Faculty Bibliography

This article debunks myths about pharmaceuticals and, more specifically, to defend the drug manufacturers from unfair attacks against their products in the media. Merck, a company which has been accused of draconian indifference to cardiac risks, should in fact be applauded for its new vaccine against Human Papillomavirus called Gardasil. The FDA has approved Gardasil, and when it is used regularly in daily medical practice, several thousand less women per year should get gynecological cancer

There is a new help-you-sleep kid on the block -- Lunesta. Like its older cousins, Ambien and Sonata, Lunesta is a hypnotic sleep drug that is not addictive and does not require larger and larger doses. Ambien and Sonata revolutionized the treatment of insomnia because they can be taken without fear of physical dependence, though they may be somewhat habit forming. Lunesta may have an advantage for people who have trouble maintaining sleep, because it has a six-hour half-life. Two other sleeping pills are in late-stage clinical trials

Dr David Katz, director of the Yale prevention research center, recently published a book, The Flavor Point Diet, in which he explores the idea that being stimulated by too many flavors stimulates more hunger. But many patients lack the discipline and do not manage to achieve a healthier lifestyle, no matter what the road map. So it is necessary to consider dietary aides. Without a perfect diet drug, many are looking with interest at Acomplia (rimonabant), a promising drug in late-stage clinical trials that works directly by blocking appetite (endocannabinoid) receptors in the brain

Many, if not most, of the author's New York City patients suffer from acid reflux disease. The introduction of proton pump inhibitors (PPIs) in the late 1980s changed everything. PPIs stand as a triumph of pharmaceutical research, and it seems that it has been underreported just how good they are. Overall, PPIs are a wonderful arrow to have in the medical quiver and have changed the course of esophageal, stomach and duodenal disease

According to a significant study published in the prestigious British journal Nature recently, the H5N1 bird flu virus is at least two large mutations and two small mutations away from being the next human pandemic virus. This virus attaches deep in the lungs of birds but cannot adhere to the upper respiratory tract of humans. Since we can't transmit the virus to one another, it poses little immediate threat to us. Fear causes the public to blur the distinction between birds and people, and so, as the H5N1 virus infects flocks of birds in Pakistan and Israel, nightly news watchers track the path to the United States. The poultry industry cringes as migratory birds that might be carrying H5N1 make their way closer to the northern shores of North America. If H5N1 spreads in pigs (a soup of viruses) and exchanges genetic material with another human flu virus before passing to humans, the result is likely to be far less deadly. The swine flu fiasco of 1976 is an example of the damage that can be done by fear of a mutated virus that never quite lives up to 1918 expectations. About 1,000 cases of ascending paralysis occurred from a rushed vaccine given to more than 40 million people in response to a feared pandemic that never arrived

The media have begun beating the stuffing out of another drug, Ambien, as they show pictures of drowsy sleepwalkers cooking or stuffing themselves at the refrigerator in the middle of the night, or write stories about the risks to motor vehicle operators. The fact is, the vast majority of the author's patients experience no side effects whatsoever. In fact, Ambien is so well tolerated and effective that it has changed the way doctors treat insomnia. Medical misinformation of this kind helps neither doctors nor their patients

The science on the H5N1 bird flu virus may not support these conclusions. Two important studies published just last month in top science journals show that this bird flu virus is still multiple mutations away from being able to pass easily among humans. This bird flu appears to be better absorbed by the deep pockets of bird lungs, whereas human flu is absorbed by the cells of our upper airways. Dr. David Swayne, director of the Southeast Poultry Laboratory at the U.S. Department of Agriculture, has worked on avian influenza for many years. He takes all highly pathogenic bird flus seriously, including H5N1, but he feels they can most often be controlled. Swayne told me that H5N1 might still be eradicated in birds with the help of 'better diagnostic tools and improved strategies to protect birds from infection.'

Many doctors like to criticize drug salespeople for over-promoting their products. But most of the drug reps the author knows are polite, well-meaning professionals who bring his attention to medications he might otherwise not consider. Many times drug reps have shown him information about their products that have helped him decide what to prescribe. Drug salespeople are a strong part of the chain that brings the latest technology to doctors and thereby to patients

The science on the H5N1bird flu virus may not support these conclusions. In fact, two important studies published just last month in top science journals show that this bird flu virus is still multiple mutations away from being able to pass easily among humans. This bird flu appears to be better absorbed by the deep pockets of bird lungs, whereas human flu is absorbed by the cells of our upper airways. Dr. David Swayne, director of the Southeast Poultry Laboratory at the U.S. Department of Agriculture, has worked on avian influenza for many years. He takes all highly pathogenic bird flus seriously, including H5N1, but he feels they can most often be controlled. Swayne told me that H5N1 might still be eradicated in birds with the help of 'better diagnostic tools and improved strategies to protect birds from infection.'