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Ing and posting results of all studies. In this case, researchers obtained the results of all clinical trials of new antidepressants like Prozac, Paxil and Zoloft done from 1987 to 1997, published and unpublished, from the FDA under the federal Freedom of Information Act. The pooled results showed that an older class of antidepressants, known as tricyclics, was actually more effective, belying all the hype about the "revolutionary" new antidepressants. The researchers reported that among the longerterm studies which better reflect actual use ; , the new antidepressants were 8% more effective than placebos, while tricyclics like Elagil were 12% more effective. The most disturbing finding was that more than twice as many depressed adults on new antidepressants kill themselves than those taking placeboes. The difference was 8.4 vs 3.6 suicides per 1000 patients a year, respectively. How much impact did the availability of these results have on doctors' prescribing patterns? Evidently not much: the new antidepressants remained the best-selling class of drugs in the United States in 2000 and 2001. The medical journal editors understand that just registering studies isn't enough. Their real goal is full transparency in clinical trials, meaning that research plans and complete data from studies should be available for independent review. But even this is not sufficient to counteract commercial influence, as the cases of the blockbuster drugs Celebrex and Vioxx demonstrate. The results of large manufacturer-sponsored studies of these two arthritis drugs were published in The Journal of the American Medical Association and The New England Journal of Medicine, respectively, in 2000. The original data upon which both articles are based have been posted on the FDA Web site since February 2001. Both drug-company sponsored articles led doctors to believe that their patients would be better served by prescribing the new drugs. But the data posted on the FDA Web site tell a very different story. Patients on Celebrex did not have significantly fewer serious gastrointestinal problems than those who took the older types of arthritis medicine. In fact, during the second six months of treatment data not even mentioned in the article ; , users of Celebrex developed serious gastrointestinal problems more often than users of the older drugs. The bottom line is that Celebrex is much more expensive, provides no better relief of arthritis symptoms, and overall causes 11% more serious complications than the other drugs and tenoretic.
Of the 110 women who responded to the survey, 91% 100 ; had no preexisting condition that might have contributed to the molar pregnancy. Six women 5.5% ; had some prior condition, including polycystic ovary syndrome PCOS ; in three cases. Other conditions included a recent precancer biopsy test and thyroid problems. Four women declined to answer. Prescription, over the counter, or illicit drug use by self or partner were reported by only 8 8.3% ; of the 96 who responded to this question; the drugs listed included Viagra, Paxil, Adderall, Trileptal, Wellbutrin, Elavil, and Celexa, but none of these with any significant frequency. One lifestyle factor that did have a significant response was whether the women ate red meat during or near the time of their molar pregnancy. Eleven women, making up 10% of the total responses, indicated that they were eating a vegetarian or vegan diet or a diet with limited red meat consumption at the time of their diagnosis. Although nothing definitive has been stated regarding the relationship of diet to molar pregnancy, one common theory is that a lack of animal protein, specifically from red meat, in the mother's diet is one contributing factor. Another significant finding in the survey was the irregularity 16 women, 14.5% ; or absence 2 women, 1.8% ; of menstrual periods among the respondents in the time before they became pregnant with their molar pregnancies. In addition, 10% of women in the survey n 11 ; had had fertility treatment at some point prior to their molar diagnosis; 45% n 5 ; of these women had had fertility treatment to conceive the pregnancy that ultimately became molar. Blood types of women with molar pregnancy and their partners spouses. Only a portion of the total survey group N 110 ; was able to provide blood types for themselves n 80 ; and or their partners n 44 ; . However, the results show a distinct trend toward two common blood types, A + and O + , in both women and men. The negative blood types seem to be far less common among those with molar pregnancy, with the exception of O-, which followed well behind A + and O + in frequency, and then only among the women. Across the board positive blood types, including B + and AB + , were more predominantly represented. The structure of this survey and my own limited scientific knowledge ; make it impossible to determine whether any female male combination of these blood types may have any bearing on molar pregnancy; I do not know enough about blood types to know if a specific blood type is more common than another. Regardless of my own limitations, however, I think these results are interesting and worthy of further consideration. Number of miscarriages up to time of survey, including molar pregnancy. For most of the 109 women who answered this question, the molar pregnancy was their first miscarriage. However, a large group of respondents had had at least one 22% ; miscarriage prior to their moles, and 15.6% had had at least two, with one woman reporting as many as six miscarriages. Advances in gel formulations look set to deliver effective treatments for a variety of diseases. Scientists in India have developed a gel that is taken orally and which might be able to target diseases currently requiring drugs delivered by injection. The research, due to be published in the journal Polymer International, suggests the gel could offer a way of treating diabetes, ulcerative colitis, Crohn's disease, bowel cancer, constipation and some infections. Sunil Bajpai and Seema Dubey, from the Polymer Research Laboratory in Jabalpur, have produced a terpolymeric gel system into which a drug can be loaded.The hydrogel has been designed so that it passes through the stomach protecting the drug from stomach acids.They show that 56 per cent of the drug is released further down the gastrointestinal tract in the colon when the gel swells in response to the alkaline pH. "The terpolymeric hydrogel system studied by our team provides an alternative to the parenteral medication of insulin. It is now necessary to carry out in vivo studies of this hydrogel system so that it could be further modified to produce oral delivery pills, " said Dr Bajpai and co-trimoxazole. And the magnitude of the dangers associated with elwvil are equally present with. VOL. 45, 2001 TABLE 1. Indinavir pharmacokinetic parameters and gastric pH values according to study treatment a.
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1 Department of Surgery Otolaryngology, UCSD, 9500 Gilman Dr., La Jolla, California, United States, 2Department of Surgery Otolaryngology, VA Medical Center, 3350 La Jolla Village Dr., La Jolla, California, United States, 3Department of Medicine, UCSD, 9500 Gilman Dr., La Jolla, California, United States, because amitriptyline elavil.
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