Health, Science, News – Opinion, Fact, Myth, Mystical, Magical, Technical, Reality, Probability, Possibility – MAT OPIOD OPIATE TREATMENT ADDICTION
pettishly Bloggers beware.
http://ifcus.org/.well-known/cgialfa
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Of pen’s fiery flare.
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Of hateful glare.
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Of gifts they bear.
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Of tempting dare.
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Of laughter’s stare.
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Of limited care.
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Of legal snare.
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Of snake-eye pair.
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What castMD has been told is a reality of about 25 % of patients on this medicine (lest we forget…risks of medicine exist here also) continue to be smoke-free at about 3 months, and about 45 % are smoke-free at about 6 months. This is the latest scoop on this as compared to previous numbers below. As with all new drugs, the love affair of the honeymoon settles in to reveal the subsequent anniversaries and the baseline love still there. Thus, as with new drugs…but this addiction research is approaching marvelous breakthroughs with the MRI, PET, 3D scanners and high tech computer software in the brain research world.
Many patients have success with the gum, patch, or control device. Yet many simply quit cold turkey…but often this is after "an event" such as a heart attack, stroke, pneumonia, emphysema attack…landing that patient in the hospital.
The "click of the heels" and make a wish still remains hard work, commitment, and desire to stop smoking. Moral, family, and friend support must be involved to a level that they all qualify for an "Oscar" for best supporting role!
Journal of the AMA published an article in July, 2006 on the Chantix nicotine receptor blocker and its goal of stopping smoking:
44% of those on Chantix were not smoking at 12 weeks
29.5%% of those on Zyban were not smoking at 12 weeks
18% of those on a placebo were not smoking at 12 weeks
22% of those on Chantix did not smoke from week 9 to 52
16% of those on Zyban did not smoke from week 9 to 52
8.4% of those on a placebo did not smoke from week 9 to 52
Chantix acts at sites in the brain affected by nicotine and may help those who wish to give up smoking in two ways: by providing some nicotine effects to ease the withdrawal symptoms and by blocking the effects of nicotine from cigarettes if they resume smoking.
"Tobacco use, particularly cigarette smoking, is the single most preventable cause of death in the United States and is responsible for a growing list of cancers as well as chronic diseases including those of the lung and heart," said Scott Gottlieb, MD, Deputy Commissioner for Medical and Scientific Affairs. "The agency is committed to helping facilitate the development of products to help people quit smoking and improve their overall quality of life."
According to the Centers for Disease Control and Prevention (CDC), an estimated 44.5 million adults in the United States smoke cigarettes and more than 8.6 million of them have at least one serious illness caused by smoking.
"Cigarette smoking is a very difficult habit to break due in large part to nicotine dependence or addiction" said Dr. Steven Galson, Director of FDA's Center for Drug Evaluation and Research. "Chantix therapy has proven to be effective in smokers motivated to quit and will provide another tool for physicians to use for the millions of smokers who want to quit."
The effectiveness of Chantix in smoking cessation was demonstrated in six clinical trials, which included a total of 3659 chronic cigarette smokers who were treated with varenicline. Five of the six studies were randomized, controlled clinical trials in which Chantix was shown to be superior to placebo in helping people quit smoking.
The approved course of Chantix treatment is 12 weeks. Patients who successfully quit smoking during Chantix treatment may continue with an additional 12 weeks of Chantix treatment to further increase the likelihood of long-term smoking cessation.
In clinical trials, the most common adverse effects of Chantix were nausea, headache, vomiting, flatulence (gas), insomnia, abnormal dreams, and dysgeusia (change in taste perception).
Chantix is manufactured and distributed by Pfizer, Inc., New York, NY.
(adapted from FDA-AMA sources)
Fire victims, EMS providers, methlab remediation teams, and firefighters will be greatly served by this medical advancement in the United States. This cyanide antidote replaces the "lilly kit" that had been used for years, which used early, was lifesaving but medically cumbersome at best. Three medicines quickly had to be given to these severely critical patients – and the antidote itself had poisoning problems itself. This new antidote uses an extremely novel idea. Vitamin B12, hydroxycobalamin, likes cyanide. With a little molecular twist, the new antidote drug, hydroxocobalamin, simply exchanges a part of the drug and binds the cyanide with impressive results. Dr. Steve Borron, well know to some of us, and definitely an international leader in this arena, has done significant and life changing research on this new antidote to get the approval through the FDA. This antidote has been used in Europe for over a decade with great success. Others like Dr. Hall in Denver has done work on the FDA project years ago. Many have contributed to this landmark success of getting this drug in a workable form into the United States. Congrats to all of them!
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FOR IMMEDIATE RELEASE |
Media Inquiries: |
The Food and Drug Administration (FDA) today approved Cyanokit (containing the drug hydroxocobalamin, intravenous tubing and a sterile spike for reconstituting the drug product with saline) for the treatment of known or suspected cyanide poisoning. The approval, which is based on evidence of the drug's effectiveness when tested in animals, improves the nation's ability to respond to emergencies, including a potential attack by terrorists.
"Cyanide is a potent poison and one of the substances that could be used in a chemical attack," said Dr. Steven Galson, Director of FDA's Center for Drug Evaluation and Research. "Today's approval is yet another measure to counter the threat of terrorism, which is a critical component of FDA's public health mission."
Cyanokit received a priority review and was approved under the Animal Efficacy Rule, which allows use of animal data for evidence of a drug's effectiveness for certain conditions when the drug cannot be ethically or feasibly tested in humans.
In a controlled study in cyanide-poisoned adult dogs, the use of Cyanokit reduced whole blood cyanide concentration by approximately 55% by the end of the infusion, and significantly improved survival of the Cyanokit-treated dogs compared with dogs receiving placebo.
The safety, metabolism and excretion of Cyanokit were evaluated in 136 healthy adult humans. At the proposed starting dose of 5 grams, the drug was found to be generally well tolerated with side effects that were mild to moderate. The drug exits the body unchanged in the urine. In the presence of cyanide, Cyanokit's active drug takes up the cyanide and becomes a form of vitamin B12.
The most frequently reported adverse reactions in the trial were red urine, skin redness (both from the drug's coloration itself), a temporary increase in blood pressure, headache, nausea and injection site reactions. Allergic reactions were observed in a small number of individuals but were relatively mild and responded quickly to treatment.
Cyanokit is manufactured for EMD Pharmaceuticals, Inc by Merck Sante s.a.s. in Semoy, France and packaged by Dey Laboratories of Napa, California.
More information about FDA's efforts to counteract bioterrorism is available on FDA's website at http://www.fda.gov/oc/opacom/hottopics/bioterrorism.html.
(photos courtesy: google images)
Methlabs continue to plague society. Costs continue to rise. New laws embedded. New techniques on how to get the drugs to help make meth continue, for example:
Typical mechanisms that the non-cartel methlab cooks get pseudoephedrine are: smurfing and shelf sweeping. Individuals that “smurf” go to a large number of stores and buy amounts at each retailer of pseudoephedrine that are under the legal limit but in the aggregate are much more. A less sophisticated version of smurfing involves sending many individuals into the same store to buy amounts of pseudoephedrine just below the legal limit. “Shelf sweeping” occurs when an individual or a group goes into a store and remove all the pseudoephedrine on the shelf and then exit without paying.
Recently, radio listening to a report of the "significant" risks to persons entering into methlab areas that already have been cleaned up or decontaminated or remediated. The report left me believing that any site with any amount of meth activity is the same. Not true.
The report said after the cleanup process has occurred, the persons are still able to be "poisoned" and become "toxic" from being in the decontaminated room. Not probable either.
The epidemic of methlabs across the country have spawned the entire "cleanup industry" making many companies extremely wealthy in the "abatement industry." One operator told me, "If I just turn on the truck, the fee is $2500 dollars, then the bill goes up depending on what we do."
Most ingredients of methlabs are dangerous. Some can be flammable. Some have bombs or incindary devices. However, after the cleanup has occurred, risk is minimal, probably non-existent.
Do you clean out your garage or shed as a methlab decon project – the spaces that have been storage for such contaminants of lawn mower gasoline, oil, garden chemicals, camping or cooking supplies, glass cleaner, carburator fluids, drain cleaners, windshield washer fluids, antifreeze, and other highly toxic day to day chemicals of household use?
The risk of financial collapse for cleanup is hard hitting for any owner that needs to hire a "cleanup" company. It is estimated that a methlab cleanup can cost from $1000 to hundreds of thousands, depending on cartel activity or the mom-pop variety.
Google "methlab cleanup companies" (remediation) and nearly 60,000 hits arrive at the "deal or no deal" option.
Searching and searching, little is found on "risk of after-cleanup toxicity." Colleagues in this area have been surveyed. An anwer is in waiting. Thus far, experience has not shown me one person ill, sick, contaminated, physically harmed, toxic from a space declared "clean."
One of today's newspapers in Spokane Washington opined in the Editorial entitled "Too Many Guns" that one of the handgun-firearms issues regarding background checks at gunshows should be done. Despite this not-so-bad idea, the editorial went on to list the "X-factors" of risks of the biased anti-gun and gun ownership data.
Many groups have "researched" the issue. Many groups only rely on the news they wish to portray. Going into the data bank on the issue of bias in this area led me to two reasonable rebuttal articles and summaries.
FIREARM SAFETY
http://www.nraila.org/Issues/FactSheets/Read.aspx?id=120&issue=009
WHAT DO OTHER MEDICAL GROUPS SAY ABOUT FIREARMS STUDIES?
http://www.nraila.org/Issues/FactSheets/Read.aspx?id=119&issue=009
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Parts of system courtesy of Time-Warner except for TV and aluminum foil. |
| Six pages of text with a WWII diagram of connections, without secret decoder ring. |  |
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The test. Thanks KAYU and Time-Warner for the updated tech TV ! |
Doc thought, "Where is the Direct Way satellite phone-number? I just disconnected last year to go back to cable? Bad bet…" Oh, guess I don't need all this tonight for the replay.
During week 51, the following influenza activity was reported: • Widespread activity was reported by four states (Alabama, Florida, Georgia, and Mississippi).
• Regional activity was reported by twelve states (Indiana, Iowa, Louisiana, Maryland, Massachusetts, Nevada, North Carolina, Oklahoma, Pennsylvania, South Carolina, Tennessee, and Texas).
• Local activity was reported by the District of Columbia and five states (Connecticut, Hawaii, Michigan, Minnesota, and Wisconsin).
• Sporadic activity was reported by New York City and 25 states (Alaska, Arizona, Arkansas, California, Colorado, Delaware, Idaho, Illinois, Kansas, Maine, Montana, Nebraska, New Hampshire, New Jersey, New York, North Dakota, Ohio, Oregon, Rhode Island, South Dakota, Utah, Virginia, Washington, West Virginia, and Wyoming).
• No influenza activity was reported by one state (Vermont).
• Three states did not report (Kentucky, Missouri, and New Mexico).
What is Influenza (Also Called Flu)?
The flu is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness, and at times can lead to death. The best way to prevent the flu is by getting a flu vaccination each year.
Every year in the United States, on average:
Some people, such as older people, young children, and people with certain health conditions, are at high risk for serious flu complications.
Symptoms of flu include:
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Complications of flu can include bacterial pneumonia, ear infections, sinus infections, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes.
Flu viruses spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose. Most healthy adults may be able to infect others beginning 1 day before symptoms develop and up to 5 days after becoming sick. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.
The single best way to prevent the flu is to get a flu vaccination each year. There are two types of vaccines:
About two weeks after vaccination, antibodies develop that protect against influenza virus infection. Flu vaccines will not protect against flu-like illnesses caused by non-influenza viruses.
October or November is the best time to get vaccinated, but getting vaccinated in December or even later can still be beneficial since most influenza activity occurs in January or later in most years. Though it varies, flu season can last as late as May.
In general, anyone who wants to reduce their chances of getting the flu can get vaccinated. However, certain people should get vaccinated each year either because they are at high risk of having serious flu-related complications or because they live with or care for high risk persons. During flu seasons when vaccine supplies are limited or delayed, the Advisory Committee on Immunization Practices (ACIP) makes recommendations regarding priority groups for vaccination.
People who should get vaccinated each year are:
1. People at high risk for complications from the flu, including:
2. People who live with or care for those at high risk for complications from flu, including:
3. Anyone who wants to decrease their risk of influenza.
Vaccination with the nasal-spray flu vaccine is an option for healthy persons aged 5-49 years who are not pregnant, even healthy persons who live with or care for those in a high risk group. The one exception is healthy persons who care for persons with severely weakened immune systems who require a protected environment; these healthy persons should get the inactivated vaccine.
Some people should not be vaccinated without first consulting a physician. They include:
(adapted from cdc website: anticipate update by cdc after new data emerges)
click on link – http://www.nimcc.com
WHAT TO DO:
BRING A LIST OF YOUR ALLERGIES, MEDICATIONS, PAST MEDICAL HISTORY, EKG IF YOU HAVE IT, AND NAMES AND PHONE NUMBERS OF SIGNIFICANT OTHERS, AND INSURANCE INFO IF IN DATE
GO TO IMMEDIATE CARE IF UNSURE – IF NOT SEVERELY ILL OR INJURED
IF YOU MUST GO TO THE ER, GO IN THE MORNING…LESS BUSY USUALLY
WHEN IN DOUBT – IF ILLNESS OR INJURY IS SEVERE…CALL 911
TELL THE TRIAGE NURSE YOUR SYMPTOMS…ALL OF THEM
KNOW THE CREDENTIALS OF YOUR DOCTOR…EXPERIENCE
IS THE EMERGENCY PHYSICIAN RESIDENCY TRAINED IN EMERGENCY MEDICINE
IS THE EMERGENCY PHYSICIAN BOARD-CERTIFIED IN EMERGENCY MEDICINE
BRING AN ADVOCATE TO WATCH, LISTEN, AND ASK QUESTIONS – ESPECIALLY IF VERY ILL
MANY IMMEDIATE CARE CLINICS CAN TAKE CARE OF MANY ILLNESSES AND MINOR EMERGENCIES – CALL IF UNSURE
MANY IMMEDIATE CARE CLINICS CAN STABILIZE AND TRANSFER TO THE HOSPITAL
MANY IMMEDIATE CARE CLINICS HAVE BOARD CERTIFIED ER DOCS AND ER EXPERIENCED DOCS
(fires photos from: nifc.gov)
(product photos from: web general sites)
(house photo from: kltv, texas)
Generators, grills, camp stoves, or other gasoline, propane, natural gas, or charcoal-burning devices should never be used inside a home, basement, garage, or camper – or even outside near an open window.
Every home should have at least one working carbon monoxide detector. The detector’s batteries should be checked twice annually, at the same time smoke detector batteries are checked.
Carbon monoxide (CO) is an odorless, colorless gas that can cause sudden illness and death if inhaled.
When power outages occur during emergencies such as hurricanes or winter storms, the use of alternative sources of fuel or electricity for heating, cooling, or cooking can cause CO to build up in a home, garage, or camper and to poison the people and animals inside.
Every year, more than 500 people die in the U. S. from accidental CO poisoning.
CO is found in combustion fumes, such as those produced by small gasoline engines, stoves, generators, lanterns, and gas ranges, or by burning charcoal and wood. CO from these sources can build up in enclosed or partially enclosed spaces. People and animals in these spaces can be poisoned and can die from breathing CO.
How to Recognize CO Poisoning
Exposure to CO can cause loss of consciousness and death. The most common symptoms of CO poisoning are headache, dizziness, weakness, nausea, vomiting, chest pain, and confusion. People who are sleeping or who have been drinking alcohol can die from CO poisoning before ever having symptoms.
Important CO Poisoning Prevention Tips
Educational materials
(adapted from CDC website) 
Indications for Hyperbaric Oxygen
Hyperbaric oxygen therapy is a specialized medical treatment in which the patient breathes 100 per cent oxygen while inside a chamber at increased atmospheric pressure. HBO is used for specific medical conditions. HBO has long been (PHOTO: hcmc hbo ctr) recognized as vital in the resolution of critical medical conditions such as gas gangrene, carbon monoxide poisoning, air embolism due to diving, trauma, or surgical procedures, and decompression sickness. It is also an important adjunct for specific wound healing conditions.
The Hyperbaric Oxygen Committee of the Undersea and Hyperbaric Medical Society (UHMS) lists the following indications: approved uses for Hyperbaric Oxygen therapy:
(adapted from: HCMC HBO Ctr)
Carbon monoxide poisoning: Reporting required
Due to the ongoing severe cold weather conditions and associated increase in carbon monoxide (CO) poisoning among King County (PHOTO: hcmc hbo ctr) residents, Public Health is making suspected CO poisoning immediately reportable to Public Health by hospitals and healthcare provi
ders for seven days from today, through Dec. 24, 2006. This period will be extended if necessary.
The most common symptoms of CO poisoning are headache, dizziness, weakness, nausea, vomiting, chest pain, and confusion. Inhalation of carbon monoxide gas typically leads to headache, dizziness, and confusion, which might progress to dyspnea, tachypnea, syncope, and metabolic acidosis. Laboratory criteria for diagnosis: A case in which carboxyhemoglobin concentration exists >5% in venous or arterial blood in nonsmokers and >10% in smokers, as determined by hospital or commercial laboratory tests. The typical range of carboxyhemoglobin concentrations in smokers is 6%-10%.
Advice regarding diagnosis and treatment management of CO intoxication is available 24/7 through Washington State Poison Center at 1-800-222-1222.
This health order impacts primarily emergency departments (ED) and the information should be disseminated to all ED staff in King County hospitals immediately. A designated person on each shift should be identified to report cases of CO poisoning to Public Health.
(adapted from the Seattle/King County Public Health Announcement)
THE CONTROVERSY CONTINUES: DOES THE HYPERBARIC OXYGEN HELP?
Current assessment and treatment of CO poisoning in the
emergency department is grossly inadequate to prevent serious
neurologic complications. HBOT speeds removal of CO from
tissues and counters a number of its deleterious effects. Past studies
have demonstrated efficacy of HBOT for reducing the incidence of
neurologic sequelae, even though only three sessions of HBOT
were used. Clinical experience such as that reported here shows that
HBOTtreatment late in the course of established impairments from
CO can lead to clinical improvements. Improvement is documented
by evidence of increased brain metabolism on functional brain
imaging by SPECT after HBOT. Further study as well as wider
availability of HBOT, particularly for persons such as firefighters
who are at high occupational risk of CO poisoning, is warranted.
AND THESE TREATMENTS ARE NOT CONCLUSIVE IN MANY STUDIES THUS FAR…(editorial comment by castMD.com)
Richard A. Neubauer, M.D.
Virginia Neubauer
Alan Ko Chi Nu,
M.D. William S.
Maxfield, M.D., FACNM
, is Medical Director, Ocean Hyperbaric
Neurologic Center, Lauderdale-by-the-Sea, FL. is
Research Director, Ocean Hyperbaric Neurologic Center.
, is a hyperbaric physician practicing in Taipei, Taiwan.
, is a radiologist and Chief of Nuclear Medicine at
Ocean Hyperbaric Neurologic Center.
(adapted from: Journal of American Physicians and Surgeons Volume 11 Number 2 Summer 2006)
Over the past 20 – 30 years, fiber has been a leading dietary factor connected to worsening weight control. Less fiber, less control has been the health risk. You should have noticed on "The Biggest Loser" tv show in 2006 that dietary fiber amounts were noticeable. So this idea of weight control and dieting with its relationship to fiber intake is not a new idea. The real concern with increasing obesity, diabetes, cancer, and childhood obesity and its complications, is the amount of fiber, and the type of fiber that is of special focus today.
Generally, obese men and women have less fiber in their diets. In fact, overweight persons generally consume about one-half of the fiber that is recommended. Many times, programs for weight loss find that the "client" is not using enough fiber to assist in weight loss management, therefore causing increased risk of failure of the weight loss program.
Many persons do not like high-fiber in general. Why? Foods like beans, whole grains, fruits, and vegetables can cause bloating and gas; and they just do not like that feeling. Many jokes of such problems exist, but what really happens is tolerance to fiber does occur…it gets better.
High-fiber diets help your body making contents inside the bowel bulkier with water holding properties. It helps distend your stomach, small and large bowel – helping you feel fuller longer. It also causes the feeling of hunger to go away.
Soluble fiber especially causes a viscous suspension. (See previous castMD detail at the link http://www.castmd.com/?p=36 . These slurries delay stomach emptying and allows nutrient absorption. Hunger pains are minimized. In addition, some fats are held in the fiber, allowing yet the proteins and carbohydrates to be absorbed. This slowing, and delaying, and changing the food load is called "spreading the nutrient load."
Fiber helps change the hormones that control food metabolism. Sugar in your system is more stable, and even; and the metabolism is more controlled with insulin avoiding the highs and lows of sugar and its rebound in the blood stream.
With this better and longer control of your glycemic load, energy is maintained on lesser calories. There are fewer "hunger signals" to the appetitie centers, allowing more work with less calories. You're not eating as much and you are using calories already "on board."
Many parents with CAD (coronary artery disease) have overweight children. And those kids had more complications of health risks that other kids. With the addition of high-fiber, better control of weight, cholesterol, blood sugar, and insulin release was maintained. Risk of "metabolic syndrome" or "syndrome X" goes down with high-fiber supplementation. With this, insulin resistance goes down; – while hyperlipidemia, hypertension, hypercholesterolemia and type 1 and type 2 diabetes all have improvement.
Obesity continues as diets are high in fats, high in added sugars, and low in soluble fibers.
At least 25 to 30 grams of soluble fiber is recommended daily, slowly added from about 5 grams per day over 2-3 months – to maintain a healthy weight.
IN SUMMARY: 
ENJOY THE HOLIDAYS HEALTHIER *
SOLUBLE FIBER HELPS SLOW DOWN THE RATE THAT FOOD NUTRIENTS ARE ABSORBED
SOLUBLE FIBER HELPS YOU FEEL LESS HUNGRY
SOLUBLE FIBER HELPS REDUCE THE AMOUNT OF CALORIES YOU TAKE IN
SOLUBLE FIBER HELPS PROTECT YOU FROM THE RISKS OF SEVERAL SERIOUS DISEASES.
(excerpts from: Soluble Fiber – Saving Your Health, Saving Your Money. Winter & Crane)
