Docnotes

Annals of Internal Medicine: Treatment of the common cold with Echinacea

In this article in the Annals .... echinacea was found to be no better than placebo.  The study was picked up by the NY Times ... and many other papers .. and it's now "common knowledge" (according to my wife) that echinacea doesn't help with the common cold.

Not so simple.  As the authors point out, they used pure echniacea rather than extract (as many previous studies .. reporting positive results had used) .. and this study used young health subjects rather than middle-aged subjects who may benefit more from a "boost" to the immune system such as echinacea has been demonstrated to provide.

Sock-a-month

Sam's entry into capitalism: Sock of The Month Club.  A ten year old kid decides that the perfect last minute holiday gift is a new pair of socks every month.  Not a bad idea ... We'll see how he does!

Endotext.com - Diabetes, Management of the Hospitalized Diabetic Patient

A nice little handout for the management of diabetes in the hospital.

Antibiotics Tutorial

Good education from North of The Border .... antibiotics tutorial

FDA STRENGTHENS CONTROLS, ISSUES CONSUMER ALERT

"FDA STRENGTHENS CONTROLS, ISSUES CONSUMER ALERT ON IMPORTING CERTAIN PRESCRIPTION DRUGS"

At first, I wasn't sure what this was.  Now I get it.  The FDA has instituted controls on the availablity of certain medications.  For example, in order to prescribe Accutane, I had to complete a training program to insure that I understand the risks of using this medication.  Similarly, Mifeprex has controls that limit its availability and administration (BTW .. The Access Project has excellent information on this ... it's an evidence-based look at prescribing mifeprestone.

So the FDA is advising the public that they are cincumventing these safeguards if medications are purchased off the internet.  No kidding.  I recently treated a man for opiate withdrawal who became addicted to narcotics that he purchased over the Internet.  No longer does one have to venture into the bad neighborhoods to purchase these drugs .. just fire up Internet Explorer and pull out the mastercard.

Immunization Quiz

The American Academy of Pediatrics has a quiz on immunizations that is intended to educate families about vaccines and preventable diseases.  It's done in Macromedia Flash.  Not bad.

Also on the AAP immunization website:

Documenting Parental Refusal to Accept Vaccination
Health care providers may decide it is in their best interest to formally document a parent's refusal to accept vaccination for a minor child. This form, which should not be considered a legal document without advice from a lawyer, may be used as a template for such documentation. (download word document here)

I'm not sure what It hink of this.    In many ways .. it's a good thing to document that we've counseled patients who choose not to vaccinate.  Yet I don't want to beat them over the head with a legal document .. or do I?

Strattera (sometimes misspelled straterra)

Lilly has received FDA approval for a new norepinephrine reuptake inhibitor.  Looking at the pharmacology, this medication is similar to the antidepressant effexor.   But Lilly has done some research to justify the indication for ADD/ADHD. 

This is significant because it's the first nonstimulant to be approved for ADD/ADHD.

And it's the first medication indicated for treating ADHD in adults.