French “Sunshine Act” Sheds Little Light on Drug Industry’s Payments to Doctors, Say Critics.

French “sunshine act” sheds little light on drug industry’s payments to doctors, say critics.

BMJ. 2013; 346: f3762
Benkimoun P

HubMed – drug


Academic psychiatry, research ethics, and the drug industry.

BMJ. 2013; 346: f3655
Summerfield DA

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Cold agglutinin disease.

Blood. 2013 Jun 11;
Swiecicki PL, Hegerova LT, Gertz MA

Cold agglutinin disease is a rare and poorly understood disorder affecting 15% of patients with autoimmune hemolytic anemia. We review the clinical and pathologic features, prognosis, and management in the literature, and we describe our institutional experience to improve strategies for accurate diagnosis and treatment. Retrospective analysis identified 89 patients from our institution with cold agglutinin disease from 1970 through 2012. Median age at symptom onset was 65 years (range, 41-83 years), whereas the median age at diagnosis was 72 years (range, 43-91 years). Median survival of all patients was 10.6 years, and 68 patients (76%) were alive 5 years after the diagnosis. The most common symptom was acrocyanosis (n=39 [44%]), and many had symptoms triggered by cold (n=35 [39%]) or other factors (n=20 [22%]). An underlying hematologic disorder was detected in 69 patients (78%). Thirty-six patients (40%) received transfusions during their disease course and 82% received drug therapy. Rituximab was associated with the longest response duration (median, 24 months) and the lowest proportion of patients needing further treatment (55%). Our institution’s experience and review of the literature confirms that early diagnostic evaluation and treatment improves outcomes in cold agglutinin disease. HubMed – drug


Improving performance? Dietary supplementation practice in ultramarathon runners.

Br J Sports Med. 2013 Jul; 47(10): e3
Scheer Bernd V, Valero Burgos E

Ultramarathon races have gained popularity in recent years and test the limits of human endurance. Dietary supplements are widely used, and athletes may attempt to gain a performance advantage through replenishment of real or perceived deficiencies.We conducted a prospective survey study gathering data on prevalence, types and reasons for consumption of dietary supplements among ultramarathon runners during the Al Andalus Ultimate Trail 2012. Data were obtained post race using a direct-interview technique on standardized questionnaires.Thirty-two ultramarathon runners (26 male, 6 female, mean age 39.5±7.9, previous ultramarathon experience 7.7±9) enrolled in the study and completed the questionnaires. Over two-thirds of runners said they consumed sports drinks and electrolytes, and over half used carbohydrate drinks and vitamin preparations followed by herbal supplements, minerals, magnesium, amino acids, and caffeine (38%, 38%, 28%, 25% and 22%). The main reasons cited for consumption were for improvement of performance (47%), the perception of acquired deficiencies through training (34%), or being vegetarian (16%). Sixty percent of runners said that they had had recent blood tests taken at their doctors’ surgeries – all being in the normal range and not showing any deficiencies. High street shops and/or the Internet were the main sources for obtaining dietary supplements (69%; 47%). Supplements were taken based mostly upon recommendations of fellow runners (50%), self initiative (34%), magazine advertisements (22%) and/or recommendations of friends (19%) and, while less likely, by the recommendation of professionals (doctors 16%, coaches 13%, physiotherapists 3% and nutritionists 3%).The practice of dietary supplementation is widespread among ultramarathon runners, who take a variety of supplements aimed at increasing performance or treating perceived deficiencies. Athletes should be properly educated about potential benefits and risks, especially those who are regularly tested for performance enhancing drugs, as dietary supplements can contain substances that lead to positive drug tests. HubMed – drug