Monday, December 30, 2013

Abbott Laboratories kickbacks

Reuters has the following news story:
Abbott Labs settles with U.S. over kickback claim

Thursday, December 05, 2013

Beware the stent industry

Stents Lose in Comparisons With Surgery and Medical Therapy

This is an article by Larry Husten in Cardiobrief.  He is a reliable source of information.

Sunday, November 10, 2013

Cardiotoxity of Anticancer Drugs and Radiation

Chemotherapy for cancer can lead to cardiomyopathy. Our current state of knowledge is that chemotherapy is a shotgun approach to treating cancer. Many more cells than cancer cells are affected. Among the chemotherapy drugs that can cause heart problems are the anthracyclines, a class of chemotherapy drugs that includes doxorubicin (Adriamycin) and daunorubicin (Cerubidine). There are other chemical agents that also have these terrible effects.
Radiation treatments for cancer can also create serious risks for the heart.
Some large medical centers are developing programs to treat the heart damaging effects of chemotherapy. In other words, yet another money maker for the facilities. When will we see more concern for the whole person?
Here's the link for the Heart Failure Society of America

Saturday, October 12, 2013

Many herbal products don't list all ingredients and contain fillers

Study: Herbal products omit ingredients, contain fillers

Here's the first paragraph:
Consumers of natural health products beware. The majority of herbal products on the market contain ingredients not listed on the label, with most companies substituting cheaper alternatives and using fillers, according to new research from the University of Guelph
The report says approximately 60 per cent of the products tested had cheaper alternatives.

Of great danger to people with allergies, is this quote from the story

More than 20 per cent of the products included fillers such as rice, soybeans and wheat not listed on the label.

Monday, September 02, 2013

Little Risk When Doc Says Stop DAPT

The European Society of Cardiology is having their big meeting.  Here is the story
Discontinuing DAPT per doctor's orders is ok else big trouble
Here are the highlights
  • For patients undergoing PCI and discharged on dual anti-platelet therapy (DAPT), patients who discontinue dual anti-platelet therapy on the advice of their physician are much less likely to have a disruption-triggered event, a study found.
  • Note that there was an increased risk observed in patients who stopped DAPT due to bleeding or non-compliance, although there was a wide variation according to the underlying context in which antiplatelet therapy was withdrawn.

Monday, August 26, 2013

Public Citizen petitions the FDA for a black box regarding a clopidogrel

I am not passing judgment on the wisdom of this, just making this document available
Clopidogrel warning via Public Citizen

Here is a quote from it:

Public Citizen, representing more than 300,000 members and supporters nationwide, and 
Neil A. Holtzman, M.D., hereby petition the Food and Drug Administration (FDA), 
pursuant to the Federal Food, Drug and Cosmetic Act 21 U.S.C. Section 355(e)(3) and 21
C.F.R. 10.30, to immediately add a black-box warning on clopidogrel (brand name: 
Plavix, as well as generic equivalents). The black-box warning must address the 
increased risks of major and minor bleeding with use beyond 12 months following 
implantation of drug-eluting coronary artery stents. Such warning is made necessary both 
by a lack of evidence of a further reduction of thrombotic cardiovascular events, such as 
myocardial infarction or stroke, as well as existing evidence of continued risk of major 
bleeding with more prolonged use. We also urge the FDA to require the distribution of an 
FDA-approved, updated Medication Guide containing this information to be dispensed to 
all patients when their prescriptions are filled and to ask companies to send a “Dear 
Doctor” letter to warn physicians of these preventable adverse effects that occur with use 
for greater than one year.

Follows is a link from Sanofi that gives extensive product information on Plavix.
Sanofi info on Plavix

There are two passages I am quoting regarding Plavix and excessive bleeding.

Page 7
Adverse Drug Reaction Overview
The safety profile of clopidogrel has been evaluated in clinical trials in more than 44,000 patients including over 1200 patients treated for 1 year or more and further assessed during post-marketing experience.
Of the patients who participated in the CAPRIE, CURE and CLARITY double-blind international clinical trials, approximately 50% were elderly patients (> 65 years) and 15% were 75 years and older. In the ACTIVE A trial, 75% of patients treated with PLAVIX were 65 years of age and older, and 41% were 75 years and older. In COMMIT study, approximately 58% of the patients treated with PLAVIX were 60 years and older, 26% of whom were 70 years and older.
The most frequent adverse drug reactions (≥1%) with PLAVIX (with or without associated ASA) in controlled clinical trials were hemorrhage and bleeding disorders including purpura, any rash, dyspepsia, abdominal pain and diarrhea (see "Clinical Trial Adverse Drug Reactions").
The most serious adverse drug reactions from controlled clinical trials rarely reported (<1%) were bleeding and clotting disorders including gastrointestinal hemorrhage, hemorrhagic ulcer and hemothorax.

Page 20
Overdose following clopidogrel administration may lead to prolonged bleeding time and
subsequent bleeding complications. Appropriate therapy should be considered if bleeding is
observed or suspected.
A single oral dose of clopidogrel at 1500 or 2000 mg/kg was lethal to mice and rats, and at 3000
mg/kg to baboons.
No antidote to the pharmacological activity of clopidogrel has been found. Platelet transfusion may
be used to reverse the pharmacological effects of PLAVIX when quick reversal is required.
For management of a suspected drug overdose, contact your regional Poison Control Centre.

Friday, June 14, 2013

TAVR, the new cash in for cardiologists

Aortic valve stenosis, no doubt more people will be told they have it and urged to have TAVR, transcatheter aortic value replacement.  It's the new cash in for cardiologists.  Beware, look into your options if this is proposed for you.

Monday, May 06, 2013

The relationship between the Herman Liebman Memorial Fund and the Amalgamated Houses

The Herman Liebman Memorial Fund is a 503(c)(3) organization.  From the 2010 return that is on the NYS Attorney General website,  and the last complete return, I see that its purpose is defined as 

To provide and support cultural and educational programs for residents of two moderate income housing developments, Amalgamated Housing and Park Reservoir Housing and members of the general public in the surrounding north Bronx.

The president is listed as Ed Yaker.  Robert Massre who is the finance manager of the Amalgamated Housing is listed as the person who keeps the books.  The other officers are listed as Brad Silver, Vice President, Howard Kamiel, Vice President,  Howard Leventhal, Secretary, and Jack Spiegel , Teasurer

The paid preparer is listed as Stephen W. Beer of the firm
Czarnowski & Beer.

The firm Czarnowski & Beer are the independent auditors of the Amalgamated Housing.

The ties between the Amalgamated Houses and the Herman Liebman Memorial Fund are so knotted together that I feel that at any meeting where the Amalgamated board of directors are present should also be a time when questions can be asked about the Herman Liebman Memorial Fund.

Wednesday, April 24, 2013

Good by Mr. Bagel

Good by Mr. Bagel, store closed April 2013

Saturday, March 30, 2013

Embezzlement at Penn South

Chelsea's Penn South Complex, embezzlement,

There was no excuse for this to have happened.  We had a smaller embezzlement scandal at the Amalgamated Houses and that should have been a warning to other limited dividend co-ops to implement better accounting controls.  Penn South should get new auditors, clearly the ones they have failed them.

Saturday, February 23, 2013

FFR, best tool for assessing intermediate stenoses

Fractional flow reserve the best tool for assessing intermediate stenoses : Cardiology News

This is the definition of intermediate stenosis used in the article "intermediate 50%-70% stenosis in a patient with stable ischemic heart disease"
Here is a quote:

FFR is the method par excellence for determining if an intermediate stenosis is hemodynamically significant; that is, whether the lesion is responsible for reversible ischemia. If it is, then coronary stenting will improve the patient’s functional status and reduce the likelihood of acute MI and all-cause mortality down the road. If FFR indicates that the stenosis is not responsible for reversible ischemia, however, then PCI won’t improve the patient’s prognosis. FFR has the additional virtues of being fast and simple, and it enables immediate decision-making in the cath lab, he explained.

Friday, January 25, 2013

HDL values and cardiovascular event rates

Connection between HDL values and Cardiovascular event rates under scrutiny
Here are the opening paragraphs of this commentary

HDL-raising: A good hypothesis gone bad

By: BRUCE JANCIN, Cardiology News Digital Network SNOWMASS, COLO. – The once highly attractive notion that boosting HDL cholesterol levels will reduce cardiovascular event rates is now dead, or more generously, it remains unsupported by evidence despite expenditure of billions of dollars on negative clinical trials. "An iconic concept of HDL has not borne good fruit. It really isn’t what we don’t know that hurts us so much as the things that we think are true but just ain’t so – and that’s the story of HDL," Dr. Robert A. Vogel said at the annual cardiovascular conference at Snowmass sponsored by the American College of Cardiology. Indeed, it now appears that the relationship between HDL and atherosclerosis is far more complicated than lipidologists thought. Evidence now suggests that HDL mass may not be as important as HDL function, which can switch between being anti- and pro-atherogenic in a matter of hours. And HDL may not even be playing an active role in cardiovascular risk; a low HDL may be associated with an increase in cardiovascular events simply because it is a marker for other cardiovascular risk factors, such as obesity, smoking, and insulin resistance.


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