This Week's Interesting Links: Creating Medical Blogs, the FDA and Anemia Drugs, Governor Corzine's Doctors, & Angioplasty isn't like Plumbing
Monday, May 14, 2007
Joshua Schwimmer, MD, FACP, FASN
Clinical Cases and Images, an outstanding medical blog by Dr. Ves Dimov at the Cleveland Clinic, has a post on "How to start a medical blog in 2 minutes." It points to a video on YouTube by Google showing how to create a new blog with Blogger, a free service. Also described are ways of working with medical RSS feeds to create your own webpage of medical journals.
I spoke about the controversies over anemia drugs in a previous post. Over at the Wall Street Journal Health blog -- an interesting source of information about current health and business issues -- they're following the FDA hearings on the use of drugs like Aranesp, Procrit, and Epogen by oncologists. A sample question by an FDA doctor: "What data do you have to assure me that this is not Miracle-Gro for cancer?"
Governor Jon S. Corzine of New Jersey survived a motor vehicle collision at 91 miles an hour without wearing a seatbelt. He spent 11 days in intensive care and required 3 surgeries on his broken femur. The New York Times has an article including interviews with his doctors.
Finally, Slate, a sharp and well-written online magazine, explores the implications of recent medical studies on angioplasties in Plumber's Butt? The Right and Wrong Way to Think about Heart Attacks. The piece argues that the idea that interventional cardiology is like plumbing is wrong; that not every clogged artery needs to be opened; and that opening up narrowed blood vessels does nothing to prevent future heart attacks. It also features an entertaining look at the history of cardiac catheterization:
Before angioplasty became widespread, the only emergency treatment for heart attacks was to infuse clot-busting drugs like streptokinase into a patient's whole body. This was like running concentrated Drano through a city's water supply to fix a stopped-up sink. It wasn't very effective and also caused side effects like bleeding. In 1929, a budding German crackpot named Werner Forssmann took the first tentative steps to directly unclog blocked vessels, by inserting a urinary catheter deep into his own arm. (A nurse tried to stop him, but he tied her to an operating table.) Forssmann walked up a flight of stairs and took an X-ray showing that the catheter had entered his heart—a feat that earned him the Nobel Prize.
Labels: angioplasty, aranesp, cardiology, corzine, epogen, fda, medical blogosphere, medical blogs, procrit
2 Comments:
At Tue May 15, 12:48:00 PM 2007,
Huck said…
Regarding the Slate Article:
As part of my consent for cath in stable angina patients, I make it clear that if they end up with a stent, we didn't save their life, we will be making them feel better. Atherosclerosis is a chronic illness that is managed and that the medications we give them save their lives.
At Fri May 25, 06:14:00 AM 2007,
John said…
The use of stents to treat stable angina has become controversal.
This has lead some people to forget cardiac catheterization has a diagnostic role as well as a therapeutic role. For example, all patients in the COURAGE trial underwent cardiac cathetrization in order to identify their coronary artery disease and grade its severity.
Chest pain may be caused by many different problems (e.g. acid reflux, pleurisy, pneumonia, pulmonary artery hypertension, myocardial ischemia associated with atherosclerosis, rib fracture, etc).
Due to the failure of CT angiography to equal cardiac catheterization in diagnosing coronary artery disease (e.g. see the JAMA article) we should not forget that cardiac catheterization is often a neccessary diagnostic step in the patients who were medically managed.
Skipping the diagnostic catheterization may lead to the false assumption that a patient's chest pain is cardiac in nature.
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