News in brief - July 3, 2006

AMA urges FDA to prioritize science - AMA calls for better campus mental health services - Hyperglycemia increasingly a cause of death in ICU patients

AMA urges FDA to prioritize science

In the wake of several Food and Drug Administration actions that have been perceived by many as driven by politics rather than science, the American Medical Association took a position at its Annual Meeting in Chicago last month that the agency should not allow political considerations or conflicts of interest to overshadow scientific evidence when making policy decisions. The agency also should include the "brightest" scientists on advisory committees and councils regardless of political affiliation or voting history.

"The FDA has the responsibility to approve drugs for sale once their safety and efficacy have been demonstrated. ... The integrity of this process of approving drugs by the FDA is now in question," said Jacob Gerritsen, MD, president of the Maine Medical Assn.

The agency responded that politics did not interfere with decisions that were supposed to be scientific in nature.

"We appreciate the sentiment expressed. ...We make our decisions whether or not to approve a product based on a thorough analysis of the data," said Theresa Toigo, RPh, the FDA's acting associate commissioner of external relations, who spoke for the agency at the meeting.

AMA calls for better campus mental health services

To deal with the increasing rate of depression, addiction and other mental health disorders in undergraduate and graduate students, colleges need to place a high priority on integrating the best practices for prevention, screening and follow-up of these illnesses into campus services, said a report issued at the American Medical Association Annual Meeting in Chicago last month.

The report from the AMA Council on Science and Public Health also called for student health insurance to give full parity to mental health and substance abuse treatment and for institutions to increase the availability of on-campus services. Colleges also should scrap policies that discriminate against students who seek help.

"[Students] need to receive whatever help they need," said Sarah Walker, a first year medical student at the University of South Alabama College of Medicine in Mobile.

In a related action, the AMA also intends to work with mental health organizations, other medical societies and public health groups to develop programs that encourage patients to discuss mental health concerns with their physicians.

Hyperglycemia increasingly a cause of death in ICU patients

A study of 216,000 critically ill patients in Veterans Affairs hospitals demonstrated that hyperglycemia is associated with increased death in patients in intensive care units. The study was presented June 12 at the American Diabetes Assn.'s Annual Scientific Sessions in Washington, D.C.

"The increased deaths associated with hyperglycemia in intensive care units was highest in those without diagnosed diabetes and in those admitted with cardiovascular disorders, such as heart attacks, unstable angina and strokes," said lead author Mercedes Falciglia, MD, assistant professor of medicine at the University of Cincinnati College of Medicine.

In the study, hyperglycemia was found to be an independent predictor of mortality starting at only 1 milligram per deciliter above normal glucose levels. The impact of high blood glucose levels was variable but increased death to as high as 14 times that which would be expected in stroke patients with the highest blood glucose levels.

The bottom line is that "All patients should have their blood glucose levels monitored when they are admitted to an intensive care unit because hyperglycemia occurs in one-third of ICU patients," Dr. Falciglia said.