Tuesday, April 04, 2006

CNN Health News : Obesity as a National Threat ?

International Diabetes Foundation (IDF) 2005 telah merelease definisi baru tentang Metabolic Syndrome - lebih menekankan Central obesity (waist circumference) berdasar ras.

Untuk orang Indonesia (= south asia), lingkar pinggang ideal adalah 90 cm (pria) dan 80 cm (wanita). Bila berlebih, cardiovascular risk pun akan meningkat.

Tapi ternyata di US, hal ini menimbulkan issue baru: Fat Politics

Fat Politics : The Real Story Behind America's Obesity Epidemic

Author : J. Eric Oliver
Published : November 2005

In Fat Politics, Eric Oliver, a University of Chicago political science professor and former health policy scholar at Yale, unearths the real story behind America's "obesity epidemic." Oliver shows how a handful of doctors, government bureaucrats, and health researchers, with financial backing from the drug and weight-loss industry, have campaigned to misclassify more than sixty million Americans as "overweight," to inflate the health risks of being fat, and to promote the idea that obesity is a killer disease.

By telling us we need to be thin, the proponents of the "obesity epidemic" are pushing millions of Americans towards dangerous surgeries, crash diets, and harmful diet drugs.

Menurut Olliver:

"... It's not obesity, but the panic over obesity, that's the real health problem..."

See more at http://www.cnn.com

Comments from NEJM

"Eric Oliver's book debunks almost every conventional theory that causally relates obesity to diseases and early death. It will infuriate countless obesity researchers, weight-loss doctors, and the food, diet, and pharmaceutical industries. Whether or not you agree with all of his critiques, one thing is indisputable: the entire field badly needs a good shakeup." --Jerome P. Kassirer, M.D., Editor-in-Chief Emeritus, New England Journal of Medicine , and author of On The Take: How Medicine's Complicity with Big Business Can Endanger Your Health

Mungkin kalau buku ini di film-dokumenter-kan bisa saja menyaingi kontroversi seperti Michael Moore's Fahrenheit 9/11


Sorry colleguae - karena kesibukan luar biasa, baru sempat update today.

Info buat colleguae yang belum mendapat second invitation. See you in Medan.

PS: Ada colleguae yang mau mengantar saya bernostalgia di Medan? eg: My elementary school (SD Harapan Medan) - konon kabarnya masih megah berdiri didepan patung Ahmad Yani. Mudah2an guru2 ku masih lengkap disana. Have a good memory outthere ....

Friday, November 18, 2005

8th APSCPE CONGRESS : finale reminder

Sekadar mengingatkan buat all my fellow colleagues. Masih bisa onsite registration tg 8-10 Desember 2005 di Bali International Convention Center. See you at Denpasar and have a great reunion, mate ...

Thursday, November 10, 2005


Buat rekan-rekan ku di Indonesia Timur (termasuk saya),
Setiap hari kita selalu mendapat pertanyaan tentang keamanan malaria prophylaxis dari client. Kurangnya guideline dan research membuat kita kesulitan meng-explain yang terbaik.
Mudah-mudahan update terbaru dari WHO ini bermanfaat (20 halaman khusus malaria, lengkap dengan treatment table).


Long-term travelers are defined as those who are visiting or traveling through malaria-endemic countries for > 6 months.

1. Chloroquine and Chloroquine-Proguanil
The risk of serious side effect associated with long term prophylaxic use of chloroquine and proguanil is low. However those two cannot be used for a long term prophylaxis owing to high resistance rates in most endemic regions.
Anyone who has taken 300 mg of chloroquine weekly for over 5 years and requires further prophylaxis should be screened twice yearly for early retinal changes. If daily doses of 100 mg of chloroquine have been taken, screening should start after three years.

2. Mefloquine
Data indicate no increased risk of serious side effects with long term use of mefloquine if the drug is tolerated in the short term. Mefloquine is suitable for most malaria-endemic regions, although its use is restricted by neuropsychiatric side effects, particularly in women.

3. Doxycycline
Experience with Doxycycline for a long term prophylaxis (i.e more than 4-6 month) is limited, but available data are reassuring.

4. Atovaquone/Proguanil
The use of atovaquone-proguanil is restricted on duration of use to 28 days in some European countries, but clinical studies indicate that its use is suitable for at least 20 weeks.

Info lanjut berhubungan dengan malaria update termasuk WHO regimen guideline 2005 dapat di download FREE di http://www.who.int/ith/en/. Bisa di compare dengan CDC regimen guideline 2004.

Semoga berguna buat teman sejawat seperti kita-kita yang berada di malaria area.

Sunday, November 06, 2005


Bagi colleguae yang berminat di Occupational Health.
Jogjakarta, 29 November - 1 December 2005

Topik bahasan:
Serving the Underserved Working Population and Best Practice in Industry

Sponsor: Menteri Kesehatan RI, World Health Organization, International Labor Organization, Indonesian Medical Association for Occupational Health
Final announcement dapat melalui: http://www.icohis2005.com atau email ke info@icohis2005.com
Semoga bermanfaat.

Saturday, November 05, 2005


Colleguae, sepertinya tidak habis-habis update tentang Avian Flu. Ini berita terakhir:

World Health Organization, Food and Agriculture Organization, The World Organization for Animal Health dan the World Bank akan mengadakan pertemuan dengan agenda Avian Flu dan Human Pandemic Influenza tanggal 7-9 November 2005 di Markas Besar WHO, Geneva.

Materi yang akan dibahas:
- Program kerja pencegahan jangka menengah dan jangka panjang penularan Avian Flu
- Status of International Health & Country Responses (day 1)
- Adressing the global & Regional Dimensions of Avian Influenza and Human Pandemic Influenza (Day 2)
- Supporting the implementation of integrated country programmes: financing and coordination issues (Day 3)

Semoga pertemuan ini membuahkan hasil yang bermanfaat to our country....

Friday, November 04, 2005


Dear all collegue,
Masih seputar Bird Flu. Di Hari Raya yang suci ini ternyata issue bird flu tambah menghangat. Berikut 2 update terakhir dari referensi yang reliable. Tidak bermaksud membuat panik, tapi bagaimana respon pemerintah kita menghadapi possible pandemic ini?

Friday, November 4, 2005 Posted: 0257 GMT (1057 HKT)

BEIJING, China (AP) -- China reported its fourth bird flu outbreak in three weeks, saying the virus killed 8,940 chickens in a village in the country's northeast and prompted authorities to destroy 369,900 other birds.
The outbreak occurred October 26 in Badaohao, a village in Liaoning province, east of Beijing, the Agriculture Ministry said in a report posted late Thursday on the Web site of the Paris-based World Organization for Animal Health.
The report came despite government efforts to tighten controls on China's 5.2 billion chickens, ducks and other poultry and to vaccinate millions of birds.
China hasn't reported any human infections, but experts have warned that one is inevitable if the country can't stop repeated outbreaks in poultry.

Lebih lanjut click di http://www.oie.int/


Friday, November 4, 2005 Posted: 0435 GMT (1235 HKT)

UNITED NATIONS (CNN) -- U.N. Secretary-General Kofi Annan has called on the international community to make immediate preparations for a possible pandemic of bird flu.

It was not clear that the H5N1 virus, first identified in birds in Asia and recently found in Europe, would ever gain the ability to infect large numbers of people. But, he said, world leaders could not afford to ignore the threat.
"We do know what happens when millions of people die, and millions more are infected, when health systems are overburdened and overwhelmed, when families, communities and whole societies are devastated, when transport and trade, education and other services are disrupted or cease to function, when the economic and social progress of nations risks being reversed," he told the Time Global Health Summit Thursday.

Annan's warning comes as China reported its fourth bird flu outbreak in three weeks, saying the virus killed nearly 9,000 chickens in a village in the country's northeast and prompted authorities to destroy 369,900 other birds, according to The Associated Press.

On Friday, Vietnam also confirmed more bird flu outbreaks among poultry in three villages, according to The Associated Press.

Should it gain the ability -- through mutation -- to readily be transmitted among people, the results could be catastrophic, health experts say.
"Once human-to-human transmission has been established, we would have only a matter of weeks to lock down the spread before it spins out of control," Annan warned.

Lebih lanjut click di http://www.cnn.com


Update terakhir dari CNN.com tentang Tamiflu supplies untuk Bird flu.

Patients, schools, doctors looking for guidance
Friday, October 28, 2005 Posted: 1450 GMT (2250 HKT)

CHICAGO, Illinois (AP) -- Worried that bird flu in Asia could morph into a human flu pandemic, healthy patients, schools and even some doctors are asking if they should stock up on Tamiflu -- the one medicine experts believe might help fight the virus.
Although some doctors' groups say no, the agency in charge of the nation's public health has no answer. That has frustrated local health officials who want to know how to advise people.
"Those are questions that are under discussion," Christina Pearson, spokeswoman for the U.S. Department of Health and Human Services, said this week. "Right now we're focused on the seasonal flu."
HHS includes the federal Centers for Disease Control and Prevention, whose job includes dispensing public health recommendations.

"A lot of people have asked the CDC to provide some guidance about this, with patients asking doctors for prescriptions," said Dr. Craig Conover, medical director for the Illinois Department of Public Health.
Personal hoarding isn't fair, he said, "but on the other hand, I have heard people say that the more this gets used, the more manufacturing ability they'll develop. We've chosen to wait for CDC guidance on this."
Tamiflu is a prescription pill designed to treat regular flu. But it also seems to offer some protection to people against the type of flu that has devastated Asian poultry flocks and is spreading to birds in Europe. Bird flu has killed more than 60 people over the past two years.

On Thursday, Tamiflu's Swiss maker, Roche Holding AG, said it was temporarily suspending shipment to private U.S. suppliers because of increased global demand.
"We've seen recently some very large purchases at the wholesale level, companies or large entities who are possibly hoarding Tamiflu right now," said Darien Wilson, spokeswoman at Roche's U.S. offices in Nutley, N.J.
Prescriptions for the drug last week were nearly quadruple what they were a year before, according to Verispan, a Pennsylvania-based company that monitors pharmacy sales.
And this winter's flu season hasn't even started yet.
Maura Robbins of Chicago said she and her husband have discussed whether to seek prescriptions for their two young children as a precaution against a pandemic. They won't for now, because they "didn't want to buy into the hysteria or overreact," she said.
Dr. Bennett Kaye, a pediatrician affiliated with Chicago's Children's Memorial Hospital, said he tells patients that stocking up on Tamiflu "is definitely a bad, bad idea."
The virus circulating among Asian birds is not spreading between people and is not even very easy for people to catch from birds.
"Parents should not be worried about their kids catching bird flu this year unless they're planning on visiting a chicken farm in Vietnam," Kaye said.

Published reports suggest that some doctors are keeping supplies of Tamiflu to give to family and friends in case the bird flu mutates into a bigger threat, but no doctors reached for this story acknowledged that.
The American Medical Association is against personal stockpiling and says the misuse of Tamiflu could lead to drug-resistant flu strains.
The American Academy of Pediatrics is preparing a statement urging pediatricians "not to do personal or organizational stockpiles," said Dr. John Bradley, a member of the American Academy of Pediatrics' infectious disease committee. "The last sentence of the statement is that no pediatrician on this committee has a personal stockpile or is prescribing the drug" for healthy people.
Dr. Deborah Yokoe, an infectious disease specialist at Boston's Brigham and Women's Hospital, said, "Doctors are human, too. They have the same sorts of anxieties themselves. I'm sure some are keeping supplies, too."
Last week, the Massachusetts Department of Public Health issued a notice advising against personal stockpiling, prompted by patients' questions, and Yokoe said such messages will discourage some doctors from writing advance prescriptions for a potential flu pandemic.

Tamiflu isn't the only hot commodity being sought because of pandemic worries.
Kimberly-Clark Health Care says it has "ramped up to full capacity" face mask production to keep up with bird flu-linked demand from governments, hospitals and individuals. Surgical N-95 masks protect against airborne disease transmission.
Company spokesman David Parks declined to specify numbers but said some orders have been 50 times higher than usual.
3M spokeswoman Jacqueline Berry also reported a rise in face-mask orders but said reasons for demand include hurricane-related mold problems.