May 26, 2006

Daily Med - Current Medication Information

DailyMed: About DailyMed

About DailyMed

DailyMed provides high quality information about marketed drugs. This information includes FDA approved labels (package inserts). This Web site provides health information providers and the public with a standard, comprehensive, up-to-date, look-up and download resource of medication content and labeling as found in medication package inserts.

Other information about prescription drugs may also be available. NLM regularly processes data files uploaded from FDA's system and provides and maintains this Web site for the public to use in accessing the information. Additional information about medicines is available on NLM's MedlinePlus Web site http://www.nlm.nih.gov/medlineplus/medicines.html.

Posted by gruwell at 1:43 PM

Are Lifestyle Measures Effective in Patients With Gastroesophageal Reflux Disease?

Arch Intern Med -- Abstract: Are Lifestyle Measures Effective in Patients With Gastroesophageal Reflux Disease?: An Evidence-Based Approach, May 8, 2006, Kaltenbach et al. 166 (9): 965

An Evidence-Based Approach

Tonya Kaltenbach, MD; Seth Crockett, MD; Lauren B. Gerson, MD, MSc

Arch Intern Med. 2006;166:965-971.

Lifestyle modifications are first-line therapy for patients with gastroesophageal reflux disease (GERD). We applied an evidence-based approach to determine the efficacy of lifestyle measures for GERD management. We used PubMed and Ovid to perform a search of the literature published between 1975 and 2004 using the key words heartburn, GERD, smoking, alcohol, obesity, weight loss, caffeine or coffee, citrus, chocolate, spicy food, head of bed elevation, and late-evening meal. Each study was reviewed by 2 reviewers who assigned one of the following ratings: evidence A, randomized clinical trials; evidence B, cohort or case-control studies; evidence C, case reports or flawed clinical trials; evidence D, investigator experience; or evidence E, insufficient information. We screened 2039 studies and identified 100 that were relevant. Only 16 clinical trials examined the impact on GERD (by change in symptoms, esophageal pH variables, or lower esophageal sphincter pressure) of the lifestyle measure. Although there was physiologic evidence that exposure to tobacco, alcohol, chocolate, and high-fat meals decreases lower esophageal sphincter pressure, there was no published evidence of the efficacy of dietary measures. Neither tobacco nor alcohol cessation was associated with improvement in esophageal pH profiles or symptoms (evidence B). Head of bed elevation and left lateral decubitus position improved the overall time that the esophageal pH was less than 4.0 (evidence B). Weight loss improved pH profiles and symptoms (evidence B). Weight loss and head of bed elevation are effective lifestyle interventions for GERD. There is no evidence supporting an improvement in GERD measures after cessation of tobacco, alcohol, or other dietary interventions.

Posted by gruwell at 8:13 AM

May 4, 2006

Vioxx Heart Risk Found to Be Early and Persistent

Vioxx Heart Risk Found to Be Early and Persistent - CME Teaching Brief - MedPage Today

MONTREAL, May 3 — Vioxx (rofecoxib) attacks hearts early, not late, and its hazardous effect is sustained for seven days after treatment is stopped, according to researchers here.

The drug is now the centerpiece of hundreds of liability suits against Merck, which voluntarily pulled the Cox-2 inhibitor from the market almost two years ago.

First-time Vioxx users had a 67% increase in the risk of a myocardial infarction during the first six to 13 days of use Linda Lev�que, a doctoral fellow at the Department of Epidemiology and Biostatistics at McGill University, and colleagues, reported in an early online release for the May 23 issue of the Journal of the Canadian Medical Association.

Posted by gruwell at 10:41 AM

Stents Trump Balloons for Restoring Blood to Ischemic Limbs

Stents Trump Balloons for Restoring Blood to Ischemic Limbs - CME Teaching Brief - MedPage Today

VIENNA, Austria, May 3 — There may be light at the end of the tunnel for diseased superficial femoral arteries, which have routinely frustrated endovascular interventions.

A self-expanding, nitinol (nickel-titanium) stent demonstrated significant efficacy in patients with severe claudication or chronic limb ischemia, reported Martin Schillinger, M.D., and colleagues of the Medical University of Vienna in the May 4 issue of The New England Journal of Medicine.

At six months the restenosis rate by intention-to-treat analysis was 24% in the stent group versus 43% in a balloon angioplasty group (P=0.05), they wrote.

Posted by gruwell at 10:22 AM

State firm's fast flu test ready for trials

State firm's fast flu test ready for trials

Mukilteo-based CombiMatrix Corp. said its quick test for H5N1 Avian Flu will get field testing this fall through a Pullman-based laboratory -- and the company is ready to step up production if the product works and the dreaded virus actually arrives on this continent.

Concerns about the virus' spread are centering on this coming autumn, when the annual migration along the Pacific Flyway will bring birds to this continent that may have mingled with others infected in Asia. The flyway includes Alaska, western Canada and West Coast of the United States.

"That problem will need solutions, and we've invested in the development of products that can be a tremendous aid," said Amit Kumar, president and chief executive of CombiMatrix.

Posted by gruwell at 10:20 AM

May 2, 2006

Antibiotics Help When Chronic Lung Diseases Flare Up

HBNS: Antibiotics Help When Chronic Lung Diseases Flare Up

Antibiotic therapy leads to fewer treatment failures and deaths among people suffering from moderate to severe flare-ups in lung diseases such as emphysema and chronic bronchitis, according to a new systematic review.

The analysis compared outcomes among patients who received either antibiotics or a placebo when they experienced acute flare-ups of chronic obstructive pulmonary disease.

“Our study is the first to show clinically measurable beneficial effects of antibiotic therapy in exacerbations of COPD,? said lead author Dr. Felix Ram of New Zealand’s Massey University. “This has been one of the most highly debated topics in respiratory medicine for years.?

However, the various trials focused on a wide range of patients, including those undergoing treatment in doctors’ offices, hospital wards and intensive care units.

“These results should be interpreted with caution due to the differences in patient selection, antibiotic choice, small number of included trials and lack of control for [other] interventions that influence outcome,? say the authors.

COPD includes a group of disorders that result in chronic blockage of air flow. Cardinal symptoms include shortness of breath, coughing and sputum production. For many patients these symptoms worsen noticeably from time to time, and antibiotics are commonly given to provide relief.

Controversy over this practice arises from data suggesting that at least one-third of these acute episodes are not caused by bacteria. Unnecessary use of antibiotics may promote emergence of drug-resistant organisms.

The review appears in the most recent issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

Posted by gruwell at 5:33 AM