Re: GYN: Antibiotics Linked To Breast Cancer?
From: Anna Meenan, MD (annam@uic.edu)
Tue Feb 17 23:15:58 2004
Just curious, Joanne. Have you ever actually had anyone refuse
antibiotics when they were recommended? If so, what were the
circumstances? I don't believe I ever have. I'm kinda hoping against
hope that the lay press around this study will convince some folks not
to insist on antibiotics for every little sniffle. I recently took care
of my first patient with a staph osteomyelitis resistant to EVERYTHING,
and the looks on the family's faces when we told them we had absolutely
nothing to give her and she was going to die, well, I hope I don't have
to see those looks again anytime soon. Very frightening.
--
Anna Meenan, MD
At Tue, 17 Feb 2004, Joanne Bulley, MD wrote:
>
>I heard this antibiotic thing on the radio today. They said "heavy duty
>doeses" of antibiotics were associated. I bet a lot of those who just
>don't want antibiotics will use this "sound bite" to try to NOT take
>antibiotics that are truly needed. Meanwhile - those that are
>harrassing us for antibioitcs for the viral stuff that has to run its
>course won't stop!
>
>I bet the FDA dosen't make antibiotic producers totally change the
>package inserts from this one study - they way that they did with pretty
>much all estrogens - despite the fact that it was the combined E&P and
>only prempro in the study!
>
>Even though the final data and statistics froom the WHI showed there was
>NO statistically significant increased risk of cardiovascular disease,
>breast cander OR stroke by Prempro vs placebo ... they chaged all the
>package inserts BEFORE the final stats were out ... and I doubt they
>will change them back.
>
>The year 1 or 2 data is almost certainly caused by the older women put
>into the study (matching the HERS data).
>
>The WHI used a totally new type of statistical evaluation in their
>"global index" that has never before been used. As a recent lecturer
>said - if that is done - you first have to do a study to prove the
>validity of the tool before using it. They also created a global index
>with each parameter having "equal weight" - and mmore probable negative
>parameters than positive. Also by stopping it when they stopped it -
>the two "postives" were just beginning to show themselves (with the
>fractures and colon cancer) - the curves for those were definitly
>diverging by more each year - but by stopping it early it was before
>they could be statistically significant. On the other hand the CVD part
>only showed risk in year one (like the HERS) and when sorted by # of
>years since menopause - there was a reduction in risk (but not
>statistically sig) for the women at <10 years. Unfortunately by the
>design they did not have enough women under 5 years to look at the group
>which may have shown the CVD reduction at a statistically sig level.
>
>As the most recent lecturer I heard on the subject (William Butler) said
>- the only thing you CAN say from the study - is that you should not
>start asymptomatic women of 70 years of age on prempro. That you really
>can't extrapolate to the newly menopausal woman by data done on older
>women who had no symptoms!
>
>Ok, I'll get off the soap box!
>
>By the way, Joe, once the "event" happens - it does not become a
>"statistic" - it becomse a single "data point" that then becomes part of
>a statistic!
>
>Joanne
>
>At Tue, 17 Feb 2004, art fougner, md wrote:
>>
>>There's a new study reporting a possible link between antibiotic usage
>>and breast cancer -
>>
>>http://www.msnbc.msn.com/id/4283052/
>>
>>art
>>
>>--
>>art fougner, md
>>ich bin ein New Yorker
>>
>--
>Joanne Bulley, MD
>Keene, NH, USA
>
>-----
>"It is easier to understand a nation by listening to
>its music than by learning its language" -Anonymous
>
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