Understanding the wastewater method, and addressing ethical issues 1. Originally used in the s to monitor the environmental impact of liquid household waste, the method has since been used to estimate illicit drug consumption in different cities Daughton, ; van Nuijs et al.
There's not enough convincing evidence linking statins to benefits beyond cardiovascular disease, analysis says Researchers say that existing evidence is suggestive enough to warrant further study CNN Despite some studies suggesting that statin drugs have benefits beyond cardiovascular healthfor such issues as cancer and Alzheimer's, a broad new analysis says there's a lack of compelling evidence linking such benefits to statins -- and, thus, little reason to change recommendations for who gets these cholesterol-lowering meds and An analysis of drugs.
The drugs are commonly prescribed to prevent heart disease in individuals above a certain risk level, but the new analysis -- published Monday in the journal Annals of Internal Medicine -- looked at other health conditions and effects. Drugmaker touts benefits of fish oil derivative, experts reserve judgment The analysis found limited evidence of positive outcomes related to cancer, dementia, kidney disease and chronic obstructive pulmonary disease, known as COPD.
But only one of these outcomes was significant in a randomized trial -- lower all-cause mortality in patients with chronic kidney disease -- and the authors say it could still be driven by the drugs' impact on cardiovascular disease; the two often go hand in hand.
On the other hand, clinical guidelines currently do not indicate the use of statins to improve cancer prognosis or COPD," Theodoratou said. Different statins are sold under brand names such as Lipitor and Crestor.
Michael Pencina, vice dean for data science and information technology at the Duke University School of Medicine, said the analysis was important because people will invariably be on statins for long periods of time for their heart health, but the question remains: What else could those statins be doing, good or bad?
Researchers say this doesn't mean these outcomes aren't necessarily null; they just haven't been sufficiently tested yet. Ahern has studied the link between statins and breast cancer but was not involved in the new analysis.
Ahern noted that the new paper omits studies conducted in a lab, which could contain important information. The study says there is "suggestive" evidence gleaned from observational analyses that recurrence-free breast cancer survival is linked to statins.
Pros and cons Some patients on statins report a number of side effects, such as muscle pain, increased blood sugar and memory problems. But the majority of patients have no side effects at all.
The new analysis detected "no significant effects" of the drugs on a range of side effects, including muscle pain. Theodoratou described this as "reassuring" but cautioned that "we cannot exclude the possibility that some of these harms such as muscle pain may be too rare to rule out with certainty.
Should you take statins? Guidelines offer different answers "We did not find strong evidence for an association but not all of the original studies had adequately reported side effects. So, we cannot conclude that the drugs do not cause muscle pain," she said.
Doctors have said certain people are "miserable" taking statins, and muscle pain in particular is a commonly reported side effect. The disconnect between these experiences and the new analysis could be explained by how individual studies select patients or how difficult it might be to tell whether muscle symptoms are actually a result of statins, according to the authors.
Experts have described how, the more patients are aware -- and perhaps fearful -- of statins and their side effects, the more likely they are to report those side effects.
This phenomenon is known as the nocebo effect, the opposite of the placebo effect. The new paper reviews previous metaanalyses -- Pencina called it a "summary of summaries" -- but does not closely evaluate individual studies, which may have their own selection bias, inedequate follow-up, missing data, and potential financial conflicts and industry influence.
While studies funded by drugmakers tend to produce more effective outcomes than independently funded studies, some have refuted the effect of industry bias on statin research.
Theodoratou says that differences in how studies were designed and potential bias may explain why some findings, like Alzheimer's, were significant in observational studies but not randomized trials. She also noted that how researchers rated the evidence is mostly based on "artbitrary thresholds, and currently no gold standard exists Similarly, Pencina called the new study "hypothesis-generating" and said it could be useful in better weighing the pros and cons of statins for people who are taking them for heart health.
Health experts say that no pill, including statins, should replace a healthy diet, exercise and avoiding smoking -- whose benefits extend well beyond heart health, research shows.identification of isomers.
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The non‐medical use of over 30 dissociative drugs are reviewed spanning over 60 years. A complete portrait of this underground market is presented along with the relevant legal, technological and scientific developments which have driven its evolution. Analysis of Drugs Manual March 30, This document is an internal Drug Enforcement Administration quality system document.
The document is updated periodically and current as of March 30, and is provided for informational purposes only. Any sensitive, privileged or otherwise protected information has been redacted, to include the.
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