Faculty Bibliography

With bird flu, scientists have been working on the structure of the viruses in an attempt to protect us. Studies published in the journals Nature and Science over the last six years have given scientists a road map with which to track the current bird flu and alert health officials if it mutates further. It is reasonable to try to control the bird flu while it remains in the bird population. There is great value in improving our emergency health response system and upgrading our vaccine-making capacity. Government subsidies in these areas could make the public safer. But, right now, there is no value in scaring the public with Hitchcockian bird flu scenarios. The public must be kept in the loop, but potential threats should be put into context. The worst case is not the only case

In order to safely produce a multi-dose vial it is often necessary to add a chemical such as thimerosal. Unfortunately, when the questions about this additive were first raised, vaccine manufacturers did not quickly shift production to another product, Instead, they left themselves open to accusations that they have caused thousands of cases of autism. Thimerosal is not a crucial part of vaccines, it could have been removed long before the current outcry

What isn't clear to the public is that drugs like Celebrex are largely safe when taken for shorter periods at lower doses, which is the way they're generally intended to be used for common joint inflammation. The increased risk to the heart is a result of taking them at high doses over a prolonged period of time. Celebrex diminishes an enzyme that prevents clotting, which is associated with heart attacks. The prolonged use of Aleve, and perhaps all non- steroidal anti-inflammatory drugs, can lead to fluid retention and elevated blood pressure, itself a risk factor to the heart. Yet these drugs are being overprescribed by doctors and overused by patients who consider them safe and effective. Public expectation regarding Celebrex and Vioxx was ramped up by direct-to-consumer advertising, a process not adequately overseen by the Food and Drug Administration. The public was told these Cox 2 inhibitors protect the stomach in a way that other non-steroidal drugs, all of which can cause bleeding ulcers or gastritis, don't. Thinking of Celebrex as a wonder drug, the public feels betrayed now that it understands that the stomach-sparing qualities were not proven, and now that it knows about the elevated heart risk, which FDA scientists suspected from the outset. The FDA that engages in that analysis will have to be a much stronger and more effective agency than the one in place now. In an editorial in the Nov. 30 issue of the Journal of the American Medical Association, deputy executive editor Phil Fontanarosa discussed the creation of a new office of drug safety to ensure a more independent and extensive evaluation of drugs than the FDA can provide. It would seem that a better first step would be to try to strengthen the FDA itself, to make it a more effective regulatory agency less dependent on drug company money and political appointments

My answer was always the same. 'No. Tamiflu is an antiviral drug that has not yet been proved effective against bird flu. And even if it worked, there's still no bird flu to treat.' The facts are these: The current H5N1 avian influenza virus has not mutated into a form that can easily infect humans. The 60 people in the world who have died of this bird flu have done so not because this bug is on the road to mutation but because millions of birds throughout Asia have been infected, and the more birds that have it, the more likely that an occasional human bird handler will be infected. Why the overreaction? For one thing, direct comparisons to the Spanish flu of 1918, a scourge that killed more than 50 million people worldwide, has alarmed the public unnecessarily. In fact, there are many scenarios in which the current bird flu won't mutate into a form as deadly as the 1918 virus

[Bobby Short] reportedly entered a hospital less than a week before his death, thinking his abdominal symptoms were from diverticulitis, only to be diagnosed with leukemia. He succumbed to the disease a few days later. But diverticulitis, an infected wall of the large intestine caused by an in-pocketing of the bowel lining, is not at all similar to leukemia. So were there telltale signs of leukemia overlooked in the months before Short's death?

Combining prescription drugs has advantages, but various combinations can have conceptual differences. When 2 medications are combined in 1 pill, as in 2 new statin combos, a doctor may not be able to identify which drug is causing a side effect. Packaging 2 drugs physically separate but together in a blister pack makes the most sense for initial therapy

With bird flu, scientists have been working on the structure of the viruses in an attempt to protect us. Studies published in the journals Nature and Science over the past six years have given scientists a road map with which to track the current bird flu and alert health officials if it mutates further. It is reasonable to try to control the bird flu while it remains in the bird population. There is great value in improving our emergency health response system and upgrading our vaccine-making capacity. Government subsidies in these areas could make the public safer. But, right now, there is no value in scaring the public with Hitchcockian bird- flu scenarios

Drug safety is not as absolute as it has been made to appear in the media. Few drugs on the market are villains, and few are heroes.

The recent lawsuit lost by Merck to the tune of many millions of dollars does not prove that Vioxx is a dangerous chemical. A dangerous precedent has been set in terms of other cases of Vioxx users against Merck. The drug company now appears vulnerable to other Vioxx allegations even when a direct cause/effect has not been shown. Merck's mistake was trying to downplay Vioxx's effects over four years and several studies, an action that made the company appear villainous in the eyes of a jury