevelopmental Disorders Following Removal of Thimerosal-Containing Vaccines (pdf). I've quoted the entire abstract below:

"Contemporaneously with the epidemic rise in neurodevelopmental disorders (NDs), first observed in the United States during the 1990s, the childhood immunization schedule was expanded by the U.S. Centers for Disease Control and Prevention (CDC) to include several additional thimerosal-containing vaccines (TCVs). On July 7, 1999, a joint recommendation was made by the American Academy of Pediatrics (AAP) and the U.S. Public Health Service (PHS) to remove thimerosal from vaccines. A two-phase study was undertaken to evaluate trends in diagnosis of new NDs entered into the Vaccine Adverse Event Reporting System (VAERS) and the California Department of Developmental Services (CDDS) databases on a reporting quarter basis, from 1994 through 2005. Significant increasing trends in newly diagnosed NDs were observed in both databases 1994 through mid-2002. Significant decreasing trends in newly diagnosed NDs were observed in both databases from mid-2002 through 2005. The results indicate that the trends in newly diagnosed NDs correspond directly to the expansion and subsequent contraction of the cumulative mercury dose to which children were exposed from TCVs through the U.S. immunization schedule."

The big news is the last sentence: trends in newly diagnosed ND's [ed: autistic spectrum disorders] correspond directly to the expansion and subsequent contraction of the cumulative mercury dose to which children were exposed from TCVs through the U.S. immunization schedule.

There were suspicions during the time that vaccines contained Thimerisol that it was responsible for an associated increase is the so-called autistic spectrum disorders. The suspicion was based on reports of increases in autism in the community. These were explained away by the observation that diagnosis had become much better during the same time period and the fact that scientific data supporting such a link were of very poor quality. Nonetheless, many parents chose to forgo immunization of their children out of concern that vaccination would increase their risk of autism or related disorders. Skipping immunization did not increase their risk of infectious disease because of herd immunity, up until enough members of a population are unprotected and disease can once again propagate among the non-immunized.

There are ongoing flame wars among blogs about this issue, but his article should cause many of those involved to rethink their position.



Tuesday, February 28, 2006

Is this what Constant Gardener Was About?

Desperate for Dollars - The Nation of Guinea Pigs:

"How India became the global hot spot for drug trials. Big pharmas have a billion people vying to be part of clinical trials of untested drugs. Areas known only for snakes and heat now have good hospitals after the government passed a law allowing the drug testing and advertised its "treatment naive" patients."

[Via digg]



Sunday, February 26, 2006

Gum, one stick, p.o. times 1 hour, TID prn ileus

Gum Chewing May Speed Recovery From Postoperative Ileus:

"In a randomized study, gum chewing was associated with faster recovery after elective open sigmoid resection by stimulating bowel motility. (CME,CE)
"

Something to mention across the ether screen Monday....

[Via Medscape Headlines]



Wednesday, February 8, 2006

Aspect Medical Fearmongering Pays Off

Aspect Medical is the company that sells the 'awareness' monitors for anesthesia. Their product is the one featured so prominently in photos accompanying every print story I've seen on intra-operative awareness. This Yahoo Finance headlines seems to indicate it's paying off:

"Aspect Medical posts revenue, profit gains in 2005 (bizjournals.com via Yahoo! Finance):
Aspect Medical Systems Inc. ended 2005 with a large jump in both revenue and net income, as demand for its anesthesia monitoring systems expanded at a healthy clip."

Full disclosure: I still don't use a BIS monitor

[Via Yahoo Search: anesthesia]

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