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Analgesic Use and the Risk of Hearing Loss in Men
Hearing loss is a common sensory disorder, yet prospective
data on potentially modifiable risk factors are limited. Regularly used
analgesics, the most commonly used drugs in the US, may be toxic to the ear and contribute
to hearing loss. Regular use of aspirin, NSAIDs, or acetaminophen increases the
risk of hearing loss in men, and the impact is larger on younger individuals.
Avandia and Heart Attack
GlaxoSmithKline finds itself
defending its product Avandia following a recent U.S. Senate report citing an
FDA estimate that Avandia resulted in 83,000 heart attacks between 1999 and
2007. The Senate report cites GSK for
their failure in that they “had a duty to sufficiently warn patients in a
timely manner.” The report indicates that not only did they fail to notify
the public in a timely manner of the drug’s risks, but that the company tried
to downplay the potential risks.
This report, which was two years in the making, follows a 2007 NEJM
article that detailed a 43% higher risk of heart attack for patients taking
Avandia.
MRI, CT and PET Scan Use Increases
by 400%
In the period between 1996 and
2006, the use of MRI, CT and PET Scans in emergency room visits increased by
400%; in individual offices and clinics, the increase was 300%. In 2006, there
were 8,000 MRI machines in the U.S., an increase of 100% in ten years. In the
period from 2003 to 2006, the number of CT scanners jumped to 10,100, an
increase of 20%. Medicare spends $12 billion on the scans and they are starting
to get concerned!
A CT can run between $500 and $1,000 for the technical component. Then be sure
and add in the professional component for the total cost. MRI and PET scans are
more expensive…an MRI in Japan costs about $100. Hmmm. The big player
manufacturers in this area also build and sell smaller versions of the scanners
themselves for way less money in Japan…these aren’t even available in the
U.S. market.
Fish Oils and Psychosis
I know you have all read the Archives
of General Psychiatry and that you were likely thrilled as I was about the
February 2010 edition-what a page turner! Nonetheless, I feel compelled to
review with you one of the more interesting articles from Austrian authors who
identified and followed 81 patients between the ages of 13 and
25 that demonstrated warning signs for psychosis. Of the 81
patients, 41 were given a fish oil supplement and the other 40 were given
a placebo. At the one-year mark, 2 of the 41 patients receiving the fish oils
had deteriorated into a psychotic state. In the control group, 11 of 40 had
deteriorated into a psychotic state. Based on these findings, the researchers
have expanded the study to eight cities and are in the process of attempting to
replicate the outcome in a larger, more geographically diverse population.
The study and its findings support the hypothesis that schizophrenia may be, in
part, an aberration of fatty acid metabolism. It was suggested that
psychiatrists may begin recommending fish oils as there is a potential benefit with
no known downside. What a wonderful thing if something so simple could address
a circumstance that can be so devastating.
Insurers kickin’ butt during the
recession
A report from an advocacy group
Health Care for America Now, dated February 2010, detailed the profits of the
top five insurers in America–which increased by 56% in 2009–and the fact that
these insurers dropped 2.7 million persons.
“The five largest U.S. health insurance companies
sailed through the worst economic downturn since the Great Depression to set
new industry profit records in 2009, a feat accomplished by leaving behind 2.7
million Americans who had been in private health plans. For customers who kept
their benefits, the insurers raised rates and cost-sharing, and cut the share of
premiums spent on medical care. Executives and shareholders of the five biggest
for-profit health insurers, UnitedHealth Group Inc., WellPoint Inc., Aetna
Inc., Humana Inc., and Cigna Corp., enjoyed combined profit of $12.2 billion in
2009, up 56 percent from the previous year. It was the best year ever for Big
Insurance”
The full report can be found at Health Care for America Now
Serving Size Sleight of Hand
When you read the nutrition
label on food packaging and see how many calories you’re eating, do you ever
take into consideration what the manufacturer considers a serving size? Well you should. Here’s an interesting video
that discusses the problem of serving size as it relates to our total calorie
intake. New York Times video
Humor
Actual Medical Records
A collection of documentation statements actually found on patient’s charts during a recent review of medical records.
These statements were written by various health care professionals including a doctor or two at
several major hospitals:
The baby was delivered, the cord clamped and cut and handed to the pediatrician, who breathed and cried immediately.
Exam of genitalia reveals that he is circus sized.
The skin was moist and dry.
Rectal exam revealed a normal size thyroid.
She stated that she had been constipated for most of her life until 1989 when she got a divorce.
The patient was in his usual state of good health until his airplane ran out of gas and crashed.
I saw your patient today, who is still under our car for physical therapy.
The patient lives at home with his mother, father, and pet turtle, who is presently enrolled in day care three times a week.
Bleeding started in the rectal area and continued all the way to Los Angeles.
She is numb from her toes down.
The patient had waffles for breakfast and anorexia for lunch.
Exam of genitalia was completely negative except for the right foot.
While in the emergency room, she was examined, X-rated and sent home.
The lab test indicated abnormal lover function.
The patient was to have a bowel resection. However he took a job as a stockbroker instead.
Occasional, constant, infrequent headaches.
Coming from Detroit, this man has no children.
Examination reveals a well-developed male lying in bed with his family in no distress.
Patient was alert and unresponsive.
When she fainted, her eyes rolled around the room.- She has no rigors or shaking chills, but her husband states she was very hot in bed last night.
- Patient has chest pain if she lies on her left side for over a year.
- On the second day the knee was better, and on the third day it disappeared.
- The patient is tearful and crying constantly. She also appears to be depressed.
- The patient has been depressed since she began seeing me in 1993.
- Discharge status: Alive but without my permission.
- Healthy appearing decrepit 69 year old male, mentally alert
but forgetful.
- The patient refused autopsy.
- The patient has no previous history of suicides.
- Patient has left white blood cells at another hospital.
- Patient’s medical history has been remarkably insignificant with only
a 40 pound weight gain in the past three days.
- Patient had waffles for breakfast and anorexia for lunch.
- Both breasts are equal and reactive to light and accommodation.
- The lab test indicated abnormal lover function.
- Skin: somewhat pale but present.
- The pelvic exam will be done later on the floor.
- Patient was seen in consultation by Dr. Blank, who felt we should sit on the abdomen and I agree.
- Large brown stool ambulating in the hall.
- Patient has two teenage children, but no other abnormalities.
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