Medical Issues

Chantix/Champix- A Review

2012-01-27T08:21:00.003-08:00

Chantix/Champix (Varenicline)- A Review

Tobacco is the leading cause of preventable death in the world today. The CDC global report on tobacco states that about 5.4 million deaths occur every year from tobacco-related illness. In the U.S , it responsible for 443,000 deaths annually(650,000 for the EU) and concerted effort is being made by both public and private enterprises and institutions to put a firmer control on this public scourge. More deaths are caused each year by tobacco use than by all deaths from human immunodeficiency virus (HIV), illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined (CDC). Smoking causes an estimated 90% of all lung cancer deaths in men and 80% of all lung cancer deaths in women. An estimated 90% of all deaths from chronic obstructive lung disease are caused by smoking. The World Health Organization warns that unless urgent steps are taken to control tobacco use the number of people dying from tobacco use could reach 8 million by 2030!

When compared with non-smokers, smoking increases the risk of coronary heart diseases and stroke 2-4 times, men developing lung cancer 23 times women developing lung cancer 13 times and dying from chronic obstructive airway disease such as chronic bronchitis and emphysema, 12-13 times!

The CDC has reported that smoking causes the following types of cancers:

Acute myeloid leukemia
Bladder cancer
Cancer of the cervix
Cancer of the esophagus
Kidney cancer
Cancer of the larynx (voice box)
Lung cancer
Cancer of the oral cavity (mouth)
Pancreatic cancer
Cancer of the pharynx (throat)
Stomach cancer

Other health risks include infertility, preterm delivery, stillbirth, low birth weight, and sudden infant death syndrome (SIDS).

Chantix

Varenicline, marketed as Chantix in the U.S and Champix in Europe and Canada, has proven to be a very effective adjunct to smoking cessation management. It was discovered through research by Pfizer and approved for use in the U.S by the FDA in may 2006, and by the EU in September 2006.

How it works

Chantix works by decreasing the effects of nicotine (from cigarette/tobacco) on the brain. This causes a decrease in the craving for the substance, thus decreasing its addiction; and consequently increases the likelihood of abstinence from smoking for as long as one year compared to treatment with placebo(FDA).

Usage in the U.S

Approximately 21.8 million Chantix prescriptions were dispensed and approximately 8.9 million patients received Chantix prescriptions from U.S outpatient retail pharmacies from approval in May 2006 through July 2011(FDA).

Side effects

Postmarketing reports on Chantix have included changes in mood and behavior during and after its use.

Based on FDA’s assessment of currently available data, the Agency continues to believe that the drug’s benefits outweigh the risks and the current warnings in the Chantix drug label are appropriate.

Ema Uko-Abasi
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2012-01-18T20:59:00.000-08:00

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On Defensive Medical Practice: Patients' Compensation System (PCS)- a proposed bill to replace medical malpractice litigation system

2011-12-24T16:34:00.000-08:00

Dear Dr. Uko-Abasi,

It goes without saying that physicians are the lifeblood of our business. Every day we talk to you on the phone about your work, and we understand the pressures you face and frustrations you experience. We wouldn't be good at what we do if we didn't care deeply about matters that affect your professional lives. We understand the pressure you feel each work day as you balance your patients' needs with the constant threat of litigation.

After listening to so many of you describe your dissatisfaction with medical malpractice over the years, we realize that the system is broken – it doesn't work for doctors or patients. That is why we're endorsing a new and exciting proposal from our parent company, Jackson Healthcare.

In a continuation of their efforts to expose the truth about defensive medicine and advocate for change, Jackson Healthcare is announcing the formation of a new nonprofit organization whose mission is to promote the creation of a Patients' Compensation System (PCS): a no-fault, state-driven system modeled after the workers' compensation system.

This system would revolutionize malpractice litigation. It would free physicians from the pressure of being personally financially liable for medical errors.

Please find out about a proposed PCS bill in a letter from Rick Jackson, the Chairman and CEO of Jackson Healthcare, our parent company.

We are excited to share this proposal with you, and we hope you will choose to get involved and share this information with your colleagues.

Click here to read the letter.

Warm regards,

R. Shane Jackson
President

LocumTenens.com

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LocumTenens.com, LLC
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Defensive medicine practices could signal a new ‘norm’ in the climate of fear

2011-12-09T15:48:00.000-08:00

Defensive medicine practices could signal a new ‘norm’ in the climate of fear

A Case for Universal Health Insurance in the U.S

2011-12-04T15:38:00.000-08:00

In 2000, the World Health Organization health systems rankings placed our health system at the 37th position among national health care delivery systems. The world's health authority used five performance indicators in doing the assessment: overall level of population health; health inequalities (or disparities) within the population; overall level of health system responsiveness (a combination of patient satisfaction and how well the system acts); distribution of responsiveness within the population (how well people of varying economic status find that they are served by the health system); and the distribution of the health system's financial burden within the population (who pays the costs)(1).

Currently, it is estimated that 45 million Americans lack health care insurance, hence unable to access care when they need it.This has contributed to the low ranking. While the U.K spending just 6% of her GDP on health, is at the 18th position, the U.S is spending 16% to achieve this rating. There should be no reason why the superpower nation should leave 45 million of its population without health care insurance! It could be likened to a whole country having no access to health care!

While President Obama's health care reforms which has attracted the ire of the affluent is a step in the right direction, it is my sincere opinion that the superpower owes its citizens universal access to health care.

Reference
1. World Health Organization Assesses the World's Health Systems. http://www.who.int/whr/2000/media_center/press_release/en/

5 Servings of Fruits and Vegetables

2011-11-29T19:39:00.000-08:00

The CDC explains that fruits and vegetables contain essential vitamins, minerals, and fiber that may help protect a person from chronic diseases (1). The American Cancer Society (ACS) says that these essential vitamins minerals and oxidants in fruits and vegetables help prevent cancer (2). Such cancers include breast, prostate, esophageal, stomach, colon and rectal cancers (3). Many weight loss programs also recommend substituting calories from carbohydrates with fruits and vegetables. It is interesting to know that we have a Fruits and Vegetable Council which works to ensure that each state, territory, and the District of Columbia have one person designated as the Fruit and Vegetable Nutrition Coordinator(3).

Just how affordable is eating the recommended 5 servings of fruits and vegetables recommended by health authorities such as DHHS, USDA, the American Cancer Society, physicians and nurses? In some states like Tennessee, the WIC program which provides supplemental foods to low-income women, infants, and children at nutritional risk (4), has included fruits and vegetables cash vouchers to ensure women/children eat fruits and vegetables. This is good (but leaves out men!). The Food Stamp program should also use fruits and vegies vouchers to recipients.

According to a February 2011 study report, USDA Economic Research Service, researchers found that, in 2008, an adult on a 2,000- calorie diet could satisfy recommendations for vegetable and fruit consumption in the 2010 Dietary Guidelines for Americans (amounts and variety) at an average price of $2 to $2.50 per day, or approximately 50 cents per edible cup equivalent(5).

A new research report on WebMD actually recommends 8 servings(6)! We’re all urged to eat five servings of fruits and vegetables a day, but new research finds eight servings may be needed to cut the risk of dying from heart disease.The research on the diet and lifestyles of more than 300,000 people across eight countries in Europe found that people who ate at least eight portions of fruits and vegetables a day had a 22% lower risk of dying from heart disease than those who ate three portions a day. Each additional portion in fruits and vegetables was linked to a 4% lower risk of death.

Exactly how much is a serving? The ACS has the following explanations to help.

½ cup of fruit
1 medium piece of fruit
¼ cup of dried fruit
½ cup (4 ounces) of 100% fruit or vegetable juice
1 cup of leafy vegetables
½ cup of cooked or raw vegetables

Trying to visualize the serving sizes? This may help:

1 medium apple or orange = the size of a tennis ball
1 cup vegetables or fruit = the size of a baseball
1 medium potato = the size of a computer mouse
1 cup of lettuce = 4 leaves

The CDC has an interesting and useful interactive tool called “analyze my plate”, which enables one to calculate meal portions and calorie. This can be found at http://www.fruitsandveggiesmatter.gov/activities/analyze_my_plate.html.
The CDC also has a tool for calculating the amount of fruits and vegetables a person needs using age, sex and activity level (http://www.fruitsandveggiesmatter.gov/form.html)

The USDA has a similar tool “Myplate” .

References

1. Fruit and Vegetable Consumption Among Adults --- United States, 2005. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5610a2.htm

2. Fruits and Vegetables: Do You Get Enough? http://www.cancer.org/Healthy/EatHealthyGetActive/EatHealthy/fruits-and-vegetables-do-you-get-enough

3. Diet and Cancer. MedlinePlus. http://www.nlm.nih.gov/medlineplus/ency/article/002096.htm?debugMode=false

4. Ephraim Leibtag and Aylin Kumcu. The WIC Fruit and Vegetable Cash Voucher: Does Regional Price Variation Affect Buying Power? Economic Information Bulletin No. (EIB-75) 21 pp, May 2011. http://www.ers.usda.gov/Publications/EIB75/

5. Hayden Stewart, Jeffrey Hyman, Jean C. Buzby, Elizabeth Frazão, and Andrea Carlson. How Much Do Fruits and Vegetables Cost? Economic Information Bulletin No. (EIB-71) 37 pp, February 2011. http://www.ers.usda.gov/publications/eib71/

6. Tim Locke. 5-a-Day ‘Not Enough’ Fruits and Vegetables. WebMD Health News

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2011-11-03T22:13:00.000-07:00

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Seasonal flu

2011-10-31T07:23:00.000-07:00

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The Electronic Residency Application Service(ERAS): TIME FOR CHANGE

2011-10-29T15:42:00.000-07:00

Sent:	Tuesday, March 15, 2011 5:06 PM
To:	ErasUser@eraspod.aamc.org

Dear ERAS Applicant,

As you know, the NRMP and ERAS have been experiencing technical difficulties
which adversely affected the delivery of our services today. ..

The above is the response to telephone complaint following repeated frustrations trying to log in for the "scramble ". I had changed networks 4 times under the impression it was a network issue or problems with my computers but nothing worked for an extremely time -sensitive process -ERAS Scramble! I tried several times to reach ERAS on phone and but nothing worked! It was not until about 3 hours later that ERAS emailed me a list of programs!

I truly believe the ERAS process is due for CHANGE!

Residency Process: Graduation Year Discrimination Petition

2011-10-26T12:14:00.000-07:00

Dear friends,

I wanted to let you know about a new petition I created on We the People, a  
new feature on WhiteHouse.gov, and ask for your support. Will you add your  
name to mine?  If this petition gets 25,000 signatures by November 25, 2011,  
the White House will review it and respond!

We the People allows anyone to create and sign petitions asking the Obama  
Administration to take action on a range of issues.  If a petition gets  
enough support, the Obama Administration will issue an official response.

You can view and sign the petition here:

http://wh.gov/T5o

Here's some more information about this petition:

Stop year of graduation cut offs for medical residency interviews and  
positions imposed by residency programs.
Dear President Obama,
I hereby petition you stop the discrimination upon residency applicants by  
residency programs based on year of graduation. While the Education  
Commission for Foreign Medical Graduates(ECFMG) which organizes the United  
States Medical Licensing Examinations(USMLE) places no limitations on year of  
graduation as a criterion for taking the prescribed examinations for  
physician-certification in the United States, which process qualifies medical  
school graduates for medical residency in our nation, it has been the  
practice of program directors to place graduation year cut offs as a  
selection criterion for invitation for residency interviews and subsequent  
positions. This is discrimination and an injustice in our nation.

The ERAS process is due for change.

Ema Uko-Abasi,MD

Medical Issues: U.S Residency Process: Time for Change

2011-10-16T13:58:00.000-07:00

Medical Issues: U.S Residency Process: Time for Change

U.S Residency Process: Time for Change

2011-10-16T13:41:00.000-07:00

About two weeks ago, I wrote about the residency process within the US graduate medical education and suggested an alternative General Practice/Primary Care Pathway to decongest the system and utilize the vast number of IMGs stuck in the system. I would like to inform readers that I have presented the residency issue to President Obama and my constituency Congressman, Dianne Black. I have also written the Letters Editor, New York Times. I believe setting graduation year cut offs by residency programs in the absence of a lack of such by ECFMG which runs the certification exams and ERAS which runs the yearly residency application process, is not the right thing to do. It is discrimination and cannot be allowed to continue in a liberal polity such as ours in the United States. It is not right to be denied an opportunity despite meeting the requirements for such, otherwise the ECFMG, ERAS and NRMP are deceptive and fraudulent in their operations for financial gains from IMGs. Last week, a program denied me an interview opportunity on year of graduation despite my passing the Step 3 examination and currently in my final year at an MPH program. I have been informed of friends who have had to exit the system because of this problem.This oppression must stop.
If IMGs are being discriminated against, why allow them to sit for the required exams?

Sometime ago, only IMGs were required to take the USMLE exams until an Asian physician fought and won the case, which set both the U.S trained and IMGs at par, requiring the locally trained to also take the same examination. I wish to use this medium to request for your support in whatever way you can. I would appreciate should you know an IMG that has been so discriminated against, to contact me via email-ema.ukoabasi@aol.com.Thank you.

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2011-10-15T00:33:00.000-07:00

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2011-10-13T21:41:00.002-07:00

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2011-10-13T21:41:00.000-07:00

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