Kaiser Permanente’s Armenian Business Group invites you to join a virtual town hall meeting with Lena Nanushyan, MD, MPH, Armenia’s Deputy Minister of Health on Monday, April 22 at 3:00 PM EST.

Click here to join meeting

No one loves the preparation for a colonoscopy, but by staying up to date on yours, you’re greatly reducing your risk of colon and rectal cancer, sometimes referred to collectively as colorectal cancer. Regular colonoscopies can catch these cancers early, when they’re easiest to treat, and can even prevent them altogether.

“As Gastroenterologists (GI doctors), we do our best to remind everyone how important a colonoscopy or other screening methods can be. Unfortunately, we are seeing more and more patients being diagnosed with colon cancer at a younger age,” noted AAHPO member and Gastroenterologist Vahe Shahnazarian, MD MPH.

People who have no family history or symptoms of colorectal cancer should get their first colonoscopy at age 45, Dr. Shahnazarian said. That guideline has changed in recent years based on a troubling and so far unexplained trend of more young people being diagnosed with colon cancer.

“One common story I hear from patients or their family members is that they did not go for their colonoscopy because they felt fine and had no symptoms or complaints. However, the purpose of a screening procedure, like a colonoscopy, is to prevent the symptoms (and the cancer) from ever occurring. By the time you develop symptoms, we are typically dealing with an aggressive cancer, as opposed to either completely preventing the cancer or having a scenario with a much better outcome,” Dr. Shahnazarian observed.

Symptoms to call your doctor about include rectal bleeding, abdominal pain, weight loss, a change in bowel habits, and anemia.

“For those who are just opposed to colonoscopy for whatever reason, there are non-procedural tests that can be done, such as the Cologuard stool test. While these tests are not as accurate as a colonoscopy, they are still good screening tests and are better than not being screened at all,” Dr. Shahnazarian said. “In short, please speak to your Gastroenterologist about when you should be screened and what options you have. And like all my patients say, when you have a colonoscopy, it will be the best sleep you’ve ever had!”

You Are Invited to a Zoom Lecture with AAHPO Member Sharon Chekijian, MD, MPH

To register, scan the QR code above or CLICK HERE!

Editors note: In the news, celebrities like Oprah Winfrey are showing off trimmer figures attributed to weight-loss drugs. AAHPO member and medical weight loss expert Tro Kalayjian, MD:

“Many of my patients have come to me with questions about this new class of medications that are being used for both diabetes and weight loss. The new blockbusters are called Ozempic, Wegovy, and Mounjaro and seemingly every celebrity has tried it. Some with wild success and others have seemingly already gained the weight back. The question everyone should be asking is what are the benefits and what are the risks?”

Click here to read more from Dr. Kalayjian

Below, read a related article from Johns Hopkins University

Image by stockking on Freepix

Nearly 42% of American adults were obese from 2017 to 2020, up from roughly 30% in 2000, according to the Centers for Disease Control and Prevention. With that rise in obesity comes an increased risk for heart disease, stroke, type 2 diabetes, and some cancers.

Patients and their doctors are increasingly turning to in-demand drugs like Ozempic and Wegovy, but are they safe and effective? A recent episode of the Public Health on Call podcast explores the pros and cons with two Johns Hopkins University experts: gastroenterologist Sameer Khan of the Johns Hopkins School of Medicine and podcast host Joshua Sharfstein, vice dean for public health practice and communication engagement at the Bloomberg School of Public Health. Khan says the drugs work, but they are hard to find, expensive—around $700 a month without insurance for Wegovy which is prescribed for weight loss—and need to be taken forever to maintain weight loss and improve cardiovascular health when researchers don’t yet fully understand their long-term effects. Read on for three key takeaways from their conversation.

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Note from AAHPO President Lawrence V. Najarian, MD: Recently, while driving at night on a highway, my family was almost killed by a wrong way driver. The only thing that saved my family was a reflexive understanding of the situation that I developed after reading about a fatal, wrong way driver accident that happened in our area two years ago. That understanding was critical to my reaction in the few seconds I had to grasp and respond to this situation. I would like to share information about wrong way drivers to help others who may find themselves in this dangerous situation that I thought would never happen to me.

Photo courtesy NTSB

Wrong-way driving, where a driver operates a vehicle the wrong way on a road or highway against the intended flow of traffic, can result in some of the most severe types of crashes according to the National Transportation Safety Board.

The AAA Foundation for Traffic Safety reports that despite accounting for only 3.7% of all fatal crashes on divided highways between 2010 and 2018, a high percentage of these incidents are fatal as they typically result in head-on collisions.

A study of wrong-way driving from the Iowa State University Institute for Transportation notes that wrong-way driving can occur on a variety of roadways including divided highways, freeways or arterial roads. These events are often associated with driver confusion resulting from roadways that are challenging to navigate.

Recent data from the AAA Foundation for Traffic Safety also shows a concerning rise in fatalities related to wrong-way crashes. An average of 500 deaths occurred annually from wrong-way driving crashes on divided highways between 2015 and 2018, a 34% increase from 375 deaths annually from 2010 to 2014. Wrong-way drivers made up 52.8% of fatalities from wrong-way driving crashes followed by their passengers (5.7%) and occupants of other vehicles (41.1%) between 2010 and 2018. These numbers remained elevated as roughly 500 people died in wrong-way crashes annually in 2019 and 2020, according to the Federal Highway Administration (FHWA).

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What to Do if You Encounter a Wrong Way Driver

It’s essential to take immediate and decisive actions to protect yourself and others from a wrong way driver. Here are some steps to follow if you encounter a wrong-way driver:

1. Stay calm and focus on your own driving.
2. Quickly assess the situation to determine the best course of action.
3. Safely and promptly move to the right lane or shoulder, and create as much distance as possible from the wrong-way driver.
4. Do not swerve into oncoming traffic or abruptly change lanes, as this can increase the risk of a collision with other vehicles.
5. Obey traffic signals and signs while trying to distance yourself from the wrong-way driver.
6. Signal and Honk:
   – Turn on your headlights and hazard lights to make yourself more visible.
   – Honk your horn to alert the wrong-way driver and other nearby motorists.
7. Dial 911 to report the situation, and provide information about your location, the direction of travel of the wrong-way driver, and any other relevant details.
8. Avoid confronting the wrong-way driver or attempting to block their path. Let law enforcement handle the situation.

Remember that your safety and the safety of others are the top priorities. Always use your best judgment and follow the guidance of emergency services when encountering a wrong-way driver.

Note from AAHPO Board Member John Bilezikian, MD, a renowned metabolic bone disease expert, regarding the article which appears below these remarks:

Osteoporosis, a disorder of weakened bones associated with increased risk of fracture, is a major international health problem. A recent update of the scope of this problem was recently published by Douglas Kiel, Professor at Harvard and a leader in studies related to the global epidemiology of osteoporosis. In the report recently published in the Journal of Bone and Mineral Research, the flagship journal of the American Society of Bone and Mineral Research, Dr. Kiel reports that the expected incidence of hip fracture, the most serious complication of osteoporosis, is likely to increase over the next 30 years, despite a downturn in hip fractures in many countries. The study accessed data from 19 different countries and included over 4 million hip fractures. The reason for the expected doubling in the number of hip fractures, worldwide, relates to the aging population. With aging comes increased risk of osteoporosis and fractures. Another important finding of the study confirms the point that many individuals who sustain an osteoporotic hip fracture do not received therapy to prevent another one. The risk of another fracture in someone who has sustained a hip fracture is markedly higher if treatment is not instituted. This study describes differences among countries but underscores, overall, the need for greater awareness of this disease and for implementation of measures to prevent and treat it.

Image by kjpargeter on Freepik

An international study that included researchers from Harvard Medical School indicates that while age- and sex-standardized hip fracture incidence rates have decreased in most regions around the globe, the number of hip fractures worldwide is projected to nearly double by 2050, compared to 2018.

A significant treatment gap in patients sustaining a hip fracture and not receiving therapy to prevent future fractures was also observed in all countries and regions, particularly in men.

The study, recently published in the Journal of Bone and Mineral Research, reviewed more than 4 million cases and highlights an urgent need for better strategies in hip fracture prevention and care.

Hip fracture remains a global public health concern contributing to increased dependency, morbidity, and mortality and placing a burden on patients, their families, and health care systems.

READ FULL ARTICLE

Editor’s note: This article is co-authored by AAHPO Board Member Kim Hekimian, PhD and AAHPO Member and MD/PhD student Christopher Marskosian, as well as Shant Shekherdimian, MD, Kent Garber, MD, MPH, and Ara Darzi, KBE, MD. The article was recently published in The Lancet, a prestigious British medical journal.

The immediate health needs of the refugees are immense. Before the exodus, people of Nagorno-Karabakh had been living under a punitive 9-month blockade, resulting in malnutrition and worsening health conditions due to scarcity of food, medicine, and vaccines. During their exile, a fuel depot explosion led to hundreds of casualties among refugees. Other factors contributing to medical needs include the suddenness of displacement, forfeiture of medical records, and loss of established longitudinal health-care providers.

But as headlines fade and humanitarian priorities shift elsewhere, Nagorno-Karabakh refugees will continue to face challenges in accessing high-quality health care. The Armenian Government intends to integrate displaced people into the health-care system, providing them with the same care as their host communities. However, Armenia has a health-care infrastructure with scarce resources and of inadequate quality. Given this reality, it would be wise for the global health response—typically focused on the acute needs of the refugees, and sometimes guilty of setting up health programming in parallel to government efforts—to simultaneously strengthen local health services towards universal health coverage, improved primary care, and optimized outcomes.

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On Sunday, January 21, AAHPO recognized Ara Kayayan, MD and Raffi Barsoumanian, MD for their exemplary medical service to Armenians (see photos below). This was the highlight of the Winter Brunch, which was well-attended and enjoyed by AAHPO members, families and guests. CLICK HERE and scroll to the bottom of the page to see more event photos of our Winter Brunch event.

Ara Kayayan, MD, center, accepts the AAHPO Service Award from AAHPO President Lawrence V. Najarian, MD, left, and AAHPO Vice President Garbis Baydar, MD, right. Dr. Kayayan is an internist in Albany, NY who was “AAHPO’s eyes and ears” during the treatment and recovery of Bishop Mesrop, who was severely injured in 2022. Dr. Kayayan is a highly respected physician in the Albany area, and an active member of the Armenian community there.

Raffi Barsoumanian, MD, left, accepts the AAHPO Service Award from AAHPO Vice President Garbis Baydar, MD, center, and AAHPO President Lawrence V. Najarian, MD. Dr. Barsoumanian, a surgeon, was recognized for traveling to Armenia to treat soldiers who suffered severe burns in the 2020 war and required skin grafts. Dr. Barsoumanian returned to Armenia a second time to bring essential medical supplies for the treatment of soldiers.

Editor’s Note: Pediatric Infectious Disease Specialist and AAHPO Board Member Tsoline Kojaoghlanian, MD reviewed the article below and approved sharing it with AAHPO newsletter readers.

In early November 2023, the latest COVID variant, called JN.1, caused less than 5% of COVID-19 cases in the U.S. Now it is estimated to cause more than 60% of them. Virologists including Andy Pekosz, a professor in the Department of Molecular Microbiology and Immunology at the Johns Hopkins Bloomberg School of Public Health, are paying attention.

Here, Pekosz explains what virologists are seeing, what this new variant means for case rates and treatments, and why it’s so important for more people to get the updated COVID-19 vaccine rolled out this fall.

What’s most important to understand about this variant?
This latest variant should be a reminder that we have tools to fight off COVID infection and minimize severe disease: Tests detect JN.1, the new vaccines protect against severe disease, and antivirals are still capable of treating infection from JN.1. We just have to use these tools more effectively than we have over the last six months.

So far, only 8% of children and 19% of adults have received the latest vaccine, so a lot of people are missing out on protection from this virus.

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Editor’s Note: Pediatric Infectious Disease Specialist and AAHPO Board Member Tsoline Kojaoghlanian, MD agrees with the article below, which asserts that Paxlovid is helpful and should be more widely prescribed and taken.

With COVID-19 cases again on the upswing, the antiviral Paxlovid has been slow to gain traction among patients and doctors even though the medication reduces hospitalizations and deaths.

A recent National Institutes of Health study of about 1 million people found that only 15% at risk for severe disease took a five-day course of the prescription medicine. Of the patients who took Paxlovid, the medication reduced the risk of death by 73% and hospitalizations dropped 26%, showing the medicine is highly effective for people at risk of severe complications.

COVID-19 deaths, hospitalizations and visits to the emergency room increased at double-digit rates in the last week of December, the Centers for Disease Control and Prevention reported. But deaths and hospital stays remain far below earlier peaks.

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