A new study published in the July issue of the American Journal of Preventive Medicine indicates that overweight individuals are at a higher risk for injury than people who are physically fit.

Obese people were found to be twice as likely to injure themselves, with more than 1 out of 4 extremely overweight men reporting injury in the last year as opposed to less than 1 in 5 normal weight men.

The study, the first to examine personal injury among different weight groups, considered more than 2,500 adults residing in Colorado by compiling information on both personal injuries reported last year and Body Mass Index (BMI).

 BMI is a measure of weight in relation to height, which defines normal weight and obesity.  For example, a 5-foot-9-inch man who weighs 235 pounds or more or a 5-foot-4-inch woman who weighs at least 205 pounds would be considered extremely obese.

The study found that having a BMI over 35 doubled the risk of personal injury. It showed that 26% of extremely obese men reported injuries compared with 17% of normal weight men, while nearly 22% of extremely obese women reported injuries compared with 12% of normal weight women.

In addition, the most common causes of nonfatal injuries among the obese were overexertion and falls. More than half of these injuries were found to occur within the home. Others happened in transportation areas, such as parking lots.

Huiyun Xiang, a researcher at the Center for Injury Research and Policy at Ohio State University, stated in a news release: "There is undeniably a link between obesity and injury risk in adults. Efforts to promote optimal body weight may reduce not only the risk of chronic diseases, but also the risk of unintentional injuries.”

Earlier this week, a federal grand jury in California indicted Orange County physician Dr. George Kooshian and his assistant, Virgil Opinion, for intentionally giving AIDS patients lower than the prescribed doses of medications while billing insurance companies for the cost of full treatments. 

Allegedly, Kooshian ordered Opinion and other staff members to administer medication at 50% or even 25% of the prescribed dosage. In some cases, he is even accused of ordering saline or water injections be given in place of actual medication.

An investigation into Kooshian’s offenses did not begin until after Opinion left her job in 2001. At that time, Opinion and a former patient Bryan Noble filed lawsuits stating that Kooshian charged as much as $7,000 dollars for treatments of saline.

 In a 2001 interview with the OC Weekly, Opinion made the accusations public. According to U.S. Attorney Jeannie Joseph, the law suits were settled for an undisclosed amount. 

Joseph argues that while Kooshian’s actions may not directly have caused deaths, his preying upon vulnerable and suffering patients caused unnecessary distress for those who put their care in his hands.  She remarks "We can’t say with any certainty that what he did caused anyone’s death, but it certainly affected his patients’ quality of life."

A review of the history of the case, including coverage of the investigation into the allegations of Opinion’s 2001 interview can be found in the current issue of the OC Weekly.

A new study conducted at the Roswell Park Cancer Institute in Buffalo, New York, and published in the August issue of the American Journal of Preventative Medicine has found a significant percentage of smokers mistakenly believe cigarettes marketed as “less harmful” are safer than regular cigarettes.

While these researchers and others before them have found no credible evidence that any cigarette advertised as “less harmful” is any safer than traditional brands, too few smokers seem to know that.

Of the 2,000 adult smokers surveyed, only 39% had heard of these “less harmful” cigarettes and even fewer (27%) could actually name a brand. Finally, 25% actually believed they were not as dangerous as regular cigarettes. Those over 55 were more likely to have heard of these products.

Whether the claim involved is the older marketing ploy of reduced toxin exposure, “light” (or “ultra-light) or “low tar” or the newer approach of “less harmful,” herbal, or “smoke-free,” the same percentage of those surveyed believed there to be less danger involved.

Over 50% of those surveyed were already smoking “light” or “ultra-light” brands.

The researchers stated that because smokers are “confused” by advertising claims, those companies marketing any cigarette in this questionable category “should be required to demonstrate convincingly that smokers will not be confused or misled by the marketing claims.”

The results of this survey, however, should not surprise anyone familiar with the history of cigarette advertising since the tobacco industry has always led the public to believe that smoking “light” or “low tar” versions of cigarettes is less harmful because health risks are minimized.

Studies have indicated that this is not really the case at all. There are a number of factors which show that the information provided by the tobacco industry is indeed misleading.

•    A report published by the National Cancer Institute found that people who switched to low-tar cigarettes actually smoked more in order to get the same total amount of nicotine. For the most part, the ratio between tar and nicotine remains the same in all cigarettes and, therefore, the risk for the smoker exposing his or her lungs to the carcinogenic ingredients remains the same. The same report found that smokers of these “mild” brands inhale eight times more nicotine than the amount listed on the packet. “The [report] clearly demonstrates that people who switch to ‘low-tar’ or ‘light’ cigarettes…are likely to inhale the same amount of cancer-causing toxins,” says Scott Leischow, Ph.D., Chief of the NCI Tobacco Control Research Branch. “Scientific research does not show that changes in cigarette design and manufacturing over the last 50 years have benefited public health.”

•    According to an analysis in Tobacco Control, a British Medical Association publication, many tobacco companies recognized that low tar products were as dangerous as regular cigarettes, yet continued to market them as “healthier” alternatives. The industry believed that, with all the evidence linking tobacco with lung cancer, smokers would be encouraged to quit and thus they devised “low tar” and “light” products in order to reassure them that smoking was not as bad as they originally thought.

•    Cigarettes that are branded as “hi-fi” or “high filtration” imply that they are somehow able to reduce health risks associated with smoking. This filtering ploy has been described in industry documents as “an effective advertising gimmick” which was merely cosmetic, offering “the image of health reassurance.”

•    While some test results related to “low tar/light” cigarettes seemed to illustrate they are a healthier alternative to full-flavor cigarettes, the test results themselves are subject to question. The tobacco industry designed cigarettes specifically so that the Federal Trade Commission tests, which have used smoking machines since the 1960s to determine the levels of smoke toxicity, would find that these “light” and “low-tar” cigarettes yield less tar when smoked. In actuality, they still deliver full doses of tar and nicotine to actual smokers.

•    Although low-tar cigarettes are frequently made with porous paper and more loosely packed tobacco in an effort to reduce tar intake, research has shown that smokers will still receive the maximum levels of tar because they will usually take more (and deeper) puffs or smoke more total cigarettes per day. Some of these cigarettes also have small holes in the filters designed to dilute the tar and nicotine with air. Reports show, however, that many people will consciously or unconsciously cover these holes with their mouths while smoking thus receiving the same amounts of tar and nicotine as in regular cigarettes.

•    In a study conducted in 2002 by the American Journal of Preventative Medicine, less than 10% of smokers nationwide knew that one light cigarette could deliver the same amount of tar as one regular cigarette.

•    William Farone, a former employee of Phillip Morris, the nation’s largest cigarette manufacturer, has testified that the company increased the tar in one “low-tar” brand, Cambridge Lights, from 0 to 12 mg. over a seven-year period. The company never told consumers that the tar content had gradually been increased. Smokers of that brand as well as smokers who bought Marlboro Lights subsequently sued Phillip Morris on the grounds that the label “lights” was deceptive regarding tar and nicotine levels. (The lawsuit was for the refund of money they paid for the cigarettes as opposed to one for personal injuries). A spokesman for Phillip Morris said that the company did not want the terms “light” and “low-tar” banned from cigarette packs but would support greater regulation of their use.

Clearly, a significant number of smokers are being taken in by the tobacco industry’s unsubstantiated and misleading advertising campaigns with respect to various “less harmful” cigarettes. Once that happens, people will be less likely to attempt to quit. They may even be encouraged to take up smoking again after successfully quitting.

The FDA has approved a new prescription sleep aid called Rozerem, which will reportedly treat insomnia without causing dependence.  The drug is manufactured by Takeda Pharmaceuticals, based in Lincolnshire, Illinois, a wholly owned subsidiary of Takeda Pharmaceutical Co. Ltd., Japan’s largest pharmaceutical company.

The new drug, which will be available by late August, works differently from other sleep aids by helping to regulate the body’s sleep-wake cycle. This will provide a new option for relief to the one-third of American adults who suffer from insomnia to one degree or another.

Rozerem works by stimulating the melatonin receptors in the brain, which regulate the sleep-wake cycle.  It is this cycle that keeps you alert during the day and in the evening allows the body to wind down and fall asleep at night.
"In people who sleep normally, the pineal gland in the brain responds to darkness by producing a hormone called melatonin," says psychiatrist Louis J. Mini, MD, Takeda North America’s medical director for neuroscience. "This natural melatonin … dampens the alerting signal so the sleep load overrides [the waking drive] and allows a person to fall asleep." Insomnia occurs when these drives get out of balance.

Whereas many sleeping pills address the problem by trying to enhance the sleep drive, Rozerem it seems tries to suppress the wake drive by simulating the effect of melatonin. Rozerem, Mini claims, is more effective that melatonin supplements, for which there no clinical trials yet.

In addition, Rozerem, unlike the sleeping pills Ambien, Lunesta, and Sonata, is completely non-addicting and is the first prescription sleep aid that is not a controlled substance.

According to a news release by the drug’s manufacturer Takeda Pharmaceuticals North America, the 8-milligram tablets show no evidence of abuse and can safely be prescribed for long term use.

 Some doctors believe that because Rozerem is not habit forming, it will be a popular alternative to other sleeps aids and will encourage those afflicted with insomnia to treat the condition with medication.

David Neubauer, MD, associate director of the Johns Hopkins Sleep Disorders Center and author of Understanding Sleeplessness: Perspectives on Insomnia, said: "There will be a lot of interest. One, because it is the first sleep drug in a very long time to have a new mechanism of action. And two, I think there is going to be a very high comfort level in prescribing this drug. The safety level is extremely positive. A lot of doctors — and a lot of patients who haven’t been interested in a sleeping pill — may view this in a different light and may be more comfortable giving it a try."

Others, however, such as Dr. Milton Kramer, who is director of the sleep disorders center of Bethesda Hospital in Cincinnati and teaches psychiatry at the University of Cincinnati and at Wright State University School of Medicine in Dayton, Ohio, do not believe the impact of the drug will be that substantial, stating “its effectiveness in chronic [sleeping-pill] users is not enormous.”

While Rozerem will likely be seen as safe alternative for insomnia relief it does have several side effects including somnolence, dizziness, and fatigue. It is intended for people who have difficulty falling asleep and should not be used by people who have severe liver problems, since the drug is metabolized by the liver. 

Calgary-based Westfair Foods Ltd. is voluntarily recalling certain ground beef products, including ground sirloin that consumers may have purchased last month at four British Columbia grocery outlets. The beef, supplied by XL Grinding, may be contaminated with E. coli 0157:H7 bacteria.

The E. coli 0157:H7 bacteria can cause serious and potentially life-threatening illness by producing a toxin that can break down the lining of the intestines and damage the kidneys. Food contaminated with the E. coli bacteria will not look or smell spoiled.

The Canadian Food Inspection Agency and Westfair Foods warned Friday that Westfair Foods ground beef sold during a small window in early to mid-June at the four stores should not be consumed. So far, there have been two reported illnesses associated with the product.

Lori Stene, spokeswoman for Westfair Foods, said it is not known how much beef product was affected. "Because we enlarged the recall and the warning to include absolutely everything, it’s really hard to say how much ground beef we’re talking about."

Westfair Foods ground beef products from the following locations are affected by the warning:
Real Canadian Superstore at 291 Cowichan Way, RR No. 6, Duncan, bearing a best-before date of JN15 to JN19, purchased between June 12 and June 17.

Real Canadian Superstore at 1105 Eaton Centre, Metrotown, Burnaby, bearing a best-before date of JN08 to JN11, purchased between June 5 and June 8.

Real Canadian Wholesale Club at 5335 Kingsway, Burnaby, bearing a best-before date of JN08 to JN12, purchased between June 6 and June 9.

Extra Foods at 7190 Kerr St., Vancouver, bearing a best-before date of JN08 to JN12, purchased between June 6 and June 9.

Health officials have confirmed that a 39-year-old shop assistant from Bury, Greater Manchester, died of rabies which she contracted from a dog bite during a trip to Gao, India.

The woman lived in Bury with her husband and was admitted to Fairfield General Hospital when she felt sick shortly after her return to London.

As soon as her condition was diagnosed as rabies she was transferred to the Walton Centre in Liverpool, which specializes in neurology and neurosurgery. Where, despite her treatment, she died on Saturday.

The Health Protection Agency confirmed the death. A spokesman said: "We can confirm that a female patient who was apparently bitten by a dog during a visit to the Indian sub continent has died in the Walton Centre for Neurology and Neurosurgery in Liverpool, where she was being treated for rabies."

Although there is no history of rabies contraction between humans, the spokesman said all hospital staff that had close contact with patient had been offered vaccinations. He assured that the incident did not pose a concern for public health.

The incident is, however, a reminder that travelers should obtain the proper inoculations for the country they are visiting and should exercise caution around animals. Both standard travel guides and the Centers for Disease Control and Prevention (CDC) provide an outline of recommended vaccinations for tourists.

All medical professionals agree that a smooth transition from paper files to electronic records could do wonders for the operations of both private practice and hospitals.

Electronic files would reduce errors, facilitate tests, and make scheduling appointments and obtaining a patient’s history much easier. Currently, the problem is that electronic systems can cost many thousands of dollars to purchase, not including the time needed to ensure they are installed and operating properly.

In an effort to encourage the change over to electronic systems, Medicare, which claims that old paper filing systems present one of the biggest impediments to improved health care, has announced that it will give software to doctors free of charge to computerize their offices. They will also provide a list of companies which will administer technical support.

The program being released by Medicare next month called Vista Office is a simplified version of the successful electronic health recorded system called Vista. Vista, developed by the federal government has been used for two decades by 1,300 V.A. hospitals in both inpatient and outpatient facilities. This amounts to over 10 million records for more than five million veterans treated per year.

Vista’s improvements in these facilities included a scanning system, which allowed the barcodes on medicines to be crossed checked with a barcode on the patient’s wristband, reducing drug errors by 80%.

Another major attraction of Vista is that it is so affordable. Typically software systems can cost each doctor in a practice $20,000 to $25,000 dollars, whereas Vista would cost between 10,000 and 12,000 for the whole office. This could save an office with five doctors $100,000 dollars.

Despite these major benefits doctors point out that, using a system that someone else installs and maintains is different from mastering it yourself. Dr. David Kibbe, director of the center for health information technology at the American Academy of Family Physicians, which is working on the Vista project said “at the beginning, there was a lot of wishful thinking. They said, ‘We’ll just release it.’ I said, ‘Where’s the fairy dust?’ "

Several doctors have reported problems installing Vista. Dr. Nancy Anthracite, a family physician in Washington relied on many hours of technical support from a group of Vista supporters called Hardhats, who volunteered their time.

While Dr. Kevin Toppenberg was attracted to the V.A. version of Vista because it greatly lowered the expense of converting to an electronic system he remarks, “You just have to figure out how to get it to work." It took him six months.

Some doctors fear that, even with free software and the new Vista Office, the transfer to an electronic system will be expensive because of the time required to implement and operate the technology costs money, usually $250 dollars per hour.

A 36-year-old former popcorn plant worker, who believed his respiratory illness resulted from a chemical used to make butter flavoring, sued his former employer. After a trial, the jury agreed and awarded $2.7 million dollars.

Kenneth Moenning is one of 30 former and current workers at Jasper Popcorn Co., who have sued International Flavors and Fragrances Inc., and subsidiary of Bush Boake Allen Inc.

The plaintiffs claim the company knew that it was using chemicals that cause lung cancer to synthesize butter flavor and did not warn workers.

Moenning worked in the plant’s flavoring room from 1993-1996 and experts testified that his lung disease resulted directly from exposure to diacetyl and other chemicals used to make butter flavor.

Moenning has bronchiolitis obliterans a rapidly progressing rare lung disease that doctors testified would require a transplant.

Defense attorneys stated that management was unaware of the danger the chemicals posed to employees. "Someone is trying to blame the defendants for something no one knew or could have known," said Mike Patton, the attorney for International Flavors and Fragrances, in his closing arguments.

The jury deliberated for seven hours. When it returned its verdict on Tuesday in Jasper County Circuit Court, nine jurors (the minimum necessary) supported a $2.69 million  award to Moenning and 50, 000 for his wife. Moenning had asked for $20 million, plus $5 million for his wife for emotional suffering.

While health officials claim microwave popcorn is safe, they admit that the chemicals released during popping require additional study. If pre-packaged, fake flavored foods tastes too good to be true, the recent verdict suggests they probably are.

The FDA Division of Drug Marketing, Advertising and Communications has about three dozen employees to review 30,000 to 40,000 Direct-to-Consumer (DTC) ads each year. Lester M. Crawford, then Acting Commissioner of the agency noted that “our patience is sometimes worn thin” by all the advertising claims.

Several times each year, the FDA issues warnings to pharmaceutical manufacturers for a variety of reasons associated with their advertising claims and marketing approaches. Unsubstantiated or exaggerated claims of effectiveness, advertising a drug for unapproved uses, minimizing or omitting information regarding side-effects, and improperly casting doubt on similar drugs manufactured by competitors are but some of the ways in which prescriptions drugs are over-promoted.

This trend toward over promotion is precisely what caused the Food and Drug Administration to issue warnings against two biopharmaceutical companies, Cytogen Corporation and Abbott Laboratories Inc.

The FDA has determined the companies have exaggerated the effectiveness of their products while downplaying negative side-effects.

In a warning letter to Cytogen, the FDA admonished the company concerning its radio commercials, testimonial video, and website for the cancer pain drug Quadramet all of which suggested the drug was used for cancer therapy rather than as a pain reliever.

Furthermore the advertisements overstated the amount of relief the drug could provide and implied that it would be immediate.

Conversely, the drug’s side effects were concealed or minimized in the commercials. Quadromet is a radioactive drug, which can suppress bone marrow and produce radioactive urine for several hours.

In response, Cytogen President and Chief Executive officer Michael Becker stated that the FDA’s concerns were being addressed. “We are already cooperating with the FDA” he said. The questionable advertisements are no longer in circulation and the entire website is under review.

Similarly, in a second letter to Abbott Laboratories, the FDA claimed Abbott had, in a direct mail promotion, made unsubstantiated effectiveness claims and minimized the risks posed by the drug Survanta, used for treating respiratory distress in infants.

While the flyer’s descriptions and charts highlighted Survanta’s effectiveness, the FDA observed that dangerous side effects were “relegated to page three of the four page piece and is presented in small font in two lines at the very bottom of the page, below both the references and the footnotes.”

Survanta is made from bovine lung extract and can have dangerous side effects including unsteady heart rhythms and difficulty processing oxygen. The drug is not approved for babies weighing less then 600 grams or more than 1,750 grams at birth.

Abbott acknowledged receipt of the letter on July 15 and confirmed it was cooperating with the FDA and discontinuing the flyers. “The subject pieces under review are no longer being used.” Moreover, Abbott’s Ross Products Division is working with the agency on these issues, according to Ross’ spokeswoman Keri Butler.

As drug promotion on television and the internet becomes increasingly popular, it seems the regulation of advertising claims will continue to be an issue. However, the FDA’s recent actions suggest that false claims have the potential not to be financially profitable. As a result of the accusations against the companies, Cytogen shares were down 5 cents, or about 1 %, to close at $4.81 on the Nasdaq on Tuesday and Abbott shares closed down 6 cents at $46.35 on the New York Stock Exchange.

As obesity reaches epidemic proportions and becomes more problematic, the number of medical studies on the subject has also increased. 

The connection between obesity and diabetes in children, the relationship between stress and belly fat, and the link between milk consumption and obesity in children have all made the headlines in the past two months.
A new study is now addressing the adverse affects of living in a fast-food society. Fatty liver disease, unheard of in children twenty years ago, has become a serious concern of health care professionals and pediatricians.
Fatty liver disease occurs when fat builds up in the liver causing inflammation and scaring. This can lead to serious liver damage that resembles the affects of alcoholism.

The disease affects one in five people who are overweight or obese. According to Dr. Eve Roberts, a hepatologist at Toronto’s Hospital for Sick Children, at least 5% of Canadian children show at least the early stages of the condition.

Unlike diabetes, however, fatty liver disease often exhibits few symptoms and therefore is difficult to diagnose.  In some cases, in fact, it is not until a child exhibits physical symptoms that anyone even suspects fatty liver disease.
When specific examinations are done, however, children are often seen to be in the beginning stages of liver disease. If diagnosed early, damage to the liver can be reversed with a commitment to lifestyle changes.

Thus, doctors are encouraging such a commitment to healthy diet and exercise in children before the onset of liver damage. Dr. Peter Nieman of the Calgary Pediatric Obesity Centre says "Clearly we have our job cut out for us to explain to families not to worry just about diabetes or just about high cholesterol or just about the obesity per se, but also to start thinking about the liver,"