As a former college athlete, Daniel J.Hilferty, president and chief executive officer of AmeriHealth Mercy/Keystone Mercy in Philadelphia, knows how critical teamwork is. Teammates are especially helpful when dealing with complicated healthcare issues, such as serving the Medicaid population.
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Migraine therapy: balancing efficacy and safety with quality of life and cost (PDF)
December 1st 2002Successful management of migraine attacks and their symptoms leads to economic benefits such as decreased reliance on healthcare resources, decreased employee absenteeism, and increased productivity. Appropriate treatment includes prophylaxis with lifestyle changes and drug therapy, and acute therapy with drugs. Over-the-counter analgesics can be effective acute therapy for mild migraine; for moderate to severe attacks, the 5HT1B/1D agonists, or triptans, offer significant efficacy and cost-effectiveness.
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Ezetimibe: a novel cholesterol absorption inhibitor (PDF)
December 1st 2002Ezetimibe (Zetia), approved in late October, represents the first new class of cholesterol-lowering drugs in 15 years. Ezetimibe, an intestinal cholesterol absorption inhibitor, has a unique mechanism of action, distinct from those of statins and bile acid sequestrants. When used as monotherapy, ezetimibe lowers low-density lipoprotein cholesterol (LDL-C) levels up to 18.5%. Coadministration of ezetimibe with statin therapy reduces LDL-C levels up to an additional 22%. The article reviews ezetimibe?s chemistry, pharmacology, pharmacokinetics, and clinical trial results.
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The Journal of the American Hospital Assn. voted it one of the most wired hospitals in the United States for the third consecutive year, but it's not backing off its investment in information technology. Northwestern Memorial Hospital has been operating in its new, $258 million facility since 1999.
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B&H talks to . . . Charles Crispin, Evergreen Re
November 14th 2002He's president of Evergreen Re, a managed-care consulting firm and reinsurance broker. Evergreen&s annual survey of the finances of managed care prompted a wide-ranging conversation from capitation to IT investments to inappropriate transplants.
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From ICAAC: Microbial resistance, preventing herpes transmission at conference forefront
November 1st 2002Microbial resistance is a concern in treating urinary tract infection (UTI) and bacteremia. But analysis of data from more than 200 US hospitals in the Surveillance Network Database-USA from 1999 to 2001 demonstrated bloodstream and urinary tract isolates with the potential to cause urosepsis to be very susceptible in vitro to broad-spectrum b-lactams and aminoglycosides. The study results were reported at the 42nd Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) in San Diego, CA.
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From the Stanley Conference: Options expand for bipolar disorder
November 1st 2002Studies presented at the Third European Stanley Foundation Conference on Bipolar Disorder in September in Freiburg, Germany, show two newer antipsychotics are each more effective than standard therapy for preventing mania relapse or reducing symptoms.
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From the MTIRS: Anticonvulsant reduces migraine headache frequency
November 1st 2002A phase III study presented at the 14th annual meeting of the Migraine Trust International Research Symposium (MTIRS) in September in London showed that topiramate (Topamax) significantly reduced migraine frequency at doses as low as 100 mg/d. The onset of efficacy was observed as early as the first month of treatment. Topiramate is already approved in the United States and worldwide as an
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Aripiprazole: First of a new class of antipsychotics (PDF)
November 1st 2002Aripiprazole is an investigational atypical antipsychotic that received an approvable status from FDA in September 2002 for the treatment of schizophrenia. The decision on approval could be made as early as the end of this year. Aripiprazole offers a unique mechanism of action as a dopamine system stabilizer. Aripiprazole has been found to be effective in both short-term (4?6 wk) and long-term (26?52 wk) treatment trials. It appears to produce less hyperprolactinemia, weight gain, and extrapyramidal symptoms than other antipsychotics.
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HMG CoA reductase inhibitor-induced muscle toxicity: risks, monitoring, and management (PDF)
November 1st 2002Although the commonly used HMG CoA reductase inhibitors (statins) are well tolerated and relatively safe, muscle toxicity and rhabdomyolysis can occur with administration and can be severe. This risk is higher with more bioavailable and lipophilic statins. This article summarizes what is known about the etiology of statin-associated muscle toxicity, the risks for each statin, and the current recommendations for monitoring and management.
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Charging drug representatives for physician visits: Three leadersexplain why and how
November 1st 2002Formulary has identified three organizations that recently begancharging pharmaceutical representatives a fee to meet withphysicians. Two of the organizations-Queen City Physicians and thePolyclinic-are physician group practices based in Cincinnati, OH,and Seattle, WA, respectively.
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Sixteenth century author Thomas Deloney likened lawsuits to "the winter nights: long and wearisome." Wearisome legal battles in healthcare can be exhausted with motions as costs increase proportionately. Ultimately, the chill is felt in the premiums of millions of Americans.
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