"For every complex problem, there is a solution that is simple, neat, and wrong." - HL Mencken
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"I hear and I forget. I see and I remember. I do and I understand." - Confucius
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"The good physician treats the disease; the great physician treats the patient who has the disease" - Sir William Osler
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" The best test of a person's character is how he or she treats those with less power." - Bob Sutton
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"Those are my principles, and if you don't like them - well, I have others." - Groucho Marx
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"The difference between genius and stupidity is that genius has its limits." - Albert Einstein
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"It is hard enough to remember my opinions, without also remembering my reasons for them" - Friedrich Nietzsche
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"Anyone can make the simple complicated. Creativity is making the complicated simple." - Charles Mingus
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"Not everything that can be counted counts, and not everything that counts can be counted." - Albert Einstein
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"A foolish consistency is the hobgoblin of little minds, adored by little statesman and philosophers and divines. With consistency a great soul has simply nothing to do." - Ralph Waldo Emerson
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"This ain't no party, this ain't no disco, this ain't no fooling around." - Talking Heads, Life During Wartime
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"What is hateful to you, do not do to your neighbour. This is the whole Torah; all the rest is commentary. Go and learn it." - Hillel, Talmud, Shabbath 31a
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"You will never understand bureaucracies until you understand that for bureaucrats procedure is everything and outcomes are nothing." - Thomas Sowell
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"An idealist is one who, on noticing that a rose smells better than a cabbage, concludes that it will also make better soup." - HL Mencken
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"If you only have a hammer, you tend to see every problem as a nail." - Abraham Maslow
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"A great teacher is one who realizes that he himself is also a student and whose goal is not to dictate the answers, but to stimulate his students creativity enough so that they go out and find the answers themselves." - Herbie Hancock
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"There are no facts, only interpretations." - Nietzsche
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"An education isn't how much you have committed to memory, or even how much you know. It's being able to differentiate between what you do know and what you don't." - Anatole France
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"In character, in manner, in style, in all things, the supreme excellence is simplicity." - Henry Wadsworth Longfellow
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Workouts by month - Goal 200 from 11/1/09 through 10/31/10
I generally resist new medications. Most 55 year old physicians do. I know the old drugs well. And I have seen too many new drugs withdrawn from the market after side effect reporting.
Pharmaceutical giant Merck & Company is pulling its blockbuster arthritis drug Vioxx from the market worldwide because new data from a clinical trial found an increased risk of heart attack and stroke.
Whitehouse Station-based Merck said Thursday that data from the trial showed the increased risk of heart attack and other cardiovascular complications began 18 months after patients started taking Vioxx.
The data comes from a three-year study aimed at showing that Vioxx at a 25 milligram dose prevents recurrence of polyps in the colon and rectum. The trial was stopped after Merck discovered the higher heart risk compared to patients taking dummy pills.
Evidence indicating these same sorts of adverse cardiovascular effects for Vioxx was published in JAMA in 2001. Nevermind Merck or the FDA, aren’t the physicians who prescribed this drug just as liable? Shows what you get when you rely on drug reps for your CME. With a nod to the impact of the religious right on the news media landscape, I’m afraid that all those who have written scripts for this drug these past three years may end up burning in hell for their part in this travesty.
I was never convinced of the value of this class of drugs (Cox-2 inhibitors) over plain old NSAIDs, especially in light of recent evidence that they’re harder on the stomach than originally supposed.
OT link of the day: medical students find their education humiliating.
merck estimates US sales of vioxx to be 2 billion annually.
(roughly that equates to 2 million prescriptions/year.)
from a generalist perspective of seeing numerous NSAID related complication over the past 12 years, “older”
NSAIDs have a lot of risk in themselves. GI Bleeding, fluid retention precipating overt Congestive Heart failure, renal failure , liver inflammation…etc…
Older NSAID’s despite this are my preferred meds but I must admit when patients seemed at very high risk for GI bleeding and had severe arthritis my choices were limited. Cox 2 seemed like a break through. it is scary to see someone transfused with several units of blood, NG tube, cardiac monitor or ICU and then telling a loved one that the GI bleed led to a Heart attack.
Narcotics have their own multiple attendent risks,
it seems like we are back to NSAIDs and narcotics.
is this good or bad?
Vioxx medblog roundup
There’s been plenty of discussion going on among the medical bloggers about Merck’s withdrawal of its arthritis drug. For posts especially relating to the courtroom implications, follow the italics: Derek Lowe (first, second posts); KevinMD (lots of …
Agreed, I have seen several comments and concerns raised regarding Vioxx. Sort of troublesome to know this is possible, something once safe now harmful.
8 Responses to Vioxx recalled
Subaqua Sternal Rubs » Merck recalls Vioxx
September 30th, 2004 at 10:49 pm
[...] overed the higher heart risk compared to patients taking dummy pills. Seen at: Kevin, MD DB’s Medical Rants Rangel, MD
Stef
September 30th, 2004 at 1:57 pm
Should we worry about Celebrex as well?
Is there any theoretical reason that Vioxx would be more susceptible to this problem than Celebrex?
swift
October 1st, 2004 at 2:14 pm
Evidence indicating these same sorts of adverse cardiovascular effects for Vioxx was published in JAMA in 2001. Nevermind Merck or the FDA, aren’t the physicians who prescribed this drug just as liable? Shows what you get when you rely on drug reps for your CME. With a nod to the impact of the religious right on the news media landscape, I’m afraid that all those who have written scripts for this drug these past three years may end up burning in hell for their part in this travesty.
Bernie Simon
October 1st, 2004 at 8:26 pm
I was never convinced of the value of this class of drugs (Cox-2 inhibitors) over plain old NSAIDs, especially in light of recent evidence that they’re harder on the stomach than originally supposed.
OT link of the day: medical students find their education
humiliating.
pj
October 3rd, 2004 at 7:53 pm
merck estimates US sales of vioxx to be 2 billion annually.
(roughly that equates to 2 million prescriptions/year.)
from a generalist perspective of seeing numerous NSAID related complication over the past 12 years, “older”
NSAIDs have a lot of risk in themselves. GI Bleeding, fluid retention precipating overt Congestive Heart failure, renal failure , liver inflammation…etc…
Older NSAID’s despite this are my preferred meds but I must admit when patients seemed at very high risk for GI bleeding and had severe arthritis my choices were limited. Cox 2 seemed like a break through. it is scary to see someone transfused with several units of blood, NG tube, cardiac monitor or ICU and then telling a loved one that the GI bleed led to a Heart attack.
Narcotics have their own multiple attendent risks,
it seems like we are back to NSAIDs and narcotics.
is this good or bad?
Overlawyered
October 7th, 2004 at 10:49 pm
Vioxx medblog roundup
There’s been plenty of discussion going on among the medical bloggers about Merck’s withdrawal of its arthritis drug. For posts especially relating to the courtroom implications, follow the italics: Derek Lowe (first, second posts); KevinMD (lots of …
Drug Vioxx
November 9th, 2004 at 9:11 am
Agreed, I have seen several comments and concerns raised regarding Vioxx. Sort of troublesome to know this is possible, something once safe now harmful.
Subaqua Sternal Rubs » Blog Archive » Merck recalls Vioxx
May 22nd, 2005 at 12:24 pm
[...] overed the higher heart risk compared to patients taking dummy pills. Seen at: Kevin, MD DB’s Medical Rants Rangel, MD [...]