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Am Fam Physician. 2004 Jul 15;70(2):235-236.

FDA Warns Against Using Domperidone to Increase Breast Milk Production

The U.S. Food and Drug Administration (FDA) is warning breastfeeding women not to use domperidone because of safety concerns. The FDA has not approved the drug for any use, but has received reports that women have purchased the drug from compounding pharmacies and sources in other countries. Domperidone may increase the secretion of prolactin, which is needed for lactation. Published reports document case studies of cardiac arrhythmias, cardiac arrest, and sudden death in persons receiving an intravenous form of domperidone that has been withdrawn from the market in a number of countries. The drug is excreted in breast milk and could expose an infant to unknown risks. The oral form of domperidone still used in some countries to treat gastric disorders has labeling that warns breastfeeding women not to use the drug. The FDA has issued an alert to field personnel to be on the lookout for attempts to import the drug. Warning letters have been sent to pharmacies that compound products containing domperidone and firms that supply the drug. More information is available online at http://www.fda.gov/bbs/topics/answers/2004/ans01292.html.

AAFP Members Visit Lawmakers in Washington, D.C.

About 80 leaders and members of the American Academy of Family Physicians (AAFP) visited Washington, D.C. for the Family Medicine Congressional Conference on May 19–20. Participants at the conference, formerly called AAFP’s Spring Legislative Conference, included national and constituent chapter leaders and family physicians who often contact members of Congress about issues important to the specialty. The group focused on support of Title VII funding, Medicare graduate medical education funding, and health care for the uninsured. More information on the conference is available online at http://www.aafp.org/x27953.xml.

CDC Reports Data on Suicide Behaviors, Risk Factors, and Prevention

An analysis conducted by the Centers for Disease Control and Prevention (CDC) found that suffocation (mostly hangings) has replaced firearms as the most common method of suicide in those 10 to 14 years of age. These and other findings were released in the June 7 issue of Morbidity and Mortality Weekly Report. Data on the relationship between suicide attempts and physical fighting in high school students, school-associated suicides, and suicide trends in Hispanic populations and in China are included. Students who reported attempting suicide in the past 12 months were nearly four times as likely to report involvement in physical fights. With regard to incidents of school violence, 20 percent were suicides, and one in four of these students injured or killed someone else before their suicide. More information is available online at http://www.cdc.gov/od/oc/media/pressrel/r040610.htm and http://www.cdc.gov/mmwr.

AAFP Sponsors National Conference for Residents and Medical Students

On July 28–31, the AAFP will host the 2004 National Conference of Family Medicine Residents and Medical Students in Kansas City, Mo. Participants can meet AAFP leaders, participate in resident and student leader elections, attend clinical workshops, and gather information from more than 300 family medicine residency programs. Scheduled presenters include AAFP President Michael Fleming, M.D., and the 2004 AAFP Family Physician of the Year, Eric Ossowski, M.D., Phoenix, Ariz. More details about scheduling and featured events are available online at http://www.aafp.org/x26565.xml.

HHS Awards $498 Million to Improve Disaster Response

At the end of May, the U.S. Department of Health and Human Services (HHS) announced awards totalling $498 million to strengthen the ability of hospitals and other health care facilities to respond to bioterror attacks, infectious diseases, and natural disasters that could cause mass casualties. Health departments in the states, territories, and metropolitan areas receiving funds will be expected to improve the readiness of hospitals and other health care facilities to manage mass casualties. Recipients will use the funds to increase coordination on disease reporting among hospitals and local or state health departments; enhance coordination between public health and hospital-based laboratories; and integrate the communications capabilities of these entities. A table containing the breakdown of funding is available online at http://www.hhs.gov/news/press/2004pres/20040524.html.

HHS Responds to Requests for Clarification About HIPAA Privacy Rule

One year after implementation of the privacy rule of the Health Insurance Portability and Accountability Act (HIPAA), misconceptions about the application of the rule still exist. To help answer questions, the HHS has posted a letter from Richard Campanelli, J.D., director of the Office for Civil Rights at http://www.hhs.gov/ocr/Healthcare-Provider-letter.pdf. Examples of misinterpretations of the privacy rule and where to find information about these topics are included: HIPAA does not require patients to sign consent forms before physicians, hospitals, or ambulances can share information for treatment purposes ( http://www.hhs.gov/ocr/privacysummary.pdf); HIPAA does not cut off all communication between practitioners and the families and friends of patients; and HIPAA does not stop calls or visits to hospitals by family, friends, clergy, or anyone else (see answers to frequently asked questions at http://www.hhs.gov/ocr/hipaa).

WHO Survey Results Show High Rate of Mental Illness in the U.S.

In the 2001–2003 World Mental Health Survey Initiative, the World Health Organization (WHO) conducted face-to-face surveys with more than 60,000 adults in 14 countries in the Americas, Europe, Middle East, Africa, and Asia. According to the results of the survey published in the June 2, 2004 issue of JAMA, the United States had the highest prevalence of mental illness (26.4 percent). Overall, more Americans received treatment than patients in other countries, but 48 to 66 percent with moderate to serious illness received no treatment. The report indicates that systemic barriers, such as unequal access to care caused by lack of insurance coverage, may contribute to the problem. More information is available online at http://jama.ama-assn.org/cgi/content/full/291/21/2581.


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