Could alternative medicine practitioners take the lead in health policy?
Posted by: admin on: July 12, 2011
Recently, a medical student attended a conference on integrative medicine. It was a conference a lot: about Chinese therapies used for cancer, about osteopathic manipulation, and about the growing community of doctors that respect the value of complimentary medicine practices and are working to integrate them into their general practice.
She left with a sense of dissatisfaction with what she knew of the allopathic medical education experience and a series of questions about how it is taught.
Screening and Risk Assessment for Osteoporosis in Postmenopausal Women
Posted by: admin on: July 12, 2011
A direct comparison of the recommendations presented in the above guidelines for screening and risk assessment for osteoporosis in postmenopausal women is provided in the tables below.
Areas of Agreement
Risk Assessment
All of the groups recommend an assessment for risk factors associated with osteoporosis and osteoporotic fracture. All adult patients ≥ age 50 (American College of Preventive Medicine [ACPM]); all postmenopausal women (The North American Menopause Society [NAMS]); all adults (University of Michigan Health System [UMHS]). The guidelines are in agreement that the key components of a risk assessment are assessing the individual for osteoporotic risk factors and subsequent BMD testing (if indicated) based on risk profile.
All three guidelines list common risk factors for osteoporosis that should be assessed for, including clinical risk factors (e.g., age, tobacco smoking, history of fragility fracture, low body weight, etc) as well as secondary risk factors (e.g., glucocorticoid therapy, rheumatoid arthritis, other secondary causes of osteoporosis).
Venlafaxine Becomes First-Line PTSD Therapy in Latest VA Guidelines
Posted by: admin on: July 12, 2011
The most recent set of treatment guidelines for posttraumatic stress disorder also are the first ever to boost venlafaxine to first-line status as “strongly recommended” alongside the well-established selective serotonin reuptake inhibitors.
Another milestone in the Veterans Affairs/Department of Defense PTSD treatment guidelines released in late 2010 is that mirtazapine has risen in status to second-line therapy in response to recent mounting evidence of efficacy.
The new Veterans Affairs/Department of Defense evidence-based guidelines strongly recommend that all adults with PTSD be offered pharmacotherapy with a first-line agent. The guidelines also strongly recommend offering all patients trauma-focused psychotherapy that includes elements of exposure and/or cognitive structuring, or stress inoculation training.
Updated Clinical practice guideline for managing febrile neutropenia in cancer patients.
Posted by: admin on: July 12, 2011
- This guideline is intended for the use of antimicrobial agents in managing patients with cancer who experience chemotherapy-induced fever and neutropenia.
- Due to the previous iteration of this guideline in 2002, Department of Medicine, University of Nebraska Medical Center, Omaha, Nebraska have a developed a clearer definition of which populations of patients with cancer may benefit most from antibiotic, antifungal, and antiviral prophylaxis.
- Categorizing neutropenic patients as being at high risk or low risk for infection according to presenting signs and symptoms, underlying cancer, type of therapy, and medical comorbidities has become essential to the treatment algorithm.
- Risk stratification is a recommended starting point for managing patients with fever and neutropenia. Clinical vigilance and immediate treatment for all patients who present with fever and neutropenia should be treated swiftly and broadly with antibiotics to treat both gram-positive and gram-negative pathogens.
Read more at: http://www.ncbi.nlm.nih.gov/pubmed/21205990?dopt=Abstract
Are You Prescribing Unapproved Drugs?
Posted by: admin on: July 11, 2011
Dr. Charles Lee. Medical officer in the Office of Compliance at the US Food and Drug Administration’s (FDA’s) Center for Drug Evaluation and Research.
- Many healthcare providers are unaware that unapproved drugs exist and that they can pose a significant public health risk. Many of these products have been on the market for a significant period of time, some for decades. In 1938, the federal Food, Drug, and Cosmetic Act (FDCA) required that drugs be proven safe, and in 1962, additional requirements were added that drugs be proven effective as well as safe. These changes were enacted in the wake of significant tragedies involving unapproved prescription drugs, yet many unapproved prescription drugs remain on the market illegally.
- Marketed unapproved prescription drugs are a significant public health concern because they have not been evaluated by FDA, and may not meet modern standards for safety, effectiveness, manufacturing quality, and labeling. For example, FDA recently warned 2 companies to stop marketing unapproved nitroglycerin sublingual tablets, as FDA had seen significant quality and effectiveness problems with unapproved nitroglycerin products. A second example demonstrates how product labeling of an unapproved drug impacted public health. Read the rest of this entry »
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