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- 14.07.2010 What Would You Do About an Impaired or Incompetent Colleague?
Only two thirds of U.S. physicians with direct knowledge of a colleague's incompetence to practice medicine have reported it, according to a JAMA study.
Some 1900 physicians responded to a 2009 survey on professionalism. The survey focused on what respondents would do in the face of an impaired or incompetent colleague. + zobacz więcej - 13.07.2010 Drug Maker Purportedly Hid Information on Rosiglitazone Risks for a Decade
GlaxoSmithKline has known about the elevated heart risks with its diabetes drug rosiglitazone (Avandia) since 1999 — and has been attempting to hide the data since then — according to the New York Times.
The Times reports that a 1999 study showed that the drug was no better than its competitor, pioglitazone (Actos), and that there were "clear signs that it was riskier to the heart." However, the company failed to publish the findings or submit them to federal regulators. + zobacz więcej - 13.07.2010 Current Screening Guidelines Miss Children With High Cholesterol
Limiting pediatric cholesterol screening to children with positive family histories misses a substantial number who might benefit from treatment, according to a Pediatrics study.
Researchers examined data on some 20,000 fifth-graders in West Virginia who underwent lipid measurement and provided family history information as part of the CARDIAC project. + zobacz więcej - 13.07.2010 A Single Question Can Accurately Identify Drug Use in Primary Care
A single question can help identify drug use disorders among adult primary care patients, according to an Archives of Internal Medicine study.
The study included some 300 adults in an urban primary care waiting room. Researchers asked each patient: "How many times in the past year have you used an illegal drug or used a prescription medication for nonmedical reasons?" One third of patients said they had done so at least once and thus were considered to have a drug use disorder. + zobacz więcej - 13.07.2010 Vitamin D Deficiency Associated with Dementia and Parkinson Disease
Two studies seem to point to vitamin D deficiency as having a role in both cognitive decline and Parkinson disease, but commentators aren't certain about the clinical implications.
One study, published in the Archives of Internal Medicine, followed some 850 older adults for about 6 years. Low serum levels of vitamin D at the outset of the study were associated with substantial cognitive decline (as measured by the Mini-Mental State Examination) by study's end. Editorialists caution that "low vitamin D levels may simply be a marker for lower health status than a cause of it." They write that "a rigorous evidence base ... does not currently exist" to favor using vitamin D supplementation to improve health outcomes. + zobacz więcej - 12.07.2010 FDA to Consider Market Withdrawal of Rosiglitazone
An FDA advisory committee will review whether to recommend withdrawing the antidiabetic drug rosiglitazone (Avandia) from the U.S. market because of cardiovascular risks.
On July 13 and 14, the committee will also consider whether to recommend halting or altering an ongoing manufacturer-sponsored postmarketing trial of rosiglitazone's safety that the FDA mandated in 2007. The trial aims to compare the cardiovascular safety of rosiglitazone with that of placebo and of pioglitazone (the other thiazolidinedione on the market). + zobacz więcej - 12.07.2010 Follow-Up: Interview on Patients' Self-Titrating Drug Dosages in Hypertension
The Journal Watch podcast "Clinical Conversations" has an interview with Dr. Gbenga Ogedegbe, the editorialist from last week's Lancet paper in which hypertensive patients had better pressure control when they titrated their own medications under pre-agreed rules. + zobacz więcej - 09.07.2010 Cigarette Use Declining Slowly Among U.S. High School Students
Cigarette use among U.S. high school students is declining, but at a very slow pace, according to an MMWR report.
CDC researchers examined data from the Youth Risk Behavior Survey from 1991 through 2009. The anonymous survey showed that, in general, cigarette use among high school students increased during the early and mid-1990s, began to decline somewhat rapidly in the late 1990s, and then slowed to a gradual decline after 2003. In 2009, nearly half of high school students had ever tried smoking, 20% were current smokers, and 7% were current frequent smokers. + zobacz więcej - 09.07.2010 Veterans' Agency to Ease Rules for PTSD Claims
Patients may ask about a report from the New York Times that the Department of Veterans Affairs will make it "substantially easier" for veterans to receive disability benefits for post-traumatic stress disorder. The rules will apply to veterans of all wars, not just the most recent ones.
Under the new rules, first proposed last summer and scheduled to take effect as early as next week, veterans will not have to document specific events that may have caused PTSD. Claimants need "simply show that they served in a war zone and in a job consistent with the events that they say caused their conditions," according to the Times. + zobacz więcej - 09.07.2010 FDA Warns of Risks of Using Malaria Drug Qualaquin for Leg Cramps
Qualaquin (quinine sulfate), a malaria drug, should not be used off-label to prevent and treat nighttime leg cramps due to the risk for serious side effects, the FDA warned on Thursday.
Thirty-eight cases of serious side effects associated with quinine use — including two deaths — were reported to the FDA's Adverse Event Reporting System between 2005 and 2008. Side effects included kidney damage, thrombocytopenia and other hematologic reactions, hearing loss, and cardiovascular problems. Most of these reports were the result of off-label use for leg cramps or restless leg syndrome, according to the agency. + zobacz więcej
