September 16th, 2013
Selections from Richard Lehman’s Literature Review: September 16th
Richard Lehman, BM, BCh, MRCGP
This week’s topics include the AMPLIFY trial, D2B time and mortality among those undergoing primary PCI, and more.
September 16th, 2013
Realistic Expectations for Renal Denervation
Larry Husten, PHD
Early trials of renal denervation have resulted in extremely impressive drops in systolic blood pressure approximating 30 mm Hg. These results have sparked a great deal of excitement in the hypertension community and stirred the interest of a multitude of medical device companies. Some experts have proclaimed renal denervation a potential “cure” for resistant hypertension, […]
September 16th, 2013
Combining Randomized Trials And Registries: A New Paradigm
John S Rumsfeld, MD, PhD
Ultimately, we need clinical trials to know what drugs and medical devices work. Without them, we will not have the evidence we need for clinical practice guidelines, and clinical care will not evolve. But traditional clinical trial approaches are not sustainable – too expensive and too inefficient. The new hope for clinical trials is to […]
September 12th, 2013
Colchicine Found Effective in Acute Pericarditis
Larry Husten, PHD
Although colchicine has been shown to be beneficial in patients with recurrent pericarditis, which is thought to have a large inflammatory component related to an immune response, until now its efficacy in a first episode of acute pericarditis has been uncertain, as these episodes are thought to usually have a viral component that might benefit from […]
September 11th, 2013
A New Standard For Pulmonary Hypertension Trials
John Ryan, MD
Recently the New England Journal of Medicine published the SERAPHIN trial studying the effects of macitentan, a new endothelin receptor antagonist, in pulmonary arterial hypertension (PAH). This was a well-conducted study in 742 patients with PAH randomized to placebo, a low dose of macitentan (3mg once a day) and a high dose of macitentan (10mg once […]
September 10th, 2013
Have We Solved The Problem of Ghostwriting?
Harlan M. Krumholz, MD, SM
Several years ago, in the midst of the Vioxx litigation, I became aware of the practice of ghostwriting throughout academic medicine. In general, marketing arms of pharmaceutical companies wanted to seed the peer-reviewed journals with articles published by academics. They would identify an academic and provide him or her drafts of the article. Sometimes they […]
September 9th, 2013
Clear! CPR in the Hospital Is Not Always Good for the Patient
Larry Husten, PHD
On TV it always seems clear and simple. A patient in the hospital goes into cardiac arrest and the medical team springs into action. After a few tense moments of furious activity, and only after all seems lost, the patient is successfully revived. A few scenes later the smiling and now fully healthy patient thanks […]
September 5th, 2013
Lancet Formally Retracts Jikei Heart Study of Valsartan
Larry Husten, PHD
The Lancet has formally retracted the Jikei Heart Study paper, originally published in 2007. The retraction had been widely anticipated for more than a month, after a series of news reports in Japan made it clear that the long-simmering controversy over scientific misconduct involving the Novartis blood pressure lowering drug valsartan (Diovan) had come to a full boil. […]
September 4th, 2013
Too Much Emphasis on Door-to-Balloon Time?
Larry Husten, PHD
One of the great medical advances in recent years has been the improved treatment of acute myocardial infarction. As the enormous benefits of earlier reperfusion became evident, medical systems in many parts of the world aimed to treat increasing numbers of patients in a shorter time frame. The door-to-balloon (D2B) time as a performance measure […]
September 4th, 2013
New Dual Biomarker Test Could Speed Rule-Out of MI in the ED
Larry Husten, PHD
A new study suggests that patients with suspected ACS and negative troponin and copeptin results at admission can safely be discharged if the clinical assessment is consistent with that decision.
