November 07, 2005

Hospice Founder, Dame Cicely Saunders

This summer Dame Cicely Saunders died in St. Christopher's Hospice, the orginal hospice she founded.

Posted by gandola at 03:57 PM

November 04, 2005

Muraglitazar and cardiovascular risk

The FDA has approved muraglitazar (Pargluva), a hypoglycemic agent. It has been associated with increased cardiovascular mortality.

Here is Public Citizen testimony before the FDA (Sept 9, 2005).

A subsequent JAMA editorial cautions about cardiovascular adverse effects and the insufficiency of safety data.

A paper by Nissen, Wolski and Topol reviews the associated excess risk of combined cardiovascular death and non-fatal stroke. To answer the question they call for a dedicated cardiovascular risk trial.

Posted by gandola at 06:05 AM

November 03, 2005

Pap Smears annually up to age 30

ACOG's clarification. JAMA this week goes into detail about Papanicolaou (Pap) smear strategies [1, 2].

1. Before a woman gets her annual birth-control pill refill she needs a Pap smear.
a. true
b. false

2. A teenager's routine Pap smear testing should begin soon after sexual activity begins.
a. true
b. false

The answers can be found in a case discussion in JAMA this week. (Briefly, the article suggests false positives raised by testing in either circumstance can outweigh the benefits.)

Posted by gandola at 06:07 AM

November 01, 2005

Celiac Plexus Pain and Treatment

Here is a drawing of the celiac plexus, also known as the solar plexus.

Radiologist, and others, can do celiac axis blocks to relieve chronic pain. Pancreas, esophagus and other gastrointestinal malignancies can lead to such pain. The relative benefit of blocks is discussed.

Posted by gandola at 02:53 PM