National Institute on Drug Abuse provides new resource

The National Institute on Drug Abuse (NIDA), a part of the National Institutes of Health (NIH), revealed a series of new educational resources through its Centers of Excellence for Physician Information Program (NIDA CoEs).

Why this new resource? There's a tremendous need for medical education on this topic.

Drug abuse and addiction are often insufficiently covered in medical school curricula, despite the fact that drug use affects a wide range of health conditions and drug abuse and addiction are themselves major public health issues.

It's great to see the government investing some much needed resources in this area. Here's a brief summary of what you can expect:

The new NIDA CoE curriculum resources provide scientifically accurate information on substance abuse, addiction and its consequences to help meet the educational needs of medical students, residents and medical school faculty. The first seven curriculum resources include lectures, problem-based case studies, a faculty workshop, and a web module, any of which can be incorporated into existing medical curricula.

To learn more, visit: http://www.nida.nih.gov

Affordable Health Care for America Act (H.R. 3962)

You've probably seen the news by now. The House narrowly passed the health care reform bill and now it's headed to the Senate. The only Republican supporting this bill was Anh "Joseph" Cao (Louisiana). Is our nation ready to completely overhaul our existing health care system? Or will we try to place a few patches and hope that it lasts a few more years?

According to the latest from CNN, the Affordable Health Care for America Act (H.R. 3962) restricts insurance companies from denying coverage to anyone with a pre-existing condition or charging higher premiums based on gender or medical history. It also provides federal subsidies to those who cannot afford health insurance. And it guarantees coverage for 96 percent of Americans.

Will the Senate pass a bill that contains the controversial "public option?" Not if it's up to Sen. Joseph Lieberman. Maybe those who live in Connecticut don't really need a public option, but those who live in Louisiana probably do.

Senator John Cornyn collecting info on Sermo

Senator John Cornyn (R) from Texas is collecting info on Sermo about Comparative Effectiveness. Here are the questions he's asking Sermo physicians:

• What impact would one-size-fits-all coverage decisions from Washington have on your ability to make health care decisions with your individual patients?
• In your opinion, how effective would one-size-fits-all coverage decisions from Washington be in reducing “unnecessary” tests and treatments?

If you're a physician, what do you think about these questions? If you'd like to have some input, then vote on Sermo.

An artificial hand that can "feel"

This is very cool: An artificial hand that can "feel."
According to CNN, the SmartHand project is funded by the European Union and is a collaboration between researchers from across the continent. It has produced a prototype motorized prosthetic hand that researchers say gives unprecedented sensory feedback.

Doctors and mistakes: big and small

Doctors are humans and we all make. Some are really big and others are small. Over the past week, we've seen two dramatic examples of physicians who appear to have done some terrible things. I don't write this to judge them, but to say that physicians are vulnerable to stress, mental health problems, greed, and other conditions.

• We've all heard of Maj. Nidal Malik Hasan, a military psychiatrist who shot and killed people at Fort Hood (Military stress and tragedy at Fort Hood).
• If you've been following the FDA news, you may also know of Dr. Torrino Jennings who was sentenced in federal court on charges that he wrote prescriptions over the Internet for people whom he had never met or examined, as well as tax evasion (DOCTOR SENTENCED FOR WRITING PRESCRIPTIONS OVER THE INTERNET FOR PEOPLE WHOM HE HAD NEVER MET OR EXAMINED).

It's a sad reality, but doctors can fall and make some really big mistakes. I don't know if we'll ever fully understand why these individuals did the things they did. Some may think that it's a simple matter of greed, anger, or hatred. Perhaps they suffered serious mental trauma. I personally think that it probably involves a combination of many different psychological factors to cause physicians to make such poor decisions. After all, the brain is very complex and we really don't understand what makes certain people do crazy things that are irrational and bizarre.

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FDA and FSIS to improve food safety

FDA NEWS RELEASE:

For Immediate Release: Nov. 5, 2009

Media Inquiries:
Michael Herndon, 301-796-4673, michael.herndon@fda.hhs.gov
Neil Gaffney, 202-720-9113, neil.gaffney@fsis.usda.gov
Consumer Inquiries: 888-INFO-FDA

FDA and FSIS Collaborate To Improve Tracing of Unsafe Food Products
The Goal is to Prevent or Mitigate Foodborne Illness

A joint public meeting focused on improving the system for tracing of food products and ingredients that are causing illness outbreaks or presenting other risks to the health of consumers was announced today by the Food and Drug Administration (FDA) of the U.S. Department of Health and Human Services and the Food Safety and Inspection Service (FSIS) of the U.S. Department of Agriculture (USDA).

Recognizing the need to increase the speed and accuracy of traceback investigations and traceforward operations, both agencies are building on existing efforts by seeking public input that would help identify elements of effective food product tracing systems, identify current gaps in food product tracing, and suggest specific mechanisms for improvements.

The meeting is also intended to improve the ability of FDA and FSIS to use the information in such systems to respond to outbreaks more quickly by rapidly identifying the source of contamination during outbreaks of foodborne illness, and improving the ability of all persons in the supply chain to more quickly identify food that is (or potentially is) contaminated and remove it from the market during traceforward operations.

“This public meeting provides an opportunity for FDA to collaborate more closely with FSIS as well as with members of the food industry, many of whom have been making important innovations in food safety practices and technology, and all of whom bear primary responsibility for producing and marketing safe food,” said Michael R. Taylor, senior advisor to FDA’s Commissioner Margaret Hamburg, M.D.

“The Food Safety and Inspection Service is eager to work with FDA, public health officials, consumer advocates, and the food industry to improve our ability to trace products that may cause illness outbreaks,” said Jerold R. Mande, USDA’s Deputy Under Secretary for Food Safety. “The public can provide valuable input to strengthen our prevention, surveillance and response and recovery efforts, as outlined by the Administration’s Food Safety Working Group (http://www.foodsafetyworkinggroup.gov/).” In March 2009, President Obama announced the formation of the Food Safety Working Group, and in July, President Obama released Key Findings, which highlight steps that FSIS, FDA, and other Federal Agencies are taking to improve food safety.

Food can become contaminated at many different steps in the supply chain. Experience in conducting foodborne disease outbreak investigations suggests that improved product tracing abilities could help identify products associated with disease more quickly, get risky products off the market faster, and reduce the number of sicknesses associated with foodborne illness outbreaks.

The FDA and FSIS share authority for helping to ensure the safety of the nation’s food supply. Each agency investigates foodborne illness outbreaks and other foodborne risks associated with the products they regulate. These investigations, conducted in close cooperation with the U.S. Centers of Disease Control and Prevention and state and local health and agriculture departments, often involve tracing backward or forward in the supply chain the distribution of food products and ingredients associated with risk to consumer health.

A traceback investigation is an investigation to determine and document the distribution and production chain, and the source(s), of contaminated (and potentially contaminated) food, often in the context of an outbreak of foodborne illness. A traceforward operation is an operation to determine the distribution of contaminated (and potentially contaminated) food.

The meeting will be held Dec. 9 and 10 in Washington at the U.S. Department of Agriculture’s South Building in the Jefferson Auditorium, 1400 Independence Avenue, SW, Washington, D.C., 20250.

Those interested in attending the public meeting can pre-register online at: http://www.fsis.usda.gov/News_&_Events/Meetings_&_Events/index.asp. Online pre-registration is preferred, but pre-registration can also be done by faxing registration information (including name, title, firm name, address, telephone number, e-mail address and fax number) to 1-877-366-3322 by Dec. 2. Pre-registration is strongly encouraged for all persons who wish to attend the meeting, regardless of whether they also wish to request an opportunity to make oral comments at the meeting on issues and questions described in the Federal Register notice.

For more information on food safety visit: www.foodsafety.gov

Military stress and tragedy at Fort Hood

My heart goes out to all the families recently affected by this tragic event at Fort Hood Texas. CNN is reporting that the suspect in this shooting case is a military psychiatrist (Maj. Nidal Malik Hasan) who was practicing at Darnall Army Medical Center at Fort Hood. Previously, he worked at Walter Reed Army Medical Center.

It's hard to imagine the level of stress some people must go through. According to this story, Hasan was to get deployed to Iraq. What caused this type of erratic behavior? Was it stress? The human mind is so complex that it's hard to imagine what Hasan must have been experiencing as a military psychiatrist.

FDA: Dangerous sexual enhancement booster

FDA NEWS RELEASE

For Immediate Release: Nov. 5, 2009

Media Inquiries: Christopher Kelly, 301-796-4676, christopher.kelly@fda.hhs.gov
Consumer Inquiries: 888-INFO-FDA

FDA Warns Consumers on Sexual Enhancement Products
Another dietary supplement is found to be contaminated with potentially dangerous ingredient

The U.S. Food and Drug Administration is warning consumers that Stiff Nights, a product marketed as a dietary supplement for sexual enhancement, contains an ingredient that can dangerously lower blood pressure and is illegal.

Over the past several years, the FDA has found many products marketed as "dietary supplements" for sexual enhancement that contain undeclared active ingredients of FDA-approved drugs, analogs of approved drugs and other compounds that do not qualify as “dietary ingredients.” The FDA has issued multiple alerts about these contaminated dietary supplements.

Consumers and health care professionals should be aware of this problem and the health hazard it presents. Sexual enhancement products that claim to work as well as prescription products are likely to contain a contaminant. Use of such products exposes consumers to unpredictable risk and the potential for injury or even death.

In the case of Stiff Nights, following a consumer complaint, the FDA determined that the product contains sulfoaildenafil. This is a chemical similar to sildenafil, the active ingredient in Viagra. Sulfoaildenafil may interact with prescription drugs known as nitrates, including nitroglycerin, and cause dangerously low blood pressure.

The product is distributed on Internet sites and at retail stores by Impulsaria LLC of Grand Rapids, Mich. It is sold in bottles containing 6, 12, or 30 red capsules or in blister packs containing one or two capsules.

"Because this product is labeled as an ‘all natural dietary supplement,’ consumers may assume it is harmless and poses no health risk," said Deborah M. Autor, director of FDA’s Center for Drug Evaluation and Research Office of Compliance. "In fact, this product is illegally marketed and can cause serious complications.”

The FDA advises consumers who have experienced any adverse events from sexual enhancement products to consult a health care professional. Consumers and health care professionals should report adverse events to the FDA's MedWatch program at 800-FDA-1088 or online at www.fda.gov/medwatch/report.htm

The FDA remains committed to stopping the illegal marketing of unapproved drugs and will continue to protect the public with vigorous law enforcement and criminal prosecution of violators.

The risks of daily aspirin may outweigh the benefits

According to this story on CNN (which is a summary of a report published in Drug and Therapeutics Bulletin), the risks associated with taking a daily aspirin for primary cardiovascular prevention may outweigh the benefits. The major risks include gastrointestinal bleeding (bleeding in the gut) or hemorrhagic stroke (bleeding around the brain).

I'm very curious to see how the American Diabetes Association (ADA and the American Heart Association (AHA) respond to this new study.

What if we're not using the proper methods to risk stratify patients? Those who have diabetes are considered to be at "high risk" automatically because they're considered to have a coronary heart disease "risk equivalent" based on the ATP III or Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III).

Before you make any changes to your medications, discuss this issue with your health care provider.