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FDA Requires Label Changes For The Patch

After cautiously clearing Yaz for continued use Thursday, an FDA Advisory Panel Friday addressed post-marketing data showing similarly increased blood clot risks among users of the contraceptive patch.  The committee, after having been clearly quite  extensively briefed,  heard testimony from Ortho Evra’s  manufacturer and experts in epidemiology, gynecology and hematology. They also heard moving testimony about  a young woman who died from a massive pulmonary embolism while using the Nuvaring, whose parents argued that not only the Patch, but most of the newer methods carry an increased clot risk that no woman should be allowed to take without being adequately informed.

The committee ruled that despite limitations of the data, the patch most likely carried a 1.5 times relative risk of blood clots compared to 2nd generation levonogestrel pills, but not necessarily higher than that of newer pills containing 3rd and 4th generation progestins and drosperinone.  With a few dissenters, the committee voted to allow the Patch to stay on the market, but asked for Read more »

*This blog post was originally published at The Blog That Ate Manhattan*

Women At Higher Risk Of Having A Stroke With Afib

You don’t want this…

When it comes to the risk of stroke in atrial fibrillation, it pays to be a boy. Sorry, ladies.

An important question came up on my recent post on AF and stroke.

Why does being female give you an automatic point on CHADS2-VASc?  I keep seeing it, but I don’t see why that is.

It doesn’t seem intuitive that female AF patients should have more strokes. Why? AF should equal AF.

But it does matter. When it comes to AF and stroke, women are very different.

Here are three references that support the fact that female gender increases the risk of stroke in AF.

–First: Read more »

*This blog post was originally published at Dr John M*

More Care Can Lead To More Complications

I have a patient that comes in every so often that demands a PICC line (peripherally inserted central catheter).  PICC lines are convenient for patients and nurses and doctors because they can be used to obtain blood without needing to stick the patient on a daily basis.  They can be kept in for weeks and weeks and weeks with proper care.  They can maintain adequate IV access when old ladies and drug addicts present with poor veins.  Often they save the patient during acute decompensations of their critical illness.  However, they come with frequent complications.  I have had my share of patients return to the hospital with sepsis from their PICC line. Read more »

*This blog post was originally published at A Happy Hospitalist*

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

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Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

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Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

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“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

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Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

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