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A major change in the treatment of advanced or metastatic colon cancer has been made in a new update from the National Comprehensive Cancer Network (NCCN). The network's "Clinical Practice Guidelines in Oncology: Colon Cancer," published in January, were revised to reflect new scientific data and expert judgment.

Migraines are now viewed as a chronic disorder with episodic manifestations, and emphasis should be put on evaluating impairment between headache attacks. This is the gist of a new consensus statement recently released by the National Headache Foundation (NHF), an organization focusing on migraine prevention.

The notion of a fully integrated electronic healthcare record across the entire health system is no longer pie-in-the-sky thinking. In reality, however, few hospitals have attained that level of technology penetration. But for those that have, the benefits are immense.

The basic principle of health-care treatment-"First, do no harm"-should apply also to the proper disposal of hazardous pharmaceutical waste. A new product, EcoRex, from Vestara in Irvine, Calif., is designed to achieve that end, using customized software to reduce the potential harm of such waste.

The Alaska Native Medical Center (ANMC) is the recipient of the 2006 Award for Excellence in Medication-Use Safety. McLeod Regional Medical Center and St. Joseph's/Candler Health System were honored as award finalists. The three sites were chosen by a multidisciplinary team based on four criteria: medication use system initiative/scope, planning and implementation, measurable outcomes and impact, and innovation and applicability.

Healthcare experts from two Michigan hospitals are helping the Food & Drug Administration find ways to prevent medical device errors. The FDA hired Beaumont Technology Usability Center (BTUC) late last year to help identify the causes of and risks associated with tubing and catheter misconnection errors. The move is part of an ongoing national effort by the FDA to closely monitor the safety of medical devices.

The results of a new study indicate that lower literacy and a greater number of prescription medications can lead to the misinterpretation of the instructions on prescription drug labels. The study, "Literacy and misunderstanding prescription drug labels," was released on-line in November and published in the Dec. 19 issue of Annals of Internal Medicine.

A 75-year-old man, D.P., is seen regularly in your hospital clinic for severe chronic obstructive pulmonary disease (COPD) as a result of a 50-year pack-a-day habit (FEV<50% predicted). He quit smoking last year but still admits to being a heavy drinker. His current medications include fluticasone/ salmeterol 250/50 mcg (Advair, GlaxoSmithKline) one puff twice daily and albuterol inhaler when needed. He has had several COPD exacerbations within the past year, necessitating oral steroid therapy. He was just diagnosed with osteoporosis: recent X-rays show two vertebral fractures. His physician is contemplating osteoporosis therapy. What do you recommend?

The National Comprehensive Cancer Network (NCCN) recently updated its guidelines for the prevention of emesis in patients receiving chemotherapy or radiation. The new guidelines serve as an update to the 2006 guidelines and are consensus based, with explicit review of the scientific evidence by a multidisciplinary panel of expert physicians and pharmacists.

There was a time when the diagnosis of cancer was ominous, but not anymore. Cancer has evolved into a chronic disease, with 95% of cancer patients treated in outpatient settings. Novel drug therapies and advances in radiation treatment have made many cancers survivable. That's good news for patients, and so is the fact that pharmacists are playing a more pivotal role in managing not only the clinical but also financial aspects of patient care.

CHD Meridian Healthcare, an I-trax Inc. company, appears to have struck the right note with large corporations seeking to bring on-site clinics to their employees.