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The future of statin therapy

Use in normal-cholesterol patients is on the horizon — will over-the-counter be next?

The most frequently prescribed drug class in Canada may soon become much, much more popular.

AstraZeneca has filed an application with Health Canada to add a new indication for its drug rosuvastatin (Crestor). The application, filed late last year and still under review, asks that rosuvastatin be licensed for use in older patients with normal cholesterol levels but elevated high-sensitivity C-reactive protein (CRP). If approved, the new indication could potentially result in millions of Canadian patients being put on preventive statin therapy.

Whether or not AstraZeneca’s new application is approved, however, recent research makes it all but certain that statins are well on their way to far wider use in the years to come.

to read the rest of this article on the Parkhurst Exchange website.

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WHO growth charts replace US charts as gold standard

The way we keep track of kids' height and weight is changing.

The Canadian Paediatic Society and the College of Family Physicians of Canada have signed on to a new policy statement (PDF) endorsing the WHO's revised growth charts rather than the American CDC growth charts that have long been in use in this country. The new policy is also published in the February issue of the journal Paediatrics & Child Health.

On the Canadian Paediatric Society's website you can find more information, including a health professional's guide to using the WHO growth charts, a fact sheet for parents, and (soon) copies of the WHO charts specifically designed for Canadian doctors.

What was wrong with the CDC growth charts? Basically, they were outdated: their data were based on the assumption that most babies are fed formula, which may have been true 40 years ago but is not today. In a May 2009 column in Parkhurst Exchange magazine, Dr Richard Haber, an associate professor of pediatrics at McGill University and the Director of the Pediatric Consultation Centre at the Montreal Children’s Hospital, explained the CDC charts' problems:

"The revised [CDC] charts don’t necessarily represent optimal growth in infancy as the population data sets represent periods when most babies were bottle-fed; since 1970, only about 50% of infants were breastfed and of these merely 30% for greater than three months. What’s important to remember is that exclusively breastfed babies will plot higher for their weight in the first 6 months and lower for weight in the 6-12 month period. So they may appear to ‘fall off’ their curve. One other disadvantage is that the CDC curves represent cross-sectional data sets based on chronological age and not pubertal stage, and therefore don’t take into account the pubertal growth spurt."
Visit the PE website to read the rest of Dr Haber's May 2009 column, "," and its June 2009 follow-up on spotting red flags in growth data, "."

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