Are You Going to Use Finasteride for Hair Loss? Read This First

Sold in the market under the brand names Propecia and Proscar, finasteride is a medication that is intended to treat people who are suffering from hair loss.  In the early days, finasteride was just like other medications that were originally used to treat benign prostatic hypertrophy and prostate cancer. It turns out that patients who took finasteride for their prostate-related issues had experienced great results with it, along with a surprising bonus, and that is, the growth of hair.

Finasteride actually works by means of inhibiting or stopping type II 5-alpha reductase, the enzyme responsible for converting the hormone testosterone into dihydrotestosterone (DHT).  DHT, in turn, is the one responsible for losing one’s hair, resulting to baldness if not remedied.  Thus, simply put, the action of finasteride is to prevent the conversion of testosterone into DHT, and the end result would be the prevention of hair loss. This “favorable side effect” of preventing hair loss and promoting growth of new hair by finasteride is what made it famous in the pharmaceutical world, not by its primary use which is for treating benign prostatic hypertrophy and other prostate-related ailments. Read more…

Concern grows as radioisotope-producing Ontario nuclear plant remains closed

after electrical repairs have forced the temporary closure of Chalk River, Ontario nuclear reactor that supplies two-thirds of the radioisotopes used for diagnostic imaging worldwide. Canadian medical tests are already being canceled, reports Reuters.

The reactor shutdown threatens to delay a substantial amount of medical tests around the world, a Canadian expert on radiopharmacy said. [...]

“This is a critical radioisotope that is used to produce radiopharmaceuticals to diagnose many types of diseases and, therefore, the impact is quite widespread and important for patients with all kinds of health conditions,” [said Raymond Reilly, a radiopharmacist and professor of pharmacy at the University of Toronto.]

The isotope is used in about 90 per cent of all imaging studies in nuclear medicine.

“It is basically the cornerstone of nuclear medicine in terms of diagnostic imaging,” Mr. Reilly said.

Andrew Ross, a nuclear medicine specialist in Halifax, Nova Scotia, told the Canadian Broadcasting Corp. he has already cancelled tests for 100 patients and expected to cancel 100 more next week.

It is difficult to predict how widespread the testing delays will be, however, as some supplies can be obtained from other sources, Mr. Reilly said, noting that European sites obtain their isotopes from a different supplier.
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Alberta DCA drug firm garners award

The University of Alberta-spinoff firm responsible for developing the controversial drug dichloroacetate (DCA) was named Emerging Company of the Year at Bioalberta's annual meeting on November 28.

Cardiometabolics Inc, based in Edmonton, is studying the use of a type of DCA "as a potential therapy to improve heart function, surgical outcomes, patient quality of life and increase speed of recovery. The trial is being conducted at the University of Alberta Hospital in high risk geriatric patients following open heart surgery."

That research is taking place in parallel to another, more controversial study into DCA's anti-tumour effects.

Research from the University of Alberta spawned a spate of n-of-1 DCA trials in unsupervised metastatic cancer patients, , who worried that patients could be endangering themselves by buying the chemical online and trying it without a physician's help.

"He's a pest exterminator with a biology degree who's hired a chemist and is profiting from desperate people," said Dr Michelakis of in the Edmonton Sun back in the spring. "He is bypassing every regulatory principle that exists to ensure pharmaceuticals are safe and selling hope for money. It's horribly unethical."

DCA enthusiasts are, nevertheless, acquiring and imbibing the substance in greater and greater quantities; much discussion about methods of procuring and administering the drug is found on another site owned by Mr Tassano, .

At least two physicians in Canada -- Drs Akbar and Humaira Khan of Medicor Cancer Centres, in Toronto -- are , NRM reported this summer. "I'm pretty confident we're not harming anyone," Dr Akbar Khan told me at the time.

In the meantime, Cardiometabolics's DCA trials are still in its infancy. Health Canada approved a phase I and a phase II trial (PDF).

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CMA prez Day pulled strings to jump queues

Dr Brian Day has used personal connections to skip to the front of the wait list in order to get faster treatment for himself and for his daughter, :

When his five-year-old daughter's bone scan revealed a tumour that might be cancerous, the man who is now president of the Canadian Medical Association decided to jump the queue.

His wife, also a doctor, had taken their daughter into the emergency room of a Vancouver hospital after the little girl experienced a sudden pain in her leg, Dr. Brian Day recalled. The initial bone scan indicated a tumour, but couldn't reveal whether or not it was cancerous.

"The hospital said, 'We'll do a CT scan, bring her back next week,'" Dr. Day said. "To me, it's completely unacceptable, sending a mother home for six days not knowing whether her daughter has a malignant or a benign bone tumour. I made the phone call ... I made them do it that day." [...]

He admits that he himself used the system when he needed knee surgery, jumping a long queue to get the procedure done within a week by a surgeon who was also his friend.
See also NRM's two Q&As with Dr Day: , not long after he won the CMA presidential election, and is from September 30, 2007.

Photo: Lyle Stafford, NRM

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Airborne MDs terrified of emergencies

McGill's takes off tomorrow -- and not a moment too soon, it seems, given about doctors' fear of hearing the PA crackle, "Is there a doctor on board?"

The article begins with Dr Vincent Poirier, one of the course's creators, recounting a harrowing in-flight emergency:

Vincent Poirier was flying to central America on vacation when the page came over the airline PA system: a physician was urgently needed. Dr. Poirier had just finished medical school but was not yet licensed, so he decided to wait and see if someone else responded.

No one did and he finally, fearfully volunteered. The patient turned out to be a young girl suffering from anaphylactic shock. "If I hadn't done anything, she would have died," Dr. Poirier recalled. "She was wheezing, getting flushed, she was gasping for air."

He ended up saving her life, but his initial reluctance was typical of many physicians who, despite their expertise, react with trepidation to that sudden call to onbaord action.

To try to make the experience a little more comfortable, Dr. Poirier and a colleague at McGill University Health Centre have developed what they call the first continuing-education course in North America to teach physicians how to handle airline emergencies.
NRM recently wrote about in-flight emergencies and the rewards given to physicians by the airlines for providing their services -- or, more accurately, .

Dr Anna Carvalho, the course's co-creator alongside Dr Poirier, a couple months ago, as have a number of Canadian doctors. Most of them, unsurprisingly, have been with the gifts offered them by the airlines.

The movie poster above is from the 1980 disaster-movie parody Airplane!, which starred Saskatchwan-born, Northwest Territories-raised actor Leslie Nielsen as a physician named Dr Rumack. Here's one of the from the film:
Dr Rumack: Captain, how soon can you land?
Captain Oveur: I can't tell.
Dr Rumack: You can tell me. I'm a doctor.
Captain Oveur: No. I mean I'm just not sure.
Dr Rumack: Well, can't you take a guess?
Captain Oveur: Well, not for another two hours.
Dr Rumack: You can't take a guess for another two hours?
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Monday morning reading

To help you through this snowy Monday, Canadian Medicine's got a few interesting tidbits to share with you from around the web.

  • Doctors vs politicians: The Alberta Medical Association (along with the Canadian Medical Association, the College of Physicians and Surgeons of Alberta, the Professional Association of Residents of Alberta representing medical residents, the University of Alberta Medical Students' Association and Calgary Medical Students' Association) in Saturday's Edmonton Journal and Calgary Herald denouncing the Alberta government's proposed Bill 41, which would put a number of professional regulatory powers in the Minister of Health's hands.
  • The ratings are off the charts: A London, Ontario physician says she's "become obsessed" with comments posted about her on RateMDs.com: "I try to do my best every day and I appreciate positive comments. Negative comments kill me, they just break me apart," Dr Annette Richard told the London . After an anonymous user alleged she abandoned them after they were diagnosed with MS, she couldn't help but respond. (She's got a .)
  • Doping and hoping: Dr Maurice Duquette, the Quebec orthopedic surgeon who prescribed the performance-enhancing drug EPO to patients including cyclist Geneviève Jeanson, in front of the Supreme Court of Canada to withdraw his previous plea of 'guilty.' He had tried to change his plea on the day the Quebec College of Physicians and Surgeons judgment was to be announced in 2004, reports the Montreal Gazette.
  • On Friday in the House of Commons, the Conservatives got an earful from the NDP on , and from the Liberals on : "Is [the government] oblivious to how destructive its policies are or does it just not care how many Canadians will be hurt by its actions?" fumed Geoff Regan.
  • And now for something completely different... Is romance in your blood? Why does love evoke such strong feelings of obsession? "It is reasonable to hypothesise that [falling in love] must be mediated by a well-established biological process ... [We set out to] examine the relationship between the serotonin (5-HT) transporter, the state of being in love and obsessive-compulsive processes," Guardian correspondent and Annals of Improbable Research editor Marc Abrahams .
  • On the lighter side: "," by Blair Becker from the McSweeney's website.
    GAUNT: Listen, ever since I decided to subspecialize and take that residency in leechology, I have been raking in the livestock and cord wood. I've got a nice private practice in the hamlet out east and I bleed them all dry. [...] HASTINGS: Call me naive, but I truly believe that everyone deserves to be bled or sweated when they're at death's door, regardless of the feudal position they're born into.
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