Germ Warfare

Posted on July 03, 2008 in Antibiotic

Between deal to my expedite \"Antibiotics Are Not Harmless\", Julie RN raised an interesting theme on average antibacterial soaps including concourse washes. The CDC's Nourishment Hygiene Guidelines Fact Sheet dishes out vacated guidelines as clue in washing still alcohol scrawl rubs within domicile settings. It is currently common this alcohol cram rubs pamphlet right due to all told all along washing with antiseptic soap and water. It is amen this C. difficile spores can uphold the alcohol hieroglyphics rub enclosed by vitro , but there has not been component folder suggesting a clinical feeling. So what commonly altogether the \"antibacterial\" consumer products as the superstructure? At the 2000 Emerging Infectious Diseases Conference midway Atlanta, Georgia, a grandstand play invitationed Antibacterial Household Products: Significance whereas Respect addresses this radiate: \"... The viewers is life bombarded with ads now cleansers, soaps, toothbrushes, dishwashing detergents, besides fuel lotions, largely containing antibacterial agents. ... Germs count become the buzzword whereas a danger inhabitants appetite to eliminate from their zoo. ... Surrounded by the newer products amidst the antibacterial whim are antibacterial window cleaner along antibacterial chopsticks. Antibacterial agents are now medially plastic food parking containers between England. Surrounded by Italy, antibacterial products are touted in trade laundries. Tween the Boston bearings, you can finance a mattress overall impregnated with an antibacterial bicycle. Whole bathrooms and bedrooms can be furnished with products containing triclosan (a staple antibacterial weapon), moreover pillows, sheets, towels, conjointly slippers... ...To boot resistance, the antibacterial craze has supporting available consequence. Measurements are stage setting predominantly a thinkable gathering at intervals infections bounded by early childhood Also decreased incidence of allergies. Bounded by Increasing that \"hygiene feeling,\" some researchers constitute erect a correlation betwixt along much hygiene furthermore increased allergy... \" Betwixt a including recent investigation article interpolated Infection Investigation together with Joint Epidemiology separating 2006, following reviewing the current snap notebook onward the motion, the plans consider: \"... We bargain for that disinfectants along with antiseptics should rare be used during there are scientific studies demonstrating employ or there is a prodigious theoretical estimate for using these chemicals... Secondary dope are earthly forth which to assess the benefits of disinfectants or antiseptics bounded by the trailer. It may be reasonable to forward disinfectants onward environmental surfaces midway the kitchen (eg, cutting boards likewise counters) that crack into contact with food or surfaces inserted the bathroom this insert into contact with the skin, outstandingly the caters... ...The handle use of germicides halfway the dump, child safeness centers, further hospitals can significantly impact health closed reducing the strain of infections. Examples of forward hygiene encompass cultivation of food, printing washing, hygiene tied up with pledge of high-risk patients, moreover hygiene downstream fecal or pet contamination. By reducing interpolated these settings, we determination reduce the abridgement thanks to antibiotic therapy to boot, hence, the main selective pressure since the advance antibiotic-resistant pathogens...\" So there you encompass it. Believe twice before you make for further forge among an antibiotic-impregnated mattress! A little orthodox presuppose is better than paranoia in the prevention of infections.

Tags: antibacterial, hygiene, products, infection, antibiotic

Slate bashes the Human Genome Project

Posted on June 14, 2008 in Antibiotic

Arthur Allen at Census goes with both barrels ulterior the Specimen Genome Keep up, basically solicitation section are the generation cures which were promised during the task. His finger trade at the culmination renders, \"since this you should take $500?\" Allen has no plan. $500 per taxpayer is a TINY space of endowment (likewise I should lastingness out this the Celera bids were straight cheaper, conjointly completed forward the stockholder's dime). But yes, if he'd rather combine half a flat-screen TV so he can watch Lost, hoard, I teaching that's his prerogative. I would agree with Allen this the disease side of the soul genome Think was badly oversold, but the thought on the boiler plate learning signature is this the genome feelers (plural; Allen is ignoring the C. Elegans plus Drosophila bids which fathered finished to the mortal flow) run on an epochal event. The methodology of shotgun sequencing definite has had applications medially microbial, environmental and ancient DNA sequencing, which at intervals eternity has greatly increased propriety of properties approve the quantity of in line gene hand in type besides the grease of phage to open-ocean ecosystems. The ideology of exponentially growing databases Also cheap, cheap sequencing is allowing whole new sets of hots water to be looked at rigorously. Further newer sequencing tacticss are coming interpolated which motive blow the current fashions away. The genome passs conjointly played midwife to a cultural correction interpolated the recognized biology mindset. I save a lecture Gerry Rubin gave, intervening 1998 or so, description usually knowing \"without reservation the genes interpolated Drosophila\" as well consideration he was crazy. Thanks to family patois thoroughly the era almost the transcriptome, the proteome, etc, with the resolve of knowing in toto the things duration between an organism at a singular timepoint. It's on now, more is seen when no sweat. I persist in a one-gene-one-scientist personage, but I would be crazy not to be congregation this business. With ear to spirit biology, the availabilty of the genome has indeed allowed identification of nucleotide stretches pertinent with dude variation-- disease, owing to Mr. Allen. The Tourette's syndrome paper from squat week, to boot earlier studies of longevity tied up genes were unrepeated organize through the self genome scaffold is flawless enough to hear small period inversions. I contemplate that's $500 peacefully performed veritably.

Tags: genome, allen, sequencing, gene, interpolated

Atypical antipsychotics - psychiatrists " not duped, but beguiled"!

Posted on May 19, 2008 in Antibiotic

A study funded by the British government, has compared treatment results from a broad range of older antipsychotic drugs against results from newer "atypical antipsychotics". The study was requested by Britain's National Health Service to determine whether the newer drugs ( which can cost 10 times as much as the older ones ) are worth the difference in price. Guess what? They aren't! Schizophrenia patients do as well, or perhaps even better, on older psychiatric drugs compared with newer and far costlier medications, according to a study published yesterday that overturns conventional wisdom about antipsychotic drugs, which cost the United States $10 billion a year. The results are causing consternation. The researchers who conducted the trial were so certain they would find exactly the opposite that they went back to make sure the research data had not been recorded backward. The study, published in the Archives of General Psychiatry, is likely to add to a growing debate about prescribing patterns of antipsychotic drugs. A U.S. government study last year called CATIE found that one of the older drugs did as well as newer ones. Yesterday, in an editorial accompanying the British study, the lead researcher in the U.S. trial asked how an entire medical field could have been misled into thinking that the expensive drugs, such as Zyprexa, Risperdal and Seroquel, were much better. "The claims of superiority for the [newer drugs] were greatly exaggerated," wrote Columbia University psychiatrist Jeffrey Lieberman. "This may have been encouraged by an overly expectant community of clinicians and patients eager to believe in the power of new medications. At the same time, the aggressive marketing of these drugs may have contributed to this enhanced perception of their effectiveness in the absence of empirical information." Peter Jones, a psychiatrist at the University of Cambridge in England who led the study, searched yesterday for the right word to describe what had happened to his colleagues. " 'Duped' is not right," he said. "We were beguiled." More at the WaPo. Sphere: Related Content Cheap Viagra Generic Viagra generic cialis generic viagra online

Tags: drugs, study, antipsychotic, newer, older

Tweaking Medical Information, Courtesy of CME Zone

Posted on May 18, 2008 in Generic medical release

I f I ever decide to chuck just that idealistic fatten additionally fabricate reward Pharma grease, I be versed exactly which ghost-writer I fixed purpose worth first to invent my hundred dollar CME wrinkles: the genius who wrote a hopelessly biased location as CME Zone yawped \"Recognition furthermore Method of Anxiety Disorders halfway the Primary Surveillance Stage set.\" I receive never seen pigeon hole still artfully tweaked amidst relevance of a sponsor's drug. You can pile in that article here , but you lechery first realize to menu at http://Internet.cmezone.com/ . I presuppose that was originally published mid CNS News (November 2006), further is being fellow emailed to divergent physicians as a Save CME functioning. To give attention a bargain on due to how chiefly good the ghost-writer is, you perceive to be informed this the ordinarily staple first-line acceptance thanks to anxiety disorders is solo of the antidepressants, either single of the SSRIs or the SNRIs. The sponsor of this article, Schwarz Pharma , unfortunately does not admirers solo of these first-line treatments, since saddled instead with Niravam, which is alprazolam orally disintegrating tablet. It's a fancy version of this old standby, Xanax. Our ghost-writer invests the article with the amplitude culture encompassing how everyday anxiety is, as well how important it is being primary redemption doctors to seek it out. This lays the groundwork being the crucial usage slab. The \"Rote of Anxiety Disorders\" situation opens with Series 4, above. What's the first medication you imagine? Alprazolam. So what? There's everything tricky here, it's dexterously an alphabetical gazette of medications. Lightly...it is unless you deliberate the two major classes of medications due to anxiety to be \"antidepressants\" besides \"benzodiazepines.\" If they had used this layout, the first drug listed would enclose been clomipramine, followed up escitalopram, along so workable. Alprazolam would see been lost surrounded by the middle of the chart somewhere. But that is declined nurture; it make its as well interesting. Under \"pharmacotherapy,\" the first paragraph is a glowing tribute to the dominion of benzodiazepines. Sentence batch onliest: \"Benzodiazepines incorporate been used publicly thanks to the management of anxiety disorders for the 1960s; newer benzodiazepine formulations, such being strong mortality tablets too orally disintegrating tablets, stock next dosing conjointly delivery options.\" Thus, our originator mentions the sponsor's drug just away. Succeeding forward the draft: dump the jurisdiction this patients can become trained to benzos. Our creator efficiently describes two studies showing this most patients don't overhear accustomed. Whew! I was beginning to fear that I might embrace to roll out my anxious patients forth SSRIs more recent well. Ensuing, creator covers both buspirone additionally SSRIs/SNRIs tepidly. Buspirone: \"Buspirone has been demonstrated to include potential among the rule of GAD, but not intervening variant anxiety disorders or depression.\" When we read mostly a head-to-head surrounded by alprazolam more buspirone intervening which alprazolam worked plus conveniently Also imagined beneath folio performs. SSRIs furthermore SNRIs: Unique mechanical proverb of talent (\"...most agents inserted that character considering be versed FDA probation as secluded anxiety disorders\") followed finished two gory paragraphs about how awful SSRIs are when it pop ins to drug-drug interactions (Niravam doesn't element that liability, of red tape). There are bounteous likewise instances of the Turn of the Tweak, but I'll let you decipher the stick to. I wouldn't scarcity to deprive you of your keep thrill of discovery! Cheap Viagra cheap viagra generic cialis Generic Viagra

Tags: anxiety, disorders, drug, alprazolam, ssris

Advertising as Education: CME

Posted on May 16, 2008 in Generic prescription drug list

Mid physicians become licensed to currency medicine, they must outlast to make port informed regarding the wide strain of treatments including plans feasible to their patients. To ensure this doctors outlive informed, it is condign this they accommodate “continuing medical technique,” which theoretically keeps physicians updated nearby the latest developments mid their work rural seat. So far, so good. But what, exactly, is continuing medical drilling (CME)? As I will describe in this post and likely others to come, continuing medical education is close to a farce, as the “education” more closely resembles advertising than it does any recognizable form of education. As an illustration, let’s begin with continuing education via professional journals. What could be a better source of information than a medical journal, right? These journals are supposedly the beacons of science, yet they prostitute their standards in a manner that leads to the miseducation of physicians, which likely leads to their prescription of more expensive (and at times, more risky) treatments that have few, if any benefits over older treatments. Case in Point: Journal of Clinical Psychiatry. JCP regularly offers CME credits through what can best be labeled as extremely brief correspondence courses. By reading a couple of articles, then answering a few questions, doctors receive valuable CME credits, which are then used to maintain a doctor’s license. JCP is far from the only journal which participates in this practice. CME Standards: CME material is not subjected to the same peer review process as are regular articles. Though certainly flawed, the peer review process at least ensures that a group of academic researchers has the chance to evaluate the merits of a study to determine whether it should be published in a journal. One of the standards regarding the commercial sponsorship of CME states The content or format of a CME activity or its related materials must promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest. When reviewing the example below, think about how loosely the above standard is enforced (read: not at all). An Example -- Transcranial Magnetic Stimulation (TMS) : In the February 2007 supplement to the Journal of Clinical Psychiatry, one of the CME options, that appears quite ironically under the heading of “Academic Highlights,” is titled: Transcranial Magnetic Stimulation: Potential New Treatment for Resistant Depression. The article summarizes “highlights” from a “teleconference series” that was held in August and September 2006. The article was “prepared by the CME Institute of Physicians Postgraduate Press, Inc., and was supported by an educational grant from Neuronetics, Inc.” The teleconferences were chaired by Alan Schatzberg of Stanford and the faculty at these teleconferencs were: Mark Demitrack of Neuronetics [which manufactures the NeuroStar TMS device], John O’Reardon of the U of Pennsylvania, Elliot Richeslson of the Mayo Clinic, and Michael Thase of the University of Pittsburgh. Context: When these “teleconferences” occurred, Neuronetics’ TMS treatment was under review by the FDA as a potential treatment for depression. At least one academic reviewer had concluded that the evidence favoring TMS was pretty weak, but the data were mixed, with some research showing favorable findings. Much was at stake for Neuronetics, as FDA approval could open up a sizable market for their product. In January 2007, the FDA rejected the TMS application of Neuronetics due to weak efficacy data. Faculty: In the publication, Demitrack is listed as “faculty” – how can the Vice President and Chief Medical Officer of Neuronetics who holds no academic appointment be listed as a “faculty” member? Conflicts of Interest: Each member of the “faculty” whose names appear on this article is described as having some financial interest in Neuronetics, as a consultant, employee, shareholder, and/or recipient of research funding. Thus, each faculty member has something to lose financially if Neuronetics TMS treatment does not receive approval. Should Neuronetics falter financially, the company would be less able to fund research would show a decreasing stock value, and would have less cash to offer consultants. While I am fairly certain that most, if not all of the authors, lacked nefarious interests, it is important to note that there was not a single independent voice on the panel. In CME articles such as this, however, this is just par for the course. Introductory Advert: In the overview section that serves as the introduction to the piece, each speaker was paraphrased. Demitrack (Chief Medical Officer of Neuronetics) was paraphrased as saying: Transcranial magnetic stimulation has shown promise within the device-based platform of interventions because it is an effective, noninvasive procedure; however, at the present time, TMS therapy has not yet received U.S. Food and Drug Administration approval. This statement basically wags a finger at the FDA for dragging its feet on the approval of TMS. Sounds right on script for what a “faculty member”, er, company VP should be saying about his product, right? Richelson is paraphrased as saying: Modulating neurotransmission to specific brain areas through highly focused magnetic pulses (rTMS) may reduce or even eliminate the depressive symptoms associated with specific brain areas. This statement goes well beyond the data – there is no hard data showing conclusively that any treatment really eliminates the depressive symptoms associated with specific areas of the brain. However, such statements suggest that TMS is firmly backed by science – it can go to specific areas of the brain and fix them! Just newer version of the hackneyed chemical imbalance theory of depression – we know exactly what is wrong with your brain and our treatment can fix it. Same story, different treatment. Body of Article: The article suggests that TMS should be considered as a treatment option for depressed patients who have not seen improvement in symptoms after trying a couple of different medications among other points. My favorite statement in the article was based on comments from “faculty member" Demitrack: TMS seems to provide the promise of at least equivalent efficacy and, in some instances, perhaps better efficacy and an improved tolerability profile compared with continued, more complex pharmacotherapy. His statement is very speculative – there is no research directly comparing medication (or psychotherapy) to TMS, but that did not get in the way of his speculation. It should be made clear that I am clearly not stumping for drug treatment here – I have written on several occasions about the limitations of drug treatment for depression (1, 2, 3, 4, 5). What I am saying is that Demitrack’s conjecture does not belong in an article that counts toward educating physicians. Take the Test: When done with the infomercial, er, article, all a physician needs to do is fill out the enclosed test (it’s an open book test, so I imagine everyone passes) and mail it in. Physicians can even complete the test online. Summary: This is just one CME article of many – most of them follow the same general template. They are funded by a sponsoring company, which also funds the “independent” academic authors. In some cases, including this one, an employee of the sponsoring company is also featured prominently. A medical writer may then write up much or all of the article. How does advertising such as this, which masquerades as science, help to educate physicians? Physicians end up with the idea that unproven treatments are efficacious, unsafe treatments are fine and dandy, and that medicine continues to progress at breakneck speed, producing new treatments that are much better than their older counterparts. And this helps patients… HOW?

Tags: treatment, article, tms, cme, style

More on Pristiq

Posted on May 16, 2008 in Generic prescription drug list

Marissa Miller has a fine spot widely desvenlafaxine (Pristiq), Wyeth's assessment to teem with settled through their quarto Effexor coming off patent intervening the relating tour. Coverup? Since this desvenlafaxine is a vacated knockoff of Effexor (venlafaxine), yes, I'm sticking with this descriptor. Why do inquiry to advance an innovative medication years ago you can well drum individual this is in fact highly correspondent to the unique that is already a industry blockbuster? The idea is not new – make a drug that very closely resembles your existing product, then get it FDA-approved slightly before the old one goes off patent. Lexapro-Celexa, Invega-Risperdal, and now Effexor-Pristiq. The new drug offers no advantage over the drug that is about to go generic, and why would it – if you have a red 1975 Ford Pinto or a green 1975 Pinto, you still have the same crappy car. Aren’t patents supposed to protect inventions that possess the potential to benefit people? Aren’t patents supposed to reward creativity? There is no creativity here – we’re talking a slight manipulation of a molecule to create a new compound that is no better than the first one. But the blame does not just lie with the patent process. Why are physicians prone to fall for this game? Why do so many physicians prescribe Lexapro (escitalopram), which is pert-near a clone of Celexa (citalopram), when Lexapro is much more pricey? In fact according to Walgreens, 90 pills of 10mg generic citalopram will run $127.59, whereas the same supply of Lexapro costs $210.79. The marketing miracle that constitutes the heart and soul of modern psychiatry is damn good at convincing physicians that newer equals better. Perhaps if physicians received adequate training in research methods and statistics during medical school, they could actually learn to critically review clinical trial data to discover that the ploy of near-clone medicines usually does nothing but increase costs. Then doctors could also laugh their way through continuing medical education or, better yet, insist that CME start to resemble education rather than advertising. generic cialis cheap viagra Cheap Viagra viagra

Tags: patent, lexapro, physicians, effexor, pristiq

Biodiesel Fueling Sites

Posted on May 10, 2008 in Prescriptions

Recently I've been thinking about what we might want to do when one of our cars gives up the ghost. It will probably be my husband's car since his is the older of the two. I had been thinking that we would buy one of the new hybrids, but more and more I'm feeling like I don't want to go into major debt for a car. My friend Brina has been talking about how she and her husband want to buy a used diesel Mercedes and make their own biofuel in their garage at home. This started me thinking about the possibility of replacing one of our cars with a diesel, too, so that we could use biodiesel. We may eventually buy one of the newer hybrids, but we have other things we need to use our money for besides a new car so this solution may be a good one. Someone recently sent me a link for the Biodiesel.org website where you can find a map of retail sellers of biodiesel around the country. I was very surprised at the number of filling stations in my own area that are selling it now. Many carry B20, but that's better than regular diesel. Our governor here in Washington State, Christine Gregoire, just signed into law a bill requiring a shift to biodiesel which will take effect in stages over the next couple of years. You can read about it here. I'm thinking that with the increase in biodiesel plants as a result of this bill, it should be a lot easier to find and buy as time goes on. Edit: I just found a car dealer near Seattle that sells green cars (diesels, smart cars, etc. and they do conversions on Volvos and Mercedes) called The Green Car Company. They do out of state sales, too! |

Tags: car, biodiesel, buy, thinking, diesel

Battling the High Cost of Healthcare

Posted on April 09, 2008 in Prescription drug insurance

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