Posts (page 2)
FDA is investigating new preliminary data regarding a potential increased risk of serious skin reactions including Stevens Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) from phenytoin therapy in Asian patients positive for human leukocyte antigen (HLA) allele, HLA-B*1502. This allele occurs almost exclusively in patients with ancestry across broad areas of Asia, including Han Chinese, Filipinos, Malaysians, South Asian Indians, and Thais. Until the FDA evaluation is completed, healthcare providers who are considering the use of phenytoin or fosphenytoin should be aware of the risks and benefits described in the current prescribing information for this drug. Healthcare providers should consider avoiding phenytoin and fosphenytoin as alternatives for carbamazepine in patients who test positive for HLA-B*1502. A summary of the data currently being analyzed by FDA, and information for patients and healthcare professionals to consider, can be found in the links provided in the MedWatch safety alert.
Read the MedWatch safety summary, including links to the Information for Healthcare Professionals and FDA Drug Information pages, at:
http://www.fda.gov/medwatch/safety/2008/safety08.htm#Phenytoin
I'm testing blogging via blogIt, typepad's iPhone app. Pretty easy!
I was suprised at how many folks I cared for in my medical clinic yesterday, knew of the Motrin Moms ad. 10% , 3 of 30. How ridiculous for Motrin to be snarky and blame moms for baby bjorning or slinging their babies! that's just craZy! If I blamed folks for their behavior, Noone would come back to see me in clinic. Generic ibuprofen is just as good as Motrin anyways!
Navigenics has partnered with Scripps Translational Science Institute (STSI) to see if 10,000 folks from Scripps Health system in San Diego will change their behaviors based on their genetic risks. This is made possible by gene array chips from Affymetrix, a portal and genetic counselors at Navigenics, as well as storage at Microsoft's HealthVault.
As a beta user of Navigenics, I've been impressed with how differently I see my own personal health risks after getting tested. I previously knew of my family history predisposing me to specific health risks, but it was really brought home by being shown the increase in risk based on the genetic test. Whereas I knew previous to being tested that I would think about getting screened earlier, now that I have a positive test result for an allele, I've actually decided to do something about it and am going to get screened earlier.
I think that's the magic about this, it provides some level of evidence that you've inherited increased risk for a particular condition, gives you statistics showing the increase in that risk, lets you review the evidence supporting those studies, so you can decide what you want to do with some evidence.
As a physician who have patients asking me about these tests, I tell them that you need to examine the evidence that certain alleles are associated with increased risk. The evidence isn't strong in some cases, so you may not take certain positive results with as much weight as others. The great thing about Navigenics is that they're constantly adding to their testing and process your DNA thru these new tests as they discover the associations. I'm looking forward to a year of updates as being part of the beta testing group.
When asked whether or not storing health data at Microsoft HealthVault has any value -- I let my patients know that they could have a benefit if they have multiple independant physicians that use HealthVault and can store the records in one place for exchange between them. Since Navigenics' updates thru the year could continue to add updates, that may be of value. If you don't have any of your docs using HealthVault, it doesn't seem to offer any value in my opinion, over checking out your values at Navigenics' own portal.
This will be an exciting study to see if what I suspect to be true will be proven -- that individuals with a family history for conditions will decide to act and change their risk factors if they are told that their genes increase their risk. Somehow there's this hope that we're not quite like our folks, but if you show someone their genes, I think that will get them to act. One would hope ;)
To be clear, I have no financial relationship with Navigenics, Affymetrix, Microsoft, own no stock or options in any of them, and the only benefit to me has been free testing through the beta program, and Microsoft gave me a polar wireless monitor at the HealthVault release party that doesn't work with my mac.
The SF International Wine Competition '08 gold and double gold award winners were tasty at The Tasting Panel's review of their wines. The Mandarin Oriental was a gorgeous setting in their library, and we were even escorted from the door to the tasting. It was a unique tasting for me, as I used to having winemakers or distributors' reps there to talk about their wines, but instead we were self-pouring. It was also unique in the selectivity -- more of a minimalist apporach than the usual hundreds of wines.
Nicholas Feuillante champagne was a treat, i've ben a fan since John @ Mt View BevMo hyped it 5 years ago
Sparkling Gewurtz was delightful, with a nose of litchi and peach
Across the reds, I was surprised at the restraint and accessibility, none of the fruit bombs or tannin monsters (other than the zin).
Notably absent were any pinot noirs, probably all sold out of that year already
I was surprised at the selection of spirits, and as I'd never been to a spirits tasting. Highlights include the ginger liquor, chartreuse, two Lagavuilins (16 year and 1991) peat monsters tho they were, the nose of the malbec vodka. The spinning glass top of the tequilla would have been fun to show the kids, but they'll have to do with my video...
I'm sadly missing the Wine & Spirits Top 100 which i've gone to for years but will be taking my daughter to Bible Study Fellowship since I'm gone too much this month...
amazing!
prawn on parsley
chocolate trio, hamachi
After a week on the road presenting @ cdhcc hbs & health2.0 there's nothing as comforting as a birthday party - back to normal life!
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