A collection of related notes since stuff disappears from the web every once in a while.

1894 - first treatment for hypothyroidism developed involving desiccated thyroid glands from cows
1914 - thyroxine first isolated in pure form from extracts of hog thyroid glands
1927 - hormone synthesized by British chemists Harington and Barger
1958 (1955?) - first synthetic T4 enters market, manufactured by Flint Laboratories
1986 - Flint contracts with University of California at San Francisco research team headed by Betty Dong to conduct study showing Synthroid is more effective than Levoxyl and two generics
1986 - Boots America acquires Flint from Baxter Travenol Laboratories for $555M
1990 - UCSF study completed showing that Synthroid is bioequivalent to generics
1991 - Boots attempts unsuccessfully to terminate study
1994 - Dr. Dong submits final draft of manuscript to Boots
1995 - under legal pressure by Boots, thyroid article is withdrawn from publication in JAMA
1995 - Knoll Pharmaceuticals acquires Boots
1995 - BASF AG acquires Knoll for $1.4B
1997 - UCSF study results published in JAMA
1997 - FDA revokes approval status for all brands of levothyroxine
2001 - Abbott Laboratories acquires BASF AG
2002 - Synthroid receives FDA approval
2011 - Abbott announces plan to separate medical products and pharmaceuticals into two companies
2013 - Abbott spins off research-based pharmaceuticals company as AbbVie

[] Synthroid Information Center

[WSJ] Bitter Pill: How a Drug Firm Paid For University Study, Then Undermined It

The levothyroxine spectrum: Bioequivalence and cost considerations

Why do we continue to write for Synthroid?


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Nuts. Resurfaced (minor compared to past flare-ups) this morning after no issues for at least a month. Not fond of the idea of surgery. Hmmph!

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During a recent visit to the dentist, I was offered an oral cancer screening using a product called ViziLite Plus (Zila Pharmaceuticals). Given a $65 price tag that is not covered by insurance, I accepted the marketing literature but politely declined the screening until I had a chance to do my own research. Apparently, everyone above the age of 18 is at an "increased risk" for oral cancer. I was then asked to sign a waiver (part of the Zila exam materials), which in my opinion, reeks of scare tactics.

As far as the details go, it seems you rinse with a dilute acetic acid solution, after which the dentist sticks a special light in your mouth to better see lesions that may be an indicator of oral cancer. According to the web site, unit price on the exam kit runs from $20-30. There are some interesting references to be found online:

Vizilite denied ADA seal of Approval [2005/11/10]

Kinda long, but very interesting:

listserv discussion of ViziLite [Bulletin Board of Oral Pathology, Nov 2005]

Short and to the point:

Efficacy of the ViziLite System in the Identification of Oral Lesions [abstract from Journal of Oral and Maxillofacial Surgery, March 2007]

[Edit 2009/04/24: This entry was posted originally a year and a half ago and continues to receive feedback, which thrills me to no end. I am adding a link to a fairly recent article that discusses the subject more thoroughly. Please note that I have no affiliation with the web site, and the author of the article is not a dentist but a retired psychiatrist and consumer advocate.]

ViziLite Screening: Does It Make Sense? [Quackwatch, September 2008]

[Update 2011/02/16: Adding related link, info from Zila web site. I'm not sure what information is presented in patient brochures currently (it's been a long time since I wrote my original post), but this is good information to have as a patient as opposed to telling everyone over 18 that they are at an increased risk for oral cancer without putting the statement into proper context.]

From the Zila Vizilite FAQ:

Because more than 25% of oral cancer victims have no lifestyle risk factors, many practices are now offering annual ViziLite exams to all adult patients (age 18 and older tobacco users of any age). Patients age 18 to 39 are at increased risk for oral cancer; Adults age 40 and older, and tobacco users of any age, are at high risk for oral cancer. Patients age 40 and older with lifestyle risk factors such as tobacco use, chronic alcohol use, diabetes, HIV an HPV 16/18 are at highest risk for oral cancer.

Regarding the profit issue, check out the Zila product training materials, specifically the "Revenue Production" section under "3. Incorporating Vizilite." The video clip touts the benefit of increasing office revenue and notes a $20-32 cost for the test assuming patient charges ranging from $35-100.

Study questions effectiveness of oral cancer detection devices [ 2008/09/30]

[Update 2011/03/22: updated BBOP link (Nov 2005) as archives were moved]

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You tell me it calms your nerves

Surgeon General Sees 4-Year Term as Compromised. Why would anyone try to water down a report on secondhand smoke? Who is bought and sold?

Former Surgeon General Richard H. Carmona told a Congressional panel Tuesday that top Bush administration officials repeatedly tried to weaken or suppress important public health reports because of political considerations.

The administration, Dr. Carmona said, would not allow him to speak or issue reports about stem cells, emergency contraception, sex education, or prison, mental and global health issues. Top officials delayed for years and tried to “water down” a landmark report on secondhand smoke, he said. Released last year, the report concluded that even brief exposure to cigarette smoke could cause immediate harm.


In his testimony, Dr. Carmona said that at first he was so politically naïve that he had little idea how inappropriate the administration’s actions were. He eventually consulted six previous surgeons general, Republican and Democratic, and all agreed, he said, that he faced more political interference than they had.


Dr. Carmona described being invited to testify at the government’s nine-month racketeering trial of the tobacco industry that ended in 2005. He said top administration officials discouraged him from testifying while simultaneously telling the lead government lawyer in the case that he was not competent to testify. Dr. Carmona testified anyway.


After nearly a decade of morning workouts, I have started shifting to evening workouts. Getting up before 5:30am is just too brutal.

Gitmo: The Worst of the Worst?. Life is quite nice here (despite my being incredibly busy with work) so it is very easy to forget to be angry about things that should piss me off.


A nice guide on ergonomics from (gasp!) Microsoft.

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Power Steer: I used to think people who pushed for organic foods were a bunch of tree-hugging freaks, but this article about beef cattle really got me fired up. 😉

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I had thought originally that the hospital would be an interesting place to work, but now I find it rather depressing.

How to Read a Statement of Cash Flows


At 3:45 this morning, I let an empty G train pass. Screw that.

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Feeling pretty good today. Extra sleep is finally working its magic. Lots of clean-up to do this week. NFL preseason is just a week away...

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