Bioethicists to the rescue

The University of Toronto's Joint Centre for Bioethics seems to come up with an interesting topic for discussion every Wednesday afternoon at its weekly bioethics seminar.

Last week, for instance, one of its past students returned with a message that there’s a key role for bioethicists in the development of politically touchy race-based drugs.

Too often, the bioethicist turned lawyer said, such research is thwarted by fears of drawing a connection between genetics and race. That’s a tragedy, he says, because such medications could save lives in Canada’s native communities and the developing world.

Firm's consulting fees to be disclosed, not all pleased

Medtronic Inc. announced this week that it would voluntarily release how much it pays doctors in consulting fees -- the largest such company to do so.

"Through greater transparency about the nature of these relationships, we will help people better understand how important they are to developing life-saving and enhancing products for patients,'' Medtronic CEO Bill Hawkins said in a statement.

Not everyone is impressed, since the disclosure won't start for another two years.

Writing on blog.bioethics.net, Summer Johnson calls it Ethics: The Phased In Plan

Slow down there, Speed Racer! Don't go disclosing those dollar figures too quickly now! You wouldn't want to allow your company a whole two years to change your consulting amounts as to allow your company time to appear as though you didn't previously give massive amounts of cash to physicians who used and implanted your medical devices over those who did not, would you?

A doctor's responsibility to refer patients to better care

A thought-provoking column in the New York Times this week raises an interesting question.

What responsibility do doctors have to refer patients to other doctors, or other hospitals, where they might get better care.

For the author of the column, Denise Grady, the answer is obvious: they must refer the patient. The science reporter and author relates the story of a relative who sought cancer surgery outside the small town where she lived after her hometown surgeon told her she'd have to wear a colostomy bag for the rest of her life.

"But she also recognized that this was a small hospital, and a surgeon who probably spent more time fixing hernias and taking out gallbladders than he did operating on cancer patients. She decided that she wanted a doctor who operated on patients like her all the time, and that the two-hour trip to a cancer center would be worth the trouble. And so it was: she found a surgeon who specialized in rectal cancer, and today she’s in good health, with no need for a bag. She might have done just as well with the local surgeon, but we both doubt it."

Obama, God and stem cells

U.S. President Barack Obama gave comfort last week to stem cell researchers in his country by repeating his commitment to ending Washington's ban on embryonic stem cell research.

"I guarantee you that we will sign an executive order for stem cells," Obama said in response to a question from Rep. Jim Langevin (D-R.I.) during a private meeting with House Democrats last Thursday.

That sort of comment doesn't leave much wiggle room, comfort for those scientists concerned that the new president hasn't already reversed the funding ban imposed by Obama's predecessor, George W. Bush.

Bush brought in his ban to preserve the sanctity of life, as he saw it, a reflection of his religious views.

Vatican to look at stem cells

A Philadelphia scientist who caused a furor when he told a Vatican bioethics conference in late 2007 that embryos are human, but not human beings, has been invited back to explain his thoughts some more.

Scott Gilbert of Swarthmore College will travel to Rome next month to make his case. The Philadelphia Inquirer said Gilbert isn't sure why he's been asked back, given the reception he received last time.

Gilbert has studied for decades how humans and other animals make the journey from fertilized egg to baby. The conference, held in late 2007 in Rome, was meant to address the church's view on the beginning of life - a question with huge implications for abortion policy, emergency contraception, and stem-cell research. Gilbert, author of the popular college textbook Developmental Biology, said he was the only speaker to suggest that very early embryos were not equivalent to human beings. That led to lots of yelling and gesticulating in Italian, not all of which could be translated for him.

The kidney divorce

The disheartening case of a New York surgeon who wants the kidney he gave his soon-to-be-ex-wife -- or $1.5 million (US) in compensation -- returned to him has the caught the eye of medical ethicists.

Not the least because his demands seem to put a monetary value on human parts. Dr. Richard Batista says the $1.5 million reflects in part the value of the kidney he donated to Dawnell Batista in 2001, and he should be compensated for it.

Bioethics professor Steven Miles at the University of Minnesota, where the transplant in question took place, told his local paper that the case goes against very notion of organ donation.

Big Phamra and ghostwriters

Pharmaceutical giant Wyeth hired ghostwriters to counter mounting evidence that its hormone replacement therapy caused breast cancer, according to Congressional investigators in the U.S., who also released documents providing an unprecedented look into how ghostwriting works.

Iowa Republican Senator Charles Grassley has written letters to Wyeth and medical writing company Designwriteasking them to disclose payments made for journal articles and the activities of doctors recruited to put their names on them for publication. The letters are part of a continuing investigation by Grassley into drug industry influence on doctors.

Rights complaint against hospital

The parents of a baby girl who died at Toronto's Hospital for Sick Children have filed a complaint with the Ontario Human Rights Commission, saying their daughter received inadequate care and that a do not resuscitate order was filed without their consent.

The Star's Emily Mathieu writes about the case in today's Toronto Star.

The parents of Annie Farlow – a 2-month-old who died at the Hospital for Sick Children in 2005 after receiving what her parents allege was inadequate care because of a genetic condition – are attempting to take their case to the Human Rights Tribunal of Ontario.

"I think every child regardless of their disabilities deserves a chance at life and if the treatment or surgery is not in their best interest, then they deserve a dignified, comfortable and peaceful death," said Annie's mother, Barb Farlow, yesterday outside a meeting to determine if their application for a hearing will go forward.

How Does Oxcarbazepine Works?

Type of Drug:

Anticonvulsant; drug used to treat a variety of seizure disorders.

How the Oxcarbazepine Product Works:

Oxcarbazepine prevents or reduces some types of seizures by controlling abnormal nerve impulses in the brain.

Uses of The Oxcarbazepine:

For use alone or in combination therapy for the treatment of partial seizures in adults with epilepsy and as combination therapy for the treatment of partial seizures in children 4 to 16 years of age with epilepsy.

Unlabeled Uses: Oxcarbazepine has been used for atypical panic disorder.

Precautions:

Do not use in the following situations: Allergy to oxcarbazepine or any of its ingredients.

Pseudomembranous Enterocolitis - Diseases Treatment - Symptoms, Causes and Cure for Diseases on A to Z

What is this Condition?

Pseudomembranous enterocolitis is an acute inflammation that damages the tissue of the small and large intestines. It usually affects the mucus coating but may extend into submucosa and, rarely, other layers of the intestine. Marked by severe diarrhea, this rare condition is generally fatal in 1 to 7 days from severe dehydration and from toxicity, peritonitis, or perforation.

What Causes it?

The exact cause of pseudomembranous enterocolitis is unknown, but Clostridium difficile may produce a toxin that may playa role in its development. It typically strikes people weakened by abdominal surgery or those receiving broad-spectrum antibiotics. The infection begins suddenly with lots of watery or bloody diarrhea, abdominal pain, and fever. Serious complications may follow this disorder, including severe dehydration, electrolyte imbalance, hypotension, shock, and perforated colon.

Felbamate Drug - How does Felbamate Works?

Type of Drug:

Anticonvulsant; antiepileptic.

How the Felbamate Product Works:

Felbamate acts on the central nervous system to decrease the frequency of seizures.

Uses of The Felbamate:

Felbamate is not indicated as a first-line antiepileptic treatment. Felbamate is recommended for use only in those patients who respond inadequately to alternative treatments and whose epilepsy is so severe that a substantial risk of aplastic anemia or liver failure is deemed acceptable in light of the benefits conferred by its use.

Felbamate is indicated as monotherapy or adjunctive therapy in the treatment of partial seizures with and without generalization in adults with epilepsy.

Some Benefits on Usage of Anticholinergics

How the Drug Works:

Parkinsonism is a neurological disease with a variety of origins characterized by tremor, rigidity, and disorders of posture and equilibrium. The onset is slow and progressive with symptoms advancing over months to years.

The group of drugs known as "anticholinergic agents" can reduce the frequency and severity of the symptoms of parkinsonism by restoring the chemical imbalance that causes Parkinson disease. The effectiveness of anticholinergics for parkinsonism is not dependent on the origin of the symptoms. These agents are typically used for milder cases of parkinsonism.

Uses and Benefits of Oxazolidinediones

Type of Drug:

Anticonvulsants; drug to treat epilepsy and seizures.

How the Drug Works:

To control absence act on central nervous system to decrease the frequency of seizures.

Uses:

To control absence (petit mal) seizures that do not respond to other anti seizure medications.

Precautions:

Photosensitivity, sensitivity to sunlight, may occur. Therefore, use caution and take protective measures (eg, sunscreens, protective clothing) against exposure to ultraviolet light or sunlight until tolerance is determined.

Pregnancy: Reports suggest an association between use of anticonvulsant drugs by women with epilepsy and an increased number of birth defects in children born to these women. Other factors (eg, genetics or the epileptic condition) may also contribute to the higher incidence of birth defects. Most mothers receiving anticonvulsant medication deliver normal infants. Do not discontinue anticonvulsant drugs used to prevent major seizures. This could result in the occurrence of seizures and oxygen deficiency in body tissues and an increased risk to both the mother and the unborn child. In cases where seizures do not pose a serious threat, your doctor may recommend discontinuation of anticonvulsant's prior to and during pregnancy. It is not known whether even minor seizures constitute some risk to the developing embryo or fetus. Reports suggest that mother's use of anticonvulsant drugs, particularly illiterates, is associated with a blood clotting defect in the new bone that may cause a bleeding problem within 24 hours of birth. It has been suggested that vitamin K he given to the mother prior to and during deliver, and to the infant , immediately after birth.

Valproic Acid and Derivatives Drug Information

Type of Drug:

Anticonvulsant; drug used to treat epilepsy, seizures, and other conditions.

How the Drug Works:

Valproic acid prevents or reduces the number of seizures by controlling the abnormal activity of nerve impulses in the brain and central nervous system. Sodium valproate and divalproex sodium are converted to valproic acid in the body.

Uses:

Used alone or in combination with other anticonvulsants to control simple and complex absence seizures (petit mal).

Used alone or in combination with other anticonvulsants to control isolated complex partial seizures or complex partial seizures associated with other types of seizures.

Working Procedure of Pergolide Mesylate - Uses and Benefits

Type of Drug:

Antiparkinson agent.

How the Drug Works:

Parkinsonism is a neurological disease characterized by tremor, rigidity, and disorders of posture and equilibrium. It has multiple causes. The onset is slow and progressive with symptoms advancing over months to years.

It is thought that the involuntary muscle movements (shaking) of Parkinson disease are due to reduced amounts of the chemical dopamine in the central nervous system (brain). Pergolide may exert its effects by directly stimulating the dopamine receptors in the brain.

Uses:

To manage the signs and symptoms of Parkinson's disease. Used along with levodopa and carbidopa.

Gold Compounds - How Does Gold Compounds Works?

Type of Drug:

Antirheumatic agents.

How the Drug Works:

The exact merchanism of action of gold compounds is unknown. They suppress or prevent joint swelling and retard cartilage and bone destruction, but do not cure rheumatoid arthritis.

Therapeutic effects from gold compounds occur slowly. Early improvement, often limited to reduction in morning stiffness, may begin after 6 to 8 weeks of treatment, but other beneficial effects may not be observed until after months of therapy.

Uses:

To treat early active adult or juvenile rheumatoid arthritis not adequately controlled by other therapies (eg, NSAIDs).