Research from the Nestlé Research Center in Switzerland and published in the Journal of Proteome Research.

In a clinical trial made up of 22 men, half of which described themselves as “chocolate lovers” while the other half were “chocolate indifferent,” participants ate chocolate or placebo over a five-day period. During this time, their blood and urine was monitored for various metabolite levels. The researchers found a “hallmark” profile in the men who described themselves as chocolate lovers: low levels of LDL-cholesterol and slightly raised levels of albumin protein. The same levels were found in the chocolate lovers even when they ate no chocolate. The researchers also noted that the activity of the gut microbes of chocolate lovers was distinctively different from the other subjects.

(They should have used women. :haw: )

But seriously… what the heck is a chocolate placebo? Wouldn’t you know that you’re not eating chocolate?

The money being wasted on pointless research, that is. Xyzal (levocetirizine), is beginning to have some money spent on research proving that it’s a good drug. I have no doubt it’s a good drug. They’ve isolated the active isomer and decided to market it since the patent on Zyrtec (cetirizine) is running out.

Let’s review, SAT-style:

Zyrtec:Xyzal::Claritin:Clarinex

Expect Zyrtec to go OTC as a means of ensuring continued profitability through marketing. (More people buy brand name Tylenol than the generic — same story for Claritin.)

Here’s the bottom line: everything that Zyrtec works for, Xyzal will work for, and vice versa. Same side effects, too. And because this is so, you will never see a head-to-head study comparing Xyzal with Zyrtec, because the results will prove that it’s just a waste of money. Like Clarinex. Oh sure, there will be a few isolated cases where Xyzal is 0.5% better for 0.1% of the study population, and these studies will be trumpeted, but remember that they’re actually meaningless. You’ll also see studies that show Xyzal is effective for some obscure condition that Zyrtec was never studied for. Just remember that this is done to make Xyzal seem like something more than a me-too drug, and that if someone bothered to spend the money, Zyrtec would work just as well.

So if you like to waste your time doing PAs or you feel an insane need to throw your patients’ money away, prescribe Xyzal. Otherwise keep on using Zyrtec.

“My son is 7 years old, and whenever something exciting happens, he throws up. We’re supposed to go to the amusement park today if the weather clears up, and he’s afraid — and so am I — that if we go, he’ll throw up while we’re there.

“I don’t know what to do anymore. On the first day of school, he throws up. On the last day of school, he throws up. Waiting in line for a roller coaster, he throws up. If he gets really happy for any reason, he throws up. And he throws up because he throws up and worries that he’s going to throw up again.

“Is there anything I can give him so he stops throwing up?”

Straight Face held firmly in place — with superhuman effort — I stopped to think about the problem.*

And lest you think me an insensitive clod, I can assure you that I did (and still do) feel awful for this kid. I wonder what his home life is like. I wonder if he’s chemically imbalanced. I wonder if it’s a phase he’ll grow out of. I wonder how to help him in the short term, today, hopefully without robbing him entirely of the excitement that an amusement park brings. I wonder about abuse, too. I wonder if this behavior is conditioned in some way, and if it might be self-reinforcing, not unlike that destructive positive feedback loop that plagues those with panic disorder. I wonder if he’ll grow up with anxiety problems. I wonder if he’ll end up a well-adjusted adult, hopefully without the need to be on long-term psych meds.

Most of all, right now, I hope mom has a talk with the pediatrician about it.

Given that my options are severely limited by a lack of prescribing powers, the best solution OTC would be Benadryl to blunt the edge, with the side effect of probably making him very sleepy. Not optimal, for sure, but better than puking before you get on the ride, no? Some would think Emetrol, maybe, but that’s a poor solution because that’s not going after the actual problem. If the child is overexcited, better to take that down a notch than merely cover the side effects of being in that condition in the first place.

What do you guys think? What would you have done?

* When I was in junior high, my friends and I used to talk about the worst, most absurd “super power” to have. We decided it would be the superhuman ability to crap your pants every time you got excited. “Haha! Yay!… ohhhh….” This is where I coined the phrase “My bowels are aquiver with excitement.”

I’d say this child’s difficulty ranks right up there…

This past week, we had a guy gentleman come in with prescriptions written for some usual suspects in the treatment of Parkinson’s, one of them being Klonopin. His symptoms were relatively obvious, too. What was funny in a “Haha, this is really pathetic” sort of way was that the prescriber had signed them in blue ink with rather normal (even neat!) handwriting.

In the no sub box, this guy had scrawled “no substitution” in handwriting that looked like calligraphy done with a squiggle pen. And of course the ink was black.

Yeah okay, buddy. I mean, I don’t really care if you want the brand name, just drive up the road to New Hampshire and request it. Don’t alter the damn prescription and think I’m not going to notice. There are two parties that should be writing things on the prescription, and you are not one of them.

I didn’t rake him over the coals for it. It wasn’t worth the time and emotional energy, and he seemed like a nice enough fellow. I hope it doesn’t happen again.

The ending is that the insurance (Tricare) wouldn’t cover brand name if there was a generic available. Big surprise. So he ended up with his clonazepam, generic Sinemet CR, and generic something else. What a bunch of idiotic hoops to jump through to end up back at square one.

But seriously, what person — who knows they can’t write due to a medical condition — alters their own prescription? In the wrong colored ink, no less?

Never ascribe to malice that which is adequately explained by stupidity.

For you folks that stand all day every day, how do you keep your knees from going to shit? I’m in my mid-20s, and my knees hurt so badly after even an hour of standing that I’m considering going to the doctor. What, if anything, he’ll suggest, I don’t know. I’m starting to dread my long days, and I’m starting to get pissed off at people more easily because I’m in pain.

This is not cool, and it’s only come about recently thanks to working 6 on and 1 off.

When I had time to work out regularly, this wasn’t a problem. I just don’t have the time to work out at all right now — and yes, it’s not simply a matter of “making time” — the time does not exist during the day for me to do this.

This man, Carlos Camejo — seen holding his own death certificate — woke up during his own autopsy after a car wreck:

Carlos Camejo, 33, was declared dead after a highway accident and taken to the morgue, where examiners began an autopsy only to realize something was amiss when he started bleeding. They quickly sought to stitch up the incision on his face.

“I woke up because the pain was unbearable,” Camejo said, according to a report on Friday in leading local newspaper El Universal.

Ouchies. I guess they’re not as thorough in other countries when it comes to pronouncing someone dead…

He should go as a vampire for Halloween. ;)

(Images preserved in order to stave off the inevitable Reuters link rot.)

She swerved to avoid the cup of soda and drove into the side of the pharmacy instead. How she got up on the MASSIVE SIDEWALK is anyone’s guess.

Just bloody brilliant.

Today’s Close to Home reminded me of something we used to do to take the edge off the sauce when my dad was having heartburn problems: a small amount of baking soda into the sauce while it was simmering.

Baking soda is sodium bicarbonate, also available in tablet form for — you guessed it — heartburn. Certainly though, Tums (calcium carbonate) are far more common than soda bicarb tabs. I suspect this is due to marketing more than anything else.

I wonder if McPherson knew he was unintentionally close to a mark?

[tags]Lasagna, heartburn, cooking[/tags]