Huge Price Hike for Obstetric Drug Stokes Outrage

A huge price hike for a drug administered to prevent premature birth and, hopefully, the medical complications that come with it, has sparked outrage. (Image: JAMA, ©AMA)

A growing chorus of outrage has emerged from physicians, patients, and politicians in response to a drugmaker’s decision to set the price for its newly approved drug for preventing premature birth at $1500 per injection.

In the past, physicians treating women at high risk for premature delivery were able to obtain the drug, a progesterone injection, from some pharmacists, who would prepare it for them for about $10 to $20. That changed after February 4, when the US Food and Drug Administration (FDA) approved the drug under the agency’s accelerated approval program to reduce the risk of delivery before 37 weeks in at-risk women. Continue reading

Author Insights: Long-term Benefits From Gastric Banding Are Questioned

Laparoscopic adjustable gastric banding, a type of weight-loss surgery, has relatively poor long-term outcomes, according to a new study by Jacques Himpens, MD, and colleagues at the European School of Laparoscopic Surgery, Saint Pierre University Hospital in Brussels, Belgium. (Image: Christine D’haese)

A study released today in the Archives of Surgery concludes that a type of weight-loss surgery, laparoscopic adjustable gastric banding, offers relatively poor long-term outcomes in extremely overweight patients.

The findings come a few weeks after guidelines issued by the American Heart Association suggested that weight-loss surgery is an appropriate treatment for those with morbid obesity (defined as having a body mass index [BMI] greater than 40) and the US Food and Drug Administration approved use of an adjustable gastric banding device for patients with a BMI as low as 30 who also have an obesity-related condition, such as type 2 diabetes, hypertension, or sleep apnea.

In the Archives article, lead author Jacques Himpens, MD, of the European School of Laparoscopic Surgery, Saint Pierre University Hospital in Brussels, Belgium, and colleagues assessed 82 patients with morbid obesity, some of whom also had an obesity-related condition, who underwent laparoscopic adjustable gastric banding at least 12 years ago. Study participants reduced their excess weight by 42.8%, going from a mean BMI of 41.57 to 33.79. But the proportion having hypertension, type 2 diabetes, or sleep apnea had increased. Furthermore, 39% had experienced a major complication and 60% had undergone at least one additional surgery. Ultimately, nearly half had the banding device removed. Even so, 60% of patients said they were satisfied with the procedure’s results. Continue reading

Mental Impairment From Liver Damage May Foster Unsafe Driving

Chronic liver disease may cause cognitive impairments that lead to unsafe driving. (Image: Thomas Eckstadt/iStockphoto.com)

Many patients with severe chronic liver disease experience cognitive impairments that may make them unsafe drivers, and physicians may have a legal obligation to intervene, according to a study published today in Clinical Gastroenterology and Hepatology.

Cognitive impairments—such as problems with memory, thinking, and judgment—often arise in patients with cirrhosis, a scarring of the liver and poor liver function that is the result of damage to liver cells from various causes, including excessive alcohol consumption or diseases such as hepatitis. In more extreme cases, these impairments are obvious and hamper daily activities. Continue reading

Cancer Risk Can Linger Following Radiation Leaks

Cancer risks can remain elevated for decades following radiation exposure, a new study has found. (Image: Sergey Kamshylin/iStockphoto.com)

Amid concerns about how much radiation might be released from the Fukushima Daiichi nuclear power plant that was damaged in the devastating earthquake that struck Japan on March 11, a new study underscores that such events can have long-term consequences to human health.

Nearly 25 years after the 1986 nuclear power plant disaster in Chernobyl, Ukraine (then the Soviet Union), the risk of thyroid cancer has yet to decline for individuals who were children or adolescents when they were exposed to radioactive iodine 131 (¹³¹I), reports an international team of researchers in an article released online today by Environmental Health Perspectives. Continue reading

How Risk Statistics Are Presented May Mislead

How statistical results are presented may mislead patients and clinicians, a new study has found. (Image: Alex Slobodkin/iStockphoto.com)

The way in which many clinical studies present risk may mislead clinicians and patients about the magnitude of a treatment’s benefit and hamper their ability to make informed decisions, according to a Cochrane systematic review published today.

The review from the Cochrane Collaboration, a group that analyzes and synthesizes findings from medical research, examined the results of 35 studies that assessed how health consumers, health care professionals, or both perceived the benefits of a treatment depending on how the statistical results were presented. Continue reading

AHA Endorses Weight-Loss Surgery for Some

Bariatric surgery can be considered for weight loss for certain individuals with severe obesity, says the America Heart Association. (Image: Jeff Morin/iStockphoto.com)

In its first focused look at bariatric (weight-loss) surgery, the American Heart Association (AHA) said the procedure is appropriate for reducing cardiac risk factors, but only for certain groups of severely obese individuals for whom the benefits of the procedure outweigh the risks. Previously, the AHA said bariatric surgery should be considered as a weight-loss treatment for individual patients following careful evaluation by a physician.

In a new scientific statement, the AHA said that bariatric surgery is a viable option for weight reduction in patients who are severely obese, who can safely undergo the surgical procedure, and who have not succeeded in losing weight through diet, exercise, and behavioral modification. The AHA defines severe obesity as having a body mass index (BMI) of more than 40 or a BMI of greater than 35 when it is accompanied by an obesity-related condition that can affect heart health, such as hypertension, type 2 diabetes mellitus, or obstructive sleep apnea. The statement authors said that bariatric surgery can lead to significant weight loss and reduce health risks associated with these conditions, as well as risks associated with high cholesterol, liver disease, and cardiovascular dysfunction. Continue reading

Author Insights: Study Links Heavy Drinking With Pancreatic Cancer

Heavy drinking is associated with an increased risk of pancreatic cancer, according to results from a study by Susan M. Gapstur, PhD, MPH, of the American Cancer Society and her colleagues. (Image: American Cancer Society)

Daily consumption of 3 to 4 drinks of hard (distilled) liquor is associated with an increased risk of pancreatic cancer, even for those individuals who have never smoked, according to results from a massive prospective study published today in the Archives of Internal Medicine.

In 2009, a panel of experts convened by the International Agency for Research on Cancer concluded that the evidence of such a link was limited. But the new data from the Cancer Prevention Study II, a prospective study of more than 1 million individuals who were followed up for more than 20 years, bolster the evidence base by addressing some of the limitations of previous studies.

“One of the remaining concerns was teasing out the effects of smoking because drinkers are also often smokers,” explained Susan M. Gapstur, PhD, MPH, vice president of epidemiology research at the American Cancer Society (ACS) in Atlanta. “Because the Cancer Prevention Study II was such a large study, we were able to look at the risk of pancreatic cancer in those individuals who drank alcohol but were never smokers.” Continue reading