Tuesday, January 10, 2012
Essay - Steven Lewis - The Fraser Institute Wait Time Reports: Madness in the Method, but Method in the Madness :: Longwoods.com
The Fraser Institute Wait Time Reports: Madness in the Method, but Method in the Madness
Steven Lewis
"The answer lies in its (The Fraser Institute) mission statement, helpfully reproduced at the end of the wait times report: “Our vision is a free and prosperous world where individuals benefit from greater choice, competitive markets, and personal responsibility.” Public health care sucks because it must suck, because it’s public. Therefore, let’s gather skewed estimates on a hot-button issue, retail them as hard data, and lure Canadians toward the promised land of private medicine."
Canada: Cancer wars: are we winning? - Health - CBC News
....But trying to answer the question of whether the war on cancer is being won means stepping into a contradictory tangle of statistics, anecdotes, hopes and fears.....
Clifton Leaf, author of an article in Fortune magazine called "Why We're Losing the War On Cancer," is one of the beneficiaries of the success against certain cancers affecting children.......
Leaf focuses on actual death rates, which haven't budged much in decades for the diseases that tend to be the hardest to treat: lung cancer, pancreatic cancer, liver cancer.
Prognostic significance of L1CAM in ovarian (serous) cancer and its role in constitutive NF-κB activation
Background: Overexpression of L1-cell adhesion molecule (L1CAM) has been observed for various carcinomas and correlates with poor prognosis and late-stage disease. In vitro, L1CAM enhances proliferation, cell migration, adhesion and chemoresistance. We tested L1CAM and interleukin-1 beta (IL-1β) expression in tumor samples and ascitic fluid from ovarian carcinoma patients to examine its role as a prognostic marker.
MedWatch - consolidation/links - re: Excedrin, NoDoz, Bufferin, Gas-X Prevention, Endo Pharmaceuticals Opiate Products
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm286265.htm?source=govdelivery
Message 1
From: FDA MedWatch
Date: Jan, Mon 9 2012 10:53 -0500 (EST)
Subject: FDA MedWatch - Novartis Consumer Health Over-The-Counter Products: Recall - Potential Presence of Foreign Tablets or Chipped or Broken Tablets or Gelcaps
Novartis Consumer Health Over-The-Counter Products: Recall - Potential Presence of Foreign Tablets or Chipped or Broken Tablets or Gelcaps
including Excedrin, NoDoz, Bufferin, Gas-X Prevention
AUDIENCE: Consumer, PharmacyISSUE: Novartis Consumer Health Inc. is voluntarily recalling all lots of over-the-counter products Exedrin, Bufferin, Gas-X Prevention and NoDoz. Reports were received of chipped and broken pills and inconsistent bottle packaging clearance practices at the Lincoln, Nebraska facility, which could result in the bottles containing foreign tablets, caplets, or capsules.
Mixing of different products in the same bottle could result in consumers taking the incorrect product and receiving a higher or lower strength than intended or receiving an unintended ingredient. This could potentially result in overdose, interaction with other medications a consumer may be taking, or an allergic reaction if the consumer is allergic to the unintended ingredient.
BACKGROUND: This voluntary recall pertains to all lots of select bottle packaging configurations from retailers of Excedrin and Nodoz products (expiry dates of December 20, 2014 or earlier), and Bufferin and Gax-X Products (expiry dates of December 20, 2013 or earlier), in the United States.
RECOMMENDATION: All of the pills in the bottle should look the same. If patients find a pill that is different in shape, size, color, or markings, they should bring their medicine bottle to their pharmacist and not take any of those pills.
Consumers that have the product(s) being recalled should stop using them and contact the Novartis Consumer Relationship Center at 1-888-477-2403 (available Monday-Friday 9 a.m. to 8 p.m. Eastern Time) for information on how to return the affected products.
Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:
- Complete and submit the report Online: www.fda.gov/MedWatch/report.htm
- Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm286265.htm
Message 2
From: FDA MedWatch
Date: Jan, Mon 9 2012 11:13 -0500 (EST)
Subject: FDA MedWatch - Endo Pharmaceuticals Opiate Products by Novartis Consumer Health: Public Health Advisory - Potential Safety Risk
Endo Pharmaceuticals Opiate Products by Novartis Consumer Health: Public Health Advisory - Potential Safety Risk
Including the following products:- Opana ER (oxymorphone hydrochloride) Extended-Release Tablets CII
- Opana (oxymorphone hydrochloride) CII
- Oxymorphone hydrochloride Tablets CII
- PERCOCET (oxycodone hydrochloride and acetaminophen USP) Tablets CII
- PERCODAN (oxycodone hydrochloride and aspirin, USP) Tablets CII
- ENDOCET (oxycodone hydrochloride and acetaminophen USP) Tablets CII
- ENDODAN (oxycodone hydrochloride and aspirin, USP) Tablets CII
- MORPHINE SULFATE Extended-Release Tablets CII
- ZYDONE (hydrocodone bitartrate/acetaminophen tablets, USP) CIII
AUDIENCE: Pharmacy, Consumers
ISSUE: FDA is advising healthcare professionals and patients of a potential problem with opiate products manufactured and packaged for Endo Pharmaceuticals by Novartis Consumer Health at its Lincoln, Nebraska manufacturing site. Due to problems that occurred when these products were packaged and labeled at the site, tablets from one product type may have carried over into packaging of another product. This could result in a stray pill of one medicine ending up in the bottle of another product.
BACKGROUND: Opiates are potent medications used to alleviate pain and are available only by prescription. Endo Pharmaceuticals reports that they are aware of only three product mix-ups with respect to these products since 2009; all three were detected by pharmacists. Endo is not aware of any patient having experienced a confirmed product mix-up, nor any adverse events attributable to a product mix-up.
RECOMMENDATION: FDA advises patients and healthcare professionals to examine opiate medicines made by Endo in their possession and ensure that all tablets are the same.
Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:
- Complete and submit the report Online: www.fda.gov/MedWatch/report.htm
- Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm286280.htm
You are encouraged to report all serious adverse events and product quality problems to FDA MedWatch at www.fda.gov/medwatch/report.htm
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Monday, January 09, 2012
open access: Recurrent Somatic DICER1 Mutations in Nonepithelial Ovarian Cancers — NEJM (germ cell, sex cord-stromal, leydig, granulosa...
"Sex cord–stromal tumors and germ-cell tumors account for less than 10% of ovarian cancers.1 Unlike epithelial ovarian cancers, both sex cord–stromal tumors and germ-cell tumors can also occur in the testicle; testicular germ-cell tumors are the most common cancer in boys and men of European descent between the ages of 15 and 34 years.2,3 Other than a pathognomonic somatic mutation in FOXL2 in adult granulosa-cell tumors,4-6 little is known about the pathogenesis of ovarian sex cord–stromal tumors and germ-cell tumors. Recently, germline mutations in the microRNA processing gene DICER1 have been reported in probands with pleuropulmonary blastoma or the related familial tumor dysplasia syndrome, known as pleuropulmonary blastoma–family tumor and dysplasia syndrome (Online Mendelian Inheritance in Man [OMIM] number, 601200), which includes cystic nephroma, ovarian sex cord–stromal tumor (especially Sertoli–Leydig cell tumor), and multinodular goiter.7......."
open access: Jan 2012 - Assessing the malignant potential of ovarian inclusion cysts in postmenopausal women within the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a prospective cohort study
Objective To evaluate the malignant
potential of ultrasound-detected ovarian inclusion cysts in the
development of ovarian cancer (OC) in postmenopausal women.
Design Prospective cohort study.
Setting UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS).
Population Postmenopausal women.
Conclusions Postmenopausal women with ultrasound-detected inclusion cysts do not seem to be at increased risk of ovarian or breast/endometrial (hormone-dependent) cancers.
see also
Table 1. Details of ovarian cancers detected in the cohort of women with inclusion cysts in year 1
Table 2. Details of ovarian cancers detected in the cohort of women with normal scans in year 1
Conclusions Postmenopausal women with ultrasound-detected inclusion cysts do not seem to be at increased risk of ovarian or breast/endometrial (hormone-dependent) cancers.
see also
Table 1. Details of ovarian cancers detected in the cohort of women with inclusion cysts in year 1
Table 2. Details of ovarian cancers detected in the cohort of women with normal scans in year 1
| Table 3. Relative risks of developing gynaecological cancers in women with inclusion cysts |
|---|
abstract: Therapy-related myeloid leukemia after treatment for epithelial ovarian carcinoma: An epidemiological analysis
CONCLUSION: Development of t-AML is a rare but lethal event among EOC patients, and its incidence has decreased significantly since the use of platinum/taxane-based chemotherapy became the standard of care.
video: Maurie Markman, MD - Incredibly Shrinking Risk for Secondary AML (leukemia as a second primary treatment related)
referenced paper:
Citation: Vay A, Kumar S, Seward S, et al. Therapy-related myeloid leukemia after treatment for epithelial ovarian carcinoma: an epidemiological analysis. Gynecol Oncol. 2011;123:456-460. Abstract
Canadian Medical Association Journal: Nothing cutting edge about Canadian ehealth strategy, critics say
Blogger's Note: note the 'PC" reference to the billion dollar e-health scandal
Editorial: Canadian Medical Association - Early and continuing education: a prescription for achieving patient-centred care
"....It thus seems likely that bringing the patient’s perspective into the system isn’t enough to achieve the health outcomes people want and expect.
Even a perfect system won’t work if patients don’t know how to access it effectively. No matter what resources are available, lack of knowledge about what resources exist — both within and outside the health care system — and how to access them keeps people from receiving what they need when they need it. Also, our failure to help patients adequately understand their disease and its treatment underlies much of the suboptimal adherence to treatment that leads to otherwise preventable outcomes......"
Novartis' Troubles With Packaging Continue (drug packaging concerns) important to read
"Novartis Consumer Health announced earlier today a recall on certain OTC medicines that were badly packaged and might have broken or chipped pills, as well as incorrect product mixed into bottles of pills. Rather worrying for consumers with risks of possible wrong or overdoses of their medicine.
Now the problems seem to be more endemic with the FDA inspection of the Novartis' Manufacturing facility finding other drugs that may have become mixed in the packing process."
"The products in the spotlight this time are opiate products made for Endo Pharmaceuticals by Novartis Consumer Health. The FDA is working closely with both companies to resolve the problems and prevent them occurring in the future.The FDA is providing links on its website to help consumers and practitioners identify if there is a wrong pill in their medication. Patients and healthcare professionals would be wise follow the instructions on the links below closely, to identify whether there is a wrong pill in a medication bottle. Whilst the previous issue related to OTC products, these powerful oxymorphone and oxymorphone based painkillers could cause a patient serious issues if wrongly taken."
The problem relates to the following products :
- Opana® ER (oxymorphone hydrochloride) Extended-Release Tablets CII
- Opana® (oxymorphone hydrochloride) CII
- Oxymorphone hydrochloride Tablets CII
- PERCOCET® (oxycodone hydrochloride and acetaminophen USP) Tablets CII
- PERCODAN® (oxycodone hydrochloride and aspirin, USP) Tablets CII
- ENDOCET® (oxycodone hydrochloride and acetaminophen USP) Tablets CII
- ENDODAN® (oxycodone hydrochloride and aspirin, USP) Tablets CII
- MORPHINE SULFATE Extended-Release Tablets CII
- ZYDONE® (hydrocodone bitartrate/acetaminophen tablets, USP) CIII
Visual Guide
Additional information is available from the FDA and Endo's website :
http://www.fda.gov/Drugs/DrugSafety/ucm286226.htm
http://www.fda.gov/Drugs/DrugSafety/ucm286232.htm
NT Times Health: Really? The Claim: Grief Can Cause a Heart Attack
"In a large new study, scientists have confirmed what the medical world has long suspected (blogger's note - and patients/families have known): The so-called broken-heart syndrome is real. The study, published on Monday in Circulation: Journal of the American Heart Association, found that a person’s heart attack risk is 21 times higher than normal the day after a loved one dies....."
What Parents Tell Their Kids About Breast-Cancer Gene Test Results - Health Blog - WSJ
Blogger's Note: this has been an area of much discussion and debate over many years which not only includes age issues (age of majority-adult) but also ethical dilemmas (eg. because you carry a mutation the risk of a cancer varies and does always mean a cancer diagnosis).
------------------------------------------------------------------------------------
"If you were tested for the “breast cancer gene” — mutations in the BRCA1 and BRCA2 genes that raise the risk of breast, ovarian and other cancers — would you tell your children?...."
"There isn’t much to do with the information for that age group: kids who learn that a parent carries a BRCA mutation aren’t advised to have the test themselves until at least age 18, and any additional screening resulting from a positive result wouldn’t likely begin until age 25, says Angela Bradbury, lead author of the study and the director of breast and ovarian cancer risk assessment at Fox Chase Cancer Center in Philadelphia......"
Medical News: Statins Up Diabetes Risk in Older Women - in Primary Care, Diabetes from MedPage Today (2nd article)
Action Points
- This study found that older women who take statins may be at an increased risk for developing type 2 diabetes.
- Note that the risk was seen with all types of statins.
In an analysis of data from the Women's Health Initiative, postmenopausal women who were on a statin at study entry had almost a 50% greater risk of diabetes than those who weren't on the cholesterol-lowering drugs, Yunsheng Ma, MD, PhD, of the University of Massachusetts School of Medicine, and colleagues reported online in the Archives of Internal Medicine.
"This study urges us to further evaluate the risk-benefit profile of statins," Ma told MedPage Today, adding that the ratio will likely vary by patient population....."
webinar - Wed Jan 11th - 2011 Commonwealth Fund International Health Policy Survey of Sicker Adults
| Date: | Wed, Jan 11, 2012 |
| Time: | 11:30 AM EST |
| Duration: | 1 hour 30 minutes |
| Host(s): | Christine Haran |
2011 Commonwealth Fund International Health Policy Survey of Sicker Adults
|
Please register for this meeting.
|
|
|
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Meeting Description: |
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This webinar will examine the findings of the latest International Health Policy Survey of Sicker Adults in Eleven Countries, conducted
in Australia, Canada, France, Germany, the Netherlands, New Zealand,
Norway, Sweden, Switzerland, the United Kingdom, and the U.S.
Published
in November, the study compared the experiences of adults with complex
care needs on financial barriers to care, access to care, care
coordination, preventive care, and support for self-management.
International respondents from England, Switzerland, and the Netherlands
will comment on survey findings.
|
Multinational Comparisons of Health Systems Data, 2011 - The Commonwealth Fund including link to 2011 patient care coordination (11 countries)
"International comparisons of health care systems offer valuable tools to health ministers, policymakers, and academics wishing to evaluate the performance of their country's system. In this chartbook, we use data collected by the Organization for Economic Cooperation and Development (OECD) to compare health care systems and performance on a range of topics, including spending, hospitals, physicians, pharmaceuticals, prevention, mortality, quality of care, and prices. We present data across several industrialized countries: Australia, Canada, Denmark, France, Germany, Japan, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. Whenever possible, we also present the median value of all 34 members of the OECD.......
Downloads
message from David Haas ' Networks That Support Cancer Patients
Blogger's Note: please respond directly to David
Networks
That Support Cancer Patients
Receiving a cancer diagnosis is a frightening
and life-changing event. It brings worries about treatment and fear of dying,
as well as how to keep spirits up during the darkest days. There are many
things to consider, big decisions to be made and emotions can be overwhelming. This where cancer support networks come in.
A support network is made up of people who have gone through the cancer experience and can lend their own unique perspective, in the hope of helping others. The groups meet in hospitals, libraries, in church or other public spaces and are led by doctors, social workers and psychologists who understand the challenges of cancer, from breast cancer to mesothelioma.
Face to face groups offer an intimate atmosphere of sharing and social activities, as well as love and understanding. It is in these support networks that the many different faces of cancer can be seen clearly and stories of survival can be heard. Sometimes all a patient needs for encouragement is to know they are not alone.
Cancer support networks can be found on the Internet, as well. This type of group is suited for those who are too ill to attend a public get together, or wish to talk about their experience anonymously. Online support often encourages a larger degree of sharing, as there is no pressure of speaking in front of a live group or fear of judgment over physical weakness and a loss of looks.
Regardless of the type of network a patient participates in, it is the emotional support that matters, as this is just as important as the medical treatment itself. Maintaining a positive outlook and eliminating feelings of isolation can go a long way toward promoting remission of the disease.
Any cancer patient who wishes to take part in a support network can ask their doctor, social worker or simply do a search online. Most patients are recommended to join a support group as a regular part of their treatment.
Cancer is not a death sentence. It is a chance to regain perspective and begin life again from a new place.
A support network is made up of people who have gone through the cancer experience and can lend their own unique perspective, in the hope of helping others. The groups meet in hospitals, libraries, in church or other public spaces and are led by doctors, social workers and psychologists who understand the challenges of cancer, from breast cancer to mesothelioma.
Face to face groups offer an intimate atmosphere of sharing and social activities, as well as love and understanding. It is in these support networks that the many different faces of cancer can be seen clearly and stories of survival can be heard. Sometimes all a patient needs for encouragement is to know they are not alone.
Cancer support networks can be found on the Internet, as well. This type of group is suited for those who are too ill to attend a public get together, or wish to talk about their experience anonymously. Online support often encourages a larger degree of sharing, as there is no pressure of speaking in front of a live group or fear of judgment over physical weakness and a loss of looks.
Regardless of the type of network a patient participates in, it is the emotional support that matters, as this is just as important as the medical treatment itself. Maintaining a positive outlook and eliminating feelings of isolation can go a long way toward promoting remission of the disease.
Any cancer patient who wishes to take part in a support network can ask their doctor, social worker or simply do a search online. Most patients are recommended to join a support group as a regular part of their treatment.
Cancer is not a death sentence. It is a chance to regain perspective and begin life again from a new place.
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