...HARLAN M. KRUMHOLZSEPT. 17, 2015 IN this age of instant information, medicine remains anchored in the practice of releasing new knowledge at a deliberate pace. It’s time for medical scientists to think differently about how quickly they alert the public to breakthrough findings. Last week the National Institutes of Health announced that it had prematurely ended a large national study of how best to treat people with high blood pressure because of its exceptional results. In this trial of more than 9,000 people age 50 and older with high blood pressure, an aggressive treatment strategy to keep systolic blood pressure below 120 was compared with a conventional one aimed at keeping it below 140. The subjects all had a high risk of heart attacks, stroke and heart failure. The N.I.H. concluded, six years into a planned eight-year study, that for these patients, pushing blood pressure down far below currently recommended levels was very beneficial. Ending a study early is rather unusual. In such cases, studies are stopped not by the investigators, but by an independent group of expert scientists who monitor the trial for evidence of unexpected harm or benefit that requires swift action. When a trial is halted early it is a surprise to the researchers who must not only move quickly to notify the participating doctors and subjects, but also decide how to communicate the results. The usual practice is to make a public announcement with an interpretation of the findings and then finalize the...
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...death for both men and women worldwide. Acute coronary syndrome occurs when the heart muscle does not get enough oxygenated blood. As a result of this, heart muscle experience symptoms such as pain, pressure or tightness to alert the severity and progression of the disease. If the symptoms are left untreated, it can be life threatening. Acute coronary syndrome includes myocardial infarction (MI), also known as a heart attack, and unstable angina, which is a sudden severe chest pain that typically occurs when a person is at rest. Every year, acute coronary syndrome affects an estimated 1.4 million people in the United States and another 1.4 million people in Europe ("Heart Disease: Symptoms,...
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...This article examines a multicenter double-blind placebo-controlled trial of cilostazol in preventing and reducing the risk of strokes. The results showed that cilostazol improved symptomatic regression by 2% in MRA scans and 4% in TCD tests. The effectiveness of cilostazol as a prevention for ischemic strokes was also compared against aspirin and reducing alcohol consumption. A background on ischemic strokes Ischemic strokes account for around 80% of all strokes, making them the most common type 1. The brain has a network of blood vessels that supply it with the oxygen and nutrients, importantly glucose, which it needs to work efficiently, as well as to remove waste such as carbon dioxide. A stroke is ischemic when the artery supplying...
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...Abstract The United States is one of the leading countries with the most overweight people. There are many parents who are unaware of the situation and do not have enough information to address this issue. As Michelle Obama is trying to get schools to eat healthier, the responsibility lies in the parents because what children eat at home also affect their weight. Research shows that being obese or overweight is linked to risks of chronic disease, disability, death, and decreased productivity and quality of life. These individuals have high risk of hypertension, diabetes, coronary artery disease, heart failure, stroke, etc. And that Child obesity increases the risk of having heart disease and stroke before they turn 30. Studies have also found that more children are eating away from home, snacking in between meals, consuming more junk food, and the lack of exercise due to more TV time can lead to being overweight and obesity. A survey was done and one of the findings that were expected was the correlation between more TV hours and the effect on the weight of the children. It was confirmed with the surveys received that as TV hours went up, weight also went up. It also holds true that children don’t eat as much fruits and vegetable servings as recommended. Parents need to reshape their thinking about the way they live to help prevent or reduce obesity in their children. Parents should be aware that what the kids do or eat at home has a direct effect on the children’s...
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...2006). NEJM boasts the largest paid circulation among medical journals, with close to 200,000 paying subscribers. It is printed weekly in the United States, Canada, the Netherlands, and Japan, and a range of translated articles reaches approximately 140,000 (New England Journal of Medicine.org, 2006). The NORVIT study was designed as a randomized, controlled, double-blind, intervention study. It included 3,749 men and women who had suffered and acute myocardial infarction within the last 7 days. The rationale behind the study was that high homocysteine levels are considered a risk factor for cardiovascular disease (Bonaa et al, 2006). The aim was to measure how effective lowering blood serum homocysteine levels with B vitamins was in preventing a secondary event. A collaborative meta-analysis published in The Journal of the American Medical Association, states that homocysteine levels are an independent predictor of ischemic heart disease and that studies on disease risk of genetic variants affecting homocysteine may help establish whether homocysteine is causally linked to vascular disease (2002: cited by Bonaa et al, 2006). The meta-analysis suggests that a large randomized trial of vitamin supplementation to lower homocysteine levels and the effect on heart disease should be carried out (The Journal of the American Medical Association 2002: cited by Bonaa et al, 2006). Looking at a study by in the American Journal of Clinical Nutrition, which looked at the lowest dose of...
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...effects in the body. There have been numerous reports linking cigarette smoking to diseases such as cancers of the lung, mouth, heart attacks, and other ailments. Moreover, smoking in public areas is an unhealthy habit because it harms not just the smokers, but also others who breathe the smoker’s cigarette smoke, that called secondhand smoke or passive smoke. Most studies of the effects of smoking focus on the public health aspects. However, smoking also negatively impacts on society through environmental problems and economic problems. Therefore, Federal and State Government should ban smoking in public area. When thinking of disease caused by smoking, the first one that comes to mind is always lung cancer, but there are many other serious diseases that are associated with smoking. Smoking damages nearly every organ of the body and diminishes a person’s overall health. Most of the substances contained in tobacco smoke are harmful to the body such as: tar, nicotine and carbon monoxide. They are the major cause of cancer as well as the heart attack, stroke and peripheral arterial disease. Actually, in 2010, the Surgeon General at U.S Department reported that: “Smoking is a leading cause of cancer and death from cancer. It causes cancers of the lung, mouth, throat, kidney, stomach as well as acute myeloid leukemia (6). Smoking also causes heart disease and stroke (8)”. Moreover, cigarette smoking and exposure to tobacco smoke are also the leading cause of premature death. Centers for...
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...Business Ethics Second Paper – Deontological Analysis June 19, 2013 Direct-to-Consumer Drug Advertising: Ethical or Not? The United States and New Zealand are the only developed countries that allow direct-to-consumer advertising. Whether the practice of direct to consumer advertising is beneficial to the consumers or not is a highly debated subject with both positions presenting sound reasoning for their position. Whether the practice is beneficial or not to the consumer is not the question, but rather, is advertising prescription drugs directly to consumers ethical? To analyze this question I will use Rawls’s second principle of distributive justice for analysis. (2) use that method, developing the argument in support of your case; In utilizing direct to consumer advertising for prescription drugs is the advertising “reasonably expected to be to everyone’s advantage”? and “attached to positions and offices open to all?” (DeGeorge 78) One of the predominate claims of the pharmaceutical companies that the advertisements educate the consumer, thus giving them more information to evaluate their needs and to speak intelligently with their doctor. So, is the information provided in an ad or commercial “reasonably expected to be to everyone’s advantage?” It is reasonable to assume that everyone is exposed to the ads with the various media outlets used, such as TV, radio, newspaper, magazines and so forth, but is the education to everyone’s advantage? The drug...
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...In the end, I brainstormed in order to explore my interest and what would broaden my knowledge. According to (Moule et al, 2011) in order to follow the research process, one must follow a series of stages; such as identifying problems, searching the literature, critically reading research, research aims, questions and hypothesis, ethical issues, sampling techniques, data collection, data analysis and interpretation of results. At first it was hard to identify what article I would critique as there were many articles that I could have chosen. The area that I have a particular interest in researching is related to my work with critically ill and often terminally ill patients. The topic that I have chosen to research relates to nurse’s experience in caring for terminally ill patients and their families. Evidence Based Practice in Nursing, Ellis, P (2013) 2nd Ed London Sage Literature search My primary approach to sourcing reliable research data was to use the online databases Cinahl and Medline. Table 1 shows the process of searching for a suitable research topic to critique. The search words consisted of “nurses’ attitudes”, “patients” and “death” with the number of results from each word...
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...The continuous pauses and jolting awake make for a light sleep rather than the necessary deep, restorative sleep, resulting in daytime sleepiness and poor concentration. Chronic sleep deprivation can also contribute to serious health conditions, such as diabetes, high blood pressure, heart disease, stroke and weight gain. Back to the Top Sleep Apnea Treatment How we can help you Sleep Apnea Treatment A good night’s sleep without having to wear a mask is an alternative for most mild to moderate Sleep Apnea sufferers Back to the Top If you are not sure you have Sleep Apnea If you think you have sleep apnea, but your are not sure, your first step is to make a visit to our office for a consultation with Dr. Takacs and to fill out a free questionnaire. If your questionnaire indicates a possiblity that you are suffering from sleep apnea, Dr. Takacs will arrange for your to go to the trusted sleep clinic she partners with for a sleep test. In some cases you will be able to do your sleep test at home. The sleep center will give you a definitive...
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...Diabetes Mellitus Machelle Van N140 Instructor’s Name November 5, 2012 Diabetes Mellitus According to the Australian Institute of Health and Wellness, “Diabetes Mellitus is a chronic condition in which the body makes too little of the hormone insulin or cannot use it properly” (pg. 1, para 1). The pancreas produces insulin which helps glucose to enter cells through the bloodstream; the sugar is then converted into energy. Diabetes is uncontrollable when there is a build-up of glucose in the bloodstream, and there is not enough glucose entering the cells. If left untreated, diabetes can cause damage to the brain, kidney disease, heart disease, stroke, and complications to other parts of the body. Diabetes often appears in childhood or adolescence. Etiology The disease affects more than 20 million Americans and more than 40 million Americans have pre-diabetes that can lead to type 2 diabetes. In type 2 diabetes, the cells become resistant to the action of insulin, and the pancreas is unable to produce enough insulin to overcome the resistance. Three Major Types of Diabetes Type I Diabetes | Type 2 Diabetes | Gestational Diabetes | Diagnosed in childhood or adolescence; the disease can occur in adults. | Common than type 1 diabetes; makes up many of the disease. | Develops at any time during pregnancy. | The body cannot produce insulin. | Occurs frequently in young people, and adulthood. | Women are at a higher risk of developing type...
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...medical research is wrong.” He tracks 49 of the most highly acclaimed research findings in medicine over the previous 13 years. He puts his contention to the test, not against some random run-of-the-mill researches, or even merely well-accepted research, but against the absolute tip of the research pyramid. These research findings had been judged by the science community’s two standard measures: (1) the papers appeared in the journals most widely cited in research articles, and (2) those 49 articles themselves were the most widely cited articles in those journals. These articles had been considered as game changer that had lead to the widespread popularity of treatments such as: (a) the use of hormone-replacement therapy for menopausal women, (b) vitamin E to reduce the risk of heart disease, (c) coronary stents to ward off heart attacks, and (d) daily low-dose aspirin, a nonsteroidal anti-inflammatory drug (NSAID), to control blood pressure and prevent heart attacks and strokes. He laid out the facts: (a) out of the 49 articles, 45 claims had been uncovered effective interventions; (b) 34 claims had been...
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...Product Liability Research Paper Michelle Wright Professor Ellen Kapalko Law Ethics & Corporate Governance Yaz The Product Liability of Bayer Pharmaceuticals The Bayer Pharmaceuticals Company was founded in 1893 by Friedrich Bayer and Johann Wescott in Barmen, Germany. Bayer is known for their trademarked Bayer Aspirin which was created in 1899. Bayer spent decades marketing heroin worldwide as a cough medicine for children. The side effects of selling heroin to children were not a concern for them. Although they originated as a pharmaceutical company they turned their attention to manufacturing chemical weapons. Bayer formed a close relationship with German firms during the World War which formed the conglomerate called IG Farben. They became the largest donor to Hitler’s army. In the post-war years Bayer grew to become the third largest pharmaceutical company in the world. In the mid-1980s Bayer was one of the companies which sold a product called Factor VIII concentrate to treat haemophilia. Factor VIII turned out to be infected with HIV and in the U.S. alone; it infected thousands of haemophiliacs, many of whom died in one of the worst drug-related medical disasters ever. But it was only in 2003 that the New York Times revealed that Bayer had continued producing and selling this infected product to Asia and Latin America after February 1984 when a safe product had become available, in order to save money. Dr. Sidney M. Wolfe, who investigated...
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...The Effects of Adderall During Exercise In modern society where most people have trouble concentrating, there is a group of people that are diagnosed with attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD). Although the drug is intended to help students and adults complete daily tasks, it has been recently been discovered to enhance physical performance during exercise. Although there is a lot more room for research, fatigue is the main physical aspect that Adderall is used to combat. Scientists are still running tests to learn more about the effects of Adderall on different aspects of the body. The purpose of the drug is to release dopamine because ADD/ADHD is caused from a lack of dopamine. Adderall also affects multiple body systems such as the digestive system, central nervous system, and circulatory system. The development of Adderall has caused professional sports leagues to set guidelines in the use of the drug during competition and training. Research is still developing around the full affect of Adderall during exercise but there is strong evidence to prove the enhancement of performance. Adderall is a common stimulant that when used properly treats ADHD/ADD in adults and children. The neurobehavioral disorder is more common in the youth, affecting between 3%-7% of school-aged children. ADD/ADHD can result in delayed learning ability, compromised academic success, and suspended maturation if not treated. Adderall is an amphetamine...
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...Chapter 1 Introduction Disorders related to hypertension are one of the most common medical complications during the pregnancy. It is also an important cause of maternal and preinatal morbidity and mortality worldwide (Baha, 1996). The term hypertension in pregnancy describes a broad spectrum of medical conditions, for which the pressure in the blood vessels varies widely. According to studies conducted by WHO (2004), hypertension causes complications in 5 to 7% pregnancies in the United Kingdom. The risks associated with hypertension are high for pregnant women and they are higher risk for complications such as organ failure, cerebrovascular accident, abruptio placentae and disseminated intravascular coagulation (Mark, 1998). Also hypertension creates complications for the featus and it is at the risk or intrauterine growth retardation, prematurity and intrauterine death. Hypertension is also a major cause of maternal, fetal and neo natal morbidity and mortality, not only in developing but in developed countries also,(Pesola (2001). The rate of eclampsia in the UK have fallen recently, hypertension during the pregnancy remains one of the main causes of maternal death. According to a study conducted by NICE one third of maternal morbidity was caused as a result of hypertensive conditions. Hypertensive disorders also carry a risk for the baby. In the most recent UK perinatal mortality report, 1 in 20 (5%) stillbirths in infants without congenital abnormality occurred...
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...yet. He explains further that when his brother had a “heart attack” in 2005, he was immediately placed on a beta blocker because the cardiologist reported how beta blockers reduce mortality after myocardial infarction (MI). The patient wants to know if a beta blocker would reduce his chance of mortality? Using the Patient-Intervention-Comparator-Outcome (PICO) format we formulated the following question. In a 67-year-old male with multiple co-morbidities with MI (P), does treatment with a beta blocker (I), compared with no beta blocker or placebo (O), reduce mortality rate (O)? Risk Factors, Incidence and Prevalence of Disease * US incidence rates of cardiovascular disease, including MI, are seen in men more than women (Alexander et al., 2007). This trend is also true in Utah ("Impact of heart," 2007). * The incidence rates of cardiovascular disease increase with age (Alexander et al., 2007). * Risk factors for cardiovascular disease include not eating enough fruits and vegetables, lack of physical exercise, smoking cigarettes and the co-morbidities of diabetes, hypertension, hyperlipidemia, and obesity ("CDC national heart," 2010). * The clinical scenario patient was at high MI risk being male, over 65, diabetic and obese. Article Critiques * The following primary article critiques were based on the CONSORT statement (2010). Primary Article One Article selection and evidence. * The article by Chen et al. (2005) was selected because it was the...
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