Sunday, March 25, 2012

 Some drugs just never go away< but they should

We first criticized this drug in 2006, when in the BMJ we first mooted rosiglitazone in the DREAM trial – which cost $23million - caused a significant increase in heart failure, despite the population being at low risk of such a problem. The drug showed no clear benefit at 3 years on clinical outcomes and the rate of all cardiovascular events tended to be higher in the treatment group. What happened after that was good news, in that Steven Nissen in 2007 from the Cleveland Clinic undertook a systematic review of the effects of rosiglitazone, combining results from a total of 42 trials. The results clearly showed rosiglitizone was associated with a significant increase in the risk of heart attack and death confirming what we had suspected. Around the same time a Cochrane review also found there was no evidence of any benefits with the drug over other available treatments for diabetes and, because of side effects such as edema, fractures, and possible increased risk of MI, recommended other antidiabetic medications be used in preference. The uses of composite end points in the DREAM trial were also aptly criticized by Victor Montori in the BMJ. These drugs were making significant inroads in the drug market with more than 1.5 million prescriptions for rosiglitazone and pioglitazone issued in England alone in 2007. The week of the 5th of June, to my surprise the Lancet published the RECORD trial of rosiglitazone as an oral agent combination therapy. In English that means they combined it with another therapy. What they showed is rosiglitazone increased heart failure; but they then went on to report it doesn’t reduce cardiovascular death and the data was inconclusive on myocardial infarction rates. This is one of those interpretations designed to keep the drug on the market. Highly marketing driven and usually highly dangerous. A couple of points however are worth noting: more people were on a statin (9%) in the rosiglitazone group, they had an excess of heart attack, and although this was not significant it adds to the findings in the Nissen systematic review. Also, in the subgroup of RECORD patients with pre-existing heart disease, there was a 26% increase in heart attack. In addition, it seems the treatment also raises the risk of fractures. Finally, the RECORD trial had an unexpected low event rate, 2.5 % per year, whilst the trial was powered on an expected event rate of 11% per year; taken together with losses of 3% per year leads to very significant concerns about the results. The final nail in the coffin of this drug is that at the time of Nissen’s original review, approximately 30% of patients in the trial assigned to receive rosiglitazone had stopped taking the drug. By the time of the recent Lancet publication there is no mention of how many were actually on the drug. This is a no brainer, how can you assess the safety of a drug if you can’t tell who is actually taking it.

Saturday, March 24, 2012

Qualities ov A perfect wine

Wine tasting is a highly subjective art. Different varietals appeal to tasters for different reasons. For instance, if you prefer sweet white wines, an inexpensive Riesling may taste better to you than a high-quality Chardonnay. However, there are some general characteristics of good wine, which with practice and experience you may learn to discern in any vintage that you quaff.

Myths of Drug Abuse

Myths about Drug Abuse and Addiction

MYTH 1: Overcoming addiction is a simply a matter of willpower. You can stop using drugs if you really want to. Prolonged exposure to drugs alters the brain in ways that result in powerful cravings and a compulsion to use. These brain changes make it extremely difficult to quit by sheer force of will.
MYTH 2: Addiction is a disease; there’s nothing you can do about it. Most experts agree that addiction is a brain disease, but that doesn’t mean you’re a helpless victim. The brain changes associated with addiction can be treated and reversed through therapy, medication, exercise, and other treatments.
MYTH 3: Addicts have to hit rock bottom before they can get better. Recovery can begin at any point in the addiction process—and the earlier, the better. The longer drug abuse continues, the stronger the addiction becomes and the harder it is to treat. Don’t wait to intervene until the addict has lost it all.
MYTH 4: You can’t force someone into treatment; they have to want help. Treatment doesn’t have to be voluntary to be successful. People who are pressured into treatment by their family, employer, or the legal system are just as likely to benefit as those who choose to enter treatment on their own. As they sober up and their thinking clears, many formerly resistant addicts decide they want to change.
MYTH 5: Treatment didn’t work before, so there’s no point trying again. Recovery from drug addiction is a long process that often involves setbacks. Relapse doesn’t mean that treatment has failed or that you’re a lost cause. Rather, it’s a signal to get back on track, either by going back to treatment or adjusting the treatment approach.

Don't do drugz__Plz

Some people are able to use recreational or prescription drugs without ever experiencing negative consequences or addiction. For many others, substance use can cause problems at work, home, school, and in relationships, leaving you feeling isolated, helpless, or ashamed.If you’re worried about your own or a friend or family member’s drug use, it’s important to know that help is available. Learning about the nature of drug abuse and addiction—how it develops, what it looks like, and why it can have such a powerful hold—will give you a better understanding of the problem and how to best deal with it.

People experiment with drugs for many different reasons. Many first try drugs out of curiosity, to have a good time, because friends are doing it, or in an effort to improve athletic performance or ease another problem, such as stress, anxiety, or depression. Use doesn’t automatically lead to abuse, and there is no specific level at which drug use moves from casual to problematic. It varies by individual. Drug abuse and addiction is less about the amount of substance consumed or the frequency, and more to do with the consequences of drug use. No matter how often or how little you’re consuming, if your drug use is causing problems in your life—at work, school, home, or in your relationships—you likely have a drug abuse or addiction problem. 

Why do some drug users become addicted, while others don’t?

As with many other conditions and diseases, vulnerability to addiction differs from person to person. Your genes, mental health, family and social environment all play a role in addiction. Risk factors that increase your vulnerability include:
  • Family history of addiction
  • Abuse, neglect, or other traumatic experiences in childhood
  • Mental disorders such as depression and anxiety
  • Early use of drugs
  • Method of administration—smoking or injecting a drug may increase its addictive potential

no offense:F-ak u haterz

Who gives a shit what people talkin bout fam, Haters shake my hand but i keep the sanitizer on deck!Wave to the haters like nanananana.Fuck you, pussy ass haters you should do you.Coldest thing droppin' and these b-tches wanna snow blow. And they just give me head while the haters give me promo. Haters: they hate what you look like, whacha wearing, whacha drivin, whacha think about, whacha talk about...they fuckin hate it but you gonna have to understand thats the way it is.....Have you eva caught a muthafuka starin at you with the i just caught the stomach virus face? ever just out yo peripheral everything bout you just fuck with them.Never hate those people who are jealous of you but respect their jealousy because they are the ones who think that you are better than them.Love your haters; biggest fans.Take photos with hater n-ggas and crop them. I am not them. I photoshop them out cause they dont understand what Im about.Hating someone will not make you any prettier!