FDA: Nationwide Alert - Weight Loss Products

There are many different commercial weight loss products that are sold in this country. The FDA has identified additional weight loss products (Herbal Xenicol, Slimbionic, and Xsvelten) and new undeclared active pharmaceutical ingredients (fenproporex, fluoxetine, furosemide, and cetilistat). According to the FDA, these tainted weight loss products pose a great risk because they contain undeclared ingredients including prescription drugs in amounts that exceed maximum dosages. Read more at the FDA site here.

Reading about Moyamoya Disease in the NEJM

I admit, I don't remember learning about moyamoya disease/syndrome in medical school. I must have been asleep during that lecture. The NEJM has a great review article on moyamoya disease and defines it like this: "The moyamoya syndrome is a cerebrovascular condition that predisposes affected patients to stroke in association with progressive stenosis of the intracranial internal carotid arteries and their proximal branches."

Moyamoya can cause strokes in children and adults. I remember treating a teenager who had suffered several strokes. She had no known coagulopathies, so now I wonder if she might have had moyamoya syndrome (I doubt it).

29th Annual Medical Communications Conference

The 29th Annual Medical Communications Conference is about to occur in Santa Ana Pueblo, New Mexico. The conference is presented by the AMA and this year, the National Association of Medical Communicator (NAMC) members have voted and the board members moved to officially nominate Dr. Sanjay Gupta for the first annual Health Communications Achievement Award. I've never attended this conference that started back in 1980, but I hope to some day.

Verizon System Updates = Network Problems

I've been told that Verizon Wireless is currently performing some system updates to their 3G wireless network. Earlier today, I was getting the dreaded Error Code: 11 & PPP Connection Issues. I hope Verizon is quick to implement these updates so that I can get back online!

David Blumenthal, MD, MPP as National Coordinatior for Health IT

According to the Associated Press, the HHS announced that David Blumenthal, MD, MPP, will serve as national coordinator for health information technology (health IT). He has done a considerable amount of research on health IT issues so I'm eager to see how he will direct the future of health IT in this country. Congratulations to Dr. Blumenthal! Health IT is a growing industry and there are many opportunities for clinicians in this space.

Advances in e-Learning Platforms

I've been exploring some e-learning platforms that work really well for healthcare professionals. They offer unique features that are relevant for adult learners and these interactive components really enhance the learning experience. Articulate is one such e-learning platform that offers various solutions such as Presenter, Quiz Maker, and Enagage. I've been using this for several years now and I've been impressed by the improvements that Aritulcate has made in their software solutions. The e-learning industry is growing very rapidly as more people embrace distance-learning modalities for continuing education and corporate training. Healthcare professionals are so busy that on-demand e-learning is one of the most practical way for them to access educational content.

When is Windows Mobile 6.5 Coming to Verizon?

We've all been hearing about the nice new features on Windows Mobile 6.5. Isn't it funny how Microsoft went from version 6, to 6.1, and now to 6.5? Will there be a 6.8 or 6.9 before version 7 gets released? Why such incremental changes?

For me, the biggest advantage of Windows Mobile 6.5 is the new Pocket Internet Explorer 6.5. I currently have a nice version of PIE because of the custom ROM loaded on my XV6800. However, it's not as nice as PIE 6.5 and I don't think my XV6800 could handle PIE 6.5 because the hardware just isn't robust enough for those requirements. It's a shame because these little devices have such incredible potential. They are considered mobile internet devices (MIDs) by many, but they don't really have the firepower as other dedicated MIDs.

Internet Explorer 8

So have you tried IE 8? It reminds me a bit of the Windows 7 interface. I haven't run into any pages that aren't compatible with IE 8 yet, but then again, I just installed it a few hours ago. It's supposed to be faster, but I haven't really noticed much of a change on my Thinkpad X200 tablet PC. I'm just waiting for Foxmarks to release a version that will be compatible with IE 8.

Another Physician Compensation Survey

According to the American Medical Group Association (AMGA) 2008 Medical Group Compensation and Financial Survey, physician pay went up in 2007 by roughly 3.5%. According to this report, medical specialties that experienced the lowest increases included allergy medicine, endocrinology, pulmonary medicine and emergency medicine. With Medicare reimbursement decreasing and managed care organizations trying to push pay-for-performance (P4P) and other initiatives, physician payment is all over the map for various specialties. The survey was conducted among 44,000 health care providers, 2,700 medical groups, and 116 specialties in the United States.

Pharmaceutical Executive

There are many types of publications for executives working in the pharmaceutical industry. One magazine/journal is simply titled, "Pharmaceutical Executive" and is published by Advanstar Communications. Care to take a look at it? Using Nxtbook Media technology (e-publishing/digital publishing), they have published the March issue here:

http://www.nxtbook.com/nxtbooks/advanstar/pe_200903/

Take a look and see what's happening in the pharmaceutical industry. There are many corporate changes occurring. Jobs are responsibilities are evolving and companies are trying to adapt to all this change.

Healthcare IT Jobs

Healthcare IT News is published in partnership with HIMSS. Although I'm not looking for a new job, I like to glance at the job posts and see what's going on the health IT sector. Currently, many of the advertised job opportunities appear to be for health IT consultants who have extensive experience and expertise in the EMR/EHR space. People are looking for integration consultants, clinical documentation consultants, clinical systems analysts, and more. Expect to travel if you get hired as a consultant. Some of the job descriptions indicate "ability to travel 100%." Sounds like fun if you're single, but not if you have a family.

The Addictive Potential of ADHD Stimultants According to JAMA

Provigil® (Modafinil) is a stimultant drug that is used to treat attention-deficit/hyperactivity disorder (ADHD). It is also a drug that is often misused by students to help them increase their study performance, and there have been many ethical debates on this issue. At what point does "off-label" cross ethical boundaries?

Recently on JAMA, an article came out titled, "Effects of Modafinil on Dopamine and Dopamine Transporters in the Male Human Brain: Clinical Implications." Can you guess what it was about? Students who are really driven are often looking for ways to increase their grades (unless they easily get straight A's and they're already at the top of their class). The misuse of stimulants has been such a hot topic recently. The authors of this JAMA article concluse that, "Because drugs that increase dopamine in the nucleus accumbens have the potential for abuse, and considering the increasing use of modafinil, these results highlight the need for heightened awareness for potential abuse of and dependence on modafinil in vulnerable populations."

What exactly does this mean? Provigil is a Class IV controlled substance and is in that class with benzos and anabolic steroids.

Medical Students and BlackBerry

Medical students often need to get some type of PDA for their clinical clerkships. They may be required to enter patient information or log their procedures. Also, since they're often asked to write prescriptions (not sign them, just write them), they need to know how to look up drug dosing. Software like Epocrates can be very helpful when you're filling out 15 scripts on different medications. Gone are the days of flipping through a huge PDR to look up dosing.

So how does the BlackBerry fit into all of this? Traditionally, Palm had the greatest marketshare in the medical field. Recently, the Apple iPhone has become very popular among medical students, residents, fellows, and attendings. Yet you still find some medical students who are in their early years of training who are attracted to the BlackBerry. Why? Part of the reason could be that they may have come from a corporate background. Others may be serious "texters" and they may have gravitated to the BlackBerry because of the excellent keyboard and texting capabilities. For others, it's simply about cost. You can get a free BlackBerry from many carriers.

I've been wondering why RIM hasn't been more aggressive with their marketing towards medical professionals. They should partner with more software developers and have more available for their devices. Otherwise, they'll be left in the dust with the Apple iPhone and the Microsoft Windows Phone running off into the sunset.

Free Epocrates® Essentials for Medical Students – Download Days iPhone March 17-18, 2009

Free Epocrates® Essentials for Medical Students – Download Days iPhone March 17-18, 2009

If you're a US medical student, go here:
http://www.epocrates.com/downloaddays/

It's great to see Epocrates offering this 1-year license for free to medical students. Med students have enough student loans and books cost a fortune. So, anything that's free is generally warmly welcomed.

Torch Mobile Iris Browser

Torch Mobile has released an updated version of its Iris mobile web browser. This browser is similar to Opera Mobile and Skyfire and allows you to view full web pages and easily zoom in and out. I've run into a few "out of memory" errors on my Windows Mobile XV6800 while using Iris, so it's not optimized for devices that have limited amounts of internal RAM. I'm sure you won't have any problems if you have a newer PDA smartphone that's faster and more equipped than my old device.

As mobile browsers become more powerful, I often wonder how medical students and residents will use their smartphones in the hospital setting. If they can literally access any website in its entirety, then this opens up tremendous educational resources. I think that's probably one of the biggest reasons why the iPhone has been so popular among medical students and residents. Speaking of the iPhone, Apple just announced the updated iPhone OS 3.0 and it seems silly that you still can't multi-task on the iPhone. It reminds me of the old Palm OS.

Happy Saint Patrick's Day Today!

Happy Saint Patrick's Day Today! I'm wearing green. Are you?

Match Week 2009

Good luck to all the graduating medical students and residency programs this week. This week is match week and Thursday is Match Day. Best of luck to all those who need to scramble!

Lenovo Pocket Yoga - A Touchscreen Netbook?

Looks like Lenovo is releasing a netbook-type of pocket notebook/UMPC that looks almost like the Sony Vaio P with a touch screen. Is that right? I wonder if this has a backlit keyboard (I doubt it). I imagine that the screen is a passive touch screen.

So, is this practical for healthcare professionals? Is this new innovation in technology applicable to the medical/healthcare industry? Will you see doctors carrying this device around the hospital and using it to run EHR/EMR applications? In the healthcare world, productivity is key. Therefore, you really need something that has a larger screen so that you can be efficient and productive with your time. However, if you're a doctor who takes call from home, this may be a great little gadget to carry around with you when you go out for social events (and you're on call). Imagine being at a restaurant or a party. You get a phone call from your intern/resident/patient, and you whip out your pocket notebook to look up labs, patient history, etc. Or, you use this to enter electronic orders. Either way, you can carry a full PC in your pocket. That's what made the OQO so popular among some healthcare professionals.

Campaign for Safe Cosmetics Report on Baby Shampoo

The Campaign for Safe Cosmetics released a report called, "No More Toxic Tub." This report alleges that a vast number of baby products, including Johnson's Baby Shampoo and other products have trace levels of 1,4-dioxane and formaldehyde which are known carcinogens. I say "alleges" because I'm uncertain about the research methods that were used in this study on various baby products. An independent research group called Analytical Sciences performed the tests. I don't think J&J has officially released a public statement yet, but I'm curious to see how they react. Retailers in Taiwan have already pulled J&J shampoos from their shelves until more information can be obtained.

Pegintron (Peginterferon alfa-2b) Receives Expanded FDA Indication

You may have already seen this on Forbes. On March 11, the FDA approved the combination of Pegintron (Peginterferon alfa-2b) and Rebetrol (ribavirin) for treating chronic hepatitis C in patients 3 years of age and older with compensated liver disease. This is now the first and only pegylated interferon combination therapy approved in the United States that is not restricted to treatment-naive patients. Treatment to this combination is often dependent on your type of hepatits C virus genotype. There is such a need for better therapies for patients with chronic hepatitis C in this country. So many people got infected by blood transfusions before 1992 when the medical community didn't know about hepatitis C.

Pegintron is manufactured by Schering-Plough. If Schering-Plough merges with Merck, then the new company will be called Merck, so things may get a bit confusing.

Mobile Phones and Public Health Implications

There's been a lot of controversy regarding the health effects of mobile phones. Recently, CNN reported about some of the potential public health implications of homes that only rely on mobile phones. My home is one of them. We don't have a landline phone. In fact, we haven't had a landline phone in years. I should sell my old landline phones on eBay.

Anyways, this article addresses the importance of epidemiological surveys conducted by the CDC and other organizations. These surveys are primarily conducted by phone, and only landline phone numbers get included in these studies. At 26 percent, Oklahoma has the highest percentage of homes that only have a mobile phone. Vermont has the lowest at only 5 percent. These are old statistics and most experts suspect that the numbers are considerably higher in 2009.

So if the CDC and other government agencies can't accurately track the health of the nation, where does that put us? Surveys will result in skewed data because of selection bias. The question remains, what type of people are more likely to live in a home that doesn't have a landline phone? My guess: just about anyone. Why? Because almost everyone now has a mobile phone. If you're young and single, why do you need a landline? What if you're a young married couple with no kids? Once again, no need for a landline. What if you're an active senior? You probably have a mobile phone since you're active and you're going out. Do you need a landline? What if you're a family with teenage kids? If they each have a mobile phone and both parents have phones, then who needs a landline?

I'm not making the argument that people should get rid of their landline phones. I think there are some serious public health implications at stake and perhaps the government needs to come up with a way to conduct surveys using more creative measures (like e-mail?).