Forensics Talk

Group sues FDA over addictive painkiller

 USA Today                                                                                             

Health & Behavior

   WASHINGTON (AP) — A prescription painkiller sold under such names as Darvon and Darvocet is too risky to stay on the market, a consumer advocacy group argued Thursday in suing the Food and Drug Administration.

Public Citizen petitioned the FDA two years ago seeking a ban on the drug, calling it no more effective than safer painkillers and citing the accidental deaths of more than 2,000 people since 1981.

Thursday, Public Citizen filed suit in U.S. District Court in Washington arguing that FDA has violated the law by not ruling on its petition within the required six months.

At issue is a narcotic known chemically as propoxyphene, sold by numerous generic manufacturers as well as under the brand names Darvon and Darvocet.

It is considered a relatively weak painkiller. Public Citizen's Dr. Sidney Wolfe cited a recent review of research studies that found ibuprofen worked better for most kinds of pain... Read More

Poor Sleep Can Affect A Student's Grades, Increase Emotional, Behavioral Disturbance

 

Medical News Today                                                                           

Main Category: Sleep / Sleep Disorders / Insomnia
Also Included In: Conferences;  Pediatrics / Children's Health;  ADHD
Article Date: 11 Jun 2008 - 4:00 PDT

     Insufficient sleep among adolescents may not only contribute to lower grades and a lack of motivation, but may also increase the odds of serious levels of emotional and behavioral disturbances, including ADHD, according to a research abstract presented on Monday at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS).

The study, authored by Fred Danner, PhD, of the University of Kentucky, focused on 882 high school freshmen who provided information about their sleep habits and school grades and also completed psychological and behavioral assessments.

According to the results, students reported sleeping, on average, 7.6 hours per school night, with 48 percent reporting less than eight hours. Hours of sleep per school night were significantly positively associated with GPA and level of motivation, and significantly negatively associated with clinically significant levels of emotional disturbance and ADHD. Each additional hour of sleep on school nights lowered the odds of scoring in the clinically significant range of emotional disturbance and ADHD by 25 percent and 34 percent, respectively... Read More

Critical Care Management Associated with Higher Mortality in ICU Patients

Medical News Today
Main Category: Respiratory / Asthma
Also Included In: Hypertension;  Diabetes;  Public Health
Article Date: 04 Jun 2008 - 0:00 PDT

     A database review of 101,832 critically ill patients in 123 hospital intensive care units (ICUs) found that the risk of dying in hospital was higher for patients who were managed by physicians who were critical care specialists than those who were not (Article, p. 801). Patients managed by critical care specialists were generally sicker and received more procedures. However, analyses that adjusted for the tendency for sicker patients to be managed by critical care specialists still showed higher mortality among patients managed by the specialists. Authors say, their "results are surprising and completely contrary to previously published findings." They call for future studies to explore the role of protocol use, procedures, drug-resistant infections and other issues involved in care for patients in hospital ICUs. Two practicing intensivists discuss the study in an accompanying editorial (Editorial, p. 877)... Read More

Drug-Users Who Are Young And Homeless Are More Likely To Exit Treatment Early

Medical News Today
Main Category: Alcohol / Addiction / Illegal Drugs
Also Included In: Compliance
Article Date: 25 Apr 2008 - 3:00 PDT

     Almost a quarter of the most problematic drug-users in some areas exit drug treatment programmes before they've even completed 30 days reports a new study published in BioMed Central's open access Harm Reduction Journal. It found that problem drug-users who were younger, homeless or not currently injecting are significantly more likely to exit early, possibly because drug services are off-putting and not suited to their needs.

Since 1998, the UK has seen a big expansion in its drug programmes that has led to a 113% increase in the numbers of people being assessed for structured treatment. However, problem drug-users may not benefit from these programmes if they do not stay the course.

Researchers from the University of Kent and Kings College London analysed data from 2,624 service users from three English drug action team areas (two metropolitan and one provincial) who had been assessed and recommended for treatment programmes.

Whilst a quarter of problem drug-users exited early before completing 30 days, two thirds of these actually failed to even begin the recommended course of treatment - i.e. these programs fail to engage them at the outset. The ages of people leaving before starting treatment or before 30 days was significantly lower than those who remained on the programme.

How much drug users stuck at their treatment varied between agencies; they were more than two times more likely to exit early in agencies that have a longer waiting time between the assessment of the drug user and the start of their treatment. This finding suggests that exiting treatment early is not just due to inherent, individual factors but may relate to program differences.

Interviews with problem drug-users and agency staff backed up these findings. "Whilst it is easy to blame the early exit out rate of problem drug-users on the 'chaos' in their lives of drug and their lack of motivation our data and interviews suggest that there is much that services can do to enhance the rate of retention in the first few days and weeks," notes Dr Alex Stevens, who led the study.

For example, problem drug-users who do not belong to the traditional client group of injecting heroin users in their late 20s and 30s (eg - those who use stimulants) may find traditional drug services, provided from central locations in often run-down buildings, off-putting. The limited opening hours of services may exclude many potential clients, especially those who work, from being able to attend treatment. Techniques for enhancing early retention, such as proactive, personalised contacting for appointments and motivational interviewing during treatment sessions are available but not yet widespread.

----------------------------
Article adapted by Medical News Today from original press release.
----------------------------

1. Early Exit: Estimating and explaining early exit from drug treatment
Alex Stevens, Polly Radcliffe, Melony Sanders and Neil Hunt
Harm Reduction Journal (in press)
Article available at the journal website.
All articles are available free of charge, according to BioMed Central's open access policy.

2. The research was funded by Department of Health (Policy Research Programme) under their Drugs Misuse Research Initiative. The views expressed are those of the authors and not necessarily of the Department of Health.

3. Harm Reduction Journal is an Open Access, peer-reviewed, online journal whose focus is prevalent patterns of psychoactive drug use, the public policies meant to control them, and the search for effective methods of reducing the adverse medical, public health, and social consequences associated with both drugs and drug policies.

4. BioMed Central (http://www.biomedcentral.com/) is an independent online publishing house committed to providing immediate access without charge to the peer-reviewed biological and medical research it publishes. This commitment is based on the view that open access to research is essential to the rapid and efficient communication of science.

Source: Charlotte Webber
BioMed Central

    

Patients Are Encouraged To Consult Healthcare Professionals Before Discontinuing Medications

Medical News Today
Article Date: 04 Apr 2008 - 3:00 PDT

     Patients concerned about recent news regarding the safety and efficacy of medications should seek guidance from their pharmacist, physician or other healthcare professional before they stop taking their medications.

The American Pharmacists Association (APhA) strongly encourages patients to stay informed about their medications and ask their pharmacist or prescriber about any questions or concerns they may have about their medications. Patients should speak with their healthcare professional before stopping any prescribed medication. Physicians and pharmacists can help educate them about risks and benefits of medication, available treatment alternatives, proper ways to withdraw from medicines and ways to achieve optimal drug therapy.

APhA issues the following guidance:

-- Patients with questions are encouraged to talk to their pharmacist, physician or other healthcare provider about their medications. Take medication as indicated/directed and do not abruptly stop taking medications.

-- If you are advised by a healthcare professional to stop taking a medication, to properly dispose of unused medications:

- DO NOT FLUSH unused medications, except when expressly instructed by the label.
- To ensure children and pet protection, crush or dissolve medications in water (also applies to liquids) and mix with kitty litter or a solid kitchen substance (such as coffee grinds), then place in a sealed plastic bag and dispose.
- To ensure protection of your privacy, remove and destroy all identifying personal information (such as the prescription label) from the medication container.

For more about medication disposal visit http://www.SMARxTDISPOSAL.net

About the American Pharmacists Association (APhA)

The American Pharmacists Association, founded in 1852 as the American Pharmaceutical Association, represents more than 63,000 practicing pharmacists, pharmaceutical scientists, student pharmacists, pharmacy technicians, and others interested in advancing the profession. APhA, dedicated to helping all pharmacists improve medication use and advance patient care, is the first-established and largest association of pharmacists in the United States. APhA members provide care in all practice settings, including community pharmacies, hospitals, long-term care facilities, managed care organizations, hospice settings, and the military.

American Pharmacists Association

    



    

Risk Of Death From Acute Kidney Failure Reduced By 'Renal Assist Device'

Medical News Today
Article Date: 05 Mar 2008 - 5:00 PST

     For patients with acute kidney injury (AKI), an external device containing human kidney cells promotes recovery of the injured kidneys and significantly reduces the risk of death, according to a preliminary clinical study published in the May Journal of the American Society of Nephrology.

The experimental renal tubule assist device (RAD) appears safe and effective for desperately ill patients with AKI. "Deployment of the RAD was associated with remarkably better outcomes for these patients - speeding recovery of kidney function and reducing risk of death by half," comments Dr. H. David Humes of University of Michigan, one of the study authors.

Patients with AKI have sudden loss of kidney function, resulting from a wide range of possible causes (such as blood loss or toxic injury). The goal of treatment is to replace lost kidney function through dialysis and related techniques until the kidneys have time to recover. However, even with treatment, the risk of death during an episode of AKI is 50 percent or higher.

In the new study, 40 of 58 patients with AKI were randomly assigned to treatment with the RAD, in addition to standard renal replacement therapy. The RAD is a conventional blood filter device lined with human renal tubule cells, grown from donor kidneys. "The cells are made available to carry out subtle metabolic and endocrine functions that the patient's failing kidneys can no longer perform, thereby staunching a cascading decline in the patient's health and allowing time for the patient's own organs to recover," Dr. Humes explains.

Outcomes were significantly better for AKI patients treated with the RAD. After one month, 33 percent of patients in the RAD group had died, compared to 61 percent of those treated with renal replacement therapy only. Patients who received the RAD were also more likely to be alive after six months. With adjustment for other factors, the risk of death was about 50 percent lower in the RAD group.

Patients in the RAD group also had a shorter time to return of kidney function. Overall, kidney function recovered in 53 percent of patients with RAD, compared to 28 percent without RAD. In both groups, about 20 percent of patients survived but never recovered kidney function, requiring chronic dialysis.

Although the initial results are encouraging, the benefits of RAD treatment need to be confirmed in larger studies. In addition, the researchers need to study the effects of changes in the design of the RAD, which are needed to accommodate mass production.

In addition to improving the outcomes of AKI, the results may point the way toward entirely new classes of cell-based and tissue-engineered therapies. "The ability to harness vital processes of cells, to target their living molecular machinery on restoring critical substances which have become disordered by disease, has vast implications for the future of medicine," says Dr. Humes. "Particularly, we are encouraged that we can develop a related device to treat chronic renal failure - a wearable kidney that performs natural functions unachievable through man-made technology alone."

----------------------------
Article adapted by Medical News Today from original press release.
----------------------------

The American Society of Nephrology (ASN) is a not-for-profit organization of 10,500 physicians and scientists dedicated to the study of nephrology and committed to providing a forum for the promulgation of information regarding the latest research and clinical findings on kidney diseases. ASN publishes JASN, the Clinical Journal of the American Society of Nephrology (CJASN), and the Nephrology Self-Assessment Program (NephSAP).

Source: Shari Leventhal
American Society of Nephrology