Breaking News

The COURAGE Trial: PCI is not superior to medical therapy in patients with stable coronary disease

March 27, 2007

Commentary by Cara Litvin, PGY-3

The results of one of the more remarkable studies from the meeting of the American College of Cardiology were presented on Monday, along with the simultaneous early publishing of the study online in the New England Journal of Medicine. As a result the study results captured a front page article in today’s New York Times.

The COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation) trial was a randomized trial involving 2287 patients with stable but significant…

Conflicts of Interest

March 21, 2007

The debate about the ethically questionable relationship between physicians and the pharmaceutical industry opened up again this morning on the front page of the New York Times. Although the article is heavy on interview and anecdote and a little short on evidence, it is difficult to avoid casting a critical eye on this relationship. The impetus for the article is the new laws in a handful of states requiring drug makers to disclose all payments made to doctors. These laws have made public previously…

Will my breast cancer patient need adjuvant chemotherapy? Gene Micro array technology may help answer this question��

March 20, 2007

Commentary By Sandra D’Angelo, PGY-3

Breast cancer is the most common cancer diagnosed in women, second only to lung cancer as a leading cause of death from cancer. Experts state that approximately 210, 000 women will be diagnosed in 2006 and about 40,000 will die from the disease.1 According to data compiled by the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute, 61% of breast cancer cases are diagnosed while the cancer is still confined to the primary site…

More Breaking News for the Glitazones…

March 15, 2007

Coming right on the heels of the recent warning from the FDA about the risk of fractures and Rosiglitazone, the FDA announced on March 9th that pioglitazone (Actos) has also been linked to an increased occurrence of arm, hand, and foot fractures among women taking the drug for treatment of type 2 diabetes. In an analysis of over 15,000 patients followed for up to 3.5 years, the risk of fracture was 1.9 fractures per 100 patient years in the pioglitazone group, compared to 1.0…

More Breaking News: Rosiglitazone Linked to Fractures

March 6, 2007

Commentary By: Cara Litvin PGY-3

The FDA recently informed physicians of a report issued by GlaxoSmithKline acknowledging that Avandia (rosiglitazone) has been linked to increased fractures in females (1). The report stems from a review of the safety data from ADOPT (A Diabetes Outcome and Progression Trial) (2), which was a recently published randomized trial of 4,360 patients designed to compare glycemic control with rosiglitazone relative to metformin and glyburide monotherapies. In the published study, there were no unexpected adverse events reported, although…

PB&J Hold the P: Salmonella Outbreak Linked to Peanut Butter

February 15, 2007

Commentary By: Cara Litvin PGY-3

The CDC has issued a public health advisory regarding a large outbreak of Salmonella infections in 39 states since August. As of Tuesday February 14, 288 cases had been reported to the CDC. Among the 120 patients for whom clinical information is available, 31 patients have been hospitalized, and no deaths have been reported. The most cases have been reported in…

What Is XDR-TB?

February 12, 2007

Commentary By: Marshall Fordyce, PGY-3

Extensively drug-resistant tuberculosis (XDR-TB) is as ominous as it sounds. As a second-year resident on the Chest service, you may have treated one or two patients with multi-drug resistant tuberculosis (MDR-TB), which is resistant to at least INH (Isoniazide) and RIF (Rifampin), the two most powerful first-line agents. However, when TB becomes designated as XDR-TB, it implies resistance to any and all Fluoroquinolones and at least one of the three injectable second-line drugs (Amikacin, Capreomycin, and Kanamycin).…

More Smoke From the Tobacco Industry

February 8, 2007

Commentary By: Elizabeth Ross, PGY-3

Cigarette manufacturers have been steadily increasing the nicotine content in cigarettes over the last 7 years. The news broke in August of this year when the Massachusetts Department of Public Health discovered that the level of nicotine that smokers typically consume per cigarette had risen about 10 percent.

The Harvard School of Public Health recently re-analyzed the data with the goal of ascertaining how the tobacco industry managed the increase in nicotine content. The investigators found…

A New Take on Quitting Smoking…

January 26, 2007

Landing on the front page of the New York Times today is a study from Science that may turn addiction medicine on its head…no pun intended. Of 32 smokers who had suffered a brain injury, they found that 16 who had suffered damage to the insula were easily able to quit smoking almost fully disrupting their smoking behavior in comparison to the other 16 who had suffered damage elsewhere. The insula is a region of the brain that has been previously implicated in…

Why Are Breast Cancer Rates Trending Down?

January 9, 2007

The recent finding of decreasing breast cancer rates made headlines throughout the media; including a NY Times article entitled, Reversing Trend, Big Drop is seen in Breast Cancer on December 15, 2006.

Striking epidemiological facts tells us that breast cancer is the most common cancer in women in the U.S., and only second to lung cancer as the most common cause of cancer deaths. It is estimated that approximately 212,920 American women will be diagnosed with breast cancer in…

A Bad Break for the Purple Pill…

January 8, 2007

Commentary By Josh Remick, PGY-2

In the December 27th 2006 issue of JAMA, Yang et al. reported the results of a nested case-control study of United Kingdom patients entitled “Long-term Proton Pump Inhibitor Therapy and Risk of Hip Fracture.” Using the General Practice Research Database (GPRD), a computerized medical record system used by several of the general medical practices in the UK, new hip fracture cases were found in patients at least 50 years old (n=13,556) and matched them with…

Breaking News: FDA Advises Caution with Gadolinium Based Contrast

December 27, 2006

Commentary By: Minisha Sood PGY-3

The FDA has received reports of 90 patients with moderate to end-stage kidney disease who have undergone MRI or MRA with a gadolinium-based contrast agent and subsequently developed a new disease known as Nephrogenic Systemic Fibrosis (NSF).

Scientists first identified NSF, also known as Nephrogenic Fibrosing Dermopathy (NFD), in 1997 and its cause has not yet been identified. There have been approximately 200 reports of NSF/NFD only in people with kidney disease. Neither the duration of…

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