Heidi Splete

Current information about the ordering and distribution of the pandemic influenza A(H1N1) vaccine is available on the Centers for Disease Control and Prevention's Web site, Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases, said in a teleconference.

Every Friday, data on how many doses of vaccine were available for ordering and how many were shipped to states or large cities will be made available on the CDC Web site, she noted.

Although the CDC recommends against the overuse of antivirals, individuals who have severe illness or who are at high risk for complications, such as pregnant women, “can greatly benefit from antiviral medications,” Dr. Schuchat said. As of Oct. 1, the CDC had confirmed reports of 28 pregnant women in the United States who have died as a result of H1N1 influenza, Dr. Schuchat said. She also noted that Health and Human Services Secretary Kathleen Sebelius had authorized distribution to the states of several thousand courses of liquid Tamiflu for children.

Dr. Schuchat added that the CDC was in the process of updating its guidance on the use of personal protective equipment for health care workers to protect against influenza.

Data from a study of 221 health care workers published recently online (JAMA 2009 Oct. 1; doi:10.1001/jama. 2009.1466]) showed that standard surgical masks appeared to be no worse than N95 respirators in preventing the spread of influenza in routine health care settings.

Current information about the ordering and distribution of the pandemic influenza A(H1N1) vaccine is available on the Centers for Disease Control and Prevention's Web site, Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases, said in a teleconference.

Every Friday, data on how many doses of vaccine were available for ordering and how many were shipped to states or large cities will be made available on the CDC Web site, she noted.

Although the CDC recommends against the overuse of antivirals, individuals who have severe illness or who are at high risk for complications, such as pregnant women, “can greatly benefit from antiviral medications,” Dr. Schuchat said. As of Oct. 1, the CDC had confirmed reports of 28 pregnant women in the United States who have died as a result of H1N1 influenza, Dr. Schuchat said. She also noted that Health and Human Services Secretary Kathleen Sebelius had authorized distribution to the states of several thousand courses of liquid Tamiflu for children.

Dr. Schuchat added that the CDC was in the process of updating its guidance on the use of personal protective equipment for health care workers to protect against influenza.

Data from a study of 221 health care workers published recently online (JAMA 2009 Oct. 1; doi:10.1001/jama. 2009.1466]) showed that standard surgical masks appeared to be no worse than N95 respirators in preventing the spread of influenza in routine health care settings.

Current information about the ordering and distribution of the pandemic influenza A(H1N1) vaccine is available on the Centers for Disease Control and Prevention's Web site, Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases, said in a teleconference.

Every Friday, data on how many doses of vaccine were available for ordering and how many were shipped to states or large cities will be made available on the CDC Web site, she noted.

Although the CDC recommends against the overuse of antivirals, individuals who have severe illness or who are at high risk for complications, such as pregnant women, “can greatly benefit from antiviral medications,” Dr. Schuchat said. As of Oct. 1, the CDC had confirmed reports of 28 pregnant women in the United States who have died as a result of H1N1 influenza, Dr. Schuchat said. She also noted that Health and Human Services Secretary Kathleen Sebelius had authorized distribution to the states of several thousand courses of liquid Tamiflu for children.

Dr. Schuchat added that the CDC was in the process of updating its guidance on the use of personal protective equipment for health care workers to protect against influenza.

Data from a study of 221 health care workers published recently online (JAMA 2009 Oct. 1; doi:10.1001/jama. 2009.1466]) showed that standard surgical masks appeared to be no worse than N95 respirators in preventing the spread of influenza in routine health care settings.

The Centers for Disease Control and Prevention is pilot-testing a system to deliver information about pandemic influenza A(H1N1) and other health information directly to mobile phones, according to a statement on the CDC's Web site.

The 3-month pilot test began in September, and the CDC is soliciting feedback from users. To subscribe to the service, potential users should text HEALTH to the number 87000.

The CDC does not charge subscribers to participate in the pilot testing, but standard text messaging rates may apply based on individuals' different wireless service contracts.

Upon initial registration, users will receive several introductory messages and questions, according to the Web site. The program then sends three health tips per week.

The Centers for Disease Control and Prevention is pilot-testing a system to deliver information about pandemic influenza A(H1N1) and other health information directly to mobile phones, according to a statement on the CDC's Web site.

The 3-month pilot test began in September, and the CDC is soliciting feedback from users. To subscribe to the service, potential users should text HEALTH to the number 87000.

The CDC does not charge subscribers to participate in the pilot testing, but standard text messaging rates may apply based on individuals' different wireless service contracts.

Upon initial registration, users will receive several introductory messages and questions, according to the Web site. The program then sends three health tips per week.

The Centers for Disease Control and Prevention is pilot-testing a system to deliver information about pandemic influenza A(H1N1) and other health information directly to mobile phones, according to a statement on the CDC's Web site.

The 3-month pilot test began in September, and the CDC is soliciting feedback from users. To subscribe to the service, potential users should text HEALTH to the number 87000.

The CDC does not charge subscribers to participate in the pilot testing, but standard text messaging rates may apply based on individuals' different wireless service contracts.

Upon initial registration, users will receive several introductory messages and questions, according to the Web site. The program then sends three health tips per week.

The United States is better prepared now to handle a pandemic than in recent years, but challenges remain in the areas of surge capacity, vaccine distribution, and general emergency preparedness, according to a report by the Trust for America's Health.

“This report focuses on the challenges a pandemic poses for our health care system,” Jeffrey Levi, Ph.D., executive director of the Trust for America's Health, said in a telebriefing.

The report's authors based their estimates on two predictions from the scientific community: The pandemic influenza A(H1N1) virus is relatively mild, and up to 35% of Americans could potentially become ill during flu season.

If that percentage were to become ill, hospitals in 15 states could potentially run out of beds, according to the report. States and localities also would have to manage a likely influx of people in doctors' offices and ambulatory care settings, Dr. Levi noted.

Challenges related to vaccination include issues of distribution, reimbursement, and getting the message out to populations that don't often get vaccinated, such as young adults and minority populations, Dr. Levi said.

“State and local governments are struggling to create distribution systems,” especially for priority groups for H1N1 vaccination. The administrative costs of the H1N1 vaccine also could become a burden for state and local health departments, he noted.

Inconsistent resources remain a problem, Dr. Levi added, because emergency departments and public health departments have lost personnel and funding in recent years.

Local health department staffing levels this fall are lower than they were in spring 2009, according to the National Association of County and City Health Officials (NACCHO). That reduction comes just as the demands on these systems are likely to increase with the spread of the pandemic virus. State and local health departments need “renewed and sustained and constant funding to give us the core capacity that people expect,” said NACCHO Executive Director Robert M. Pestronk, during the telebriefing.

The take-home message for clinicians is to stay on top of the H1N1 situation as it evolves, and communicate with their local health departments, Dr. Levi said. H1N1 “is going to pose a challenge for the entire health care system,” he said. “Clinicians are going to be on the front lines to educate patients” about the importance of vaccination and about protective measures such as hand hygiene and covering coughs. “Local physicians should be working closely with their local health departments,” added Mr. Pestronk. Clinicians might also consider stepping outside their practices to help administer vaccinations or volunteering staff members to assist with these efforts, he said.

To view the complete report, including state-specific data on hospital capacity, visit healthyamericans.org

The United States is better prepared now to handle a pandemic than in recent years, but challenges remain in the areas of surge capacity, vaccine distribution, and general emergency preparedness, according to a report by the Trust for America's Health.

“This report focuses on the challenges a pandemic poses for our health care system,” Jeffrey Levi, Ph.D., executive director of the Trust for America's Health, said in a telebriefing.

The report's authors based their estimates on two predictions from the scientific community: The pandemic influenza A(H1N1) virus is relatively mild, and up to 35% of Americans could potentially become ill during flu season.

If that percentage were to become ill, hospitals in 15 states could potentially run out of beds, according to the report. States and localities also would have to manage a likely influx of people in doctors' offices and ambulatory care settings, Dr. Levi noted.

Challenges related to vaccination include issues of distribution, reimbursement, and getting the message out to populations that don't often get vaccinated, such as young adults and minority populations, Dr. Levi said.

“State and local governments are struggling to create distribution systems,” especially for priority groups for H1N1 vaccination. The administrative costs of the H1N1 vaccine also could become a burden for state and local health departments, he noted.

Inconsistent resources remain a problem, Dr. Levi added, because emergency departments and public health departments have lost personnel and funding in recent years.

Local health department staffing levels this fall are lower than they were in spring 2009, according to the National Association of County and City Health Officials (NACCHO). That reduction comes just as the demands on these systems are likely to increase with the spread of the pandemic virus. State and local health departments need “renewed and sustained and constant funding to give us the core capacity that people expect,” said NACCHO Executive Director Robert M. Pestronk, during the telebriefing.

The take-home message for clinicians is to stay on top of the H1N1 situation as it evolves, and communicate with their local health departments, Dr. Levi said. H1N1 “is going to pose a challenge for the entire health care system,” he said. “Clinicians are going to be on the front lines to educate patients” about the importance of vaccination and about protective measures such as hand hygiene and covering coughs. “Local physicians should be working closely with their local health departments,” added Mr. Pestronk. Clinicians might also consider stepping outside their practices to help administer vaccinations or volunteering staff members to assist with these efforts, he said.

To view the complete report, including state-specific data on hospital capacity, visit healthyamericans.org

The United States is better prepared now to handle a pandemic than in recent years, but challenges remain in the areas of surge capacity, vaccine distribution, and general emergency preparedness, according to a report by the Trust for America's Health.

“This report focuses on the challenges a pandemic poses for our health care system,” Jeffrey Levi, Ph.D., executive director of the Trust for America's Health, said in a telebriefing.

The report's authors based their estimates on two predictions from the scientific community: The pandemic influenza A(H1N1) virus is relatively mild, and up to 35% of Americans could potentially become ill during flu season.

If that percentage were to become ill, hospitals in 15 states could potentially run out of beds, according to the report. States and localities also would have to manage a likely influx of people in doctors' offices and ambulatory care settings, Dr. Levi noted.

Challenges related to vaccination include issues of distribution, reimbursement, and getting the message out to populations that don't often get vaccinated, such as young adults and minority populations, Dr. Levi said.

“State and local governments are struggling to create distribution systems,” especially for priority groups for H1N1 vaccination. The administrative costs of the H1N1 vaccine also could become a burden for state and local health departments, he noted.

Inconsistent resources remain a problem, Dr. Levi added, because emergency departments and public health departments have lost personnel and funding in recent years.

Local health department staffing levels this fall are lower than they were in spring 2009, according to the National Association of County and City Health Officials (NACCHO). That reduction comes just as the demands on these systems are likely to increase with the spread of the pandemic virus. State and local health departments need “renewed and sustained and constant funding to give us the core capacity that people expect,” said NACCHO Executive Director Robert M. Pestronk, during the telebriefing.

The take-home message for clinicians is to stay on top of the H1N1 situation as it evolves, and communicate with their local health departments, Dr. Levi said. H1N1 “is going to pose a challenge for the entire health care system,” he said. “Clinicians are going to be on the front lines to educate patients” about the importance of vaccination and about protective measures such as hand hygiene and covering coughs. “Local physicians should be working closely with their local health departments,” added Mr. Pestronk. Clinicians might also consider stepping outside their practices to help administer vaccinations or volunteering staff members to assist with these efforts, he said.

To view the complete report, including state-specific data on hospital capacity, visit healthyamericans.org

A pilot program on how to better counsel patients and families about childhood obesity is underway in five California-based residency programs.

Pediatric and family medicine residents are trained in strategies to help patients make behavioral changes proven to reduce and prevent obesity. For example, the program provides tips for helping individuals decrease their consumption of sugary beverages. Residents are armed with handouts on healthy beverage options and a visual aid that shows how much sugar is in a soda or sports drink.

The hope is that preparing future primary care physicians to effectively motivate lifestyle changes will help stem the prevalence rates of pediatric obesity, type 2 diabetes, and heart disease, Dr. Lydia Tinajero-Deck, the project's principal investigator, said in an interview.

The pilot, dubbed Fit for Residents, was developed by the University of California, Los Angeles, in collaboration with the American Academy of Pediatrics and American Academy of Family Physicians, said Dr. Tinajero-Deck, a pediatrician at Children's Hospital & Research Center in Oakland, Calif.

“The actual pilot program for our residents is 1 year, with the goal of sustainability and integration” into the residency program as a permanent education piece, she said. To expand it nationwide, “We need to collect data on how the curriculum was taught within these pilot programs” to identify and promote the best practices, she added.

A pilot program on how to better counsel patients and families about childhood obesity is underway in five California-based residency programs.

Pediatric and family medicine residents are trained in strategies to help patients make behavioral changes proven to reduce and prevent obesity. For example, the program provides tips for helping individuals decrease their consumption of sugary beverages. Residents are armed with handouts on healthy beverage options and a visual aid that shows how much sugar is in a soda or sports drink.

The hope is that preparing future primary care physicians to effectively motivate lifestyle changes will help stem the prevalence rates of pediatric obesity, type 2 diabetes, and heart disease, Dr. Lydia Tinajero-Deck, the project's principal investigator, said in an interview.

The pilot, dubbed Fit for Residents, was developed by the University of California, Los Angeles, in collaboration with the American Academy of Pediatrics and American Academy of Family Physicians, said Dr. Tinajero-Deck, a pediatrician at Children's Hospital & Research Center in Oakland, Calif.

“The actual pilot program for our residents is 1 year, with the goal of sustainability and integration” into the residency program as a permanent education piece, she said. To expand it nationwide, “We need to collect data on how the curriculum was taught within these pilot programs” to identify and promote the best practices, she added.

A pilot program on how to better counsel patients and families about childhood obesity is underway in five California-based residency programs.

Pediatric and family medicine residents are trained in strategies to help patients make behavioral changes proven to reduce and prevent obesity. For example, the program provides tips for helping individuals decrease their consumption of sugary beverages. Residents are armed with handouts on healthy beverage options and a visual aid that shows how much sugar is in a soda or sports drink.

The hope is that preparing future primary care physicians to effectively motivate lifestyle changes will help stem the prevalence rates of pediatric obesity, type 2 diabetes, and heart disease, Dr. Lydia Tinajero-Deck, the project's principal investigator, said in an interview.

The pilot, dubbed Fit for Residents, was developed by the University of California, Los Angeles, in collaboration with the American Academy of Pediatrics and American Academy of Family Physicians, said Dr. Tinajero-Deck, a pediatrician at Children's Hospital & Research Center in Oakland, Calif.

“The actual pilot program for our residents is 1 year, with the goal of sustainability and integration” into the residency program as a permanent education piece, she said. To expand it nationwide, “We need to collect data on how the curriculum was taught within these pilot programs” to identify and promote the best practices, she added.

Approximately 38% of American adults use some type of complementary and alternative medicine, and they spent nearly $34 billion on CAM products and practitioners over the past 12 months, based on data from the 2007 National Health Interview Survey.

Researchers reviewed interviews with 23,393 adults aged 18 and older that were included in the National Health Interview Survey (NHIS). The survey is conducted annually by the Centers for Disease Control and Prevention. Lead author Richard L. Nahin, Ph.D., is acting director of the division of extramural research at the National Institutes of Health's National Center for Complementary and Alternative Medicine.

Overall, approximately 65% ($22 billion) of American adults' spending on CAM went toward self-care, while approximately 35% ($11.9 billion) was spent on visits to CAM practitioners, Dr. Nahin and colleagues reported.

Of the money spent on self-care, nearly 44% ($14.8 billion) went to nonvitamin, nonmineral natural products. Another $4.1 billion were spent on classes such as yoga and tai chi; $2.9 billion, on homeopathic medicine; and $200 million, on relaxation techniques.

The money spent on CAM products was approximately one-third of the $47.6 billion American adults spent on pharmaceutical drugs in 2007, the researchers noted.

The money spent on CAM provider visits was approximately one-quarter of the $49.6 billion spent on conventional physician services.

Although the overall number of visits to CAM providers (except for acupuncturists) decreased in 2007, compared with a decade earlier, “at least 20% of persons visiting practitioners of acupuncture, homeopathy, naturopathy, massage, and hypnosis therapy paid $75 or more per visit,” the researchers wrote.

The results were limited by the reliance on self-reports from the survey respondents, and by estimates of each respondent's annual CAM spending based on the most recent purchase, which may not have been typical of a respondent's CAM use, the researchers said.

But the NHIS data show that U.S. adults make more than 300 million visits to CAM providers and spend billions of dollars on CAM annually.

“These expenditures, although a small fraction of total health care spending in the United States, constitute a substantial part of out-of-pocket health care costs and are comparable to out-of-pocket costs for conventional physician services and prescription drug use,” the researchers said.

View the complete report online at the CDC's Web site at www.cdc.gov/NCHS/data/nhsr/nhsr018.pdf

Approximately 38% of American adults use some type of complementary and alternative medicine, and they spent nearly $34 billion on CAM products and practitioners over the past 12 months, based on data from the 2007 National Health Interview Survey.

Researchers reviewed interviews with 23,393 adults aged 18 and older that were included in the National Health Interview Survey (NHIS). The survey is conducted annually by the Centers for Disease Control and Prevention. Lead author Richard L. Nahin, Ph.D., is acting director of the division of extramural research at the National Institutes of Health's National Center for Complementary and Alternative Medicine.

Overall, approximately 65% ($22 billion) of American adults' spending on CAM went toward self-care, while approximately 35% ($11.9 billion) was spent on visits to CAM practitioners, Dr. Nahin and colleagues reported.

Of the money spent on self-care, nearly 44% ($14.8 billion) went to nonvitamin, nonmineral natural products. Another $4.1 billion were spent on classes such as yoga and tai chi; $2.9 billion, on homeopathic medicine; and $200 million, on relaxation techniques.

The money spent on CAM products was approximately one-third of the $47.6 billion American adults spent on pharmaceutical drugs in 2007, the researchers noted.

The money spent on CAM provider visits was approximately one-quarter of the $49.6 billion spent on conventional physician services.

Although the overall number of visits to CAM providers (except for acupuncturists) decreased in 2007, compared with a decade earlier, “at least 20% of persons visiting practitioners of acupuncture, homeopathy, naturopathy, massage, and hypnosis therapy paid $75 or more per visit,” the researchers wrote.

The results were limited by the reliance on self-reports from the survey respondents, and by estimates of each respondent's annual CAM spending based on the most recent purchase, which may not have been typical of a respondent's CAM use, the researchers said.

But the NHIS data show that U.S. adults make more than 300 million visits to CAM providers and spend billions of dollars on CAM annually.

“These expenditures, although a small fraction of total health care spending in the United States, constitute a substantial part of out-of-pocket health care costs and are comparable to out-of-pocket costs for conventional physician services and prescription drug use,” the researchers said.

View the complete report online at the CDC's Web site at www.cdc.gov/NCHS/data/nhsr/nhsr018.pdf

Approximately 38% of American adults use some type of complementary and alternative medicine, and they spent nearly $34 billion on CAM products and practitioners over the past 12 months, based on data from the 2007 National Health Interview Survey.

Researchers reviewed interviews with 23,393 adults aged 18 and older that were included in the National Health Interview Survey (NHIS). The survey is conducted annually by the Centers for Disease Control and Prevention. Lead author Richard L. Nahin, Ph.D., is acting director of the division of extramural research at the National Institutes of Health's National Center for Complementary and Alternative Medicine.

Overall, approximately 65% ($22 billion) of American adults' spending on CAM went toward self-care, while approximately 35% ($11.9 billion) was spent on visits to CAM practitioners, Dr. Nahin and colleagues reported.

Of the money spent on self-care, nearly 44% ($14.8 billion) went to nonvitamin, nonmineral natural products. Another $4.1 billion were spent on classes such as yoga and tai chi; $2.9 billion, on homeopathic medicine; and $200 million, on relaxation techniques.

The money spent on CAM products was approximately one-third of the $47.6 billion American adults spent on pharmaceutical drugs in 2007, the researchers noted.

The money spent on CAM provider visits was approximately one-quarter of the $49.6 billion spent on conventional physician services.

Although the overall number of visits to CAM providers (except for acupuncturists) decreased in 2007, compared with a decade earlier, “at least 20% of persons visiting practitioners of acupuncture, homeopathy, naturopathy, massage, and hypnosis therapy paid $75 or more per visit,” the researchers wrote.

The results were limited by the reliance on self-reports from the survey respondents, and by estimates of each respondent's annual CAM spending based on the most recent purchase, which may not have been typical of a respondent's CAM use, the researchers said.

But the NHIS data show that U.S. adults make more than 300 million visits to CAM providers and spend billions of dollars on CAM annually.

“These expenditures, although a small fraction of total health care spending in the United States, constitute a substantial part of out-of-pocket health care costs and are comparable to out-of-pocket costs for conventional physician services and prescription drug use,” the researchers said.

View the complete report online at the CDC's Web site at www.cdc.gov/NCHS/data/nhsr/nhsr018.pdf

The Centers for Disease Control and Prevention has updated its guidelines for using antiviral medications to treat the seasonal and pandemic influenza A(H1N1) viruses, according to the CDC Web site.

The updated recommendations include guidance for clinicians about the following:

▸ Treating children younger than age 1 year. Oseltamivir (Tamiflu) is not approved by the Food and Drug Administration for use in children younger than 1 year of age. But given this age group's increased risk for complications from the H1N1 virus, the CDC recommends a 5-day antiviral treatment dose with oseltamivir of 25 mg twice daily for children aged 6–11 months, 20 mg twice daily for children aged 3–5 months, and 12 mg twice daily for children younger than 3 months.

The CDC's recommendations for 10-day prophylaxis with oseltamivir are 25 mg once daily for children aged 6–11 months, and 20 mg once daily for children aged 3–5 months, but oseltamivir is not currently recommended for prophylaxis for children younger than 3 months unless the situation is deemed critical.

The FDA issued an Emergency Use Authorization in April 2009 for the emergency use of oseltamivir in children younger than 1 year old.

▸ Dispenser measurements. Clinicians and pharmacists are cautioned that an oral dosing dispenser that comes with Tamiflu for oral suspension shows dose measurements in 30-mg, 45-mg, and 60-mg increments. These measurements use mg and match those currently recommended by the CDC for treatment or chemoprophylaxis against H1N1 infection, but the prescription instructions may be listed in mL or tsp, which can lead to dosing errors.

▸ Patients with neuromuscular or neurocognitive disorders. The revised recommendations for individuals who might benefit most from early treatment with antiviral therapy include patients with disorders that can increase the risk for aspiration, such as spinal cord injuries, seizure disorders, cognitive dysfunction, and other neuromuscular disorders, plus any disorders that “can compromise respiratory function or the handling or respiratory secretions.”

The CDC stated that its guidance will be updated as needed. For the latest information on the CDC's flu recommendations, visit cdc.govflu.gov

The Centers for Disease Control and Prevention has updated its guidelines for using antiviral medications to treat the seasonal and pandemic influenza A(H1N1) viruses, according to the CDC Web site.

The updated recommendations include guidance for clinicians about the following:

▸ Treating children younger than age 1 year. Oseltamivir (Tamiflu) is not approved by the Food and Drug Administration for use in children younger than 1 year of age. But given this age group's increased risk for complications from the H1N1 virus, the CDC recommends a 5-day antiviral treatment dose with oseltamivir of 25 mg twice daily for children aged 6–11 months, 20 mg twice daily for children aged 3–5 months, and 12 mg twice daily for children younger than 3 months.

The CDC's recommendations for 10-day prophylaxis with oseltamivir are 25 mg once daily for children aged 6–11 months, and 20 mg once daily for children aged 3–5 months, but oseltamivir is not currently recommended for prophylaxis for children younger than 3 months unless the situation is deemed critical.

The FDA issued an Emergency Use Authorization in April 2009 for the emergency use of oseltamivir in children younger than 1 year old.

▸ Dispenser measurements. Clinicians and pharmacists are cautioned that an oral dosing dispenser that comes with Tamiflu for oral suspension shows dose measurements in 30-mg, 45-mg, and 60-mg increments. These measurements use mg and match those currently recommended by the CDC for treatment or chemoprophylaxis against H1N1 infection, but the prescription instructions may be listed in mL or tsp, which can lead to dosing errors.

▸ Patients with neuromuscular or neurocognitive disorders. The revised recommendations for individuals who might benefit most from early treatment with antiviral therapy include patients with disorders that can increase the risk for aspiration, such as spinal cord injuries, seizure disorders, cognitive dysfunction, and other neuromuscular disorders, plus any disorders that “can compromise respiratory function or the handling or respiratory secretions.”

The CDC stated that its guidance will be updated as needed. For the latest information on the CDC's flu recommendations, visit cdc.govflu.gov

The Centers for Disease Control and Prevention has updated its guidelines for using antiviral medications to treat the seasonal and pandemic influenza A(H1N1) viruses, according to the CDC Web site.

The updated recommendations include guidance for clinicians about the following:

▸ Treating children younger than age 1 year. Oseltamivir (Tamiflu) is not approved by the Food and Drug Administration for use in children younger than 1 year of age. But given this age group's increased risk for complications from the H1N1 virus, the CDC recommends a 5-day antiviral treatment dose with oseltamivir of 25 mg twice daily for children aged 6–11 months, 20 mg twice daily for children aged 3–5 months, and 12 mg twice daily for children younger than 3 months.

The CDC's recommendations for 10-day prophylaxis with oseltamivir are 25 mg once daily for children aged 6–11 months, and 20 mg once daily for children aged 3–5 months, but oseltamivir is not currently recommended for prophylaxis for children younger than 3 months unless the situation is deemed critical.

The FDA issued an Emergency Use Authorization in April 2009 for the emergency use of oseltamivir in children younger than 1 year old.

▸ Dispenser measurements. Clinicians and pharmacists are cautioned that an oral dosing dispenser that comes with Tamiflu for oral suspension shows dose measurements in 30-mg, 45-mg, and 60-mg increments. These measurements use mg and match those currently recommended by the CDC for treatment or chemoprophylaxis against H1N1 infection, but the prescription instructions may be listed in mL or tsp, which can lead to dosing errors.

▸ Patients with neuromuscular or neurocognitive disorders. The revised recommendations for individuals who might benefit most from early treatment with antiviral therapy include patients with disorders that can increase the risk for aspiration, such as spinal cord injuries, seizure disorders, cognitive dysfunction, and other neuromuscular disorders, plus any disorders that “can compromise respiratory function or the handling or respiratory secretions.”

The CDC stated that its guidance will be updated as needed. For the latest information on the CDC's flu recommendations, visit cdc.govflu.gov

More than two-thirds of patients who were treated with stents for unprotected left main coronary artery disease were alive 10 years later, and patients who received drug-eluting stents had significantly fewer adverse events than did those who had bare metal stents, on the basis of data from 252 adults.

“Unprotected left main coronary artery disease (ULMCA) occurs in 3%-5% of coronary artery disease patients and is the subject of intense investigation,” wrote Dr. Pawel E. Buszman of the Medical University of Silesia in Katowice, Poland.

Current guidelines recommend that patients with ULMCA be revascularized with coronary artery bypass surgery. To evaluate the outcomes of stenting in this subset of patients, Dr. Buszman and his colleagues reviewed data from patients who underwent percutaneous coronary intervention to treat left main artery stenosis between January 1997 and March 2008. PCI was performed in these patients rather than surgery because of anatomical suitability, high surgical risk, or patient preference. The average age of the patients was 69 years (J. Am. Coll. Cardiol. 2009 Aug. 19 [doi:10.1016/j.jacc.2009.07.007

A total of 158 patients received bare metal stents (BMS) and 94 received drug-eluting stents (DES). Overall, angiographic success was achieved in 98% of the patients.

Angiographic success was defined as less than 30% residual stenosis of the left main artery, a minimal lumen diameter of at least 3 mm, a thrombolysis in myocardial infarction flow grade of 3, and no dissection.

During a short-term follow-up period of 30 days, major adverse cardiovascular and cerebral events (MACCE) occurred in 12 patients (5%) and 4 patients died (2%).

The long-term follow-up period ranged from 1 to 11 years, with an average follow-up period of 3.8 years. Based on a Kaplan-Meier analysis, the 5-year and 10-year survival rates were 78% and 69%, respectively.

During long-term follow-up, MACCE occurred in 64 patients (25%), including 25 MIs, 21 target lesion revascularizations, and 3 strokes. Of the 35 patients who died (14%), 28 were considered cardiac deaths. “There was significantly better long-term survival in patients with isolated left main coronary artery disease (LM) or LM with 1- and 2-vessel disease when compared with LM with 3-vessel disease,” the researchers said.

The patients in the DES group were significantly more likely to have a higher surgical risk and a higher incidence of left main artery stenosis than were the patients in the BMS group. But the unadjusted occurrence of major adverse cardiovascular and cerebral events was significantly lower in the DES group compared with the BMS group (15% vs. 26%), the researchers noted. “Further propensity score matching and data adjustment confirmed and strengthened those findings,” they said.

There were no significant differences between the stent groups in terms of death, myocardial infarction, stroke, or target lesion revascularizations.

The study was limited by the low rate of angiographic follow-up and an inconsistent use of intravascular ultrasound to evaluate the result of the stenting, the authors wrote.

But the favorable feasibility and outcome results supported data from previous studies, the researchers said. In contrast to previous studies, there was no significant difference in survival or major adverse event rates in patients with distal left main coronary artery compared with the proximal/medial left main coronary artery.

The findings are the first prospective data on long-term results of left main coronary artery stenting, using patients in the Left Main Coronary Artery Stenting (LE MANS) registry. The high procedural success rate and low rates of periprocedural mortality (1.3%) and major adverse events suggest that the stents are safe and feasible for ULMCA, the researchers noted. “Based upon the mounting evidence, there can be little dispute at this juncture that PCI can be offered as a safe alternative to CABG for a significant number of patients with left main disease, particularly nondiabetics without extensive concomitant artery disease,” Dr. Jeffrey Moses of Columbia University, New York, and his colleagues wrote in an accompanying editorial (doi:10.1016/j.jacc.2009.07.016

Neither Dr. Buszman nor Dr. Moses disclosed financial conflicts of interest. Previously, Dr. Moses disclosed that he was on the speakers bureau for and received honoraria from Cordis, Johnson & Johnson, Boston Scientific, and Sanofi, and was an adviser to Cordis and Johnson & Johnson. Dr. Buszman previously disclosed that he had no financial conflicts of interest.

More than two-thirds of patients who were treated with stents for unprotected left main coronary artery disease were alive 10 years later, and patients who received drug-eluting stents had significantly fewer adverse events than did those who had bare metal stents, on the basis of data from 252 adults.

“Unprotected left main coronary artery disease (ULMCA) occurs in 3%-5% of coronary artery disease patients and is the subject of intense investigation,” wrote Dr. Pawel E. Buszman of the Medical University of Silesia in Katowice, Poland.

Current guidelines recommend that patients with ULMCA be revascularized with coronary artery bypass surgery. To evaluate the outcomes of stenting in this subset of patients, Dr. Buszman and his colleagues reviewed data from patients who underwent percutaneous coronary intervention to treat left main artery stenosis between January 1997 and March 2008. PCI was performed in these patients rather than surgery because of anatomical suitability, high surgical risk, or patient preference. The average age of the patients was 69 years (J. Am. Coll. Cardiol. 2009 Aug. 19 [doi:10.1016/j.jacc.2009.07.007

A total of 158 patients received bare metal stents (BMS) and 94 received drug-eluting stents (DES). Overall, angiographic success was achieved in 98% of the patients.

Angiographic success was defined as less than 30% residual stenosis of the left main artery, a minimal lumen diameter of at least 3 mm, a thrombolysis in myocardial infarction flow grade of 3, and no dissection.

During a short-term follow-up period of 30 days, major adverse cardiovascular and cerebral events (MACCE) occurred in 12 patients (5%) and 4 patients died (2%).

The long-term follow-up period ranged from 1 to 11 years, with an average follow-up period of 3.8 years. Based on a Kaplan-Meier analysis, the 5-year and 10-year survival rates were 78% and 69%, respectively.

During long-term follow-up, MACCE occurred in 64 patients (25%), including 25 MIs, 21 target lesion revascularizations, and 3 strokes. Of the 35 patients who died (14%), 28 were considered cardiac deaths. “There was significantly better long-term survival in patients with isolated left main coronary artery disease (LM) or LM with 1- and 2-vessel disease when compared with LM with 3-vessel disease,” the researchers said.

The patients in the DES group were significantly more likely to have a higher surgical risk and a higher incidence of left main artery stenosis than were the patients in the BMS group. But the unadjusted occurrence of major adverse cardiovascular and cerebral events was significantly lower in the DES group compared with the BMS group (15% vs. 26%), the researchers noted. “Further propensity score matching and data adjustment confirmed and strengthened those findings,” they said.

There were no significant differences between the stent groups in terms of death, myocardial infarction, stroke, or target lesion revascularizations.

The study was limited by the low rate of angiographic follow-up and an inconsistent use of intravascular ultrasound to evaluate the result of the stenting, the authors wrote.

But the favorable feasibility and outcome results supported data from previous studies, the researchers said. In contrast to previous studies, there was no significant difference in survival or major adverse event rates in patients with distal left main coronary artery compared with the proximal/medial left main coronary artery.

The findings are the first prospective data on long-term results of left main coronary artery stenting, using patients in the Left Main Coronary Artery Stenting (LE MANS) registry. The high procedural success rate and low rates of periprocedural mortality (1.3%) and major adverse events suggest that the stents are safe and feasible for ULMCA, the researchers noted. “Based upon the mounting evidence, there can be little dispute at this juncture that PCI can be offered as a safe alternative to CABG for a significant number of patients with left main disease, particularly nondiabetics without extensive concomitant artery disease,” Dr. Jeffrey Moses of Columbia University, New York, and his colleagues wrote in an accompanying editorial (doi:10.1016/j.jacc.2009.07.016

Neither Dr. Buszman nor Dr. Moses disclosed financial conflicts of interest. Previously, Dr. Moses disclosed that he was on the speakers bureau for and received honoraria from Cordis, Johnson & Johnson, Boston Scientific, and Sanofi, and was an adviser to Cordis and Johnson & Johnson. Dr. Buszman previously disclosed that he had no financial conflicts of interest.

More than two-thirds of patients who were treated with stents for unprotected left main coronary artery disease were alive 10 years later, and patients who received drug-eluting stents had significantly fewer adverse events than did those who had bare metal stents, on the basis of data from 252 adults.

“Unprotected left main coronary artery disease (ULMCA) occurs in 3%-5% of coronary artery disease patients and is the subject of intense investigation,” wrote Dr. Pawel E. Buszman of the Medical University of Silesia in Katowice, Poland.

Current guidelines recommend that patients with ULMCA be revascularized with coronary artery bypass surgery. To evaluate the outcomes of stenting in this subset of patients, Dr. Buszman and his colleagues reviewed data from patients who underwent percutaneous coronary intervention to treat left main artery stenosis between January 1997 and March 2008. PCI was performed in these patients rather than surgery because of anatomical suitability, high surgical risk, or patient preference. The average age of the patients was 69 years (J. Am. Coll. Cardiol. 2009 Aug. 19 [doi:10.1016/j.jacc.2009.07.007

A total of 158 patients received bare metal stents (BMS) and 94 received drug-eluting stents (DES). Overall, angiographic success was achieved in 98% of the patients.

Angiographic success was defined as less than 30% residual stenosis of the left main artery, a minimal lumen diameter of at least 3 mm, a thrombolysis in myocardial infarction flow grade of 3, and no dissection.

During a short-term follow-up period of 30 days, major adverse cardiovascular and cerebral events (MACCE) occurred in 12 patients (5%) and 4 patients died (2%).

The long-term follow-up period ranged from 1 to 11 years, with an average follow-up period of 3.8 years. Based on a Kaplan-Meier analysis, the 5-year and 10-year survival rates were 78% and 69%, respectively.

During long-term follow-up, MACCE occurred in 64 patients (25%), including 25 MIs, 21 target lesion revascularizations, and 3 strokes. Of the 35 patients who died (14%), 28 were considered cardiac deaths. “There was significantly better long-term survival in patients with isolated left main coronary artery disease (LM) or LM with 1- and 2-vessel disease when compared with LM with 3-vessel disease,” the researchers said.

The patients in the DES group were significantly more likely to have a higher surgical risk and a higher incidence of left main artery stenosis than were the patients in the BMS group. But the unadjusted occurrence of major adverse cardiovascular and cerebral events was significantly lower in the DES group compared with the BMS group (15% vs. 26%), the researchers noted. “Further propensity score matching and data adjustment confirmed and strengthened those findings,” they said.

There were no significant differences between the stent groups in terms of death, myocardial infarction, stroke, or target lesion revascularizations.

The study was limited by the low rate of angiographic follow-up and an inconsistent use of intravascular ultrasound to evaluate the result of the stenting, the authors wrote.

But the favorable feasibility and outcome results supported data from previous studies, the researchers said. In contrast to previous studies, there was no significant difference in survival or major adverse event rates in patients with distal left main coronary artery compared with the proximal/medial left main coronary artery.

The findings are the first prospective data on long-term results of left main coronary artery stenting, using patients in the Left Main Coronary Artery Stenting (LE MANS) registry. The high procedural success rate and low rates of periprocedural mortality (1.3%) and major adverse events suggest that the stents are safe and feasible for ULMCA, the researchers noted. “Based upon the mounting evidence, there can be little dispute at this juncture that PCI can be offered as a safe alternative to CABG for a significant number of patients with left main disease, particularly nondiabetics without extensive concomitant artery disease,” Dr. Jeffrey Moses of Columbia University, New York, and his colleagues wrote in an accompanying editorial (doi:10.1016/j.jacc.2009.07.016

Neither Dr. Buszman nor Dr. Moses disclosed financial conflicts of interest. Previously, Dr. Moses disclosed that he was on the speakers bureau for and received honoraria from Cordis, Johnson & Johnson, Boston Scientific, and Sanofi, and was an adviser to Cordis and Johnson & Johnson. Dr. Buszman previously disclosed that he had no financial conflicts of interest.

The Centers for Disease Control and Prevention has updated its guidelines for using antiviral medications to treat the seasonal and pandemic influenza A(H1N1) viruses, according to the CDC Web site.

The updated recommendations include guidance for clinicians about antiviral treatment for very young children and information about correct dosing using the oseltamivir (Tamiflu) dosing dispenser:

▸ Treating children younger than age 1 year. Oseltamivir is not approved by the Food and Drug Administration for use in children younger than 1 year of age. But given this age group's increased risk for complications from the H1N1 virus, the CDC recommends a 5-day antiviral treatment dose with oseltamivir of 25 mg twice daily for children aged 6-11 months, 20 mg twice daily for children aged 3-5 months, and 12 mg twice daily for children younger than 3 months.

The CDC's recommendations for 10-day prophylaxis with oseltamivir are 25 mg once daily for children aged 6-11 months, and 20 mg once daily for children aged 3-5 months, but oseltamivir is not currently recommended for prophylaxis for children younger than 3 months unless the situation is deemed critical. The FDA issued an Emergency Use Authorization in April 2009 for the emergency use of oseltamivir in children younger than 1 year old.

▸ Dispenser measurements. The updated CDC antiviral recommendations caution clinicians and pharmacists that an oral dosing dispenser that comes with Tamiflu for oral suspension shows dose measurements in 30-mg, 45-mg, and 60-mg increments. These measurements use “mg” and match those currently recommended by the CDC for treatment of or chemoprophylaxis against H1N1 infection (see table), but the prescription instructions may be listed in “mL” or “tsp,” which can lead to dosing errors.

The CDC Web site states that the recommendations should be considered an interim document, which will be updated as needed. For the latest information on the CDC's flu guidance and recommendations, visit www.cdc.govwww.flu.gov

Source ELSEVIER GLOBAL MEDICAL NEWS

The Centers for Disease Control and Prevention has updated its guidelines for using antiviral medications to treat the seasonal and pandemic influenza A(H1N1) viruses, according to the CDC Web site.

The updated recommendations include guidance for clinicians about antiviral treatment for very young children and information about correct dosing using the oseltamivir (Tamiflu) dosing dispenser:

▸ Treating children younger than age 1 year. Oseltamivir is not approved by the Food and Drug Administration for use in children younger than 1 year of age. But given this age group's increased risk for complications from the H1N1 virus, the CDC recommends a 5-day antiviral treatment dose with oseltamivir of 25 mg twice daily for children aged 6-11 months, 20 mg twice daily for children aged 3-5 months, and 12 mg twice daily for children younger than 3 months.

The CDC's recommendations for 10-day prophylaxis with oseltamivir are 25 mg once daily for children aged 6-11 months, and 20 mg once daily for children aged 3-5 months, but oseltamivir is not currently recommended for prophylaxis for children younger than 3 months unless the situation is deemed critical. The FDA issued an Emergency Use Authorization in April 2009 for the emergency use of oseltamivir in children younger than 1 year old.

▸ Dispenser measurements. The updated CDC antiviral recommendations caution clinicians and pharmacists that an oral dosing dispenser that comes with Tamiflu for oral suspension shows dose measurements in 30-mg, 45-mg, and 60-mg increments. These measurements use “mg” and match those currently recommended by the CDC for treatment of or chemoprophylaxis against H1N1 infection (see table), but the prescription instructions may be listed in “mL” or “tsp,” which can lead to dosing errors.

The CDC Web site states that the recommendations should be considered an interim document, which will be updated as needed. For the latest information on the CDC's flu guidance and recommendations, visit www.cdc.govwww.flu.gov

Source ELSEVIER GLOBAL MEDICAL NEWS

The Centers for Disease Control and Prevention has updated its guidelines for using antiviral medications to treat the seasonal and pandemic influenza A(H1N1) viruses, according to the CDC Web site.

The updated recommendations include guidance for clinicians about antiviral treatment for very young children and information about correct dosing using the oseltamivir (Tamiflu) dosing dispenser:

▸ Treating children younger than age 1 year. Oseltamivir is not approved by the Food and Drug Administration for use in children younger than 1 year of age. But given this age group's increased risk for complications from the H1N1 virus, the CDC recommends a 5-day antiviral treatment dose with oseltamivir of 25 mg twice daily for children aged 6-11 months, 20 mg twice daily for children aged 3-5 months, and 12 mg twice daily for children younger than 3 months.

The CDC's recommendations for 10-day prophylaxis with oseltamivir are 25 mg once daily for children aged 6-11 months, and 20 mg once daily for children aged 3-5 months, but oseltamivir is not currently recommended for prophylaxis for children younger than 3 months unless the situation is deemed critical. The FDA issued an Emergency Use Authorization in April 2009 for the emergency use of oseltamivir in children younger than 1 year old.

▸ Dispenser measurements. The updated CDC antiviral recommendations caution clinicians and pharmacists that an oral dosing dispenser that comes with Tamiflu for oral suspension shows dose measurements in 30-mg, 45-mg, and 60-mg increments. These measurements use “mg” and match those currently recommended by the CDC for treatment of or chemoprophylaxis against H1N1 infection (see table), but the prescription instructions may be listed in “mL” or “tsp,” which can lead to dosing errors.

The CDC Web site states that the recommendations should be considered an interim document, which will be updated as needed. For the latest information on the CDC's flu guidance and recommendations, visit www.cdc.govwww.flu.gov

Source ELSEVIER GLOBAL MEDICAL NEWS

A pilot program aimed at teaching residents how to better counsel patients and families about childhood obesity is underway in five California-based residency programs.

The idea is to train pediatric and family medicine residents in strategies that can help patients make behavioral changes proven to reduce and prevent obesity. For example, the program gives the residents tips for helping individuals decrease their consumption of sugary beverages. Residents are armed with handouts on healthy beverage options and a visual aid that shows patients how much sugar is in a soda or sports drink.

The hope is that preparing future primary care physicians to effectively motivate lifestyle changes will help stem the prevalence rates of pediatric obesity, type 2 diabetes, and heart disease, Dr. Lydia Tinajero-Deck, the project's principal investigator, said in an interview.

The pilot, dubbed Fit for Residents, was developed by the University of California, Los Angeles, in collaboration with the American Academy of Pediatrics and American Academy of Family Physicians, said Dr. Tinajero-Deck, a pediatrician in the primary care department at Children's Hospital & Research Center in Oakland, Calif.

A pilot program aimed at teaching residents how to better counsel patients and families about childhood obesity is underway in five California-based residency programs.

The idea is to train pediatric and family medicine residents in strategies that can help patients make behavioral changes proven to reduce and prevent obesity. For example, the program gives the residents tips for helping individuals decrease their consumption of sugary beverages. Residents are armed with handouts on healthy beverage options and a visual aid that shows patients how much sugar is in a soda or sports drink.

The hope is that preparing future primary care physicians to effectively motivate lifestyle changes will help stem the prevalence rates of pediatric obesity, type 2 diabetes, and heart disease, Dr. Lydia Tinajero-Deck, the project's principal investigator, said in an interview.

The pilot, dubbed Fit for Residents, was developed by the University of California, Los Angeles, in collaboration with the American Academy of Pediatrics and American Academy of Family Physicians, said Dr. Tinajero-Deck, a pediatrician in the primary care department at Children's Hospital & Research Center in Oakland, Calif.

A pilot program aimed at teaching residents how to better counsel patients and families about childhood obesity is underway in five California-based residency programs.

The idea is to train pediatric and family medicine residents in strategies that can help patients make behavioral changes proven to reduce and prevent obesity. For example, the program gives the residents tips for helping individuals decrease their consumption of sugary beverages. Residents are armed with handouts on healthy beverage options and a visual aid that shows patients how much sugar is in a soda or sports drink.

The hope is that preparing future primary care physicians to effectively motivate lifestyle changes will help stem the prevalence rates of pediatric obesity, type 2 diabetes, and heart disease, Dr. Lydia Tinajero-Deck, the project's principal investigator, said in an interview.

The pilot, dubbed Fit for Residents, was developed by the University of California, Los Angeles, in collaboration with the American Academy of Pediatrics and American Academy of Family Physicians, said Dr. Tinajero-Deck, a pediatrician in the primary care department at Children's Hospital & Research Center in Oakland, Calif.

WASHINGTON — The health cost of obesity in the United States jumped over the past decade, from $74 billion in 1998 to approximately $147 billion today, based on data from a study conducted by the Centers for Disease Control and Prevention and the Research Triangle Institute. The data were presented at the CDC's inaugural Weight of the Nation conference on obesity.

“Obesity affects every body system,” Dr. Thomas R. Frieden, director of the CDC, said during opening remarks at the conference.

Obesity accounted for 6.5% of overall annual medical costs in the United States in 1998, but that proportion increased to 9.1% by 2006, said the study's lead author, Eric Finkelstein, Ph.D., of the independent Research Triangle Institute.

The annual cost of medical care per adult in the United States is 41% less for a normal-weight individual than for an obese individual, Dr. Finkelstein said. In this study, obesity was defined as a body mass index of 30 kg/m

If the obesity prevalence had remained the same between 1998 and 2006, 2006 medical costs in the United States would have been approximately $40 billion less, Dr. Finkelstein emphasized.

The study results were limited by the reliance on self-reports of body mass index, Dr. Finkelstein noted. The study examined only aggregate health costs and did not look at disease-specific costs, but “diabetes is one of the largest drivers of health care costs,” he said.

At a media briefing, Dr. Frieden said that the most effective strategies to reduce obesity may involve community intervention rather than clinical intervention. But physicians have a responsibility to encourage patients' weight-loss efforts in a clinical practice setting, he added.

The study was sponsored in part by the CDC.

To watch a video interview of Dr. Finkelstein, go to: http://www.youtube.com/watch?v=TwyTYVrnJjw

WASHINGTON — The health cost of obesity in the United States jumped over the past decade, from $74 billion in 1998 to approximately $147 billion today, based on data from a study conducted by the Centers for Disease Control and Prevention and the Research Triangle Institute. The data were presented at the CDC's inaugural Weight of the Nation conference on obesity.

“Obesity affects every body system,” Dr. Thomas R. Frieden, director of the CDC, said during opening remarks at the conference.

Obesity accounted for 6.5% of overall annual medical costs in the United States in 1998, but that proportion increased to 9.1% by 2006, said the study's lead author, Eric Finkelstein, Ph.D., of the independent Research Triangle Institute.

The annual cost of medical care per adult in the United States is 41% less for a normal-weight individual than for an obese individual, Dr. Finkelstein said. In this study, obesity was defined as a body mass index of 30 kg/m

If the obesity prevalence had remained the same between 1998 and 2006, 2006 medical costs in the United States would have been approximately $40 billion less, Dr. Finkelstein emphasized.

The study results were limited by the reliance on self-reports of body mass index, Dr. Finkelstein noted. The study examined only aggregate health costs and did not look at disease-specific costs, but “diabetes is one of the largest drivers of health care costs,” he said.

At a media briefing, Dr. Frieden said that the most effective strategies to reduce obesity may involve community intervention rather than clinical intervention. But physicians have a responsibility to encourage patients' weight-loss efforts in a clinical practice setting, he added.

The study was sponsored in part by the CDC.

To watch a video interview of Dr. Finkelstein, go to: http://www.youtube.com/watch?v=TwyTYVrnJjw

WASHINGTON — The health cost of obesity in the United States jumped over the past decade, from $74 billion in 1998 to approximately $147 billion today, based on data from a study conducted by the Centers for Disease Control and Prevention and the Research Triangle Institute. The data were presented at the CDC's inaugural Weight of the Nation conference on obesity.

“Obesity affects every body system,” Dr. Thomas R. Frieden, director of the CDC, said during opening remarks at the conference.

Obesity accounted for 6.5% of overall annual medical costs in the United States in 1998, but that proportion increased to 9.1% by 2006, said the study's lead author, Eric Finkelstein, Ph.D., of the independent Research Triangle Institute.

The annual cost of medical care per adult in the United States is 41% less for a normal-weight individual than for an obese individual, Dr. Finkelstein said. In this study, obesity was defined as a body mass index of 30 kg/m

If the obesity prevalence had remained the same between 1998 and 2006, 2006 medical costs in the United States would have been approximately $40 billion less, Dr. Finkelstein emphasized.

The study results were limited by the reliance on self-reports of body mass index, Dr. Finkelstein noted. The study examined only aggregate health costs and did not look at disease-specific costs, but “diabetes is one of the largest drivers of health care costs,” he said.

At a media briefing, Dr. Frieden said that the most effective strategies to reduce obesity may involve community intervention rather than clinical intervention. But physicians have a responsibility to encourage patients' weight-loss efforts in a clinical practice setting, he added.

The study was sponsored in part by the CDC.

To watch a video interview of Dr. Finkelstein, go to: http://www.youtube.com/watch?v=TwyTYVrnJjw