Modern Medicine

[dai bread]

...and if they're not hounded by patients saying "but I saw it on the telly..."

[piqaboo]

more on why clinical trials cost so much, therefore drugs are expensive.
Also why can take so long to get to market.

Example 1:
in a clinical trial called SEAS (Simvastatin and Ezetimibe in Aortic Stenosis), "results left unanswered whether a drug that has proved highly effective at reducing 'bad' cholesterol offers patients a proven benefit against cardiovascular disease." During this study, "Vytorin was tested against a placebo ..."

1,873 patients, and followed them for four years, USA Today <http://links.mkt1066.com/ctt?kn=84&m=1995464&r=MzEyOTkyODU1OAS2&b=0&j=OTYzNTcxMTUS1&mt=1> (7/22, Sternberg)
Bloomberg <http://links.mkt1066.com/ctt?kn=75&m=1995464&r=MzEyOTkyODU1OAS2&b=0&j=OTYzNTcxMTUS1&mt=1> (7/22, Pettypiece, Cortez) all participants were "aged 45 and older, [and] in the early stages of aortic stenosis." In the study, "158 patients developed cancer, 9.9 percent of those getting Vytorin, compared with seven percent given placebo." In addition, [d]eaths from cancer were...slightly higher in those given Vytorin."

New drugs may need more study in patients before going to market in order to reveal safety problems, researchers say.


Example 2
In the Wall Street Journal <http://links.mkt1066.com/ctt?kn=44&m=2063873&r=MzEyOTkyODU1OAS2&b=0&j=OTcwMjU2ODkS1&mt=1>'s (8/5) Health Blog, Scott Hensley wrote that "[r]esearchers from Duke [University] have a modest proposal to catch safety problems with new drugs: Study them in more people before they go to market." The researchers, using computer models, "found that doubling the size of a hypothetical study to include 4,000 patients in each group treated improved the chances of catching a safety problem that affected a little more than one percent of the population taking the drug." They reached this conclusion by "pull[ing] numbers on heart attacks and strokes from the scientific literature on Cox-2 inhibitors, the class of painkillers that includes Merck's Vioxx (rofecoxib), withdrawn in 2004 over cardiovascular risks." Hensley concluded that the research "suggests that a modestly bigger clinical test might have found problems with Vioxx before the drug hit the market."

[analog]

When i get close to terminal I'll volunteer to be a guinea pig... of course in that circumstance one might not last long enough to do the researchers any good.....

but why not let someone in that situation take a long shot?

I am interested in these doctors who treat some cancers by culturing a piece of the patient's tumor in a petri dish and re-injecting it to wake up the patient's own immune system to the cancer. Seems too logical to not be a good idea.

[Haggis@wk]

When i get close to terminal I'll volunteer to be a guinea pig... of course in that circumstance one might not last long enough to do the researchers any good.....

but why not let someone in that situation take a long shot?

I am interested in these doctors who treat some cancers by culturing a piece of the patient's tumor in a petri dish and re-injecting it to wake up the patient's own immune system to the cancer. Seems too logical to not be a good idea.

I personally believe that we are sooooo close to a new era of pharmaceuticals that I'm frustrated that too many of our social scientists view longevity as a source of dismay. Want to start a conspiracy club that I'll join? Start researching longevity research and see how many promising treatments or drugs receiving little or no attention. I want to feel like I'm 60 when I’m 110 – I feel pretty good at 60 now- and most of the science seems to say that is possible.

[piqaboo]

Safety trials (phase 1 clinical trials):
most drugs - healthy volunteers
oncology drugs - people with advanced cancer who've not responded to all avail therapies. Generally the inclusion criteria have a minimum expected lifespan (of ~ 4 months).

Feel free to go online, find the clinical trials website, and volunteer in your area.
Its a heroic and worthwhile thing to do.

[Haggis@wk]

There is a BBC comedy called "My Family" and the older son, a wonderfully goofy guy enters into a drug testing program that makes him even goofier. One of the drugs induces short term memory loss and his younger brother says "Nick? do you have that 10 quid you own me"? Nick pays him and a few minutes later they go through the same routine. Later in the show Nick has photos of all his family members and when his brother asks for the 10 quid again, Nick pulls out a photo of his brother and reads the comment on the back "This person can't be trusted, don't give him any money".

The show is hilarious.

[Haggis@wk]

Hiker Infested With Maggots Barely Survived 11 Days Stranded in Jungle

He was in bad shape, no doubt, but not from maggots. In survival training we were taught that maggots are used to clean dead or necrotic tissue out of a wound. Maggots won’t eat healthy flesh. Maggots were commercially cultivated in the U.S. in the 30’s for such use. With the advent of antibiotics the practice declined.

[Shapley]

Hiker Infested With Maggots Barely Survived 11 Days Stranded in Jungle

He was in bad shape, no doubt, but not from maggots. In survival training we were taught that maggots are used to clean dead or necrotic tissue out of a wound. Maggots won’t eat healthy flesh. Maggots were commercially cultivated in the U.S. in the 30’s for such use. With the advent of antibiotics the practice declined.

There was a girl who survived a car crash in Southern Illinois a number of years ago. She was found in a remote area several days after the accident, and was similarly infected. The doctors reported that the maggots had, in fact, probably kept her alive because they prevented the spread of infection, just as you note.

[jamiebk]

They are starting to use maggots on burn victims once again. Seems that the little critters can clean up the tissue better than mankind evene with our modern tools and techniques.

[piqaboo]

They use leeches to help establish blood supply after reattachment surgery.

I wonder with maggots how they control the subsequent adult population. Are the maggotty areas then covered with fly paper? Or do the medical staff remove the pupae daily?

Shap, the word would be infested not infected. "c" only sounds like "s" if it immediately precedes an e or an i.

[Shapley]

They use leeches to help establish blood supply after reattachment surgery.

I wonder with maggots how they control the subsequent adult population. Are the maggotty areas then covered with fly paper? Or do the medical staff remove the pupae daily?

Shap, the word would be infested not infected. "c" only sounds like "s" if it immediately precedes an e or an i.

The maggots eat infected flesh, so she was infected, and the infestation helped to contain the infection...

[piqaboo]

Wiggle, sir, wiggle!

[jamiebk]

It's what he does Piq...you know that!

I am, myself in practice medical trials. I am trying to prove that 1/2 to 1 bottle of red wine each day is the correct theraputic dose to aid in the prevention of clear thinking. So far it is working (I think)

[Shapley]

I was going to go back and correct the error, but that would violate my motto.....

[jamiebk]

Guess you are stuck then.....

[Shapley]

Roman Empire May Have Raised HIV Threat

[Shapley]

Doctor Slang Is A Dying Art

The inventive language created by doctors the world over to insult their patients - or each other - is in danger of becoming extinct.

Dr Fox recounts the tale of one doctor who had scribbled TTFO - an expletive expression roughly translated as "Told To Go Away" - on a patient's notes.

He told BBC News Online: "This guy was asked by the judge what the acronym meant, and luckily for him he had the presence of mind to say: 'To take fluids orally'."

DBI refers to "Dirt Bag Index", and multiplies the number of tattoos with the number of missing teeth to give an estimate of the number of days since the patient last bathed.

The fear of litigation is given as one of the reasons for the demise of this form of art. Police officers used to use similar notations and, in some areas still do.

[jamiebk]

Doctor Slang Is A Dying Art

The inventive language created by doctors the world over to insult their patients - or each other - is in danger of becoming extinct.

Dr Fox recounts the tale of one doctor who had scribbled TTFO - an expletive expression roughly translated as "Told To Go Away" - on a patient's notes.

He told BBC News Online: "This guy was asked by the judge what the acronym meant, and luckily for him he had the presence of mind to say: 'To take fluids orally'."

DBI refers to "Dirt Bag Index", and multiplies the number of tattoos with the number of missing teeth to give an estimate of the number of days since the patient last bathed.

The fear of litigation is given as one of the reasons for the demise of this form of art. Police officers used to use similar notations and, in some areas still do.

I am not a doctor, but we have had many conversation at work about putting, shall we say...colorful, comments in the margins of our reports and files. Legal "discovery" can be a terribly embarassing thing

[Shapley]

Banjo Ace Plays Banjo During Brain Surgery

[Shapley]

Hawaii Dropping Universal Health Coverage After Only Seven Months

Hawaii is dropping the only state universal child health care program in the country just seven months after it launched.

Gov. Linda Lingle's administration cited budget shortfalls and other available health care options for eliminating funding for the program. A state official said families were dropping private coverage so their children would be eligible for the subsidized plan.

"People who were already able to afford health care began to stop paying for it so they could get it for free," said Dr. Kenny Fink, the administrator for Med-QUEST at the Department of Human Services. "I don't believe that was the intent of the program."