Solanezumab is not a breakthrough for Alzheimer’s patients.

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Is there a breakthrough drug, that, unlike currently available medications for Alzheimer’s disease – targets the disease itself, and not just the symptoms?  That’s what various news outlets are reporting after the publication of a study in the Journal Alzheimer’s and Dementia evaluated the anti-amyloid antibody solanezumab.

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A smoke-free discussion of confounding.

I wanted to talk about confounding in observational studies.  Early on, I made a promise to myself: the example I was going to use would not involve smoking, drinking and lung cancer.  The result?  A treatise on confounding using taco’s, mud runs, and zest for life.  Clearer?  Probably not.  But way more fun.

Take a look at the full post on medpagetoday.com here.

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Have we been giving kids juvenile idiopathic arthritis inadvertently?

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If you’ve ever taken care of a kid with juvenile idiopathic arthritis, it sticks with you.  This disease, which is occasionally referred to as juvenile rheumatoid arthritis, isn’t fatal, but it can rob children of the ability to be active, play, and grow – the real essence of childhood. And to date, we still don’t know what causes it.  It’s clearly auto-immune, but there isn’t even a serologic test for the disease.

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Combining these two common medications might kill you.

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With depression a major health problem, and broadening indications for antidepressants, these medications are seeing rapidly increasing use.  Non-steroidal anti-inflammatory drugs (NSAIDs), ranging from indomethacin, to ibuprofen, to the cox-2 inhibitors, are also very frequently used. Simple logic would tell us that there would be significant overlap in the Venn diagrams for these two classes, but it turns out that individuals with depression are more likely to experience chronic pain, and thus, more likely to take NSAIDs. The combination of these two classes may be problematic.

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Liraglutide and Weight Loss – The Real Skinny

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Weight loss is something of a holy grail for pharmaceutical companies.  A large and, frankly, growing market exists not only in the US but around the world, and is only getting bigger. The list of drugs that have tried, and failed, to crack this market is ever-growing.

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Bitter news: citrus fruits linked to higher rates of melanoma.

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Browsing through article titles this week, my eye caught one from the Journal of Clinical Oncology with the words “melanoma” and “citrus fruit”.  Not worth looking at I thought, clearly a study linking citrus intake with melanoma is hopelessly confounded.  People who eat citrus fruits are probably healthier in general, have better access to care, etc – clearly they’ll have lower melanoma rates.

But then I read the abstract, and, go figure – people consuming more citrus fruits had higher rates of melanoma. This was worth a deeper dive.

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If drugs for erectile dysfunction cause cancer, would you want to know?

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If this is one of those “ignorance is bliss” situations, read no further…

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The P-Value is Ruining Medical Science

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The P-value, that most vaunted of metrics. For decades, it has been the standard by which we judge whether studies are positive or negative.  But it has a major, major problem.

I blogged about it this week on medpagetoday.com.

Take a look.

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You operate on appendicitis, right? Right?!

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If Grey’s Anatomy has taught us anything, it’s that you have to operate on appendicitis. This fact is imbued in the cultural zeitgeist – it’s the first book of the Madeline series for crying out loud. But paradigms, even one as inertial as this one, can shift.

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Heroes wanted: Will cardiac-arrest alerts come to your town?

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If you suffer an out-of-hospital cardiac arrest, your chance of surviving is only around 10%. But you can improve those odds dramatically if a bystander initiates CPR before EMS arrives.  Boosting the rates of bystander-initiated CPR, then, has become a major public health focus. But, typically, the means to increase the rate have been simple: train more people. While laudable, training can only reach a small fraction of the community, and the chance that someone in your immediate vicinity has been adequately trained remains small.

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