Atricle: Support a Ban on Unnecessary Engine Idling in Your Community

Vehicle emissions greatly contribute to the pollutants that contribute to greenhouse gases – the gases that are responsible for the climatic warming we are experiencing on Earth. Engine idling is a serious contributor to greenhouse gases. Natural Resources Canada unequivocally states that, ‘… the transportation sector is the single largest source of greenhouse gas emissions in Canada. For every litre of gasoline used, the average car produces about 2.4 kilograms of carbon dioxide (CO2), the principal greenhouse gas.’

Natural Resources Canada further advises, ‘If every driver of a light-duty vehicle in Canada avoided idling for just five minutes a day, we would prevent more than 1.6 million tonnes of CO2 from entering the atmosphere each year.’ This represents an enormous contribution to Canada's climate change efforts. Engine Idling reduction strategies are one example of how communities can assist citizens in taking responsibility for their climate change contributions.

The Oak Bay Green Committee (OBGC) and GreenGatherings have organized a No Engine Idling campaign targeting Oak Bay’s municipal schools. The campaign provided schools with No Engine Idling Aluminum Signs and Information Kits. “The No Engine Idling campaign not only educates drivers about the need to reduce emissions, it creates awareness around the relationship between society’s over-reliance on vehicles and the damage it is doing to the environment and our children,” explains campaign coordinator Britt Karlstrom.

The OBGC and GreenGatherings focused on schools as Natural Resources Canada reports that children are especially susceptible to carbon emissions due to their developing lungs and need to take in oxygen at an increased rate; exposing them to increased amounts of particulate matter believed to cause respiratory related illnesses. Often, school parking lots are hot spots for idling vehicles – as caregivers drop off and pick up children in early morning (when children are arriving) and afternoon (when children are leaving).

Serious health effects from exposure to vehicle emissions:
During the course of the engine idling campaign, the Oak Bay Green Committee became aware of the numerous studies supporting the dangers of long term exposure to both particulate matter produced from the burning of fossil fuels and vehicle emissions which emit various air pollutants including volatile organic compounds (VOCs), nitrogen oxides (NOx), particular matter (PM), carbon monoxide (CO) and sulphur oxides (SOx).

The Ontario College of Physicians, in their document The Health Effects of Urban Sprawl Air Pollution, clearly state that particulate matter and vehicle emissions have many negative effects on physical health including cardiovascular effects; a link between fine particulate pollution and lung cancer; exposure to vehicle-exhaust has also been linked to ovarian cancer; and exposure to carbon monoxide and ozone during the second month of pregnancy has been linked to cardiac and orificial defects.

The Canadian Lung Association reports that exposure to particulate matter has been linked with mild symptoms such as coughing and wheezing, with exacerbation of pre-existing lung diseases like bronchitis and COPD to serious health effects including cancer, heart attacks and strokes. This is only a very small sampling of the research available that supports the link between negative health effects and long-term exposure to particulate matter and vehicle emissions.

In the past few months, many communities have begun their own No Engine Idling initiatives. These include: City of Victoria (about to implement the first no engine idling bylaw on Vancouver Island), Saanich (implementing a ban on engine idling at their schools); Langford (in the process of implementing a no engine idling bylaw); Sidney and Esquimalt (in discussion stages of how to reduce engine idling in their communities), View Royal (decided to implement a no engine idling campaign) and Central Saanich and North Saanich (both wrote letters supporting a ban on engine idling in the Capital Regional District.)

In fact, Engine Idling bans are nothing new in Canada. Various types of anti-idling provisions have been included in municipal by-laws for at least three decades. Montreal City passed an air quality by-law in 1970 and the first stand-alone anti-idling by-law was passed by the City of Toronto in 1996.

Since then, more than fourteen municipalities in southern Ontario now have anti-idling by-laws, including six in the Greater Toronto Area. Individual citizens and local environmental organizations continue to lobby municipal governments to consider and implement No Engine Idling bylaws. The Anti Idling momentum continues to grow with other municipalities – including Markham, Newmarket, Oshawa, the City of North Vancouver, Vancouver, Welland, Whitby and Squamish currently considered adopting anti-idling bylaws.

The No Engine Idling movement is spreading across Canada and we hope it will continue to gain momentum on Vancouver Island and surrounding communities and islands. Even though there is much progress being made, one only has to visit school parking lots, drive-throughs and any ferry terminal to see that we need to continue to raise awareness about the negative effects of unnecessary vehicle idling.

Ferry terminals and unnecessary engine idling:
Ferry terminals are sites of excessive vehicle idling. Individuals, such as ferry workers, with increased exposure to vehicle idling have increased health risks. Implementing a ban on unnecessary engine idling at all BC ferry terminals would limit the exposure of ferry workers (and travelers) to the negative health effects of vehicle emissions.


source;www.pej.org

article: Brunei Joints Fight Against Smoking

Implementation of the Tobacco Act this year will see the reduction of `passive smoking' effects to the sultanate's non-smokers through restriction and control of tobacco consumption.

"We want them (smokers) to stop - and them to stop spreading smoke to other people - with the introduction of the Tobacco order 2005 which will definitely be implemented this year," the Minister of Health, Pehin Orang Kaya Indera Pahlawan Dato Seri Setia Haji Suyoi Haji Osman told The Brunei Times yesterday at the launch of World No Tobacco Day that-took place at The Mall, Gadong.

In his opening speech, the minister revealed that there has me been increase-in the number of smoking-related cases in the sultanate from 30 cases in 2003 to 56 in 2005. These cases included cancer, stroke and diabetes, with the number one disease being lung cancer and bronchitis.

Enforcement of the Tobacco Order 2005, the minister added is aimed to protect the wellbeing of citizens and residents of the country from the negative effects of tobacco consumption adding that the order will include restrictions on advertisements related to smoking, the promotion, distribution, packaging and labelling of tobacco products as well as smoking in certain areas. The order will also regulate tobacco consumption in the country.

He further urged management of public venues to take more responsibility by putting up notices in their premises according to law.

He also cited World Health Organisation's estimation that tobacco use has led to the death of 650 million people, with hundreds of thousands of nonsmokers also dying from the effects of second-hand smoke.

The theme has chosen by WHO for this year's World No Tobacco Day is ‘100% Smoke Free Environment’.

Article 8 of the WHO Framework Convention on Tobacco Control, recognises that exposure to tobacco smoke causes death, disease and disability, and asks countries to adopt and implement legislation that provides protection from second-hand smoke.

source;www.brudirect.com

Article: Stop smoking to protect our world

Did you know that your cigarettes are costing the earth? Here Claire Atherton finds some compelling reasons to stub them out for good.

SMOKING in public places is now banned throughout the UK and Northern Ireland.

And many of us are turning to pharmacists for advice on how to give up.

That’s great – if you’re a smoker, giving up is the best thing you can do for your health. But by quitting, you’ll also be cutting down on the harmful effects that tobacco production has on the environment.

Its toll is devastating and includes deforestation, pollution from heavy pesticide and fertiliser use, and soil depletion.


source;icnewcastle.icnetwork.co.uk

article: houston.injuryboard.comPaxil Facts

If you or a loved one has taken Paxil, please read this article. If you or your loved one has experienced any symptoms like the ones described below, then we can help you!

· Body as a Whole: Allergic reaction, chills, face edema (abnormal amount of fluid in the facial tissue), infection, moniliasis (infection caused by Candida (yeast like fungi), neck pain, overdose. Cardiovascular: Bradycardia (abnormal slowness of the heartbeat), conduction abnormalities (abnormal transfer of sound waves, heat, nerve influences, or electricity), ECG abnormal, hypotension (lowered blood pressure), migraine, ventricular extrasystoles (a premature contraction of the heart).
· Dermatological: Acne, alopecia (absence of hair from the body where it is normally present), dry skin, ecchymosis (blood under the skin, usually looks or appears like a bruise), eczema (an inflammatory skin disease characterized by lesions varying greatly in character, at times watery discharge and the development of scales and crust), furunculosis (a number of painful nodules formed in the skin, caused by bacteria, which enter through the hair follicles or glands, its formation is favored by digestive derangement and local irritation), herpes simplex, urticaria (reaction of the skin to certain drugs, marked by the appearance of smooth, slightly elevated patches, which are redder or paler than the surrounding skin and often includes severe itching).
· Gastrointestinal: Bruxism (grinding of the teeth especially during sleep), buccal cavity disorders (cavity running from the cheeks to the lips), dysphagia (inflammation of the esophagus), eructation (the act of belching or casting up wind from the stomach), gastroentertitis (inflammation of the stomach or intestines), gastrointestinal flu, glossitis (inflammation of the tongue), increased salivation, liver function test abnormal, mouth ulceration, vomiting and diarrhea, rectal hemorrhage.
· Hematologic and Lymphatic: Anemia, leukopenia (reduction in the number of leukocytes in the blood), lymphadenopathy (disease of the lymphnodes), purpura (condition charactized by the presence of blood just under the skin, can appear any where over the body), WBC abnormality (white blood cell abnormality).
· Musculoskeletal: Arthralgia (pain in the joint), arthritis, traumatic fracture.
· Nervous System: Akinesia (the temporary paralysis of a muscle, can include intense pain), alcohol abuse, amnesia, ataxia (failure of muscular coordination or irregularity of muscle action), convulsion, depersonalization, hallucinations, hyperkinesia (abnormally increased mobility, abnormally increased motor function or activity), hypertonia (a condition of excessive tone, tension or activity, can include increased blood pressure), incoordination, lack of emotion, manic reaction, paranoid reaction, thinking abnormal.
· Respiratory: Asthma, bronchitis, dyspnea (difficult or labored breathing), epistaxis (hemorrhage from the nose), hyperventilation, pneumonia, respiratory flu, sinusitis.
· Special Senses: Abnormality of accommodation, conjunctivitis, ear pain, eye pain, mydriasis (extreme or morbid dilation of the pupil), otitis media (inflammation of the ear which may be marked by pain, fever, abnormalities of hearing, deafness, tinnitus, and vertigo), tinnitus (a noise in the ear, as ringing, buzzing, roaring clicking etc).
· Urogenital: Abortion, amenorrhea* (absence or abnormal stoppage of menses), breast pain*, cystitis (inflammation of the urinary bladder), dysmenorrhea* (painful menstruation), dysuria (painful or difficult urination), menorrhagia* (excessive uterine bleeding occurring at regular intervals), nocturia (excessive urination at night), polyuria (the passage of a large volume of urine in a given period), urinary incontinence, urinary retention, urinary tract infection, urinary urgency, vaginitis* (inflammation of the vagina). * Gender specific side effects.

source;houston.injuryboard.com

article: Genetic Predisposition To Develop COPD Found In Some Smokers

Some people have a genetic variation that makes them more susceptible to chronic obstructive pulmonary disease (COPD) if they smoke tobacco, according to new research from Wake Forest University School of Medicine and colleagues.

"The genetic variant we studied seemed harmless on its own," said Alireza Sadeghnejad, M.D., Ph.D., lead author. "But when someone has this variant, there is more of an adverse effect of smoking on lung function. Therefore, in combination with smoking, this genetic variant represents a risk factor for COPD."

Emphysema and chronic bronchitis are components of COPD, which is the fourth leading cause of death in the U.S. and the only top-10 killer that is increasing in frequency. The World Health Organization predicts that by 2020, COPD will be the third-leading cause of death worldwide.

The study is published online and will appear in a future print issue of the American Journal of Respiratory and Critical Care Medicine. The researchers studied two variations (-1112C and -1112T) of the interleukin-13 (IL-13) gene. The gene is responsible for the production of the IL-13 protein that is involved in pulmonary inflammation and susceptibility to COPD.

Everyone has two copies of the gene, one inherited from each parent. The investigation suggests that having two copies of -1112T in the IL-13 gene is linked with a more profound adverse effect of cigarette smoking on lung function.

Study participants were 1,073 men at least 40 years old who had smoked 20 or more pack-years. One pack-year is equivalent to smoking one pack a day for a year. Participants underwent genetic testing and a pulmonary function test known as Forced Expiratory Volume, which is the volume of air that can be forced out in one second after taking a deep breath.

Jill Ohar, M.D., senior researcher and a professor of internal medicine-pulmonary, said it's likely that -1112C/T is one of several genetic variants that influence the risk of a smoker developing COPD. About 25 percent of smokers develop the disease, suggesting that genetic factors, in addition to environmental exposure (in this case cigarette smoking), play a role.

"This finding may help us to understand why some smokers develop COPD and improve our understanding of how the disease develops," said Ohar. "It shows us that it's likely the gene/environment interaction sets you up for this disease."

Sadeghnejad said that by understanding more about the role of IL-13 in COPD, the protein may one day be a target for new drugs for the disease.

The variant has been shown to be associated with asthma, which may help explain why COPD and asthma tend to cluster in families, Ohar said.

source:www.medicalnewstoday.com

article: Drug safety concerns rise as FDA dips deeper into pharma's pocket for funds

Nearly 20 years ago, AIDS activists got fed up with the time it was taking for the federal government to approve potentially life-saving drugs. They stormed the headquarters of the U.S. Food and Drug Administration, effectively shutting down the agency that decides when new medicine is ready for the market. And they demanded medication – fast.

The FDA responded to the public outcry with new regulations to speed up its drug review process. But lack of money continued to stifle the agency’s abilities over the next four years.

To remedy the situation, Congress decided in 1992 to charge pharmaceutical companies user fees for new drug applications, creating an unusual yet effective funding mechanism to supplement the money FDA received from taxpayers coupled with new goals for expedited drug review.

The infusion of industry dollars under the Prescription Drug User Fee Act enabled the agency to expand its staff, drastically cut review times and bring new drugs to the market faster than ever – helping patients with a variety of conditions across the country.

But the arrangement gave rise to a controversy being fought out in Washington now, over whether drug safety is being compromised for the sake of speedy drug reviews financed largely by the pharmaceutical industry.

The FDA and the industry’s primary trade associations, Pharmaceutical Research and Manufacturers of America and Biotechnology Industry Organization, defend the user fee system. They say user fees came to the rescue when federal funding faltered in the early 1990s and helped to streamline drug reviews and bring life-saving drugs to the market.

By 2006, a study by led by Harvard Professor Daniel Carpenter found that the user fee act had taken control of the review process due to a provision that mandates nine out of 10 drugs to meet review deadlines. The study found that the drug approvals were “piled up right around deadlines,” he said in an interview.

“Compared to drugs in the past,” Carpenter said, “the drugs approved right at the deadlines were significantly more likely to encounter safety problems once in the market.”

An FDA spokeswoman did not respond to several phone calls and an email seeking comments from the agency.

The user fee law is under scrutiny now as part of the reauthorization process, which must be completed by Sept. 30. The law ties renewal of user fees to the FDA’s ability to meet review deadlines.

Since industry dollars provide half of the agency’s total review budget, and because there is little support in Congress to dip in to the federal budget to cover pharmaceutical companies’ annual contributions of roughly $400 million, the renewal is a foregone conclusion.

“There are a lot of people now at the agency, managers, who view the agency’s job as promotion of drug development, rather than regulation,” said Dr. David Ross, who quit the FDA November 2006 after a dispute over the approval of an antibiotic called Ketek, which he said was unsafe. “People are so anxious to get new drugs out there that the regulation part of it gets put last.”

Responding to such criticism, Scott Lassman, senior assistant general counsel for PhRMA, argued that safety remains paramount. “The (user fee) funds have allowed FDA to hire more people to review these drug applications more quickly,” Lassman said. “The (review) standards haven’t changed,” he added, “FDA looks at a lot more safety issues now than they did even 10, 15 years ago.”

Under the law, average review times dropped from 27 months to 10 months for standard products and from 21 months to six months for priority drugs, according to FDA data. The companies pay a fee for each application: in 2007 the amount is $448,100; the fee goes up to $896,200 if the review also requires clinical data.

PhRMA spokesman Karl Uhlendorf expects user fees to shoot up to $1 million to $1.2 million per application after the renewal.

Since the inception of user fees 15 years ago, the industry has paid more than $1.75 billion in user fees to the FDA, agency data shows. During the same time, FDA approved more than 1,200 new drugs and biologics.

“Timely reauthorization is critical to the ability of FDA to continue to bring safe and effective drugs … to market to the benefit of the health of Americans in a timely manner,” the agency’s Deputy Commissioner Randall W. Lutter said at a Senate hearing in June.

But while consumer groups, the industry and the FDA all agree that faster reviews benefit patients, there is widespread disagreement on the merits of user fees and the agency’s capacity to ensure drug safety.

Under the user fee system, “industry negotiates with FDA officials and essentially tells them how to spend the money,” said Vera Hassner Sharav, president of patient advocacy group Alliance for Human Research Protection. “The only thing they want to fund is rapid approval … by not doing complete, thorough review.”

Without additional federal dollars, however, the agency cannot afford to give up money from the industry. If the law is not renewed, the FDA would have to lay off medical reviewers, who have nearly doubled in number from about 1,300 in 1992 to 2,412 in 2005.

“FDA has become much more reliant on user fees as a source of funding versus federal appropriations,” said Andrew Emmett, BIO’s director of science and regulatory affairs. But, it’s “a misperception that FDA is somehow beholden to the industry it regulates,” he said, and added that it “undermines the agency’s credibility.”

Decreasing user fees is not the answer, Emmett said. Instead, he said, Congress should appropriate more federal money so that public and user fee funds each make up about 50 percent of the FDA’s budget.

Under the user-fee law, the FDA has to meet “performance goals,” which dictate that the agency complete 90 percent of standard drug reviews in 10 months – six months for priority drugs. The FDA says that the agency met or exceeded its legal goals consistently over 15 years.

Carpenter, the Harvard researcher, said the agency has generally become more business friendly as part of a more conservative political climate.

“Do they (FDA) view … the industry as their client? They do,” former-FDA reviewer Ross said. “And under the circumstances they don’t want to hear dissenting voices. They have very flawed organizational structures in terms of checks and balances and until that gets fixed we are going to see more drug safety issues.”

The FDA came under intense criticism and scrutiny following the withdrawal of Merck’s anti-inflammatory drug Vioxx, which the agency later reported led to increased risk of heart attacks and cardiac arrests. The FDA later estimated that Vioxx may have contributed to 27,785 sudden cardiac deaths and heart attacks between 1999 and 2003.

Merck voluntarily pulled Vioxx from markets worldwide in September 2004.

More recently, the FDA’s review of the antibiotic Ketek – initially aimed at respiratory ailments such as pneumonia, bronchitis and sinus infections – sparked controversy. In a New England Journal of Medicine article Ross said the agency approved the drug based on data from a questionable review process.

Ketek manufacturer Sanofi-Aventis recruited more than 1,800 physicians and paid them as much as $400 per patient enrolled in the research to carry out an FDA requested study. But after the study was complete, Ross writes, four testing sites were under criminal investigation and one doctor was sentenced to 57-months in federal prison for fabrication of patient enrollment data.

Ross, who was involved with the review, said that he also warned his managers about safety concerns including heart issues and “bizarre side effects” – such as temporary blindness. “If it’s a drug for cancer, HIV, you might be able to live with some of these things,” Ross said. “But for bronchitis? Give me a break.”

The FDA revised Ketek’s label in February, limiting its use to certain cases of pneumonia.

Despite the controversy, the user fee program does not appear to be in jeopardy on Capitol Hill.

The Senate swiftly approved it in May with only Independent Sen. Bernard Sanders of Vermont voting against the measure. A companion draft bill passed a House committee and is currently on the floor, with action likely after the July 4th recess. President Bush is expected to sign the final bill once it hits his desk.

The renewal would increases total annual user fees by $87.4 million to $392.8 million.

Both bills include provisions to bolster drug safety, too: $225 million over five years to expand post-market evaluations; enhancing adverse-effect data collection on approved drugs; arming the FDA with authority to change drug labels without manufacturer approval; and enabling the agency to impose increased fines for noncompliance.

All parties involved in negotiating the act’s reauthorization regard the user fees as a financial necessity that enables the FDA to continue its review process at the current levels.

“Nobody’s against speedy review,” said Jerry Avorn, a professor of medicine at Harvard University and author of “Powerful Medicines: The Benefits, Risks, and Costs of Prescription Drugs.” “It was the funding of the adequate staffing that sped up drug reviews, not the fact that the dollars came from user fees.”

source;news.medill.northwestern.edu

Articel: "Sicko" Presents False View of Cuba's Health System

Leftist filmmaker Michael Moore claims his latest documentary, "Sicko," will "rip the band-aid off America's health care industry,"1 which Moore sees as wrongfully dominated by private drug companies and profit-seeking HMOs.

In part of "Sicko," released June 29, Moore takes a group of ill 9/11 rescue workers to Cuba for health treatment.2 Though most of the workers on Moore's two-week sojourn in March 2007 were insured,3 Moore's motive in going to Cuba is to showcase the supposed superiority of the communist country's "free" national health care and to compare this to "the misery people are put through on a daily basis by our profit-based system" in the U.S.4 (The Department of Treasury has opened an investigation into whether Moore violated the U.S.'s longstanding embargo of Cuba.)5

As with Moore's previous documentaries, "Sicko" provides a brash handling of public policy disputes. The film's underlying push is to, in Moore's words, "ignite a fire for free, universal health care."6 When this premise is examined, the rosy myth of socialized medicine's achievement in Cuba is crushed.

Cuba's Heath Care System: The Reality

Under the Cuban government's health care monopoly, the state assumes complete control. Private, non-governmental health facilities, where ailing citizens could buy treatment, are illegal.7 As a result, average Cubans suffer long waits at government hospitals, while many services and technologies are available only to the Cuban party elite and foreign "health tourists" who pay with hard currency. Moreover, access to such rudimentary medicines as antibiotics and Aspirin can be limited, and there are reports that citizens excluded from the foreign-only hospitals often must bring their own bed sheets and blankets while in care.8

Despite the reality, Cuba's universal health system continues to be glorified. "Defenders of Cuba's communist government cite universal health care and education as 'gains of the revolution,' claiming the average Cuban is far better off today than under the dictatorship of Fulgencia Batista," wrote Tom Carter of the Washington Times.9 Moreover, "The health care system is often touted by many analysts as one of the Castro government's greatest achievements," says an updated 2002 State Department report, which rejects the notion that Cuba's health conditions have significantly improved for most Cuban citizens since 1958.10

When examining the woeful reality of health care in Cuba, Moore's and other liberals' drive to establish a 'socially equitable,' centrally-planned medical system in America should be rejected as a foolish proposal. Though state-sponsored health care is trumpeted in Cuba as a basic human right achieved by the revolution, according to many reports, including those by Cuban defectors, universal availability of and accessibility to top quality care are fantasies.

Below is a snapshot of reports from those who have witnessed Cuba's health care system up front. They serve notice of the horrors of socialized medicine.

Cuba's Health Care System in Practice

Says Canada's National Post, which assessed Cuba and its health system in a three-part series:

Even the most commonly available pharmaceutical items in the U.S., such as Aspirin and rubbing alcohol, are conspicuously absent [in Cuba]... Antibiotics... are in extremely short supply and available only on the black market. Aspirin can be purchased only at government-run dollar stores, which carry common medications at a huge markup in U.S. dollars... This puts them out of reach of most Cubans, who are paid little and in pesos.11

The same National Post story continues, quoting Jasmin, a nurse from Moron, Cuba, "We have nothing. I haven't seen aspirin in a Cuban store here for more than a year. If you have any pills in your purse, I'll take them. Even if they have passed their expiry date."12

Cuban defector Dr. Leonel Cordova told the New York Times about his experience practicing in Cuba, "[E]ven if I diagnosed something simple like bronchitis... I couldn't write a prescription for antibiotics because there were none."13

Along these lines, Patricia Grogg of the Inter Press Service writes:

[A] survey carried out in pharmacies late last year [in 2000] by the local [Cuban] magazine Bohemia failed to find 211 of the medicines included on the official list of products produced to attend to the health of this Caribbean island nation's population of 11 million... 'They say scarcity of medicine is no longer such a serious problem, but I've been trying for days to buy aspirin in this pharmacy, and they always tell me there isn't any,' complained Mara Dolores Pea, a 60-year-old pensioner, outside her neighborhood pharmacy.14

In addition to a limited supply of medicine, according to a 2005 report in the Boston Globe, Cuban health care workers are in short supply:

A 45-year-old nurse in Camaguey Province said she has worked without a doctor in her primary-care clinic for more than two years since the physician was transferred to another clinic to replace a doctor sent to Venezuela. 'My patients complain every day. They want me to act as a doctor, but I can't,' she said. 'The level of attention isn't the same as before.'15

The nurse is alluding to a program in which one-fifth of Cuba's health care labor supply - some 14,000 doctors and 6,000 health workers - has been contracted out to work in Venezuela. Under a special "oil-for-doctors" exchange between Venezuela's Hugo Chavez and Cuba's Fidel Castro, Venezuelans receive free eye surgery in Cuba. In return for these medical services, Cuba receives 90,000 barrels of discounted oil per day.16

Ordinary Cubans have suffered as a result. "Blackouts, shortages of consumer goods and other problems persist," wrote Gary Marx of the Chicago Tribune.17

Indira A.R. Lakshmanan of the Boston Globe wrote:

The system has suffered setbacks... since the cutoff of Soviet aid some 15 years ago, with hospitals and clinics in need of renovation and equipment, pharmaceutical costs soaring, and patients saying they must bring bedclothes, food and fans to hospitals. But complaints about a lack of medical personnel are new, dating to the cooperation with Venezuela that some observers disparagingly call the oil-for-doctors program.18

Lourdes Garcia-Navarro of National Public Radio reported:

[S]peaking privately... some Cuban patients and doctors say the system has been feeling the strain of treating the Venezuelans in their home country and on the island. Doctors say that there's a shortage of trained specialists. Most Cuban doctors now they say become general physicians and forego specialized training because what is needed in Venezuela are community doctors. Patients in Cuba complain that their hospitals are stretched and they're not getting the same standard of care they're used to.19

Finally, the Chicago Tribute reported in 2005:

At least one nurse involved in the eye operations said Cuban physicians are sacrificing quality for quantity as they hurry to complete as many operations as possible. The nurse said the number of eye operations at her hospital has soared from about 15 to more than 120 daily, and many patients fail to receive important preoperative tests, she said. The surgeries are performed round-the-clock... 'Nobody is in agreement with this, but they say that you have to do it without discussion,' the nurse said. 'The patients are being mistreated.'20

Despite shortages of medicine and care, especially since the exchange agreement with Venezuela, not all Cubans suffer. "In Cuba there exists TWO health care systems,"21 explains U.S. Rep. Ileana Ros-Lehtinen (R-FL), who fled Cuba with her family to the United States when she was seven years old.22 "[O]ne [care system is] for tourists, as well as Communist Party officials, and another for Cubans, who are forced to take with them even the most basic necessities when visiting a Cuban hospital; even aspirins are scarce."23

Reports on therealcuba.com, a privately-run website that contains anecdotes, including ghastly images, of suffering anonymous Cubans cut off from the rich foreign-only facilities. As explained on the website,24 the horrors of socialized medicine are not, in fact, evenly or universally experienced:

Castro has built excellent health facilities for the use of foreigners, who pay with hard currency for those services. Argentinean soccer star Maradona, for example, has traveled several times to Cuba to receive treatment to combat his drug addiction. But Cubans are not even allowed to visit those facilities. Cubans who require medical attention must go to other hospitals that lack the most minimum requirements needed to take care of their patients.25

Are Cuba's health care woes the result of the longstanding U.S. economic embargo? Not a chance, according to a group of 18 exiled Cuban doctors. The doctors made their personal views clear in a joint letter in 1997:

We remain mystified as to why people of ordinarily good will and faith would seek to find fault with the United States for the disastrous situation inside Cuba, while failing to direct the blame squarely where it belongs - at the feet of Fidel Castro, who continues to rule our country with an iron fist after 38 years in power.26

The exiled doctors continued:

We, who have only recently emerged from the belly of the beast, can categorically and authoritatively state that our people's poor health care situation results from a dysfunctional and inhumane economic and political system, exacerbated by the willingness of the regime to divert scarce health resources to meet the needs of the regime's elite and foreign patients who bring hard currency.27

source:/www.nationalcenter.org

articel: Drug coverage expanded for patients to breathe easier, BC

Asthma :: Drug coverage expanded for patients to breathe easier, BC

Patients who experience severe breathing conditions such as chronic bronchitis and emphysema will benefit from PharmaCare coverage for the medication tiotropium, also known as Spiriva, announced Health Minister George Abbott.

“Anyone who has had difficulty breathing knows how terrifying these diseases can be,” said Abbott. “Our government is now adding this additional treatment option to help them breathe easier and improve their quality of life. This medication can give new hope to patients suffering from Chronic Obstructive Pulmonary Disease (COPD) that have not been responsive to other treatments.”

Government worked with respirologists and other B.C health professionals for more than a year to develop criteria to benefit Chronic Obstructive Pulmonary Disease patients.

PharmaCare estimates that initially 6,000 patients may receive coverage for tiotropium at a cost of up to $3 million or more, and the number of patients who benefit from coverage will continue to grow over time.

Approximately 53,000 British Columbians are being treated with drugs for Chronic Obstructive Pulmonary Disease (COPD). Patients with moderate to severe COPD will be eligible for access to tiotropium if treatment with the standard drug therapy is not successful after a three-month trial.

“Making this therapy available is great news for COPD patients and their loved ones,” said Dr. Frank Ervin, president of the BC Thoracic Society. “Patients who suffer from severe COPD will be very grateful to PharmaCare for including this drug in its formulary. Many of these patients will now enjoy a much improved quality of life and be less likely to require emergency treatment for their disease. On behalf of the BC Thoracic Society, I would like to recognize the leadership and vision PharmaCare and the Ministry of Health displayed in this decision."

Physicians can begin to apply for Special Authority coverage of tiotropium (Spiriva) using specialized forms by fax or mail beginning July 3, 2007 for patients who meet the eligibility criteria.

source:www.spiritindia.com

Articel:Written Statement of Joseph T. Rannazzisi Deputy Assistant Administrator

Chairman Scott, Ranking Member Forbes, and distinguished members of the House of Representatives Judiciary Committee, Subcommittee on Crime, Terrorism and Homeland Security, thank you for the opportunity to appear today and discuss and clarify any misapprehensions the Subcommittee may have regarding the role the Drug Enforcement Administration (DEA) plays in enforcing the Combat Methamphetamine Epidemic Act, upholding the Supreme Court decision Ashcroft vs. Raich, supporting cannabis research, and the responsibilities doctors in prescribing scheduled medications.

The Investigation of Methamphetamine Precursor Distribution

Methamphetamine is unique from other illicit drugs of abuse in that it is an easy to make synthetic drug and its precursor chemicals have historically been easy to obtain and inexpensive to purchase. These factors have contributed to methamphetamine’s rapid sweep across our nation. In March 2006, reacting to the devastating impact that the illicit manufacture of methamphetamine was having on our nation, Congress enacted the Combat Methamphetamine Epidemic Act of 2005 (Title VII of the USA PATRIOT Improvement and Reauthorization Act of 2005, P.L. 109-177) or CMEA. Among other things, the Act established a system to monitor and regulate the importation, production, and retail sales of non-prescription ephedrine, pseudoephedrine, and phenylpropanolamine products - common ingredients found in over-the-counter cough, cold, and allergy products. These chemicals and drugs were included in CMEA because they are key precursors used in the illicit manufacture of methamphetamine or amphetamine. This legislation provided law enforcement and regulators with tools invaluable to the containment of the drugs’ production.

As a result of the CMEA, the ability of pseudoephedrine to be sold on the spot market was effectively taken away. These transactions, which were not regulated under prior law, are now treated as new imports or exports and, therefore, subject to 15 day advance notification during which the DEA verifies the legitimacy of each transaction. In addition, the Department of Justice now has the authority to establish production and import quotas for ephedrine, pseudoephedrine, and phenylpropanolamine. These quotas will allow for greater control of precursors that are imported into the United States.

Retail provisions of the CMEA became effective in September 2006 and include self-certification, employee training, product packaging and placement requirements, sales logbooks, and daily and 30-day sales/purchase limits. In order to purchase products containing ephedrine, pseudoephedrine, and phenylpropanolamine, an individual must now show identification and sign a log book at sales locations. Law enforcement is able to monitor these log books in order to identify any person purchasing more than 9 grams within a 30-day period. CMEA also created a national database of self-certification records available to state and local law enforcement agencies to document those retail sales locations that have complied with the requirements of this law. As a testament to the effectiveness of the CMEA (and similar predecessor laws passed by the states), show a 58% decrease in the number of methamphetamine laboratories in 2006 from the previous year. DEA statistics
Additional CMEA provisions include: requiring DEA to conduct an assessment of the annual need of ephedrine, pseudoephedrine, and phenylpropanolamine, establishing production and import limits, requiring DEA be noticed of transfers following importation or exportation of methamphetamine precursor chemicals, and removing previously established sales thresholds, among others.

DEA is committed to keeping our communities safe from the dangers of methamphetamine production and abuse. Preventing the use of these chemicals in clandestine methamphetamine labs and via enforcement of the CMEA is an important element in that effort.

Investigations of Physicians Who Over-Prescribe Scheduled Drugs

The abuse of prescription drugs is a serious and growing health problem in this country. According to the 2005 National Survey on Drug Use and Health, there were more than 6.4 million current non-medical users of psychotherapeutic drugs in the United States - more than the number of Americans abusing cocaine, heroin, hallucinogens, and inhalants, combined. If we look at the people who are just starting out as new drug users, prescription drugs have overtaken marijuana and cocaine as the gateway drug of choice.

One of the goals set forth in this Administration’s 2006 Synthetic Drug Control Strategy is to reduce the abuse, or non-medical use, of prescription drugs by 15 percent over the next three years. Consistent with that end, a primary role of the DEA is to prevent the diversion of pharmaceutical controlled substances while ensuring an adequate supply for legitimate medical and scientific needs.

Diversion of legitimate controlled substances occurs from a number of sources, including, the Internet, pharmacy theft, doctor shopping, prescription forgery, and other means. Unfortunately, a small number of unscrupulous doctors are also illegally supplying those drugs. Although there are very few of them, they can cause tremendous damage. One such doctor in Panama City, Florida, was diverting so many OxyContin pills to abusers and traffickers that after the DEA arrested him, the street price of
OxyContin nearly doubled in the area because of the significantly diminished availability of the drug.

In 2006, there were approximately 750,000 medical doctors and doctors of osteopathic medicine registered with DEA. In any given year, including this past year, less than one in every ten thousand physicians in the United States loses his controlled substance registration based on a DEA investigation for improper prescribing—that is less than .01 percent of all physicians. And far fewer of those physicians are criminally prosecuted for improper prescribing.

The longstanding requirement under the law that physicians may prescribe controlled substances only for legitimate medical purposes in the usual course of professional practice should in no way interfere with the legitimate practice of medicine or cause any physician to be reluctant to provide legitimate treatment. And the DEA’s responsibility to enforce the law does not diminish our firm commitment to the balanced policy of promoting pain relief and preventing the abuse of pain medications. To help physicians meet the challenge of ensuring that people who medically need drugs get them, and that those who are diverting them don’t, the DEA has developed several initiatives since last fall.

On September 6, 2006, we published in the Federal Register Dispensing Controlled Substances for the Treatment of Pain, a policy statement that reiterated the requirements of the Controlled Substances Act and the physician’s long-standing responsibility to take reasonable steps to prevent diversion. The DEA also published a Notice of Proposed Rulemaking, which proposes to amend the DEA regulations to permit doctors to issue multiple Schedule II prescriptions during a single office visit, allowing patients to receive up to a 90-day supply of controlled substances according to the fill date that the doctor gives the pharmacist.

The DEA also launched a new section on its website to provide everyone with the facts on investigations against doctors who violate federal drug laws. It’s called “Cases Against Doctors.” So far, DEA has had more than 86,000 hits to the site. DEA created this site to provide the public with information about the scope of violations that cause DEA to investigate doctors.

In addition, the DEA also updated (and posted on its website) its Practitioner’s Manual to aid doctors with their responsibility to take reasonable steps to prevent diversion and abuse. Before it finalized the Practitioner’s Manual, the DEA asked a number of doctors to review its updates to the earlier 1990 edition, and they found the new edition helpful in understanding their legal obligations in prescribing drugs.

The DEA agrees that doctors can and should prescribe controlled substances under legitimate medical standards to treat patients in pain. The DEA knows that doctors overwhelmingly agree with what Congress mandates it do: enforce our nation’s laws to ensure drugs are used only for the health and welfare of the public.

Cannabis Research

Approval to conduct clinical research involving Schedule I substances in the United States is a joint process involving both the DEA and the Food and Drug Administration (FDA). Clinical studies of a substance for use as a drug must be performed by well qualified applicants who meet the most rigorous of standards in order to conduct bona fide research.

Following the procedures described in Title 21 of the Code of Federal Regulations, new applicants submit their applications to the DEA with research protocols and individual qualifications (typically a resume or curriculum vitae). The DEA is responsible for evaluating whether effective measures to adequately safeguard against diversion are in place as well as assessing factors relating to public interest (See 21 U.S.C. 811(b)). After a preliminary review to ensure completeness of the application and accompanying material, the application package is sent to the Controlled Substances Staff of the FDA and the DEA field office in the area of the proposed research. FDA’s role is to determine the qualifications and competency of the applicant, as well as the merits of the protocol. The DEA field office conducts an on-site, pre-registrant investigation, including a personal interview with the applicant, to ensure that security is adequate to prevent diversion or abuse of the controlled substance.
Upon receipt of favorable reports from both the FDA and the DEA field office, a certificate of registration is issued to the researcher. No research with a Schedule I controlled substance can be initiated until the DEA approves the application and a Schedule I research registration is assigned. The DEA has never denied an application to a researcher when FDA has determined that the qualifications and merits of the applicant (as well as of the research proposed) are acceptable, and that adequate security measures are in place.

At present 110 researchers are registered to perform studies within the drug category which includes marijuana, marijuana extracts and non-tetrahydrocannabinol marijuana derivatives that exist in the plant, such as cannabidiol and cannabinol. These studies include evaluation of abuse potential, physical/psychological effects, adverse effects, therapeutic potential, and detection. Nineteen researchers are currently approved to conduct research with smoked marijuana on human subjects.

Enforcing Federal Law in Light of Claims that Marijuana is “Medicine"

Marijuana is a Schedule I substance under Title 21 of the United States Code. As defined by law, a Schedule I substance is one that has no currently accepted medical use in treatment in the United States, no accepted safety for use under medical supervision and a high potential for abuse. Along with marijuana, other Schedule I controlled substances include heroin and LSD.

Under the Controlled Substances Act (CSA), DEA is required to act in consultation with the FDA in determining whether a controlled substance has a currently accepted medical use. Under the Federal Food, Drug, and Cosmetic Act (FDCA), it is unlawful to market a new drug in the United States unless FDA approves the drug as being both safe and effective for the treatment of disease or condition. To date, FDA has not found marijuana to be safe and effective for the treatment of any disease or condition. Given the absence of sound scientific evidence establishing that marijuana can be used safely and effectively as medicine, it remains a Schedule I controlled substance under the CSA and illegal under the FDCA to market as a drug. Reviews of the scientific evidence can be triggered by an application to the FDA for approval of marketing of a new drug, or for the new formulation of an existing drug. Reviews can also be triggered by rescheduling petition requests filed with the DEA.

DEA's efforts to enforce Federal law surrounding the possession and trafficking of marijuana have been hampered by the passage of laws in several states which inhibit State and local law enforcement from acting against individuals and organizations selling marijuana under the pretence that it has medicinal value.

Law enforcement has seen a growing list of ailments used by dealers, patients and physicians to justify smoking marijuana. It has become so exhaustive that anyone could claim “a medical need”. That list includes ADD, headaches, arthritis, PMS, IBS, hepatitis, renal failure, hypertension, anxiety, depression, post-traumatic stress disorder, insomnia, paranoia, bipolar affective disorder, alcoholism, cocaine and amphetamine addiction, epilepsy, bronchitis, emphysema, osteoporosis, degenerative disc disease, polio, ulcers, stuttering, seizures, color blindness and various types of pain. In a USA Today article on March 8, 2007, Scott Imler, who co-wrote the California “medical” marijuana initiative in 1995 said, “What we set out to do was put something in the statutes that said medicine was a defense in case they got arrested using marijuana for medical reasons. What we got was a whole different thing, a big new industry.” Imler added “I was pretty naïve, I thought people would act in good faith.” Anecdotal information and data have suggested in Los Angeles the significant likelihood that the marijuana as medicine dispensaries affect crime in adjacent communities.

The authority of DEA to investigate those growing, selling, and possessing marijuana, irrespective of State law, was confirmed by recent rulings by the Supreme Court. In United States v. Oakland Cannabis Buyers' Cooperative, the Supreme Court held that the Controlled Substances Act contains no exception permitting the distribution of marijuana on the basis of “medical necessity.” In Gonzales v. Raich, the Court stated that Congress’s Commerce Clause authority includes the power to prohibit the intrastate and noncommercial manufacture and possession of marijuana for claimed medical purposes pursuant to state law and concluded that, “Congress had a rational basis for believing that failure to regulate the intrastate manufacture and possession of marijuana would leave a gaping hole in the Controlled Substances Act.” These two cases made clear that Federal law prohibiting the manufacture, distribution, and possession of marijuana applies regardless of whether the person engaging in such activity claims to have a "medical necessity,” claims to be acting in accordance with state law, or claims to be acting in a wholly intrastate manner. Thus, DEA remains constitutionally obligated to enforce the Controlled Substances Act in all circumstances.

The DEA’s role is one of enforcement. It is, after all, our middle name. We will continue to enforce the law as it stands and to investigate, indict, and arrest those who use the color of state law to possess and sell marijuana.

Conclusion

The Drug Enforcement Administration is a single mission agency. Our role is to enforce the provisions of the Controlled Substances Act, which is considered by Congress to be in the best interests of the people of this nation. The DEA does not discriminate in the application of the law, nor does it interpret the law’s intent, a function left appropriately to the courts. The DEA applies the law to law breakers. Among other things, it does so through the Combat Methamphetamine Epidemic Act to prevent the spread of the bill’s namesake drug, through the carefully application of its regulatory obligations or by investigating those who would use the color of state law to traffic in marijuana.

I thank you for the opportunity to testify here today, and would welcome any questions the Subcommittee might have.

source:www.thesop.org

Articel: Increasing Patient Population Ensuring the Growth of the U.S. Chronic Obstructive Pulmonary Disease Market

The U.S chronic obstructive pulmonary disease or COPD market has seen significant expansion in recent times, largely as a result of the rising number of both current and former smokers. Growth in the older age segments of the population and increased screening for the disease are also contributing factors, but patient non-compliance remains a critical issue as current treatment options are complicated and burdensome. Novel products requiring lower dosage amounts have the potential to address compliance issues, while also opening up new opportunities in the market.

New analysis from Frost & Sullivan (pharmaceuticals.frost.com), U.S. COPD: Therapeutic Overview and Patient Outlook, provides an overview and patient forecasts for COPD, chronic bronchitis, and emphysema in the United States from 2003 to 2013.

If you are interested in a virtual brochure, which provides manufacturers, end users, and other industry participants an overview of the latest analysis of the U.S. COPD: Therapeutic Overview and Patient Outlook, then send an email to Melina Trevino - Corporate Communications at melina.trevino[.]frost.com with the following information: your full name, company name, title, telephone number, email address, city, state, and country. We will send you the information via email upon receipt of the above information.

“Smoking is the prime cause of COPD and high incidences of smoking are driving COPD prevalence rates in the United States,” notes Frost & Sullivan Research Analyst Katheryn Symank.” Smoking rates have leveled off after declining steadily since 1997. This has the potential to positively impact revenues by expanding the COPD patient population”.

Medical figures indicate that almost 80 to 90 percent of COPD patients are either current smokers or those that have given up the habit. With an estimated 45.0 million current smokers and 45.9 million former smokers in the United States, the COPD patient population is almost certain to expand in the years to come. This could increase the number of people requiring treatment for the disease and subsequently maintain positive revenue growth.

However, the high rate of patient noncompliance is a critical challenge for the U.S. COPD market, hindering its expansion. Patients often find that their treatment regimens are demanding and difficult to follow because they involve several different medications that must be taken multiple times per day. Due to this, they frequently end up taking their medications less frequently or stop taking them altogether. All the more, medications used to treat COPD come with side effects which often discourage patients from long term use of these products.

“While it is estimated that the prescription compliance rate for COPD patients is under 50 percent, many experts believe that actual compliance rates are much lower,” says Symank. “For example, in The Lung Health Study, it was determined that for bronchodilators, compliance as measured by canister weight was actually 10 percent lower then reported compliance rates. Another study found that compliance rates for patient use of inhaled corticosteroids were as low as 18 percent.”

The development of new products that require less frequent dosing could provide new treatment options that could increase patient compliance. Additionally, such products could also create new growth opportunities companies while expanding the overall market.

U.S. COPD: Therapeutic Overview and Patient Outlook is part of the Pharmaceuticals and Biotechnology Growth Partnership Service, which also includes research in the following: U.S. Generic Pharmaceuticals Market Outlook, U.S. Multiple Myeloma Market, and U.S. Opioid and Non-opioid Pain Management Pharmaceuticals Market. All research included in subscriptions provide detailed market opportunities and industry trends that have been evaluated following extensive interviews with market participants. Interviews with the press are available.

About Frost & Sullivan
Frost & Sullivan, a global growth consulting company, has been partnering with clients to support the development of innovative strategies for more than 40 years. The company's industry expertise integrates growth consulting, growth partnership services, and corporate management training to identify and develop opportunities. Frost & Sullivan serves an extensive clientele that includes Global 1000 companies, emerging companies, and the investment community by providing comprehensive industry coverage that reflects a unique global perspective, and combines ongoing analysis of markets, technologies, econometrics, and demographics.


source:www.newswiretoday.com

Bar workers suffer from customer smoking

Health officials in Oregon say people absorb notable levels of the carcinogen NNK after spending just a few hours in a smoky bar or tavern.

The study, funded by the Robert Wood Johnson Foundation, looked at 52 non-smokers working in 39 different Oregon bars or restaurants that allow smoking.

"Even within a brief work shift, we can see increasing levels of this potent lung carcinogen," lead author Michael Stark, a Multnomah County Health Department employee, told The Oregonian newspaper.

The chemical NNK is known to cause a kind of lung tumor seen in smokers and in non-smokers who live or work with people who smoke, the newspaper said.

Employees of businesses that allowed smoking were almost six times more likely to have detectable levels of the carcinogen in their urine. The levels increased about 6 percent for every hour they were at work, Stark said.

source;www.sciencedaily.com

New drug coverage for bronchitis and emphysema sufferers

Chronic bronchitis and emphysema suffers can now benefit from drug coverage announced by B.C. Health Minister George Abbott today.

B.C. PharmaCare coverage is now in place medication tiotropium, also known as Spiriva.

"Anyone who has had difficulty breathing knows how terrifying these diseases can be," said Abbott. "Our government is now adding this additional treatment option to help them breathe easier and improve their quality of life."
The medication is expected to help patients suffering from Chronic Obstructive Pulmonary Disease (COPD) that have not been responsive to other treatments, Abbott explained in a news release.

Dr. Frank Ervin, president of the BC Thoracic Society, said the announcement is great news for COPD sufferers.

"Many of these patients will now enjoy a much improved quality of life and be less likely to require emergency treatment for their disease," Ervin said.

According to the B.C. Health Ministry, government worked with respirologists and other B.C health professionals for more than a year to develop eligibility criteria for the drug.

About 53,000 British Columbians are currently being treated with drugs for COPD. Those with moderate to severe symptoms will be eligible for the newly covered drug if standard drug therapy is shown not to work after three months.

PharmaCare estimates initially about 6,000 patients could receive coverage for tiotropium - a number expected to grow over time - at a cost of up to $3 million or more.

As of today physicians can apply for Special Authority coverage of tiotropium for patients who meet PharmaCare's criteria.

source:www.canada.com

Oscient reports preliminary 2q revenues

said today that it expects to report second-quarter revenue in the range of $15 million to $16 million.

In issuing preliminary results, the Waltham biopharmaceutical company said that range would compare with $4.6 million in revenues for its second quarter in 2006.

Last August, Oscient acquired the US rights to Antara, a cholesterol drug, which is expected to account for about $14 million in second-quarter 2007 revenues for Oscient, the company said.

Oscient also sells Factive, a treatment for certain types of bronchitis and pneumonia; Factive is expected to generate about $1.5 million in second-quarter 2007 revenues, the company said.

The AP reported that, on average, analysts surveyed by Thomson Financial had expected Oscient's second-quarter revenue to be $17.4 million.

source:www.boston.com

Common sense best remedy for respiratory issues

This is the third in a summer series on sports-related illnesses and injuries that affect scholastic and youth athletes.
It isn't uncommon for athletes to play despite suffering from asthma or, more particularly, exercise-induced asthma.

Those conditions are aggravated even more while playing an outdoor sport.

Managing asthmatic conditions is critical to being successful on the athletic fields, and not paying attention to the symptoms could be harmful and compound the problems.

As much of a problem as asthma can cause an athlete, few people realize it may be secondary to an ailment that gets far less concern, the common cold.

As simple as it might seem and as lightly an ailment as it is regarded, a cold or nasal congestion, whether caused by dust or allergies or whatever, could lead to greater difficulties that would surely diminish an athlete's performance level.

Dr. Michael Pardo, an Annapolis native and ear, nose and throat specialist on staff at the Anne Arundel Medical Center, assured that he can't stress enough the need for athletes, parents and coaches, the need for common sense when dealing with congestion.

"Pediatricians are more on the front line of dealing with asthma in kids in sports when they give physicals, but exercise induced asthma is a big problem … you have kids who have to use their inhalers and …

"But what also triggers that is their allergies during the outdoor seasons. If they're out there during the grass season, the summer, or when there's tree pollen, the spring, or when there are weeds, the fall, their allergies are aggravated," Pardo explained.

"Then they're sneezing and congested and their allergies lead to sinus infections and the more upper respiratory track infection you have, the more lower respiratory track infection you'll have," he said. "That's the biggest problem with colds: Once you get upper respiratory track infection it starts to affect your lower airways and your breathing."

He explained that if an athletes has exercise-induced asthma and he or she gets upper respiratory track infections the lower respiratory track becomes more agitated and the symptoms are exacerbated and breathing is affected.

Pardo leaned on his own lacrosse experience to recall that some players with exercise-induced asthma would often run to the sideline to use their inhalers but he doesn't remember any of them ever stopping or leaving the games.

"It's so hard to get kids to stop playing. It's hard to convince them that they might be having a problem from their asthma," he continued. "They want to play all the time so you have to be aggressive in treating their asthma and their allergies.

"The best way to monitor a kid with asthma is with a peak flow meter, which is a device you breathe into that takes the guesswork out of what's going on with someone's breathing. You don't have to judge for yourself how bad your asthma may be, the peak flow meter will tell you," Pardo said.

"You know when you're getting into the danger range because the peak flow meter tells you how your lung capacity is being affected," he explained. "You might say you're fine, but if you blow into the device and you're supposed to hit 300 but you only hit 100, you know you're in trouble.

"One of the things is that kids won't recognize problems like these by themselves because they want to play no matter what," Pardo said. "They may not realize that their athletic performance is being hindered and they'll play through it."

Certified athletic trainers would be educated enough to recognize such a problem but there are few schools that have trainers at practices or games. Another problem is that few asthmatics have peak flow meters at the fields with them.

Coaches aren't likely to recognize asthmatic or other respiratory symptoms, because they have a great deal to do and are working with a full team of youngsters, but it would be wise for them to learn a little bit about such problems. With that in mind, it behooves the parents of youngsters with asthma or other respiratory ailments to be vigilant during practices or games.

"It's got to be a parent who recognizes that if their kid has asthma is running around with a cold or a sinus infection they have to be concerned that the asthma will also be triggered or worsened by it," Pardo said. "Parent recognition is a key.

"However, there's no stopping kids from catching colds and for a kid who has asthma or allergies the cold tends to worsen things. It's all connected," Pardo said.

"Obviously, if a kid with asthma starts getting sick, getting sinus infections, run around coughing or are congested should be a tip-off for a coach that a kid is going to get worse," said Pardo. "Asthma can become crippling if a sinus infection starts kicking in.

"Almost anything can aggravate asthma; allergies, dirt, dust. If it's something that irritates a cold it makes the asthma worse," Pardo said. "There are lots of things out there that we call different things, but in the end they are all inflammation of the upper or lower airways."

He implied that it's paramount for parents to use common sense when it comes whether or not to allow their youngsters to participate in practices or play in games when they have a cold. If an athlete has chills, fever or bronchitis, they should not be playing.

Pardo explained that the common cold will run its course in five to seven days. If it goes beyond that, athletes should be more careful because it could manifest itself into a sinus infection to bronchitis to pneumonia, which would force the youngsters to sit out for two weeks or more.

"A lot of times an athletes will say he feels better when he's running or exercising, that their nasal congestion actually improves. During that time they may be clear but when they stop they'll congested again and when you get congested and your sinus passage gets blocked with mucous it can get infected," Pardo said.

He pointed out that such infections can become more serious to the point of contracting a Methicillin-Resistant Staphylococcus Aurous (MRSA) type infection.

While asthma can be controlled with inhalers and the like, the common cold is something that can become something worse and at that point athletes do have to take breaks. If a cold lingers beyond seven to 10 days it has done exactly that and the athlete has to be kept off the field.

"If you allow a common cold to progress to a sinus infection that could make you feel miserable it could take a month to get better and performance will be way down," Pardo said.

"The sinus infection, which includes headache, facial pressure, nasal congestion, thickened mucus, coughing that can cause fatigue, and that can turn into bronchitis and the bronchitis can turn into pneumonia and then you're in trouble," he explained.

The responsibility of keeping an athlete from becoming more ill falls mostly on parents. Practicing or competing with a common cold may not seem extreme, but there is a definite need for the athletes to be watched to be sure it runs its course and doesn't manifest itself to a worse illness.

soucce:www.hometownannapolis.com

Insight into the Pipeline Status of Bronchitis Drugs by Company and by Stage

Respiratory and Pulmonary System - Bronchitis Drug Pipeline Report" contains detailed information on the current drug pipeline. This report provides insight into the pipeline status of bronchitis drugs by company and by stage as well as a summary of the latest news and developments in this area.

Scope of the report:

- Each Therapy Area Pipeline Report provides the user with real detail on drug pipelines, by company and by stage, for each specific therapy area. The latest news, by company, also ensures that each report is fresh and up-to-date.

- In addition to new developments and disease specific pipeline projects, each report also contains extensive information in tabular format on a company’s full product pipeline and products by phase of development with regard to the therapy area.

- Full pipeline details, by stage, are provided and include detailed product descriptions, information on partnering activity plus clinical trial intelligence. Each Therapy Area Pipeline Report also provides detail on the top 20 companies with products in the early stage of development and the top 20 companies with products in the late stage of development. Finally, each report also provides a comparison with other major indications in the disease hub based on Marketed Products vs. Pipeline Products.

Key benefits

- Understand a company’s strategic position by accessing detailed independent intelligence on its product pipeline for specific therapy areas.

- Keep track of your competitors and partners by better understanding their product pipeline.

- Monitor a company’s research effectiveness by determining pipeline depth and number of products in development by clinical phase for specific disease areas.

- Maintain a critical competitive advantage.

source:home.businesswire.com

Bronchitis Overview

Bronchitis generally refers to an acute inflammation of the air passages within your lungs. It occurs when your trachea (windpipe) and the large and small bronchi (airways) in your lungs become inflamed because of infection or other causes.

* The thin mucous lining of these airways can become irritated and swollen.

* The cells that make up this lining may leak fluids in response to the inflammation.

* Coughing is a reflex that works to clear secretions from your lungs. Often the discomfort of a severe cough leads you to seek medical treatment.

* Both adults and children can get bronchitis. Symptoms are similar for both.

* Infants usually get bronchiolitis, which involves the smaller airways and causes symptoms similar to asthma.


source:www.emedicinehealth.com

Moxifloxacin Favourable for Patients with Chronic Bronchitis: Presented at ATS

Moxifloxacin antibiotic is safe and effective for treating frequent acute exacerbation of chronic bronchitis, researchers reported at the American Thoracic Society 2007 International Conference (ATS), after results were analysed from the Greatest International Antibiotic Trial (GIANT).

GIANT is a prospective, worldwide study that is evaluating the impact of acute exacerbations of chronic bronchitis in outpatients and the safety and effectiveness of daily use of moxifloxacin tablets in approximately 50,000 patients from Europe, Latin America, and Asia.

More than 75% of physicians from Europe and Asia rate moxifloxacin treatment for acute exacerbation of chronic bronchitis to be better than previously used therapies, reported Antonio Anzueto, MD, in his poster presentation comparing interim results from Europe and Asia. In addition, physicians from both regions find moxifloxacin efficacy to be "good or very good."

Approximately 95% of patients from both geographical areas "are satisfied or very satisfied with the therapeutic effect of moxifloxacin therapy."

Patient quality of life can deteriorate with frequent acute exacerbation of chronic bronchitis because the symptoms of excess sputum production, fever, cough, shortness of breath, chest discomfort, fatigue, and sleep disturbance can last for weeks.

European and Asian patient participation in GIANT numbered 9,157 and 22,756, respectively, and patient information, such as length of last chronic bronchitis exacerbation, quality of life, and antibiotic treatment, were reviewed over 12 months.

Additional findings from the interim study are that European patients tend to be older and have had acute exacerbation of chronic bronchitis for a longer time period than Asian-Pacific patients. Also, compared to Asian-Pacific women, a greater percentage of European women not only suffer from acute exacerbation of chronic bronchitis, but also seek treatment from a physician. The greater percent of European women having chronic bronchitis is believed to originate from past smoking.
source:www.docguide.com

Cancer, bronchitis

Once considered rare diseases, Lung Cancer and Chronic Bronchitis have increased manifold in Kashmir with doctors attributing the growing number of patients to cigarette and hookah smoking.
Dr Showkat Zargar the head department of Gastroenterology at Sher-e-Kashmir Institute of Medical Sciences (SKIMS) Soura said, “We receive 200 to 300 patients suffering from Lung Cancer every year.
Dr Zargar told Greater Kashmir that Lung Cancer has become the third common cancer in the Valley after caners of food pipe and stomach. Dr Zargar was speaking at a seminar “Hazards of Smoking” organised by the NSS wing of Government Women College M A Road here Thursday to observe “World No Tobacco Day.”
“The cases of Lung Cancer have shown a steep increase as the number of cigarette and hookah smokers have increased tremendously,” the senior doctor said. The disease, Dr Showkat said was very rare in 1980s. “Twenty years back the doctors rarely would come across any patient suffering from Lung Cancer, but the disease is now predominantly seen in males smoking cigarettes,” Dr Showkat said.
Dr Zargar said the cases of Chronic Bronchitis have also increased. “Thousands of patients suffering from chronic bronchitis also known as Chronic Obstructive Pulmonary Diseases (COPD) visit SKIMS during the winter to receive treatment as they suffer from recurrent cough and difficulty in breathing,” Dr Showkat said.
The chronic bronchitis is a disease fully related with smoking. “Many women smoking hookah also suffer from COPD. They are administered oxygen as they suffer from breathlessness,” he said.
Smoking cigarettes also causes other type of cancers including throat, colon, rectum, prostrate, urinary bladder and pancreas. “About 25 per cent of the deaths related to heart diseases are caused by smoking cigarettes,” Dr Showkat said. According to the gastroenterologist, about 4.8 million deaths were recorded due to smoking of which 75 per cent were men and the rest women. “If the trend continues, the number of deaths due to smoking related illness will double in 2010,” he said. While quoting a survey conducted worldwide, the gastroenterologist said the number of women smoking cigarettes has shown increase in year 2006.
The gastroenterologist cautioned passive smokers saying the people especially women sitting beside a smoker are at a higher risk of suffering from cancer.
Dr Zargar said the ban on cigarette smoking in public places has not been enforced. “The government has passed the legislation banning cigarette smoking in public places, but the smokers are seen puffing cigarettes in hospitals, buses, meeting rooms and offices and have turned them into smoke houses,” he said.
source:www.greaterkashmir.com

bronchitis

Earlier Initiation of Tamiflu(R) Treatment Improves Clinical Benefits for Children With Influenza
New Data Presented Today Show Benefits of Early Treatment in Reducing Illness Duration, Symptom Severity & Secondary Complications
A new retrospective analysis of a pivotal pediatric study indicates that earlier initiation of treatment with Tamiflu(R) (oseltamivir phosphate) is associated with greater reduction in illness duration, symptom severity and secondary complications in children with influenza.(1) According to the data, treatment initiated within 24 hours of symptom onset provides clinically meaningful improvements, compared with treatment initiated within 24 - 48 hours. Tamiflu, the leading prescription antiviral flu medication, is indicated for the prevention and treatment of influenza types A and B in patients one year and older.

Researchers at Roche, which makes Tamiflu, collaborated with researchers at the University of Alabama (Birmingham) and Primary Physicians Research in Pittsburgh to conduct additional analysis of data from an earlier study, "Oral Oseltamivir Treatment in Children," to explore the impact of time-to-treatment initiation. The new findings were presented today at the Options for the Control of Influenza VI conference in Toronto during the "Clinical Guidance and Policies" workshop.

"Children bear a disproportionately high burden of influenza and are at particular risk of flu-related complications," said Regina Dutkowski, PhD, Clinical Director at Roche, who presented the data. "There is a crucial 48 hour window of opportunity to initiate antiviral therapy, and this analysis further underscores the importance of treating influenza in children at the first sign of symptoms."

Key Findings

The analysis showed that early initiation of treatment (within 24 hours of symptom onset) was associated with more marked treatment effects when compared with later initiation (24 - 48 hours) for several parameters. Children treated with Tamiflu within 24 hours of symptom onset had a 34.5 percent reduction in duration of illness versus placebo, compared to a 19.3 percent reduction over placebo in the group treated later. Children treated within 24 hours also showed a more pronounced reduction of fever duration versus placebo and were 54.2 percent less likely to develop otitis media (ear infection).

While the beneficial effects of Tamiflu treatment over placebo were observed in all analyses, the impact on time to return to normal health (34.2 percent in the <24 hours group vs. 37.8 percent in the 'greater than or equal to' 24 hours group) and the overall incidence of influenza-associated complications (37.9 percent in the <24 hours group vs. 40.7 percent in the 'greater than or equal to' 24 hours group) was less clear.
Flu's Impact on Children

Influenza is a serious illness that affects up to 40 million Americans every year, leading to approximately 200,000 hospitalizations and 36,000 deaths.(3) Research indicates that children are especially vulnerable to influenza and its complications. On average, one in three children in the U.S. is affected by influenza annually.(4) Children are also two to three times more likely than adults to get sick with the flu, according to the National Institute for Allergies and Infectious Diseases (NIAID).(5)

Additionally, children represent one of the most important links in influenza transmission.(6) Experts believe that compared with adults, children do not have as much natural immunity to influenza because they have had less lifetime exposure. Close contact with each other in school, home and daycare settings increases children's risk of getting and spreading the virus.

Role of Antiviral Medications

Prescription antiviral medications like Tamiflu are an important complement to vaccines in the prevention of seasonal influenza. In addition, antiviral medications play a unique role in the treatment of influenza by reducing the duration of illness.

Tamiflu belongs to a class of antiviral medicines called neuraminidase inhibitors (NAI), which help prevent the flu virus from spreading inside the body. Virtually all common flu viruses have the neuraminidase protein on their surface, which enables them to migrate from cell to cell, replicating and spreading throughout the body. Inhibiting the neuraminidase activity is believed to interfere with this process, possibly causing the viruses to become trapped and die out. Tamiflu is given orally and is systemically absorbed, meaning that it can reach all key sites in the body where the virus multiplies.

When taken within 48 hours of symptom onset, research shows Tamiflu can reduce duration of illness by 1.3 days. Clinical trials also indicate that Tamiflu is up to 89 percent effective in preventing flu when taken within 48 hours of exposure.

About Tamiflu

Tamiflu, co-developed by Gilead Sciences, Inc., based in Foster City, CA, is a systemic treatment for the most common strains of influenza (types A and B). Tamiflu is indicated for the treatment of uncomplicated influenza caused by viruses types A and B in patients one year and older who have had flu symptoms for no more than two days. Tamiflu is also indicated for the prevention of influenza in patients one year and older. Tamiflu is not a substitute for annual early vaccination as recommended by the Centers for Disease Control and Prevention.

Tamiflu has not been shown to be effective against any illness other than that caused by influenza types A and B. Efficacy of treatment in patients with chronic cardiac and/or respiratory disease has not been established. No difference in the incidence of complications was seen between the treatment and placebo groups in this population. No information is available regarding treatment of influenza in patients at imminent risk of requiring hospitalization. Efficacy of Tamiflu has not been established in immunocompromised patients.

Safety and efficacy of repeated treatment or prophylaxis courses have not been studied. In post-marketing experience, rare cases of anaphylaxis and serious skin reactions, including toxic epidermal necrolysis, Stevens-Johnson syndrome and erythema multiforme, have been reported.

There have been postmarketing reports (mostly from Japan) of self-injury and delirium with the use of Tamiflu in patients with influenza. The reports were primarily among children. The relative contribution of the drug to these events is not known. Patients with influenza should be closely monitored for signs of abnormal behavior throughout the treatment period.

In treatment studies in adult patients, the most frequently reported adverse events (incidence greater than or equal to 1%) were nausea and vomiting. Other events reported numerically more frequently in patients taking Tamiflu compared with placebo were bronchitis, insomnia and vertigo. In treatment studies in patients one to 12 years old, the most frequently reported adverse event (incidence greater than or equal to 1%) was vomiting (15%). Other events reported more frequently in patients taking Tamiflu compared with placebo included abdominal pain (5% vs. 4%), nosebleed (3% vs. 3%), ear disorder (2% vs. 1%) and pink eye (1% vs. <1%).

In prophylaxis studies in adult patients, adverse events were similar to those seen in the treatment studies. Events reported more frequently in patients taking Tamiflu compared with placebo (incidence greater than or equal to 1%) were nausea (7% vs. 3%), vomiting (2% vs. 1%), diarrhea (3% vs. 2%), abdominal pain (2% vs. 1%), dizziness (1% vs. 1%), headache (18% vs. 18%) and insomnia (1% vs. 1%). In a household prophylaxis trial that included patients one to 12 years old, adverse events were similar to those observed in pediatric treatment studies, with GI events being the most common.

The concurrent use of Tamiflu and live attenuated influenza vaccine (LAIV) intranasal has not been evaluated. However, due to the possibility for interference between these products, LAIV should not be given within 2 weeks before or 48 hours after taking Tamiflu, unless it is deemed appropriate by your doctor. Trivalent inactivated influenza vaccine can be administered at any time relative to use of Tamiflu.

Tamiflu is available for the treatment of influenza in more than 80 countries worldwide.
source:sev.prnewswire.com

Soprano Isabel Bayrakdarian, Stricken with Bronchitis, Cancels This Week's Concerts

Isabel Bayrakdarian, a young Canadian soprano well on her way to stardom at such houses as the Metropolitan Opera and Lyric Opera of Chicago, contracted bronchitis early this week and withdrew from her scheduled performances.

This should have been a big week for her. On Tuesday and Wednesday (June 5-6), she was to have given the Midwest premiere of Jake Heggie's one-act opera To Hell and Back, with Broadway diva Patti LuPone and the Philharmonia Baroque Orchestra, at the Ravinia Festival just north of Chicago. The work was commissioned by the PBO and written for Bayrakdarian and LuPone.

Filling in at Ravinia was young soprano Marnie Breckenridge, whom the Chicago Sun-Times described as "ethereal ... Her voice shone as she sang of the wildflowers she had gathered for her wedding bouquet."

Tonight Bayrakdarian was to join nine other Canadian singers, including sopranos Adrianne Pieczonka and Sondra Radvanovsky, tenor Richard Margison and baritone Russell Braun, for "Luna," an gala evening of opera arias and ensembles planned as one of the highlights of the inaugural Luminato festival in Toronto.

As happens every so often in the opera world, one singer's illness is another's big opportunity: filling in for Bayrakdarian tonight will be Marianne Fiset, who just carried off five prizes last week at the Concours international musical de Montréal.
source:www.playbillarts.com