Wednesday, September 27, 2006

migraine news roundup 20

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This article explains more about the results of the University of Wisconsin - Madison study on the relationship between sleep and depression:

Sleep, Snoring and the Blues
Although it has long been known that there was an association between poor sleep and depression, the researchers were able to take the link an important step further. They were able to measure what scientists call a dose response. This one suggests a causal relationship between the severity of a sleep disorder and the odds of becoming depressed. After adjusting for age and gender, the scientists found that patients with minimal breathing disorders were 1.6 times as likely to become depressed as those without. Those with mild cases were twice as likely, and those with moderate to severe cases were 2.6 times as likely.

A Florida doctor whose practice was destroyed by his arrest for illegal distribution of a controlled substance won a federal civil suit against the county officers who arrested him. The jury found that there was insufficient evidence to support the arrest:

Nguyen, now 68, was arrested in March 2000 for six felony counts of delivering a controlled substance and held in jail on a $60,000 bond. Three months later the case was dropped by the State Attorney's Office, which cited insufficient evidence.

An affidavit, created by investigators and using information from a woman serving as officers' confidential informant, failed to note that she had been Nguyen's patient since 1997 and falsely claimed the doctor, a general practitioner, had failed to conduct any physical exam of the woman, Nguyen's lawsuit stated.

CNN has this excellent article that discusses studies about communication between doctors and patients regarding prescribed medications:

Deadly choices: Patients quit pills too early
Many patients stop taking their medicine far sooner than they should, researchers say, and that decision can be deadly when the drugs treat heart disease or diabetes.

It took only one month after leaving the hospital for 1 out of 8 heart attack patients to quit taking the lifesaving drugs prescribed to them, a study of 1,521 patients found.

"One month is very surprising," said study co-author Dr. Michael Ho of the Denver Veterans Affairs Medical Center.

The heart patients who stopped taking three proven drugs -- aspirin, beta blockers and statins -- were three times more likely to die during the next year than patients who stayed on the pills.

The study did not examine why people stopped taking their medicine, but the patients who quit were more likely to be older, single and less educated.

One of the studies reviewed medical records of 11,532 diabetes patients. It found that those who didn't take their drugs -- hypoglycemics, blood pressure drugs and statins -- had higher rates of hospitalization and death. The link was not as pronounced as in the heart attack research, but was still significant.

In two other studies, researchers found that cost prevents many Medicare beneficiaries from taking their pills and that doctors too often neglect to explain the basics about new drugs.

In recordings of 185 patient visits, doctors failed to mention a new drug's side effects or how long to take the drug in about two-thirds of the visits.

The New York Times reports that shock therapy as a treatment for depression is a much different, safer treatment than the version most of us recall from the past:

Shock Therapy Loses Some of Its Shock Value
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Though the impression of ECT left in the public mind by such films and writings persists, ECT today is a far more refined and limited therapy. Most important, perhaps, is the use of anesthesia and muscle relaxants before administering the shock, which causes a 30-second convulsion in the brain without the accompanying movements. Thus, there is no physical damage. The pretreatment also leaves no memory of the therapy itself.

The amount of current used today is lower and the pulse of electricity much shorter — about two seconds — reducing the risk of post-treatment confusion and memory disruption. While memory losses still occur in some patients, now the most serious risk associated with ECT is that of anesthesia.

Most patients require a series of six to eight treatments, delivered over several weeks. As my friend discovered, however, it is not universally effective. About three-fourths of patients are relieved of their debilitating symptoms at least temporarily. The remaining one-quarter are not helped, and some may be harmed.

Did medical companies pay doctors to enroll patients in their clinical trials?

Federal Officials Scrutinizing Company Payments to Doctors
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Federal law prohibits certain types of payments to doctors that are meant to influence their choice of a particular product. Ela Medical, which has previously said that it complied with all relevant laws, said in its statement that it was cooperating with the investigation.

Last year, the Justice Department started to investigate the country’s biggest makers of heart devices — Medtronic, St. Jude and Guidant — to determine if they provided doctors with excessive payments to enroll patients in postmarketing studies of their devices as a way of increasing sales. All three companies have said they did nothing wrong.

Such studies can have questionable scientific value, experts say.

The Washington Post reports that 2006 health care costs showed the lowest increase since 2000, but notes that experts caution against an enthusiastic reception of these figures:

Health Premiums Rise More Slowly
Rate of Growth Doubles Inflation
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"Nobody's celebrating, and nobody should be celebrating," said Drew E. Altman, head of the foundation, a nonprofit organization that studies health-care issues. "A modest reduction in an already high rate of increase hardly looks like salvation to working people and businesses, who have been getting hammered by high health-care costs year after year."

Since 2000, workers' health insurance premiums have risen 84 percent, while their wages have increased 20 percent and inflation has risen 18 percent, according to the study, which was conducted with the Health Research and Educational Trust, a nonprofit research affiliate of the American Hospital Association. Kaiser and HRET have done the study since 1999.

Finally, a Christian Scientist's perspective on living with chronic pain:

The end of pain
A Christian Science perspective on daily life
After exhausting medical options, I tried yoga, biofeedback, meditation, diet, acupuncture, and herbal remedies. At times it seemed I was gaining some control over the pain, but then it would return with incapacitating strength.

As time went on, I began to despair over my condition. And then, unexpectedly, I found relief through prayer. Unexpectedly, because I hadn't set out to pray. Though raised in Christian Science, I hadn't thought about prayer for years. I'd had numerous healings as a child, but how the healing was done was a mystery to me. I knew it had something to do with my thought, because that was where I experienced the relief first, but I knew that I had not created that relief, and I didn't know how to find it consistently.

I find this belief system extremely fascinating. I don't think this is my path, but if it helps people, more power to them.

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