Scientists Have Found A New Way To Lose Weight.
A uncharted commentary finds that weight-loss surgery helps very obese patients smidgen pounds and improve their overall health, even if there is some risk for complications. "We've gotten good at doing this," said Dr Mitchell Roslin, main of weight-loss surgery at Lenox Hill Hospital in New York City. "Bariatric surgery has become one of the safest intra-abdominal prime procedures. The quiz is why we don't start facing the facts who was not involved in the new review. If the data were this OK with any other condition, the standard of care for morbid obesity would be surgery. He said he thinks a unfairly against obesity tinges the way people look at weight-loss surgery.
And "People don't objective obesity as a disease, and blame the victim. We have this ridiculous notion that the next diet is going to be serviceable - although there has never been an effective diet for people who are severely obese". Morbid obesity is a chronic fettle that is practically irreversible and needs to be treated aggressively. The only treatment that's effective is surgery. Review creator Su-Hsin Chang is an instructor in the division of public health services at the Washington University School of Medicine, in St Louis.
So "Weight-loss surgery provides generous crap on weight loss and improves obesity-related conditions in the majority of bariatric patients, although risks of complication, reoperation and extirpation exist. Death rates are, in general, very low. The dimensions of weight loss and risks are different across different procedures. These should be well communicated when the surgical recourse is offered to obese patients and should be well considered when making decisions".
The report was published online Dec 18, 2013 in the periodical JAMA Surgery. For the study, Chang's yoke analyzed more than 150 studies related to weight-loss surgery. More than 162000 patients, with an regular body-mass index (BMI) of nearly 46, were included. BMI is a measure of body fat based on summit and weight, and a BMI of more than 40 is considered very severely obese.
Tuesday, 26 November 2019
The Number Infected With Hepatitis From The Frozen Berries Grows In The USA
The Number Infected With Hepatitis From The Frozen Berries Grows In The USA.
The copy of the crowd now ill in a hepatitis A outbreak that may be tied to a frozen berry/pomegranate blend continues to rise, US health officials said. As of June 5, 2013, 61 masses in Colorado, New Mexico, Nevada, Arizona, Utah, Hawaii and California have been reported woe with hepatitis A that may be connected to Townsend Farms Organic Anti-Oxidant Blend frozen berry and pomegranate mix, according to an update issued by the US Centers for Disease Control and Prevention. On Tuesday, Oregon-based Townsend Farms recalled the frozen berry mixes, which were sold to Costco and Harris Teeter stores.
The mixes were sold under the Townsend Farms identify at Costco and under the Harris Teeter sort at that secure of stores, the Associated Press reported. According to the World Health Organization, hepatitis A illnesses typically rise within 14 and 28 days of infection. Symptoms may number nausea, fever, lethargy, jaundice and trouncing of appetite. There's a vaccine against hepatitis A, and it may leisure symptoms if given soon after aspect to the virus.
Data from interviews with 30 patients affected in the new outbreak shows that 37 percent have been hospitalized, with ages ranging from 2 to 71 years. The dates of the inception of illnesses categorize from April 29 to May 27, 2013. 22 of the 30 patients who were interviewed said they ate Townsend Farms Organic Anti-Oxidant Blend frozen berry and pomegranate mix.
The copy of the crowd now ill in a hepatitis A outbreak that may be tied to a frozen berry/pomegranate blend continues to rise, US health officials said. As of June 5, 2013, 61 masses in Colorado, New Mexico, Nevada, Arizona, Utah, Hawaii and California have been reported woe with hepatitis A that may be connected to Townsend Farms Organic Anti-Oxidant Blend frozen berry and pomegranate mix, according to an update issued by the US Centers for Disease Control and Prevention. On Tuesday, Oregon-based Townsend Farms recalled the frozen berry mixes, which were sold to Costco and Harris Teeter stores.
The mixes were sold under the Townsend Farms identify at Costco and under the Harris Teeter sort at that secure of stores, the Associated Press reported. According to the World Health Organization, hepatitis A illnesses typically rise within 14 and 28 days of infection. Symptoms may number nausea, fever, lethargy, jaundice and trouncing of appetite. There's a vaccine against hepatitis A, and it may leisure symptoms if given soon after aspect to the virus.
Data from interviews with 30 patients affected in the new outbreak shows that 37 percent have been hospitalized, with ages ranging from 2 to 71 years. The dates of the inception of illnesses categorize from April 29 to May 27, 2013. 22 of the 30 patients who were interviewed said they ate Townsend Farms Organic Anti-Oxidant Blend frozen berry and pomegranate mix.
Correlation Use Drugs For Heartburn And The Percentage Of Birth Defects Of Children
Correlation Use Drugs For Heartburn And The Percentage Of Birth Defects Of Children.
Babies born to women who took a standard division of heartburn drugs while they were club did not appear to have any heightened risk of birth defects, a large Danish investigation finds. This class of drugs, known as proton-pump inhibitors (PPIs), include blockbusters such as Prilosec (omeprazole), Prevacid (lansoprazole) and Nexium (esomeprazole). All were ready by prescription-only during most of the work period (1996-2008), but Prilosec and Prevacid are now sold over-the-counter.
While the authors and an editorialist, publishing in the Nov 25, 2010 delivery of the New England Journal of Medicine, called the results "reassuring," experts still guide using drugs as little as possible during pregnancy. "In general, these are probably out of harm's way but it takes a lot of time and a lot of exposures before you see some of the abnormalities that might exist," explained Dr Eva Pressman, professor of obstetrics and gynecology and big cheese of maternal-fetal medicine at the University of Rochester Medical Center. "My recommendations are always to circumvent medication exposure if at all possible.
There are very few life-threatening disorders that require these PPIs. There are other ways to get the same effect," added Pressman, who was not active in the study. "Most pregnant women have heartburn but most of it is somewhat easy to treat with simple antacids such as Tums and Maalox and Mylanta, all of which are locally acting and absorbed, and don't ask any risk to the fetus".
Even propping yourself up so you're in a semi-vertical position, as opposed to fibbing flat, can help, said Dr Michael Katz, senior iniquity president for research and global programs at the March of Dimes. The research was funded by the Danish Medical Research Council and the Lundbeck Foundation.
The authors of the recent study used linked databases to glean message on almost 841000 babies born in Denmark from 1996 through 2008, as well as on the babies' mothers' use of PPIs during pregnancy. PPI use by hopeful women was the highest between 2005 and 2008, when about 2 percent of fetuses were exposed, but risk during the critical first trimester was less than 1 percent.
Babies born to women who took a standard division of heartburn drugs while they were club did not appear to have any heightened risk of birth defects, a large Danish investigation finds. This class of drugs, known as proton-pump inhibitors (PPIs), include blockbusters such as Prilosec (omeprazole), Prevacid (lansoprazole) and Nexium (esomeprazole). All were ready by prescription-only during most of the work period (1996-2008), but Prilosec and Prevacid are now sold over-the-counter.
While the authors and an editorialist, publishing in the Nov 25, 2010 delivery of the New England Journal of Medicine, called the results "reassuring," experts still guide using drugs as little as possible during pregnancy. "In general, these are probably out of harm's way but it takes a lot of time and a lot of exposures before you see some of the abnormalities that might exist," explained Dr Eva Pressman, professor of obstetrics and gynecology and big cheese of maternal-fetal medicine at the University of Rochester Medical Center. "My recommendations are always to circumvent medication exposure if at all possible.
There are very few life-threatening disorders that require these PPIs. There are other ways to get the same effect," added Pressman, who was not active in the study. "Most pregnant women have heartburn but most of it is somewhat easy to treat with simple antacids such as Tums and Maalox and Mylanta, all of which are locally acting and absorbed, and don't ask any risk to the fetus".
Even propping yourself up so you're in a semi-vertical position, as opposed to fibbing flat, can help, said Dr Michael Katz, senior iniquity president for research and global programs at the March of Dimes. The research was funded by the Danish Medical Research Council and the Lundbeck Foundation.
The authors of the recent study used linked databases to glean message on almost 841000 babies born in Denmark from 1996 through 2008, as well as on the babies' mothers' use of PPIs during pregnancy. PPI use by hopeful women was the highest between 2005 and 2008, when about 2 percent of fetuses were exposed, but risk during the critical first trimester was less than 1 percent.
Slowly Progressive Prostate Cancer Need To Be Watched Instead Of Treatment
Slowly Progressive Prostate Cancer Need To Be Watched Instead Of Treatment.
For patients with prostate cancer that has a bawdy imperil of progression, effectual surveillance, also known as "watchful waiting," may be a suitable treatment option, according to a large-scale study from Sweden. The publication of how (or whether) to treat localized prostate cancer is controversial because, especially for older men, the tumor may not ripen far enough to cause real trouble during their remaining expected lifespan. In those cases, deferring care until there are signs of disease progression may be the better option.
The researchers looked at almost 6900 patients from the National Prostate Cancer Registry Sweden, period 70 or younger, who had localized prostate cancer and a dejected or intermediate risk that the cancer would progress. From 1997 through December 2002, over 2000 patients were assigned to animated surveillance, close to 3400 underwent thorough prostatectomy (removal of the prostate and some surrounding tissue), and more than 1400 received radiation therapy.
For patients with prostate cancer that has a bawdy imperil of progression, effectual surveillance, also known as "watchful waiting," may be a suitable treatment option, according to a large-scale study from Sweden. The publication of how (or whether) to treat localized prostate cancer is controversial because, especially for older men, the tumor may not ripen far enough to cause real trouble during their remaining expected lifespan. In those cases, deferring care until there are signs of disease progression may be the better option.
The researchers looked at almost 6900 patients from the National Prostate Cancer Registry Sweden, period 70 or younger, who had localized prostate cancer and a dejected or intermediate risk that the cancer would progress. From 1997 through December 2002, over 2000 patients were assigned to animated surveillance, close to 3400 underwent thorough prostatectomy (removal of the prostate and some surrounding tissue), and more than 1400 received radiation therapy.
Deadly Intestinal Infection
Deadly Intestinal Infection.
Increased efforts to bring the spread of an intestinal superbug aren't having a larger impact, according to a national survey of infection prevention specialists in the United States. Hospitals and other vigorousness care facilities need to do even more to reduce rates of Clostridium difficile infection, including hiring more infection forestalling staff and improving monitoring of cleaning efforts, according to the Association for Professionals in Infection Control and Epidemiology (APIC). Each year, about 14000 Americans pass away from C difficile infection.
Deaths kindred to C difficile infection rose 400 percent between 2000 and 2007, partly due to the look of a stronger strain, according to the US Centers for Disease Control and Prevention. In addition, the infections join at least $1 billion a year to US healthfulness care costs. In January, 2013, APIC surveyed 1100 members and found that 70 percent said their robustness care facilities had adopted additional measures to anticipate C difficile infections since March 2010.
However, only 42 percent of respondents said C difficile infection rates at their facilities had declined, while 43 percent said there was no decrease, according to the findings presented Monday at an APIC bull session on C difficile, held in Baltimore. Despite the actuality that C difficile infection rates have reached all-time highs in current years, only 21 percent of strength care facilities have added more infection prevention staff to tackle the problem, the evaluate found.
Increased efforts to bring the spread of an intestinal superbug aren't having a larger impact, according to a national survey of infection prevention specialists in the United States. Hospitals and other vigorousness care facilities need to do even more to reduce rates of Clostridium difficile infection, including hiring more infection forestalling staff and improving monitoring of cleaning efforts, according to the Association for Professionals in Infection Control and Epidemiology (APIC). Each year, about 14000 Americans pass away from C difficile infection.
Deaths kindred to C difficile infection rose 400 percent between 2000 and 2007, partly due to the look of a stronger strain, according to the US Centers for Disease Control and Prevention. In addition, the infections join at least $1 billion a year to US healthfulness care costs. In January, 2013, APIC surveyed 1100 members and found that 70 percent said their robustness care facilities had adopted additional measures to anticipate C difficile infections since March 2010.
However, only 42 percent of respondents said C difficile infection rates at their facilities had declined, while 43 percent said there was no decrease, according to the findings presented Monday at an APIC bull session on C difficile, held in Baltimore. Despite the actuality that C difficile infection rates have reached all-time highs in current years, only 21 percent of strength care facilities have added more infection prevention staff to tackle the problem, the evaluate found.
Muscle Memory
Muscle Memory.
Highly skilled typists actually have trouble identifying positions of many of the keys on a footing QWERTY keyboard, researchers say, suggesting there's much more to typing than routine learning. The new study "demonstrates that we're capable of doing extremely complicated things without knowledgeable explicitly what we are doing," lead researcher Kristy Snyder, a Vanderbilt University mark student, said in a university news release. She and her colleagues asked 100 males and females to complete a short typing test.
They were then shown a blank keyboard and given 80 seconds to write the letters within the exact keys. On average, these participants were proficient typists, banging out 72 words per write down with 94 percent accuracy. However, when quizzed, they could accurately place an regular of only 15 letters on the blank keyboard, according to the study published in the journal Attention, Perception, andamp; Psychophysics.
Highly skilled typists actually have trouble identifying positions of many of the keys on a footing QWERTY keyboard, researchers say, suggesting there's much more to typing than routine learning. The new study "demonstrates that we're capable of doing extremely complicated things without knowledgeable explicitly what we are doing," lead researcher Kristy Snyder, a Vanderbilt University mark student, said in a university news release. She and her colleagues asked 100 males and females to complete a short typing test.
They were then shown a blank keyboard and given 80 seconds to write the letters within the exact keys. On average, these participants were proficient typists, banging out 72 words per write down with 94 percent accuracy. However, when quizzed, they could accurately place an regular of only 15 letters on the blank keyboard, according to the study published in the journal Attention, Perception, andamp; Psychophysics.
Saturday, 23 November 2019
Doctors Told About The New Flu
Doctors Told About The New Flu.
This year's flu mellow may be off to a somnolent start nationwide, but infection rates are spiking in the south-central United States, where five deaths have already been reported in Texas. And the controlling strain of flu so far has been H1N1 "swine" flu, which triggered the pandemic flu in 2009, federal salubriousness officials said. "That may change, but uprightness now most of the flu is H1N1," said Dr Michael Young, a medical catchpole with the US Centers for Disease Control and Prevention's influenza division. "It's the same H1N1 we have been light of the past couple of years and that we really started to see in 2009 during the pandemic".
States reporting increasing levels of flu movement include Alabama, Louisiana, Mississippi and Texas. Young eminent that H1N1 flu is different from other types of flu because it tends to strike younger adults harder than older adults. Flu is typically a bigger portent to people 65 and older and very junior children and people with chronic medical conditions, such as heart disease and diabetes. This year, because it's an H1N1 mature so far, we are seeing more infections in younger adults".
So "And some of these folks have underlying conditions that put them at peril for hospitalization or death. This may be surprising to some folks, because they forget the citizens that H1N1 hits". The good news is that this year's flu vaccine protects against the H1N1 flu. "For citizenry who aren't vaccinated yet, there's still time - they should go out and get their vaccine," he advised.
This year's flu mellow may be off to a somnolent start nationwide, but infection rates are spiking in the south-central United States, where five deaths have already been reported in Texas. And the controlling strain of flu so far has been H1N1 "swine" flu, which triggered the pandemic flu in 2009, federal salubriousness officials said. "That may change, but uprightness now most of the flu is H1N1," said Dr Michael Young, a medical catchpole with the US Centers for Disease Control and Prevention's influenza division. "It's the same H1N1 we have been light of the past couple of years and that we really started to see in 2009 during the pandemic".
States reporting increasing levels of flu movement include Alabama, Louisiana, Mississippi and Texas. Young eminent that H1N1 flu is different from other types of flu because it tends to strike younger adults harder than older adults. Flu is typically a bigger portent to people 65 and older and very junior children and people with chronic medical conditions, such as heart disease and diabetes. This year, because it's an H1N1 mature so far, we are seeing more infections in younger adults".
So "And some of these folks have underlying conditions that put them at peril for hospitalization or death. This may be surprising to some folks, because they forget the citizens that H1N1 hits". The good news is that this year's flu vaccine protects against the H1N1 flu. "For citizenry who aren't vaccinated yet, there's still time - they should go out and get their vaccine," he advised.
Thursday, 21 November 2019
Another Type Of Congenital Heart Disease May Be Cured By The Device And The Surgery
Another Type Of Congenital Heart Disease May Be Cured By The Device And The Surgery.
A congenital verve shortfall that was typically catastrophic three decades ago is no longer so deadly, thanks to new technologies and surgical techniques that admit babies to survive well into adulthood, researchers report. A study in the May 27 dissemination of the New England Journal of Medicine compares the effectiveness of older and newer versions of devices aimed at fixing incompletely formed hearts. The writing-room finds both performing equally well over three years.
It's a "landmark" study, "one that we've never had before in congenital hub disease," said Dr Gail D Pearson, kingpin of the Adult and Pediatric Cardiac Research Program at the US National Heart, Lung and Blood Institute, which financed the effort. The study, which compared two devices for keeping oxygen-carrying blood flowing in 549 children born with hearts incapable of doing it alone, has not yet produced exhaustive results favoring one stratagem over the other.
But the probing is indeed just beginning. "Continuing follow-up will help us sort out the near- and long-term results". Study architect Dr Richard G Ohye, head of the University of Michigan pediatric cardiovascular surgery division, agreed. "Well be able to follow them to adulthood, and they will teach us about the best way to rule them". The children in the study were born with hearts that had a nonfunctioning - or nonexistent - hand ventricle, the chamber that pumps blood to the body. About 1000 such children are born in the United States each year, one in 5000.
A congenital verve shortfall that was typically catastrophic three decades ago is no longer so deadly, thanks to new technologies and surgical techniques that admit babies to survive well into adulthood, researchers report. A study in the May 27 dissemination of the New England Journal of Medicine compares the effectiveness of older and newer versions of devices aimed at fixing incompletely formed hearts. The writing-room finds both performing equally well over three years.
It's a "landmark" study, "one that we've never had before in congenital hub disease," said Dr Gail D Pearson, kingpin of the Adult and Pediatric Cardiac Research Program at the US National Heart, Lung and Blood Institute, which financed the effort. The study, which compared two devices for keeping oxygen-carrying blood flowing in 549 children born with hearts incapable of doing it alone, has not yet produced exhaustive results favoring one stratagem over the other.
But the probing is indeed just beginning. "Continuing follow-up will help us sort out the near- and long-term results". Study architect Dr Richard G Ohye, head of the University of Michigan pediatric cardiovascular surgery division, agreed. "Well be able to follow them to adulthood, and they will teach us about the best way to rule them". The children in the study were born with hearts that had a nonfunctioning - or nonexistent - hand ventricle, the chamber that pumps blood to the body. About 1000 such children are born in the United States each year, one in 5000.
Wednesday, 20 November 2019
Risk Factors For Alzheimer's Disease
Risk Factors For Alzheimer's Disease.
Older adults with homage problems and a narration of concussion have more buildup of Alzheimer's disease-associated plaques in the brain than those who also had concussions but don't have respect problems, according to a new study. "What we think it suggests is, head trauma is associated with Alzheimer's-type dementia - it's a endanger factor," said study researcher Michelle Mielke, an friend professor of epidemiology and neurology at Mayo Clinic Rochester. But it doesn't degenerate someone with head trauma is automatically going to develop Alzheimer's. Her turn over is published online Dec 26, 2013 and in the Jan 7, 2014 print version of the journal Neurology.
Previous studies looking at whether head trauma is a risk factor for Alzheimer's have come up with conflicting results. And Mielke stressed that she has found only a relate or association, not a cause-and-effect relationship. In the study, Mielke and her band evaluated 448 residents of Olmsted County, Minn, who had no signs of tribute problems.
They also evaluated another 141 residents with memory and thinking problems known as mild cognitive impairment. More than 5 million Americans have Alzheimer's disease, according to the Alzheimer's Association. Plaques are deposits of a protein scrap known as beta-amyloid that can erect up in between the brain's nerve cells. While most folk develop some with age, those who develop Alzheimer's generally get many more, according to the Alzheimer's Association.
They also minister to to get them in a predictable pattern, starting in brain areas crucial for memory. In the Mayo study, all participants were venerable 70 or older. The participants reported if they ever had a brain injury that implicated loss of consciousness or memory. Of the 448 without any memory problems, 17 percent had reported a cognition injury. Of the 141 with memory problems, 18 percent did.
Older adults with homage problems and a narration of concussion have more buildup of Alzheimer's disease-associated plaques in the brain than those who also had concussions but don't have respect problems, according to a new study. "What we think it suggests is, head trauma is associated with Alzheimer's-type dementia - it's a endanger factor," said study researcher Michelle Mielke, an friend professor of epidemiology and neurology at Mayo Clinic Rochester. But it doesn't degenerate someone with head trauma is automatically going to develop Alzheimer's. Her turn over is published online Dec 26, 2013 and in the Jan 7, 2014 print version of the journal Neurology.
Previous studies looking at whether head trauma is a risk factor for Alzheimer's have come up with conflicting results. And Mielke stressed that she has found only a relate or association, not a cause-and-effect relationship. In the study, Mielke and her band evaluated 448 residents of Olmsted County, Minn, who had no signs of tribute problems.
They also evaluated another 141 residents with memory and thinking problems known as mild cognitive impairment. More than 5 million Americans have Alzheimer's disease, according to the Alzheimer's Association. Plaques are deposits of a protein scrap known as beta-amyloid that can erect up in between the brain's nerve cells. While most folk develop some with age, those who develop Alzheimer's generally get many more, according to the Alzheimer's Association.
They also minister to to get them in a predictable pattern, starting in brain areas crucial for memory. In the Mayo study, all participants were venerable 70 or older. The participants reported if they ever had a brain injury that implicated loss of consciousness or memory. Of the 448 without any memory problems, 17 percent had reported a cognition injury. Of the 141 with memory problems, 18 percent did.
Certain Medications Is Not Enough In The US
Certain Medications Is Not Enough In The US.
Four out of five doctors who examine cancer were powerless to prescribe their medication of choice at least once during a six-month while because of a drug shortage, according to a new survey. The survey also found that more than 75 percent of oncologists were calculated to make a major change in patient treatment. These changes included altering the regimen of chemotherapy drugs initially prescribed and substituting one of the drugs in a nice chemotherapy regimen. Such changes might not be well studied, and it might not be unquestioned if the substitutions will work as well or be as safe as what the doctor wanted to prescribe, experts say.
And "The drugs we're conjunctio in view of in shortages are for colon cancer, bosom cancer and leukemia," said Dr Keerthi Gogineni, an oncologist who led the team conducting the survey. "These are drugs for forward but curable cancers. These are our bread-and-butter drugs for trite cancers, and they don't necessarily have substitutes. When we asked people how they adapted to the shortages, they either switched combinations of drugs or switched one medicament within a regimen," said Gogineni, of the Abramson Cancer Center and Perelman School of Medicine at the University of Pennsylvania.
So "They're making the best of a nit-picking situation, but, truly, we don't have a pick up of how these substitutions might affect survival outcomes". Results of the survey were published as a inscribe in the Dec 19, 2013 issue of the New England Journal of Medicine. The scrutiny included more than 200 physicians who routinely prescribe cancer drugs. When substitutions have to be made, it's often a generic cure-all that's unavailable. Sixty percent of doctors surveyed reported having to prefer a more expensive brand-name drug to continue treatment in the face of a shortage.
The remainder in cost can be staggering, however. When a generic drug called fluorouracil was unavailable, substituting the brand-name anaesthetize Xeloda was 140 times more expensive than the desired drug, according to the survey. Another choice is to delay treatment, but again it's not clear what effect waiting might have on an individual patient's cancer. Forty-three percent of oncologists delayed curing during a drug shortage, according to the survey.
Complicating matters for doctors is that there are no conventional guidelines for making substitutions. Almost 70 percent of the oncologists surveyed said their cancer center or vocation had no formal guidelines to aid in their decision-making. Generic chemotherapy drugs have been at jeopardy of shortages since 2006, according to background information accompanying the survey results. As many as 70 percent of opiate shortages occur due to a breakdown in production, according to the US Food and Drug Administration.
Four out of five doctors who examine cancer were powerless to prescribe their medication of choice at least once during a six-month while because of a drug shortage, according to a new survey. The survey also found that more than 75 percent of oncologists were calculated to make a major change in patient treatment. These changes included altering the regimen of chemotherapy drugs initially prescribed and substituting one of the drugs in a nice chemotherapy regimen. Such changes might not be well studied, and it might not be unquestioned if the substitutions will work as well or be as safe as what the doctor wanted to prescribe, experts say.
And "The drugs we're conjunctio in view of in shortages are for colon cancer, bosom cancer and leukemia," said Dr Keerthi Gogineni, an oncologist who led the team conducting the survey. "These are drugs for forward but curable cancers. These are our bread-and-butter drugs for trite cancers, and they don't necessarily have substitutes. When we asked people how they adapted to the shortages, they either switched combinations of drugs or switched one medicament within a regimen," said Gogineni, of the Abramson Cancer Center and Perelman School of Medicine at the University of Pennsylvania.
So "They're making the best of a nit-picking situation, but, truly, we don't have a pick up of how these substitutions might affect survival outcomes". Results of the survey were published as a inscribe in the Dec 19, 2013 issue of the New England Journal of Medicine. The scrutiny included more than 200 physicians who routinely prescribe cancer drugs. When substitutions have to be made, it's often a generic cure-all that's unavailable. Sixty percent of doctors surveyed reported having to prefer a more expensive brand-name drug to continue treatment in the face of a shortage.
The remainder in cost can be staggering, however. When a generic drug called fluorouracil was unavailable, substituting the brand-name anaesthetize Xeloda was 140 times more expensive than the desired drug, according to the survey. Another choice is to delay treatment, but again it's not clear what effect waiting might have on an individual patient's cancer. Forty-three percent of oncologists delayed curing during a drug shortage, according to the survey.
Complicating matters for doctors is that there are no conventional guidelines for making substitutions. Almost 70 percent of the oncologists surveyed said their cancer center or vocation had no formal guidelines to aid in their decision-making. Generic chemotherapy drugs have been at jeopardy of shortages since 2006, according to background information accompanying the survey results. As many as 70 percent of opiate shortages occur due to a breakdown in production, according to the US Food and Drug Administration.
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