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Saturday, May 28, 2005A spokesman for Pfizer, the makers of the drug, said the company was considering changing its warning on the drug label. "We are in discussions with the FDA to update our language to reflect these rare ocular events that have occurred," said Daniel Watts. ....There have been no reports of the condition among 13,000 people tested in clinical trials for the drug. The condition, known as nonarteritic anterior ischemic optic neuropathy (NAION), causes a rapid reduction of vision and can, in the most serious cases, lead to blindness. Dr Howard Pomeranz, co-author of a report on the condition published in the Journal of Neuro-ophthalmology in April, said the drug had long been linked to sight problems. Viagra was known to cause temporary colour changes in some men's vision, he said, but NAION was a much more serious condition. Granted, a sudden drop in blood pressure - as could happen if a person were to take Viagra with nitrates - could theoretically cause nonarteritic anterior ischemic optic neuropathy, but there's no reason to suppose that these few cases are due to Viagra. The condition is caused by a loss of blood flow to the eye. The "arteritic" type is rarer, and usually caused by an autoimmune induced inflammation of the blood vessels - (the "arteritic" comes from the word for that inflammation - "arteritis.") The non-arteritic type is much more common, occurring in 2.3-10.3 per 100,000 in the U.S. It is also often associated with other vascular diseases: NAION is not commonly associated with life-threatening conditions, although the presence of other vascular conditions is frequent (eg, hypertension, 46.9%; diabetes, 23.9%; myocardial infarction, 11%). I'll be darned. Those are the same diseases associated with impotence. Is it all that surprising some of the people who develop NAION take Viagra? What's surprising is that only 50 of them have been identified so far. posted by Sydney on 5/28/2005 09:58:00 PM 0 comments
Friday, May 27, 2005Although the first month of using he EMR was more stressful than I anticipated, my staff are now EMR boosters. They no longer have to put a patient on hold while they go searching for their chart. They no longer have to call in prescriptions to the pharmacy (I fax them), and they no longer have to refile charts at the end of the day. No one's chart is ever lost. I've heard them tell each other they would never want to go back to the old paper-based system. I'm liking it, too. Documentation is much easier - and faster - with the computer system than it was with paper. So is refilling prescriptions. The patient's previous prescriptions are kept as a list in the computerized record's summary database. I just have to click on a pull-down menu to get the stored prescriptions, select the one that's needed, then fax it directly from the record to the pharmacy. It's a much faster process than the old way, which involved writing out the drug name, dosage, instructions, quantity, and refills and then passing the note back to my staff who then had to call the pharmacy and either remain on hold while the pharmacist came to the phone or recite it into an answering machine. Although scanning incoming paper from other doctor's offices, diagnostic centers, the hospital, and labs was initially a monunmental problem, we've got that solved now, too. I've blogged about the scanning dilemma before, but to recap, I bought a Brother MFC-8840DN, combination scanner/fax/copier hoping it would not only replace three machines with one, but that it would also make it possible for the staff to scan data into charts quickly using any computer. It wasn't until after I purchased it, however, that I discovered its document feeder doesn't work with Windows XP. It only works with earlier Windows systems. The flat bed scanner works with XP, but it's a much slower process. We contacted Microsoft who said it was Brother's problem to fix, but it provd impossible to contact anyone at Brother. I didn't want to add to the stress level of my staff, who were having trouble the first four to six weeks adapting to the new system. So...for the first two or three months, I was doing most of the scanning myself with a small portable scanner that I could easily transport from the office to home. I was spending all of my free time scanning and it was driving me nuts. I finally got wise and connected an old computer that runs Windows2000 to the Brother Scanner. It's set up next to the scanner/fax/copier (which also happens to be where the incoming postal mail goes) so the staff can easily scan incoming paperwork as it arrives. I was afraid they would resent the extra work, but they don't at all. Now that I'm faxing the prescriptions, they have the time to do it. And it's just as easy to scan the papers into their respective charts as it was to sort through them and put them in appropriate folders for my review. It's also a noticeably faster process using the document feeder - even if just a series of one-page results are being scanned into different charts. What used to take me an hour with the portable scanner takes about twenty minutes with the Brother's document feeder. Which means - I hope - that I'll be having more and more free time in the evenings and on weekends than I've had these past few months. It was quite a slog for a while, but I'm finally beginning to feel it was worth it. posted by Sydney on 5/27/2005 09:00:00 PM 0 comments
Tuesday, May 24, 2005posted by Sydney on 5/24/2005 12:39:00 PM 0 comments
Monday, May 23, 2005A SUPERFIT Royal Marine collapsed and died within days of scratching his leg on a bush while on a training run — victim of a mutated superbug one doctor described as the worst she had ever seen. Richard Campbell-Smith, 18, fell victim to pneumonia caused by a rare strain of bacteria that produces a lethal toxin that kills white blood cells. A microbiologist who gave evidence at the inquest into his death yesterday said that she had come across two such cases since December but none in the previous 15 years. Marina Morgan, of the Royal Devon and Exeter Hospital, said that although cases of the toxin Panton-Valentine leukocidin were still rare, it was difficult to detect, even during post-mortem examination, and many cases might be slipping through. The toxin is produced by some strains of the ubiquitous bacteria Staph aureus., which already has a propensity to secrete enzymes that turn host cells into bacterial nutrients. The Panton-Valentine leukocidin targets white blood cells - the body's primary line of defense against infection. Fortunately, less than 5% of Staph aureus produce the Panton-Valentine leukocidin. posted by Sydney on 5/23/2005 10:27:00 PM 0 comments
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