1999.08.09 Pearls
 

Lax rules regarding online pharmacies have both physicians and pharmacists concerned about fraud and quality of care. Some pharmacists believe that quality care consists of getting to know their customers personally, in order to ensure that the medicines are being taken properly. Leigh S. Medical Tribune 1999 (April 8);40(7):1.

In regards to online pharmacies, this article states that "few mandated safeguards exist in this virtually unregulated area." Patient Care 1999 (July 15).

Online prescribing is already widespread and growing larger. Concerns about abuse are mounting, but as of yet few regulations exist. Clinical News 1999 (April);3(4):1.

According to NHANES 3, approximately 30% of American adults are deficient in vitamin E. Ford E, Sowell A. Amer J Epidemiology 1999;150:290.

For the healthy elderly, cholesterol levels are important. They should be monitored approximately every 5 years, and treatment of elevated levels strongly considered. Women shouldn't rely on hormone replacement therapy alone with their cholesterol levels are elevated. Grundy SM et al. Arch Internal Med 1999;159:1670.

In attempting to medically convert recent onset atrial fibrillation, oral propafenone (conversion rate 45%) and oral flecainide (57%) were nearly as effective as IV propafenone (58%) at restoring sinus rhythm within 3 hours. Boriani G et al. Pace 1998 (Nov);21:2470.

This review article concludes that the use of heparin- either fractionated or unfractionated- is not clearly beneficial in the treatment of an acute ischemic stroke, and because of the associated risks, heparin treatment is currently not indicated [this recommendation is still controversial -ed]. Med J Australia 1998 (Nov 16);169:534.

This French study confirmed that prolonged travel (over 4 hours straight) increased the risk of a venous thromboembolism. Ferrari E et al. Chest 1999;115(2):440.

Number Needed to Treat: the inverse of the the absolute risk reduction, for example: from 40/100 to 20/100 equals 20/100, the inverse of which is 5. This means that for every 5 people switched over to the new treatment, 1 person will benefit. BMJ 1998 (Nov 7);317:1309.

Long-term use of the herb Aristolochia (2 to 6 years) was associated with kidney failure according to these case studies of two women. Lancet 1999;354:481,494.