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December 3, 2008, 5:30 AM CT

Brand-name drugs not superior to generic drugs

Brand-name drugs not superior to generic drugs
Contrary to the perception of some patients and physicians, there is no evidence that brand-name drugs are clinically superior to their generic counterparts, according to an article in the December 3 issue of JAMA, which examined studies comparing the effectiveness of generic vs. brand-name drugs for treating cardiovascular diseases.

"The problem of rising prescription drug costs has emerged as a critical policy issue, straining the budgets of patients and public/private insurers and directly contributing to adverse health outcomes by reducing adherence to important medications. The primary drivers of elevated drug costs are brand-name drugs, which are sold at high prices during a period of patent protection and market exclusivity after approval by the Food and Drug Administration (FDA)," the authors write. To control spending, many payers and clinicians have encouraged substitution of inexpensive bioequivalent generic versions of these drugs after the brand-name manufacturer's market exclusivity period ends.

Some patients and physicians have expressed concern that generic drugs may not be equivalent in their effectiveness. "Brand-name manufacturers have suggested that generic drugs may be less effective and safe than their brand-name counterparts. Anecdotes have appeared in the lay press raising doubts about the efficacy and safety of certain generic drugs," the authors note.........

Posted by: Janet      Read more         Source


December 3, 2008, 5:25 AM CT

Exposure to secondhand smoke reduced

Exposure to secondhand smoke reduced
As the correlation between second-hand smoke and coronary heart disease (CHD) became clearer and legislation was passed to reduce such passive smoking, exposures have been reduced. In an article reported in the January 2009 issue of the American Journal of Preventive Medicine, scientists from the University of California, San Francisco, Partners Healthcare, Boston and Columbia University have recalibrated the CHD Policy Model to better predict future trends in CHD.

At 1999჻� levels, passive smoking caused between 21,800 and 75,100 CHD deaths and between 38,100 and 128,900 myocardial infarctions annually. Treatment costs ranged from $1.8 to $6.0 billion per year. If recent trends in the reduction in the prevalence of passive smoking continue from 2000 to 2008, scientists predict that the burden would be reduced by approximately 25%󈞊%.

The CHD Policy Model is a computer simulation of CHD incidence, prevalence, mortality and costs in the US population aged >35 years. Using data from a variety of sources, such as the US Census, the Framingham Heart Study (FHS), the Framingham Offspring Study (FOS), the National Health and Nutrition Evaluation Survey (NHANES), the National Hospital Discharge Survey (NHDS) and the Year 2000 National Health Interview Survey (NHIS), the scientists updated the Model to better predict how reduced second-hand smoke may reduce CHD.........

Posted by: Daniel      Read more         Source


November 25, 2008, 10:32 PM CT

Caring for ailing spouse may prolong your life

Caring for ailing spouse may prolong your life
Older people who spent at least 14 hours a week taking care of a disabled spouse lived longer than others. That is the unexpected finding of a University of Michigan study forthcoming in Psychological Science, a journal of the Association for Psychological Science.

The study supports earlier research showing that in terms of health and longevity, it really is better to give than to receive.

"These findings suggest that caregivers may actually benefit from providing care under some circumstances," said U-M researcher Stephanie Brown, lead author of the study report. "Prior studies have documented negative health effects of caregiving. But the current results show that it is time to disentangle the presumed stress of providing help from the stress of witnessing a loved one suffer".

Brown is an assistant professor of internal medicine at the U-M Medical School and a faculty associate at the U-M Institute for Social Research (ISR). She is also affiliated with the Ann Arbor Veterans Affairs Hospital.

For the study, Brown and his colleagues evaluated seven years of data from the U-M Health and Retirement Study, a nationally representative sample of Americans age 70 and older. The analysis focused on 1,688 couples, all of whom lived on their own.........

Posted by: Janet      Read more         Source


November 25, 2008, 9:37 PM CT

Disclosure of medication can save a patient's life

Disclosure of medication can save a patient's life
Do you regularly take aspirin or antiplatelet medications? Do you know whether or not these drugs should be stopped before dental procedures or surgeries? As per a research studyreported in the May/recent issue of General Dentistry, the clinical, peer-evaluated journal of the Academy of General Dentistry (AGD), stopping antiplatelet medications previous to a surgical procedure places a patient at greater risk of permanent disability or death.

The probability of a patient bleeding depends on the over-the-counter and/or prescribed drug or combinations of drugs.

"A thorough drug history should be evaluated previous to any procedures," notes Mary Aubertin, DMD, lead author of the study. Dr. Aubertin recommends that the dentist and patient start with a simple discussion. "The dentist and the patient should discuss the risks and benefi ts of therapy with or without the drugs versus no therapy and include the patient's physician's opinion in the decision making process. This will allow everyone involved to understand and prevent medical risks".

Fortunately, due to the prevalence of this type of medication, dentists are prepared to treat these situations. As per AGD spokesperson Carolyn Taggart-Burns, DDS, "excessive bleeding is a major concern with a number of dental procedures due to the extensive prescribing of blood thinners in America. Heart disease is so prevalent that a number of patients are on these drugs, which can complicate even the simplest procedure." Dr. Taggart-Burns reminds patients that it is very important "to communicate medical history with your dentist so that they can provide the best care possible".........

Posted by: Janet      Read more         Source


November 24, 2008, 9:43 PM CT

Bittersweet milestones

Bittersweet milestones
For a number of of the elderly, the golden years are anything but. Faced with health problems, financial issues and the death of a spouse or loved one, a number of adults 65 years and older suffer from depression. While research is emerging to help this group understand and treat the problem, another group - centenarians - has been left largely in the dark.

"Centenarians are still rare, and depression hasn't been studied thoroughly in this group," said Adam Davey, a developmental psychology expert in the College of Health Professions at Temple University. "We've observed that it's a very under diagnosed condition among people over 100 years old, yet it's one of the most easily treated forms of mental illness".

As per the U.S. Bureau of the Census, more than 60,000 people in the U.S. are 100 years old or over, and as baby boomers start to hit their 100-year mark, that number is expected to more than quadruple to 274,000. As a result of this new boom, a group of scientists have been studying this group more and more to learn about successful late-life aging.

In a study presented at the Gerontological Society of America's annual meeting on Nov. 24, lead author Davey and his colleagues from institutions across the country looked at indicators of depression among respondents enrolled in the Georgia Centenarian Study, a three-phased project to study quality of life for those over age 100.........

Posted by: Janet      Read more         Source


November 24, 2008, 9:40 PM CT

High blood pressure in the doctor's office may not predict heart risks

High blood pressure in the doctor's office may not predict heart risks
Continuously measuring blood pressure may help predict heart disease and related deaths among individuals with therapy-resistant hypertension, while blood pressure readings taken in a medical office do not appear to predict future heart risks, as per a report in November 24 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

About 10 percent to 30 percent of individuals with hypertension have a condition known as resistant hypertension, as per background information in the article. For these patients, blood pressure remains high despite therapy with at least three antihypertensive drugs, always including a diuretic (medicine that increases urine output). Ambulatory blood pressure monitoring, or measuring blood pressure at regular intervals throughout the day, is increasingly important in managing patients with this condition because of the possibility of a white-coat effect (when an individual only has hypertension at the physician's office).

Gil F. Salles, M.D., Ph.D., studied 556 patients with resistant high blood pressure who attended an outpatient clinic between 1999 and 2004. Participants underwent a clinical examination and had their blood pressure monitored continuously during a 24-hour period (every 15 minutes throughout the day and every 30 minutes at night). They were followed up at least three to four times a year until December 2007.........

Posted by: Janet      Read more         Source


November 24, 2008, 9:39 PM CT

Telephone counseling may be as effective as face-to-face counseling

Telephone counseling may be as effective as face-to-face counseling
CHICAGO Face-to-face and telephone follow-up sessions appear to be more effective in the maintenance of weight loss for women from rural communities compared with weight loss education alone, as per a report in the November 24 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. In addition, telephone counseling appears to be just as effective as face-to-to face counseling for weight loss management.

"Rural counties in the United States have higher rates of obesity, sedentary lifestyle and associated chronic diseases than nonrural areas, yet therapy of obesity in the rural population has received little research attention," as per background information in the article. Studies have shown that diet, exercise and behavior changes can produce significant weight loss and that extended care programs such as clinic-based follow-up sessions can improve weight loss maintenance. "However, in rural communities, distance to health care centers represents a significant barrier to ongoing care".

Michael G. Perri, Ph.D., of the University of Florida, Gainesville, and his colleagues conducted a randomized trial involving 234 obese women (age 50 to 75) who completed a six-month weight loss program in six medically underserved rural communities. The women were randomly assigned to three different extended-care programs consisting of 26 biweekly sessions for one year; 72 participants received telephone counseling, 83 received face-to-face counseling and 79 received biweekly newsletters containing weight loss maintenance tips. Estimated program costs were also assessed.........

Posted by: Janet      Read more         Source


November 24, 2008, 9:30 PM CT

Smoking, teens and their parents

Smoking, teens and their parents
A new study observed that adolescents were at the greatest risk of smoking when their parents began smoking at an early age and the parents' smoking quickly reached high levels and persisted over time.

The study, reported in the recent issue of Health Psychology, draws from the long-running Indiana University Smoking Survey and builds on prior research that suggests smoking behavior is influenced by both genetics and the environment.

"This particular study focuses more on the genetic influence in the specific case of a parent's smoking behavior impacting a teenage son or daughter's smoking," said Jon Macy, project director of the IU Smoking Survey in the Department of Psychological and Brain Sciences. "The study findings suggest that the characteristics of early onset and high levels of long-term smoking are great candidates for behavioral and molecular genetic studies of the causes of smoking and how smoking behavior is passed from one generation to the next.

"Of course, environmental influences on adolescents such as parenting practices, availability of cigarettes in the home, and parents' attitudes about smoking are equally as important and can be addressed with effective public health interventions including family-based smoking prevention programs".........

Posted by: Janet      Read more         Source


November 19, 2008, 8:05 PM CT

Primary care provides better outcomes at lower cost

Primary care provides better outcomes at lower cost
A white paper, How is a Shortage of Primary Care Physicians Affecting the Quality and Cost of Medical Care?, released recently by the American College of Physicians (ACP) documents the value of primary care by reviewing 20 years of research. An annotated bibliography based on a literature review of more than 100 studies documents the evidence to support the critical importance of primary care in providing patients with better outcomes at lower cost, and the urgency of the need to prevent shortages of primary care physicians.

"The evidence for the value of primary care is clear," said Jeffery P. Harris, MD, FACP, president of ACP. "It manifests itself in better quality of life, more productive longevity, and lower costs as a result of reduced hospitalization, improved prevention and better coordination of chronic disease care. The nation must take immediate steps to address the issues that threaten primary care's survival."

The ACP paper notes that policymakers are more likely to take the steps necessary to assure a sufficient primary care workforce if they are aware of the research on the importance of primary care to a high-performing health care system. Featuring more than 100 studies, the white paper provides an overview of current trends in the primary care doctor workforce, the importance and value of primary care, and the growing demand for primary care services in the United States.........

Posted by: Janet      Read more         Source


November 18, 2008, 5:37 AM CT

Individualists more likely to be problem drinkers

Individualists more likely to be problem drinkers
What makes residents of certain states or countries more likely to consume more alcohol? According to a new study in the Journal of Consumer Research, high levels of individualism lead to more problem drinking.

"We looked at the extent to which consumer levels of individualism (vs. collectivism) were related to their beer and problem alcohol consumption," write authors Yinlong Zhang and L.J. Shrum (both University of Texas-San Antonio).

"We found that the higher a region scored on valuing individualism, the greater their beer and alcohol consumption, and this was true even when taking into account the effects of other variables such as income, climate, gender, and religion."

The researchers first used archival data to conduct comparisons of beer and alcohol consumption. They compared countries and compared states within the United States. They found that individualism, on a whole-country basis, could significantly predict alcohol consumption. In the United States, individualism correlated with teen drinking, teen heavy drinking, and adult binge drinking.

The researchers went on to manipulate the cultural orientation of individuals in the study. "We did this by simply asking people to either think and then write about enjoying their own life (independent self-construal) or think and then write about enjoying relationships with family and friends (interdependent selfconstrual)," the authors wrote. "We found that people who were temporarily induced to have an independent self-construal were more receptive to immediate beer consumption than were people who were temporarily induced to have an interdependent self-construal." Study participants did not actually consume beer; they merely indicated whether they felt like it.........

Posted by: JoAnn      Read more         Source



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Did you know?
Adolescents who suffer physical injuries are vulnerable to emotional distress in the months following their hospitalization, yet almost 40 percent of hospitalized adolescents interviewed for a new study had no source for the follow-up medical care that could diagnose and treat symptoms of post-traumatic stress. These young trauma survivors are at risk for high levels of post-traumatic stress and depressive symptoms, as well as high levels of alcohol use, according to research by researchers at the Harborview Injury Prevention and Research Center.

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