What is the best way to take my pills?
This question is at the root of more confusion than any other question in medicine. The public wonders about which pill is best for a given disease, and we are constantly under the barrage of pharmaceutical advertising, but the fact still remains that most doctor's prescriptions are not filled. And even when the prescriptions are filled, they are rarely taken as directed. Whose fault: we all share equally, doctor, pharmacist and patient. This is not good, since we are all trying to work together.
I saw a cartoon in a magazine once on this subject. The doctor told the patient "take one pill twice a day". The patient looked confused and then asked " Doc, don't I swallow it the first time?"
One of my sons collected labels from the pharmacy and kept them on a prescription bottle. The instructions were actually comical when viewed from the right perspective. "Do not swallow". "For rectal use only." "Use as directed". "To be put in left ...
The JUPITER study has been the subject of countless headlines reporting the unprecedented reduction in heart attacks with the cholesterol drug, Crestor® . The study has received gushing pronouncements of the inestimable value of statins by my cardiology colleagues.
Pharmaceutical giant, AstraZeneca, sponsored this study of nearly 18,000 people (men 50 years and over, women 60 years and over). Participants took 20 mg per day Crestor or placebo for two years.
The premise being explored was whether a cholesterol drug like Crestor® yields any benefit in people without high cholesterol but with a high measure of the body's inflammatory state, c-reactive protein, or CRP. Participants therefore were selected to have starting LDL cholesterols in the "normal" range of no higher than 130 mg/dl and elevated CRP of 2 mg/dl or greater.
Crestor® treatment resulted in 44% reduction in nonfatal heart attack, nonfatal stroke, hospitalization for unstable angina, revascu...
Total knee arthroplasties, or knee replacements, are popular and effective orthopedic surgeries. They have a good safety record and are quite effective in most cases. However, for patients who require replacements for both knees, there is controversy regarding whether they should be done at the same time, simultaneously, or in two separate surgeries. In this study, a review of the literature, investigators found 18 previously done studies that encompassed 27,807 patients and 44,684 total knee replacements. Of the replacements, 16,419 were simultaneous bilateral procedures (both at the same time) and 458 were staged bilateral procedures. Of the 18 studies, six reported on findings of deep vein thrombosis, clots in the blood system, 11 on pulmonary embolism, clots in the lungs, eight on heart complications, and eight on the rate of death. The investigators found that there were no significant differences between having both knees done at the same time and the staged procedures when looking...
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