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  • Acutely ill patients in hospital
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  • Alcohol-use disorders: physical complications
  • Anaemia management in people with chronic kidney disease
  • Antenatal and postnatal mental health
  • Antenatal care
  • Antisocial personality disorder
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  • Atopic eczema in children
  • Atrial fibrillation
  • Attention deficit hyperactivity disorder (ADHD)
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  • Chronic kidney disease
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  • Common mental health disorders
  • Constipation in children and young people
  • Delirium
  • Dementia
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  • Depression in adults (update)
  • Depression in children and young people
  • Depression with a chronic physical health problem
  • Diabetes in pregnancy
  • Diabetic foot problems - inpatient management
  • Diarrhoea and vomiting in children under 5
  • Donor breast milk banks
  • Drug misuse: opioid detoxification
  • Drug misuse: psychosocial interventions
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  • Obsessive compulsive disorder (OCD) and body dysmorphic disorder (BDD)
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  • Type 2 Diabetes - newer agents (partial update of CG66)
  • Type 2 diabetes - footcare
  • Unstable angina and NSTEMI
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  • Venous thromboembolism - reducing the risk
  • Violence
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  • Dark side of US healthcare in focus at Sundance film fest

    PARK CITY, Utah: The ailing US healthcare system comes under the microscope in a documentary at the Sundance film festival that tries to diagnose what is wrong — and suggests a cure.

    “Escape Fire: The Fight to Rescue American Healthcare” presents a picture of a sick, money-driven system, but argues that there is a way to reorient it towards patients while driving down costs.

    The documentary, which is reminiscent of activist Michael Moore’s 2007 movie “Sicko,” is in competition at the independent film festival drawing to a close this weekend in the ski resort of Park City, Utah. “Many people feel frustrated by the healthcare that they receive now, but they don’t really understand what is wrong and how it’s broken,” Susan Froemke, co-director with Matthew

    Heineman, said. “We have a disease management system, not a healthcare system,” she added, saying the film aims to show the American people “that we have to find a new way to deliver medicine.” The cost of health insurance represents 20 percent of US GDP. Americans spend $300bn a year on medicine — almost as much as the rest of the world combined — but are among the least healthy in the developed world.

    “Americans and Europeans took a different direction after World War II,” cardiologist Steven Nissen, who features in the film, said, calling the US system “profit driven, instead of health driven.”

    The film argues that the system encourages doctors to see as many patients in as little time as possible, leading to them over- or mis-prescribing drugs, rather than taking the time to properly evaluate patients.

    “The goal was really to try to understand how the system’s broken, how there’s an entrenched, powerful group in the private sector that doesn’t want to see things change,” said Heineman.

    “But there are people out there who are trying to fix it. So we both want to highlight what’s wrong with the system, and show that people are trying to make it better as well.”

    The filmmakers sought out doctors, academics and others who want to develop a better way of treating patients.

    They follow an injured and traumatised soldier returning from Afghanistan, who gradually manages to wean himself off of the 32 different drugs he had been prescribed, with the help of acupuncture.

    They introduce Dean Ornish, a doctor known for his work on preventing cardiovascular disease by changing lifestyle and diet, in a country where 65 percent of the population is overweight.

    The film also hears from the head of the Safeway supermarket chain, which has kept health insurance costs down by offering financial incentives for workers to do more sport or eat more healthily.

    But while solutions do exist, Nissen laments that drug companies are more powerful than ever, notably due to a law which has virtually done away with ceilings on election campaign donations.

    A father’s anguish: Military killed my son with prescription pad | The Daily Caller

    A generic photo of prescription drugs taken March 20, 2009 for files. (PAUL J. RICHARDS/AFP/Getty Images)

    A father who has lost two sons to war told The Daily Caller that the U.S. Central Command’s policy of allowing troops to deploy with a 180-day supply of the antipsychotic Seroquel has contributed to the deaths of troops and veterans. Seroquel, he said, has tragic side effects that military leaders have ignored in their quest to combat insomnia and post-traumatic stress disorder (PTSD) among fighting men and women.

    The father, West Virginia school principal Stan White, said there are better ways to treat troops and veterans who suffer from PTSD. But because the maker of Seroquel, London-based AstraZeneca, has so much influence over Congress and the military, he insisted, that peer counseling and other treatment options are being shoved aside in favor of low doses of the drug.

    White’s suspicions are slowly being validated by a series of studies, legal settlements, and military rulings — including a recommendation from the Department of Defense’s own advisory body on pharmaceuticals.

    “I think AstraZeneca is so strong and has so much power that no one can speak out,” said White, who has remained stoic despite his losses. “Money talks. I truly believe AstraZeneca and other big pharma companies have control over Congress.”

    His first son, Army Sgt. Robert White, died in combat in Iraq. When Robert’s younger brother Andrew returned from his own tour in the Middle Eastern country, a Veterans Administration doctor prescribed a combination of Seroquel and antidepressants for his PTSD.

    Andrew died at home, and the state of West Virginia ruled that an accidental medication overdose was to blame.

    But his father believes the “dangerous” pill cocktail killed him. And he told TheDC that he has identified 300 other soldiers and veterans who died from sudden cardiac arrest while taking Seroquel and antidepressants in combination.

    Evidence supporting his theory has continued to accumulate, including a September 2011 study from the European Society of Cardiology which linked the “combined use of antipsychotic and antidepressant drugs” with an increased risk of sudden heart attacks.

    Seroquel has been on the market since 1997, and in that time doctors have widely experimented with prescribing it for “off-label” purposes that the FDA has not approved. The drug, a mood stabilizer, is approved to treat schizophrenia and bipolar disorder, but it has also been used to treat insomnia in Parkinson’s disease patients, dementia in adults of all ages, and a variety of disorders in children.

    Doctors have free rein to prescribe medications for off-label uses, and the FDA’s ever-growing avalanche of advisories sometimes makes it difficult for physicians to know what has been approved and what has not.

    A 2009 University of Chicago national survey of physicians, for instance, found that one in eight doctors thought Seroquel was approved for treating dementia, even though the FDA had issued a specific warning against it.

    Drug marketers, however, are forbidden to promote their products for any purpose not approved by the FDA.

    In April 2010 AstraZeneca conceded that it had crossed that line, agreeing to pay the U.S. government $520 million to settle claims related to its illegal promotion of Seroquel for off-label uses.

    NEXT: A massive increase in government spending on Seroquel

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    Bydureon, a Diabetes Drug from Amylin, Wins F.D.A. Approval - NYTimes.com

    Analysts expect annual sales of Bydureon to eventually exceed $1 billion. But they are less enthusiastic than they once were, in part because of safety concerns involving thyroid cancer and pancreatitis.

    David Kliff, publisher of Diabetic Investor, an electronic newsletter following the diabetes industry, said a once-weekly self-injection could make Bydureon an alternative for many patients to multiple insulin injections or even to multiple pills every day.

    Harvard doctor calls for greater supplement regulation in NEJM | Drug Store News

    WASHINGTON — The New England Journal of Medicine on Thursday published an opinion online that called for more rulemaking to govern dietary supplements in an effort to reign in the criminal activity of illicit prescription drug manufacturers that openly disregard the laws currently in effect.

    Author Pieter Cohen, author of the opinion and an assistant professor of medicine at Harvard Medical School, in his opening paragraph pointed to the recent recall of the product Zotrex. Marketed as a dietary supplement, the product reportedly contained the fictitious ingredient "Ophioglossum polyphyllous," but in actuality contained a drug analogue of the active ingredient in the erectile dysfunction pharmaceutical Viagra (sildenafil).

    Following a Food and Drug Administration investigation of NovaCare, the company that distributed that product online, the U.S. Attorney's Office in September 2011 revealed a 31-count indictment alleging NovaCare proprietor Kelly Dean Harvey purposefully thwarted FDA regulations after the agency first started warning consumers about NovaCare products in 2009 (the product at the time was called "Stiff Nights"). Charges against Harvey include one count of conspiracy, 12 counts of wire fraud, nine counts of mail fraud and nine counts of money laundering, according to reports. He pleaded not guilty to those charges in November.

    "Although Zotrex represented a particularly brazen violation of the law," wrote Cohen, an assistant professor of medicine at Harvard Medical School in the opening paragraph, "surprisingly, many new supplement ingredients are introduced into the market as [those found in Zotrex were], without any regulatory oversight." Specifically, Cohen calls for clinical trials establishing safety be a pre-requisite for new dietary ingredients to reach the market.