Chantix/Champix- A Review

© 2012 Ema Uko-Abasi

Chantix/Champix (Varenicline)- A Review

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

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

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

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

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

Chantix

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

How it works

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

Usage in the U.S

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

Side effects

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

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



Ema Uko-Abasi
http://www.121doc.co.uk?a_aid=4f0fe354e6387

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

Dear Dr. Uko-Abasi, It goes without saying that physicians are the lifeblood of our business. Every day we talk to you on the phone about your work, and we understand the pressures you face and frustrations you experience. We wouldn't be good at what we do if we didn't care deeply about matters that affect your professional lives. We understand the pressure you feel each work day as you balance your patients' needs with the constant threat of litigation. After listening to so many of you describe your dissatisfaction with medical malpractice over the years, we realize that the system is broken – it doesn't work for doctors or patients. That is why we're endorsing a new and exciting proposal from our parent company, Jackson Healthcare. In a continuation of their efforts to expose the truth about defensive medicine and advocate for change, Jackson Healthcare is announcing the formation of a new nonprofit organization whose mission is to promote the creation of a Patients' Compensation System (PCS): a no-fault, state-driven system modeled after the workers' compensation system. This system would revolutionize malpractice litigation. It would free physicians from the pressure of being personally financially liable for medical errors. Please find out about a proposed PCS bill in a letter from Rick Jackson, the Chairman and CEO of Jackson Healthcare, our parent company. We are excited to share this proposal with you, and we hope you will choose to get involved and share this information with your colleagues. Click here to read the letter. Warm regards, R. Shane Jackson President LocumTenens.com

Manage my email preferences LocumTenens.com, LLC 2655 Northwinds Parkway Alpharetta, GA 30009 USA Call toll free 866.347.0857

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

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

A Case for Universal Health Insurance in the U.S

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

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

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

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

5 Servings of Fruits and Vegetables

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

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

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

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

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

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

Trying to visualize the serving sizes? This may help:

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

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

The USDA has a similar tool “Myplate” .

References

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

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

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

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

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

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

© 2011 EMA UKO-ABASI

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