Archive for November, 2009

Quick Check That Could Save Your Grandparents’ Lives

Friday, November 13th, 2009

Sunday, September 13, is National Grandparents Day, and the American Academy of Dermatology (Academy) recommends that people lovingly remind their grandparents to perform a skin self-examination. Simply provide your grandparents with the Academy’s free tools to help them examine their skin for any suspicious lesions that could be cancerous. It’s an easy way to detect the only cancer that can be seen on the surface of a person’s skin.

Based on current estimates, substantially more than 1 million new cases of skin cancer are diagnosed in the United States every year. Melanoma, the deadliest form of skin cancer, is being diagnosed more rapidly in men age 65 and older than in the general population. A history of exposure to UV rays is a risk factor for skin cancer.

The Academy has created several tools to make it easy to determine if a mole is suspicious and should be brought to a dermatologist’s attention. The Academy’s Body Mole Map is a tool individuals can use to track their moles. The map provides information on how to perform a skin exam, images of the ABCDEs of melanoma and space for people to track their moles to determine any changes over time. The mole map is downloadable at no cost at www.aad.org/checkspot.

“Performing these checks regularly can help determine if a mole seems to be changing, which could be a sign of skin cancer,” said dermatologist David M. Pariser, MD, FAAD, president of the Academy. “Early detection is a key factor in the fight against skin cancer and ultimately can help save lives.”

One American dies of melanoma every hour (every 61 minutes). The five-year survival rate for people whose melanoma is detected and treated before it spreads to the lymph nodes is 99 percent. For more information about skin cancer, please visit the SkinCancerNet section of www.skincarephysicians.com, a Web site developed by dermatologists that provides patients with up-to-date information on the treatment and management of disorders of the skin, hair and nails.

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 16,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails.

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Reflux Drugs OK With Blood Thinners

Friday, November 13th, 2009

Antacids don’t interfere with anti-clotting drugs such as Plavix and Effient in patients who have suffered a heart attack or unstable angina, a new study finds.

The results counter other studies that concluded that a class of antacids known as proton pump inhibitors (PPIs) could block the effect of anti-clotting drugs. Doctors often prescribe PPIs along with anti-clotting drugs to reduce the risk of gastrointestinal bleeding.

“The current findings provide some reassurance to clinicians that PPIs and clopidogrel [Plavix] can be safely combined in patients in whom there is a strong indication to use both drugs,” said lead researcher Dr. Michelle O’Donoghue, an investigator in the TIMI Study Group at Brigham and Women’s Hospital in Boston.

As to why the findings differ from earlier results, O’Donoghue said the answer may lie in the patients themselves and in the type of data analyzed.

“Patients who are treated with a PPI may differ quite markedly from other patients,” she said. “In particular, there is concern that PPIs are often administered to sicker patients and that this may help to explain why patients on a PPI seem to do more poorly than other patients.”

In the current study, the researchers adjusted for these differences, O’Donoghue said.

“Another advantage of the current study is that it was done within the confines of a clinical trial,” she said. “In a clinical trial, all endpoints are strictly defined and adjudicated so there may be less of a risk for bias.”

The report is published in the Sept. 1 online edition of The Lancet, to coincide with the presentation of the results Monday at the European Society of Cardiology Congress in Barcelona.

For the study, O’Donoghue’s group looked at the effects of PPIs like Prilosec in two trials, the TRITON-TIMI 38 trial and a smaller trial. In the TRITON-TIMI 38 trial, researchers randomly assigned 13,608 patients to clopidogrel (Plavix) or prasugrel (Effient) after having a heart attack or unstable angina.

Giving the PPIs in combination with anti-clotting drugs did not increase the risk of death, heart attack, or stroke, the researchers concluded.

“We did not find use of a PPI to be associated with a higher risk of cardiovascular events for patients taking either clopidogrel or prasugrel,” O’Donoghue said.

Dr. Dirk Sibbing, from the Technische Universitat Munchen in Germany and co-author of an accompanying commentary, said this study shows that PPIs affect the anti-clotting drugs, but not patient outcomes.

“It seems that patients who carry a risk profile comparable to that of patients enrolled in TRITON-TIMI 38 can be safe on PPI treatment as long as compliance to regular anti-platelet drug intake is well-controlled,” Sibbing said.

However, cautions should remain for high-risk patients and those who are less responsive to Plavix, Sibbing said. Also, he said he believes that for some patients taking Effient and PPIs, the combination may be harmful, he said.

“In any case, monitoring of compliance to anti-platelet treatment is mandatory in all patients, but specifically in the group of patients under concomitant PPI treatment,” Sibbing said.

“Specific studies, however, are warranted in this group of patients to clarify this issue,” he said.

O’Donoghue doesn’t disagree. “In the end, only a randomized clinical trial can definitively demonstrate the safety of combining these two classes of drugs,” she said.

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