Should we give more Tamiflu for influenza? A look at the evidence.
As the Centers for Disease Control and Prevention (CDC) reported that people who received this season’s influenza vaccine were only 23 percent less likely to be diagnosed with influenza than unvaccinated persons, CDC director Tom Frieden was publicly urging high-risk patients and their physicians to use antiviral medications to prevent complications and disease transmission:
People who are sick with flu, if they’re very sick in the hospital or if they have underlying, chronic medical conditions, like asthma, diabetes, heart disease, women who are pregnant, children under two and people over the age of 65 ...
Source: Kevin, M.D. - Medical Weblog - February 18, 2015 Category: Journals (General) Authors: Kenneth Lin, MD Tags: Meds Infectious disease Medications Source Type: blogs
Public trust, the CDC and Tamiflu
Why do doctors lose credibility?
Consider the few public doctors out there with millions of followers. The majority of the stuff they recommend is perfect: eat good food, exercise, be nice. and sleep. Check. No problem. Everyone is good with that until they shatter the sense with nonsense. One miracle cure or stupid supplement or financial conflict ruins everything.
That goes, too, for the Centers for Disease Control (CDC). These guys must have the highest of the moral ground. For if we are to believe them about public health matters, there can be no conflicts of interest. The public good, pure evidence, that is all.
I rec...
Source: Dr John M - February 13, 2015 Category: Cardiology Authors: Dr John Source Type: blogs
Research and Reviews in the Fastlane 056
This article offers solutions in which he calls for a shift in the research mentality. The pearls:
Focus on replication of research findings (and reward this)
Broad collaboration and data sharing
Altering the reward system for publication and academic advancement (i.e. reward not the number of publications but their impact; focus on the quality of peer review)
Recommended by Lauren Westafer
Resuscitation, Emergency MedicineSmekal D et al. CPR-related injuries after manual or mechanical chest compressions with the LUCAS™ device: A multicentre study of victims after unsuccessful resuscitation. Resuscitation 2014. PMID ...
Source: Life in the Fast Lane - November 4, 2014 Category: Emergency Medicine Authors: Soren Rudolph Tags: Cardiology Education Emergency Medicine Infectious Disease Intensive Care Neurology Neurosurgery R&R in the FASTLANE Resuscitation Wilderness Medicine acute coronary syndrome airway blood transfusion critical care ENT Review Source Type: blogs
Emergency Medicine Literature of Note: The tPA Cochrane Review Takes Us For Fools
Posted by Ryan Radecki
It’s been 5 years since the last Cochrane Review synthesizing the evidence regarding tPA in acute ischemic stroke. Clearly, given such a time span, in an area of active clinical controversy, a great deal of new, important, randomized evidence has been generated!Or, sadly, the only new evidence available to inform practice is IST-3 – a study failing to demonstrate benefit, despite its pro-tPA flaws and biases. So, it ought not be a very exciting update, considering the 2009 version included 26 trials, and the 2014 update now includes only 27 trials. Their summary conclusion, with onl...
Source: GruntDoc - August 5, 2014 Category: Emergency Medicine Authors: GruntDoc Tags: Emergency Source Type: blogs
Reconstruction of 1918-like avian influenza virus stirs concern over gain of function experiments
The gain of function experiments in which avian influenza H5N1 virus was provided the ability to transmit by aerosol among ferrets were met with substantial outrage from both the press and even some scientists; scenarios of lethal viruses escaping from the laboratory and killing millions proliferated (see examples here and here). The recent publication of new influenza virus gain of function studies from the laboratories of Kawaoka and Perez have unleashed another barrage of criticism. What exactly was done and what does it mean?
According to critics, virologists should not be entrusted to carry out gain of function studie...
Source: virology blog - June 20, 2014 Category: Virology Authors: Vincent Racaniello Tags: Basic virology Information 1918 pandemic aerosol transmission avian influenza ferret gain of function H5N1 viral virus Source Type: blogs
Things that make you go hmmm! EMA policy on transparency is “strikingly” similar to deal struck with drug company, say experts
Peter Doshihttp://www.bmj.com/content/348/bmj.g3852?sso=A US drug company seems to have influenced the European Medicines Agency’s (EMA) draft policy on access to clinical trial data, which academics have claimed keeps too much information hidden.Documents obtained by The BMJ under a freedom of information request showed a significant overlap between what the US drug giant AbbVie had agreed with the EMA could be released about its drug adalimumab (marketed as Humira) and the agency’s draft policy on providing public access to drug company data.In 2012 the EMA announced a new, “proactive” transparency poli...
Source: PharmaGossip - June 12, 2014 Category: Pharma Commentators Authors: insider Source Type: blogs
TWiV 282: Tamiflu and tenure too
On episode #282 of the science show This Week in Virology, the TWiV team reviews a meta-analysis of clinical trial reports on using Tamiflu for influenza, and suggestions on how to rescue US biomedical research from its systemic flaws.
You can find TWiV #282 at www.twiv.tv. (Source: virology blog)
Source: virology blog - April 27, 2014 Category: Virology Authors: Vincent Racaniello Tags: This Week in Virology antiviral biomedical research Cochrane collaboration influenza meta-analysis NIH grant oseltamivir PhD student postdoctoral scientist systemic flaws tamiflu virus Source Type: blogs
Deadly Medicines and Organised Crime: a review
This is a web version of a review of Peter Gotzsche’s book. It appeared in the April 2014 Healthwatch Newsletter. Read the whole newsletter. It has lots of good stuff. Their newsletters are here. Healthwatch has been exposing quackery since 1989. Their very first newsletter is still relevant.
Most new drugs and vaccines are developed by the pharmaceutical industry. The industry has produced huge benefits for mankind. But since the Thatcherite era it has come to be dominated by marketing people who appear to lack any conscience. That’s what gave rise to the Alltrials movement. It was founded in January 2...
Source: DC's goodscience - April 16, 2014 Category: Science Authors: David Colquhoun Tags: Academia badscience Big Pharma blogosphere Martin Keller Peter Gotzsche Pharmaceutical Industry Richard Eastell Source Type: blogs
I'm baaaaaack . . .
It was just too painful to type for a few days so I decided not to bite the bullet. People ask me what I do for a living and I say I'm a medical sociologist, but now I realize that a better job description is typist. Anyway . . .Millions of people are locked up for shoplifting and smoking pot and shooting dope, but if you steal $20 billion you're cool. I don't know how much of this you can read, but the new BMJ has a theme issue on the latest fraud of the century. The story is that in 2006, one Tom Jefferson led a Cochrane review* of neuraminidase inhibitors -- these are drugs to treat influenza, most notably oseltamavir (...
Source: Stayin' Alive - April 14, 2014 Category: American Health Source Type: blogs
Yet another avian influenza virus, H10N8, infects humans
To the collection of avian influenza viruses known to sporadically infect humans – H5N1, H7N9, H7N2, H7N3, H7N7, H9N2, and H10N7 – we can now add H10N8, recently found in two individuals in China.
Avian influenza virus H10N8 was first detected in tracheal aspirates from a 73 year old woman who was hospitalized in November 2013 for severe respiratory illness. The patient, who died, had previously visited a live poultry market. A second infection with this virus was detected in January 2014.
Virus isolated from tracheal aspirates on day 7 of illness was named A/Jiangxi-Donghu/346/2013(H10N8). Nucleotide sequence ...
Source: virology blog - February 10, 2014 Category: Virology Authors: Vincent Racaniello Tags: Basic virology Information avian influenza China H10N8 H5N1 h7n9 HA viral virus zoonosis zoonotic Source Type: blogs
It's coming. It's coming for all of us.
At this point, it doesn't matter whether it's a mismatch between this year's flu shot and this year's virus, or a secret government plot, or just plain crappy luck: everybody I know, practically, has the flu.We have nine full-time nurses in our unit. Two of them have pneumonia. A third is out for another week, until the Tamiflu and chicken soup kick in. The remaining half-dozen of us are bathing in alcohol foam, refusing to get too close to each other (I swear; it's like Sweden up in there), and running away from anybody with the slightest hint of a cough. I myself have taken to bathing daily in boiling bleach and wrapping...
Source: Head Nurse - February 5, 2014 Category: Nurses Authors: Jo Source Type: blogs
Some additional thoughts on systematic reviews
This article has been read over 8,500 times and has opened up numerous separate discussions around systematic reviews and the nature of evidence. It's still a topic I find fascinating and have moved my thinking on further.This post follows my presentation at the Rethinking Evidence-Based Medicine: from rubbish to real meeting a short while ago....In 2005 Richard Smith, former editor of the BMJ wrote the article Medical Journals Are an Extension of the Marketing Arm of Pharmaceutical Companies in Plos Medicine. It starts with a quote from the editor of The Lancet, Richard Horton, "Journals have devolved into inf...
Source: Liberating the literature - February 4, 2014 Category: Technology Consultants Source Type: blogs
What's A Rhino Got To Do With It?
So it would of course be par for the course so to speak that as I attempt to get this up and running again I would be hit with illness. Usually my hospital visits entail being told that I have a virus of some unknown origin never given a name. I've come to accept that as reality. However, when I called out of work on Tuesday and decided that since I am in Management now I probably should have an excuse from a doctor when I call off I made the trek downtown to see my doctor on Tuesday. I got in his office, he finished the exam, politely excused himself came back a few minutes later and told me that he felt admission to ...
Source: Still arriving. - February 2, 2014 Category: HIV AIDS Source Type: blogs
