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Serious Concerns Over Methods Used To Allocate Scarce Healthcare Res
Two papers published on bmj.com today raise serious concerns over the methods used to put a value on the benefits of different treatments in order to set healthcare priorities.
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International Workshop: Infant Formula Adulteration With Melamine Underscores Need For Better Detection Methods
Following the recent adulteration of infant formula and other milk products with the industrial chemical melamine, the U. S. Pharmacopeial (USP) Convention is holding an international workshop this week to explore better ways to detect deliberately falsified protein content in food ingredients. The presence of false protein can lead to illness and death, as with thousands of Chinese children in the tragic melamine adulteration of infant formula this year and with pets in the United States in 2007. Vulnerabilities in global supply chains for food and drug ingredients allow such adulteration to affect people worldwide, which is what happened in similar instances where toxic diethylene glycol was substituted for the sweetener glycerin in toothpaste and cough syrup. USP is a scientific nonprofit organization that sets official standards for the identity, quality, purity, and strength of prescription and over-the-counter drugs. USP also sets widely recognized standards for the quality and purity of food ingredients and dietary supplements.
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BJOG Release: New Study On The Cause Of Early Preterm Birth
An exploratory study to be published in BJOG: An International Journal of Obstetrics and Gynaecology, has shown that women going into early preterm labour (before 34 weeks gestation) have low-levels of progesterone in their saliva as early as 24 weeks, and that moreover, these levels fail to rise during pregnancy in the normal way. This offers the possibility of developing a simple, non-invasive test to identify women at increased risk of delivering early.
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Stroke Patients Less Likely To Meet Treatment Goals Than Heart Disease Patients

A majority of high-risk stroke patients are less likely to meet clinical treatment targets to prevent repeat stroke or heart attacks compared to those with heart disease, suggesting the need to examine new therapeutic strategies, according to a study led by St. Michael"s Hospital neurologist Dr. Gustavo Saposnik. What"s more, medical procedures or ongoing specialty care may improve patients" awareness and consequent treatment success. The study, an analysis of 4,933 outpatients with a past history of heart attack and cerebrovascular disease (stroke) across Canada, found: * About 30 per cent of patients with heart disease achieved target blood pressure and LDL-cholesterol levels * Only 20 per cent of stroke patients met target blood pressure and LDL-cholesterol levels. (At the time of the study, Canadian guidelines recommended a LDL-cholesterol target of less than 2.5 mmol/L and a blood pressure target of less than 140/90 mm Hg or less than 130/80 mm Hg for diabetic patients). * Among stroke patients, women were also less likely to meet the targets despite a similar medical history of treatment with antihypertensive and LDL-cholesterol-lowering therapies. "With stroke the third leading cause of death in Canada and its prevalence expected to jump exponentially in the next 20 years, more effective therapeutic strategies are necessary to treat patients," said Dr. Saposnik. "By examining clinical management practices, we can better identify the gaps in patient care so that we can improve the health of stroke and heart disease patients." According to the study, inappropriate drug or dose selection, lack of aggressive management, patient nonadherence or limited drug efficacy may pose barriers to poor treatment success. The researchers suggest differences in the emphasis of recommended targets between heart and stroke prevention guidelines may account for the gap. "Despite the effectiveness and benefits of antihypertensive and lipid-lowering therapies, management of heart disease and stroke patients remains poor," said St. Michael Hospital cardiologist Dr. Shaun Goodman, who created the database used in the study. "A significant proportion of patients who failed to meet guidelines within our study were stroke patients and women. Quality improvement strategies should target these patient subgroups so that we can develop benchmarks that can lead to improved clinical practice." The study, which appeared in the Journal of the American Heart Association, was a collaborative effort involving medical professionals from cardiology, endocrinology and neurology at the Hospital led by Dr. Saposnik, Dr. Andrew Tan and Dr. Goodman. Julie Saccone St. Michael"s Hospital


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