News
IDAHO WWAMI Mini Medical School
This years focus for the Mini-Medical School will be diseases of the lung. The program is a community service providing an educational series designed for the general public. The program will highlight how medicine is taught to medical students as well as educate attendees on how to take care of themselves and technological advances. The lecturers are faculty of the Idaho WWAMI, a regional program of the University of Washington.The program will be held Tuesday evening, 7:00 - 9:00 p.m., February 17 - March 16, 2004 at St. Luke's RMC Anderson Center. Contact Dana Ellis at the WWAMI office at 327-0641 for further information.
45th Annual Winter Clinics
Plan to attend the longest running CME seminar in Idaho, February 14-16, 2004 in Sun Valley. This year we will enjoy the new Sun Valley Convention facility (an improvement over the ice rink). We have an excellent faculty bringing expertise from the University of Pittsburgh, University of Colorado, Swedish Medical Center, and the University of Washington as well as our local talent.This year the curriculum has endocrine issues for adults and kids, emergency medicine, ACLS, pediatric infectious disease, sports medicine, and adolescent medicine. If your practice touches any of these populations we think you'll find this a great family oriented weekend.
This years dinner speaker will be Cora Breuner, M.D., who directs the University of Washington's program on complimentary medicine. She'll be adding a twist to the topic giving a pediatric perspective.
Please contact Dawn at 336-2930 to sign up for the program and if you'd like to ski race.
A big thanks to the Winter Clinic Committee and this year's chairperson, Dr. Ann Erwin.
LATE BREAKING: Leslie Norwalk, Deputy Administrator for Center for Medicare and Medicaid Services, will address physicians at our February 18, 8:00 a.m., Grand Rounds, St. Luke's RMC. She will discuss "Physician Concerns and Medicare".
Idaho Perinatal Project, February 11-13, 2004 Call 342-7642 to register.
Of Interest: You might be interested in knowing that the actual numbers of industry supported programs is down 21% over 2002. This is a trend we suspect will continue for accredited CME.
2004 CME Planner
Idaho Academy of PA's, April 1-4, Sun Valley
Idaho Academy of Family Physicians, May 13-16, Coeur d' Alene
Wilderness Medical Society, June 21-24, Boise
Idaho Medical Assoc., July 22-24, Sun Valley
Idaho Orthopedic Society, September 23-25, Sun Valley
Anderson Center - Wednesday, 8:00 a.m.
Mercy Medical Center - Wednesday, 12:30 p.m. - Winter Room
McCleary Center - Friday, 8:00 a.m.
Upcoming ACMS Events
The following members were voted in
Immediately, the Pope shouted and summoned them to come over. "I give you my blessing for your brave actions!", he told them. "I heard that there was bitter hatred between loggers and environmental activist. But,
now I have seen with my own eyes that this is not true."
As the Pope drove off, one logger asked his buddies, "Who was that?" "It was the Pope", one replied. "He is in direct contact with God and has access to all of God's wisdom." "Well," the logger said. "He may have
access to God's wisdom but he sure doesn't know anything about bear hunting." "By the way, is the bait holding up okay, or do we need to go back to Boise and grab another one?"
March 2004
April 2004
It is well known that grapefruit juice inhibits the activity of cytochrome P450 which is involved in the metabolism of about half of all drugs currently prescribed. The juice inhibits the intestinal and not the hepatic form of the enzyme. The drugs most affected are those which undergo extensive first-pass metabolism in the gut wall, such as lovastatin (Mevacor). The recovery half-life of the enzyme after a single glass of grapefruit juice appears to be about one day and after three days little inhibitory affect remains. The amount of grapefruit ingested affects the magnitude of the interaction. Most of the studies have been done using reconstituted frozen juice but fresh grapefruit also contains the inhibitor. Sweet oranges and tangerines do not inhibit this enzyme. Drugs requiring careful control of serum concentrate such as amiodarone, carbamazepine, cyclosporine, sirolimus or tacrolimus, it's prudent to advise patients to avoid grapefruit juice. For most other drugs etabolized by this enzyme, limiting daily intake to one 8-oz glass of juice or one-half of a fresh grapefruit probably would avoid most adverse reactions. Among the most commonly used drugs affected are lovastatin and imvastatin. (The Medical Letter, January 2004;46:1173)
Approximately 1000 sudden deaths occur each day in the United States and as many as 20-40% of these are the result of asystolic arrests. Wenzel, etal. conducted a randomized study on out of hospital cardiac arrests in which patients received either 40 IU of vasopressin or 1mg epinephrine followed by additional epinephrine if needed. The end point was survival to hospital admission and a secondary end point was survival to discharge. Among patients with asystole the rates of restoration of spontaneous circulation and survival to hospital admission were significantly higher after vasopressin than after epinephrine, 29 percent vs 20.3 percent.
In addition, those who were given epinephrine after the first two doses of vasopressin also had rates of spontaneous circulation and survival to hospital admission higher than those who were initially treated with
epinephrine alone. An accompanying editorialist suggests that these results are so impressive that the American Heart Association and the American College of Cardiology should urgently convene and issue interim guidelines incorporating vasopressin as the first drug of choice in asystolic cardiac arrest. The drug was not helpful in cardiac arrest due to V-fib which is the most common but also the most treatable rhythm found in patients with cardiac arrest. (N Engl J Med2004; 350:105-13)
Addendum: Every physician should take time and read Abigail Zuger's excellent article entitle Dissatisfaction with Medical
Practice which appeared in the January 1, 2004 New England Journal of Medicine. Much of what she expounds
on is heard daily in the doctor's lounge.
John J. Mohr, M.D.
18 Leslie Norwalk, Deputy Administrator, Centers for Medicare and Medicaid Services.
25 Paul Markovitz, MD, Assistant Clinical Professor of Psychiatry, Case Western Reserve University, School of Medicine, Cleveland, OH; Director, Mood and Anxiety Research Center, Inc., Director, Psychiatric Development Research, Inc., Fresno, CA.
18 Leslie Norwalk, Deputy Administrator, Centers for Medicare and Medicaid Services.
25 Paul Markovitz, MD, Assistant Clinical Professor of Psychiatry, Case Western Reserve University, School of Medicine, Cleveland, OH; Director, Mood and Anxiety Research Center, Inc., Director, Psychiatric Development Research, Inc., Fresno, CA.
Tumor Boards
Mercy Medical Center - Tuesday, 12:00 noon
St. Alphonsus Regional Medical Center - Friday, 7:00 a.m.
Breast Care Panel - Saint Alphonsus RMC - Tuesday, 7:00 a.m.
St. Luke's Regional Medical Center - Tuesday, 12:00 noon
Breast Tumor Board - St. Luke's RMC - Thursday, 7:00 a.m.
MSTI Pediatric Tumor Board - 2nd & 4th Wednesday, 12:00 noon
Feb. 13-16, Winter Clinic, Sun Valley
April 13, General Membership Meeting: Legislative Update
June 3, High School Physicals
June 18, Golf Tournament
July 22-24, IMA Annual Meeting in Sun Valley
Oct. 12, Annual Meeting and New Physician Dinner
Provisional Membership: Paul Jansen, MD; Philip Jensen, MD;
Michael Kennedy, DO; Lisa Minge, MD; Daniel Reed, MD; Ralph Sutherlin, DO; Karl Zarse, MD
Full Membership: Jason Ludwig, MD; Rosalia Richardson, MD; Pawel Zieba, MD
There is still time to register for ACMS Winter Clinics. Please contact Dawn Hall, executive director, at
336-2930 find out more!
On a tour of Idaho, the Pope took a couple of days off to visit the mountains for some sightseeing. He was cruising along the campground in the Pope-mobile when there was a frantic commotion just at the edge of the woods. A helpless man, wearing sandals, Hawaiian shorts, a save-the-whales tee shirt, and a tree hugger hat was struggling frantically, thrashing around trying to free himself from the jaws of a 10 foot grizzly. As the Pope watched horrified, a group of loggers came racing up. One ran up and quickly fired a 44 mag. into the bear's chest. The other two reached out and pulled the bleeding semiconscious man from the bear. Then using long clubs, the three loggers beat the bear to death and hauled it into their truck.
3 Management of HTN, Norman Kaplan, MD
5 Management of HTN, Norman Kaplan, MD
10 Diagnosis and Treatment of Allergic Rhinitis, Ronald Simon, MD
12 Impaired Healthcare Professionals, Shana Fogarty, MD
17 Bariatric Surgery, Chris Oakley, MD
19 Type II Diabetes Mellitus: Managing the Complicated Patient, Julie Foote, MD
24 Patient Safety: Whose at Risk, Susan Gelletly, MD, Kurt Stevenson, MD
26 Management of Fatigue, Jeffrey Berlant, MD
31 Diagnosis of Autism, Richard Pines, MD
7 West Nile Virus (Mercy), Dan Wingert, MD
14 Management of Fatigue, Jeffrey Berlant, MD
16 Adjustable Laproscopic Gastric Binding, Bryan Anderson, MD
21 Syndrome X, Jeffrey Miller, MD
28 Gastroporiasis, T. Steven Roosevelt, MD, John Witte, MD
30 Rett Syndrome, Sarojini Budden, MD
Return to the top of the ACUMEN Newsletter or
Return to the ACMEC Home Page