Thursday, October 14, 2004

BMJ--Lessons from the withdrawal of rofecoxib

British Medical Journal: Lessons from the withdrawal of rofecoxib:

""Suggested measures to ensure drug safety before definite licensing of a drug:
  • Legal requirement for drug companies to register all randomised controlled trials prospectively
  • Legal requirement for drug companies to make all data on serious adverse events from clinical studies publicly available immediately after study completion
  • Continuously updated systematic reviews of adverse events based on published and unpublished data from randomised controlled trials and observational studies
  • Phased introduction of new interventions in independent, large scale, randomised trials before definite drug licensing
  • Clear cut financial firewalls between pharmaceutical companies and researchers performing systematic reviews and clinical studies

Wednesday, October 13, 2004

NEJM -- Controlling Health Care Costs

Just released by the New England Journal of Medicine--Controlling Health Care Costs (no registration required for this article):

""Every year, without fail, spending for services covered by private health insurance increases. Sometimes health care spending grows slowly, as it did in the mid-1990s during the managed-care boom. But more often, it increases rapidly, as it is doing now--in part because of the managed-care bust. Presidential candidates do not want to venture beyond platitudes concerning costs because they risk being accused of taking things away from people. Both President George W. Bush and Senator John F. Kerry have served up proposals designed to ease voters' angst about the affordability of health care, but neither proposal, as it has been elaborated through September, gets at the core issues involved in controlling the growth of health care costs.""

Tuesday, October 12, 2004

Pennsylvania Medical Society | FAQ: Act 13 Physician Self-reporting Rules

Pennsylvania Medical Society | FAQ: Act 13 Physician Self-reporting Rules:

  • How did the physician reporting provisions come to be included in the law?
  • What tort and insurance reforms were created by Act 13?
  • What patient safety elements were included in the law in exchange for these reforms?
  • What are the physician reporting requirements under Act 13, and should physicians be alarmed by these or by the State Board’s investigation process?
  • How does the State Board determine which cases warrant an investigation?

Sunday, October 10, 2004

JCAHO Sentinel Event Alert: Intraoperative Awareness

Sentinel Event Alert, Issue 32 - October 6, 2004: Preventing, and managing the impact of, anesthesia awareness

" "Anesthesia awareness is under-recognized and under-treated in health care organizations. The Joint Commission recommends that health care organizations which perform procedures under general anesthesia do the following to help prevent and manage anesthesia awareness:

1) Develop and implement an anesthesia awareness policy that addresses the following:
  • Education of clinical staff about anesthesia awareness and how to manage patients who have experienced awareness.
  • Identification of patients at proportionately higher risk for an awareness experience, and discussion with such patients, before surgery, of the potential for anesthesia awareness.
  • The effective application of available anesthesia monitoring techniques, including the timely maintenance of anesthesia equipment.
  • Appropriate post-operative follow-up of all patients who have undergone general anesthesia, including children.
  • The identification, management and, if appropriate, referral of patients who have experienced awareness.

2) Assure access to necessary counseling or other support for patients who are experiencing post-traumatic stress syndrome or other mental distress."


Tuesday, October 5, 2004

Medscape Bioterrorism Resource Center

Medscape maintains an excellent Medscape Bioterrorism Resource Center. Registration does not appear to be required for access to this resource, either.

""This Resource Center provides clinicians with the latest news, reference material, literature selections and continuing education about potential bioterrorism agents. It is designed to help healthcare professionals identify the signs and symptoms of such agents and thus be better prepared to respond in the event of a bioterrorism outbreak.""

Topics covered include:

Viral Hemorrhagic Fevers

The question I have to answer is:
a) should I have myself re-vaccinated and
b) should I approach my wife about having our two sons vaccinated.

Any informed opinions are


Monday, October 4, 2004



""Skyscape has released MGHAnes™ which is the Skyscape version of Clinical Anesthesia Procedures of the Massachusetts General Hospital, 6th Ed.

The best-selling handbook, Clinical Anesthesia Procedures of the Massachusetts General Hospital, Sixth Edition, is now available in PDA format. This easy-to-navigate handheld reference provides instant access to current, comprehensive, concise, consistent, and clinically relevant guidelines for anesthesia procedures throughout the preoperative, intraoperative, and postoperative periods. Coverage includes a comprehensive, alphabetical drug appendix, adult and pediatric resuscitation guidelines, malignant hyperthermia protocols, an anesthesia machine checklist, and information on complementary and alternative medicine and end-of-life issues


[Via The Palmdoc Chronicles]

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