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2014-42/1179/en_head.json.gz/20054 | Optima Health Named Virginia's Top Health Plan for Customer Service Sentara News Home
Virgina Beach, Va., - April 9, 2007 - Optima Health has recently been named the 2006/2007 Customer Care Award winner for the state of Virginia. The award comes from the National Research Corporation (NRC), a recognized industry leader in measuring healthcare performance measurement, and identifies health plans which members have rated as having the highest member satisfaction across multiple customer care metrics. Winners are determined by member satisfaction assessed in the company’s annual NRC Healthcare Market Guide® study. “Optima’s reputation for outstanding customer service is what sets us apart from other area health plans and plays a substantial role in our ongoing success,” said Michael Dudley, president of Optima Health. “We are committed to providing our members access to the highest quality care, advanced medical technology, reasonable prescription drug coverage and some of the industry’s most innovative wellness and disease management programs.” Over 200,000 households, representing more than 400,000 members in the contiguous 48 states and the District of Columbia were surveyed as part of the 2006/07 NRC Healthcare Market Guide study. No other study used to measure health plan performance contains more consumer responses than NRC’s study. “Today’s health plan member is increasingly more savvy about issues of cost and quality,” Dudley added. “Our NRC survey results confirm we are doing an excellent job of providing a high level of service to our members.” “As more healthcare quality information is made publicly available, we expect this trend of consumer involvement to increase,” said Michael Hays, NRC chief executive officer. “These organizations are selected for the Customer Care Award by the members they serve.” Optima Health, a Virginia-based health plan serving over 400,000 members, was recently ranked as the only commercial health plan in Virginia to make the top 50 health plans in the nation by U.S. News & World Report and NCQA. The rankings follow a review of 680 health plans, placing Virginia Beach-based Optima Health among the top 10% of health plans in the nation based on clinical quality, member satisfaction and NCQA accreditation scores. In 1999, Optima Health was the area’s first health plan to be awarded NCQA’s new ‘Excellent Accreditation Status’ and has maintained this accreditation level since this time – a claim no other regional health plan can make. 21/2007 | 医学 |
2014-42/1179/en_head.json.gz/20132 | Dealing with Mosquitoes
2007-04-16 07:55 It seems that almost everywhere I go on an outdoor excursion (especially when hunting for waterfalls), mosquitoes are around. It doesn't matter whether I'm in the alpine meadows and forests of California's Sierras, the moors of Northern Norway, the tropical jungles of the Pacific Islands, the billabongs of Northern Australia, or even the desert oases of Southern Utah. It seems that mosquitoes are everywhere looking to draw my blood. And the itchy welts they leave afterwards can be quite annoying. So why are they everywhere? Is there any cause for concern about them? What can be done to cope with them? To answer these questions, I did a little research and found out that in Nature's system of checks and balances there are things we ought to know about these pesky little buggers. There are many reasons why mosquitoes are so widespread around the planet. Like almost all organisms, they rely on water to survive, but in this case, they tend to favor standing pools of water to lay eggs. Standing pools of water can be found at some moments during the year in nearly all climate zones except the arctic cold of the polar regions (though Global Warming is changing this). For example, melting snow in the alpine regions can saturate the ground in late spring and early summer to create marshy conditions full of standing water in meadows, valleys, and plateaus. This also explains why mosquitoes are found in the desert lining rivers, creeks, and springs as water is scarce and only concentrated in these areas on the surface. Moreover, the tropical regions are natural places to harbor standing pools of water as the humidity, frequent rainfall, and dense vegetation help maintain the conditions favorable to mosquitoes throughout the year. In fact, the tropical regions are where the species are most abundant, and unlike other climate zones, they do not have population variations where their numbers significantly reduce or grow depending on the seasons. So given all these factors, it's no wonder why I constantly run into mosquitoes in my waterfall adventures as we standing water is an inevitable part of such ecosystems. Fossil records have shown that mosquitoes have survived for over 30 million years, and related ancestral species have dated back to over 100 million years. This means that they have not only used this time to successfully spread their population throughout the world, but that they have evolved to become very good at what passing on their genes to their offspring to prolong their existence as a species. It's surprising to note that for the most part, it's only the female mosquitoes that bite. That's because they need the proteins from the blood of birds and mammals (including humans) to properly nourish their eggs, which are laid in mostly standing water habitats. Their sensor-like design is perfectly adapted to detect chemicals, motion, and heat. For example, they can detect carbon dioxide and lactic acid emissions from our breathing and our sweat, they can sense when something contrasting with the background moves, and they can tell if something is giving off heat (especially from warm-blooded organisms). Take all of these factors into account and it's no wonder why mosquitoes never seem to leave you alone as well as hone in on you like a heat-seeking missile.The mechanism by which mosquitoes draw blood is through a multi-syringe-like mouth called the proboscis. It is through the proboscis that saliva (containing anticoagulants) is secreted to keep the blood from clotting and thus making it easier for the mosquito to draw blood - often times without you feeling anything due to an anesthetic-like substance. However, it's also this saliva that tends to induce an allergic reaction that often swells and becomes itchy. That's usually when we finally realize that we've been bitten. Usually their bites are merely annoyances, but mosquitoes can also pick up viruses and bacteria from one organism and transmit them to others - thus making them disease vectors. It is this fact alone that has perhaps made mosquitoes one of the biggest killers (at least to humans) on the planet. It has been said that more people have died from mosquito-borne illnesses such as Yellow Fever, Malaria, Encephalitis (including West Nile), Dengue Fever, etc. than has all the wars throughout human history combined! Mosquito-born diseases are transmitted to 69 million people with 5.3 million of them dying every year. This explains why certain regions of the world seem to be very prone to such diseases (e.g. the presence of malaria in Malaysia). With the advent of Global Warming, the population of mosquitoes and the consequent spread of diseases will increase as more parts of the planet will have climates favorable to their existence.There are some measures we can take in order to prevent or minimize the adverse impacts of mosquitoes on us while participating in nature-based activities. One approach is to wear enough clothing to minimize the amount of exposed skin. The problem with this is that mosquitoes are usually located in warm and humid areas so this can make you unbearably hot while losing more water through sweat to keep the body cool. A second approach is to apply bug repellant containing DEET, which seems to be quite effective in confusing the mosquitoes' chemical sensors. Unfortunately, there are certain health risks associated with this chemical (it has been known to burn plastic) so it ultimately comes down to a trade-off between your assessment of the risk of disease versus the unintended effects of DEET. There are other types of repellant out there, but they don't seem as effective (e.g. in my experience, Avon's Skin So Soft hardly works even though it's not as toxic as DEET-based repellants). Finally, you can do the best you can to keep moving since mosquitoes can only fly so fast and for so long. Usually a combination of the above measures gives you the least chance getting bit by a mosquito while being out in nature because each of these measures has drawbacks. In conclusion, the relationship between mosquitoes and humans are all part of the checks and balances of Nature and natural selection. In other words, we are part of the food chain and the cycle of life. And it is for this reason that they play a key role in supplying food for other insects and more complex organisms feeding on them. So we ought to respect the mosquitoes as survivors as well as role players in the overall scheme of things. Even though most of us don't like them, they're here to stay so we mind as well cope with living with them. To post a comment please click on this link: Story Nature Blog Home | | 医学 |
2014-42/1179/en_head.json.gz/20175 | An Update on MammogramsBy Sarah Osterman Myers – Posted on October 1, 2012Posted in: Health Advice The Newest Facts on Breast Cancer Prevention
Every October, we’re reminded one in eight U.S. women will develop breast cancer over the course of her lifetime. This year, as stark statistics are reviewed, the mammogram’s role as an early detector comes under pressure.
A sense of urgency fills Lindsay Avner every time she hears about another young woman diagnosed with breast cancer. As founder/CEO of Bright Pink, a non-profit organization focused on prevention and early detection of breast and ovarian cancer in young women, Ms. Avner makes it her personal goal to drive awareness to action.
For the general population, proactivity involves getting yearly mammograms starting at age 40. Recently, however, the age at which women should begin mammograms has been debated, and findings show having mammograms too early in life may lead to false positives, especially in dense-breasted women.
“Mammograms, at this point, are the gold standard,” says Virginia Kaklamani, MD, oncologist, Northwestern Memorial Hospital. “Overall, we have good studies to show that mammograms help decrease mortality in women significantly, starting at the age of 40.”
In 2009, the United States Preventative Services Task Force made the controversial recommendation of biennial screening mammography for women 50 to 74 years old. This recommendation has since been scientifically rejected by major medical organizations with breast cancer expertise, including the American Cancer Society and American College of Radiology, who continue to recommend annual screening mammograms starting at age 40.
The American Cancer Society guidelines suggest high-risk individuals should start mammograms even sooner, up to 10 years earlier than when a relative was diagnosed. Determining a patient’s risk level not only involves family history but also genetic makeup, hormone levels, illnesses, environment and diet.
Ms. Avner, who has a strong family history of breast cancer, tested positive for the BRCA1 gene, meaning her risk of developing breast cancer was 87 percent. She took a huge step to reduce her risk by becoming one of the country’s youngest women to receive a bilateral prophylactic mastectomy at age 23.
“Statistically, young women shouldn’t develop breast cancer, but if you do you should be proactive,” cautions Ms. Avner. “While mammograms are the most common form of screening, it’s still important to talk with your doctor, especially since younger women are known for having denser breasts.”
Dense breast tissue is common in younger individuals due to constant bodily changes including pregnancy, lactation, menstrual cycle, weight gain/loss, hormone use and other elements. By definition, dense breast tissue is comprised of less fat and more connective tissue, which appears white on a mammogram. Cancer also appears white on a mammogram, thus tumors are often hidden behind dense tissue. Studies show as many as 75 percent of dense-breasted women are at risk of cancer being missed if they rely solely on mammography.
“In women who have dense breasts, you might not be able to see things in a regular mammogram,” says Dr. Kaklamani, “but the digital mammogram can look at things and find hidden tumors that otherwise wouldn’t be seen with the naked eye.”
Digital and conventional mammography both use X-rays to produce an image of the breast; however, digital information has the capability of being enhanced, magnified or manipulated for further evaluation. The American College of Radiology Imaging Network Digital Mammographic Imaging Screening Trial found that digital mammography detected up to 28 percent more cancers than film mammography in women with dense breasts.
Hologic, Inc. is on the cutting edge of breast imaging technology and recently debuted Selenia Dimensions. This system has both traditional digital mammography and breast tomosynthesis, offers 3D imaging and is said to make a difference in diagnosing patients with dense breasts.
According to Jim Culley, senior director of marketing at Hologic, breast tomosynthesis is one of the most exciting technologies in many years, and access to digital mammography will continue to increase, which will enhance early detection efforts within the medical community.
No matter the controversies, major medical associations continue to recommend mammography as the preferred tool for breast cancer screening. It has helped to reduce the U.S. breast cancer death rate by 30 percent.
“It’s truly unacceptable for women to die of breast cancer; we know far too much about this disease,” affirms Ms. Avner, who adamantly instructs young women to ask questions, know your risk, know your body and be proactive.
DATA IN THE U.S.
Estimated new cases in 2012: 226,870 women; 2,190 men
Estimated deaths in 2012: 39, 510 women; 410 men
Median age of diagnosis: 61
Median age of death: 68
Percentage diagnosed as Stage IV (metastasized): 5%
Five-year survival by stage: local 98%; regional 83%;
metastasized 23%
Five-year survival overall: 89%
Diagnosed in lifetime with breast cancer: 1 in 8 women
TYPICAL TREATMENTS BY STAGE
Stage 0 (noninvasive DCIS): lumpectomy or mastectomy and radiation, sometimes hormone therapy
Stage I or II: lumpectomy or mastectomy, radiation and often chemotherapy
Stage III: chemotherapy and radiation before or after mastectomy, underarm lymph nodes removed, often targeted therapy
Stage IV and recurring: surgery (depending on where cancer has spread), chemotherapy, radiation, hormone and other therapies
Statistics and information according to
The Wall Street Journal/National Cancer Institute
Tags: cancer, health, health advice, wellness About Sarah Osterman Myers
Sarah Osterman Myers pursued studies at Mercyhurst College and the University of Nebraska Lincoln before transferring to Columbia College Chicago to study journalism and dance. As a writer, Ms. Myers is interested in the arts/culture world and has published work in ECHO Magazine and Today’s Chicago Woman. As a dancer, she's open to all types of movement experiences and has performed with Laboratory Dancers and Mucca Pazza. | 医学 |
2014-42/1179/en_head.json.gz/20232 | Neonatal staff, parents to meet at fifth reunion
by Alyssa Harvey, The Daily News, originally published on 8/17/2012To Mandy Emedi and Patty Thurman, The Medical Center’s Neonatal Intensive Care Unit staff is like family.When Emedi’s twin daughters, Anna and Brooklyn, were born about six weeks early, she found the NICU staff “amazing.”“You give birth to babies and envision yourself two or three days later going home. That was the hardest thing I’ve ever had to do, leave without my babies,” she said. “The NICU took such good care of not just the girls, but of us as a family. They really made us feel a part of the babies’ care.”NICU Parent Encouragement and Support Group coordinator Patty Thurman remembers when her twin daughters, Grace Ann and Addyson, were in the NICU.“They were born at 32 weeks. Grace Ann was my most sick child. She was on ventilators and had bowel and intestinal problems. They had to watch her real close,” she said. “Most parents don’t know they’re going to the NICU. You don’t put that on your birth plan. There’s a flood of emotion.“While you’re in the NICU, you get to know the nurses. They talk on your level,” she continued. “You get on a personal level with them. It makes you feel better about the situation your child will be in.”Both women will attend the fifth NICU Reunion, which gives parents and former patients the opportunity to reunite with physicians, nurses staff members and other parents who were involved with their child’s hospital stay.The free reunion, which will feature food, games and fun, will be from 1 p.m. to 3 p.m. Sept. 9 at The Medical Center Auditorium. Registration is preferred, but not required. Parents of former NICU patients can submit photos by Wednesday for a slideshow. For more information, call 796-2144 or email [email protected] Miller, a registered nurse in the NICU and nursery, said this year’s reunion theme is “Under the Sea.”“We’ve had a barnyard and beach theme for the kids who come back and visit. It makes it fun for them,” he said. “It’s fun for the kids, parents and nurses. There are a lot of smiles.”The reunion has drawn about 300 people over the past couple of years, nearly maxing out the capacity of the facility, Miller said.“We’ve frequently got twins who are born premature and stay with us for a while,” he said. “The longer they stay the more they get to know the staff.”Emedi agreed.“We had the same nurses for several days at a time, so you really get to know them,” she said. “I would wake up and call in the middle of the night – about 4 a.m. – and never would the nurses would be bothered by it.”Emedi said she sometimes runs into nurses outside of the hospital who still ask about her daughters, who are now nearly 4 years old.“This is our fourth reunion. At the first reunion we were so proud we had gotten a good start with them. They showed us how to feed them, how to bathe them,” she said. “It was a good learning process since I’d never really been around babies. I know people who say they can’t wait to get back to the reunion.”Thurman’s babies are now 4 years old and “doing well with no issues or problems at all,” she said.“The nurses get so excited to see your child again because they took care of this child when they were sick. To me, being a NICU nurse is an incredible job. They do miracles,” she said. “When they see a happy child and happy parents, they feel good. You can’t praise them enough. You don’t just come back the first year. You come back year after year.”Miller said the people who work with the babies enjoy the reunions as much as the parents.“We put a lot of passion in our work. It’s quite the payoff to see them a couple years later and see they’re doing so well,” he said. “It’s a thrill to know you played a little part in their success.”Copyright 2012 News Publishing LLC (Bowling Green, KY) | 医学 |
2014-42/1179/en_head.json.gz/20263 | German Village Gazette
Infant Mortality Task Force
Recommendations made to help reduce infant deaths By GARY SEMAN JR.
Tuesday July 1, 2014 9:54 AM
After six months of meetings and sifting through data, the Greater Columbus Infant Mortality Task Force adopted eight recommendations aimed at helping babies live past their first birthday.
The task force, which met June 25 at Columbus Public Health, laid out a plan that would significantly reduce the local infant mortality rate by 2020.
Officials say it's a somber statistic: Three babies die in Franklin County every week, about 150 a year.
"I know we all believe that number is unacceptable," said Andy Ginther, president of Columbus City Council and a member of the task force.
Columbus has eight "hot spots," where the infant mortality rate is significantly higher than other neighborhoods.
Ginther said it's not just about quality of health care, but quality of life.
"The fact is it's not the same for everybody," he said.
The recommendations cover a wide swath of medical and social interventions, such as reducing maternal and household smoking, which is a leading cause of preventable infant mortality.
The report also called for improving women's health.
In the report, the task force noted half of all pregnancies are unplanned and 14 percent are not "safely spaced," meaning the mother has not had time to adequately recover from her most recent pregnancy.
Additional recommendations also called for improving prenatal health care, ensuring clinical quality for labor and delivery, and improving reproductive health planning.
Columbus Public Health and the state already have put into place one of the action items: promoting infant safe sleep.
Task force members highlighted plans for immediate involvement, such as engaging and mobilizing neighborhood-level initiatives and aligning resources to improve social and economic conditions, especially in high-risk neighborhoods.
Moving forward, officials will issue an "infant mortality report card," form an executive committee to oversee plan implementation and look at data-driven performance improvements.
"All of us have a role to play in this," said Dr. Art James, an obstetrician and pediatrician at Ohio State University and Nationwide Children's Hospital. Comments | 医学 |
2014-42/1179/en_head.json.gz/20380 | » Follow The Post On: Pentagon Report Criticizes Troops' Mental-Health Care
By Ann Scott Tyson
U.S. troops returning from combat in Iraq and Afghanistan suffer "daunting and growing" psychological problems -- with nearly 40 percent of soldiers, a third of Marines and half of the National Guard members reporting symptoms -- but the military's cadre of mental-health workers is "woefully inadequate" to meet their needs, a Pentagon task force reported yesterday.
The congressionally mandated task force called for urgent and sweeping changes to a peacetime military mental health system strained by today's wars, finding that hundreds of thousands of the more than 1 million U.S. troops who have served at least one war-zone tour in Iraq or Afghanistan are showing signs of post-traumatic stress disorder (PTSD), depression, anxiety or other potentially disabling mental disorders.
"Not since Vietnam have we seen this level of combat," said Vice Adm. Donald Arthur, co-chairman of the Department of Defense Mental Health Task Force. "With this increase in . . . psychological need, we now find that we have not enough providers in our system," he said at a Pentagon news conference yesterday unveiling the report. "Clearly, we have a deficit in our availability of mental-health providers."
The ongoing "surge" of more than 30,000 additional U.S. troops in Iraq and Afghanistan will exacerbate this gap, as will the rapid growth in the number of soldiers, Marines and other troops -- now about half a million -- who have served more than one combat tour, heightening the risk of mental illnesses, the report said.
As in the aftermath of Vietnam, the costs of untreated mental illness will rise dramatically over time, the report warned. "Our nation learned this lesson, at a tragic cost," it said. "The time for action is now."
Defense Secretary Robert M. Gates is required by law to develop a plan of action within six months on the 95 recommendations included in the 64-page report.
The task force, composed of seven military and seven civilian professionals with expertise in military mental health, was formed in May 2006. It based its report on visits to 38 U.S. military care facilities in the United States, Europe and Asia; interviews with care providers, military personnel and their families and commanders; as well as expert testimony and research.
The task force found that 38 percent of soldiers, 31 percent of Marines, 49 percent of Army National Guard members and 43 percent of Marine reservists reported symptoms of PTSD, anxiety, depression or other problems, according to military surveys completed this year by service members 90 and 120 days after returning from deployments.
Two "signature injuries" from Iraq and Afghanistan are PTSD and traumatic brain injury, it said. Symptoms include nightmares and other sleep problems, trouble concentrating, anger, recklessness, and self-medication with drugs and alcohol.
The task force identified several barriers to care, including the stigma associated with seeking help, poor access to providers and facilities, and disruptions in care as service members move locations.
"Stigma in the military remains pervasive and often prevents service members from seeking needed care," the report said, citing anonymous surveys that show most members with symptoms of mental health problems do not seek help.
Some soldiers underreport problems because they want to stay with their units, and military officials note that many soldiers undergoing treatment for stress or other mental problems are allowed to deploy again after a screening to determine the intensity of their symptoms or depending on what medications they are taking. Those on lithium, for example, should not deploy while those on another class of medications similar to Prozac may be able to, said Army Col. Elspeth Cameron Ritchie, who assisted the task force.
"If you have a post-traumatic stress reaction, it's not your fault," Arthur said. "It's up to leadership to say to folks that post-traumatic stress reactions are an absolutely normal part of combat operations."
Proposals by the task force to reduce stigma include embedding health-care providers with units and offering treatment at primary medical care facilities, where service members can seek psychological help without singling themselves out. An additional recommendation is for the military to begin training troops to become more psychologically resilient, in part by conditioning them mentally, much as they conduct their physical training.
"We can use virtual-reality therapy, typing smells in to create a virtual environment," that resembles a battlefield, said Col. Jonathan H. Jaffin, commander of Army medical research.
National Guard and reserve members -- who often live far from military bases and return from deployments to rural communities -- face "particularly constrained" access to clinical care as well as to the military chaplains and family support networks that active-duty personnel can tap, the report said.
"The current complement of mental health professionals is woefully inadequate" to prevent and treat members of the military and their families, the report said. But it called the process for recruiting additional trained personnel -- both civilian and military -- "time consuming and cumbersome," stating for example that the number who could be recruited over the next six months would be "well below" the number required to meet the needs.
The shortage is deepening as active-duty mental-health professionals, also stressed by repeated deployments and other frustrations, are leaving the military in growing numbers, the report said. The Air Force has lost 20 percent of mental health workers from 2003 to 2007, while the Navy lost 15 percent between 2003 and 2006, and the Army lost 8 percent from 2003 to 2005.
Financial resources for mental health treatment in the military are also lacking, the report found. Congress provided a boost of $600 million for PTSD and traumatic brain injury in the 2007 supplemental war funding, but more will be needed, S. Ward Casscells, assistant secretary of defense for health affairs, said at the news conference.
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Jennifer LaRue Huget and Rob Stein cover health in the news -- and in your life. | 医学 |
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2014-42/1179/en_head.json.gz/20502 | Unmasking a History of Non-Compliance
By Cancerwise Blogger on April 2, 2012 8:05 AM
By Justin OzunaJustin Ozuna lives in Dallas and was diagnosed with chronic myeloid leukemia
in January 2006. His mission is to capture the ups and downs of a young
adult living with cancer and to serve people through humor, encouragement, hope and adversity at his blog, theozunaverse.com.In
January 2006, I was diagnosed with chronic myeloid leukemia. Never could I have imagined that I would be a 25-year-old living with cancer. I'd soon find out that it wasn't the leukemia
itself that was burdensome; it was the unexpected cost of managing a chronic illness that led me astray. You won't read that in the doctor's notes. That's something I had to learn the hard way. I wasn't prepared.When
you're diagnosed, nobody tells you how difficult it will be to manage a
chronic illness...I was no exception. "That will be $125," the pharmacist said. Picking up prescriptions was always a guessing game. I never knew how it worked. In fact, the only thing I knew about insurance was that I was covered. "OK, that seems like a lot of money," I replied. "The original cost of the medicine, without insurance, is $3,400," she responded. "Dollars?" I asked. I handed over my debit card as fast as I could. I
was taking Gleevec, 400 mg daily; one pill a day. "Easy enough," I thought. In fact, it was easy, for the first seven to eight months. Then
I began to compromise. I had to. It was easier to pay for my medicine every third paycheck as opposed to every second. I felt ashamed, guilty and embarrassed, but it gave me a lot of freedom. At the
time, I needed that. Pushing my diagnosis asideFor the most part, stretching my medicine worked well. Physically, I still felt good. In fact, I'd often forget that I had leukemia. I wanted to be young, carefree and not have to worry about managing an illness. As a result, I often pushed my diagnosis to the side. Instead of being deathly afraid of what could happen if I didn't manage my illness correctly, I became deathly afraid of what could happen if I did manage my illness correctly, but never experienced the fullness of my youth. I was too immature to realize that I needed to figure out a way to do both. The more I stretched my medicine, the less guilty I felt. Soon, I embraced the invincibility that provided more financial flexibility. Two or three weeks without medicine was not uncommon. I then did the only thing I could do -- base my illness on how I felt physically, as opposed to how everything was measuring up scientifically. My mind had betrayed my body and my body would soon betray my mind. In August 2008, I moved to Dallas from a small town two hours north called Wichita Falls, Texas. I tried to find a new oncologist at Baylor Medical Center, but they refused to treat me because I had a patient history of being non-compliant. I had no idea that I could even be refused as a patient.I also had no idea that I was considered "non-compliant." Sure, I had missed a couple of appointments and spent an afternoon in the emergency room as a result of not taking my medication, but it was never a case of having medicine and not taking it. It was instead a matter of not being able to afford it in the first place. Fears came trueMy world was turned upside down. After years of fighting hard to be normal, my fear of being labeled came true. Not only did I have leukemia, I now had the stigma of being non-compliant. A few days after being rejected by Baylor, I was accepted by Southwestern Medical Center in Dallas. It was there that I faced the realities of my illness and coordinated plans to talk with the social worker about how I could receive the financial help that I needed. It was a big step in the right direction. I finally felt empowered. All it took was a little assistance. It wasn't until my time at UT Southwestern that I truly understood the significance of patient compliance issues, particularly with young adults. I wish I had known all along. It may have cured the false belief that I was controlling my situation. Now, I can't help but wonder if it was the inconsistencies in my medication habits that led to a recent discovery of a t315i mutation, which will prevent all known FDA approved medications from working. Perhaps I'll never know. What I do know is that there's no greater issue to tackle in the field of medicine than patient compliance. As a patient, I understand the struggles of having good intentions without having the strength to carry them through. It's like walking into the gym and trying to lift a weight you've never lifted before, just to impress the prettiest girl in the room. Without a spotter, or someone to help you lift the weight, it will soon come crashing down. Nobody is capable of lifting the weight of cancer on their own. Read more posts by Justin Ozuna.
Cancer Patient Stories, Cancer Treatment
Leukemia - Chronic Myelogenous Leukemia (CML)
Beck12378
| April 2, 2012 9:51 AM
Justin, you've mastered something many people never master, be it a cancer patient, cardiac patient, fill in the blank patient. So many of us feel ".....I know my body and therefore......" instead of relying on the experts for guidance. Although it's understandable, it's a tough lesson.
Good for you and good for you for spreading the word! amy
| April 2, 2012 10:17 PM
You are an inspiration and a tough cookie Justin! What a journey you are taking!!
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2014-42/1179/en_head.json.gz/20525 | Home > Features > Museum Exhibit Details the Jewish Encounter with Modern Medicine
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Relief for Aspirin-Sensitive Asthma Patients a Diagnostic
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Museum Exhibit Details the Jewish Encounter with Modern Medicine
The memo on display at the Yeshiva University Museum exhibit Trail of the Magic Bullet: The Jewish Encounter with Modern Medicine, 1860 - 1960 is short and to the point: "Never admit more than five Jews, take only two Italian Catholics, and no blacks at all." The document was signed by Milton Charles Winternitz, dean of Yale Medical School from 1920 to 1935.
The College of Medicine's namesake, Albert Einstein, with a model of the institution that proudly bears his name.Having fled the growing anti-Semitism in Eastern Europe in the years preceding World War II, multitudes of Jews that emigrated to the United Sates were met with such informal yet widely enforced quotas, used at the time to limit the number of Jews, African Americans, and other ethnic groups admitted to medical schools and other fields.
In response to this, Yeshiva University President Dr. Samuel Belkin began to advocate and plan for a medical school under Jewish auspices that would be run without quotas based on racial or religious prejudices. That medical school would come to bear the name of the famous Jewish scientist and philanthropist Albert Einstein, whose primary wish was that the Albert Einstein College of Medicine of Yeshiva University would support and welcome all creeds and races. The history and motivation behind the establishment of the College of Medicine is detailed as part of the museum's multi-media exhibit.
"The exhibition is fabulous," remarked Dr. Edward Burns, executive dean at Einstein, during the opening night event. "While medicine was initially considered a religious calling for Jewish physicians, they also distinguished themselves by trying to find the scientific underpinnings of disease. In doing so, they became well-versed in secular knowledge. And when others realized that the Jews' approach was scientific rather than religious, they sought them out."
Trail of the Magic Bullet, which is curated by Josh Feinberg, explores the Jewish relationship with modern medicine by presenting both major scientific and medical contributions by Jewish doctors, and by exploring the influence of the Jewish faith on the ethics of how medicine is practiced.
The practice of quotas for certain ethnicities led to the establishment of Albert Einstein College of Medicine of Yeshiva University – a medical school where all races and creeds would be welcome.The exhibit takes its name from the famous Jewish scientist and Nobel Laureate Paul Ehrlich, widely regarded as the father of chemotherapy, who popularized the concept of selectively targeting disease-causing agents that he called the "magic bullet." One such "magic bullet" - the drug Arsphenamine, which was the first effective medical treatment for syphilis - was discovered in his laboratory.
Beginning with the story of Dr. Ehrlich, Trial of the Magic Bullet details the many other Jews that are considered giants in their fields and whose contributions between 1860 and 1960 resulted in significant medical and scientific discoveries and theories. During that time period, Jews were so predominant in fields such as dermatology and psychoanalysis, the areas were considered "Jewish Sciences."
The medical advances made by individual doctors eventually affected and contributed to public health, and the exhibit continues by examining medical philanthropy within and by the Jewish community through specific groups and hospitals, and how the Jewish faith influenced such efforts.
Following the display relating the history of the College of Medicine, the exhibit addresses various contemporary issues in Jewish bioethics. These include complex issues, such as how to deal with genetic testing that may reveal debilitating illness in an unborn child or what the most ethical approach to end-of-life issues might be in the severely ill. Perspectives of these uniquely contemporary issues are discussed by several Jewish scientists and religious leaders in a film by Ilana Trachtman, Heal, You Shall Heal.
The history of Jewish medicine on display at the Trail of the Magic Bullet demonstrates the impact of these efforts on the health and scientific understanding of the entire global community. The beautifully curated and educational exhibit remains on display at the Yeshiva University Museum until August 12, 2012. The museum is located at 15 West 16th Street, in Manhattan, and admission is free for Yeshiva University (including Einstein) students, faculty, and administration with a valid ID.
Posted on: Friday, July 27, 2012 | 医学 |
2014-42/1179/en_head.json.gz/20538 | Issue No. 14 | June 20, 2014
Stay Connected A Service of the U.S. Department of Health and Human ServicesView HTML versionNews and Features June 27 is National HIV Testing DayAccording to the Centers for Disease Control and Prevention (CDC), about 50,000 people get infected with HIV each year in the United States. However, 1 in 6 people living with HIV don’t know that they are infected. National HIV Testing Day is observed each year on June 27 to highlight the importance of HIV testing.
CDC recommends that everyone between the ages of 13 and 64 get tested for HIV at least once as part of their routine health care. Regardless of age, people at high risk of HIV should get tested more often.
Visit the AIDSinfo National HIV Testing Day webpage [en español] to learn more about HIV testing and to find a testing center near you.Changes to the Complera (Emtricitabine/Rilpivirine/Tenofovir Disoproxil Fumarate) Labeling"On June 5, 2014, FDA approved changes to the Complera (emtricitabine/rilpivirine/tenofovir disoproxil fumarate) fixed-dose combination tablet labeling to include rilpivirine dose adjustment information when Complera is coadministered with rifabutin." The updated labeling for Complera is available at the FDA website.
FDA: Press release
AIDSinfo: Patient fact sheet on Complera
New Pediatric Dosage Form and Label Changes for Reyataz (Atazanavir)"On June 2, 2014, FDA approved a new dosage form, Reyataz (atazanavir) oral powder for use in combination with other antiretroviral agents for the treatment of HIV-1, in patients over 3 months of age and between 10 kg to < 25 kg. The first part of this announcement summarizes the changes relevant to the oral formulation and use in pediatric patients. The second part summarizes other general changes to the label."
The updated labeling for atazanavir is available at the FDA website.
AIDSinfo: Patient fact sheet on atazanavir | 医学 |
2014-42/1179/en_head.json.gz/20623 | DBS :: Deep Brain Stimulation --| --BROWN UNIVERSITY ------------------------------- PARKINSON'S
CLUSTER HEADACHES
What is DBS?
Who uses DBS?
WHAT IS DEEP BRAIN STIMULATION?
DBS electrodes are implanted intracranially with wires that attach to pulse generators that are placed subcutaneously in the chest. - (Source)
Deep Brain Stimulation (DBS), also 'a pacemaker for the brain', is a surgical procedure used to treat movement disorders such as Parkinson’s disease, Alzheimer’s disease, cluster headaches, chronic pain, dystonia, epilepsy, and stroke. It has also been used on patients suffering from certain behavior disorders, most specifically Tourette’s syndrome, obsessive-compulsive disorder, and depression. In DBS, electrodes are surgically implanted into the brain and deliver electrical impulses that can be externally adjusted based on the patient’s needs.
DBS modulates brain activity through the direct electrical stimulation of different regions of the brain. The exact mechanism of action is ultimately unclear; however, the electrode that is implanted emits pulses of energy that block abnormal brain activity, which is responsible for many movement disorders. The efficacy of the surgery is dependent on isolating and stimulating the areas of the brain that are responsible each specific disorder.
DBS, though a relatively new therapy, has been studied extensively and has been FDA approved for certain neuromuscular disorders. The therapeutic format of DBS is especially novel because it can directly affect brain activity in a controlled manner and its effects are reversible, unlike those of lesioning. Two electrodes implanted into the thalamus of a transgenic mouse. The gliosis around the electrode tips implicate adenosine in the effects of deep brain stimulation. - (Source)
Timeline of the development of DBS
MECHANICS & COMPONENTS
Table of Components
Neurostimulator:
Similar to a pacemaker, the device contains a battery and microelectric circuitry that provides a controlled electrical pulse. It is implanted under the skin near the clavicle. The electrical signals generated are delivered to the desired region of the brain via an extension and lead. Also called a pulse generator.
DBS Lead:
The lead has a polyurethane cover that insulates four thin, coiled wires that each end in a 1.5 mm electrode. Stimulation can be delivered using either one electrode or a combination of the four.
This is the insulated wire placed under the skin that runs along the head, neck, and shoulder to connect the neurostimulator to the lead and electrodes. (Source)
Clinician Programmer:
Clinicians can adjust a patient’s therapy via telemetry using a hand-held programmer.
(Source) Patient Controller:
Depending on the make and model, the patient can turn the stimulation ON/OFF and check battery life with a wave over the neurostimulator and the push of a button.
Test Stimulator:
Used in the operating room after lead placement to determine patient response to stimulation.
Deep brain stimulation surgery varies among doctors and clinics. At the Cleveland Clinic, one of the foremost centers for DBS surgery, the surgical procedure entails implanting a very thin lead containing four electrodes into the target location of the brain. The lead is threaded through a small opening in the patient’s skull and is connected to an extension wire, which is attached to a pulse generator/pacemaker/neurostimulator which is implanted under the skin over the chest.
Lead insertion - (Source)
The stimulator(s) can either be implanted at the same time as electrode placement or at a later date, when the patient is placed under general anesthesia. The surgeon utilizes computerized brain-mapping technology to locate the source of nerve signals that initiate various symptoms. The physical structure and function of the brain are continuously mapped with the use of imaging and recording devices.
The patient is kept awake during the procedure to enable the surgical team to assess the patient’s brain function. When the electrode is threaded through the brain the patient experiences no pain, as the human brain does not generate pain signals. However, a local anesthetic is used when the surgeon drills a hole in the skull. Patients generally remain in the hospital for approximately three days post-operatively. For a more detailed explanation of the implantation procedure, click here.
DBS of the normal and diseased brain depends on the physiological properties of the brain tissue – which can be affected by disease state – the parameters of stimulation, and the geometric configuration of the electrode and the surrounding tissue. The effect of DBS on different neural elements depends on the inverse relationship between the stimulus duration and the amplitude that is necessary to stimulate the element. Within normal DBS parameters, the postsynaptic response results from the activity of efferent axons. The exact parameters of DBS such as stimulus amplitude, duration, and the frequency band vary based on the therapy and the targeted area of the brain. With most commercially available stimulators, these factors can be altered with an external programmer; however, the technology only permits an open-loop continuous stimulation, which cannot take into account the continuous neural feedback of the patient. Currently physicians use the patient’s behavioral state to adjust the therapy, and such ambiguity lends itself to stimulation-induced side-effects. The efficacy of DBS is also dependent on the configuration of the neural elements in relation to the electrode; proximity of the axons and cell bodies to the electrode influences the responsiveness of the neural elements. Although the mechanism of action is unknown, there is an emerging view that DBS has both excitatory and inhibitory effects. According to the theory of synaptic inhibition, DBS controls neural output by the activation of axon terminals that make synaptic connections with neurons near the electrode. The theory of depolarization blockade suggests that stimulation-induced changes occur in the activation of voltage-gated currents, which block neural output near the electrodes. The aforementioned theories can be supported by recordings of local somatic activity in the stimulated nucleus. One hypothesis about the functioning of DBS is that stimulation from an electrode blocks the somatic activity of other neural elements that are close by and causes sub-threshold activity in distal neural elements, which allows the myelinated axons of intermediate elements to receive the effects of stimulation and pass them onto other connected brains structures. Return to Top | 医学 |
2014-42/1179/en_head.json.gz/20708 | Congratulations: Dr. Elizabeth Spangler - Archived
Elizabeth Spangler, MD, chief medical officer, has been in health care a long time first as a nurse, and now as a doctor.Her story of overcoming odds and obstacles is why Dr. Spangler was recognized as one of the 2010 YWCA's Women of Achievement.
Dr. Spangler graduated from Mercy Hospital School of Nursing in Springfield, MA and served as a registered nurse for 23 years at CAMC.
Then, at age 37, she decided to go to Marshall University School of Medicine, where she graduated and later completed a residency in internal medicine at CAMC.
She is certified in internal medicine; is a fellow of the American College of Medical Quality and a member of the American College of Physicians, the American Medical Association and Alpha Omega Alpha Medical Honor Society.
In 2005, Spangler was inducted as the first female president of the West Virginia State Medical Association. Tweet | 医学 |
2014-42/1179/en_head.json.gz/20744 | Fairfax, VA – William A. Hazel, Jr., MD, Virginia Secretary of Health and Human Resources, joined Kurt D. Newman, MD, President and CEO, Children’s National Medical Center, in announcing the launch of a critical congenital heart disease newborn screening (critical CHD) initiative in Virginia. “We commend Governor McDonnell, Secretary Hazel, and Delegate Patrick Hope for their commitment to advancing best practices in newborn care,” said Dr. Newman. “This initiative will put the Commonwealth of Virginia in the vanguard of states offering this important newborn screening, which has such an impact on the lives of children and families.”
Approximately four of every 1,000 babies born are affected by critical CHD, and early detection may improve health outcomes. Pulse oximetry is a simple, non-invasive, and painless test that determines the levels of oxygen in the blood. When performed after the first 24 hours of life, pulse oximetry can be effective in identifying infants who may suffer from critical CHD. This initiative will establish a pathway for statewide implementation of newborn screening. “Children’s National has advocated for critical CHD screening of all newborns. Last year, the US Department of Health and Human Services endorsed adding critical CHD screening to the recommended uniform screening panel and encouraged the implementation of screening in the states,” said Gerard Martin, MD, Senior Vice President, Center for Heart, Lung and Kidney Disease, and Co-Director of the Children’s National Heart Institute. “We are pleased that Dr. Hazel and the Virginia Department of Health are leading this effort to make high quality newborn care available to families across Virginia.”
Dr. Martin, an internationally recognized expert and advocate in the area of screening for CCHD, developed the Congenital Heart Disease Screening Program to help to detect serious CHD while newborns are in the nursery. He and Elizabeth Bradshaw, MSN, RN, CPN, have been working with hospitals, health systems, and health departments around the country to implement this screening process. Children’s National, in partnership with Baby’s First Test, recently released two videos to help parents and clinicians understand this newborn screening. Media contact: Paula Darte or Susan Muma: 202-476-4500. | 医学 |
2014-42/1179/en_head.json.gz/20764 | Log In The official news publication for faculty and staff at the University of Colorado Colorado Springs Home
Drug-resistant bacteria is latest Café Scientifique topic
February 1, 2012Posted by Ron Fitz“Super bugs vs super drugs: the ongoing arms race between bacteria and humans,” is the first Café Scientifique lecture of the semester, scheduled from 6:30-8 p.m., Feb. 21 at Clyde’s in the University Center.
The threat of disease-carrying bacteria that resist modern antibiotics will be explored.
Connie Savor Price
Connie Savor Price, assistant professor of medicine, CU School of Medicine, is the scheduled speaker. As medical director of Infection Control and Prevention as well as chief of the Division of Infectious Diseases at Denver Health Medical Center, she has a long-standing interest in drug-resistant bacteria.
As a hospital-based infectious disease doctor, Price saw hospital-acquired infections spread via bacteria. Hospitals have many people being treated with antibiotics and many people with weakened immune systems, creating opportunities for bacterial growth. In this environment, she observed the progress of hospital-acquired drug-resistant organisms.
One of the most common causes of wound infections is staphylococcus aureus, which most people just call staph infection. Many strains found in hospitals are now resistant to the antibiotic methicillin and different versions of it such as floxacillin. The bacteria strains have become referred to as MRSA which is short for methicillin resistant staphylococcus aureus. MRSA is not resistant to all antibiotics but this limits the range of a physician’s choices, creating more difficulty in treating patients.
MRSA can produce toxic shock syndrome, and hundreds of thousands of people are hospitalized with MRSA annually in the U.S.
Another type of MRSA infection has occurred among healthy people in the wider community. This community-associated MRSA, called CA-MRSA, is spread by skin-to-skin contact. At-risk populations include groups such as high school wrestlers, childcare workers and people who live in crowded conditions. There is evidence that these strains are more virulent than those found in hospitals, but this is a controversial subject. CA-MRSA makes the same toxins as the hospital strains but greater amounts of toxin per bacterium. Some researchers are concerned that this more serious disease is the product of strains coming from antibiotic treated animals, possibly through the over-use of antibiotics.
With the rise of drug-resistant bacteria and spread of infections that might defy all available treatments, the public health implications are uncertain, and the findings have been widely misunderstood. Price will share her expertise in the matter through this latest Café Scientifique discussion.
An informal gathering of scholars and science aficionados who are passionate about debate and friendly discussion with their peers, Café Scientifique endeavors to present the foremost experts in cutting edge science and technology. Lectures are free and open to the public. Attendees buy their own food and drinks. Anticipating the popularity of the event, organizer Tom Huber, professor, Department of Geography and Environmental Studies, recommends arriving early.
The UCCS Department of Public Safety is providing free parking for the event from 5:30-9 p.m. in any regular parking space in parking lots 3 and 4 located south of Centennial Hall and the University Center. All restrictions, including handicapped parking, loading zones, and fire lanes apply.
For more information about Café Scientifique contact Huber, [email protected] or David Anderson, associate professor, Department of Chemistry and Biochemistry, [email protected].
Funding for Café Scientifique at UCCS is provided by UCCS Auxiliary Services.
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2014-42/1179/en_head.json.gz/20979 | Posts tagged with HEALTH STUDY
Aug 31, 2012Aug 31, 2012 State Considering Studying Health Impacts of FrackingBy Mireya Navarro Late in its review process, New York state regulators are now considering an examination of the potential public health effects of hydraulic fracturing as part of its review of the controversial natural gas drilling process.
What this means to the state’s timetable for deciding on whether and how to allow fracking is unclear.
Several environmental groups met Tuesday with top officials from both the New York State Department of Health and the Department of Environmental Conservation to discuss possible impacts like water contamination from accidental spills, air pollution from drilling operations equipment and higher numbers of accidents from increased truck traffic.
Some of those in attendance said the environmentalists – including members of major groups like the Natural Resources Defense Council, Sierra Club, Environmental Advocates of New York, Riverkeeper and Environmental Defense Fund – pressed for an independent health assessment by medical experts before regulations are finalized and any drilling is allowed to start.
But it was not clear what the agencies would ultimately do and whether adding another layer to the ongoing environmental review of fracking would further delay a decision by Gov. Andrew M. Cuomo to allow such drilling in the state. Mr. Cuomo has been under increasing pressure to ban fracking altogether or at least hold off on a decision until more research is done.
Critics of the state’s proposed drilling rules, including medical associations and dozens of state legislators, say that it doesn’t properly address the potential impacts to public health or the safe disposal of millions of wastewater produced by each natural gas well.
For now, the state only plans to set up a surveillance system to monitor health impacts once fracking gets underway, according to people at the meeting who did not want to be identified because they agreed not to discuss the meeting publicly.
A spokeswoman for the Department of Environmental Conservation, the agency drafting the fracking regulations, did not answer questions about the meeting or its implications to the timing of the governor’s decision.
“We are considering a variety of issues raised through the public comment process,” said the spokeswoman, Emily DeSantis. | 医学 |
2014-42/1179/en_head.json.gz/20998 | Health First NewFit Earns National Accreditation from the American College of Surgeons
Rockledge, FL (October 11, 2013) – Health First NewFit is pleased to announce it has earned national accreditation from the American College of Surgeons (ACS). Health First NewFit has been accredited as a Level 1 facility under the Bariatric Surgery Center Network (BSCN) Accreditation Program of the ACS.
“We are honored to receive this designation,” said Health First Holmes Regional Medical Center President Sean Gregory. “This accreditation is proof of Health First NewFit’s ongoing commitment to delivering the highest quality of care possible to its patients and our community.”
To earn the accreditation, Health First NewFit met the essential criteria that ensure its ability to support a bariatric surgical care program and the institutional performance requirements outlined by the BSCN Accreditation Standards. Accredited bariatric surgery centers provide both the hospital resources necessary for optimal care of morbidly obese patients and the support and resources necessary to address the entire spectrum of care and needs of bariatric patients (both pre- and postoperatively).
"I am very proud of our team's hard work and accomplishmnets," said Health First New Fit Bariatrics Medical Director Dr. Nathan Allison. "We have committed ourselves to the best possible patient experience and this is the pinnacle of excellence in the field of weight loss surgery."
In the United States, more than 15 million people suffer from severe obesity and the numbers continue to increase. Obesity increases the risks of morbidity and mortality because of the diseases and conditions that are commonly associated with it, such as type II diabetes, hypertension, and cardiovascular disease, among other health risks. At the present time, weight-loss surgery provides the only effective, lasting relief from severe obesity. Therefore, the ACS believes it is of utmost importance to extend its quality initiatives to accrediting bariatric surgery centers so that it can assist the public in identifying those facilities that provide optimal surgical care for patients who undergo this surgical procedure. The American College of Surgeons is a scientific and educational association of surgeons that was founded in 1913 to raise the standards of surgical education and practice and to improve the quality of care for the surgical patient. Its achievements have placed it at the forefront of American surgery and have made the College an important advocate for all surgical patients. The College has more than 79,000 members and is the largest organization of surgeons in the world.
Bariatric Surgery Centers that are accredited under ACS BSCN program standards are part of the Metabolic Bariatric Surgery Accreditation Quality Improvement Program (MBSAQIP) administered by the American College of Surgeons. In March 2012, the ACS and American Society of Metabolic and Bariatric Surgery (ASMBS) announced plans to combine their respective national bariatric surgery accreditation programs into a single, unified program to achieve one national accreditation standard for bariatric surgery centers. That transition is now in process. The ASMBS is the largest society for this specialty in the world. Its vision is to improve public health and well-being by lessening the burden of the disease of obesity and related diseases throughout the world.
For more information about Health First NewFit, visit www.newfitnewlife.com.
Founded in 1995, Health First is a fully integrated health system. The not-for-profit employs more than 7,500 people and has four hospitals (including Holmes Regional Medical Center, Palm Bay Hospital, Cape Canaveral Hospital and Viera Hospital). Health First Health Plans also offers a wide variety of health insurance plan options for Brevard and Indian River Counties. In addition, Health First is home to Brevard County’s only Trauma Center. Health First Medical Group is the largest multi-specialty physician group on the Space Coast. Health First offers numerous outpatient and wellness services, including four Pro-Health and Fitness Centers. Visit www.Health-First.org for more information. ©2014 Health First | 6450 US Highway 1, Rockledge, FL 32955 | (321) 434-4335 Contact Us | Privacy/Other Policies | Non Discrimination Policies | En Espanol | Site Map | 医学 |
2014-42/1179/en_head.json.gz/21095 | Taming An Overactive Bladder: July 16, 2012
It’s an embarrassing condition that plagues millions of people young and old. Urge incontinence leaves people with an uncontrollable need to use the rest room.
For seven years, Peggy Popper lived with a humbling condition. Urge incontinence left her unable to control her bladder. She found herself running to the bathroom. “All the time. I had a few misadventures with it. So I had to stay close to home,” says Popper.
It’s estimated at least 17 million people share her pain and her condition – a voiding dysfunction, or overactive bladder.
“If you’re leaking and you’re having to wear Depends or having to go to the bathroom every hour to hour and a half or two hours, you don’t really have a lifestyle. What we’re trying to get back is people; we basically give them back their social life,” says Dr. Mark Mintz, a urologist on the medical staff of Lee Memorial Health System.
When lifestyle changes or medication don’t work, patients may benefit from interstem therapy. It uses a medical device to provide neuro-stimulation to tame the overactive bladder.
The device is smaller than the palm of your hand. It’s implanted on upper backside of the hip where it stimulates the nerves that control the bladder.
“I call it the pacemaker, but they call it a generator or stimulator to the area. It basically sends a pulsation though the wire. It’s almost like telling the nerve to be quiet,” says Dr. Mintz.
A hair-like wire touches the nerve; it’s regulated by the generator. The device runs on a battery that lasts five to eight years, at which time doctors will reopen the site and replace the cell. A price Peggy is willing to pay to take control of her bladder.
“I would say that since I’ve had it put in, it goes on my time,” says Popper.
“That’s the whole idea. They don’t have to worry about whether they’ve got a leak or are going to have an accident. That’s a game-changer for a lot of people,” says Dr. Mintz. | 医学 |
2014-42/1179/en_head.json.gz/21176 | West Nile deaths in US mount, one dead in Maryland
The West Nile virus, responsible for more than 60 deaths in the United States so far this year, has now claimed its first victim in the eastern state of Maryland, state health officials said Thursday.
"We reported 13 cases of West Nile virus that occurred since the 1st of July," a spokeswoman for the state health department, Dori Henry, told AFP.
Between 2001 and 2011, 20 people died of the virus in Maryland, out of a total of 215 infected. So far this year, the virus has killed 66 people across the country, out of a total of 1,590 infected. It is the worst outbreak of the mosquito-borne disease since it was first detected in the United States in 1999, according to the Centers for Disease Control (CDC).
The CDC says more than 70 percent of infections were reported in only six states—Texas, Mississippi, Louisiana, Oklahoma, Michigan and South Dakota. Texas alone has seen 45 percent of the cases reported nationwide.
But nearly all of the country has been hit by the virus, which is more prevalent in the summer months when mosquitoes are most active. Forty-eight states have reported cases.
Authorities in New York City announced Tuesday that several neighborhoods would be sprayed with pesticide to combat the spread of the virus.
The record number of cases registered in 2012 could be due to a relatively mild winter, an early spring and hot summer, according to the CDC. Other factors potentially contributing to the outbreak are birds transporting the virus—first identified in Uganda in 1937—and the exploding mosquito population.
About one in 150 people infected will develop severe illness with symptoms that include high fever, convulsions, vision loss, numbness, coma and can cause permanent paralysis and neurological damage.
Eighty percent of those infected will not show any symptoms at all and milder symptoms range from headaches to skin rashes, the CDC said.
West Nile virus kills 17 in Texas, sickens hundreds
The US state of Texas is battling an outbreak of the West Nile virus, with 17 deaths being blamed on the mosquito-borne disease, authorities said Wednesday.
Officials: West Nile outbreak 1 of largest in US
(AP) — There are four times the usual number of cases in the current West Nile outbreak in the U.S. and it's too early to say how bad it will be at year's end, federal health officials said.
Dallas-fort worth brace for West Nile spraying
(HealthDay) -- The Dallas-Fort Worth metropolitan area -- the epicenter of the nation's worst outbreak of West Nile virus this year -- could see aerial spraying of insecticides as early as Thursday night ...
Texas outbreak of West Nile virus prompts aerial spraying
Aircraft have begun spraying pesticide over parts of Dallas, Texas to combat an outbreak of mosquito-borne West Nile Virus blamed for 17 deaths this year, authorities said Friday.
West Nile virus on the rise in US: CDC
(HealthDay) -- With 241 cases of West Nile virus and four related deaths reported so far this year, the United States is experiencing the biggest spike in the mosquito-borne illness since 2004, health officials ... | 医学 |
2014-42/1179/en_head.json.gz/21213 | You are hereHome › Science › Medicine › Anatomy › Who Discovered Pulmonary Circulation, Ibn Al-Nafis or Harvey?
By: Ibrahim Shaikh Sir William Harvey is wrongly credited with the modern theory of Pulmonary Circulation. Ibn Al-Nafis, an Arab physician of the 13th Century, explained the basic principles of Pulmonary Circulation nearly 350 years before Harvey was born.
+ Click to read the full article- Click to close Ibn Al-Nafis (Ala al-Din Abu al-A'la Ali ibn Abi Hazm al-Quraishi) of Damascus, an Arab physician of the thirteenth century (1210-1288 CE), explained the basic principles of the modern theory of the lesser or PULMONARY circulation. This was nearly three hundred and fifty years before Sir William Harvey of Kent, England, who is wrongly credited with this discovery.
This fact was acknowledged in 1957 by Professor Dr J B Latham of the University of Manchester at the tercentenary of the death of William Harvey (Sunday Times 9 June 1957).
He also stated that Ibn Al-Nafis had "recognised the fallacy of Galen's theory of invisible channels between the ventricles.
He similarly explained that blood was purified in the lungs where it was refined on contact with the air inhaled from the outer atmosphere. "It should not be assumed too readily that great discoveries were made only in Europe." (The Statesman, Calcutta, 11 June 1957).
Ibn Al-Nafis was the chief physician at the Al-Mansuri Hospital, Cairo, Egypt, where he practised and taught medicine and Muslim theology until his death at the age of 77. He wrote a book "Sharh Tashrih al-Qanun" in which he expounded the pulmonary circulation for the first time. This commentary was consulted by Ibn Al-Quff, a great scientist and contemporary of Ibn Al-Nafis.
All scholarly standards and historical fairness should accredit Ibn Al-Nafis as being the first to discover and describe the Pulmonary Circulation.
Keywords: ScienceMedicineAnatomyIbn al-NafisHarveyPulmonary CirculationphysicianWilliam HarveybloodScienceMedicineAnatomyRate this article: Select ratingGive it 1/5Give it 2/5Give it 3/5Give it 4/5Give it 5/5
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2014-42/1179/en_head.json.gz/21236 | EDITORS' BLOG Last Updated: Wednesday, 22 November 2006, 10:21 GMT
'Only surgery can cure my headache'
Rachel Crellin
Producer, Brain Hospital
Barbara had to rely on oxygen to ease the pain
Until three years ago teacher Barbara Cullen was fit and healthy, spending most of her leisure time outdoors pursuing various hobbies which included a passion for surfing.
Suddenly out of the blue she started getting severe headaches.
As they first began around Christmas time she wondered if it was due to yuletide excess, but the headaches became more and more severe. All her husband Fred could do was to sit and watch.
"To actually watch somebody holding their head in their hands and then getting down on their knees on the floor and literally shaking, you think this is not a normal headache," he said.
The nervous system is one of the last great frontiers we don't understand
Mr Laurence WatkinsNeurosurgeon
"I initially assumed this is something that she's going to die from, she's going to have a brain haemhorrage."
Barbara was getting the headaches up to eight times every day - the pain was so intense that she began to contemplate taking her own life.
"It's excruciating and it's there all the time, it doesn't go away. And being in constant pain you are dragged down, it's a vicious circle, because I can't sleep, I'm constantly tired. "You have to take morphine-based painkillers and you become disorientated and it would be quite easy to just take a few extra and just get rid of the pain once and for all."
The only thing Barbara could do to help ease the pain was to breathe in pure oxygen, she needed to keep a supply close at hand at all times even when at work. Eventually, Barbara was referred to the National Hospital for Neurology and Neurosurgery in London. The surgery does not work for all patients
The National is one of Britain's leading brain hospitals where around 100 consultants treat everything from head injuries to Parkinson's disease, paralysis to epilepsy. Some doctors here are the only specialist of their kind in the country and for many patients the National is their last chance. At the National Barbara's headaches were diagnosed as cluster headaches. The pain they cause is thought to be ten times worse than childbirth - they have been nicknamed suicide headaches because of the excruciating pain - like being stabbed in the head with a needle.
Barbara's only chance of getting rid of the pain was to have an operation to implant an occipital nerve stimulator into the back of her head.
Brain activity
Barbara's surgeon was Mr Laurence Watkins - the only surgeon in the country who carries out this operation.
No-one knows exactly what causes a cluster headache but it is thought to be abnormal activity deep inside the brain. Doctors also are not sure how the occipital nerve stimulators stop the headaches but they think that the stimulator modifies the abnormal activity.
Mr Watkins was attracted to brain surgery as a student because there was still so much to learn about the brain. "The nervous system is one of the last great frontiers we don't understand and yet we all have a brain, it is what makes us what we are. "We still know relatively little about it and I think it is the biggest challenge still around."
Barbara's husband Fred was relieved when he found out she would be suitable for the pioneering surgery. "If we hadn't heard of this operation I don't think she'd be here today," he said, speaking before the operation. "This is the treatment and if this doesn't work the future doesn't bear thinking about, it really doesn't. This operation has got to work."
Unpredictable outcome
In consultation with Barbara, Mr Watkins had to explain that the operation was relatively new and that he could not predict the outcome. It's given me a new lease of life
Barbara Cullen
"My impression is that it seems to work in about two out of three people. Of course there is always a slight unknown with something that hasn't been around for a long time. "We're only really doing it with patients who have chronic headache continuously and where nothing else has worked." Barbara's operation involved planting two electrodes near the occipital nerves which run up the back of her head, through an incision in the skin in her neck. The electrodes were then connected to a stimulator - a little like a pacemaker - which was implanted in her abdomen. Barbara was awake for the first part of the operation to position the electrodes as she had to tell Mr Watkins how far up the back of her head she could feel the "tingling sensation" which was generated by the stimulator.
She was then anaesthetised for the rest of the procedure to implant the stimulator in her abdomen. The hope was that when the stimulator is turned on after the operation her headaches will disappear. Barbara's operation was a success and two months after leaving hospital she was back surfing.
"The fact that I can even think about going in the sea swimming or anything else is just unbelievable. It's given me a new lease of life, there's a future now so I just want to go out and enjoy it." Brain Hospital is on Wednesdays at 2100GMT on BBC One from 22 November 2006
Women 'get more headache drugs'
16 Feb 06 | Health
National Hospital for Neurology and Neurosurgery
Jerusalem car 'attack' kills baby The Brazilian walk-in siesta centres | 医学 |
2014-42/1179/en_head.json.gz/21244 | Rural women who do seek mental health help are more likely to receive care from their primary physician than are urban women.
Image: © iStock Photo Alex Raths Rural primary care physicians offer insight into rural women's health careBy Victoria M. IndiveroFebruary 5, 2014 Rural primary care physicians offer insight into rural women's health care
HERSHEY, Pa. -- Women living in rural communities are less likely than urban-dwelling women to receive sufficient mental health care, in large part due to limited access to services and societal stigma, according to medicine and public health researchers.
Some reports indicate that rural women are more likely than urban women to have depressive mood and anxiety symptoms. However rural women do not have adequate access to mental health care, compared with city women. Rural women who do seek mental health help are more likely to receive care from their primary physician than are urban women.
"We asked rural primary care physicians about how they care for women's mental health," said Jennifer S. McCall-Hosenfeld, primary care physician and assistant professor of medicine and public health sciences, Penn State College of Medicine. "Theirs is an important perspective because rural primary care physicians provide a substantial proportion of mental health services for their patients."
McCall-Hosenfeld and colleagues interviewed 19 primary care physicians who provide care to rural women in central Pennsylvania. The physicians answered questions that focused on screening and diagnosis of mental health conditions, barriers to treatment among rural women, management of mental illnesses in rural women and ideas to improve care for this population. The questions focused on practicing medicine in rural areas and specifically about providing care to rural women. The researchers report their findings in the current issue of Mental Health in Family Medicine.
As of 2005, only 7.4 percent of all U.S. psychiatrists practiced in a rural area. Primary care physicians in rural communities experience significant barriers in providing care to rural women with mental health problems. They commonly reported caring for mental health conditions that were often outside the scope of their training.
"I do a lot of psychiatry in my practice that I really wish I didn't have to do, but I do it because someone's got to do it," said one of the primary care physicians interviewed by the researchers.
Another problem, as several primary care physicians reported to the researchers, results from the stigma surrounding mental health.
"Rural women may not want to be seen walking into the office of a mental health care provider due to fear of judgment by family and friends," the researchers noted in the article.
Identification of mental illnesses was another challenge. About one-third of the physicians reported that they routinely screened for depression, while others stated that time constraints and competing priorities would not allow them to regularly screen patients. Identification of post-traumatic stress disorder among rural women may be particularly challenging because some of the rural doctors did not feel that PTSD was likely to affect rural women. Most of the physicians noted that many of their patients were underinsured and did not have mental health coverage.
"Despite the barriers to optimal healthcare, we found that many of the physicians are seeking creative solutions and developing informal networks with mental health care professionals for consultation," said McCall-Hosenfeld. "This study reinforced the fact that there are problems with access to health care in rural communities, but also provided some examples of potential solutions to those access issues, such as formalizing and expanding existing consulting networks.
"We need a two-pronged approach. We need to improve access to mental health care in rural communities and we need to address the stigma of mental health issues by helping rural women understand that being depressed, for example, is not something to be ashamed of."
Also working on this research was Maria C. Colon-Gonzalez, formerly a resident in family medicine at Penn State, now a fellow and clinical instructor in the department of family medicine, Brown University. Additional researchers from Penn State were Carol S. Weisman, Distinguished Professor of Public Health Sciences and Obstetrics and Gynecology, and Cynthia H. Chuang, associate professor of medicine and public health sciences, both at the College of Medicine; and Marianne M. Hillemeier, professor of health policy and administration and demography, and Amanda N. Perry, graduate student in rural sociology.
The Penn State Clinical and Translational Sciences Institute and the Penn State Building Interdisciplinary Research Careers on Women's Health Program, supported by National Institutes of Health's Eunice Kennedy Shriver National Institute of Child Health and Human Development, supported this research.
Contacts: Victoria M. [email protected] Phone: 814-865-9481 Matthew [email protected] Phone: 717-531-8606 Last Updated March 13, 2014 Share this story
submit to redditLinkedInSubmit this story to StumbleUponPin this story on PinterestShare on TumblrEmail this articlePrint this article Related ContentOverweight pregnant women not getting proper weight-gain advicePrimary care physicians can be critical resource for abused women in rural areasPartner abuse counseling for women insufficientTopicsAcademicsCampus LifeHealth and MedicineResearchSociety and CultureSustainabilityTagsJennifer McCall-Hosenfeld, medicine and public health sciences, rural mental healthAudienceAlumniFaculty and StaffVisitors and NeighborsCampusHersheyCollegeMedicine News for: | 医学 |
2014-42/1179/en_head.json.gz/21265 | News Sports Opinions Living Special Sections Ads Coupons Classifieds Jobs CU Contact Us Business Profiles Around the Region
WGH working now on changes under Health Care Act
Medicare payments will reduce slightly September 25, 2010
By LYDIA COTTRELL [email protected]
Save | Since the landmark health care reform bill became law, health care providers, like Warren General Hospital, have been challenged to cope with the upcoming changes.
The Patient Protection and Affordable Care Act was signed into law by President Barack Obama on March 23. According to WGH compliance officer Christine Kuntz, the bill has three objectives: have health insurance available for most Americans, increase the quality or value of health care and reduce to the cost of health care.
Over the next five years, components and provisions of the law will be phased in, and the executive staff at WGH is already working with the effects of those changes.
“While the bill creates challenges, our focus needs to be on meeting the overall premise of the bill, and that is assuring access to care and ensuring quality of care. We must continue to find ways to work together to meet those goals,” said hospital CEO John Papalia.
A reduction in revenue will be the result of lower Medicare reimbursements which begin this year with a reduction in Medicare inpatient, outpatient, inpatient rehabilitation facility and psychiatric hospital payments by 0.25 percent. The decreases continue with a reduction in Medicare payment by a productivity adjustment of 0.1 percent in 2011 and 2012, and 0.3 percent in 2013. Additionally, Medicaid hospital payment cuts of $600 million will be applied to each state in fiscal years 2015 and 2016.
According to the Hospital and Healthsystem Association of Pennsylvania, the law reduces Medicare and Medicaid payments to adjust for reductions to the number of uninsured individuals. These decreases are particularly important to hospitals like WGH because, as Skip Marsh, WGH Chief Financial Officer said, the federal government classifies WGH as a Medicare dependent hospital.
“I like where (the bill) was going strategically, but the devil is in the details,” Marsh added.
In terms of increased costs, the new law calls for more transparency, which involves more man-hours for data collection and reporting. There is also a technology component. In order to improve quality and efficiency, the government has mandated hospitals to implement a fully functional electronic medical record system. According to Kuntz, WGH has until 2015 to implement the technology before facing monetary penalties. She described the provision as a large undertaking in terms of the cost of implementation and way the hospital does business. With this provision, paper charts will become a thing of the past.
“This method reduces redundancy in care,” she said. While the hospital has until 2015 to implement the technology, they have already begun the process with implementation of electronic medical records, digital archiving, and digital technology in medical equipment.
As to the transparency requirements, WGH has been at the forefront of this movement for years, and is actually ahead of the curve. Warren General volunteered to be part of pilot programs participating with state and federal reporting agencies. “Hospitals will have to publicize their financial assistance policies,” Kuntz said. Related to this, hospitals will be prohibited from taking “extraordinary” collections efforts unless they make a “reasonable effort” to determine whether a patient is eligible for the hospital’s financial assistance. Kuntz went on to explain that Warren General has been following these guidelines for years. We have a dedicated financial assistance counselor, who works with patients to identify those who qualify for financial assistance through a wide variety of programs.
The new law also limits how much hospitals may charge for emergency and medically-necessary care to those patients who qualify for the hospital’s financial assistance program. This means self-pay patients will be not be charged rates greater than those paid by the insurance companies. As the provisions of the law come into effect, hospital officials are looking to the organization’s long standing goals of continued quality care, patient satisfaction, fiscal viability, growth, patient safety and good medical practices to weather the storm.
“What we as a hospital will continue to do is find more effective, efficient ways to deliver quality care,” Papalia said.
He added that WGH will continue to work towards finding opportunities to improve access points for primary care service in Warren County and the surrounding region.
“Our strength lies in our ability to collectively work together on these issues,” he said. Save | Subscribe to Observer Today Dunkirk Weather Forecast, NY | 医学 |
2014-42/1179/en_head.json.gz/21308 | An Investment in America's Future: Racial/Ethnic Diversity in Mental Health Research Careers
http://www.nimh.nih.gov/about/advisory-boards-and-groups/namhc/reports/nimh-diversity.pdf
Cultural and Linguistic Issues | Cultural and Linguistic Competence | Mental Health | race/ethnicity
Mental disorders adversely affect individuals, family systems, our national infrastructure, and the global economy. In the United States, mental disorders account for more than 15% of the burden of disease from all causes, and their respective direct costs and indirect costs are estimated to be $69.0 billion and $78.6 billion. These data indicate the social effects of mental disorders and reflect their staggering economic impact on our Nation in its entirety. There exist, however, a paucity of empirical data that describe the impact and effects of mental disorders on our Nation’s racial/ethnic minority groups, defined in this report as African Americans, American Indians/Alaska Natives, Asian/Pacific Islanders, and Hispanics. Members of these groups remain underrepresented or unreported in most studies of mental illness, although they are overrepresented among the conditions thought to generate susceptibility to, or prolong the effects of, mental illness, such as poverty, racism, homelessness, incarceration, substance abuse, and poor access to health care. Thus the burden of mental illness falls disproportionately on minority groups. The Workgroup believes that an important component in reducing that burden will be to bring a diverse population of research investigators to the task. (National Advisory)
The National Advisory Mental Health Council's Workgroup on Racial/Ethnic Diversity in Research Training and Health Disparities Research
The Culture of Emotions: A Cultural Competence and D...
Race, Quality of Care, and Antipsychotic Prescribing...
Meeting the Challenge: Ending Treatment Disparities ...
Meeting the Mental Health Needs of Asian and Pacific...
Issues in the Psychiatric Treatment of African Ameri...
Cultural Awareness Tool: Understanding Cultural Div...
Racial/Ethnic Disparities in Admissions to Public an...
A Home-Based Family Intervention for Ethnic Minoriti...
Issues in Culturally Competent Mental Health Service...
Perceived Burden Among Caregivers of Adults with Ser...
Cultural Competence Standards in Managed Mental Heal... | 医学 |
2014-42/1179/en_head.json.gz/21410 | Originally published December 16, 2012 at 6:00 PM | Page modified December 17, 2012 at 10:10 AM
The Hutch, Uganda get creative in cancer fight
The Fred Hutchinson Cancer Research Center and its counterpart in Uganda are collaborating on research and ways to improve care in a country where cancer kills more people than the more publicized diseases of AIDS, tuberculosis and malaria.
By Joanne Silberner
JACQUELINE KOCH
Noeline Nakato, 8, who has an intestinal cancer, receives care from nurse Freda Wabwire as Noeline's mother, Aisha Nabukeera, watches at the Uganda Cancer Institute in Kampala. The Hutch helped train doctors, nurses and other personnel; now those people are training others. JACQUELINE KOCH
Swabura Namiiro, 4, has leukemia. "I was very afraid when I discovered my child had cancer," said her mother, Rashida Lubeda. "... But we learned that there was treatment for the disease." An IV infusion drips into the child's arm. JACQUELINE KOCH
Swabura Namiiro, 4, receives care at the Uganda Cancer Institute in Kampala. Her family discovered the institute had many patients with leukemia. "This gave us a sense of support and gave us some strength," Swabura's mother says. Related
Ugandan doctor helping reshape cancer care there
Joanne Silberner's series on cancer in the developing world | PRI's The World
Seattle doctor takes cancer treatment to developing world | KUOW
Interactive graphic: Cancer's global footprint
Funding for this projectThis story was produced with support from the Pulitzer Center on Crisis Reporting: www.pulitzercenter.org
Additional funding for this story and other international reporting in The Seattle Times is provided by a grant from the Seattle International Foundation: www.seaif.org
Click to enlarge graphic
Is this the same Uganda that wants to execute gays? (December 16, 2012, by Spoon Bender)
Spoon bender --- it totally caught my attention too at the irony in a local business gr... (December 17, 2012, by alkijim)
Maybe Uganda needs to spend less time & money on executing gays and more time on... (December 17, 2012, by darkmoonman)
KAMPALA, UGANDA —
Visit the simple stucco-walled, tin-roofed outpatient department at the Uganda Cancer Institute in Kampala, and through the unscreened windows you hear the sound of women sweeping the sidewalks with homemade brooms made of branches and twigs.
Stand in the gleaming, state-of-the-art molecular virology laboratory at the Fred Hutchinson Cancer Research Center in South Lake Union, and you'll hear the quiet whir of centrifuges and the hum of DNA analyzers.
Yet in 2008, the two institutes formally agreed to collaborate on clinical care and research projects, and more recently a major building project at Uganda's only cancer-research center.
It was a bold move. Africa is littered with failed attempts to help out. Money disappears, equipment fails and there's no one to repair it, locals shun the outsiders.
"The Hutch" set out to change the equation, motivated by humanitarian desire and a second, less common spur — research.
"If you are studying something, you would usually go to the place where the disease is," says Larry Corey, president and director of The Hutch.
Uganda has two particular types of cancer that are on the wane in the U.S. — Kaposi's sarcoma, which hits people with untreated HIV infections, and Burkitt's lymphoma, the first cancer to be associated with a virus.
And cancer is a global disease. Nearly two-thirds of cancer deaths occur in developing countries. Perhaps most surprisingly, more people in low- and middle-income countries die from cancer than from the much more publicized diseases of HIV, tuberculosis and malaria combined.
If the collaboration succeeds in the long run, it will do so on the bones of the many failed medical projects in sub-Saharan Africa.
Two donated "mammovans" parked in front of the Uganda Cancer Institute (UCI) show the problem.
"The vans are too large to actually go on the streets of Uganda and they have no film and there's no one who's trained to read mammograms," says Corey Casper, director of the UCI/Fred Hutchinson Research Center Cancer Alliance.
But what the UCI and The Hutch have done with the vans is pretty creative.
In a country that had only one oncologist as recently as 2008, The Hutch has trained about a dozen Ugandan doctors to be cancer specialists.
Some of them go out in the vans, sticking to the main streets as they educate people about cancer's warning signs and the need for early treatment. That's no small task. Many of the tribal languages in Uganda don't even have a word for cancer.
The challenge of treating cancer in a low-resource environment was evident recently in the pediatric ward of the Uganda Cancer Institute. About two dozen cots were filled with children, each accompanied by a parent. Many of the children had grotesque swellings distorting their heads and necks — a sign in these parts of Burkitt's lymphoma.
At medication time, nurses came through giving shots and adjusting intravenous lines. Some of the children were sleeping, some were smiling, others looked sad and scared.
Halfway down the aisle, a woman sat on a bed with her 11-year-old son, who had a cancer she called "the swellings." The cancer left him too weak to walk.
Before coming to UCI, his mother carried him to several local hospitals near her village, where he had been diagnosed with malaria, and then measles.
Transportation troubles
The trip to UCI was onerous. She left her village at 4 p.m. on a minibus, transferring to another minibus, then on to a bigger bus and finally, with her son in her arms, to the back of a motorcycle, arriving in Kampala at 2 a.m. Her son was treated with chemotherapy.
"When they gave him the first dosage," she said through a translator, "he got healed of the swellings and he got back his color."
But she wasn't certain she'd be able to bring him back every two weeks for the four or five cycles that are needed for the chemo to work. Her son's father has abandoned her, and the only way she can raise money for transportation is if someone needs help tilling a field.
"That is how I will get the money. If I don't get it, I won't come," she said.
But not returning, or coming back late, is a real problem. "By the time they return, you have missed the boat," says Abrahams Omoding, one of the Ugandan physicians who came to The Hutch for training, and is now back at UCI. "The tumor has regrown or it has spread to other parts of the body, so this ultimately leads to very poor survival outcomes. You come late, you die soon."
About 90 percent of patients don't come in until they're in a late stage of cancer. Casper, who's based at The Hutch but spends several months each year in Uganda, asked several patients why. "Some said, 'I couldn't afford transport,' some said, 'I didn't know what this is; I hoped it would go away.' "
And some just figured if it was cancer, it was untreatable — a reasonable assumption when most people come in so late that they die anyway.
So Casper, along with Erica Sessle, managing director of the collaboration, and Omoding, of the UCI, launched a study in July.
"It's not the typical research study," says Casper. "The question is if we can take what we already know about care for cancer and optimize it."
The idea is to deal with transportation, diagnosis and therapy, with funding from the Seattle-based Burkitt's Lymphoma Fund for Africa. Tissue samples are carefully analyzed, and the children are getting nutritional support and pain control. Their parents are getting cellphone minutes so they can receive reminders before visits. There's enough chemotherapy on hand, and a transport team will make sure parents and children can get back and forth.
In the U.S., the survival rate for Burkitt's lymphoma is higher than 90 percent. At UCI, it's been around 30 percent. The study will show whether optimizing therapy can improve things.
High-tech research
Another big part of the collaboration is high-tech medical research. Doctors at UCI collect data and tissue samples from people with different types of cancer. Some is analyzed in Uganda, and some comes up to South Lake Union.
The studies are focusing on a hot area of research — how infections cause cancer. Worldwide, about 20 percent of cancer cases arise from infection. Think liver cancer, which is caused by the hepatitis B virus. Cervical cancer is caused by HPV. The bacterium H. pylori causes stomach cancer.
The goal, says Corey, of The Hutch, is to figure out how infections cause cancer and do something practical with that information.
"If you know an infection is the cause of cancer, if you attack the infection you can actually prevent the cancer," he says.
And infections can be attacked with vaccines. Already, the vaccine against hepatitis B has dropped liver-cancer rates in China. The UCI and The Hutch are homing in on the virus that causes Kaposi's sarcoma — together they've figured out its gene structure and the proteins it produces.
The Hutch has been careful to avoid the downfall of previous efforts that excluded local medical personnel.
"All of our studies are a partnership and all have a local Ugandan investigator who leads the project with our U.S. investigator," Casper says. "They're the ones who are really the arbiters of saying, 'Yeah, the potential findings from this study are actually of local relevance and are of importance.' "
In Kampala, the Seattleites are more than welcome. The head of the Uganda Cancer Institute, Jackson Orem, says that Hutch researchers who come to Uganda get a sense of what sort of diagnostics and treatments are possible.
Because of the partnership, the results are likely to be helpful to his patients. "Anything which is discovered, we are going to be stakeholders," he says.
Orem's happy about something else as well. From 2004 to 2008, he was the only trained oncologist in Uganda.
"It was very demanding," he says. "I was doing everything," seeing 10,000 patients a year. Now he's got those Ugandan physicians trained by The Hutch to help.
The stakes for the collaboration are high. Hutch head Corey says it has the potential to demonstrate "that you can do first-rate research that can alter the impact of cancer care in the developing world, and that the craft of oncology can be practiced as well in Africa as it is in the developed world, just like it is with HIV."
Doctors, nurses and other medical personnel have been trained, and they're now training others. Researchers from both institutions have collaborated on dozens of scientific papers.
The Hutch is spending $900,000 toward construction of a three-story, 5,600-square-foot clinic and training institute for research and outpatient treatment.
Prompted by the rejuvenation of the cancer institute, the Ugandan government is building a 200-bed hospital nearby — the first cancer hospital in the country.
When the project first got going, Casper was told by the dean of the public-health school in Uganda, " 'You know, all of us, physicians, villagers, everyone used to think that the only reason you would send someone to the cancer institute is for them to die.' "
That's not so anymore, says Casper.
Joanne Silberner, a Seattle journalist, received a grant from the Pulitzer Center on Crisis Reporting for travel to Uganda. | 医学 |
2014-42/1179/en_head.json.gz/21429 | Home > Medical > Emergency Room > Red Cross to Bear
Red Cross to Bear
Claim: The American Red Cross charges a fee to persons whom they assist.
MIXTURE:
FALSE: The Red Cross charges disaster victims for the assistance they receive.
TRUE: During World War II, the Red Cross charged American GIs for off-base food and lodging.
Example: [Collected on the Internet, 2005]
We heard that the red cross was charging people in New Orleans 70 for a cup of juice and a cookie? Assuming we donate money to pay for the aid could this be true? I've recently heard the Red Cross & maybe the Salvation Army sends bills to the people they help. Say it isn't so!!
Origins: The Red Cross has long been dogged by the persistent belief that it extracts payment for its services from victims of disaster. In the wake of Hurricane Katrina, that notion surfaced again, this time asserting those left homeless and desperate were being charged for coffee, cups of juice and cookies.
The rumor is false. The Red Cross does not solicit payment for services rendered from the folks it is called upon to assist during times of emergency. The American Red Cross says on its page about disaster preparedness for seniors: "All American Red Cross emergency services are provided free of charge." Southeast Michigan Red Cross web site's 'Ask Us' page says:
Q: How much does American Red Cross disaster assistance cost?
A: All American Red Cross disaster assistance is free, made possible by the voluntary donations of time and money from the American people. Disaster assistance is given free-of-charge without judgment or a promise of support.
The current rumor about the service's turning a profit by selling to the needy items it had been supplied with via donation dates back to World War I. George Creel, Chairman of the Committee on Public Information at that time, offered the opinion that vilification tales aimed at the Red Cross bore unmistakable signs of enemy origin. Such backfencing was begun in hopes the negative stories would turn people against the organization. In WWI, and again in WWII, the slander took the form of cautionary tales about sweaters knit by volunteers as gifts for men serving at the front being instead sold to them by the Red Cross. The altruistic knitter, it was said, afterwards received a letter from the sailor who had come to be in possession of her work both thanking her for the garment and asking if she thought it fair he'd had to pay six dollars for it. Also rampant in WWII was scuttlebutt that soldiers serving in the Pacific were forced to pay five dollars for cardigans that had Red Cross labels in them. The sweaters the Red Cross collected from volunteers and sent to servicemen were, of course, never sold to GIs; they were always provided for free.
Similarly, the Red Cross was said to be selling to servicemen cigarettes that had been donated by major tobacco companies. The Red Cross blood donor service was also a target of rumormongering in WWII. Whispers swept along that blood donations had been accepted from the Japanese, thereby (it was said) making it likely the offspring of those receiving such transfusions would display Japanese characteristics. Similar concerns were raised about blood from African-Americans being added to the pool. Rumor was also used to discourage those inclined to donate blood: stories were spread that those who gave ran the risk of contracting infection or disease from unsterilized instruments.
The Affairs of Dame Rumor, a 1948 book about rumors rampant in America, recorded the following:
The Red Cross rumors illustrate that the enemy rumor mill was designed to sabotage anything the American people might do to help their own war effort. If they were asked to lend aid by contributing their money to this organization, there was a lie that the Red Cross money was terribly mishandled and their books unaudited. If they were asked to become volunteer workers, there was a canard about men in the army saying there is no need for it. If they were being enlisted as consistent blood donors, there was a prohibitive fable about how blood plasma could be kept for only two months and if not used by then was thrown away. If American ladies persisted in knitting sweaters, the falsehood to discourage them was that garments sent to England were being ripped up and the wool sold to the British people. And lies of inefficient practices and waste dogged the efforts of the Red Cross throughout the war.
There is truth to one of the rumors, however. During WWII the American Red Cross did indeed charge American servicemen for coffee, doughnuts, and lodging. However, they did so because the U.S. Army asked them to, not because they were determined to make a profit off homesick dogfaces. The request was made in a March 1942 letter from Secretary of War Henry L. Stimson to Norman H. Davis, chairman of the American Red Cross. Because American soldiers were fighting as part of the Allied Forces, matters had to be considered on a Force-wide rather than a solely American basis. The Red Cross was asked to establish club facilities for U.S. servicemen overseas where Allied troops would be welcome, and because English and Australian soldiers were being charged for the use of such facilities, it was deemed unfair that Americans were to get similar benefits for free (especially in light of the fact that their pay was higher than that of their Allied counterparts). For the good of the alliance, the American Red Cross was persuaded to exact nominal charges from American GIs for off-base food and lodging.
This act resulted in the Red Cross' coming to be regarded by numerous GIs as having profited off them. Bad feeling exists to this day over the decision to charge American servicemen for these services, with any number of such soldiers and their families carrying long-lasting resentments against the service. Yet while that ire might have been merited, it was misdirected: the culprit was the U.S. Army, not the Red Cross.
General Dwight D. Eisenhower, Chief of Staff, United States Army, addressed the controversy surrounding this issue in a statement to the press on 10 April 1946:
I am surprised to learn that one of the reasons [for Americans not contributing to the American Red Cross] is the complaints being leveled at the organization�s overseas operations by returning servicemen. For the most part these criticisms have grown out of a Red Cross policy of making nominal charges to our forces for food and lodgings in fixed Red Cross installations abroad. These complaints are distressing to me since this particular Red Cross policy was adopted at the request of the Army, so as to insure an equitable distribution among all service personnel of Red Cross resources.
I know the Red Cross. I have seen it in action. Overseas it performed with the precision of a well-trained army. It would be grave injustice to the splendid work of the Red Cross if its campaign should be retarded anywhere by mistaken criticisms.
Even after World War II, the Red Cross continued to be dogged for years by false tales about their imposing fees on military personnel for basic humanitarian services, such as the following 1952 rumor that claimed the organization had charged a U.S. serviceman interest on money he borrowed from them to attend his mother's funeral:
A recent rumor to the effect that a serviceman had been loaned money by the Red Cross at 6 per cent interest so he could attend his mother's funeral was revealed by the local chapter.
When the rumor proved to be unfounded, said a local Red Cross official, the serviceman wrote to deny the story: "I have not been asked to pay 6 per cent interest on this loan nor has it ever been suggested by anyone employed by the American Red Cross that I pay interest," he said. "It was through the joint effort of the Hartford Chapter and the office of the field director that I was granted a leave ..."
The story of the interest charging went through a nearby summer resort "like wildfire," reported the official.
The Red Cross' version was this: the local serviceman had just been inducted and was beginning his service at an Air Force base. The Red Cross notified him of his mother's death, and since the serviceman was without enough money for the trip, the chapter advanced him more than $100 which he agreed to pay over a prolonged period — without interest.
Barbara "president and accounted for" Mikkelson
Jacobson, David J. The Affairs of Dame Rumor.
New York: Rinehart & Co., 1948 (pp. 356-359).
Landers, Ann. "Ann Landers."
11 March 1989 [syndicated column].
Associated Press. "Red Cross Charged for Food, Lodging at Army's Request."
The Milwaukee Journal. 10 April 1946.
The Hartford Courant. "Serviceman Who Borrowed Money Denies Red Cross Charged Interest."
23 August 1952 (p. 7). | 医学 |
2014-42/1179/en_head.json.gz/21496 | Timeless The Patient Body: An Irresistible Force
Oct 9, 2013 • 3:27 pm 1 Comment
Barbara Mancini with her father, Joe Yourshaw.(http://www.compassionandchoices.org)
By Ann Neumann
*This is the first of an ongoing monthly column, The Patient Body, about issues at the intersection of religion and medicine.*
By the great force of my disease is my garment changed: it bindeth me about as the collar of my coat. – Job 30:18, KJV
In 1971, Geertruida Postma, a medical doctor in the Netherlands, gave her mother a lethal injection of morphine. She could no longer watch her mother suffer the agony of a brain hemorrhage when she knew how to end it. For the next thirty years Dutch law had a gaping hole in it. Assisted suicide, defined as helping to take the life of a person–even at the person’s explicit request–was not legal; nor was it prosecuted.
“He who takes the life of another person on this person’s explicit and serious request will be punished with imprisonment of up to twelve years or a fine of the fifth category,” read Article 293 of the Dutch Penal Code that rendered assisted suicide (or euthanasia or aid in dying) a criminal offense. And yet, the penal code also includes, in Section 40, a clause that ameliorates the assisted suicide prohibition. It states, in part, that “an individual was not punishable if he or she was driven ‘by an irresistible force’ (legally known as force majeure) to put another person’s welfare above the law.” Assisted suicide was legalized in The Netherlands in 2002. In 2010, 4,050 patients, roughly three percent of those who died, utilized the law.
As Bruce Jennings, Director of Bioethics at the Center for Humans and Nature, stated at a symposium on ethics and hospice at New York University last month, medicine is now able to “do bad things to the people who are dying.” His statement is passive, a construction that implicates not just medicine (the treatments, the operations, the drugs, the machines), but the medical community (its patients and practitioners), the justice system (used to formulate society’s laws) and ultimately, all of us. Doctor Postma, even in 1971, knew what Jennings was getting at. The advancement of medical technology over the past fifty years has created a nightmare, even as it has saved lives. With respirators, pacemakers, defibrillators, and new treatments employed each day, how do we make ethical choices that both honor our patients and maintain what we call “our humanity?”
Also in 1971, Catholic pacifist Eileen Eagan first defined the “seamless garment,” a metaphor for our absolute duty to preserve the human body. It was incorporated by Cardinal Joseph Bernardin twelve years later into his “consistent life ethic”: that all human life is sacred and should be protected by the law. Absolutes have an enticing romance, particularly when discussed in the abstract. We hark them when we don’t have clear answers; they become fast laws that protect our consciences, our social mores, what makes us care for one another. But what is our duty when a life can’t be saved? Or when preservation of life comes at a terrible cost, either unbearable suffering for the patient, or an unsustainable use of medical resources? The principle that “all human life is sacred and should be protected” is then changed by individual circumstances, by the patient and their body, by varying conceptions of what is sacred and what must be protected.
Erring on the side of life is an unquestionable principle. Until, perhaps, you’re standing where Postma was standing, watching your mother’s death drag her over the last coarse days of life. Or perhaps when you’re standing where many doctors stand today, watching terminal patients’ lives prolonged by treatments and machines that can no longer cure.
What gets lost in the chasm between Bernardin’s “all human life is sacred” and Postma’s “irresistible force” is a world of definitions. What is life when death is the decision to remove a feeding tube? What does sacred mean to us today? What is suicide to an actively dying person? To their family? What is dignity in the face of pain? Even too, what is pain?
Erring on the side of life is an unquestionable principle, perhaps, until you’re standing where Barbara Mancini was on February 7, 2013, in her father’s home outside Philadelphia, Pennsylvania. Joseph Yourshaw asked his daughter, Barbara, a nurse, to hand him a bottle of morphine. Yourshaw was 93, a war veteran with diabetes, end-stage renal disease, heart disease and the effects of a stroke. She gave him the bottle. He took the morphine.
Moments later, a hospice nurse arrived and–against Yourshaw’s written wishes, Mancini’s verbal request, and the general guidelines of hospice–called 911. Michael Vitez writes at the Philadelphia Inquirer:
Durkin [the police captain] also said he spoke with Barbara Mancini: “She told me that her father had asked for all his morphine so he could commit suicide and she provided it.”
When the ambulance arrived, Durkin continued, Barbara Mancini “told them not to take or treat her father.” But the officer said he told Mancini “that she no longer had any say in the matter and her father was going to the hospital.”
Her father was revived at the hospital with the drug Narcan. He was given a urinary catheter and breathing mask, among other treatments.
Barbara Mancini was arrested and released on $100,000 bail. Yourshaw died four days later in the hospital – after receiving morphine to ease his pain.
Mancini could spend ten years in prison if she is convicted. I suspect that, as a nurse, she knew the potential ramifications of doing what her father asked her to. His request was an irresistible force, one that filled the chasm between two duties: “The duty of not taking a life and the humane duty to end a patient’s intolerable suffering.”
Asking what our duty is when faced with situations like Mancini’s is not a thought exercise. Today in the U.S., assisted suicide, or what activists call Death with Dignity, is legal in four states. There are multiple initiatives to legalize assisted suicide at any given time. New drugs and treatments that can prolong death are developed constantly. As the US populations grows increasingly older and we watch our loved ones struggle with the “bad things” that medicine can now do, new understandings about how we die will continue to challenge each of us. The question is not whether we have the courage to imagine ourselves in Mancini’s place, but–as a society charged with formulating ethics, opinions, laws and policies–when each of us will be forced to.
Ann Neumann, a hospice volunteer, has written for Guernica, the Nation, New York Law Review, and Religion & Politics, among others. She is contributing editor at The Revealer, a publication of the Center for Religion and Media at New York University, where she is a Visiting Scholar.
Tags: ann neumann, death with dignity, Kali Handelman, religion and medicine, science and religion
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The Patient Body: What’s a Kidney Worth? | The Revealer says: Nov 6, 2013 […] Patient Body” is a monthly column about issues at the intersection of religion and medicine. You can read the October column […] | 医学 |
2014-42/1179/en_head.json.gz/21505 | Health by ZIP code
By MIKE STOBBE
ATLANTA - If you're 65 and living in Hawaii, here's some good news: Odds are you'll live another 21 years. And for all but five of those years, you'll likely be in pretty good health.Hawaii tops the charts in the government's first state-by-state look at how long Americans age 65 can expect to live, on average, and how many of those remaining years will be healthy ones.Retirement-age Mississippians fared worst, with only about 17½ more years remaining and nearly seven of them in poorer health.U.S. life expectancy has been growing steadily for decades, and is now nearly 79 for newborns. The figures released Thursday by the Centers for Disease Control and Prevention estimate life expectancy for people 65 years old, and what portion will be free of the illnesses and disabilities suffered late in life."What ultimately matters is not just the length of life but the quality of life," said Matt Stiefel, who oversees population health research for Kaiser Permanente.The World Health Organization keeps "healthy life expectancy" statistics on nearly 200 countries, and the numbers are used to determine the most sensible ages to set retirement and retirement benefits. But the measure is still catching on in the United States; the CDC study is the first to make estimates for all 50 states.Overall, Americans who make it to 65 have about 19 years of life ahead of them, including nearly 14 in relatively good health, the CDC estimated.But the South and parts of the Midwest clearly had lower numbers. That's not a surprise, experts said.Southern states tend to have higher rates of smoking, obesity, diabetes, heart disease, and a range of other illnesses. They also have problems that affect health, like less education and poverty.These are issues that build up over a lifetime, so it's doubtful that moving to Hawaii after a lifetime in the South will suddenly give you more healthy years, they said.After Mississippi, Kentucky, West Virginia and Alabama had the lowest numbers for both life expectancy and healthy life expectancy. States with the best numbers included Florida - a magnet for healthy retirees - as well as Connecticut and Minnesota.The estimates were made using 2007 through 2009 data from the census, death certificates and telephone surveys that asked people to describe their health.The CDC's Paula Yoon cautioned not to make too much of the differences between states. Results could have been swayed, for instance, by how people in different states interpreted and answered the survey questions.Other findings:n Nationally, women at 65 can expect nearly 15 more years of healthy life. Men that age can expect about 13 years.n Blacks fared much worse than whites. They could expect 11 years of healthy life, compared to more than 14 for whites. | 医学 |
2014-42/1179/en_head.json.gz/21510 | Thirdage.com
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Psoriasis-Hypertension Link
By Third Age on Wednesday, October 22, 2014 @ 9:28 am Patients with more severe psoriasis are also more likely to have uncontrolled hypertension, according to research done at the Perelman School of Medicine at the University of Pennsylvania. Through a cross-sectional study using information collected from a medical records database, the results provide further evidence of a strong link between psoriasis and hypertension. The results were published in October 2014 in JAMA Dermatology.
Tags: psoriasis hypertension high blood pressure Discovery May Help Prevent Blindness
By Third Age on Wednesday, October 22, 2014 @ 12:00 am A team of researchers at the Institut de Researches Cliniques de Montréal (IRCM) led by Michel Cayouette, PhD discovered that a protein found in the retina of the eye plays an essential role in the function and survival of light-sensing cells that are required for vision. These findings could have a significant impact on the understanding of retinal degenerative diseases that cause blindness. The study was published in Octoner 2014 in The Journal of Neuroscience.
Tags: retinal degenerative diseases blindness Improving Bladder Function After Spinal Cord Injuries
By Third Age on Wednesday, October 22, 2014 @ 12:00 am People who have suffered spinal cord injuries are often susceptible to bladder infections, and those infections can cause kidney damage and even death. Research done at the University of California, Los Angeles may go a long way toward solving the problem. A team of scientists studied 10 paralyzed rats that were trained daily for six weeks with epidural stimulation of the spinal cord and five rats that were untrained and did not receive the stimulation. The team found that training and epidural stimulation enabled the rats to empty their bladders more fully and in a timelier manner.
Tags: paralyzed spinal cord injuries bladder function Getting the Most from Your Oral Healthcare Providers By Third Age on Wednesday, October 22, 2014 @ 12:00 am By Marijke Vroomen Durning RNEditor's note: This is the eighth in a series of articles on getting the most from the members of your healthcare team.
It used to be that if you went to the dentist, unless you needed some special work, the dentist took care of just about everything. But over the years, dentistry and its specialties have come into their own and you may see many people at your local dental office or clinic. Here’s a primer of who does what.
Tags: oral healthcare providers dentists dental assistants dental hygeiists periodontists Public Health in the 21st Century
By Third Age on Wednesday, October 22, 2014 @ 12:00 am An American Journal of Preventive Medicine supplement published in October 2014 addresses critical challenges to public health in the 21st century. Although disease outbreaks and epidemics that are drawing worldwide attention emphasize the importance and acute need for public health professionals, the world faces a longer-term challenge—a public health workforce that is truly effective in the 21st century.
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2014-42/1179/en_head.json.gz/21553 | The Feline Health Center
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Bladder and Kidney Stones Cornell Feline Health Center
Cornell University College of Veterinary Medicine
Ithaca, New York 14853
The feline kidneys have many important functions. Among them are: to filter metabolic waste such as urea, mineral salts, and various toxins from circulating blood; to help regulate the volume of body fluids and the blood levels of important chemicals and hormones; to initiate the recirculation of purified blood throughout an animal’s system; and to facilitate the excretion of the filtered-out waste products (mixed with water to form urine) before they reach toxic concentrations in the body. Most cats will go through life without experiencing a serious disruption in these vital processes. Some others, however, will experience urolithiasis—a potentially lethal condition marked by the formation of small stones (uroliths) somewhere within this elaborate system.
The upper tract consists of two kidneys, which handle the biochemical processes; and two slender tubes (ureters)—one leading from each kidney—that deliver waste-containing urine from the kidneys down to the lower tract. The lower tract, whose function is purely excretory, consists of the bladder, a muscular sac that receives the urine delivered to it through the ureters and stores it until it is expelled from the body via the other component of the lower tract, the urethra, a thin tube leading from the bladder to the outside world. Stones can develop anywhere within either the upper or lower tracts of the urinary system.
Bladder stones, says Richard Goldstein, DVM, associate professor of small animal medicine at Cornell University’s College of Veterinary Medicine, are composed of minerals—either struvite or calcium oxalate—while kidney stones are always made of calcium oxalate. “These minerals are present naturally in a cat’s body,” he says, “and the stones form when the minerals exceed a certain threshold of concentration in the urinary system. When the concentration goes over that threshold, they start to form crystals, and the crystals accumulate and may grow into stones. We don’t know why this process takes place, but we’ve observed that it tends to occur frequently in domesticated cats, especially in those that are not very active, don’t take in enough fluids, and don’t urinate enough.” In some cases, bladder stones may be tiny and inconsequential, remaining harmlessly lodged somewhere within the urinary tract or passed without notice in a cat’s urine. In other cases, however, they can grow to significant size, painfully irritate the tender tissue lining the tract, and cause internal bleeding. In the worst case, they can slip into a cat’s urethra and interfere with the passage of urine. A complete blockage—one that totally obstructs the flow of urine and prevents the elimination of poisonous waste from a cat’s system—will present a medical emergency that, without immediate veterinary care, may prove fatal. Blockages are most common in male cats since they have a very narrow and easily obstructed urethra. Typical early signs include blood in the urine as well as increasingly frequent and painful urination. Kidney stones, on the other hand, do not typically cause noticeable signs of disease until they become very large. "So most of those cats go undiagnosed until there is a problem,” says Dr. Goldstein. Both kidney stones and bladder stones, he notes, can be readily diagnosed by means of x-rays and ultrasound. Regarding the treatment of kidney stones, he says: “In most cases, we don’t believe that we should go in, open the kidneys, and remove the stones unless they’re causing significant obstruction or infection. But bladder stones are typically treated either surgically or by going in with a laser and sort of blowing up the stones.” Unfortunately, he adds, stones are likely to recur unless certain preventive measures are taken, which generally entail a combination of dietary and medicinal therapies. To reduce the risk of kidney and bladder stones, Dr. Goldstein makes the following recommendations to cat owners: "Make sure that your cat always has access to water and is drinking it. Cats prefer fresh water, so don’t let it stand around for days. We also believe that at least 50 percent of a cat’s diet should be wet food. And make sure that the cat is getting plenty of exercise.” Keeping the litter box clean will encourage more more frequent urination and is advisable.
By Tom Ewing | 医学 |
2014-42/1179/en_head.json.gz/21672 | Diseases & Conditions >
Lungs & Respiratory System >
Cystic fibrosis (CF) is an inherited disease that causes the body to produce mucus that's extremely thick and sticky. The mucus is thicker than normal because CF affects cells in the epithelium (pronounced: eh-puh-THEE-lee-um), the layer of cells that lines the passages in the body's organs.
In a person who does not have CF, the epithelial cells produce a thin, watery mucus that acts like a lubricant and helps protect the body's tissues. In someone with CF, however, the thicker mucus doesn't move as easily. This thick, sticky mucus clogs passages in many of the body's organs and infection sets in.
The two organs most affected are the lungs and pancreas, where the thick mucus causes breathing and digestive problems. The thicker mucus has trouble moving out of the lungs, so bacteria can remain and cause infections.
The thick mucus also is in the pancreas — an organ that produces proteins called enzymes that flow into the intestine to support the body's digestion process. Because the mucus can block the path between the pancreas and the intestines, people with CF have trouble digesting food and getting the vitamins and nutrients they need from it.
CF can also affect the liver, the sweat glands, and the reproductive organs.
What Causes CF?
Approximately 30,000 people in the United States have been diagnosed with CF, which affects both males and females. It's not contagious, so you can't catch CF from another person.
Cystic fibrosis is an inherited disease caused by mutations (changes) in a gene on chromosome 7, one of the 23 pairs of chromosomes that children inherit from their parents. CF occurs because of mutations in the gene that makes a protein called CFTR (cystic fibrosis transmembrane regulator). A person with CF produces abnormal CFTR protein — or no CFTR protein at all, which causes the body to make thick, sticky mucus instead of the thin, watery kind.
People who are born with CF have two copies of the CF gene. In almost all people born with CF, one gene is received from each parent. This means that the parents of kids with CF are usually both CF carriers — that is, they have one normal and one defective gene — but the parents may not have CF themselves because their normal gene is able to "take over" and make the necessary CFTR protein.
Each child born to parents who are both CF carriers has a 1 in 4 chance of having the disease. Cystic fibrosis occurs most frequently in Caucasians of northern European descent, in whom the CF gene is most common — although people of other heritages can get the disease, too.
People who have a close relative with CF are also more likely to carry the CF gene — approximately 12 million Americans, or 1 in every 20 people living in this country, is a CF carrier. And most of them don't know it. Parents can be tested to see if they carry the CF gene, but because there are hundreds of specific CF gene mutations (not all of which are known), genetic testing for CF won't detect everyone who is carrying a CF gene.
Doctors can also perform tests during pregnancy so prospective parents can find out more about the chances that their child will have CF. However, these tests also won't always detect a CF gene.
What Happens When You Have CF?
Doctors diagnose most kids with CF by the time they are 3 years old, but if someone has a milder form of the disease, it may not be diagnosed until that person reaches the teen years. Babies are usually tested if they are born with an intestinal blockage called meconium ileus, which is more common in CF infants.
frequent lung infections or pneumonia persistent wheezing
persistent cough with thick mucus
bulky, light-colored, foul-smelling bowel movements or diarrhea (because food isn't being digested properly)
failure to gain weight, even though the child eats normal amounts
very salty sweat
poor height growth
nasal polyps (small growths of tissue inside the nose)
frequent sinus infections
People with CF get frequent lung infections that can damage their lungs over time and require strong antibiotics along with stays in the hospital. They may have trouble growing or gaining weight because of digestive problems.
Adults with CF may also develop other illnesses, such as diabetes (when blood sugar is too high) or osteoporosis (a weakening of the bones).
The ends of the toes and fingers may become rounded and enlarged, a condition that's called clubbing.
What Do Doctors Do?
If doctors suspect that a person has CF, they will order a sweat test. In this test, the doctor or technician uses a chemical and a very mild electrical current to cause sweating on an area of skin, usually on a person's forearm (this test doesn't hurt). The doctor or technician collects a large amount of sweat in a pad and then analyzes it.
If the test results show a high level of chloride (a chemical in salt), there's a possibility the person has CF. In some states in the United States, all newborns are checked for CF with a blood test, although the blood test isn't as good at detecting the disease as the sweat test.
Doctors and people with CF can do several things to slow the progression of the disease and fight its complications. To loosen mucus, people with CF exercise regularly and may use inhalers (like kids with asthma use) or nebulizers that help deliver medication to the lungs.
Coughing helps people with CF clear the mucus from their lungs. They may also take antibiotics to prevent or fight lung infections. Chest physical therapy may also be an important part of the CF treatment routine. After lying down in a position that helps drain mucus from the lungs, the person has a helper, such as a parent, gently bang on his or her chest or back to loosen the mucus.
A newer device called a therapy vest shakes the chest, allowing teens to be more independent by doing their therapy on their own.
For digestive problems, someone with CF can take enzymes by mouth to help digest food and get nutrients from it. A doctor may also prescribe vitamin supplements and a high-calorie diet.
Living With CF
Right now, there is no cure for CF. Even if symptoms are mild at first, they get steadily worse over time.
But there is hope: 15 years ago, most children with CF would die before reaching their teens. Now, with new treatments available, more than half live into their thirties, and new research is leading to the possibility of a cure. Statistics now show that nearly 40% of the people living with CF in the United States are 18 years or older.
Since researchers identified the gene that causes CF in 1989, they have tried to replace abnormal CF genes with normal ones. Some are working on finding the right method of delivering that normal gene into the cells of a person with CF. Other scientists are trying to find new ways of fighting lung infections and different ways of moving chloride in and out of cells, bypassing the defective CFTR protein. In some cases, lung transplants have extended the lives of people with CF.
If someone you know has CF, you can be a supportive friend by learning about the disease so you can help others understand what your friend is going through. Just hanging out with your friend and taking part in the activities you enjoy doing together can be a great help.
If you have CF, focus on staying as healthy as possible by following your doctor's treatment instructions, taking your medications, eating right, and exercising. Meeting other teens who have CF via chat rooms is fine, although personal contact between two CF patients can present problems since it carries the risk of passing dangerous bacteria to each other.
Your hospital's child life and CF specialists will have all kinds of ideas and tips for coping with the disease and keeping your spirits up. Ask them to recommend groups you might join, either online or locally. They can provide you with information about clinical trials, legislative actions, handouts about CF, and even a college or vocational school scholarship program.
Reviewed by: Floyd R. Livingston Jr., MD
Date reviewed: April 2014
Balancing Schoolwork and Hospital Stays
Dealing With a Health Condition | 医学 |
2014-42/1179/en_head.json.gz/21681 | Imagine a malady that has reached epidemic proportions by affecting more than 3 in 10 Louisiana residents.
Alas, it’s no dream, it’s a nightmare. Almost 35 percent of the state’s adult population is considered obese, according to
a report by the Trust for America’s Health and the Robert Wood Johnson Foundation.
The report ‘‘F as in Fat: How Obesity Threatens America’s Future 2013’’ ranks Louisiana No. 1 in adult obesity, surpassing
Mississippi that held that inglorious crown for the previous eight years.
There are simple causes and effect.
Though some people are pre-disposed because of heredity, obesity’s main
culprits are unhealthy
foods consumed in large quantities and a sedentary lifestyle.
Louisiana cookbooks heavy with fried food delicacies are a contributing factor. All-you-can-eat buffets where patrons pay,
then strive to get their money’s worth can be a factor. So is the state’s climate that limits many outdoor activities from
May through September.
All of this leads to such deadly health issues as heart attacks, strokes, diabetes, cancer, osteoarthritis and sleep apnea
— and in many cases either premature death or a severely limited lifestyle.
“There’s been generation after
generation of lack of motivation and proper eating habits that have just
been conditioned in
people,” said Dr. Clint Guillory, an emergency room physician in
Louisiana. “I remember when I was growing up, we’d run outside
and play baseball. No | 医学 |
2014-42/1179/en_head.json.gz/21682 | Botox and Numbskulls
By Jan LaRue
You have to wonder how thoroughly the FDA tested Botox before approving it for use on human heads. Evidence is mounting that the magical face-lift potion affects the brain, and that even non-users may suffer from second-hand Botox. Or maybe I'm just trying to give some Hollywoodites, politicians, and talking heads a break by making an excuse for their buffoonery. Think about it. Botox is a protein derived from botulism toxin, which is a paralytic illness. I'm thinking anyone who wants it injected anywhere near their brain has deeper problems than wrinkles.When low doses of Botox are used, it actually paralyzes or relaxes facial muscles, giving the recipient a clean, smooth facial appearance. This is where it's gone askew-it's only safe in low doses.There's been serious over-medicating at this chemical fountain of youth. It's penetrating skulls and paralyzing frontal lobes. And the smoother the forehead, the more oblivious they are to their denseness. What else explains the daily deluge of drivel?Take Sen. Joe Biden. Who can keep up with this guy? On top of too much Botox, some quack lifted his eye lids so much he looks in the mirror and sees Confucius, except he sounds like Costanza, Seinfeld's slow-witted sidekick.Biden said Hillary Clinton may have been a better vice presidential pick than he. That paying more taxes is the patriotic duty of the rich. And, he encouraged wheelchair-bound Missouri State Senator Chuck Graham to stand up at a campaign rally. I haven't checked since I started writing this, but Biden's most recent and best gaffe yet was in an interview with Katie Couric on Monday night. Biden said: "When the stock market crashed, Franklin Roosevelt got on the television and didn't just talk about the princes of greed. He said, ‘Look, here's what happened.'" Is Botox causing our potential vice president's brain to atrophy, or did Biden see a satellite rebroadcast of a long-lost episode of The Twilight Zone guest-hosted by Franklin Delano Roosevelt before he became president? Maybe everybody else missed it because couch potatoes were hogging the remote at the time.Couric let Biden's goofiness pass without comment. Imagine if it had been Sarah Palin instead. Couric and her liberal media pals are convinced Palin isn't qualified to be a heart-beat from the presidency," but they're quite comfy with giving Biden access to our nuclear codes.Actress Laura Linney received an Emmy Award last Sunday night for her portrayal of Abigail Adams in HBO's outstanding series, John Adams. At the end of her acceptance speech Linney said, "I just have the most tremendous respect for anyone who serves their community. Our founding fathers were community organizers. And that is fact to me. And I feel that has been disparaged." Linney's performance was undoubtedly worthy of the award, but I wouldn't bet on her against any of the kids on Are You Smarter Than a 5th Grader?The next one is more likely due to comatose celebrititis, though secondhand exposure to Botox is always a threat in Hollywood. According to the AP, Paris Hilton, 25, tried to explain her most recent drunk-driving arrest to radio host Ryan Seacrest this way. "Hilton said she was ‘starving because I had not ate all day' and possibly ‘speeding a little bit' in her Mercedes-Benz SLR on her way to grab a bite. ‘I was just really hungry and I wanted to have an In-N-Out burger,' said the one-time pitchwoman for Carl's Jr." If you've ever had an In-N-Out burger, you can almost excuse her conduct, especially if you "had not ate all day." The word on the street is she's auditioning for a "Hooked on Phonics" commercial.Obama must have been thinking about Hilton when he referred to giving a kid with asthma a "breathalyzer test." Is he suffering from Botox overload, or has he been watching too many reruns of Ghostbusters? What else explains why he saw some of America's "fallen heroes" in his Memorial Day audience in New Mexico?On Meet the Press, host Tom Brokaw asked the perpetually perplexed House Speaker Nancy Pelosi about "Senator Obama saying the question of when life begins is above his pay grade, whether you're looking at it scientifically or theologically. If he were to come to you and say, 'Help me out here, Madame Speaker. When does life begin?' What would you tell him?" Having checked previously with the "doctors of the church," except for the ones licensed to practice medicine, said Pelosi, "I don't think anybody can tell you when life begins, human life begins."She topped it off with another stunner: she told Brokaw she believes, "in natural gas as a clean, cheap alternative to fossil fuels." She repeated it just to make sure we get it.The Speaker of the United States House of Representatives doesn't know when life begins and she doesn't know that natural gas is a fossil fuel. Forget loyalty oaths for Congress. What we need is a ban on Botox and proof of active brain waves. I say we start drilling in ANWR and move on to Pelosi's skull.Because Botox numbs the muscles, it can cause the appearance of surprise, which explains why Biden and Pelosi usually look clueless, and why they make the rest of us look like we were zapped with a stun gun.Jan LaRue served as Chief Counsel at Concerned Women for America, Director of Legal Studies at Family Research Council, and Senior Counsel at the National Law Center for Children and Families. She is currently a member of the Board of Advisors of the Culture and Media Institute, a division of the Media Research Center. | 医学 |
2014-42/1179/en_head.json.gz/21707 | Home // Monitor on Psychology // May 2012 Monitor on Psychology // Alone, in ‘the hole’ Feature Alone, in ‘the hole’
Psychologists probe the mental health effects of solitary confinement.
By Kirsten Weir May 2012, Vol 43, No. 5
For most of the 20th century, prisoners' stays in solitary confinement were relatively short. "People would get thrown in 'the hole' for a couple days at a time, maybe a couple weeks at a time," says Craig Haney, PhD, a social psychologist at the University of California, Santa Cruz, whose research has explored the psychological effects of incarceration.
That's changed over the last two decades or so. "Now they're in the hole for years at a time," he says. Over the last 20 years, so-called "supermax" prisons have become increasingly popular. There, tens of thousands of inmates spend years locked in small cells for 23 to 24 hours a day, according to Jeffrey Metzner, MD, a clinical professor of psychiatry at the University of Colorado School of Medicine, and Jamie Fellner, a senior advisor with Human Rights Watch (Journal of the American Academy of Psychiatry and the Law, 2010).
The issue of solitary confinement is a complicated and controversial one. Different states and prison systems define solitary confinement conditions differently, so reliable statistics about its prevalence are hard to come by, as Michigan Sate University researcher Jesenia Pizarro, PhD, reports (The Prison Journal, 2008). But experts who study the issue agree that U.S. prisons are turning to solitary confinement more frequently.
"Some type of segregation has always been part of American corrections," says Joel Dvoskin, PhD, a forensic and clinical psychologist in Arizona. "What's new is that it's being used a lot more often."
As solitary confinement has become more common, so have questions about its psychological impacts. Chief among those questions: What really happens to people deprived of social contact for months or years on end?
Two types of solitary confinement are commonly in use today. The first, known as disciplinary segregation, is leveled as punishment when inmates break the rules. Steal a cellmate's radio, for instance, and you might be in solitary for a week or two. During disciplinary segregation, an inmate is separated from other inmates for a specified period of time.
The second type of confinement is known as administrative segregation, which is used when prisoners are deemed a risk to the safety of other inmates or prison staff. Prisoners in administrative segregation are placed into isolation units for months or years. Corrections officials first turned to this strategy in response to growing gang violence inside prisons, Dvoskin says. Though critics contend that administrative segregation has never been proven to make prisons safer, use of this type of confinement has continued to rise. That's worrisome to most psychologists who study the issue. Deprived of normal human interaction, many segregated prisoners reportedly suffer from mental health problems including anxiety, panic, insomnia, paranoia, aggression and depression, Haney says (Crime and Delinquency, 2003).
To Haney, evidence of these effects comes as no surprise. "It borders on being common sense, but it's common sense with a lot of empirical research that supports it," he says. "So much of what we do and who we are is rooted in a social context."
However, much of the evidence of harm comes from cross-sectional studies or research done on people who are not in prison, such as the isolated elderly. Designing a long-term study to follow prisoners in solitary confinement is challenging. Each correctional system is unique, inmates move in and out of segregation, and many states prohibit or limit psychological studies of incarcerated individuals due to ethical concerns.
In an effort to better understand the issue, Maureen O'Keefe, a researcher with the Colorado Department of Corrections, and Kelli Klebe, PhD, a psychologist at the University of Colorado, recently conducted a longitudinal study of the psychological effects of administrative segregation in a Colorado prison, with funding from the Department of Justice. The researchers studied 65 male inmates and 24 controls who were being evaluated at institutional hearings to decide whether they would be placed in solitary confinement or the general prison population.
Klebe and colleagues hypothesized that segregated inmates would show worsening psychological health measures over time, and that negative effects would be even more pronounced among inmates who had previously been diagnosed with a mental illness. To her surprise, neither hypothesis was supported by the data.
The researchers found that the segregated prisoners did show elevated rates of various psychological disorders, says Klebe, but she cautions that those symptoms are often present even before inmates enter administrative segregation. It's possible that inmates who are referred for a segregation hearing have a lot of psychological problems to begin with, she suggests, "and that's what's earning them the way into a lockdown situation."
Haney, however, argues that the study design had numerous methodological flaws, including the fact that all of the participants were initially exposed to a form of solitary confinement that the report acknowledges was especially severe. When prisoners were flagged for an administrative segregation hearing, they were immediately placed into disciplinary segregation until the outcome of that hearing. Therefore all study participants had been in confinement for several days to a week, according to Klebe, before they were ever evaluated by the researchers.
"I frankly don't think you can draw any conclusions from [the study]," Haney says. "There's very little doubt in psychology in general that enforced isolation is psychologically stressful and for some people will be harmful."
Meanwhile, in a growing number of states, mostly as a result of litigation, it's now illegal to place mentally ill individuals in administrative segregation. Still, mentally impaired prisoners are disproportionately represented in solitary confinement. O'Keefe estimated that in 2005, the prevalence of mental illness in administrative segregation in that state was greater than 35 percent, compared with a mental illness rate of less than 25 percent among the general prison population (Journal of Offender Rehabilitation, 2008).
That pattern is troublesome, says Metzner. "It's hard to give a reasonable argument that you can provide adequate treatment to someone with serious mental illness who's locked up in a cell for 23 hours a day," he says. "Our correctional system has become our mental health system for too many people."
Different individuals have different capacities for resilience, and even among people without mental illness, it's impossible to know who might be seriously harmed by extended isolation. Yet there are other good arguments for limiting segregation.
One is that most prisoners will eventually be released back into society. "Some people have told me they've been locked down so long they're fearful of their own behavior if they're around human beings," says Dvoskin. "That's especially counterproductive if you think this person is going to leave prison."
In 2007, researchers at the University of Washington reported that prisoners released directly from supermax prisons into the community committed new crimes sooner than prisoners who had been transferred from segregation into the general prison population for several months before being released (Crime and Delinquency, 2007).
Meanwhile, critics point out that supermax prisons are expensive and there's no good evidence that they're safer than the alternatives. Dvoskin says most psychologists who study confinement agree that at the very least, solitary confinement is used too much.
"We ought to be looking for any other way to keep prisons safe, including new ways that maybe haven't been invented yet," he says.
Kirsten Weir is a writer in Minneapolis. | 医学 |
2014-42/1179/en_head.json.gz/21765 | BarbadosAdvocate.com
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Gov�t happy with status of mental health care services1/25/2013When it comes to the delivery of mental health care services in Barbados, information suggests that the care provided locally, is comparable to that of more developed countries.
The above was recently revealed by Health Minister Donville Inniss, who has noted that the country has budgeted well to ensure adequate provision of mental health care services and a good ratio of mental health professionals, as needed for the local population.
�An examination of the status of mental health care services in Barbados, has revealed that despite the work that is yet to be done to accomplish the vision for accessible, comprehensive and fully integrated services, the level of care currently provided and the allocation of resources to this sector, is comparable with that of the more developed countries� Inniss recently commented.
�Over the past five years, approximately 7% of the national health budget was utilised by the Psychiatric Hospital. This does not include additional expenditure for operation of the community inpatient unit at the Queen Elizabeth Hospital or expenditure for the purchase of psychotropic drugs by the Barbados Drug Services,� he said. �This level of care is also verified through the WHO (World Health Organ-isation) AIMS (Assessment Instrument for Mental Health Systems) Report for Barbados, which indicates that the ratio of mental health care professionals to the population is in keeping with international standards� Inniss pointed out. The Health Minister revealed that during the reporting period, 212 persons worked in public mental health facilities, including 11 psychiatrists, 8 medical doctors (not specialized in psychiatry), 107 nurses, 24 psychologists, 5 social workers, 7 occupational therapists, and 50 other health or mental health workers. There was ratio of 4.08 psychiatrists per 100,000 persons.
Inniss further revealed that since the publication of this Report, the staffing complement for the community-based services carried out by the Psychiatric Hospital has also been strengthened, with the establishment and filling of sixteen community mental health nurse positions. In addition, during August of last year, the number of consultant psychiatrists serving in the community, was increased from one to three, providing specialized services within each of the polyclinics, on a shared basis. Acknowledging the need for the reform and modernization of local mental health services however, Inniss remarked that a multi-faceted approach will be needed. This will require the resources and expertise of a number of legislative, social, health and economic entities, he said. New models of financing would also need to be examined with the re-organisation and regulation of services, Inniss also remarked.
He also asserted that incorporating structures for involvement of family members as important partners in care provision, is another aspect of mental health care reform, that must be considered.
�Enhanced care without this participation does not encourage self-reliance on the part of families, and this continues to place total responsibility for care in the hands of health care professionals� Inniss said. (RSM) | 医学 |
2014-42/1179/en_head.json.gz/21777 | How can raising the price of alcohol improve health?
By Michelle Roberts
Health reporter, BBC News
Drinking too much alcohol on a regular basis increases health risks
High alcohol price 'benefits all'
Plans for minimum alcohol pricing
Health campaigners say a minimum price for a unit of alcohol should be introduced in the UK to help tackle the nation's rise in problem drinking. The government in England and Wales is set to announce plans today. Last year the Scottish parliament rejected a similar idea.
What evidence is there to suggest a minimum alcohol price would help?
According to experts, one in four men and women in the UK is currently drinking dangerous amounts of alcohol that are causing, or have the potential to cause, physical and mental damage.
In the UK the number of alcohol-related deaths has more than doubled in the past 16 years, with more than 8,000 people dying of conditions such as alcohol poisoning and liver cirrhosis every year.
And it costs the NHS over £2bn annually to treat the chronic and acute affects of alcohol. Campaigners argue that part of the problem is down to the wide availability of cheap booze in supermarkets and other retail outlets.
It's certainly true that the bigger the price change the bigger the effect”
Researcher Professor Petra Meier
England's last Labour government asked economic experts to do some number crunching to work out if introducing a minimum price would help to curb the nation's drinking.
Researchers at the University of Sheffield took on the challenge and looked at how high to set the bar per unit (10ml or 8g) of alcohol.
As expected, they found the higher the price tag went, the greater the reduction in consumption would be.
But they were concerned that if the price was set too high it would penalise all drinkers, including so-called "sensible" drinkers. Conversely, setting it too low would do nothing to stop heavy drinkers loading up on strong "bargain" booze.
The government in England and Wales is looking at introducing a minimum price of 21p per unit for beer and 28p per unit for spirits.
But the the University of Sheffield experts calculate that a minimum cost of at least 50p per unit would be necessary achieve the desired effect.
Not far enough
Professor Petra Meier, a public health expert at the university, said: "It's certainly true that the bigger the price change the bigger the effect. "Effects of 20p-30p are very modest compared to 45p-50p per unit.
"Alcohol-related harm is driven through consumption and we don't really predict that people's consumption would change at all under 20p minimum price and very modestly under 30p."
Setting the bar at 50p should save up to 50,000 people from illness in a decade, Professor Meier and colleagues estimate.
Continue reading the main story Alcohol costs with a 50p per unit limit
A 750ml bottle of wine (12% alcohol by volume) could not be sold for less than £4.50. A 700ml bottle of whisky (40% alcohol by volume) could not be sold for less than £14. Six 500ml cans of lager (4% alcohol by volume) could not be sold for less than £6. A two-litre bottle of cider (5.5% alcohol by volume) could not be sold for less than £5.50. They say harmful drinkers would be affected considerably more than moderate drinkers by this minimum price policy. For a 50p minimum price, a harmful drinker will spend on average an extra £163 per year whilst the equivalent spending increase for a moderate drinker is £12. This would reduce levels of alcohol consumption by 10.3% among harmful drinkers - those who drink above the recommended limit of 4 units per day for men or 3 units per day for women. It would also have a big impact on the health of moderate drinkers - men drinking three bottles of wine or 21 or fewer units per week, and women drinking a bottle and a half of wine or 14 units or fewer. And in terms of the overall burden of alcohol-related ill health, about 20% is for moderate drinkers who make up half of the population.
A 50p limit should cut alcohol consumption among moderate drinkers by about 3.5%, or half a unit for women and two-thirds of a unit for men. Although this may not sound much, the researchers say it equates to big health gains with time. It would slash rates of high blood pressure, diabetes and heart disease. Their calculations show a 50p limit would mean 2,900 fewer premature deaths a year as well as 41,000 fewer cases of chronic illness. It would also mean 8,000 fewer injuries each year, 92,000 fewer hospital admissions per year and a saving to the healthcare system in England of £270 million each year.
23 MARCH 2010, HEALTH Plans for minimum alcohol pricing
18 JANUARY 2011, UK POLITICS Related Internet links
Estimated effect of alcohol pricing policies on health - The Lancet
1: Police killer Harry Roberts to be freed 2: Ottawa shootings: Soldier killed and city on lockdown Video/Audio | 医学 |
2014-42/1179/en_head.json.gz/21806 | Personalized Medicine in the Spotlight at BIOTECHNICA 9/3/2013 9:09:50 AM
Hannover, Germany. Tomorrow’s patients will enjoy the benefit of far more patient-centric approaches to treatment – approaches which fully take the patient’s individual traits into account. This will open up new avenues in the prevention and treatment of auto-immune disease, cancer and infections. Personalized medicine technology is one of the hottest topics to be featured at BIOTECHNICA 2013, which takes place from 8 to 10 October in Hannover. At a dedicated marketplace for Personalized Medicine Technologies, scientists and industry experts will be showcasing their latest advances and signalling their interest in new partnerships and commercial projects.
One of modern medicine’s most outstanding breakthroughs is the ability to fine-tune cancer treatments to the molecular properties of a specific patient’s cancer. Due to this progress in our understanding of molecular processes, together with the advent of new immunological and biochemical test systems as well as innovative imaging processes, it is already possible to assess potential side-effects and the suitability of specific therapies for any given patient. At BIOTECHNICA, major attention will be given to product innovations, new concepts and initiatives in the field of personalized medicine. Recent developments are opening up new horizons and numerous opportunities for companies and research institutes in such areas as IT, biobanks and diagnostics. The Marketplace Personalized Medicine Technologies offers the ideal arena for suppliers and users of innovative medical technology to meet and discuss new scientific findings and techniques. For research institutes and universities, but also for representatives of pharmaceutical and biopharmaceutical companies, diagnostics, biobanks and laboratories, the Marketplace provides a valuable platform for presenting and discussing new developments in diagnostics and therapeutics.
One of the outstanding representatives of this sector at BIOTECHNICA is the Ci3 cluster for individualized immunotherapy. The Ci3 cluster networks players from business, research, health care and politics with the aim of establishing the Rhine-Main region, a centre of the pharmaceuticals industry, as a leading global hub for individualized forms of immunotherapy. The cluster comprises more than 120 partners, including pharmaceutical companies, numerous small and medium-sized companies and academic research institutes. “It is foreseeable that individualized medicine will play a major role in immunotherapy”, says Dr. Andrea Schilz, a senior member of Ci3 Management UG. “The objective of Ci3 is to develop forms of medical treatment that make use of the immune system and ensure that such innovative customized therapies are available to patients. Our lighthouse projects focus on research into stratified and individualized vaccines to treat solid tumours and the development of new forms of treatment for coeliac disease.” In addition to Ci3 there will be other leading-edge clusters representing German medical research at BIOTECHNICA: the Biotech Cluster Rhine-Neckar (BioRN) based in Heidelberg focuses on cell-based and molecular medicine, the m4 cluster from Munich specializes in targeted therapy and personalized medicine, while the Medical Valley cluster in Erlangen in the European Metropolitan Region Nuremberg is another renowned cluster. All these clusters have collaborated with the industry associations representing the pharmaceutical companies engaged in research, vfa and vfa bio, in order to stage the Forum at the Marketplace Personalized Medicine Technologies. Every morning and afternoon, on each of the three days of the trade fair, they will present an interesting program of talks and presentations. On Tuesday, the first day of the event, representatives from the relevant associations and leading clusters will kick off the discussion with an introduction to the progress achieved and the current status of personalized medicine, including the associated science and techniques. The Forum will also highlight the different directions being pursued in cancer research. For instance, Dr. Frank Kischkel, CEO at TherapySelect, will be speaking on “Cancer Therapy: Drug Treatment Testing before Therapy”, while Dr. Ralph M. Wirtz, CEO and CSO at Stratifyer Molecular Pathology GmbH, will focus on “Third Generation Gene Signatures: Genomewide Sequencing and Subtype Specific Biomarkers”. Next-generation sequencing and biomarkers will be the keynotes of the trade fair program on Wednesday, while attention will be focussed on molecular imaging on the Thursday. The full program can be viewed online at www.biotechnica.de.
About BIOTECHNICA BIOTECHNICA opens its gates again for the 20th time from 8 to 10 October 2013. As Europe’s No.1 Event for Biotechnology, the Life Sciences and Lab Technology, BIOTECHNICA is the leading meeting-place for this sector. BIOTECHNICA puts the focus on technological developments and innovations from R&D, as well as biotech products and applications in the areas of medicine, food production, industry and the environment. The event also provides a global platform for a broad range of services for the biotech and pharmaceutical industries. The trade show is augmented by a program of international conferences, special presentations and workshops. Number of characters (incl. spaces): 5,490
Your contact at Deutsche Messe for further information:
Katharina Siebert
Tel.: +49 511 89-31028
E-mail: [email protected]
Further press releases and digital photos can be downloaded at:
www.biotechnica.de/pressservice
BIOTECHNICA Release - BioServices: Marketplace for Service Providers in the Pharmaceuticals and Biotech Industry OvaScience to Ring the NASDAQ Stock Market Opening Bell Sustainable Drug Production Through Biotechnology: DBU and BIO Germany Present Cutting-Edge Projects CEL-SCI (CVM) Announces That NYSE MKT Approves Plan BIOTECHNICA 2013: Spotlight on the Food Industry Incyte Corporation (INCY) to Ring the NASDAQ Stock Market Opening Bell BIOTECHNICA: The German Biotech Sector: Status Quo and the Latest Trends Immucor (BLUD) to Host Debt Investor Conference Call on Wednesday, September 4, 2013 Switzerland to be Showcased as BIOTECHNICA Partner Country in 2013 Oramed Pharmaceuticals Inc. (ORMP.OB) to Ring the NASDAQ Stock Market Closing Bell Please enable JavaScript to view the comments powered by Disqus.
BIOTECHNICA | 医学 |
2014-42/1179/en_head.json.gz/21807 | Startup Allecra Therapeutics Raises $19.5 Million Series A Financing 4/18/2013 7:05:51 AM
Lörrach, Germany and Saint Louis, France – The creation of Allecra Therapeutics, a new company joining the established European BioValley Life Sciences cluster, was announced today. Allecra is a biopharmaceutical company dedicated to the development of novel antibiotics to combat multi drug-resistant bacterial infections. Allecra’s €15 million Series A financing round was co-led by Edmond de Rothschild Investment Partners and Forbion Capital Partners. EMBL Ventures also participated. Allecra is a strategic partnership between the company’s founders including Nicholas Benedict, CEO of Allecra working in conjunction with Orchid Chemicals & Pharmaceuticals Limited (Chennai, India).
Bacterial resistance to current antibiotics is widespread and growing exponentially, compromising doctors’ ability to treat serious infections in patients receiving care both in hospitals and in the community. Governments, non-governmental agencies and the medical community have called for increased urgency and decisive action to combat what has been called the “epidemic of antibiotic-resistance”[1]. Allecra‘s mission is to contribute to this cause by developing new treatments which overcome emerging bacterial resistance mechanisms, thereby saving lives of patients whose infections may otherwise may be inadequately treated.
Nicholas Benedict, Allecra’s CEO said, “To combat the increasing threat of bacterial resistance the medical community is trying to conserve the use of currently available antibiotics. At the same time, the biopharmaceutical industry is working to find new antibiotics. These objectives are complimentary activities in the increasingly urgent battle against bacterial resistance. Allecra has been formed in order to find new cures for some of the most widespread and hardest to treat resistant infections.”
Commenting on this partnership, Orchid’s Chairman & Managing Director, Mr K. Raghavendra Rao said, “We have always believed in building collaborative business models to achieving our vision. This strategic partnership with Allecra is yet another demonstration of how we can create value by harnessing the relative strengths of each company.”
Holger Reithinger of Forbion Capital Partners and member of Allecra’s Board said, “It is our shared objective at Allecra to deliver to the medical community novel treatments to help fight the epidemic of bacterial resistance. We have a specialist team, each of whom is deeply experienced in the development of antibiotics and which collectively is supported by a world-leading group of Opinion Leaders.”
Olivier Litzka of Edmond de Rothschild Investment Partners and member of Allecra’s Board added, “Allecra’s strategic partnership with Orchid is an innovative collaboration bringing together Allecra’s strong development capability with Orchid’s track record in antibiotic research and manufacturing. Allecra is supported by a Scientific Advisory Board consisting of world-renowned experts and Allecra’s Board of Directors comprises key appointments of entrepreneurs and industrialists with records of success in this area. This is a new company built on a solid foundation for success.”
For further information please contact
Allecra Therapeutics GmbH
Nicholas Benedict
[email protected]
About Allecra Therapeutics
Allecra is a biopharmaceutical company established in 2013 in the European BioValley Life Sciences cluster which is located in the Upper Rhein valley encompassing northwest Switzerland, southeastern Germany and the Alsace Region of France. Allecra is focussed on the development of novel treatments to combat multi drug-resistant bacterial infections. The company is based on a strategic partnership between its Founders, Orchid Chemicals and Pharmaceuticals Ltd. (Chennai, India) and its lead investors Forbion Capital Partners and Edmond de Rothschild Investment Partners. Allecra’s mission is to contribute towards the global effort to combat antibiotic resistance by developing new treatments which overcome emerging resistance mechanisms thereby saving lives of patients whose infections may otherwise may be inadequately treated. For more information on Allecra please visit www.allecra.com or email [email protected].
About Orchid Chemicals & Pharmaceuticals Ltd.
Orchid Chemicals & Pharmaceuticals Ltd. (Orchid) was established in Chennai, India in 1992 as an export-oriented unit (EOU). Orchid is a vertically integrated company spanning the entire pharmaceutical value chain from discovery to delivery with established credentials in research, manufacturing and marketing. Orchid today ranks among the top 15 pharmaceutical companies in India and enjoys a multi-therapeutic presence across segments like anti-infectives, anti-inflammatory, central nervous system (CNS), cardio vascular segment (CVS), nutraceuticals and other oral and sterile products. Orchid’s pharmaceutical solutions include active pharmaceutical ingredients (API), finished dosage forms, new drug discovery (NDD), novel drug delivery systems (NDDS) and contract research and manufacturing services (CRAMS). Orchid is globally present across 70+ countries through alliances, joint ventures and partnerships with globally reputed majors.
About Forbion Capital Partners
Forbion Capital Partners is a dedicated Life Sciences venture capital firm with offices in Naarden, The Netherlands, and Munich, Germany. Forbion invests in life sciences companies in drug discovery & development as well as medical device companies addressing substantial unmet medical needs. Forbion’s investment team of nine investment professionals has built an impressive performance track record since the late nineties with successful investments in Rhein Biotech, Crucell, Neutec, Glycart, Borean, Impella, Alantos, Acorda, Fovea, PanGenetics, Argenta Discovery and most recently Biovex and Pathway Medical. Current assets under management exceed $550M, split between four active funds and comprising some 29 promising portfolio companies. Forbion Capital Partners Fund II is supported by the European Investment Fund through its ERP and LfA facilities. Forbion co-manages Biogeneration Ventures, an early stage fund focused on (academic) spin-outs and seed investments in the Netherlands. For more information, please visit www.forbion.com.
About Edmond de Rothschild Group Edmond de Rothschild Investment Partners is the private equity affiliate of the Edmond de Rothschild Group which is specialised in asset management and private banking (EUR 125bn under management, 2,900 employees and 30 offices throughout the world). Founded in 1953, the Group has been chaired since 1997 by the founder's son, Baron Benjamin de Rothschild .
About EMBL Ventures
EMBL Ventures is an independent venture capital investor that manages two Funds with a total of €68 million capital on behalf of major European institutional and private investors. Currently it invests with its second Fund, the EMBL Technology Fund II. EMBL Ventures' close relationship with the European Molecular Biology Laboratory (EMBL) and its technology transfer organization EMBL Enterprise Management Technology Transfer GmbH (EMBLEM) allows it to finance disruptive technologies in an entrepreneurial start-up environment, aiming ultimately for a transaction with a partner that is seeking to acquire external product innovation. EMBL Ventures is exclusively focused on life-science investments. EMBL Technology Fund II is supported by the European Communities Growth and Employment Initiative, MAP - ETF Start up Facility.
VistaGen Therapeutics, Inc. Raises $36 Million Portola Pharmaceuticals, Inc. Files for $115 Million IPO Pharma Startup, Syros Pharmaceuticals Gets $30 Million for Genetic Cancer Treatments Device Startup, Adagio Medical Gets $2.5 Million Investment but Stays Quiet on Technology for Heart Disease Cydan Launches With $16 Million In Backing GenSight Biologics Raises $41 Million to Advance Gene Therapy for Blinding Disease Auris Medical AG Secures $50.6 Million Series C Financing Biotech Chimerix, Inc. Shines in IPO Debut as Interest Grows in Antiviral Drugs Novaliq GmbH Raises $18.1 Million Sanofi (France) (SAN.PA) to Invest $75 Million in Plant in Vietnam Please enable JavaScript to view the comments powered by Disqus.
Biotech/Pharma - Finance, Start-Up
BioPharm Executive - Money Talk | 医学 |
2014-42/1179/en_head.json.gz/21809 | Print this page Novavax, CPL Biologicals, ICGEB join hands for malaria research
20 Jul 2012, BioSpectrum Bureau , BioSpectrum
Bangalore: Novavax, CPL Biologicals (CPLB) and the International Centre for Genetic Engineering and Biotechnology (ICGEB), have formed a new collaboration to develop a novel malaria vaccine in India. This unique public-private partnership will combine the advanced vaccine technology of Novavax with the malaria vaccine research capabilities of ICGEB and vaccine manufacturing capability of CPLB, to develop a new and effective malaria vaccine.
The project is being funded by India's Department of Biotechnology Vaccine Grand Challenge Program and will be managed by the Malaria Vaccine Development Program, a New Delhi-based not-for-profit organization established to support the development of malaria vaccines.
Novavax's virus-like particle (VLP) vaccine technology platform will be applied to construct malaria vaccine candidates, which CPLB will manufacture for advanced preclinical studies, clinical trials and commercialization. The partners will develop and evaluate VLPs that express Plasmodium falciparum circumsporozoite protein (PfCSP), which has been used to develop the only recombinant malaria vaccine that has shown efficacy in field trials. After establishing the feasibility of Novavax's technology, the partners will explore the possibility of producing additional VLPs against antigens from other stages of malaria parasites. The partners believe a multi-stage VLP malaria vaccine has the potential for higher efficacy compared to vaccines based on a single antigen or that target only one stage of the malaria parasite.
Malaria remains a major public health problem in many regions of the tropical world. Forty percent of the world's population lives in malaria endemic regions of Africa, Asia and Central and South America. Despite the widespread use of insecticides, bed nets and other malaria control efforts, there are approximately 210 million cases of malaria each year that lead to around 650,000 deaths, primarily in children less than five years of age. There is an urgent need for malaria vaccines with high efficacy that can be used in conjunction with other control efforts to provide protection against malaria.
Dr Virander Chauhan, director of ICGEB, New Delhi, which will provide their extensive experience in pre-clinical and clinical development of vaccines, said, "ICGEB is excited about the possibility of working with Novavax and CPLB to advance malaria vaccine development."
Mr Indravadan A Modi, chairman of Cadila Pharmaceuticals, said, "CPLB will develop manufacturing processes for the vaccine candidates and will provide GMP production capability in support of this initiative." He also stated, "Malaria is a common health problem for tropical countries and efforts have been ongoing for years for its eradication. I am confident that a multi-stage VLP malaria vaccine will prove beneficial in saving precious lives by restricting morbidity and mortality associated with malaria."
Dr Gale Smith, vice president- vaccine development at Novavax, stated: "Novavax is honored to be working with leading malaria experts at ICGEB and with the Department of Biotechnology of the Government of India to support the development and production of malaria vaccine candidates by Novavax and CPLB. By combining our knowledge and experience with these partners to pursue the most advanced malaria vaccine concepts, we hope to one day have an effective vaccine against one of the world's most devastating diseases." | 医学 |
2014-42/1179/en_head.json.gz/21810 | Ganymed Closes $61M Internal Round for Lead IMAB Program By Cormac Sheridan
The deep-pocketed brothers Thomas and Andreas Strüngmann have signed another big check, leading a €45 million (US$61 million) internal round in Ganymed Pharmaceuticals AG to enable it to take forward its pipeline of “ideal” monoclonal antibodies (IMABs) in cancer indications.
Its lead compound, IMAB362 is undergoing a Phase IIb trial in gastroesophageal cancer, which will report preliminary data next year.
The Mainz, Germany-based firm has an enviable position within European biotechnology, having raised €170 million since it was spun out from the universities of Mainz and Zurich, Switzerland, in 2001 .
Its majority shareholder is ATS Beteiligungsverwaltung GmbH, an investment vehicle of the Strüngmann family, who realized a cash fortune of €5.65 billion from the 2005 sale of generic drugmaker Hexal AG, of Holzkirchen, Germany, and a majority stake in its U.S. affiliate Eon Labs, to Basel, Switzerland-based Novartis AG.
“We did not need to look for new investors,” Ganymed CEO Özlem Türeci told BioWorld Today. “They have a strong commitment to this company.” The other participants in the transaction were MIG Fond and FCPB Gany GmbH.
The company expects recruitment in the three-arm, open-label study of IMAB362 as first-line therapy in gastroesophageal cancer to be completed by next April. The primary endpoint of the 210-patient study is progression-free survival, while overall survival is a secondary endpoint. “The first trends and tendencies will be seen by late summer,” Türeci said.
The final study report will not be available until late 2015, however. If the data are positive, the company aims to be in a position to begin a Phase III study quickly, although it has yet to decide whether it will do so alone or with a partner. “We are in a position where we could perform a Phase III by ourselves, and we are backed to do that by our investors,” Türeci said. Either way, it plans to pursue the study in the U.S. and in Europe.
Several other antibodies have fallen in that indication, including Avastin (bevacizumab, Roche AG) and Erbitux (cetuximab, Eli Lilly and Co.), although Herceptin (trastuzumab, Roche AG) gained approval earlier this year for treating HER2-overexpressing metastatic gastric or gastroesophageal junction adenocarcinoma.
Ganymed’s first clinical readout is as second-line therapy as well. “We already have convincing data from a Phase IIa trial,” Türeci said. According to preliminary data, 20 percent of per-protocol patients (n = 21) with metastatic, refractory or recurrent advanced gastroesophageal adenocarcinomas achieved a partial remission, while another 28 percent had stable disease.
Ganymed’s antibodies have a conventional structure but are directed against targets that are highly specific to cancer cells, which allows for a wider therapeutic window than many other antibodies that are directed at solid tumors. In addition to hitting its intended target, the company is also able to deploy immune-related functions, including induction of apoptosis, antibody-dependent cell-mediated cytotoxicity and antibody-dependent complement cell lysis without excessive toxicity.
IMAB362 is directed against claudin 18 splice variant 2 (claudin 18.2), a tight-junction protein, the expression of which is normally confined to fully differentiated epithelial cells of the gastric mucosa. It is expressed in about 80 percent of gastroesophageal adenocarcinomas and in about 60 percent of pancreatic tumors. The company is developing a companion diagnostic in parallel, Claudetect 18.2, which already has received a European CE mark.
The present Phase IIb study will test whether there is a correlation between high levels of claudin 18.2 expression and clinical benefit from IMAB362.
Ganymed is competing against several big guns in its leading indication. Amgen Inc., of Thousand Oaks, Calif., is in Phase III trials with Rilotumumab (AMG102), which targets the hepatocyte growth factor/scatter factor pathway. Roche AG, of Basel, Switzerland, is conducting Phase III trials of onartuzumab, which targets hepatocyte growth factor receptor, or c-Met. | 医学 |
2014-42/1179/en_head.json.gz/21843 | The Radiology Department
Diagnostic Radiology Services
The first step in addressing a medical problem—whether it’s a blocked artery, a tumor, or broken bone—is to find its precise location within the body, accurately measure it, and provide a “roadmap” that guides physicians during treatment. The staff of Bridgeport Hospital’s Radiology department, including board-certified physician-radiologists and radiology technologists, provides a full range of diagnostic and imaging services for this purpose. Services are performed for adult and pediatric patients admitted to various units of the hospital and on an outpatient basis at multiple locations throughout Fairfield County.
Learn more about Diagnostic Imaging Services at Bridgeport Hospital
Learn more about Bridgeport Hospital Outpatient Radiology
Radiology in Treating Disease
The role of radiologists has evolved as technology has become more sophisticated. “Interventional” radiologists have the advanced training to “intervene,” or participate, in medical procedures. Bridgeport Hospital has been among the first hospitals in Connecticut to introduce many interventional radiology procedures. These procedures are an alternative to radical surgery for many patients.
Learn more about Interventional Radiology Services at Bridgeport Hospital | 医学 |
2014-42/1179/en_head.json.gz/21844 | Health & Wellness > Health NewsBiggest Ever Weekly Rise in Ebola Cases, U.N. Agency SaysFRIDAY, Aug. 29, 2014 (HealthDay News) -- The West African Ebola outbreak took a more deadly turn Friday with the World Health Organization announcing an estimated 500 new cases this week -- the biggest jump in infections so far.Most of the new cases arose in Liberia, the U.N. health agency said, but cases in Guinea and Sierra Leone also rose sharply, the Associated Press reported."There are serious problems with case management and infection prevention and control," according to the WHO report. "The situation is worsening in Liberia and Sierra Leone."Senegal -- a prime tourist destination in the region -- has also now recorded its first case, an infected university student from Guinea who sought treatment at a hospital in Senegal's capital city, Dakar, the AP reported.According to Senegal's Health Minister, Awa Marie Coll Seck, the young man had had contact with Ebola patients in Guinea and has now been placed under quarantine. Tests have confirmed he is infected with Ebola virus, the AP said.The news follows a WHO update released on Thursday that warned that the deadly Ebola outbreak hitting five West African nations could eventually infect more than 20,000 people. Already the largest Ebola outbreak ever, the viral infection has produced 3,069 cases so far and killed 1,552 people in Guinea, Liberia, Nigeria and Sierra Leone, with Senegal now added to that list.Nearly 40 percent of the total number of reported cases have occurred in the past three weeks, the health agency said."This far outstrips any historic Ebola outbreak in numbers. The largest outbreak in the past was about 400 cases," Dr. Bruce Aylward, WHO's assistant director-general for emergency operations, said at a news conference, the AP reported.In the meantime, many American universities say they plan to run extra health checks on college students arriving from the affected region.According to the AP, about 30 students from Nigeria are expected to arrive this semester at the University of Illinois. According to Dr. Robert Palinkas, director of the university's health center, the Nigerian students will be asked to undergo a temperature check for signs of fever and to have a private discussion about Ebola when they arrive at the university health center for required immunization paperwork and tuberculosis testing.Health experts stress that the threat to U.S. college students remains very small, but Palinkas told the AP that the added precautions should reassure parents. "Parents are comforted to know that there is a screening process, that we are alert for it, that we are prepared for it," he said, "and that we're doing everything we can without infringing on the rights of anybody to make sure their son or daughter is going to have the lowest risk possible."Similar precautions are being conducted at the University at Buffalo in New York, Mercer University in Georgia, Liberty University in Lynchburg, Va., and the University of Akron in Ohio, the AP said.In response to the crisis, WHO unveiled a battle plan Thursday that calls for stopping Ebola transmissions within six to nine months, while "rapidly managing the consequences of any further international spread," the WHO said in a news release.The plan calls for spending $489 million over the next nine months and enlisting 750 international workers and 12,000 national workers, the AP reported.Also Thursday, the U.S. National Institutes of Health (NIH) said it would begin testing an experimental Ebola vaccine in humans next week. It will be tested in 20 healthy adults in Maryland to see if it's safe and able to produce an appropriate immune system response.The vaccine was developed by the U.S. National Institute of Allergy and Infectious Diseases and drug maker GlaxoSmithKline. It will also be tested on healthy volunteers in Great Britain and the West African nations of Gambia and Mali, the NIH said. Unlike diseases such as tuberculosis or flu, Ebola isn't spread by breathing air from an infected person. Transmission requires direct contact with blood, secretions, organs or other body fluids of infected living or dead persons or animals, according to the WHO.Ebola, one of the world's most virulent diseases, kills up to 90 percent of people it infects. Symptoms include a sudden fever, intense weakness, muscle pain, headache and sore throat. This is followed by vomiting, diarrhea, rash, poor kidney and liver function and, in some cases, both internal and external bleeding.Many of those killed during the current Ebola outbreak have been health care workers.According to the CDC, health care workers must be able to recognize a case of Ebola and be ready to use "isolation precautions or barrier nursing techniques." Barrier nursing techniques include:wearing protective clothing, such as masks, gloves, gowns, and goggles;using infection-control measures, including complete equipment sterilization and routine use of disinfectant;isolating patients with Ebola from contact with unprotected persons.The aim of these techniques is to avoid contact with the blood or secretions of an infected patient, the CDC said.More informationFor more on Ebola virus, visit the U.S. Centers for Disease Control and Prevention.SOURCES: U.S. National Institutes of Health, news release, Aug. 28, 2014; World Health Organization, news release, Aug. 28, 2014; Associated PressCopyright ©2013 HealthDay. All rights reserved.Health & WellnessHomeLibraryDiseases & ConditionsTests & ProceduresRecipes by Food CategoryWellness LibraryNews CenterHealth NewsNewslettersPrevention GuidelinesQuizzes & CalculatorsMultimediaHealth Centers | 医学 |
2014-42/1179/en_head.json.gz/21891 | Mayo Clinic's New Plan Targets Heart Disease - Health & Science - CBN News - Christian News 24-7 - CBN.com
Mayo Clinic's New Plan Targets Heart Disease By Lorie Johnson
CBN News Medical Reporter
ROCHESTER, Minn. - Nearly one out of every three Americans suffers from heart disease, a statistic one world-renowned medical center would like to reduce. The Mayo Clinic is targeting heart disease with their new "Eat 5, Move 10, Sleep 8" plan. Heart disease is the number one killer of men and women in the United States; however, according to research, an astonishing 80 percent of those deaths are preventable. Dr. Martha Grogan, a cardiologist at the prestigious clinic, said even small lifestyle changes can make a big difference. Grogan lays out her simple plan in a new book titled Mayo Clinic Healthy Heart for Life! which includes eating five fruits and vegetables a day. "Eating a more healthy diet sounds hard to some people, but don't worry about the things you can't eat," she explained. "Just focus on the things you can eat. So try to eat five fruits and vegetables a day and you'll be full. You won't eat as much junk food," she said. Most Americans know that smoking is bad for their heart, but did you know sitting most of the time is just as bad? A sedentary lifestyle doubles the risk for a heart attack. The good news, even a little bit of exercise can make a big difference. Just 10 minutes a day can cut your chance of a heart attack in half. "If you do more activity, you'll benefit even more. But people have gotten into the habit of thinking that 10 minutes is nothing, and it's not," Grogan said. Getting eight hours of sleep a night should be considered a necessity, not a luxury, because sleep deprivation has devastating effects on your heart. "One of the most important things about sleep is that getting adequate sleep can help people lose weight. so it not only protects you against heart attacks, but helps you maintain a healthy weight," Grogan explained. Finally, be joyful. Because negative emotions like anger, anxiety, grief, and loneliness can damage your heart. So changing to a heart healthy lifestyle is easier than you think, and as an added bonus, you'll also reduce the risk of stroke, Alzheimer's, and cancer. Buy The Book:
Mayo Clinic Healthy Heart for Life!
Coconut Oil Touted as Alzheimer's Remedy
Lorie Johnson
Lorie Johnson reports on the latest information about health and wellness. Since medicine is constantly changing, she makes sure CBN News viewers are up-to-date on what they need to know in order to live a healthy life. Follow Lorie on Twitter @LorieCBN and "like" her at Facebook.com/LorieJohnsonCBN. | 医学 |
2014-42/1179/en_head.json.gz/21935 | ‘Healthy Woman’ draws crowd
CHRISTY ARMSTRONG Banner Staff Writer
Sep 11, 2013 | 3194 views | 0 | 16 | | Newspaper columnist delivers the keynote
It was loud, and there was a lot of pink. Healthy Woman, an initiative of SkyRidge Medical Center to hold events that promote awareness of women’s health issues, held its seventh anniversary event Tuesday night. Hundreds of women filled the gym, lobby and sanctuary of Peerless Road Church to see what was available to them in the community and hear from Lisa Smartt, a speaker who gave her advice on working with people. After taking part in an expo with more than 60 vendors and partaking in refreshments, attendees filed into the sanctuary. Ann Marie Brewer, director of community relations for SkyRidge Medical Center, took the stage first to thank everyone who had supported Healthy Woman throughout the years and as the event was being planned for that night. She said she was pleased with how the night had been going so far, adding that, though she did not have an exact number of attendees sitting in the room, 525 tickets had been sold. The hospital holds events on a regular basis to “empower women with the knowledge and confidence to make informed health care and well-being decisions.” With the exception of annual events like the one held Tuesday, all other events are free. Past events have ranged from topics like heart health to self-defense. The event’s main speaker focused on having healthy relationships with people. Smartt, a newspaper columnist originally from Kentucky and living in Dresden, titled her speech, “I thought I was a people person ... until I started working with people.” Amid stories of turning 50 and noticing a variety of unpleasant bodily changes like having to wear certain undergarments and find bathrooms more often, she spoke of how she had learned to work with people over the years. “I cannot give you one word of encouragement when it comes to other people,” Smartt said. “There is one person you can control; that is yourself.” She compared working with people to losing weight, saying that it is small, gradual changes that make the most difference. Then, she listed several concepts she believes can help with relationships. “If you think you’re better than others, it’s a sure sign you’re not,” Smartt said, listing her first concept. She told about a conversation she had with an uppity woman from California who was taken aback by her Southern accent on the phone. The woman asked her if she was sure she would be fine with speaking at a high-end event like the one she was planning. Smartt replied that, with her height of more than 6 feet, she would “have the highest end there.” Despite differences like accents and personal lifestyles, everyone has the same kind of problems in their lives, and all people matter, she said. “There is no high or low end when it comes to people,” Smartt said. “We can never, ever use terms like ‘white trash’ because people aren’t trash.” She also spoke of the need to depend on other people, telling a story of how a man in overalls once had to help her refuel a rental car at a gas station because she could not figure out how to do so. Smartt said everyone has different strengths and weaknesses, and one person’s strength can help someone else in their weakness. “We need people that aren’t like us,” she said. The other concepts she shared with the audience included the importance of not living in the past, not being arrogant, not gossiping, forgiving those who have done wrong and being merciful to others. Smartt’s talk was followed by a giveaway of door prizes donated by the expo’s vendors. Some of the vendors also served “partners” to help support the event. Gold partners included the Cherokee Pharmacy, the Cleveland Daily Banner, Outland Travel and WCLE 104.1. Silver partners included Blush Magazine, Gastrointestinal Associates of Cleveland, the Ocoee OB/GYN Center for Women’s Health, Surgical Associates of Cleveland, P.C. and the Plastic Surgery Clinic of Cleveland. Bronze parters were Chick-fil-A, Jittery Joe’s Coffee, Ocoee Regional Health Centers, Serendipity CB, Stevi B’s Pizza, Tennessee Valley Urology Center, Voytik Center for Orthopedic Care and Welcome Friends. For more information about joining Healthy Woman and taking part in upcoming events, visit www.skyridgemedicalcenter.net/HealthyWoman.
Titans hoping QB’s thumb healed so he can play
27th Block Party nears
Editorial: Utility celebration was a family affair
Jones off to flying start for Falcons | 医学 |
2014-42/1179/en_head.json.gz/21982 | Cleveland Clinic researcher receives a four-year, $600,000 award for brain cancer research CRAIN'S HOME | CRAIN'S BLOGS | ALL POSTS ENERGY GUEST BLOG -- ANDREW THOMAS
Schadenfreude revisited
Blog Entry: September 06, 2013 4:30 AM | Author: Andrew Thomas is Executive in Residence at the Energy Policy Center of the Levin College of Urban Affairs at Cleveland State University.
In the energy chapter for our coming Cleveland State University Urban College book, “Road from the Rustbelt” (published by W.E. Upjohn Institute), I write about a Michael Kinsley editorial that first appeared in the New Republic on April 6, 1986.Even though I had studied German in college, it was the first time I had seen the word “schadenfruede,” which Kinsley translated roughly to “glee over the misery of others.”English has no word that quite expresses this sentiment so succinctly. But we sure do recognize the feeling, so we have adopted the word into our own language.But the editorial was not memorable for its use of a curious German word. What made it memorable was what it had to say about life at that time in the American Midwest and on the Texas and Louisiana Gulf Coast, both places near and dear to my heart at the time.What the Northeast and Midwest were gleeful about in April 1986 was the sudden crash of oil prices. Oil prices had fallen almost overnight from $36/barrel (bbl) to $12/bbl. In today's dollars, that would equate to a drop from about $100 to $30.As a result, Texas was experiencing “Michigan-like” unemployment rates of over 8%. Within a few years, two-thirds of the oil and gas industry in the United States would be laid off.After years of watching both its wealth and its young people flee to Texas, the Midwest had reason to gloat. Relentless and dramatic increases in oil, natural gas and electricity prices had placed the Midwestern economy into a decade-long freefall, precipitating the rise of the Rust Belt. Now the Texas economy was collapsing.So Kinsley wrote about the Midwestern and Northeastern hopes for recovery. It makes for a great read today, and you can find the editorial here.It is memorable to me because I somehow had managed to be on the wrong side of both economic collapses. I grew up in Northeast Ohio during the 1970s, when my family struggled to adjust on my father's public school teacher's salary. Like many other young people from Ohio, I left for the Gulf Coast to work in the oil and gas business. But within a few years after I moved to New Orleans, the oil business was in shambles. I certainly understood what Kinsley was saying, but there would be no gloating for me.Today, nearly 30 years later, we are back to 1986 — sort of. Michael Kinsley is once again writing for the New Republic and we are once again looking back over a decade of economic decimation in the Midwest, wrought by $100/bbl oil. And today, once again, we are enjoying the collapse in pricing of an energy commodity — this time natural gas. I wonder what Kinsley would say now if he were to write this column.The following from his original editorial is worth quoting: “What often gets overlooked is that Texas' decade of prosperity was made possible by a classic illegal price-setting conspiracy. If the OPEC oil ministers weren't beyond the reach of American justice, they would all be in jail. But even though it was foreigners who staged this rip-off of American citizens and businesses, it was other Americans who raked in most of the profits. That's because, throughout the energy crisis, most of the oil America consumed was domestic, not imported. The oil states were, in effect, auxiliary members of OPEC.”The situation today is much different. Today, we import most of our oil. Further, traditional American oil states such as Texas are getting a smaller and smaller piece of this largesse as their oil reserves are depleted. New oil states, like North Dakota, are emerging as major producers. Meanwhile, Ohio and Pennsylvania are becoming hotbeds of natural gas development. Importantly, natural gas prices have dropped, but oil prices have held fairly steady by comparison. In short, we have no obvious American graves to dance on.But there is nonetheless reason for optimism for the economy. With natural gas projected to sell at less than one-fourth the price of oil on a dollar-per-BTU basis for the foreseeable future, inevitably oil will be displaced by natural gas in America both as a fuel for transportation and as a chemical feedstock. When that happens, we can expect to see oil prices finally drop.When it happens, will we be able to enjoy some Schadenfreude again? And whose suffering might we enjoy? Well, the obvious targets would be the OPEC nations. But OPEC has not really been a force in price-fixing for 30 years. And it is not like the Nigerians and the Venezuelans don't need every penny they get. Still, we can perhaps smile when we think of some Saudi prince unhappily keeping his new Mercedes a year longer than he would like. For now, it seems we will just have to enjoy low-priced natural gas without the pleasure of someone else's concurrent misery.But it still feels pretty good. | 医学 |
2014-42/1179/en_head.json.gz/22071 | Inside the World of OCD December 25, 2012
Jennifer says that for the past 20 years, she has been suffering from obsessive-compulsive disorder, or OCD, and that it rules every aspect of her life. Watch as Jennifer demonstrates how everyday tasks — like preparing food, cleaning furniture and just leaving the house — have become exhausting rituals that take her up to 13 hours to complete. Jennifer reluctantly travels to Dr. Phil with the help of her best friend, Howard. “I don’t want to live with OCD, but I don’t know if I know how to live without it,” Jennifer confesses.Dr. Frank Lawlis, chairman of the Dr. Phil Advisory Board weighs in on Jennifer’s condition and offers treatment. Can she leave her comfort zone in order to get help? Then, Pam and Jack say their 25-year-old son, Michael’s, OCD is so severe that they’re afraid to leave him alone. They say Michael often goes into a trance — the longest lasting 21 hours — during which he screams, curses and punches himself repeatedly. Pam and Jack say they’ve tried multiple treatments and more than 10 different medications, but nothing has helped. Watch as Michael visits leading neuroradiologist Dr. Bradley Jabour, who performs a brain scan to see what’s going on inside Michael’s head. See the fascinating results, and hear Dr. Jabour’s plans for Michael — and Jennifer. Plus, meet Bob, who says Dr. Jabour’s program saved his life. More than 16 million kids in the United States are at risk for hunger each day. Fortunately, you can help. Visit Feeding America to find your local food bank. And, help Dr. Phil raise enough money for 10 million meals. Donate today!
JenniferHoward, Jennifer's best friendDr. Frank Lawlis, Chairman of Dr. Phil Advisory BoardMichaelJack, Michael's fatherPam, Michael's motherDr. Bradley Jabour, Chief of Neuroradiology/CEO-Founder Smart Brain and HealthMichael's brain scan resultsBob, in remission from OCD
Jennifer’s Rituals
Jennifer says her OCD has destroyed her quality of life. She says she typically wakes up late in the afternoon, after exhausting herself with her daily rituals, which can take up to 13 hours to complete. She has a checklist that she runs through each day, in the exact order — and when she completes a task, she says she second guesses herself, because it doesn’t feel like she’s finished it.
“I believe that I have a problem with food,” Jennifer admits. She typically weighs and measures everything repeatedly to make sure she has an exact amount of food. If she overestimates, she’ll often throw out any excess food, just to make sure it’s at a certain weight. “I feel like everything I do is dictated by the OCD," Jennifer says, after taking five hours to leave the house to go to the gym. "Everything is scheduled and rigid and regimented, and the moment I step out of those boundaries, then I feel out of control, but it doesn’t make any sense, because the OCD is the thing that’s out of control.” She says she realizes the illness is ruining her life, but she’s afraid she’d feel lost without it. Jennifer’s best friend, Howard, says he supports her financially and emotionally and that he's afraid he'll lose her if she doesn't get help. “My greatest fear is that she’s going to give up hope, that she will finally just feel that there’s nothing worth living for,” he says.
Jennifer shows what a typical day is like for her, including how the simple task of cracking an egg becomes a time-consuming frustration. Jennifer explains how difficult it was to travel to Dr. Phil. Dr. Phil introduces Jennifer to Dr. Frank Lawlis, chairman of the Dr. Phil Advisory Board and author of Retraining the Brain. Dr. Lawlis offers to help with Jennifer’s treatment. Michael’s Nightmare
Pam and Jack say when their 25-year-old son, Michael, was 13, he went to bed one night and woke up a completely different person. He was eventually diagnosed with OCD, which they say is now so severe that they’re afraid to leave him alone. “People tell me, ‘The only thing you can do is have him committed,” Jack says.
Pam says she reached out to Dr. Phil as a last resort. “My doctor finally said, ‘I give up. I don’t know what to do for you anymore,’” she says. “I’m not giving up on this kid. I love him too much.”
Home video shows how Michael’s severe OCD affects his everyday life. And, his parents explain their exhaustive efforts to find an effective treatment. Michael describes what he feels during his trances. “I’m aware of everything around me. I can hear everything. I can see everything.”
Neuroradiologist Dr. Bradley Jabour shows what's going on inside Michael's brain. Is there hope for treatment?
See how Dr. Jabour’s treatment works. And, meet one of his patients, Bob, who is in remission from his OCD. Dr. Jabour and Smart Brain and Health offer to treat Michael and Jennifer at their facilities in Los Angeles, and Dr. Phil offers to take care of their living arrangements during that time. Both graciously accept.
“Where do I sign?” Jennifer quips.
“You’ve saved my whole entire life,” Michael tells Dr. Phil, with tears in his eyes.
MESSAGE BOARDSTalk about this show.Do you suffer from obsessive behaviors? Find support here. Advice Signs that Your Child May Have OCD Do You Have Obsessive-Compulsive Tendencies? Self-Directed Systematic Desensitization Related Resources General and Mental Health Resources Dr. Phil Help Resources Special Thanks Lawlis Peavey PNP CenterDr. Frank Lawlis Dr. Bradley Jabour Services Provided By Be on the Show
Mothers Who Strictly Discipline?Conflict so Big it needs a Dr. Phil Solution?Caught on TapeAre You at War with Your Best Friend?Chaos in your life? Related Links What OCD Is and Is Not Facing Fears and Phobias OCD Nightmares OCD Follow-Up Obsessive-Compulsive Behavior Phobias Paralyzed by Fear What Do You Fear? | 医学 |
2014-42/1179/en_head.json.gz/22132 | Contact: Jennifer Beal
[email protected]
Anakinra for rheumatoid arthritis: A modest benefit with some risk
New research supports a modest beneficial effect of anakinra for rheumatoid arthritis patients, but warns against potential risks for serious infections and its use with other biologic medications.
Rheumatoid arthritis is a chronic inflammatory disease affecting as many as one in 100 people worldwide. It affects the joints, making them stiff and painful. Anakinra is one of a new breed of arthritis drugs licensed in the past decade called 'biologics'. The drug is the first to target the immune protein IL-1, thought to be partly responsible for inflammation in arthritis patients. It is given by daily injection.
In a Cochrane Systematic Review of five recent anakinra trials involving 2,876 patients, researchers found anakinra reduced pain and stiffness in patients, and helped to improve joint function, when compared to placebo. However, while around a quarter of patients experienced improvement in their symptoms as a result of taking anakinra, the researchers say the improvements are notably less than those seen with other biologics. In addition, there were more injection site reactions with the use of anakinra and the rate of serious infections with anakinra was approaching statistical significance when compared to placebo. "We would recommend caution with the use of anakinra for rheumatoid arthritis, especially with the only modest beneficial outcomes compared to other biologic medications studied for rheumatoid arthritis," said lead researcher Dr. Marty Mertens of the University of Minnesota in the US.
One study included in the review investigated the combination of anakinra with another biologic medication, etanercept. This found no benefits in arthritis outcomes, but did show a significant increase in the number of serious adverse events. "On the basis of these results, we recommend that doctors avoid combining biologic medications with anakinra when treating patients with rheumatoid arthritis,' said Mertens. Dr. Mertens thinks more research is required to better inform patients and doctors about the safety of the drug: "We have only limited data on the safety of anakinra, and need more long-term studies to evaluate this, especially the potential for increased risk of serious infections." | 医学 |
2014-42/1179/en_head.json.gz/22133 | Public release date: 8-Mar-2010
Contact: Clare Ryan
[email protected]
Outreach program brings relief to traumatized London bombing survivors
A new mental health outreach programme set up after the 2005 London bombings has successfully identified and treated hundreds of survivors.
After the 7/7 bombings in 2005 a group of clinical psychologists targeted nearly a thousand survivors of the attacks by painstakingly compiling hospital treatment records, police witness files and referrals from GPs. The need for this new method of reaching potential patients was evident after results showed that only 4% of patients contacted by the programme had been referred for treatment by their GPs � the traditional pathway to mental heath care. Overall, more than a third of people contacted needed treatment for post-traumatic stress disorder. Published today in the journal Psychological Medicine, the results of the programme strongly suggest that a similar mental health care programme needs to be included in the standard planning for the aftermath of a terrorist attack. "If this programme hadn't existed then there would be hundreds of people still suffering from post-traumatic stress or other psychological problems as a result of the 2005 terrorist attack. This intervention is really a new way of identifying traumatised people," explained Professor Chris Brewin, lead author of the study at UCL Department of Clinical, Educational & Health Psychology. "Many of the survivors complained that GPs often did not recognise or know how to treat their post-traumatic stress, a finding which is reflected in the literature. This study highlights that there are some extreme situations when relying on GPs and the primary care mechanism doesn't work," added Professor Brewin. The authors of the study are calling for a similar programme to be featured in future plans for responding to disasters and terrorist attacks. Other suggestions to improve the provision of mental health care after a disaster or terrorist attack include:
The Health Protection Agency (HPA) to be responsible for compiling a list of all affected individuals
The Department of Health to issue clearer guidance about how strategic health authorities should respond to similar crises
Centrally based organisation and funding to be made available for mental health treatment, to ensure equal access to high quality care regardless of where patients live
The outreach programme ran between September 2005 and September 2007. Patients diagnosed with post-traumatic stress disorder were treated with standard cognitive behavioural therapy. The programme was a partnership between NHS post traumatic stress centres in London and the London Development Centre for Mental Health. The programme was evaluated by psychologists at University College London led by Professor Chris Brewin, with funding from the Department of Health. ###
1.) For more information or to interview Professor Chris Brewin, please contact Clare Ryan in the UCL Media Relations Office on tel: +44 (0)20 7679 9726, mobile: +07747 565 056, email: [email protected] 2.) The paper 'Outreach and screening following the 2005 London bombings: usage and outcomes' is published online in Psychological Medicine today. For copies of the paper, please contact UCL Media Relations
About UCL
Founded in 1826, UCL was the first English university established after Oxford and Cambridge, the first to admit students regardless of race, class, religion or gender, and the first to provide systematic teaching of law, architecture and medicine. UCL is the fourth-ranked university in the 2009 THES-QS World University Rankings. UCL alumni include Marie Stopes, Jonathan Dimbleby, Lord Woolf, Alexander Graham Bell, and members of the band Coldplay. UCL currently has over 12,000 undergraduate and 8,000 postgraduate students. Its annual income is over �600 million. | 医学 |
2014-42/1179/en_head.json.gz/22150 | HomeNewsUKNew regulation to tackle care abuse New regulation to tackle care abuse
Tougher regulation including possible new criminal legislation to strengthen corporate accountability could be introduced in the wake of the "devastating" scandal of abuse at the Winterbourne View private hospital, the Government has announced.
Published: Mon, December 10, 2012
Six staff members at Winterbourne View residential hospital were jailed in October [PA] Care services minister Norman Lamb said the Winterbourne View case had revealed weaknesses in the system's ability to hold the leaders of care organisations to account.
Under the plans, proposals to hold boards, directors and senior managers accountable for the safety and quality of care that their organisations provide, including exploring whether tougher regulatory or criminal sanctions are necessary, will be brought forward by spring next year.
Mr Lamb said he felt "very strongly" that those in charge of care homes at the centre of abuse cases should be held accountable.
"When you look at Winterbourne View, the people who committed the abuse and the assaults were convicted, but what about the people making the money from that company?" he said. "We need to have a situation where people who run care organisations, public or private sector or voluntary, know that they are accountable for the services they provide and there are consequences if they don't.
"Next spring we will announce proposals to address the gap in the law on effective corporate accountability."
The minister's remarks were made as the Government unveiled plans to move out of long stay hospital every person with a learning disability or autism who does not need to be there.
Under the plans, the cases of all patients in current placements will be reviewed by June next year with a view to placing anyone being treated "inappropriately" in hospital into community-based support by June 2014.
"I want this to be seen as a moment when there is a collective view that there needs to be a substantial culture change in society, that people with learning disabilities have the same rights as anybody else, and that we cannot any longer tolerate inappropriate care or treatment for these people and we have a collective obligation from top to bottom to change this and that there is a national imperative that we act decisively on that," Mr Lamb said.
In October six members of staff - four support workers and two nurses - were jailed for between six months and two years for their roles in the abuse at the Winterbourne View Hospital in Hambrook, South Gloucestershire. Five others were given suspended prison sentences by a judge at Bristol Crown Court, who condemned the "culture of ill-treatment" and said it had "corrupted and debased". | 医学 |
2014-42/1179/en_head.json.gz/22302 | Health First Medical Group Names George Tirlokhi Director of Revenue Cycle
ROCKLEDGE, FL (August 9, 2013) — Health First Medical Group is pleased to announce George Tirlokhi as its new Director of Revenue Cycle. In this position, Tirlokhi is responsible for ensuring efficient and timely management of the physician billing offices.
Tirlokhi has extensive experience in hospital financial management. He most recently served as Director of Revenue Cycle for Mount Sinai Medical Center in New York, New York where he directed the revenue cycle operations for a medical institute with annual gross revenues in excess of $400 million and more than 200 providers. He also previously served as Assistant Director of Patient Accounting at Lakeland Regional Medical Center in Lakeland, FL and Director of Capital Planning and Budgeting at NYU Medical Center in New York. George earned his Bachelor of Business Administration, Accounting and his Executive Master of Science in Finance from Baruch College in New York, NY. He is also a Certified Patient Accounts Manager with the American Association of Healthcare Administrative Management and a member of the Healthcare Financial Management Association.
Health First is Central Florida’s only fully integrated health system. With a mission to positively change the health and wellness of the communities we serve, Health First offers multiple commercial and Medicare health plan products, the latest technological advances and quality care through our four hospitals and numerous Outpatient & Wellness Services, including four fitness centers to help members of our community stay healthy. We offer Brevard’s only Trauma Center, and the Health First Medical Group is the largest multi-specialty physician group in Brevard County. ©2014 Health First | 6450 US Highway 1, Rockledge, FL 32955 | (321) 434-4335 Contact Us | Privacy/Other Policies | Non Discrimination Policies | En Espanol | Site Map | 医学 |
2014-42/1179/en_head.json.gz/22339 | Blind World Magazine
Retinal degeneration: don't lose hope.
Dr Mahipal S. Sachdev,
The Tribune - Chandigarh,India.
Tuesday, September 05, 2006.
Every time a patient of advanced retinal degeneration, age-related macular degeneration or retinitis pigmentosa goes to an ophthalmologist, the most common answer he gets to hear is that there is nothing that we can do.
It is disheartening to know that one has no hope. Not only the patient but the doctor is also extremely disappointed to tell his patient that no treatment can be offered.
This is the reality status for now as far as the treatment of these diseases is concerned. But do we lose all hope? The answer would be a big NO!
Is there anything which can be offered to these patients? The answer may lie in using certain artificial devices that can be implanted onto neural retina. Using artificial devices means treatment of extreme vision impairment has come of reality during the past few decades.
What happens in these diseases that nothing can be done?
A variety of disease processes can affect the retina and/or the optic nerve. These disease processes may selectively damage certain parts of the retina or optic nerve.
The retina is the innermost part of the eye, which acts like the film of a camera. It is made up of cells known as rods and cones. These cells once destroyed cannot be regenerated, that is why these retinal diseases are potentially blinding.
Retina is made up of outer and inner layers. Diseases like age-related macular degeneration, pathologic myopia and retinitis pigmentosa involve the outer layer. Although these outer cells are lost, the inner retina is preserved and may help in designing retinal prosthesis (artificial retina)
Retinitis pigmentosa and advanced cases of age-related macular degeneration are incurable diseases that result in profound vision loss due to the degeneration of these cells.
Currently, there is no real treatment available for these blinding disorders that stem from the degeneration of retinal cells and affect at least 50 million individuals worldwide. There is no effective treatment for these patients with advanced ARMD, retinitis pigmentosa and associated diseases. The good news, however, is that studies are being carried out for the potential of the retinal cell transplantation to decrease the progression of these blinding diseases
A few surgical modalities like macular translocation and displacement of blood in certain cases of age-related macular degeneration have shown promising results. The aim of these surgeries is to utilise the function of the living residual cells. Experiments are being carried out to introduce such devices as cause magnification or surgical implantation of electronic devices.
What does the future hold?
With advances in microchip technology, surgical treatment of low vision is now showing promising results.
The artificial silicon retina (ASR) microchip which can be implanted onto retina offers an option to totally blind people in the future. This chip can take up the function of dying or dead cells. Certain devices for optic nerve are also being studied. But there is need to prove long-term safety for both human subject and the electronic implant.
The evolution of surgical methods to treat patients with low vision is leading to promising outcomes. Retinal surgery to provide telescopic magnification in low vision patients and retinal microchip implants, where no retinal function exists, are now a reality. Although still experimental, they provide a ray of hope for these patients Research is being carried out to create an implantable medical device that provides useful vision to patients who are left with no alternatives. These implants are still in their experimental stages.
Stem cells also form a significant potential source for ocular repair. The procurement of these donor cells is still a problem.
Stay clear of certain misconceptions!
l Certain claims are being made about the treatment of these diseases by acupuncture and other modalities. Definitive scientific proof is still lacking for the efficacy of these treatment modalities. As these patients are desperate to regain some amount of vision, they are easily taken for a ride by such claims.
l For a layman, eye transplant means the whole of the eye can be replaced. Actually, when we talk about eye transplant we only mean the anteriormost part of the eye, which is the cornea and can be replaced. It does not indicate that an old eye is replaced and a new one put!
The writer is Chairman and Medical Director, Centre for Sight, New Delhi. E-mail: [email protected]
http://www.tribuneindia.com/2006/20060906/health.htm#1
Any further reproduction or distribution of this article in a format other than a specialized format, may be an infringement of copyright. | 医学 |
2014-42/1179/en_head.json.gz/22466 | Hurt and taking an ambulance? Not so fast
By Davis Wahlman
TRI-CITIES, Wash. -- It would make sense that if you're hurt an ambulance would take you to the closest hospital. But that's not the case here in the Tri-Cities.It's a scary thought for most people. A car wreck, bike accident, or heart attack that requires an ambulance ride."What decides where you take a person other than where they want to go?" says David Mank.And he isn't the only one. He had an accident last year and wanted to be taken to Kadlec. Based on his injury, paramedics told him they had to go to KGH."They were just like...we have to go there."Reporter: "And you didn't fight them on that?""No no, I said what ever, just fix me," he recalled.There are now four emergency centers in Tri-Cities. Lourdes in Pasco, Kadlec in Richland and Kennewick, and KGH. Kennewick Fire Captain Eric Nilson says it's not about location, but what kind of injury you have and who's best-equipped to handle it."What is most likely the cause of the problem. Based on that, that will put them into an algorithm," Nilson says.That algorithm dictates which hospital will give you the best care."For example, Kadlec is the level one cardiac center in the area, Kennewick is the highest level pediatric center in the area, so it really depends on the person's emergency," he added.But Captain Nilson says sometimes, people refuse to go to certain hospitals. Paramedics generally won't fight you on it."The most important thing at that point is just to get them to the hospital," he says.These patients may end up transferred to another hospital that can suit their needs better.David says, he just didn't want to be slapped with a thousand-dollar ambulance fee or procedures not covered by insurance."In the end, it's all about money. Unfortunately that's the way it is," he says.Paramedics say when it comes to simple injuries like cuts and bruises, all of the centers in the area are equipped to handle them.It's when you get into the more serious injures like heart attacks and brain aneurysm where choosing the right hospital could mean life or death. | 医学 |
2014-42/1179/en_head.json.gz/22492 | OHSU eases rules on marijuana use and organ transplants
File - In this March 28, 2011, file photo shows a marijuana plant, in Portland, Ore. Medical marijuana advocates have a message for Democratic leaders and federal prosecutors with an eye on political office: Don’t mess with pot. Pushing back against the Obama administration’s crackdown on state medical marijuana programs, one of the nation’s largest pro-pot groups is claiming credit for the defeat of a former federal prosecutor in the Democratic primary for Oregon attorney general. As interim U.S. attorney, Dwight Holton called Oregon’s medical marijuana law a “train wreck” and oversaw efforts to crack down on pot shops and marijuana gardens that claim to be operating under the state law. (AP Photo/Rick Bowmer, File)
PORTLAND, Ore. (AP) — Oregon Health & Science University Hospital in Portland has eased restrictions on marijuana use among people seeking organ transplants.
The state's largest organ transplant program had required six months of negative drug tests before a patient could go on the waiting list for a liver transplant.
The revised policy allows marijuana users who meet all other criteria to be waitlisted for liver transplants if a single screen turns up negative, The Oregonian newspaper reported.
The new approach also applies to kidney, pancreas and heart transplant procedures.
Doctors altered the policy after seeing potential transplant candidates who were medical marijuana patients with no obvious addiction problems, said Dr. Willscott Naugler, a liver specialist and medical director for the liver transplant program at OHSU.
"If you had a beer last weekend, no one would say you are an alcoholic," Naugler told the newspaper. "You might be. But it doesn't mean you are. We have taken the same approach to marijuana. If you had it last weekend, you may not have an abuse problem."
Only OHSU and the Portland Veterans Affairs Medical Center perform liver transplants in Oregon. The new guidelines apply to both facilities, which share a team of specialists and surgeons.
Surgeons on the team performed 60 liver transplants last year, and OHSU typically performs 20 heart, 100 kidney and eight to 14 pancreas transplants annually.
No federal guidelines or national standards apply to medical marijuana and the organ transplant screening process. Transplant programs throughout the country screen potential organ recipients for substance abuse, which can complicate a patient's recovery, to ensure organs go to those who will benefit most.
OHSU officials said the new policy isn't an endorsement of marijuana or its medicinal value. After being placed on a waiting list and after surgery, patients are still told not to use marijuana, tobacco, alcohol or illicit substances.
In Oregon, 137 people are on the waiting list for a new liver, according to the United Network for Organ Sharing, which manages the country's organ transplant system. Nationwide, 16,011 patients are on the liver transplant list. The agency says 92,853 patients in the country are on the kidney waiting list.
Information from: The Oregonian, http://www.oregonlive.com | 医学 |
2014-42/1179/en_head.json.gz/22538 | Life Extension Update
November 04, 2004 Printer Friendly In this issue Life Extension Update Exclusive: Vitamin E may be helpful in Alzheimer’s disease prevention Protocol: Alzheimer’s disease Featured Products: Gamma E Tocopherol/Tocotrienols Huperzine A Life Extension Magazine November 2004 issue: In the News: Memantine found effective against Alzheimer’s disease Life Extension Update Exclusive Vitamin E may be helpful in Alzheimer’s disease preventionThe results of research reported in the October 2004 issue of the Journal of Alzheimer’s Disease identifies a culprit in Alzheimer’s disease and shows vitamin E may help slow the destruction of brain cells that occurs as a result. In a study funded by the National Institutes of Health, University of Kentucky chemistry professor Allan Butterfield and colleagues compared rat and human forms of amyloid beta peptide, a compound that forms the plaques in the brains of Alzheimer’s patients which are believed to be responsible for the damage incurred by this disease. They found that amyloid beta peptide from both rats and humans caused DNA fragmentation in neurons, a loss of neuron connections, and lowered cell viability. It had previously been proposed that copper binding sites in human amyloid beta contributed to the disease. In the current study, Dr Butterfield’s findings show that rat amyloid beta, which lacks copper binding sites, still causes damage, and that it is the methionine residue in beta amyloid that damages brain cells. Methionine is an amino acid that occurs in relatively high amounts in animal-derived proteins and contributes to the formation of homocysteine, another amino acid that when elevated has been determined to double the risk of developing Alzheimer’s disease. Earlier research had revealed that methionine was involved in the neurotoxicity and oxidative stress caused by amyloid beta in humans. Protein oxidation and lipid peroxidation were similar in both animal and human amyloid beta and were both inhibited by vitamin E, an antioxidant vitamin. Studies have found an association between vitamin E intake and reduced cognitive decline and Alzheimer’s disease, adding evidence to the suggestion that it may help retard the disease in humans. The findings indicate that that reactive oxygen species play a role in the toxicity of amyloid beta peptide, and that the oxidative stress it causes may be due to methionine rather than copper. Protocol Alzheimer’s diseaseThe most characteristic features of Alzheimer's disease are senile plaques of beta-amyloid peptide, neurofibrillary tangles involving tau protein, loss of synapses, and (ultimately) the death of neurons. Although neurofibrillary tangles are more closely associated with neuronal death than beta-amyloid, the evidence is becoming convincing that beta-amyloid is the factor most responsible for starting the degenerative processes of Alzheimer's disease. Researchers have shown that cultured cells are prevented from beta-amyloid toxicity with the addition of vitamin E (Grundman 2000). Researchers at the University of Kentucky published a ground-breaking article showing that vitamin E prevented the increase of polyamine metabolism in response to free-radical mediated oxidative stress caused by the addition of beta-amyloid to the rat neurons (Yatin et al. 1999). Research conducted in Germany showed that both natural and synthetic vitamin E were more effective than estrogen (17-beta estradiol) in protecting neurons against oxidative death caused by beta-amyloid, hydrogen peroxide, and the excitatory amino acid glutamate (Behl 2000). Research conducted at the University of California, San Diego, School of Medicine studied the protective effects of vitamin E in apolipoprotein E-deficient mice. Those treated with vitamin E displayed a significantly improved behavioral performance in the Morris water maze. Also, the untreated mice displayed increased levels of lipid peroxidation and glutathione, whereas the vitamin E-treated mice showed near normal levels of both lipid peroxidation and glutathione (Veinbergs et al. 2000). A study of 44 patients with Alzheimer's disease and 37 matched controls showed that vitamin E levels in the cerebrospinal fluid (CSF) and serum were significantly lower in Alzheimer's patients (Jimenez-Jimenez et al. 1997).In the Alzheimer's Disease Cooperative Study, 2000 mg of vitamin E were given to Alzheimer's disease patients. This slowed the functional deterioration leading to nursing home placement (Grundman 2000). An article by Sano et al. (1997) described a double-blind, placebo-controlled, randomized, multicenter trial of patients with Alzheimer's disease of moderate severity. A total of 341 patients received the selective monoamine oxidase inhibitor selegiline (10 mg a day), alpha-tocopherol (vitamin E, 2000 IU a day), both selegiline and alpha-tocopherol, or placebo for two years. The baseline score on the Mini-Mental State Examination was higher in the placebo group than in the other three groups. Both vitamin E and selegeline delayed the progression of the disease with vitamin E acting slightly better than selegeline (median time 670 vs. 655 days, respectively). http://www.lef.org/protocols/prtcl-006.shtml Featured Products Gamma E Tocopherol/Tocotrienols softgel capsules One or more members of the vitamin E family may: Maintain cell membrane integrity and reduce cellular aging. Inhibit the potentially damaging peroxynitrite radical. Maintain healthy platelet aggregation. Synergize with vitamin A to protect the lungs against pollutants. Protect nervous system and retina. Delay cognitive decline. Enhance immune function. http://www.lef.org/newshop/items/item00559.html Huperzine A This standardized extract from the Chinese club moss is an all-natural herbal supplement that may help prevent the breakdown of acetylcholine. This product is standardized for maximum efficacy, and its patented delivery system that includes fat-soluble vitamin E increases absorption. http://www.lef.org/newshop/items/item00627.html Life Extension Magazine November 2004 issue In the News: Memantine found effective against Alzheimer’s disease Memantine is an N-methyl- D-aspartate (NMDA) receptor antagonist that is neuroprotective by blocking glutamate, which can cause overstimulation of the nerves and become toxic to the nervous system. Memantine may benefit individuals with Alzheimer’s disease by improving cognition and overall functioning. http://www.lef.org/magazine/mag2004/nov2004_itn_01.htm If you have questions or comments concerning this issue or past issues of Life Extension Update, send them to [email protected] or call 954 766 8433 extension 7716. For longer life, Dayna DyeEditor, Life Extension [email protected] West Commercial BoulevardFort Lauderdale FL 33309954 766 8433 extension 7716 Sign up for Life Extension Update at http://mycart.lef.org/subscribe.asp Help spread the good news about living longer and healthier. Forward this email to a friend! View previous issues of Life Extension Update in the Newsletter Archive.
The latest news on aging, disease, nutrition, and vitamins updated daily.
CRN decries JAMA for exaggerating extent of findings in new study of spiked products
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2014-42/1179/en_head.json.gz/22548 | Vitamin E users show lower ALS risk
Explaining The Basics Of Ginseng
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NEW YORK (Reuters Health) - People who regularly take vitamin E supplements over the years may have a decreased risk of developing the fatal neurological condition amyotrophic lateral sclerosis (ALS), a new study suggests.ALS -- also known as Lou Gehrig's disease -- is an invariably fatal disease in which the nerve cells that control movement progressively degenerate, leading to paralysis and death from respiratory failure. It is diagnosed in about 5,000 Americans each year. Up to 10 percent of ALS cases are an inherited form of the disease. In most cases, though, ALS occurs for no known reason. Some research has suggested that people with higher intakes of vitamin E have a lower risk of ALS. Those findings do not prove that vitamin E is the reason, but lab research has found that the vitamin -- which acts as a cell-protecting antioxidant -- can delay the onset of symptoms in mice genetically altered to develop an ALS-like condition.Since ALS is so rare, researchers need to study large groups of people to see what lifestyle factors might be related to the disease.So for the new study, researchers at Harvard University combined the results of five large U.S. studies involving more than 1 million adults in all.They found that there was a relationship between the length of vitamin E use and ALS. People who, at the start of their study, had been using vitamin E supplements regularly for at least five years were about one-third less likely than non-users to develop ALS. However, it's too soon to make any recommendations on vitamin E, Dr. Eilis J. O'Reilly and her Harvard colleagues report in the American Journal of Epidemiology.For one, the findings do not prove that vitamin E, itself, provided the benefit. The researchers did try to account for other lifestyle factors -- like people's weight, smoking habits, overall diet and exercise levels. And longer use of vitamin E supplements (from multivitamins or single supplements) was still linked to a lower ALS risk.But there could still be other explanations for the finding. And promising findings on vitamin E have failed to pan out in the past.Researchers once thought vitamin E supplements might prevent heart disease, based on studies showing lower rates among vitamin E users. But clinical trials -- where people were randomly assigned to take vitamin E or a placebo -- later showed no such benefit.In addition, the current findings are based on small numbers. Of the 1 million-plus study participants, 805 were eventually diagnosed with ALS. And of those who had been using vitamin E for at least five years at the outset, just 18 developed ALS; there were 19 cases among people who had used the vitamin for fewer years.Further studies, O'Reilly's team writes, are needed to see whether vitamin E does in fact affect ALS risk.In general, experts recommend that adults get 15 milligrams, or 22 international units (IU), of vitamin E each day.Food sources include wheat germ, nuts such as almonds and hazelnuts, vegetable oils such as sunflower and safflower oils, and some green vegetables, such as spinach and broccoli.It's unlikely that people could get too much vitamin E from food. But high doses of vitamin E from supplements carry a risk of bleeding. Experts advise that adults consume no more than 2,500 IU of synthetic vitamin E per day.Multivitamins usually contain 30 IU of vitamin E, while the typical dose in single supplements is 400 IU.SOURCE: http://bit.ly/hqriq3 American Journal of Epidemiology, online February 18, 2011. | 医学 |
2014-42/1179/en_head.json.gz/22593 | High-dose better protects seniors
ATLANTA (AP) — A new high-dose flu vaccine for seniors works better than the standard shot in that age group, according to a long-awaited study by the vaccine's manufacturer.
Experts say regular flu shots tend to be only about 30 to 40 percent effective in people 65 and older, who generally have weaker immune systems. Sanofi Pasteur's Fluzone High-Dose vaccine boosted that to 50 percent.
"I wouldn't call it great" said Dr. Edward Belongia of the Wisconsin-based Marshfield Clinic Research Foundation, a flu vaccine researcher who was not involved in the Sanofi study.
But any improvement is welcome, and the results could mean fewer illnesses — and, hopefully, hospitalizations and deaths — in seniors, he said.
For other ages, effectiveness can run 60 percent or higher for the regular vaccine.
The Food and Drug Administration licensed the higher-dose Sanofi vaccine in late 2009, based on a study that showed it led to higher levels of flu-fighting antibodies in seniors a month after vaccination. The new study is the first to measure how much protection it actually provides against the flu.
The study involved 32,000 seniors in the U.S. and Canada during the last two flu seasons. Half got a regular flu shot and half got the high-dose version. Researchers called the participants to see if they had flu symptoms or were hospitalized; tests to confirm the flu were done in more than half of the people reporting symptoms.
The high-dose shot was 24 percent more effective than the regular shot at preventing flu, against all strains, the company said.
Sanofi has the only high-dose flu shot for seniors on the market. It was used last year in 1 in 5 seniors who got vaccinated, according to Sanofi. The $27 per dose cost is more than twice the $12 for the company's older version. But Medicare pays for both, and Sanofi executives say they don't think cost is a significant deterrent.
Instead, they believe doctors have been holding off until they saw real-world effectiveness studies.
Dr. David Greenberg, a Sanofi vice president, is scheduled to present preliminary study results on Thursday at a meeting of vaccination experts in Atlanta. The Advisory Committee on Immunization Practices advises federal health officials, who then make vaccination recommendations to doctors.
The government already recommends flu vaccines for everyone, except babies under 6 months. The panel is expected to discuss whether to one day voice a preference for Fluzone High-Dose for seniors.
Among infectious diseases, flu is considered one of the nation's leading killers. On average, about 24,000 Americans die each flu | 医学 |
2014-42/1179/en_head.json.gz/22620 | Kent Holtorf, MD
Kent Holtorf, MD Male
Specialties: Endocrinology, Hypothyroidism
Holtorf Medical Group and National Academy of Hypothyroidism
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Medical Practice Holtorf Medical Group and National Academy of Hypothyroidism
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BS, University California at Los Angeles
MD, St. Louis University School of Medicine
Medical Training LA County/Harbor - UCLA Medical Center - Internship University of California, Los Angeles Center for Health Sciences - Residency About Me
Kent Holtorf, M.D. has personally trained numerous physicians across the country in the treatment of complex endocrine dysfunction; hypothyroidism; and innovative therapies for weight loss, metabolic dysfunction, chronic fatigue syndrome, fibromyalgia and chronic infectious diseases, including Lyme disease.
He is the medical director of the Holtorf Medical Group Affiliate Centers, the medical director of the non-profit National Academy of Hypothyroidism and was the founding medical director for Fibromyalgia and Fatigue Centers. He is a diplomate, board examiner and fellowship lecturer for the American Board of Anti-Aging Medicine (ABAAM) and The Endocrinology Expert for America Online (AOL) Health. He is a founding director of the non-profit Bioidentical Hormone Initiative and a senior faculty member of the Bioidentical Hormone Institute.
He has published a number of peer-reviewed endocrine reviews, including the most extensive review to-date on the safety and efficacy of bioidentical hormones, inaccuracies of standard thyroid testing, testosterone replacement for men and women, diagnosis and treatment of growth hormone deficiency and on the diagnosis and treatment of adrenal dysfunction in chronic fatigue syndrome and fibromyalgia. He is also a reviewer for the journal Endocrine.
He has been a featured guest on numerous TV shows, including CNBC, ABC News, CNN, Fox News, Fox Business, Good Morning America, The Today Show, Discovery Health, CBS The Doctors, The Learning Channel, and has been quoted in numerous print media including the Wall Street Journal, US New and World Report, Los Angeles Times, San Francisco Chronicle and WebMD. About Us | | 医学 |
2014-42/1179/en_head.json.gz/22623 | Dr. Michael Fallon, MD
Dr. Michael Fallon joined The University of Texas Medical School - Houston in November of 2008 as the Director of the Division of Gastroenterology, Hepatology and Nutrition. He previously served as University Professor of Medicine and Director of the Section of Hepatology in the Division of Gastroenterology and Hepatology at the University of Alabama at Birmingham. He also served as Chief of Gastroenterology and Hepatology at the Birmingham Veterans Affairs Medical Center.He received his medical degree from the University of Virginia School of Medicine. He completed his residency and chief residency at Yale-New Haven Hospital in Connecticut and his fellowship in Digestive Diseases at Yale University School of Medicine. He served on the Yale School of Medicine faculty for five years before moving to the University of Alabama at Birmingham.He is a member of the American Medical Association, the American Gastroenterological Association, the American Federation for Clinical Research, the American Association for the Study of Liver Disease, and the American Association of the Advancement of Science.He has received numerous teaching awards and has held a number of leadership positions within the American Association for the Study of Liver Disease. He serves on the American Board of Internal Medicine Transplant
Hepatology Test Committee and has served on the editorial board of many
prominent journals in Gastroenterology and Hepatology. Currently, he is an Associate Editor of Clinical Gastroenterology and Hepatology.He
is board certified in Internal Medicine, Gastroenterology, and Transplant Hepatology and is licensed to practice in Texas, Connecticut,
and Alabama.ResearchHis translational research is aimed at understanding the pathogenesis of vascular alterations in chronic liver disease, with a specific focus on defining and characterizing endothelial dysfunction in the pulmonary vasculature that results in vasodilatation and the hepatopulmonary syndrome. His clinical research interests include diagnosis and therapy of the hepatopulmonary syndrome and the prevention and treatment of complications of chronic liver disease as well as therapy for Hepatitis C, B and non-alcoholic fatty liver disease.
Affiliated Centers:Memorial Hermann Texas Medical Center
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2014-42/1179/en_head.json.gz/22643 | Biogen Idec profits fall, as firm seeks revenue from older drugs
Biogen Idec's third-quarter profit fell 26 percent compared to the previous year as the biotech firm took charges from its 2003 merger and expenses from a layoff that began in September.The firm reported net income of $27 million, or 8 cents per share, in the third quarter, compared to net income of $37 million, or 10 cents per share, in the third quarter last year. But revenues grew to $596 million, up 10 percent from the same period last year, boosted by improved sales of non-Hodgkin's lymphoma (NHL) drug Rituxan (Rituximab) and Avonex (Interferon beta-1a), its therapy for patients with relapsing forms of multiple sclerosis (MS).Biogen Idec made cost-cutting moves in the quarter, including the layoffs of 17 percent of its workforce and other efforts to channel money into business development. The firm signed a deal with Protein Design Labs worth as much as $660 million to develop three treatments for MS, cancer and other diseases. Biogen Idec so far has paid $40 million to Protein Design Labs.Charges that brought down earnings included $88 million of write-downs related to the 2003 merger of Biogen and Idec, $27 million in layoff expenses and $21 million in losses from the sale of a California manufacturing plant.The firm also said it could learn as soon as February whether the FDA will allow it to market Rituxan for use in patients with a different form of NHL. The agency granted priority review status to the firm's request to market Rituxan in front-line patients with the intermediate grade or aggressive, CD20-positive, B-cell type of NHL.If granted, the expanded NHL indication is not expected to have a major impact on Rituxan sales. But the Cambridge, Mass., biotech company has also applied to the FDA to market the drug as a treatment for rheumatoid arthritis, a potentially very lucrative area.Mining older drugs like Rituxan, approved in 1997, for revenue was necessitated by the withdrawal of MS drug Tysabri (natalizumab) by Biogen Idec and Elan, its marketing partner. Tysabri was pulled in February due to safety concerns but could be reinstated, pending a ruling from the FDA, in the first half of 2006.
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2014-42/1179/en_head.json.gz/22837 | Behavioral Healthcare Appeals
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Hold on Tight – 2010 Could be Rough. . .
February 27, 2010 by Moderator Filed under Featured, HEAT Enforcement Leave a Comment (February 27, 2010): The number of auditors, reviewers, investigators and prosecutors going after CMHCs is increasing and signals an alarming, unprecedented effort by the government to uncover and recover alleged overpayments for partial hospitalization claims.
CMHCs now face not only simple repayment demands, but also civil False Claims Act cases and criminal Medicare / Medicaid fraud claims identified by various new government contractors. Regrettably, we have seen unintentional mistakes, incomplete documentation and technical errors cited as the basis for seeking the repayment of millions of dollars, representing Medicare services rendered long ago, in some cases as many years before the demand letter was sent. Perhaps most troubling is the fact that no one, including the ZPIC and / or PSC conducting the medical review, doubts that the medical services were rendered and in most cases, the Medicare beneficiary benefited from the partial hospitalization care and treatment provided. Today, every health care provider, including CMHCs, must beware of:
“RACs” or Recovery Audit Contractors.
“ZPICs” or Zone Program Integrity Contractors.
“MICs” Medicaid Integrity Contractors.
“MCFU” Medicaid Fraud Control Unit.
“HHS-OIG” Department of Health and Human Services, Office of Inspector General.
“DOJ” U.S. Department of Justice, and
“HEAT” Healthcare Fraud Prevention & Enforcement Task Force (in a number of U.S. Attorney’s Offices around the country).
RACs and the havoc they are expected to wreak is old news, quite frankly. Thankfully, they appear to be focused on the larger players at this point. The newest players in town, ZPICs, MICs and HEAT Teams should be at the top of your current list of concerns. As you will recall, CMS consolidated functions of all Program Safeguard Contractors (PSCs) and Medicare Prescription Drug Integrity Control (MEDIC) contracts into ZPIC contracts. ZPICs are designed to combine claims data (FIs, Regional Home Health Intermediary, Carrier, DMERC) and other data to create a platform for documenting complex data analysis. While RACs (until recently) have focused solely on recovering money, ZIPCs also look for fraud.
MICs are just now revving up around the country. Unburdened by many of the restrictions placed on RACs, CMHCs with a heavy Medicaid beneficiary base should diligently review their Medicaid coding and billing efforts to better ensure compliance with applicable statutory and regulatory requirements. HEAT Teams are made up of top level law enforcement and professional staff from DOJ and HHS. HEAT was implemented to prevent fraud and enforce current anti-fraud laws and prevent waste that focuses on improving data and information sharing between the Center for Medicare & Medicaid Services and law enforcement agencies. HEAT is working to strengthen program integrity activities to monitor and ensure compliance and enforcement. HEAT’s tools to identify fraud include hotlines and web sites for healthcare workers and ordinary citizens. Furthermore, HEAT officials are helping state Medicaid officials conduct better audits and provide better monitoring to detect fraudulent activities.
How should you respond? The best response is to follow the rules. If you don’t already have an effective Compliance Plan in place, we recommend you take steps to immediately implement one. Should you have any questions regarding these changes, don’t hesitate to contact us. For a complementary consultation, you may call Robert W. Liles or one of our other attorneys at 1 (800) 475-1906.
Tags: medicare audit, medicare fraud, Medicare Fraud Strike Force, medicare overpayment, psc, rac, zpic
The U.S. Sentencing Commission has issued proposed changes that may significantly impact compliance plans and compliance professionals.
February 21, 2010 by Moderator Filed under Compliance, Featured Leave a Comment (February 21, 2010): An effective Compliance Plan can greatly reduce the likelihood that your Community Mental Health Center (CMHC) will find itself in violation of criminal statutory and regulatory requirements. Should a violation still occur, Federal Sentencing Guidelines have long credited an organization’s efforts to comply with the law. Notably, on February 9, 2010, the U.S. Sentencing Commission announced that a number of changes to the Federal Sentencing Guidelines has been proposed, at least one of which should be of considerable interest to your CMHCs Compliance Officer and other members of its mangement team. The provisions of §8B2.1 of the Federal Sentencing Guidelines (Effective Compliance and Ethics Program) are generally regarded as the model from which effective compliance plans are based for corporations.
The proposed amendments make several understated but important changes to the structure of an “effective compliance plan.” In particular, they focus on the increasingly important role document retention policies must play in an organization’s compliance program. Specifically, after criminal conduct has been detected:
A CMHC must respond appropriately to the criminal conduct, including providing to the restitution to any vicitims (which would include repayments to the Medicare program), self-report the violation and cooperate with authorities. The CMHC must assess its program and modify it to make the program more effective. The use of an independent monitor to ensure implementation of these changes would be encouraged. In addition, as part of periodic compliance plan review, the provider should make sure (in writing) that all employees are aware of the organization’s document retention policies, and that such policies correspond to the goals of an effective compliance plan.
Dangling a carrot in front of companies for proper compliance, the proposed guidelines raise the issue of whether an organization should receive credit for an Effective Compliance plan even when Senior Executives are involved in and offense, where (1) the Compliance Officer has a direct reporting relationship to the Board of Directors (or Board Committee), (2) the Compliance Program successfully detected the offense before it was uncovered outside of the organization, and (3) the organization promptly reported the violation to the appropriate authorities.
The Sentencing Commission’s other proposals are out for comment until March 22, 2010. A public hearing on the proposals is scheduled for March 18, 2010. The Sentencing Commission will then vote in April on whether to send any amendments to Congress. If it does, the amendments would become effective November 1, 2010, unless Congress takes action to prevent the amendements from taking effect. Notably, these proposed changes further highlight the issue of “self-disclosure.” The determination of whether or not to self-disclose a potentially criminal violation can be quite complicated. CMHCs desiring to self-disclose should consult their legal counsel prior to taking such a step. Should you have any questions regarding these changes, don’t hesitate to contact us. For a complementary consultation, you may call Robert W. Liles or one of our other attorneys at 1 (800) 475-1906.
Tags: CMHC, Compliance, Fraud and Abuse, Sentencing Guidelines
Ever Wonder Why so Many CMHCs are Being Audited by the Government?
February 17, 2010 by Moderator Filed under False Claims Act, Featured, Medicare Audits Leave a Comment (February 17, 2010): HHS-OIG has alleged that $1.44 billion in “savings” could be achieved by ensuring the appropriateness of Medicare payments for partial hospitalization services.
The last few years have been tough for Community Mental Health Centers (CMHCs) around the country. Many CMHCs have found themselves the subject of Medicare post-payment audits by Program SafeGuard Contractors and / or Zone Program Integrity Contractors (ZPICs). Others have been placed on pre-payment review by PSCs, effectively cutting-off Medicare reimbursement until the contractors could decide if their claims for partial hospitalization program (PHP) services qualify for coverage and payment. Some areas, such as South Florida and Louisiana have been hit especially hard.
Many of our CMHC clients have asked – “Why us, all we are trying to do is take care of a population who has no where else to turn?” One reason may be because the government appears to believe that Medicare is being improperly billed for partial hospitalization services – to the tune of $1.44 billion.
For the third straight year in a row (2007, 2008 and 2009), the Department of Health and Human Services, Office of Inspector General (HHS-OIG) has reported that it found that Medicare has improperly paid for inappropriate outpatient mental health services. According to HHS-OIG, “[b]illing abuses involving beneficiaries who are unable to benefit from psychotherapy demonstrate a special need for enhanced program and beneficiary protections.” Furthermore, HHS-OIG indicated that beneficiaries with mental illness sometimes do not receive all the services that they need, so both underutilization and overutilization problems exist.
HHS-OIG is pointing its finger specifically at providers of partial hospitalization services. HHS-OIG doesn’t hesitate to allege that partial hospitalization services, which may be provided by both hospitals and community mental health centers, “have been particularly vulnerable to payment errors.” According to the HHS-OIG, “[w]e have estimated that Medicare payment error rates for partial hospitalization in community mental health centers were as high as 92 percent.” In its 2009 “Compendium of Unimplemented Office of Inspector General Recommendations,” HHS-OIG noted that in 2003, miscoded and undocumented services accounted for 26% and 19%, respectively of all Medicare mental health services. Finally, medically unnecessary services and services that violated the “incident to” rule each accounted for 4% of all Medicare mental health services in 2003. The “incident to” rule allows a physician to bill for mental health services performed by his or her staff if the services are rendered incident to the physician’s professional services.
Based on the foregoing, HHS-OIG recommends that the Centers for Medicare & Medicaid Services (CMS) ensure that mental health services are medically necessary and reasonable; are accurately billed and are ordered by authorized practitioner by using a comprehensive program of targeted medical reviews, provider education, improved documentation requirements, and increased surveillance. This, according to HHS-OIG, will result in a savings of $1.44 billion.
While CMS agreed with the HHS-OIG’s findings and recommendations, HHS-OIG declared that there are still significant unallowable payments. As HHS-OIG stated, “[w]e believe that CMS still needs to monitor partial hospitalization services provided by community mental health centers, which we consider particularly vulnerable.” As a result, HHS-OIG indicated that it will continue to monitor CMS’s efforts to ensure that mental health services are medically necessary and reasonable and are accurately billed.
Should you have any questions regarding these changes, don’t hesitate to contact us. For a complementary consultation, you may call Robert W. Liles or one of our other attorneys at 1 (800) 475-1906.
Tags: behavioral health, CMHC, DOJ, medicare audit, medicare fraud, medicare overpayment, oig
Expansion of Medicare’s “HEAT” Strike Force
February 1, 2010 by Moderator Filed under HEAT Enforcement, Medicare Audits Leave a Comment (February 1, 2010): On December 15, 2009 Assistant Attorney General Lanny A. Breuer of the Criminal Division of the Department of Justice (DOJ) and United States Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced the expansion of Medicare Fraud Strike Force teams to Baton Rouge, Brooklyn and Tampa in a effort to target individuals and health care companies that fraudulently bill the Medicare program.
The joint DOJ-HHS Medicare Fraud Strike Force is a multi-agency team of federal, state and local investigators designed to combat Medicare fraud through the use of Medicare data analysis techniques and an increased focus on community policing. After expanding to Baton Rouge, Tampa and Brooklyn, Strike Force Fraud Strike Force will be operating in a total of seven cities in the United States: Miami, Los Angeles, Detroit, Houston, Brooklyn, Tampa and Baton Rouge.
The Strike Force started in March 2007 in Miami (Phase One), Los Angeles (Phase Two), Detroit (Phase Three), Houston (Phase Four), and Brooklyn (Phase Five). Since that time, the Strike Force has obtained indictments of more than 460 individuals and organizations that collectively have falsely billed the Medicare program for more than one billion dollars.
During the press conference related to the expansion to the three cities, DOJ also publicized five indictments that were unsealed on December 15, 2009 in Miami, Detroit and Brooklyn, following the arrests of twenty-five individuals in Miami, four individuals in Detroit and one in Brooklyn. In addition, Strike Force agents also executed four search warrants at businesses and homes in Coconut Creek, Fla.; Miami and Brooklyn.
The DOJ press announcement also noted that individuals charged in the indictments that were unsealed were accused of various Medicare fraud crimes, including conspiracy to defraud the Medicare program, conspiracy to launder money, money laundering, criminal false claims, making false statements and receiving kickbacks.
According to the DOJ indictments, the defendants participated in schemes to submit claims to Medicare for products and services that were in fact medically unnecessary and oftentimes, never provided. In the Detroit cases, DOJ alleged that the defendants participated in a scheme whereby they paid pay kickbacks to patients who received instructions from the clinic owners and patient recruiters to feign symptoms to justify expensive testing, including nerve conduction studies. In Brooklyn, the two defendants are alleged to have billed Medicare for durable medical equipment, including expensive shoe inserts reserved for diabetes patients, when in fact much cheaper and over-the-counter shoe inserts were provided to beneficiaries who often didn’t need them. In Miami, 15 individuals, including doctors and nurses, are charged in connection with fraudulent claims to Medicare for home health services. In another case in Miami, individuals are charged for their various roles in running a medical clinic that purported to provide injection and infusion treatments to HIV/AIDS patients and submitted fraudulent claims Medicare for such services, which were often medically unnecessary and/or never provided.
Collectively, the DOJ announced that the physicians, company owners, executives and others charged in the indictments are accused of conspiring to submit approximately $61 million in false claims to the Medicare program.
Tags: Baton Rouge Louisiana, Medicare Fraud Strike Force
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DOJ is Criminally Prosecuting Virginia Physician Who Improperly Disclosed Patient Health Information
CMHC Compliance Officers Should Review Their Compliance Plans to Ensure that “I-9s” are Being Properly Handled and Completed by Staff. The Failure to do so Can Result in Civil and / or Criminal Penalties.
The Zone 7 ZPIC Has Recommended Revocation of 82% of CORFS and 79% of CMHCs in South Florida – Is Your ZPIC Next?
HHS-OIG has Identified “Partial Hospitalization Program Services” as a New Audit Area of Interest in its 2011 Work Plan
Is the Government Overreaching with its use of the False Claims Act? The AHA Sure Seems to Think So.
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2014-42/1179/en_head.json.gz/22947 | REX - UNC Health Care
Home>Diabetes News and Information
Diabetes News and Information
Tea, Coffee Seem to Protect Against Diabetes
Drinking lots of coffee and tea every day -- even decaf -- might keep diabetes away, new research shows.
In a meta-analysis of 18 studies, drinking three to four cups of coffee per day was associated with a 25% lower risk of diabetes than drinking two cups or less per day.
There were similar results for decaf coffee and tea.
"If such beneficial effects were observed in interventional trials to be real, the implications for the millions of individuals who have diabetes, or who are at future risk of developing it, would be substantial," the researchers concluded in the Dec. 14/28 Archives of Internal Medicine.
Over the years, a variety of investigators have reported that coffee and tea consumption are inversely associated with type 2 diabetes. The research showed each additional cup of coffee consumed in a day was associated with a 7% reduction in the excess risk of diabetes.
Six of the studies reported on the association between drinking decaffeinated coffee and subsequent risk of diabetes.
A pooled summary estimated that those who drank more than three to four cups of decaf coffee per day had about a third lower risk of diabetes than those who didn't drink any decaf. Seven studies also looked at the association between tea and diabetes risk. Again, pooled summaries showed that patients who drank more than three to four cups of tea per day had about a 20% lower risk of diabetes than those who drank no tea
The researchers noted that the coffee findings may be an overestimate due to "small-study bias," and cautioned that any possibility that the association between coffee and diabetes risk is age-dependent warrants further investigation.
The findings suggest that the protective effects of tea and coffee may not be solely related to the effects of caffeine, but rather involve a broader range of chemical constituents including magnesium, lignans and chlorogenic acids, the researchers wrote.
Tea catechins, for example, may decrease glucose production in the gastrointestinal system, leading to lower levels of glucose and insulin, and green tea in particular may prevent damage to pancreatic beta cells. The study was limited by the potential for uncontrolled confounding, and because it precludes a more detailed analysis of the effect of adjustment for confounders at an individual level.
Also, it may be limited in its generalizability because only 20% of cohorts were from nonwhite populations. Lars Rydén, MD, of the Karolinska Institute in Sweden, a spokesperson for the European Society of Cardiology, called the study a "cautiously and carefully conducted meta-analysis."
"There are sometimes claims that coffee may do harm, that it may increase the propensity to cardiovascular disease, but there is no evidence for this," Dr. Rydén said. "The message is that people may drink coffee safely. Coffee from this point of view may actually be of benefit, as well as reducing the risk of getting diabetes - although the reduction is small."
But Rydén noted that other lifestyle issues are far more important than coffee intake. "Coffee helps, but other things are even more important," he said. "Those who are overweight should reduce their bodyweight by 5% to 10% -- not too much -- and include physical activity, such as a brisk walk for 30 minutes a day. Then those people who are at risk of developing diabetes will reduce this risk by 40 to 50%."
The study was supported by grants from the National Heart Foundation of Australia, the National Health and Medical Research Council of Australia, the UK Wellcome Trust, and Institut Servier, France, and Assistance Publique-Hopitaux de Paris.
The researchers reported no conflicts of interest.
By Kristina Fiore, Senior Writer, MedPageTodayReviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston. December 14, 2009
Primary source: Archives of Internal Medicine Source reference: Huxley R, et al "Coffee, decaffeinated coffee, and tea consumption in relation to incident type 2 diabetes mellitus" Arch Intern Med 2009; 169(22): 2053-63
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2014-42/1179/en_head.json.gz/22955 | We don't just have a voice in healthcare. At Riverside, we help direct it. riversideonline.com Home » About Riverside About Riverside Health System Home Why Riverside Our Purpose Our Leadership Our History Awards and Recognition News Facility Directory Awards and Recognition
Most Wired Hospital/Health System
Riverside Health System has been named to the nation’s Most Wired list for the seventh consecutive year, according to the results of the 2011 Most Wired Survey and Benchmarking Study released in the July issue of Hospitals & Health Networks magazine. Riverside’s Most Wired designation highlights the importance of using electronic medical records in patient care.
Read the article >
Medical Group Preeminence
Riverside Medical Group (RMG) has been honored with the annual Medical Group Preeminence Award. This prestigious national award is given annually by the American Medical Group Association (AMGA) to organizations that continuously strive to improve patient care through innovation, advanced communications and information sharing, the creation of sound public policy and effective physician leadership development. Read the article >
See also: Riverside Medical Group
Exemplary Efforts Serving The Community
In recognition of its broad-based efforts to improve the lives of the most vulnerable members of its community, Riverside Health System in Newport News, Va., has been named a national finalist for the 2007 Foster G. McGaw Prize – one of the most prestigious honors for excellence in community service in healthcare. The Foster G. McGaw Prize is sponsored by the American Hospital Association (AHA), The Baxter International Foundation and the Cardinal Health Foundation.
Riverside Health System, following a rigorous evaluation process, received the national honor of being designated "Employer of Choice®." This award recognizes an organization’s dedication to a higher level of employee commitment that assures customer loyalty and satisfaction.
See also: Careers and Employment Elite Heart/Stroke Physician Recognition
Twenty-six Riverside Medical Group physicians recently earned recognition by the National Committee for Quality Assurance (NCQA) for delivery of quality cardiovascular and cerebrovascular care. The Heart/Stroke Recognition Program (HSRP), created by the NCQA, the American Heart Association, and the American Stroke Association, awards recognition to physicians who demonstrate high quality in providing care to patients with heart or vascular conditions or who have had a stroke.
See also: Riverside Medical Group Hospital of Choice
Recognized as one of the most customer-friendly hospitals in the United States, Riverside Regional Medical Center was selected to receive the Hospital of Choice Award from the American Alliance of Healthcare Providers (AAHCP). Riverside received this award for three years.
See also: Riverside Regional Medical Center Top Heart and Vascular Center
Riverside Regional Medical Center has been selected as one of the nation’s 100 top cardiovascular hospitals by Solucient®. The annual Solucient® award for cardiovascular services objectively measures performance on key criteria at the nation’s top performing acute-care hospitals. This was the second time Riverside has been recognized with this honor.
See also: Riverside Cardiac Services Reader's Choice
Readers of the Daily Press voted on the 2007 Reader's Choice Awards for the Greater Hampton Roads area. The Reader's Choice results, based soley on the opinions and preferences of the general public, have three award designations: Gold, Silver and Bronze.
Hospital: Riverside (Gold)
Health Club: Riverside Wellness & Fitness Center (Gold)
Retirement Community: Warwick Forest (Gold)
Family Practice: Riverside Family Practice (Silver)
Riverside Diagnostic Center - Oyster Point Named Among Top in Nation
The Riverside Diagnostic Center Oyster Point has been designated a "Breast Imaging Center of Excellence" by the Commission on Quality and Safety and the Commission on Breast Imaging.
Riverside Regional Medical Center Receives Top Ranking for Orthopedic Care
Riverside Regional Medical Center has been recognized by Medicare for excellent results in hip and knee surgery. The 3-year study is called HQID Medicare and is designed to improve the quality of patient care.
Top Places to Work
Riverside Rehabilitation Institute, a five time winner, Women’s Healthcare and Hilton Family Practice, were recognized as three of the Top 25 Best Places to Work in Hampton Roads. A panel of five judges reviewed and scored applications based on the criteria of company culture/personality, compensation, family friendly policies, and employee development. The competition is sponsored by “Inside Business,” a Hampton Roads based business magazine. ER WAIT TIME Riverside Regional | 医学 |
2014-42/1179/en_head.json.gz/23340 | VCA Town and Country Animal Hospital
Heartworm Disease in CatsPet Info
PrintHeartworm Disease in Cats
What causes heartworm disease?Heartworms are a blood-borne parasite called Dirofilaria immitis that reside in the heart or adjacent large blood vessels of infected animals. The female worm is 6 to 14 inches long (15 to 36 cm) and 1/8 inch wide (5 mm). The male is about half the size of the female. Heartworm disease is much more common in dogs. "...incidence of heartworms that is far greater than previously thought." However, recent studies of cats with heart and respiratory diseases have found an incidence of heartworms that is far greater than previously thought. Cats are relatively resistant to heartworm infection when compared to dogs, with the infection rate in cats reported to be 5-20% of the rate in dogs in the same location. Approximately 1/3 of infected cats live indoors only. Typically, cats have fewer adult worms than dogs, usually less than 6. How are heartworms transmitted to a cat?The life cycle of the heartworm is complex and requires two host animals in order to complete it. Heartworms require the mosquito as an intermediate host and as many as 30 species of mosquitoes can act as this host and transmit heartworms. Mosquitoes ingest immature heartworm larvae, called microfilariae, by feeding on an infected cat or, more commonly, an infected dog. The microfilariae develop further for 10 to 30 days in the mosquito's gut and then enter its mouthparts. When an infected mosquito bites a cat, it injects infective larvae into the cat. The larvae migrate and mature for several months, ending up in the right side of the heart and the pulmonary arteries. There they mature into adult heartworms capable of reproduction about six months from the time they enter the cat. Shortly thereafter, at around eight months after infection, they begin to produce a new crop of microfilaria that will live in the cat's blood for about one month. Cats are resistant hosts, and few circulating microfilaria are generally found. We’ve Got Positive Cattitude! We help to make cat care easier for you – Get a Free Feline First Exam* (for new clients). "It is necessary for a cat to be bitten by an infected mosquito in order to become infected with heartworms." Because of this life cycle, it is necessary for a cat to be bitten by an infected mosquito in order to become infected with heartworms. Heartworms are not transmitted directly from one cat to another or from a dog directly to a cat. How are heartworms diagnosed?There are several methods used in diagnosing heartworms; unfortunately, none are 100% reliable so a combination of tests is often needed. The diagnostic sequence usually progresses as follows: "The most common signs are a sudden onset of coughing and rapid breathing..." Clinical Signs One of the most challenging aspects of diagnosing feline heartworm disease is that there are no specific clinical signs. The most common signs are a sudden onset of coughing and rapid breathing, signs that can also be caused by several other diseases. Other common non-specific clinical signs include weight loss and vomiting. On occasion, an apparently normal cat may be found dead, or may develop sudden overwhelming respiratory failure and heartworm disease is diagnosed on a post-mortem examination. Sudden death is thought to be due to a reaction within the lungs to the young heartworms, or to a reaction to dead or live heartworms entering the pulmonary arteries and obstructing the flow of blood to the lungs. Acute Clinical Signs Chronic Clinical Signs collapse Coughing dyspnea Vomiting convulsions Dyspnea diarrhea/vomiting lethargy blindness anorexia tachycardia weight loss syncope chylothorax sudden death Blood Tests Several blood tests are used for heartworm diagnosis, but the heartworm antibody test and the heartworm antigen test are proving to be most helpful in diagnosing the disease in cats. 1. The heartworm antibody test determines that the cat's immune system has been exposed to heartworms. A positive test may indicate that an active infection is present. However, cats who have had heartworms but whose heartworms have died will also have antibodies for an unknown time. Currently, it is believed that the antibodies persist for two to four months after the heartworms have died. Cats with late stage larvae that are not yet adults, and cats with adult heartworms in places other than the heart, may also test positive with the antibody test. This test is very sensitive, so it is used first. If it is positive, the next test is performed. 2. The heartworm antigen test detects the presence of adult female heartworms. It is very specific, but not as sensitive as the antibody test. A positive test indicates that heartworms are present, but a negative test does not mean that they are absent. Because the cat must have at least two adult female worms present to make this test positive, a negative test may mean that the cat may only have a small number of worms or that all the worms present are male. "A diagnosis of feline heartworm infection is confirmed when both the antibody and antigen tests are positive." In summary, a diagnosis of feline heartworm infection is confirmed when both the antibody and antigen tests are positive. 3. A blood sample can be tested for the presence of microfilariae. However, less than 20% of cats with heartworms have microfilariae in their blood, and microfilariae are only present for one to four weeks. Although a positive test is diagnostic, a negative test means little. 4. An eosinophil count can be measured in cats suspected of harboring heartworms. Eosinophils are a type of white blood cells that occur in increased numbers when certain parasites are present. They are elevated in the presence of heartworms, but this elevation only occurs for a few months. This test is not specific, since cats with other parasites (intestinal worms, fleas, etc.) or allergies also commonly have increased eosinophil counts. An eosinophil count is often performed with a Complete Blood Cell Count (CBC) and serum chemistries during the initial diagnostic workup. Radiographs (x-rays) permit us to view the size and shape of the heart. They also allow us to measure the diameter of the pulmonary arteries. Many cats with heartworms have an increase in the size of the pulmonary arteries, or the arteries may appear blunted (suddenly come to an apparent stop) on their way to the lungs, due to worms obstructing them. However, many other cats with heartworms have no abnormal findings on their radiographs, especially early in the infection. Cardiac ultrasound or Echocardiography Echocardiography allows the examiner to directly view the internal structures of the heart and surrounding vessels and assess the condition and function of the heart. In some cats, the actual adult heartworms can be seen; this finding confirms the presence of heartworms. However, because most infected cats have a low number of worms this does not occur often. Can feline heartworm disease be treated?There is no drug approved for treating heartworms in cats. One of the drugs for treating dogs has been used in cats, but it causes significant side effects. "There is no drug approved for treating heartworms in cats the reaction to the dead and dying worms can cause sudden death." To complicate things further, when the adult heartworms die during this treatment, they pass through the pulmonary arteries to the lungs where the reaction to the dead and dying worms can cause sudden death. Thus, we have a dilemma when a cat is diagnosed with heartworms. One of two main choices must be made: 1. Treat with the drug designed for dogs. However, this drug can have serious side effects in cats. These side effects include acute pulmonary (lung) failure and death in a small percentage of cats. 2. Treat the symptoms of heartworm disease and hope the cat outlives the worms. Since heartworms live in a cat for about two to three years (as opposed to five to seven years in dogs), several months of treatment are needed. When cats are in a crisis, they are treated with oxygen and corticosteroids ("cortisone") to relieve the reaction occurring in the pulmonary arteries and lungs, and, if needed, drugs to remove fluid from the lungs (diuretics). When they are stable, they are treated continuously or periodically with corticosteroids. However, the threat of an acute crisis or sudden death always exists. 3. Another possible treatment option, surgical removal of the heartworms, is currently being performed in Japan and some parts of Europe. Surgical extraction may become a better treatment option in the future, as the technique improves. Is there a way to prevent heartworms?Veterinarians now strongly recommend that all cats receive year-round monthly heartworm preventative in areas where mosquitoes are active all year round. "There are excellent heartworm preventatives now available for cats, making prevention of heartworm disease safe and easy. " Cats that live in colder areas, where mosquitoes are seasonal, should be on monthly preventative for at least 6 months of the year. There are excellent heartworm preventatives now available for cats, making prevention of heartworm disease safe and easy. The reasons that heartworm prevention is now recommended for all cats are: 1. Diagnostic Difficulty. Diagnosing heartworms is not as easy in cats as in dogs. 2. Unknown Incidence. Heartworms are not nearly as common in cats as they are in dogs. However, they are probably more common than we realize. As we look more aggressively for heartworms in cats with better and better tests, we expect to find that the incidence is greater than previously thought. University studies have shown that up to 15% of all cats in certain locations, regardless of whether they are indoor and outdoor cats, have been exposed to feline heartworm disease. 3. There Is No Treatment. There is simply no good treatment for heartworm-infected cats. Effective drugs are not available, and cats that seem to be doing well may die suddenly. Treating heartworm infections in cats is risky at best, and not treating these cats is just as risky. It will take about two years for the parasitic infection to be eliminated in the cat, and serious clinical signs can suddenly appear at any time during this period. 4. Prevention Is Safe and Easy. Cats given heartworm prevention drugs have not shown signs of toxicity. There is a wide margin of safety, even in kittens as young as six weeks of age. 5. Indoor Cats Get Heartworms, Too. Exposure to mosquitoes is required for transmission. Cats do not have to be exposed to cats or dogs infected with heartworms. Obviously, cats that go outdoors are more likely to be exposed. However, an infected mosquito can easily get into the house and infect the cat. This client information sheet is based on material written by: Ernest Ward, DVM
Related Tagsacute, adult, animals, antibody, antigen, arteries, blood-borne, cats, clinical, coughing, crisis, death, diagnosed, diagnosing, diagnostic, died, disease, dogs, drug, drugs, dyspnea, eosinophil, exposed, feline, female, greater, heart, heartworm, heartworms, host, incidence, increased, indoor, infected, infection, larvae, lungs, male, microfilariae, mosquito, mosquitoes, negative, parasite, performed, presence, prevention, previously, pulmonary, rate, reaction, resistant, shown, specific, treated, treating, treatment, vessels, vomiting, weight, worm, worms | 医学 |
2014-42/1179/en_head.json.gz/23389 | Comparative Neuromuscular
Teaching Links
Craig P. McGowan, Ph.D.
My research focuses on understanding the evolution of musculoskeletal design and the relationships between morphology and performance. I received my Ph.D. in 2006 from Harvard University under the guidance of Dr. Andrew Biewener.
For my graduate research, I examined how musculoskeletal specialization influences the functional plasticity of individual muscles and coordination of whole limb design. As a model for examining specialization, I conducted experiments using different species of kangaroos and wallabies.
As an NIH NSRA Post-doctoral research fellow I worked with Dr. Rodger Kram at the University of Colorado at Boulder and Dr. Richard Neptune at the University of Texas at Austin. The goal of my work was to provide a better understanding of how individual muscles contribute to biomechanical subtasks during human walking (e.g., body support and forward propulsion), how muscles are modulated in response to changes in mechanical demand, and how intrinsic muscle properties influence locomotor performance. My research on human locomotion also includes the study of sprint running biomechanics in elite level trans-tibial amputee athletes.
Link to CV
Anne Gutmann, Ph.D.
My research focuses on understanding how the mechanics and energetics of locomotion affect movement control and peak performance. I am also interested in applying these principles to improve sports performance, prosthetic/orthotic design, and rehabilitation. I received a Ph.D. in Medical Science from the University of Calgary in 2011, and a M.S. in Theoretical & Applied Mechanics from Cornell University in 2007. For my Ph.D. dissertation I studied the relationship between the mechanics and energetics of human hopping. This included examining how minimization of metabolic energy influences hop height and frequency selection, and determining how the mechanical properties of the leg muscles dictate maximum hop height. For my M.S. thesis, I studied how constrained Link to CV
optimization of metabolic energy influences speed and stride frequency selection in running.
I am also a scientific illustrator. I enjoy the challenge of translating complex scientific concepts into understandable and attractive graphics. Check out my illustration website
Missy Thompson, MS
My research focuses on the role of sensory feedback in the regulation of gait parameters. The goal is to integrate biomechanical analyses with musculoskeletal modeling and forward dynamics simulations to gain insight into the role of sensory feedback during gait. Understanding the role of sensory feedback in altering gait parameters may provide important knowledge as to why diseases such as Diabetes Mellitus cause gait alterations and contribute to improved treatment strategies.
Katie Shine
I am an international student, originally from Bristol, England. I started my PhD at U of I in fall 2011 having studied for my undergraduate at The Royal Veterinary College in London. I am studying the biomechanics of bears, particularly grizzly bears in collaboration with the Washington State University Bear Research Centre in Pullman, WA. I will be looking at how the anatomy of the bear limbs affects their locomotion and relating this to their evolutionary history. This will involve travelling to various museums and measuring bones from all species of bears as well as using 3-D kinematic and kinetic analysis of live bears.
Lab Alumni
Redgy Fuller -
Redgy was a 2012
INBRE Fellow and is completing his senior year at Lewis and Clark State College in Lewiston, Idaho. He will be applying to medical school in the fall. Marina Van Pelt - Marina was a high school student participating in HOIST (Helping Orient Indian Student and Teachers), a highly innovative summer program that assists ambitious Native American students with an interest in the areas of Science, Technology, Engineering, Mathematics and related fields. Travis Morgan - Travis graduated form the University of Idaho Spring 2012. He is currently working in his native Alaska and exploring the possibility of going to graduate school. Samantha Welker -
Sam will start in the Art as Applied to Medicine Program at Johns Hopkins University in Fall 2012. Dayne Sullivan - Dayne was a 2011
INBRE Fellow. He graduated from Lewis and Clark State College in Spring 2012 and is now working in industry. The research conducted with Dayne's help is currently in preparation for publication. Ashley Vaughn -
Ashley worked in the lab as a 2011 McNair Scholar. Ashley plans to graduate from the University of Idaho in Spring 2013 and is applying to graduate schools. The McGowan Lab is looking for energetic, creative and motivated people to join the research team! Interested in functional morphology, ecology, and the evolution of musculoskeletal design? Check out the
in the Department of Biological Sciences at UI. Interested in motor control, muscle function, and computer modeling and simulation? Check out the
Neuroscience Program at UI.
There are also opportunities for post-docs and undergraduate students.
Please contact Dr. McGowan via e-mail for more information. (c) University of Idaho. All rights reserved.
University of Idaho, Moscow, Idaho 83844 | 医学 |
2014-42/1179/en_head.json.gz/23402 | Holland Hospital among 9 Michigan hospitals to make America's 100 Best Hospitals 2013 Caroline MacGregor
February 19, 2013 | WGVU Healthgrades' collects information on hospitals, physicians, long-term care facilities and other healthcare providers from a number of sources. The information is then used to generate ratings of the Healthcare Providers which helps consumers evaluate physicians and health care facilities. The hospitals in the Healthgrades 2013 ratings list are recognized for better than expected outcomes across a broad spectrum of conditions and procedures over an extended period of time. This translates into lower mortality rates and fewer complications across 27 common conditions and procedures for a minimum of four years. Included on the list is Holland Hospital. Vice President of Ancillary Services and Quality, Mark Paulick, says they are delighted to have made the list. “Very excited about it, yes. We've actually received the Tompson's Reuters top 100 award for 7 years consecutively and when we heard Healthgrades was creating their own version of that we were kind of wondering, well, let's see, is this going to further validate our position as a preeminent organization? So yes, the staff and physicians and leadership of our organization are very excited about the distinction."Other hospitals that made the Michigan list include Bronson Methodist Hospital in Kalamazoo, Munson Medical Center in Traverse City, Allegiance Health in Jackson, Beaumont Hospital - Troy in Troy Providence Hospital in Southfield Saint Mary's Mercy Hospital in Livonia Spectrum Health Butterworth Hospital, including Spectrum Health Blodgett Hospital in Grand Rapids.Healthgrades research determines the nation's best performing hospitals based on an evaluation of objective measures of clinical quality at nearly 4,500 hospitals nationwide. Data from Medicare is analyzed for risk-adjusted mortality and in-hospital complications taking into account differing levels of severity of illness at different hospitals - allowing those hospitals to be compared equally. No hospital can opt-in or opt-out of being evaluated, and no hospital pays to be evaluated. More WGVU News | 医学 |
2014-42/1179/en_head.json.gz/23425 | Bipolar Disorder Drugs May 'Tweak' Genes Affecting BrainBipolar Disorder Drugs May 'Tweak' Genes Affecting Brain
HealthDay News Home | News Archive | News CategoriesTHURSDAY, April 25 (HealthDay News) -- Medications taken by people with bipolar disorder may actually be nudging hundreds of genes that direct the brain to behave more normally, according to new research.The study suggests that antipsychotic drugs activate a wide range of genes, changing their function, said lead author Dr. Melvin McInnis."A gene's activity in any given cell will vary depending on what it's exposed to," said McInnis, a professor of bipolar disorder and depression at the School of Medicine at the University of Michigan. It's not often that scientists stumble upon something in research that they totally weren't expecting to see. "It was a major surprise to us that people treated with an antipsychotic [medication] had changes in the gene expression pattern," McInnis said.The findings could help point the way to new gene-targeted and stem cell therapies, and provide valuable insight into what causes manic-depressive mood swings, he added.However, a genetics expert not connected to the study was more cautious about drawing implications from its findings. Bipolar disorder, also known as manic-depressive illness, affects about 5.7 million American adults, or about 2.6 percent of the U.S. population aged 18 and older, according to the U.S. National Institute of Mental Health (NIMH). The brain disorder causes severe and unusual shifts in mood, energy, activity levels, and the ability to carry out routine daily tasks.The new research, published in a recent issue of the journal Bipolar Disorders, involved examining 26 brains donated to a nonprofit brain bank. Fourteen of the brains were from people who had bipolar disorder. Of those, seven were from people who had been taking one or more antipsychotic medications -- such as clozapine, risperidone and haloperidol -- when they died. Twelve brains were from those with no mental health condition. In comparing the brains, the scientists observed that the genes of those that had been exposed to antipsychotics at the time of death or during their lifetime were similar to those from people who did not have bipolar disorder. This suggests that the drugs may normalize or suppress the kinds of brain pathology one would expect in bipolar disorder, according to the researchers.The study also supports the idea that the ability of brain cells to effectively communicate with each other may be impaired in people with bipolar disorder. The researchers found that the brains of people who were taking antipsychotics and those who did not have bipolar disorder showed striking similarities in how their brains relayed signals between cell gaps, or synapses, and on high-speed neuronal "freeways" called the nodes of Ranvier.While antipsychotic medications can often be effective in moderating the effects of bipolar disorder, the side effects are often difficult for people to deal with. These include metabolic syndrome -- a combination of symptoms that increase the risk of developing cardiovascular disease and diabetes -- as well as weight gain, increased blood sugar levels, and tremors, McInnis said.However, one expert expressed some concerns about the study."It's still not known if these changes just happen to occur or play a key role in the therapeutic effect," said Dr. Francis McMahon, chief of the human genetics branch at the NIMH Intramural Research Program. McMahon also noted that the researchers don't have data on what medications the brains were exposed to during their lifetimes. "Patients [with bipolar disorder] are exposed to antidepressants, drugs of abuse, and other medications, and we don't have medication exposure data on the brains [of the people without bipolar disorder]."For his part, study author McInnis said the research represents a step toward a radical evolution in the design of drugs for psychiatric conditions by the pharmaceutical industry."A lot of these psychiatric illnesses fluctuate, but now we give medications at a constant rate, almost as if we were giving a diabetic the same amount of insulin no matter what the person's blood sugar is," McInnis said. "Medications as we know them will change based on our understanding of the biological mechanisms behind disease." More informationLearn more about bipolar disorder from the U.S. National Library of Medicine. 2013Health News Copyright © 2013 HealthDay. All rights reserved. Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition. | 医学 |
2014-42/1179/en_head.json.gz/23451 | 2013 Award Winners Dr. Christopher Katz Receives Veterinarian of the Year Award
The Wisconsin Veterinary Medical Association (WVMA) awarded Christopher Katz, DVM, MRCVS, of Two Rivers, the WVMA Veterinarian of the Year Award at its 98th Annual Convention on Friday, Oct. 11.
Keith Philppi, president of the Lakeshore Humane Society has work and served with Dr. Katz on the Lakeshore Humane Society Board of Directors.
"Chris has consistently demonstrated his professionalism in dealing with veterinarians, contractors, members, animal care personnel and employees," says Philippi "Chris is able to put aside his personal feelings and make decisions on what is best for the animals and the mission of Lakeshore Humane Society."
Dr. Katz graduated from Iowa State University College of Veterinary Medicine in 1981. He currently owns and practices at Two Rivers Veterinary Hospital as a small animal practitioner. Dr. Katz is also the medical director at the Lincoln Park Zoo in Manitowoc.
Outside of the WVMA, Dr. Katz has volunteered his service to the Lakeshore Human Society, Wildlife of Wisconsin, the Free Roaming Feline Program and the Manitowoc Sherriff's Department K-9 Unit for over thirty years.
"Dr. Katz has demonstrated many times that he is not in the business strictly for the money. He has donated veterinary services for the Sherriff's Department K-9 program for 34 years and provided medical services to injured wildlife and other hardship cases without guarantee that he would ever be compensated for those services," says Thomas Kocourek, a retired Manitowoc County Sherriff. Working with wildlife if one of Dr. Katz's areas of interest. Having completed research on black bears in Wisconsin and lecturing at several universities, many see him as a wildlife expert.
"Dr. Katz has mentored many students in his practice which always means he has a longer day in the office. He does this with a smile and is glad to give back to his profession," says Drs. Samual Vainisi and Gretchen Schmidt of Eaton Highland Farm, a deer farm located in Denmark.
"Dr. Katz's professional life is the example we all aspire to be and do," they continue.
Dr. Katz practices at Two Rivers Veterinary Hospital and resides in the same town with his wife, Shelley.
Dr. Jane Clark Begins Term as Wisconsin Veterinary Medical Association President Elect
Dr. Clark will serve as WVMA President Elect for one year before assuming the presidency in 2014.
Dr. Clark graduated from Iowa State University College of Veterinary Medicine in 1984 and has been a WVMA member since. Currently, Dr. Clark is the faculty instructor for the veterinary technician program at Madison College.
Her vision for the WVMA is “to increase participation by our associate WVMA members, ‘To advocate and promote veterinary medicine, while enriching human and animal health.’” Dr. Clark hopes to encourage members to be actively involved in the WVMA no matter how big or small their contribution to aid their profession in progressing into the future is.
Within the WVMA, she serves as a consultant to WVMA committee members regarding veterinary technician education and essential skill training as required by the AVMA. She was elected to the WVMA Executive Board in October of 2011 and served as the District 5 Representative until 2013. Outside of the WVMA, Dr. Clark is active in the AVMA, American Association of Equine Practitioners, Association of Veterinary Technician Educators and the Dane County VMA. Executive Board Members, Dr. Robert Zukowski and Dr. Jane Clark, Complete Terms
Robert Zukowski, DVM completed a four-year term serving on the WVMA Executive Board. Dr. Robert Zukowski represented District 9, which is comprised of Vilas, Oneida, Forest, Langlade, Lincoln, Taylor, Marathon, Portage, Wood, Waushara, Adams and Marquette counties. Dr. Zukowski practices large animal medicine at Marshfield Veterinary Service in Marshfield, Wis. He received his DVM from the University of Minnesota College of Veterinary Medicine.
The WVMA thanks Dr. Zukowski and Dr. Jane Clark for their dedication to organized veterinary medicine in Wisconsin.
Seven WVMA Member Awarded 50 Year Awards
Dr. James Dougherty
Dr. Richard Faulkner
Dr. Lyle Hart (pictured with his wife, Ruth)
Dr. Orlin Herrild
Dr. Charles Mayer
Dr. Roger Meads
Dr. Roderick Zachary
Kim Brown Pokorny Awarded WVMA Friend of Veterinary Medicine Award
Over the past five years, as WVMA’s executive director, Brown Pokorny has played a crucial role in the advancement of veterinary medicine in Wisconsin. When the office receives inquiries on everything from veterinary medicine to legal to accounting to records and more, she will find the answer. She provides veterinary medicine’s perspective at numerous meetings across the state and nation, and is continually looking for ways to improve the profession. Brown Pokorny played a vital role in veterinarian’s receiving an exemption from the Prescription Drug Monitoring Program, saving Wisconsin veterinarian’s over $7 million per year in extra resources and lost revenue. In addition, she has been a voice for public health, working to keep the sale of raw milk illegal. In 2012 she saw the need and helped establish the Wisconsin Veterinary Medical Foundation.
“Kim is a tireless champion for the entire veterinary medicine community, including the WVMA, Wisconsin Veterinary Technician Association (WTVA) and the Wisconsin Practice Managers Association (WVPMA),” says Lyn Schuh, WVPMA Convention and Marketing Committee. She is a master of communications and if there is ever a problem or concern, Kim is on it.”
Brown Pokorny has been a fundamental member in creating and executing a multi-faceted, multi-phase program to address proper drug use on farms, called What Matters – veterinarians and producers working together to ensure save meat and milk. However, one of the most important aspects of this program is the full-day trainings for the veterinarian-producer team on the WVMA HACCP For Proper Drug Use which emphasizes and strengthens the importance of a valid, working veterinary-client-patient relationship, which Pokorny organizes and attends to help in answering questions. Brown Pokorny resides in Waupun with her husband Doyle and their three children, Dylon, Katrina and Cameron.
Dr. Philip Johnson and Dr. James Kazmierczak Awarded WVMA Meritorious Award
The Meritorious Service Award is given to veterinarians in recognition of their service, commitment, and contributions specifically to the WVMA and organized veterinary medicine. Two veterinarians were selected as recipients. Dr. Philip Johnson was nominated for his years of commitment to the WVMA and organized veterinary medicine.
Since joining, Dr. Johnson has been an active member of the WVMA. He has served on the Legislative Committee, as the District 3 representative on the Executive Board, been a member of the Executive and Personnel Committees and was president in 2010.
As a member of the Executive Board, he pushed for required veterinary continuing education. Dr. Johnson believes this keeps the profession moving forward in the life long education process. This requirement has increased attendance at local and state meetings offering continuing education across the state.
Dr. Johnson practices small animal medicine at Omro Animal Hospital and reside in Winneconne with his wife, Molly.
Since joining in the WVMA, Dr. James Kazmierczak has been an active member of the WVMA Public Health and Food Safety Committee.
As a member of the committee, he has been a knowledgeable source for all matters related to zoonotic diseases. Joining the committee in 2001, Dr. Kazmierczak has always been willing to provide additional information and/or create educational material.
Dr. Kazmierczak is the State Public Health Veterinarian with the Wisconsin Division of Health, Bureau of Communicable Disease and Emergency Response along with being an adjunct professor at UW-Madison Department of Population Health Sciences in the School of Medicine and Public Health and in the Department of Pathological Science at the School of Veterinary Medicine.
Representative Dean Knudson, DVM Awarded WVMA Presidential Award
State Representative Dr. Dean Knudson of Hudson was awarded the President's Award. The President's Award is given by the outgoing president to a person or company who, in the opinion of the president, has provided extraordinary service to the WVMA.
During the past two years, Rep. Knudson has been a vital liaison between the WVMA, Wisconsin veterinarians and our state government. As a practicing veterinarian and state assemblyman, he has served as not only a voice for the people of the 30th Assembly district, but also brings a combination of practical veterinary medicine and small business experience to Madison that only a veterinarian can. His work and leadership in promoting and obtaining the Prescription Drug Monitoring Program repeal for veterinarians was critical for the WVMA's success. Rep. Knudson is a vital ally to Wisconsin veterinarians on issues affecting the profession and small businesses in general.
Dr. Knudson is a graduate of Iowa State University School of Veterinary Medicine and now practices in Hudson. He is married, with two children and was first elected to the state assembly in 2010 and re-elected in 2012. | 医学 |
2014-42/1179/en_head.json.gz/23534 | Parents And Addiction Experts Call For I-STOP Legislation
Written by Ronald Scaglia: [email protected] Thursday, 31 May 2012 00:00 “Mommy, help me. How did I get into this? Get me out of this.”Maria Basmas recalls those heartbreaking words that her son, Christopher, spoke to her while he was in the throes of an addiction to prescription medication, specifically Xanax and Oxycodone. She recalls the painful ordeal that her family went through as her son struggled to do simple tasks that most people can do effortlessly. She recalls the pain she felt as she helplessly watched her son have difficulty walking, speaking, getting out of a shower and holding a spoon. And most painfully, she recalls the awful day last October when her son lost his battle. While fighting through the pain, Basmas joined with other parents whose children have also battled prescription drug addiction who are demanding tighter controls on the availability of prescription pills. They are calling on New York State lawmakers to pass I-STOP legislation, which would require physicians to check an online database before prescribing prescription pills. It is hoped that by creating a more effective database, it would put an end to the process of “doctor shopping,” in which some obtain prescriptions from multiple physicians to collect a supply of controlled substances to feed an addiction or sell for profit. “I feel it is very easy for them to get these pills,” said Basmas through tears.Dr. Jeffrey Reynolds, executive director of the Long Island Council on Alcohol and Drug Dependence (LICADD), expressed frustration at the lack of action in getting the legislation passed. He says that lawmakers called for measures to halt the abuse of prescription medications after the fatal shootings at a Medford pharmacy last Father’s Day and he further added that the New York State attorney general stood with elected officials in LICAAD’s Mineola office in February and said that legislation would be forthcoming. Yet, it has not happened.“Now it’s May,” said Reynolds. “Mother’s Day is upon us and we still have no legislation. Since they promised initially to do the legislation back in June, [there have been] more than 300 fatal overdoses in Nassau and Suffolk County [and] an untold number of car crashes; kids are run down in the street by drivers who are high on prescription medicine.”It is hoped that I-STOP would be more effective than the current online database. If enacted, it would require doctors to check an online database to ensure that patients have not received a prescription for a controlled substance from another doctor.“The message is very clear,” said Reynolds. “Get it done. We’re losing too many lives.”Saveria, a mother of two children who are recovering from drug addictions, blasted doctors who recklessly prescribe medications to children with no regard for the potential consequences.“They’re basically writing a death sentence to our children,” she said. “ It’s a crime. Our insurance pays for all this. The insurance, the doctors, I call it one big drug ring. They need to see the look in our kids’ eyes when they write out these prescriptions.”Bob and Charlene Streppal also have a daughter who is recovering from a drug addiction. Expressing similar sentiments, they also both called for the I-STOP legislation to be passed.“Our taxes pay for this,” said Charlene. “We need to control the controlled substances.”According to Reynolds, the legislation hasn’t passed because it is meeting opposition from the medical community. In particular, Reynolds said that some are arguing that requiring physicians to check a database places an additional burden on doctors and takes time away from practicing medicine, claims that Reynolds dismisses.“My doctor ensures that he gets enough information to ensure he gets paid,” said Reynolds. ‘We’re in the midst of an epidemic.”Another concern is the right to privacy. The prescription medications, which are being abused and sold for profits, do indeed have legitimate purposes for those with bona fide medical conditions. It has been suggested that creating a database invades the privacy of the many who use controlled substances as intended for authentic medical conditions. Reynolds concurred with this and said that those who struggle with chronic pain should have access to these medications, which improve their quality of life. He emphasized that his organization is not trying to prevent those who legitimately need these medications from getting them legally. Instead, they are focused on the misuse and the diversion of the medication. He further addressed privacy concerns saying that sensitive medical data is already being relayed between medical professionals and insurance companies.“I would say that there is no more greater threat to privacy with this then through your doctor and your pharmacist ensuring that they’re getting paid from the insurance company,” said Reynolds. “There’s already a ton of information that, for better or for worse, gets transmitted electronically. In the existing database there’s never been a privacy or a security breach.”“It’s important that we pass I-STOP legislation,” said Linda Mangano, wife of Nassau County Executive Ed Mangano. “No parent should have to bear the heartache of losing a child.”One such parent is Teri Kroll of Lindenhurst. Her son, Tim, died from an overdose in August of 2009. He had multiple prescriptions for painkillers. Through tears, she recalled the tragic night, almost three years ago, when she waited for her son to emerge from the emergency room, only never to do so. Her tears intensified when she spoke of the anguish of having to enter that emergency room to say goodbye to her son. Kroll said that she is sharing her story and calling on Albany to pass I-STOP in the hope that it will prevent other parents from enduring such a tragedy.“I’m not the first parent to lose a child to a drug addiction but I would love to be among the last,” she said. | 医学 |
2014-42/1179/en_head.json.gz/23539 | Angel�s Pediatric Heart House was created in February of 2004 by Sonia Perez. Sonia�s late husband, Dr. Angel R. Perez, was a pediatric cardiologist in the South Florida area. Dr. Perez was a respected cardiologist amongst his colleagues and loved by the families he served. In 1999, Dr. Perez was diagnosed with kidney cancer; and in January of 2000, Dr. Perez succumbed to his illness. He left behind a wife and two daughters.
In September of 2000, Mrs. Perez and her daughters hosted a picnic for the families that were under his care. What was really special that day was that parents and children got an opportunity to meet and socialize with other families affected by CHD in a casual and fun atmosphere. The picnic became an annual event, but it became clear that the families needed more than just an annual event, they needed a place outside of the hospital or physician�s office where they could come together and offer each other social and emotional support throughout the year.
Angel�s Pediatric Heart House is a non-residential, congenital heart defects support community. It is a place where the entire family�parents, CHD child, siblings and relatives�can come together and join others affected by CHD to give hope and encouragement and to share their experiences. We look forward to seeing you there.
Coming Soon "Miles and Millas Across America"
Heart Shadow Buddiestm Spreading Hope and Encouragement to Families Affected by Congenital Heart Defects (CHD) - A Congenital Heart Defects Awareness Weektm Yearlong Celebration.
Angel�s Pediatric Heart House is a 501(c)3 nonprofit organization supporting families affected by congenital heart defects. Our mission is to provide a place where families affected by congenital heart defects (CHD) or childhood acquired heart disease can come together to receive encouragement, emotional and social support.
Our vision is to be a leader in the community by helping to alleviate the hardships and challenges of families affected by CHD and promote awareness.
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Email: [email protected] Copyright � 2011 Angel's Pediatric Heart House. All Rights Reserved.
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2014-42/1179/en_head.json.gz/23549 | HomeThis is the archived site - Click here for the new site CCSVI and the Politics of Medicine
Swift Written by Dr. Steven Novella There is a continuing controversy over the hypothesis, first proposed by Italian vascular surgeon, Dr. Paolo Zamboni that multiple sclerosis (MS) is caused by chronic blockage of the veins that drain the brain, called Chronic Cerebrospinal Venous Insufficiency (CCSVI). The current scientific consensus is that MS is a chronic autoimmune disease, and the pathology is caused by primary inflammation. Dr. Zamboni believes that the venous anomalies he has discovered are the primary cause and the inflammation is secondary. If true, Zamboni's hypothesis of CCSVI would be a major paradigm change for MS. It also holds out the promise of a new effective treatment for MS, endovascular treatment - using expanding balloons to open up the narrowed or closed veins. These kinds of controversies take place all the time in medicine. Many diseases are complicated and imperfectly understood, and there are competing theories to explain what we observe. Often there are competing treatments with interesting strengths and weaknesses. While definitive evidence is lacking, personal opinion holds sway. In the best case scenario rigorous studies are performed and a generally accepted standard of care is built on the evidence. Sometimes, however, controversies seem to take on a life of their own, and move into the ideological and political realm where evidence may not hold final sway. It seems that this has happened with the CCSVI controversy. First, let's take a look at the current state of the evidence. In Zamboni's original study he claimed that 100% of MS patients had significant blockage in the large veins that drain the brain. Before we move to theories and studies about how this relates to MS and whether or not treatment is effective it makes sense to test this original observation. If it's true, then more research is warranted. If not, then we move on. There have been a number of attempts to replicate Zamboni's findings, or use other techniques to investigate venous draining to see if it correlates with MS. The results of these studies are (as is almost always the case) mixed. No study has found the 100% results that Zamboni did. Some studies find a correlation between blockage and MS, sometimes there is also an association with other neurological disorders, and in some studies there is no association at all.
In a 2011 review Awad et. al. concluded:
"Currently, there is inconclusive evidence to support CCSVI as an etiological factor in patients with multiple sclerosis. Endovascular procedures should not be undertaken outside of controlled clinical trials." Of note studies have failed to find an association between MS severity and CCSVI, arguing against a causal relationship. Further, studies looking at venous blockage show that only those with >80% blockage had any significant effect on venous function, so lesser degrees of blockage are probably not clinically significant. Having looked at many such controversial issues, my impression of the literature to date is that it is most consistent with the null hypothesis - that CCSVI is not a real and clinically significant phenomenon. The spread of results and lack of clear causal association is consistent with (or at least compatible with) the kind of research noise we see when there is no clear signal. This is different than concluding that the evidence is sufficient to confidently rule out an effect. We are not yet there with CCSVI, and therefore there is room for further research with rigorous blinded designs to settle the issue definitively. Because this is a medical question the issue is complicated by treatment decisions - should we treat MS patients for alleged CCSVI while the data is still inconclusive? This is as much an ethical question as a scientific question. The concept of compassionate use of experimental treatments for otherwise incurable illnesses is generally accepted, but is very tricky in the details of application. MS can be a very severe and debilitating disease, and response to existing treatments is variable. There are certainly patients who have progressive disease despite our best current treatment. Desperate patients are often willing to try any new treatment that promises benefit. At the same time it is not ethical to offer highly implausible treatments to patients that are not supported by at least some evidence. Here, when it comes to CCSVI, experts disagree. Some think there is insufficient reason to progress to clinical trials or to offer compassionate treatment, while others believe that both are indicated. Here is where politics intrudes, especially in Canada where this has been a hot issue. Patients are seeking treatment for CCSVI (the so-called liberation procedure) and clamoring for clinical trials. Some vascular doctors and supporters of CCSVI are also. Most neurologists, however, remain skeptical and think it's premature to progress to clinical trials. These are the kind of issues that should be resolved at scientific meetings and in the literature, with experts fighting it out. Instead, politicians with little medical background are taking charge of the issue with political posturing. The response of some patients in the MS community has also been unfortunately, and perhaps a reflection of the times. Comments to articles on this topic are full of conspiracy mongering, claims that neurologists are just protecting their turf, and accusations of Big Pharma influence and corruption. There is a disturbing disconnect between the science and evidence-based discussion that is happening among experts and the fairy tale view of villains and heroes reflected in the public and political discourse. The intense anger and distrust on display is very counterproductive, and makes me wonder what is its source. Has it always been this way, or is this something new (at least in its magnitude)? I suspect that the rise of the alternative medicine movement and the internet are playing a role. Promotion of anti-mainstream medicine sentiment and distrust of institutions, the government, the "medical industrial" complex, and Big Pharma are all part of the promotion of unscientific medical modalities. I suspect that a lot of the venom we are seeing in the CCSVI debate is being fueled by the spread of these sentiments generally on the internet. Meanwhile, the science trudges on. It seems likely at this point that what will happen is further studies will either be mixed or negative. CCSVI will not gain mainstream acceptance because the evidence will not support it, but it will continue on the fringe - to what extent remains to be seen. Of course, it's possible that there is some truth to the claims of CCSVI, in which case that is eventually what the scientific evidence will show, but I think that is unlikely given current evidence. Steven Novella, M.D. is the JREF's Senior Fellow and Director of the JREF’s new Science-Based Medicine project.Dr. Novella is an academic clinical neurologist at Yale University School of Medicine. He is the president and co-founder of the New England Skeptical Society and the host and producer of the popular weekly science show, The Skeptics’ Guide to the Universe. He also authors the NeuroLogica Blog. | 医学 |
2014-42/1179/en_head.json.gz/23634 | How to Select a Good Support Group
By Kate Thieda
Earlier, I wrote about the benefits of support groups for partners of people with mental illness. Today I have some tips for how to go about selecting an appropriate group.
I’m not going to lie and say that every support group is terrific and that no matter where you go, it’ll be a positive experience. I will tell you that doing some homework, like you did when researching your partner’s illness, will go a long way in your actually getting support from a group.
What to look for in a support group:
What is the focus of the group? Is the group relevant for your situation?
Who is leading the group? Many support groups, such as NAMI’s Family-to-Family program, are led by family members of people with mental illness, or lay people who have a lot of knowledge about the illness, and are often not trained professionals. Support groups are not the same as group therapy.
Is the group open or closed? An open group means you can join at any time. A closed group means that there are openings for new members only at certain times, and you are usually committing to attend the group for its duration, which can be several weeks to months.
How convenient is the group meeting time and place? Like anything else, if you have to struggle to get there, it’s probably not going to work. On the other hand, how committed are you to learning about your partner’s illness and helping yourself cope? If you absolutely can’t attend a group in person, how about online?
How much does the group cost? Usually for a support group, there is no charge. If there is, it may be a donation to the organization sponsoring the group.
Depending on the situation you are facing, finding support groups may or may not be a challenge. Certain illnesses, such as substance abuse, have more support groups available than other illnesses. Don’t give up if you can’t find one right away, as there are online options as well.
Some resources for locating support groups:
Right here on PsychCentral: online and in-person options
Your local NAMI Local Mental Health America site
Referral from your therapist or your partner’s treatment team
For substance abuse, Al Anon or Nar Anon
From the Depression and Bipolar Support Alliance
For people who have attended support groups, what other tips would you give about finding a good group?
Kate Thieda, MS, LPCA, NCC, is a patient advocate for Women's and Children's Services at Duke University Hospital in Durham, North Carolina. She is a licensed professional counselor associate and a National Certified Counselor who specializes in cognitive-behavioral and dialectical behavior therapies. Her book, Loving Someone With Anxiety, will be published by New Harbinger in the spring of 2013.
Like this author?Catch up on other posts by Kate Thieda
Benefits of Support Groups for Partners | Partners in Wellness (April 4, 2011)
Mental Health Social (April 6, 2011)
The F-Word in Mental IllnessWhen Your Partner Has Bipolar DisorderSelf-Care to Prevent Relationship BurnoutBenefits of Support Groups for PartnersA Partner In Pain: How To Help TwoR.E.S.P.E.C.T. Gimme Some Baby!DBSA Conference is DonePart 2: Caregiving & Coping with Disturbing Behavior: Non-Suicidal Self-Injury: 3 Tips!Caregiving & Coping with Disturbing Behavior: Non-Suicidal Self-Injury Peace at the Beach!
Last reviewed: 6 Apr 2011
Thieda, K. (2011). How to Select a Good Support Group. Psych Central. Retrieved on October 23, 2014, from http://blogs.psychcentral.com/wellness/2011/04/how-to-select-a-good-support-group/ | 医学 |
2014-42/1179/en_head.json.gz/23708 | GCMC nurses approve new contract
By Laura Legere
Nurses at Geisinger Community Medical Center have accepted a new contract that includes wage increases and benefits changes, labor and hospital officials announced Friday. The accord extends the collective bargaining agreement for the hospital's 405 registered nurses, certified registered nurse anesthetists and nurse practitioners through January 2017. The nurses' union passed the contract nearly unanimously on Thursday night.The agreement calls for wage increases of between 11 and 16 percent during the three-and-a-half-year period, a gradual transition to Geisinger Health System benefit programs and cost sharing, a premium for bedside nursing, improvements in pay for night and evening shifts and a wellness initiative that will allow participating nurses to cut their health insurance contributions, according to the hospital and union.Hospital leaders and the members of the Pennsylvania Association of Staff Nurses and Allied Employees reached the agreement well in advance of the January 2014 expiration of the current contract. Both sides said they were pleased with the negotiations and the outcome."We certainly have our differences, but I must say that Geisinger approached these negotiations with professionalism and respect," said PASNAP Executive Director Bill Cruice, who was the lead negotiator on behalf of the nurses.The medical center's chief nursing officer, Maureen Fitzsimmons, said the agreement is "fair to everyone.""We were able to establish rates to effectively attract and retain qualified registered nurses," she said. "This is extremely important as Geisinger continues to invest and grow programs in the Lackawanna County area."Hospital CEO Robert Steigmeyer said the agreement is an example of the health system "investing in our workforce." Contact the writer: [email protected]
National Business Video | 医学 |
2014-42/1179/en_head.json.gz/23812 | Winter 2013 Front PageCardiologyHealthy GivingNeuroscienceOncologyOrthopedicsPrimary CarePulmonaryRehabilitationWell-Being Getting To The Heart o...In this issue of Healthy Living, the focus is on Eisenhower’s Cardiovascular Center of Excellence — a fitting topic to start the New Year as many of us make resolutions to improve our fitness. The... click for moreMajid Torabi, MDIn the world of yoga and deep breathing, there is a common saying: a healthy mind has an easy breath. If that is true, the patients of Majid Torabi, MD have him to thank. Board Certified in... click for moreWhite House Briefing O...In 2012, Eisenhower Cardiologist Charlie Shaeffer, Jr, MD met with senior White House officials as part of a discussion with community leaders who are actively involved in the prevention, treatment... click for moreEisenhower Medical Cen...Eisenhower Medical Center has again received full accreditation as a chest pain center from the Society of Cardiovascular Patient Care (SCPC). Originally accredited in 2006 and then in 2009,... click for moreLuke Magnotto, MDThe similarities between Luke Magnotto, MD, Board Certified in Emergency Medicine, and his great-greatgreat… grandfather Leonardo Di Capua, who lived at the end of the Renaissance period (b. 1617 in... click for moreIt’s Berry Good For Yo...One of the best weapons in fighting cancer could be your fork.“Whether you want to prevent cancer or are currently fighting it, it’s important to provide your body with the proper fuel,” says Carolyn Katzin, MSPH, CNS, MNT, a nutritionist who works with Eisenhower Lucy Curci Cancer Center. “My goal here is to help people make small changes that can have a profound effect on overall health.”
If you’ve already begun treatment for cancer, Katzin recommends focusing on two critical areas of your diet. “Getting enough protein is incredibly important,” she says. “For most people, that means adding one more serving per day. Also, sufficient hydration is essential, and in some cases, that means electrolytes as well.” click for moreFive Things You Can Do...1. Plan a Homemade Pizza Party Invite some friends and ask everyone to bring a favorite topping and drink to share. Give awards for most creative and best tasting pizzas.
2. Stretch Your Face Prop yourself in front of a mirror and open your mouth wide, raise your eyebrows, wink, and wiggle your nose and ears, if you can. Laughing is permitted and highly encouraged. 3. Walk Your Neighborhood As Katherine Hepburn once stated, “Exercise each day, in all kinds of weather.” Early mornings are quite pleasant even in the hottest months. click for moreWhat’s In A Label?Have you ever considered the notion that the fewer the ingredients, the less likely you are to ingest a long list of additives? Although it may seem daunting to wend your way through the supermarket reading food labels, knowing exactly what you’re eating is an important step to good health.
Salt The American Heart Association® and The Centers for Disease Control and Prevention™ (CDC) list the recommended adequate amount of daily sodium as 1,500 milligrams or less. click for moreCelebrity Golf Invitat...The 25th annual Frank Sinatra Celebrity Invitational, benefiting the Barbara Sinatra Children’s Center for abused children, tees off February 21-23, 2013. Eagle Falls Golf Course and Fantasy Springs... click for moreDiscover Art!The posh boutiques, upscale restaurants and glitzy galleries of El Paseo in Palm Desert couldn’t have asked for a better new neighbor.
The Palm Springs Art Museum in Palm Desert, located at the... click for moreThe Picture of HealthTom and Michael Rice, big dude and little dude, about to get totally tubular in a gnarly surf sesh at Seaside, dude.
TRANSLATION:Tom and Michael Rice, father and son, enjoy an early November surf... click for more Table of Contents
Breathing Deeply Nothing Short of a Miracle By: Roxanne Jones SPECIAL NOTE: Eisenhower Medical Center recently opened the Eisenhower Pulmonary Specialty Clinic on the main campus in the Wright Building, Suite 201. For more information, call 760-834-3564.Betty Benner was only in her late forties in 1991 when she began experiencing extreme shortness of breath. An avid walker, she had been clocking five miles almost daily, yet found herself having to stop to catch her breath.
“At first, I attributed it to getting older,” she says. “But I wasn’t that old.”
By the time Benner reached her mid-fifties, she was really struggling. “I was having trouble singing lullabies to my grandchildren,” she recalls. “I couldn’t walk across the street without gasping for breath and no one could figure out what was going on.”
In 1997 at a hospital in Oregon, Benner had her first perfusion lung scan, an imaging exam that shows the pattern of blood flow in the lungs. It revealed that she had a condition called chronic thromboembolic pulmonary hypertension (CTEPH).
In people with CTEPH, blood clots lodge in segments of the lungs. This condition increases the blood pressure in the pulmonary (lung) artery, which carries oxygen-poor blood from the lower chamber on the right side of the heart (right ventricle) to the lungs where it picks up oxygen. The increased pressure puts a strain on the right ventricle and, as a result, it begins to weaken. This, in turn, causes symptoms such as shortness of breath, fatigue, dizziness and fainting, heart palpitations and chest pain — all with only minimal exertion.
Benner spent a week in the hospital on a heparin drip (a blood thinner administered intravenously) to help restore blood flow to her lungs, and was told she’d have to take Coumadin® (warfarin, a blood thinner taken orally) for the rest of her life to prevent clot formation. The doctor told Benner’s husband that she might have only two to five years to live because her condition was progressive and couldn’t be cured.
Over the next few years, their business took the Benners to live in Maui, Hawaii, then to Roseville in northern California. During this time, Benner saw several different pulmonologists.
“They all reviewed my films, but other than keeping me on Coumadin, no one thought there was anything they could do,” says Benner.
In 2008, Mrs. Benner and her husband visited the Coachella Valley for a “winter warm-up.” They liked the desert so much that they moved, settling in La Quinta.
Benner began seeing Eisenhower Medical Center Internist John Samples, MD for her primary care. He suggested that she contact Hassan Bencheqroun, MD, FCCP, a specialist in interventional pulmonology and critical care.
“I was burned out,” says Benner. “I’d had every test possible and had resigned myself to ‘this is what it is.’ But Dr. Samples made sure I got an appointment with Dr. Bencheqroun, and the rest is history.”
“When I first saw Betty, her opening statement was ‘every year, I’m losing a little bit more of my breath,’” Dr. Bencheqroun recalls. “She could walk, but the distance was getting shorter and shorter, and she used a wheelchair whenever she went shopping. She was on supplemental oxygen. Once in a while, she’d have heart palpitations and feel lightheaded, signs of severe blood clots in her lung that were putting a strain on her heart.”
Benner also remembers that first meeting. “He was such a delight,” she says. “He said, ‘I will not be afraid of telling you the truth, and I will always treat you like one of my own.’”
Dr. Bencheqroun ordered a series of tests for Benner. He also had Benner see a hematologist (blood specialist) to see if she could find a cause for why Benner’s blood formed so many clots. Dr. Benchegroun suspected she might have a genetic predisposition, since several of her family members had had early heart attacks and strokes.
“There was a pattern of blood anomalies in my family, but no one else had put it together before Dr. Bencheqroun,” recalls Benner.
Most importantly, however, Dr. Bencheqroun believed that Benner was a candidate for a surgical procedure called a pulmonary thromboendarterectomy, a highly specialized, open-chest operation in which chronic blood clots are physically removed from the arteries in the lung. The world’s leading experts in this procedure happened to be at the University of California, San Diego (UCSD), and they agreed that Benner’s case was operable.
“When you remove the obstacle, the blood can do its job, and the patient can regain her quality of life,” explains Dr. Bencheqroun. “It also can extend her life.”
Why had no one recommended this surgery before?
“People don’t know much about CTEPH, therefore it goes unrecognized and untreated,” Dr. Bencheqroun says. “But my message to Betty and others with this condition is, ‘You don’t have to live like this.’ Of all the causes of pulmonary hypertension, CTEPH is the only reversible one. Something can be done about it. And here at Eisenhower, we keep abreast of the latest advances.”
Mrs. Benner underwent the surgery at UCSD on May 7, 2012. Three days post-operation, she was off oxygen. After ten days, she was out of the hospital. Three months later, she took a Mediterranean cruise with her 20-year-old granddaughter. And when she returned, she and her husband took a 4,000-mile road trip throughout the West, visiting such high-altitude destinations as the Grand Tetons and Cascade Mountains.
“My husband had more trouble breathing at high elevations than I did!” smiles Benner. “I really do have a new lease on life.”
“Betty has essentially been cured,” notes Dr. Bencheqroun. “She just needs to stay on a blood thinner due to her inherited disorder, but she can go through the rest of her life naturally.”
“There are no words to describe what I think of Dr. Bencheqroun and Eisenhower Medical Center,” Benner says. “I applaud him and his commitment to make other doctors more aware of circumstances like mine.”
“I want people to know about this condition and to ask their doctors about it,” adds Dr. Bencheqroun. “If we put a face on surgery like this, I hope people will be less afraid, and know they can come out the other side even better.” Healthy Living Magazine is a publication of Eisenhower Medical Center · © Copyright 2014 All Rights Reserved · Email the Webmaster | 医学 |
2014-42/1179/en_head.json.gz/23841 | explore.georgetown.edu
FOR IMMEDIATE RELEASE: April 15, 2010
Karen Mallet (media only)
[email protected]
Drug shared by addicts seems to protect against HIV brain dementia
Could heroin hold the clues for a new protective agent?
Washington, DC – To their surprise, researchers at Georgetown University Medical Center (GUMC) have discovered that morphine (a derivate of the opium poppy that is similar to heroin) protects rat neurons against HIV toxicity- a finding they say might help in the design of new neuroprotective therapies for patients with the infection. The discovery, being presented at the annual meeting of the Society of NeuroImmune Pharmacology, also helps explain why a subset of people who are heroin abusers and become infected with HIV through needle sharing don’t develop HIV brain dementia. This brain disorder includes cognitive and motor abnormalities, anxiety and depression. “We believe that morphine may be neuroprotective in a subset of people infected with HIV,” says the study’s lead investigator, Italo Mocchetti, PhD, professor of neuroscience at GUMC. “That is not to say that people should use heroin to protect themselves – that makes no medical sense at all – but our findings gives us ideas about designing drugs that could be of benefit. “Needless to say we were very surprised at the findings,” he added. “We started with the opposite hypothesis – that heroin was going to destroy neurons in the brain and lead to HIV dementia.” The researchers conducted the study because they knew that a number of HIV-positive people are also heroin abusers, and because of that, some are at high risk of developing neurological complications from the infection. Others, however, never develop these cognitive problems, Mocchetti says. Because little is known about the molecular mechanisms linking opiates and HIV neurotoxicity, Mocchetti and his team conducted experiments in rats. They found that in the brain, morphine inhibited the toxic property of the HIV protein gp120 that mediates the infection of immune cells. With further investigation, they concluded that morphine induces production of the protein CCL5, which they discovered is released by astrocytes, a type of brain cell. CCL5 is known to activate factors that suppress HIV infection of human immune cells. “It is known to be important in blood, but we didn’t know it is secreted in the brain,” says Mocchetti. “Our hypothesis is that it is in the brain to prevent neurons from dying.” They say morphine blocked HIV from binding to CCR5 receptors it typically uses to enter and infect cells. The researchers believe CCL5 itself attached to those receptors, preventing the virus from using it. In this way, it prevented HIV-associated dementia. This effect, however, only worked in the M-trophic strain of HIV, the strain that most people are first infected with. It did not work with the second T-trophic strain that often infects patients later. “Ideally we can use this information to develop a morphine-like compound that does not have the typical dependency and tolerance issues that morphine has,” says Mocchetti. The study was funded by the National Institute on Drug Abuse, part of the National Institutes of Health. Moccetti reports no related financial interests. About Georgetown University Medical Center Georgetown University Medical Center is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through Georgetown’s affiliation with MedStar Health). GUMC’s mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis -- or "care of the whole person." The Medical Center includes the School of Medicine and the School of Nursing and Health Studies, both nationally ranked, the world-renowned Lombardi Comprehensive Cancer Center and the Biomedical Graduate Research Organization (BGRO), home to 60 percent of the university’s sponsored research funding. ### | 医学 |
2014-42/1179/en_head.json.gz/23927 | Public Affairs Home | Table of Contents | Contact the Editor Health Sciences Report Summer 2003
By Jeffrey R. Botkin, M.D., M.P.H.
U of U associate vice president for research integrity
Professor of pediatrics and
adjunct professor of human genetics and internal medicine
U of U School of Medicine
Why does a university need a vice president to oversee research integrity?
Roughly 40 years ago, a Harvard anesthesiologist, Henry Beecher, published an analysis of 22 clinical research articles that had appeared in the U.S. medical literature. Beecher made the startling claim that these articles and similar publications demonstrated that unethical research was commonplace.
In some projects, for example, numerous subjects died when treatments of known efficacy were withheld in placebo-
controlled trials. It was apparent that, for the occasional scientist, the zeal for discovery clouded ethical judgment. This landmark article became one of the cornerstones of contemporary research ethics and was instrumental in founding our current system of peer review and informed consent for research. From the 1970s through the early 1990s, a series of professional groups, fueled by broad social dialogue, established a set of standards and regulations by which human subject research is to be conducted. A key element of the new process is the Institutional Review Board, or IRB. This panel, composed of academic peers and lay participants, has the responsibility of reviewing research protocols to address research ethics, including the informed consent of participants. Without IRB approval, a human research protocol cannot be conducted. While this system is cumbersome, it has placed the protection of research subjects at the forefront of an institution's research enterprise.
In the last three years, there has been renewed attention to research ethics. In part, this is due to high-profile tragedies, like the deaths | 医学 |
2014-42/1179/en_head.json.gz/23966 | Aetna Settlement Favorable to Psychologists and Their Patients
PR Newswire Association LLCWASHINGTON, Dec. 11, 2012 /PRNewswire-USNewswire/ -- The following is being released by the American Psychological Association Practice Organization:Aetna has agreed to a $120 million settlement of a class action lawsuit filed by psychologists, other health care professionals and patients in the federal court in New Jersey. The lawsuit alleges that Aetna used a faulty database to underpay claims for services from out-of-network providers. Aetna licensed the Ingenix database to determine payment for out-of-network services. The Ingenix database, however, allegedly was flawed and consistently understated what is known as the "usual, customary and reasonable" (UCR) reimbursement rate. The UCR is supposed to represent the "going rate" that health care professionals charge for their services in a particular geographic area of the country.These allegations were the basis for a class action lawsuit against Aetna filed in 2009 by providers, policy holders and health professional associations, including the New Jersey Psychological Association (NJPA). A settlement was reached with Aetna on December 7th.Aetna, United HealthCare, owner of Ingenix, and other insurers agreed to stop using the Ingenix database pursuant to settlements with the New York Attorney General in 2009. That settlement led to the creation of the FAIR Health database, designed to replace the Ingenix system with a more accurate and transparent system. Insurers nationwide can use the FAIR Health database to determine reimbursement rates for out-of-network claims. Like several insurers, however, Aetna bases its rates instead on Medicare rates.Barry Helfmann, PsyD, NJPA Director for Professional Affairs said, "We're pleased with the outcome of this case and glad to see patients and their psychologists getting compensation for past underpayments."Additional class action suits against other companies that used the Ingenix database are still pending. They include a case in which the California Psychological Association is one of the plaintiffs against the WellPoint/Anthem companies, and other cases in which NJPA is a plaintiff against CIGNA and Horizon Blue Cross Blue Shield of New Jersey."We hope that cases like these will result in fairer reimbursement practices by the insurance companies and ultimately create greater access to mental and behavioral health services for patients," said Katherine C. Nordal, PhD, executive director of the American Psychological Association Practice Organization, which works with state psychological associations to provide legal, policy, communications and other support on managed care lawsuits and advocacy issues.The American Psychological Association Practice Organization is an affiliate of the American Psychological Association, the largest scientific and professional organization representing psychology in the United States. APA's membership includes more than 137,000 researchers, educators, clinicians, consultants and students. SOURCE American Psychological Association Practice OrganizationWordcount:429 | 医学 |
2014-42/1179/en_head.json.gz/24005 | Native Americans and Medicaid: Coverage and Financing Issues « » The Henry J. Kaiser Family Foundation
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Native Americans and Medicaid:Coverage and Financing Issues
Medicaid as Medicare Premium Assistance
The Medicare program provides health insurance coverage for the nation’s elderly and disabled.16 To enroll in Medicare Part B, which offers coverage for physician and other outpatient care, individuals must be 65 or older or must be disabled, and must pay a monthly premium. This monthly premium, which is generally deducted from an individual’s Social Security check, is $43.80 per month in 1997. The Balanced Budget Act of 1997 raises the Part B premium to $67.00 per month by 2002. To protect low-income Medicare beneficiaries against these monthly premium costs, all state Medicaid programs are required to pay the entire Part B premium amounts on behalf of certain groups of Medicare beneficiaries, including Native American Medicare beneficiaries:
Dual Eligibles. These are elderly or disabled individuals who are eligible for both Medicare and Medicaid benefits. State Medicaid programs are required to pay on behalf of these individuals the entire Medicare Part B monthly premium as well as Medicare deductibles and co-insurance requirements. Dual eligibles are also entitled to coverage of nursing home care, prescription drugs, and other Medicaid benefits that are not covered by Medicare.
QMBs. Qualified Medicare beneficiaries, or QMBs, are Medicare beneficiaries who are not also eligible for Medicaid benefits but who have incomes at or below 100 percent of the poverty line ($7,890 for an individual, $9,870 for a couple in 1997) and countable resources no greater than $4,000. Like dual eligibles, QMBs are entitled to have payment made by Medicaid on their behalf for the entire Medicare Part B monthly premium as well as Medicare deductibles and co-insurance requirements. Unlike dual eligibles, QMBs are not eligible for full Medicaid benefits and are not entitled to Medicaid coverage of nursing home care or prescription drugs.
SLIMBs. Specified Low-income Medicare Beneficiaries, or SLIMBs, are Medicare beneficiaries with income between 100 and 120 percent of the poverty line (up to $9,468 for an individual and $12,732 for a couple) and countable resources no greater than $4,000. SLIMBs are entitled to have payment made on their behalf by state Medicaid programs for the cost of the monthly Medicare Part B premium. Unlike QMBs, SLIMBs are not entitled to Medicaid payment of their Medicare deductible or coinsurance requirements. Unlike dual eligibles, SLIMBs are not entitled to Medicaid payment of nursing home care, prescription drugs, or other services that Medicaid covers.
Under the Balanced Budget Act of 1997, states are required to pay some or all of the Medicare Part B premium on behalf of Medicare beneficiaries with incomes between 120 and 135 percent of the poverty line. A fixed amount of federal funding for this premium assistance is provided to each state for each of the next 5 years; no state is required to contribute any of its own funding. Unlike SLIMBs, these individuals are not entitled to premium assistance; states are required only to select individuals from qualified applicants on a first-come, first-served basis, up to the amount of federal funding available. Because the statute does not require that states notify near-poor Medicare beneficiaries of their potential eligibility for this assistance, the IHS and the tribes will, as a practical matter, frequently be the only source of information about this benefit for Native American Medicare beneficiaries.
Medicaid as a Source of Long-Term Care Coverage
Medicaid is the nation’s single largest purchaser of nursing home care. More than half of all nursing home revenues come from Medicaid. The program also covers a wide range of home- and community-based (HCBS) services for frail elderly and chronically ill disabled individuals who are at risk of nursing home care. The transition to managed care that is occurring in Medicaid’s purchase of acute care services has generally not reached the long-term care sector. Most Medicaid nursing home and HCBS services are still paid for on a fee-for-service basis. Because nursing home care costs on average $40,000 per year, the availability of Medicaid coverage for nursing home and other long-term care services is a major source of financial protection for low- and moderate-income families. It is particularly important to Native American families because few IHS or tribally-operated facilities offer comprehensive long-term care services.17 Yet it is precisely the high cost of these services that has lead many states to impose restrictive income and resource eligibility requirements on elderly and disabled individuals and their spouses. In addition, federal law requires that states seek to recover the costs of Medicaid nursing home care from the estates of deceased beneficiaries and authorizes the states to impose liens in certain circumstances in order to carry out such recoveries. These restrictive eligibility and estate recovery rules have reportedly discouraged many otherwise eligible Native Americans from establishing eligibility for Medicaid nursing home coverage.
III: Policy Issues For Native Ameircans In Managed Care
The Medicaid program’s historic shift from fee-for-service to managed care presents critical policy issues for the IHS, for tribes and their health programs, and for urban Indian health programs. Because state Medicaid programs differ from one another, and because local circumstances vary considerably, these issues will take different forms in different communities. Many of the issues raised by Medicaid’s shift to managed care are not unique to eligible Native Americans but affect all Medicaid beneficiaries.18 There are, however, some issues unique to Native Americans that are also common to all state Medicaid programs:
Preserving Choice for Medicaid-Eligible Native Americans. The Balanced Budget Act of 1997 overrides the right to freedom of choice of provider for most Medicaid beneficiaries by giving the states express authority to require Medicaid beneficiaries to enroll in MCOs or PCCMs. However, states under this authority may only force eligible American Indians and Alaska Natives to enroll in MCOs or PCCMs if these managed care entities are operated by the IHS, by a “638” tribe, or by an urban Indian organization. The purpose of this limitation on state flexibility is not so much to assure that Native American Medicaid beneficiaries have choice of providers; they will generally have a choice because IHS and tribal providers cannot refuse to treat Indians who are eligible for their services. Instead, the purpose of this provision is to assure that, when these beneficiaries obtain care from IHS or tribal providers, the providers, rather than MCOs or PCCMs unaffiliated with the IHS or the tribes, receive Medicaid reimbursement for the covered services they deliver. The provision does not bar Medicaid-eligible Indians from voluntarily enrolling in an MCO or PCCM that is not affiliated with the IHS or a tribe.
For many Native American Medicaid beneficiaries, the issue of choice of provider is more theoretical than practical, especially in sparsely-populated rural areas with few physicians or clinics or hospitals. Medicaid coverage that allows beneficiaries to choose from among all participating providers means little in underserved areas that have few providers of any kind, much less providers that participate in Medicaid. The movement toward Medicaid managed care has the potential to improve these circumstances and give Native American beneficiaries more choices. For example, if states opt to enroll all rural Medicaid beneficiaries in one MCO or PCCM, the resulting Medicaid market could potentially attract established, reputable managed care firms and give them an incentive to bring primary care physicians and other providers into these areas in order to be able to offer the necessary provider networks. However, the availability of more provider choices for Native American beneficiaries has potentially adverse consequences for traditional Native American delivery systems, whether operated by the IHS or by “638” tribes. If significant numbers of Native American beneficiaries elect to enroll in an MCO or PCCM unaffiliated with the IHS or a tribal facility, the Medicaid revenues of the IHS or tribal facilities will likely decline, undermining their capacity to deliver quality care to their remaining patients. The current law provision – prohibiting states from enrolling Indian beneficiaries in MCOs or PCCMs that are not operated by the IHS or tribal “638” contractors – is not a sufficient protection against this result. If the MCO or PCCM with which the state contracts does not in turn contract with the IHS or tribally-operated facilities in the area, the Indian beneficiaries who do not choose to enroll in the MCO or PCCM would continue to receive care on a fee-for-service basis from the IHS or tribal facility. This would tend to isolate both the Indian beneficiaries and the IHS or tribal facilities from the Medicaid patients and providers in the rest of the area – not necessarily a desirable outcome. This result could be avoided if MCOs or PCCMs that receive the Medicaid franchise for the rural area were required to allow any IHS or tribally-operated facility in the area meeting the entity’s quality standards to participate – if the facility so chooses – on terms at least as favorable as those offered to other facilities. In addition, the Secretary of HHS should consider not granting waivers that would allow states to require Native American beneficiaries to enroll in MCOs or PCCMs that have not incorporated IHS or tribal facilities into their provider networks.
Protecting IHS, Tribal, and Urban Indian Providers. Medicaid revenues can make the difference between a financially viable hospital or health clinic and a facility that must reduce the services it offers or close altogether. To the extent that Medicaid-eligible Indians enroll (or under waivers are enrolled by the state) in MCOs or PCCMs, the funding to pay for the provision of covered services to these patients will flow to the MCO or PCCM. Unless the IHS or tribal or urban Indian facility is affiliated with the MCO, either as an owner or as a subcontractor, or unless the facility has an arrangement with the state under which it will be reimbursed for treating Indian MCO enrollees who go “out of network,” the facility will lose some or all of the Medicaid revenues associated with these patients. The loss of these revenues can in turn undermine the capacity of the facility to deliver quality care to the Indian population that it is responsible for serving as well as any non-Indian patients it undertakes to serve.
The federal government has a strong interest in the financial viability of IHS, tribal, and urban Indian health care providers. These providers enable the federal government to discharge in part its legal obligation to cover the cost of basic health care to Native Americans and to promote tribal self-determination. In addition, these providers are frequently the only practical source of health care for Indians and other Americans living in underserved rural areas. Because the federal government, on average, pays 57 percent of the cost of the Medicaid program, it also has an interest in assuring that Medicaid payment policies support rather than undercut the IHS, tribal, and urban health care programs that it funds with appropriated dollars. State Medicaid programs have a strong financial incentive to facilitate the use of IHS or “638” tribally-operated health facilities by Medicaid beneficiaries who are Native Americans. As noted above, under federal statute and a HCFA-IHS Memorandum of Agreement (MOA), the federal matching rate for state expenditures in such cases is 100 percent; the state is not required to contribute any of its own funds. However, if the beneficiary receives covered services from a non-IHS or non-tribal provider, the state must assume between 20 and 50 percent of the cost. If states are aware of their financial interest and take advantage of it, they will be seeking to work with IHS and tribal providers to maximize the use of those facilities by Native American beneficiaries, and the Medicaid revenues associated with those beneficiaries should improve the fiscal position of those facilities. The need to sustain an IHS and tribally-run health care infrastructure has a number of policy implications. It means that Medicaid fee-for-service payments made directly to Indian hospitals and clinics must be adequate to cover the costs of care. (The recent amendment phasing out cost-based payments to federally-qualified health centers (FQHCs) runs counter to this). Similarly, Medicaid payments to MCOs should be conditioned on the affiliation of MCOs with IHS, tribal, and urban health care programs that meet the MCO’s quality standards. State payment rates to MCOs for eligible Native American enrollees should be adequate to enable the MCOs to pay subcontracting programs their costs of treating Indian beneficiaries, and the MCOs should be required to pay the subcontractors at an adequate level in a timely fashion. Finally, the federal government (through the IHS or through a tribally-accountable entity subcontracting with the IHS) should make start-up capital and technical assistance available to tribal programs (or IHS facilities) that seek to become MCOs or PCCMs and contract with their state Medicaid programs to enroll Medicaid beneficiaries residing in their service areas. Program Data. To date, the transition toward managed care has led to a decline in the quality of Medicaid program data available to the federal government and the tribes, among others.19 However, this transition has the potential of significantly improving the data available to tribes, to the IHS, and to federal and state policy-makers regarding the impact of Medicaid coverage on the use of health services by, and the health status of, Native Americans. To realize this potential, however, current reporting requirements will need to be significantly strengthened. Currently, neither the IHS nor the Health Care Financing Administration (HCFA) have reliable data on how many American Indians or Alaska Natives in each state are enrolled in Medicaid; how many of these individuals are enrolled in a Medicaid MCO or PCCM; and the average cost of covering these beneficiaries through fee-for-service or through managed care. As a condition of receipt of federal Medicaid funds, states could be required to report this data on a quarterly basis, broken down by category (non-disabled child under 19, disabled individual, aged individual, and non-disabled, non-elderly adult). In addition, MCOs or PCCMs contracting with state Medicaid programs should be required to report to the State Medicaid agencies encounter data with respect to Native American enrollees, including encounter data sufficient to monitor compliance with the early and periodic screening, diagnostic, and treatment (EPSDT) program for children. The State Medicaid agencies, in turn, should make this information (without individual patient identifiers) available to tribes and IHS available on request.
In the coming years, the IHS, Medicaid, and state welfare programs will continue to evolve in response to changes in the economy, changes in the health care system, and changes in budgetary and regulatory policy at the state and federal level. These changes will have profound implications for tribes and their health care programs and, ultimately, for the health status of Native Americans. In all likelihood, these changes will intensify the challenges described in this Policy Brief and create new ones. It is crucial that these developments be carefully monitored to identify problems as they arise and to give the tribes and the IHS the information they need to improve the access of Native Americans to quality health care services.
1. See Medicaid Facts: Medicaid Program at a Glance, November 1997; Medicaid Facts: Medicaid and Managed Care, November 1997; Medicaid Facts: Medicaid’s Role for Children, November 1997; Policy Brief: Restructuring Medicaid — Key Elements and Issues in Section 1115 Demonstration Waivers, May 1997.
2. For a general overview of these provisions, see Andy Schneider, Overview of Medicaid Provisions in the Balanced Budget Act of 1997, P.L. 105-33, Center on Budget and Policy Priorities, September 3, 1997, http://www.cbpp.org. 3. See Kaiser Family Foundation, A Forum on the Implications of Changes in the Health Care Environment for Native American Health Care (1997).
4. U.S. Department of Health and Human Services, Indian Health Service, Regional Differences in Indian Health 1996.
5. These figures were reached by a CBPP analysis of unpublished data from March 1997 CPS, Bureau of the Census. The percentages sum to more than 100 percent because some Native Americans had multiple sources of insurance coverage. 6. Indian Health Service, IHS Medicare and Medicaid Eligibility Data Current as of August 12, 1997, compiled September 23, 1997.
7. At its Winter, 1996 meeting, the National Governors’ Association adopted the following policy: “States do not have treaty-based trust responsibilities to provide health care to Native American peoples and, consequently, have no proper role in the financial support or operation of Indian Health Service facilities.”
8. “Indians and other native Americans are entitled under the Fifth and Fourteenth Amendments to the Constitution of the United States, and title VI of the Civil Rights Act for 1964, to equal access to State, local, and Federal programs to which other citizens are entitled.” Department of Health, Education and Welfare (HEW), Memorandum of Agreement, January 7, 1975.
9. In a case involving a dispute over the entitlement of Indians living off the reservation to federal benefits, the Supreme Court in Morton v. Ruiz, 415 U.S. 199 (1974) recognized that “[an Indian thus is entitled to social security and state welfare benefits equally with other citizens of the State.” Id. at 209, n. 11 (citing State ex rel. Williams v. Kamp, 106 Mont. 444, 449, 78 P.2d 585, 587 (1938); U.S. Dept. of the Interior, Federal Indian Law 287, 516 (1958)).
10. In Morton, the Supreme Court also noted that “[a]ny Indian, whether living on a reservation or elsewhere, may be eligible for benefits under the various social security programs in which his State participates and no limitation may be placed on social security benefits because of an Indian claimant’s residence on a reservation.” Morton, 415 U.S. at 209.
11. Under section 1115 of the Social Security Act, the Secretary of Health and Human Services is authorized to waive many of the requirements of federal Medicaid law to enable states to receive federal Medicaid matching funds for carrying out demonstration projects that in the Secretary’s judgment, “is likely to assist in promoting the objectives of [the Medicaid program].” See Kaiser Medicaid Commission Policy Brief, Medicaid: Key Elements and Issues in Section 1115 Demonstration Waivers (May 1997).
12. Peter J. Cunningham, “Health Care Utilization, Expenditures, and Insurance Coverage for American Indians and Alaska Natives Eligible for the Indian Health Service,” Changing Numbers, Changing Needs: American Indian Demography and Public Health, National Research Council, 1996, at 291.
13. A further complication occurs if an MCO or PCCM is not owned or operated by the IHS or by a tribe or tribal organization, but subcontracts with IHS or tribal facilities or programs to deliver services covered under Medicaid risk contract with the state. It is not clear if the capitation payments to the MCO on behalf of Indian beneficiaries are subject to 100 percent matching if the beneficiary uses the IHS or tribal subcontractor.
14. This and the following examples of current arrangements are described in Mim Dixon, Case Studies of Managed Care in Indian Health, National Indian Health Board. February, 1997. pp. 28-40.
15. See Sara Rosenbaum and Ann Zuvekas, Integrating Indian Health Programs into Medicaid Managed Care Systems: A Round Table Sponsored by the Indian Health Service, Final Summary Report, April 25, 1996.
16. For an overview of Medicare, see Harriet Komisar, James A. Reuter, Judith Feder, and Patricia Neuman, Medicare Chart Book, The Kaiser Medicare Policy Project, June, 1997. For a study of issues affecting low-income Medicare beneficiaries, see Patricia B. Nemore, Variations in State Medicaid Buy-in Practices for Low-Income Medicare Beneficiaries, Henry J. Kaiser Family Foundation, November, 1997. For a summary of these issues, see Medicaid’s Financial Protections for Medicare’s Poor and Near-Poor, Henry J. Kaiser Family Foundation, November 1997.
17. Indian Health Service. National Resource Directory for American Indian and Alaska Native Elders. June 1996.
18. For more information on Medicaid and managed care, see Medicaid Facts: Medicaid and Managed Care, Kaiser Commission on the Future of Medicaid, November 1997. Schneider, et al, Background Paper: Medicaid and Managed Care, Henry J. Kaiser Family Foundation, December 1997.
19. David Liska et al., Medicaid Expenditures and Beneficiaries, National and State Profiles and Trends, 1990-1995, Kaiser Commission on the Future of Medicaid, November, 1997, Authors’ Note, p. xiii. Return to top
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2014-42/1179/en_head.json.gz/24032 | Hospitals and health systems
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We are proud to be a national leader in Joint Commission accreditation. Whereas just seven percent of home health agencies nationwide have achieved Joint Commission accreditation, 100 percent of our home health and hospice locations have earned accreditation or are completing the accreditation process.
A total of 124 LHC Group home health locations have been ranked among the 2014 HomeCare Elite, an independent rating of home health quality and performance. The 2014 HomeCare Elite listing, compiled annually by OCS HomeCare and DecisionHealth, names the top 25 percent of home health agencies in the United States.
We also helped one of our joint venture partners, New Orleans-based Ochsner Health System, secure a $3.8 million Health Care Innovation Award from the U.S. Department of Health and Human Services. The award is funding efforts to improve the care of stroke patients in the acute and post-acute settings. The program is expected to reduce readmissions and save an estimated $5 million over the next three years.
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2014-42/1179/en_head.json.gz/24070 | News Media GalleryExpertiseSocial MediaContact UsMedia Policies Want to help? Learn about ways to give and volunteer »
News & Media Room > News Releases > Some Heart Tests May Not Be Gauge for Best Treatment
Some Heart Tests May Not Be Gauge for Best Treatment
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Page BodyCOLUMBUS, Ohio – Medical tests used to determine the extent of damage to a patient’s heart may be useful in predicting which patients can benefit from surgical treatment or medical therapy; however, such testing is not an effective tool in identifying which treatment will provide the greatest chance of survival.The long-awaited study results will aid clinicians who must determine how to treat patients with coronary artery disease and left ventricular dysfunction, according to Philip Binkley, a study author and cardiologist at Ohio State University Medical Center. For researchers, the study leaves open a door for further study of testing regimens, such as magnetic resonance imaging, that may be more accurate in selecting myocardial viability.Results of the National Institutes of Health-initiated study were presented today (4/4) at the American College of Cardiology’s scientific conference. The study is published online in the New England Journal of Medicine at http://www.nejm.org/doi/full/10.1056/NEJMoa1100358 . There were 99 study sites in 22 countries, and OSU Medical Center led the country with enrollment.“The data suggests that in the presence of coronary artery disease, studies of myocardial viability do not direct practitioners in the need for coronary artery bypass,” said Binkley, the site principal investigator in a sub-study for the Surgical Treatment for Ischemic Heart Failure (STICH) trial.Tests for myocardial viability attempt to identify areas of heart muscle that are "living" but have a reduction of blood flow. Tests used in the study were the single photon emission tomography and dobutamine echocardiography.“The study demonstrates that the presence of significant coronary artery disease rather than evidence that the heart muscle will improve with bypass surgery should dictate the treatment,” said Binkley. Among the 1,212 STICH trial participants, 601 had assessments for myocardial viability. Of these, 298 were randomized to medical therapy including coronary artery bypass graft and 303 were selected for medical therapy alone.A total of 178 (37 percent) of the 487 patients with viable myocardium and 58 (51 percent) of the 114 patients without viable myocardium died. However, the association with mortality was not significant after adjustment for other baseline variables. The viability studies did not include newer methodologies, such as MRI, that may be more accurate in selecting myocardial viability, according to Binkley. Future studies, using newer and advanced resources, may be more proficient in determining patient assignment for surgery or medical treatments.“The study tells us that noninvasive assessment of myocardial viability may guide patient management. Multiple imaging techniques have been developed to assess viable and nonviable myocardium by evaluating perfusion, cell membrane integrity, mitochondria, glucose metabolism, scar tissue, and contractile reserve,” added Binkley.The study by Binkley and other researchers is one of two major studies presented at the American College of Cardiology conference today. OSU Medical Center cardiologist William Abraham is author of a companion study from the STICH trial that examined coronary artery bypass surgery in patients with left ventricular dysfunction. A copy of the news release for Abraham’s study is available at: http://medicalcenter.osu.edu/mediaroom/Pages/release.aspx?newsID=6481###
Related Links: Click here for a high-quality JPEG of Dr. Philip Binkley
David CrawfordPublic Affairs and Media [email protected]
Research Findings; Heart Disease | 医学 |
2014-42/1179/en_head.json.gz/24073 | New drug target for Alzheimer's, stroke discovered October 11th, 2011 in Alzheimer's disease & dementia / A tiny piece of a critical receptor that fuels the brain and without which sentient beings cannot live has been discovered by University at Buffalo scientists as a promising new drug target for Alzheimer's and other neurodegenerative diseases. The research on the NMDA (N-methyl-D-aspartate) receptor is being published online Oct. 11 in Nature Communications.
"This is the first time that this site has been shown to be useful as a drug target," says Gabriela K. Popescu, PhD, associate professor of biochemistry in UB's School of Medicine and Biomedical Sciences and senior author on the study.
"If we could find a drug that attaches itself to this site and locks together NMDA receptor subunits, that would be huge for fighting disability from stroke and Alzheimer's and other neurodegenerative diseases."
The research focuses on the brain's receptors for the neurotransmitter, glutamate, which is implicated in these diseases as well as in other conditions, such as glaucoma.
The two main glutamate receptors in the brain are NMDA and AMPA receptors, both of which play critical roles in human learning and memory. Both types of receptors are made of four subunits and within each receptor these subunits are organized in pairs called dimers.
Because these receptors are so similar in structure, Popescu explains, it was assumed that they function in much the same way.
"But when we altered the dimer interface, the site where two subunits come together within each pair, we found that the NMDA receptor works just the opposite of the way that the AMPA receptor works," Popescu explains. "Cementing this interface in AMPA receptors leads to more activity, whereas we found just the opposite to be true in NMDA receptors."
By locking the subunits together, the UB researchers were able to achieve a marked reduction in NMDA activity and, subsequently, a marked reduction in the amount of calcium that enters neurons in response to the neurotransmitter glutamate. Calcium overload due to overactive NMDA receptors is what eventually kills off neurons, Popescu explains, leading to the symptoms that occur after a stroke, and in Alzheimer's and other neurodegenerative diseases.
"The fact that by cross-linking the subunits, we could so dramatically reduce NMDA receptor activation demonstrates, for the first time, the tantalizing possibility that we may be able to develop new therapies that can much more effectively treat, or even one day prevent, some of these devastating diseases, like Alzheimer's and stroke," says Popescu.
And, because each type of NMDA receptor has a slightly different dimer interface, Popescu explains, this finding represents a new opportunity for rationally designing drugs that would preferentially inhibit only a select population of NMDA receptors in the brain, thus reducing the possibility of side effects.
Currently, the Alzheimer's drug called Namenda, one of the only existing pharmaceuticals that inhibit the NMDA receptor, targets a different site within the receptor.
"If a new drug could be developed to target the dimer interface, which we discovered to be inhibitory, it would allow more specific effects than current drugs," explains Popescu. "That's because at this particular interface, the interactions between these subunit interfaces are more precise than those currently being targeted."Provided by University at Buffalo "New drug target for Alzheimer's, stroke discovered." October 11th, 2011. http://medicalxpress.com/news/2011-10-drug-alzheimer.html | 医学 |
2014-42/1179/en_head.json.gz/24077 | The doctor will ask about your symptoms and medical history. A physical exam will also be done. It often is difficult to diagnose
(MS) because the symptoms are similar to those of other conditions. There is no definitive test for MS; however, the findings of some tests can contribute to a diagnosis.
—This test uses magnetic and radio waves to check for damage to the myelin sheath of the nerves in the brain and spinal cord. A contrast substance may be used to help doctors identify damaged areas. MRI may also be used to track changes in the disease.
Evoked responses—This test records the speed of the electrical responses in sensory, visual, or auditory nerves after a repeated sensory stimulus. This test can help identify abnormal areas affected by MS.
Visual evoked potential tests
are most often used in evaluating MS.
Lumbar puncture (spinal tap)
—In this procedure, a small amount of fluid from around the spinal cord is removed and checked for white blood cells, antibodies, and proteins. Doctors look for abnormal changes associated with MS.
Other tests may be done to rule out other conditions that may have similar symptoms.
Multiple sclerosis. Access Medicine website. Available at:
http://www.accessmedicine.com.ezp-prod1.hul.harvard.edu/quickam.aspx | 医学 |
2014-42/1179/en_head.json.gz/24079 | Share Neonatal Family Reunion Honors Intensive Care Nursery Graduates
(May 2, 2008) –. The Department of Neonatology at Memorial University Medical Center (MUMC) will hold its 30th Neonatal Family Reunion on Saturday, May 10, from 1 to 4 p.m. in the William and Iffath Hoskins Center for Biomedical Research on the MUMC campus. The reunion will honor graduates of the MUMC intensive care nurseries along with their families. The Neonatal Intensive Care Nursery (NICN) at MUMC opened in the summer of 1977 as the fifth regional neonatal tertiary care center in Georgia. Today, Memorial University Medical Center’s NICN is one of only six Level 3 NICNs in the state of Georgia, representing the highest level of care available for premature or critically ill newborns. Approximately 700 newborns come through the Memorial University Medical Center NICN each year.The annual reunion gives the NICN graduates and their families a chance to reunite with caregivers, old friends, and other former patients.Memorial University Medical Center is a two-state healthcare organization serving a 35-county area in southeast Georgia and southern South Carolina. The system includes its flagship hospital, a 530-bed tertiary medical center; Memorial primary and specialty care physician networks; a major medical education program; business and industry services; and NurseOne, a 24-hour call center. Memorial University Medical Center has been named a Distinguished Hospital by J.D. Power and Associates four years in a row for providing an outstanding patient experience. | 医学 |
2014-42/1179/en_head.json.gz/24095 | News Opinions Sports Special Sections Features Ads Jobs Classifieds Extras Customer Service Routes Available Wellness
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MEDICAL BRIEFS - Level 2 trauma designation reaffirmed
Save | Post a comment | The American College of Surgeons has again re-verified Trinity Hospital as a Level 2 trauma center. The approval follows a site visit in August by the group's Verification Review Committee. Only 130 centers in the country have Level 2 verification, and Level 2 is the highest level of trauma care available in North Dakota. Trinity Hospital was first verified in 1996. The group reviewed response times and the hospital's ability to document quality medical outcomes. Level 2 criteria include 24-hour availability of trauma-trained physicians and nurses, continuous availability of trauma emergency care, surgery staff, critical care and radiology. In addition, neurotrauma care and orthopedic trauma care must be promptly and continuously available, along with other types of subspecialty care. -------------------- UND medical school names new NAME president Mary Ann Sens, professor and chair of the department of pathology at the University of North Dakota School of Medicine and Health Sciences has been selected president of the National Association of Medical Examiners. The association is the national professional organization of physician medical examiners, medical death investigators and death investigation system administrators who perform the official duties of the medicolegal investigation of deaths of public interest in the United States. The group is recognized as the premiere professional organization of forensic pathologists and death investigators. Sens has been the chair of the Department of Pathology since 2002. She is certified by the American Board of Pathology in Anatomic and Forensic Pathology and licensed to practice medicine in North Dakota, Minnesota, South Dakota and South Carolina. In addition to her work at UND, Sens serves as the Grand Forks County Coroner and is the medical examiner for Marshall, Kittson, Red Lake and Mahnomen counties in Minnesota. -------------------- New Web site helps teens transition to adulthood The North Dakota Department of Human Services' Independent Living Program has launched a new Web site to help teens make the transition to adulthood easier. The North Dakota Youth Web site can be found at (www.nd.gov/ndyouth). The site was developed by older teens and young adults as a resource for others, especially youth receiving foster care, juvenile justice, or mental health services who are now preparing to live on their own. The N.D. Youth Web site contains 15 individual sections with information on independent living, money management, addiction recovery, careers, employment, cultural resources, housing, education, crisis management and more. -------------------- Bay appointed director of developmental disabilities division Tina Bay has been hired as the director of the North Dakota Department of Human Services' Developmental Disabilities Division. Bay has served as the division's assistant director since November 2008. Bay will be responsible for the planning, budgeting, and licensing of community-based residential and day support program providers for individuals with developmental disabilities in North Dakota. Bay has over 10 years of experience in delivering supportive direct care services and program coordination for individuals with life-long disabilities and physical impairments. She joined the department in 2004. -------------------- Kouba heads health council Marlene Kouba of Regent was recently elected to a second term as chairman of the North Dakota State Health Council. Other members of the council are vice-chairman Gordon Myerchin of Grand Forks, secretary Carmen Toman of Bismarck, Dennis E. Wolf of Dickinson, Howard Anderson of Turtle Lake, Hjalmer Carlson Jr. of Minot, Jerry Jurena of Rugby, Lee Larson of Leeds and Gary Riffe of Jamestown. Terry Dwelle is the state health officer, heading the North Dakota State Health Department. Some of the duties of the council are to establish standards, rules and regulations necessary for the maintenance of public health, including sanitation and disease control and to provide for the development, establishment and enforcement of basic standards for hospitals, nursing homes and related medical institutions. The committee monitors health care and makes recommendations to the North Dakota Legislature. The group awards grants to nurses, physicians, dentists and veterinarians. Save | Post a comment | Subscribe to Minot Daily News I am looking for: | 医学 |
2014-42/1179/en_head.json.gz/24121 | June 2003 Volume 5, Issue 6:
Life Lessons from a Politician
By Dan Bammes
In the rotunda of the Salt Lake City courthouse, a life-size bronze statue of Governor Scott Matheson comes striding out to meet you, its hand extended. It captures the energy Scott Matheson had in life. He was an extraordinary man.
This issue of Myeloma Today is sponsored in part by an unrestricted educational grant from Novartis Pharmaceuticals.Salt Lake City has a beautiful new courthouse across from City Hall on State Street. It's named for a former governor, Scott M. Matheson. In the rotunda of the courthouse, a life-size bronze statue of Governor Matheson comes striding out to meet you, its hand extended. It captures the energy Scott Matheson had in life. He was an extraordinary man. Scott Matheson
Scott Matheson died at the age of 61 from multiple myeloma. In the 1950's, when he worked as a local prosecutor in the town of Parowan in southern Utah, he used to go out with friends early in the morning to watch the flash from atomic bomb tests more than a hundred miles away in Nevada. Like most people in that era, he didn't think much about the fallout that spread from the test site across the West, and in fact, across the country. Today, there's enough association between multiple myeloma and fallout exposure to include it on the list of diseases for which compensation is available from the federal government under the Radiation Exposure Compensation Act. Matheson's family believes it was the cause of his cancer. It may have been for me as well, though it's difficult to know for sure. I used to spend part of every summer at my grandmother's home in Kanab, just north of the Arizona state line. It's likely I was exposed to fallout from the Sedan test in 1962, possibly the dirtiest nuclear weapons explosion in the history of the program. I was six years old. In January 2003, I was home with a respiratory infection when I felt a severe pain in my chest after a hard coughing spell. The next day I went to the doctor, who took an x-ray, and found a spot he was worried about. Three weeks of follow-up diagnostics later, I was told I had multiple myeloma. A plasmacytoma on my 6th rib had caused a pathological fracture. Without that, I might not have been diagnosed until the disease was in a much more advanced stage. As it is, I'm in Stage I. I've been through radiation treatments for the plasmacytoma and I'm now getting thalidomide and dexamethasone. Eventually, I'll enter the University of Utah hospital for a stem cell transplant. While friends, including some other myeloma patients, tell me this will just be a "speed bump" in my life, I have more concern than that, though I've tried not to worry too much about problems that I don't have yet. Remarkably, having cancer has been among the more positive experiences in my life. I've discovered so many people who really mean it when they ask if there's "anything I can do." That includes a member of a neighborhood church who helps me with my yard (the broken rib is still healing) and a very understanding employer at KUER, the public radio station at the University of Utah (www.kuer.org). My employment comes with excellent medical insurance, and I'm a five-minute walk from the Huntsman Cancer Institute, where I'm getting state-of-the-art medical care. My family has been enormously supportive. I have to say my religious position has also been a help. I am Buddhist, and having cancer brought to mind a teaching called the Kosala Sutta, in which the Buddha teaches a king whose wife has just died that it is futile to hope that something subject to illness and death, such as ourselves, will not get sick or will not die. To me, it seems a far more realistic position than hoping for a cure through faith. To accept what is seems far more compassionate than to wish for some nebulous maybe. Perhaps the most difficult challenge I'm facing now is "getting over it." In the three months since my diagnosis, multiple myeloma has dominated my consciousness in a way few other things have. I need to find a way to live with this as a chronic disease, part of my life but not the center of my attention. It seems a given that the cancer will progress, even if my doctors are doing all they can. In the meantime, every day is a precious opportunity for mindful attention to everything from spring violets to the Dixie Chicks. Scott Matheson was a thoughtful, decent man, a smart politician who spoke often about "good public policy." Utah is far better off for his leadership, though perhaps poorer because he chose not to run for a third term. When he passed away, a newspaper editorial proclaimed him "too young." I disagree. He left us at a time when we could remember his energy and commitment. He was and is an excellent role model, and his example is just one more reason why it seems pointless to feel sorry for myself.
Dan Bammes chronicles his experience with multiple myeloma on his weblog at http://www.mustard.com/myeloma.htm. | 医学 |
2014-42/1179/en_head.json.gz/24137 | Remembering Marine Sgt. Oscar Canon, A ‘Superstar’ by: February 24, 2012 After the explosion of the rocket-propelled grenade on a road in Fallujah, Oscar Canon saw the white of his own thigh bone. At the medical unit, the young Marine sergeant grabbed the doctor by his collar and yelled, “Don’t cut off my f***ing leg.” That was in October of 2004 and the first of dozens of surgeries — 72 separate operations, by a family member’s count — that saved his leg.
Last week, Staff Sgt. Oscar Canon, 29, died. A Marine Corps spokesman at Camp Pendleton says the death is still being investigated.
But family and friends say his leg got infected — which is not unusual after an operation — and that after Canon drove himself to the hospital last week he went into shock, or had a heart attack and ended up in a coma.
I met Canon at his home at Camp Pendleton in California in January of 2005 and followed his surgeries for most of that year. And I reported for Morning Edition about his attempt to save his leg (scroll down to the end of this post if you’d like to listen).
For more than 100 years, the standard was for doctors to amputate a badly damaged arm or leg. Think of Civil War surgeons at the battlefront wielding cleavers. In the decades since, the field of prosthetics has advanced. Prosthetic legs were once crude stumps of wood. Today, soldiers get legs powered by computer chips and made from materials used on spaceships.
For limb salvage, it’s been less than 20 years since surgeons began to master complex ways to save a leg instead of amputating it. It involves closing wounds, fixing fractures, moving muscle, tissue and blood supply. The limb construction done for Canon was among some of the most extensive doctors anywhere had ever tried at the time.
Canon had a magnetic personality and drew in many people who became his advocates. Ed Eckenhoff, the founder and president emeritus of the National Rehabilitation Hospital, a private hospital in Washington, D.C. where Canon went for physical rehab, quickly befriended Canon. “He was a superstar at our place,” says Eckenhoff, who as a college student was paralyzed by a spinal cord injury. “He couldn’t work hard enough. He wanted as much therapy as anyone could throw at him. He wanted to be in therapy at 8 p.m. He was very interested in getting back to the theater.”
At the time, it was almost unthinkable that a Marine with such a severe injury would go back to war. But Canon did. He returned to Iraq as a Special Forces instructor. Canon’s Facebook page shows him nuzzling his face into the neck of his young son, Elijah, now 18-months. Family members say he was involved in a bitter battle for full custody of the boy.
After so many surgeries, family members were shocked when Canon died after he went to the hospital for what they thought was a routine check of a persistent rash. Julian Canon says his nephew was optimistic after his last surgery at the turn of the year and so was the rest of the family. “We were jumping up and down, [saying] ‘Yeah, this is going to be the last operation. This is going to be great.’ Then he goes to the hospital for a check up and he’s in a coma,” Julian Canon says softly. “A coma?.” There will be a memorial service for Canon next week in Oceanside, Calif., and family say he’ll be buried later at Arlington National Cemetery.
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2014-42/1179/en_head.json.gz/24138 | Polio Outbreak In Kenya: A Threat To Global Eradication by: May 22, 2013 Kenya has recorded its first case of polio in two years, the World Health Organization said Wednesday.
A 4-month-old girl came down with paralysis on April 30, and then two healthy kids nearby also tested positive for the virus.
But this handful of infections with poliovirus has the potential to set back global efforts to eradicate polio, WHO spokeswoman Sona Bari tells Shots.
“Polio is a virus that spreads silently,” she says. “One case represents between 200 and 1,000 people infected. It’s the tip of an iceberg.”
Kenya hasn’t seen a case of wild polio (as opposed to the rare ones linked to vaccination) since July 2011. And now the risk to neighboring countries is very high, Bari says.
“This is a particularly fragile part of the world in terms of immunity,” she says. “Overall, Kenya has a robust health care system, but if polio lands in a pocket with low immunity it could spark a large outbreak.”
The new case occurred in the largest refugee camp in the world, the Dadaab Refugee Camp in southeast Kenya. About 500,000 people from neighboring countries live there or move in and out of the camp each year.
“There is a lot of travel through this nexus in Africa,” Bari says. Viruses can spread rapidly.
“Last time we saw polio in this region, it caused infections in Sudan, Ethiopia, Somalia and even Yemen.” Eventually the virus spread as far as Indonesia and paralyzed more than 700 children.
A few weeks ago, Somalia recorded its first wild polio case in over five years. A 32-month-old girl became paralyzed in the region near Mogadishu.
Many parts of Somalia have not held polio vaccination campaigns since 2009, Global Polio Eradication Initiative said, and the country, in general, has one of the lowest immunization rates in the world.
Genetic analysis suggests that the poliovirus in Somalia came from Nigeria, which is more than 3,000 miles away. It’s still unknown if the Somalia case is connected with the ones in Kenya. But the international health community has responded quickly to contain both outbreaks.
“Fortunately, we’re prepared for these things,” Bari says. Vaccinations campaigns will start in Kenya this Sunday. In Somalia, they’ve already immunized about 400,000 children. “About 1 million children will get vaccinated in eastern Kenya,” she says.
Such rapid responses are critical if the WHO and other foundations hope to reach their target of eradicating polio by 2018 — a goal that health leaders said would cost about $5.5 billion.
Polio is currently endemic in just three countries: Afghanistan, Pakistan and Nigeria. There were only 223 cases recorded worldwide in 2012 and so far, just 34 in 2013. More than half of the cases occurred in Nigeria.
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2014-42/1179/en_head.json.gz/24145 | Provinces’ new weapon against Big Pharma: each other
Tom Blackwell | April 26, 2012 | Last Updated: Apr 27 10:34 AM ETMore from Tom Blackwell | @tomblackwellNP
As British Columbia’s health minister, Mike de Jong has seen it time and again: A pharmaceutical manufacturer launches an expensive new drug, brings forward a patient who desperately needs the medicine but cannot afford it, and pressures the province to cover the cost.
Suddenly, though, the balance of power in Canada’s multi-billion-dollar prescription-drug system is shifting, as provinces and territories begin an historic push to combine their buying power and jointly bargain down the high cost of pharmaceuticals.
Not unlike department-store chains bulk-purchasing washing machines or televisions, all the jurisdictions but Quebec have combined forces to negotiate the price of a series of new medicines to be covered by their drug plans, and hope to make the process routine in future.
RelatedCanada’s deadly love affair with painkillersMore drugs added to ‘short supply’ list
Analysts call it a unique case of cross-border collaboration between governments that typically run their health-care systems as distinct fiefdoms.
“The territorialism that we see has developed over the years, if not the decades,” said Mr. de Jong. “It is a remarkable feature of the Canadian federation that something that would seem so eminently logical has taken this length of time to become a reality. But it has, and that’s good news.”
The minister said he wants to push for another concession from the pharmaceutical firms, too. Industry now insists that the price produced by the haggling be kept secret, but taxpayers have a right to know, Mr. de Jong said.
Canada spends about $26-billion annually on prescription drugs, making them the third-largest health care cost after hospitals and doctor services. Provincial drug plans for senior citizens and others pay 46% of that total, private insurance and workplace health plans 36%, and uninsured patients 18%, according to the Canadian Institute for Health Information.
‘As drugs are added to the formulary, we want to negotiate a common [national] price’
The bulk-pricing talks began last year after premiers instructed their health ministers to negotiate jointly for Soliris, the only drug available to treat PNH, a rare and often-fatal blood disease that affects just 90 people across Canada.
The price tag of about $500,000 per year makes it the world’s most expensive medicine, according to Forbes magazine. Working together, though, the provinces managed to secure a deal “significantly less than what the company had started with,” said Judy McPhee, pharmaceutical-services director with Nova Scotia’s Health Department.
Driving the negotiations in part was the discovery that Alexion Pharma, the Connecticut-based manufacturer, was selling Soliris to the U.S. Department of Veterans Affairs for about half the price it was offering Canadian buyers, said Mr. de Jong.
A deal has also just been completed on Pradax, a blood thinner, while a third set of talks is underway on an undisclosed product and others are being eyed, provincial officials said.
“As drugs are added to the formulary, we want to negotiate a common [national] price,” said Deb Matthews, Ontario’s health minister. “If we can work together and get a better price, that’s what we need to do.”
Walter Robinson, a vice president of Canada’s Research-based Pharmaceutical Companies, the main industry trade group, struck a more cautionary note, though, saying the provinces have to consider more than cost when they choose which medications to cover.
“It’s not just a question about price,” said Mr. Robinson. “We must ensure we don’t limit choice or therapeutic options … and ensure that the prescribing doctor can still prescribe what they consider most important.”
Until a few years ago, the companies actually offered only one firm price, with no back and forth; then individual provinces and other buyers began negotiating for discounts in the form of confidential rebates.
It makes total sense for jurisdictions to band together to gain more leverage and also to prevent “whip-sawing” – using one province’s decision to pay for a drug to put political pressure on others, said Steve Morgan, a pharmaceutical-policy expert at the University of British Columbia.
Still, such “horizontal integration” between provincial governments is highly unusual, he said.
Soliris — the test case for national negotiations — was approved by Health Canada in May 2009, but most provinces initially chose not to cover its huge cost. By 2010, media stories began appearing about patients who said they faced suffering and possible death if their governments did not foot the bill. Studies suggest that the compound does prevent dangerous blood clots, organ damage and other symptoms.
‘It’s not just a question about price. We must ensure we don’t limit choice or therapeutic options’
The lobbying for government coverage was led by the Canadian Association of PNH Patients, launched in the same year Soliris hit the market and funded by “unrestricted educational grants” from Alexion, according to the group’s web site.
Mr. de Jong said he understands the need for pharmaceutical companies to exact the best price they can to recoup large R&D investments, but questioned some of their strategies.
“The practice has become fairly refined by some of the drug producers: come into a jurisdiction, find a patient, a very compelling case, highlight that case in a way that attracts the sympathy of people … and force the politicians, on behalf of the taxpayers, to pay whatever rate the drug company decides is fair,” said the B.C. minister. “That’s not acceptable.”
• Email: [email protected]
Topics: Canada, News, pharmaceuticals, Science & Health | 医学 |
2014-42/1179/en_head.json.gz/24274 | Media Release, 25 February 2008
Media release: 19 August 2014
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Australian Psychological Society supports call for action following release of report on youth alcohol abuse
The Australian Psychological Society (APS) today called attention to the release of the Australian National Council on Drugs (ANCD) report into Supporting the Families of Young People with Problematic Drug Use.
This timely report coincides with concerns raised in the past weeks by the Prime Minister, Mr. Kevin Rudd, and his Health Minister, Ms Nicola Roxon, regarding the abuse of alcohol by young people. The report is a hard-hitting reminder of the effects of alcohol on our society, and particularly of the health and social effects on young people and their families. "The report highlights not only the issues which we are now facing in relation to teenage use of substances, and particularly of alcohol, but also emphasises the role that parents and other adults in the community play as role models and teachers. Young people are taking notice of parental models, and families need support and guidance to address this growing problem," said Ms Lynne Magor-Blatch, National Convener of the APS Interest Group "Psychology and Substance Use".
"We know that nearly all teenagers will be offered drugs, especially alcohol, but also nicotine and the full range of illegal drugs. Many will experiment with drugs, as adolescents will push the limits, and in response to peer group pressure. Also, our culture endorses drug use as a solution to bad feelings of all kinds and as a form of recreation. In this context, it is fortunate that only a minority of teenagers develop serious drug problems but for that minority, their families, and the rest of the community, the costs of this are high. This minority clearly have a vulnerability that is brought out when they are exposed to drug use, and the earlier they are given access to effective, research-based treatment, the better the chance of saving them from long-term drug use problems."
Unless there is an identifiable mental health problem, families are not yet able to access psychologists skilled to assist them in changing their own behaviour and assisting their young family members through the Medicare Benefits Scheme. This is despite the recognition by government that 50-80% of people in alcohol and other drug treatment services also have a co-occurring mental health problem.
"The Australian Government has done a great deal to increase access to psychologists for treatment of mental health problems through making items available on the Medicare Benefits Scheme, but there is an ever-increasing need for more psychologists trained in alcohol and other drug interventions, and more services in the community to assist young people and their families".
Psychologists work in the community in a variety of roles, within private practice, in general practice centres and in government and non-government agencies. The APS is the largest professional association for psychologists in Australia, representing more than 15,700 members. The APS is committed to advancing psychology as a discipline and profession. It spreads the message that psychologists make a difference to peoples' lives, through improving psychological knowledge and community wellbeing.
For further information, please contact: Lynne Magor-Blatch
Elaine Grant
Manager Communications
Australian Psychological Society
www.psychology.org.au | 医学 |
2014-42/1179/en_head.json.gz/24483 | Southern College of Optometry Eye Health and Vision Clinic Opens at University of Memphis
, Tenn.—
Southern College of Optometry (SCO) has opened a full-service vision clinic at the University of Memphis (U of M). The clinic, named University Eye Care, will offer comprehensive pediatric and adult primary eyecare to U of M students, faculty, staff and the surrounding community.
University Eye Care will be staffed by five optometric physicians with additional support from student interns. Services will include eye examinations, contact lens fitting and ocular disease management, along with designer eyewear and contact lens dispensing. Most major medical insurance plans will be accepted, SCO said.
SCO has also created the Tiger Eye Care Program which will offer affordable vision care to students and their families who do not have vision coverage. Packages are available for both eyecare services and optical materials and range from $35 to $169.
“This has been in the works for more than three years,” said Dr. James Venable, vice president for clinical programs at SCO. “We have worked closely with the medical director and staff at U of M Student Health Services to facilitate referrals of urgent eye health conditions, and our goal was to expand those services to include primary care. We have realized that goal with University Eye Care.”
Dr. Richard Phillips, president of SCO, said, “This is a wonderful partnership. We look forward to bringing top-notch eyecare to the U of M community.”
Labapalooza Pays Tribute to Wholesale Labs | 医学 |
2014-42/1179/en_head.json.gz/24563 | HomeAbout ACOGACOG DistrictsDistrict IIPress Release
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CONTACT: Sue Nigra, Director of Communications
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NEW YORK ELIMINATES
"SAFE MOTHERHOOD INITIATIVE"
PROGRAM AIMED TO PREVENT PREGNANCY-RELATED DEATHS
Albany, NY - March 17, 2010 - The New York State Chapter of the American Congress of Obstetricians and Gynecologists, (ACOG District II) is deeply troubled over the elimination of the Safe Motherhood Initiative (SMI) - a ground breaking program that was created to save the lives of women across New York State while improving patient safety. Funding will cease for the Safe Motherhood Initiative March 31, 2010. "Without the SMI, more women will die from unknown causes. It's as simple as that," said Cynthia Chazotte, MD, FACOG, Co-Chair of the SMI. "How heartbreaking it is that the State of New York - our partner in this initiative - is eliminating a program designed to save lives." Since 2001, ACOG District II and the New York State Department of Health have collaborated on the SMI, which was formed in response to the alarming rate of pregnancy-related deaths (also known as maternal mortalities) in the state. Alarmingly, the maternal mortality rate in New York is among the highest in America. A major element of the SMI is to conduct timely, on-site reviews of such deaths. These visits, known as maternal mortality reviews, assist ACOG District II in developing state-wide recommendations and educational materials. Hospitals can then make changes in protocols to prevent future deaths, while medical staff gain a heightened awareness of the risk factors associated with these tragic losses. "Through the SMI we have been able to identify key risk factors for maternal mortality such as obesity and hypertension," said Sandra McCalla, MD, FACOG, Co-Chair of the SMI. "The data we gather from SMI reviews are invaluable because the information plays a key role in preventing the tragedy that occurs when a family loses a mother due to a pregnancy related death."
The seriousness of maternal mortality continues making national headlines. Time Magazine recently issued a report entitled Too Many Women Dying in U.S. While Having Babies. ABC News recently aired THIS STORY, citing a new report that says the number of women who died in California after giving birth has nearly tripled in the past decade. In addition, the Joint Commission, the group responsible for accrediting hospitals, recently issued an alert stating that "current trends and evidence suggest that maternal mortality rates may be increasing in the U.S."
"I would hope that legislative leaders, and the governor himself, realize how critical the SMI program is," said Scott Hayworth, MD, FACOG, Chair of ACOG District II. "New York has an opportunity to become a national leader in the effort to reduce maternal mortality. The SMI program should be duplicated in other states - not eliminated by our own. How very unsettling that is."
For more information about the Safe Motherhood Initiative (SMI), please CLICK HERE. For more about ACOG District II,visit www.acogny.org. ################
[email protected]
ACOG District II: | 医学 |
2014-42/1179/en_head.json.gz/24610 | News Releases News Release Detail Overview
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Amgen Receives FDA Breakthrough Therapy Designation For Investigational BiTE® Antibody Blinatumomab In Acute Lymphoblastic Leukemia
Breakthrough Designation Reinforces Significant Unmet Need in the Treatment of This Highly Aggressive Cancer
THOUSAND OAKS, Calif., July 1, 2014 /PRNewswire/ -- Amgen (NASDAQ:AMGN) today announced that the U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy Designation to investigational bispecific T cell engager (BiTE®) antibody blinatumomab, for adults with Philadelphia-negative (Ph-) relapsed/refractory B-precursor acute lymphoblastic leukemia (ALL), a rapidly progressing cancer of the blood and bone marrow1. The Breakthrough Therapy Designation was based on the results of a Phase 2 trial of 189 adult patients with Ph- relapsed/refractory B-precursor ALL treated with blinatumomab. Data from the Phase 2 trial were most recently presented at the 50th Annual Meeting of the American Society of Clinical Oncology (ASCO) and the 19th Congress of the European Hematology Association (EHA). "There is a high unmet need for new medicines to treat relapsed and refractory ALL patients, who have very few treatment options," said Sean E. Harper, M.D., executive vice president of Research and Development at Amgen. "The results from the Phase 2 trial evaluating blinatumomab in adult patients with relapsed or refractory ALL are encouraging and provide a strong basis for a regulatory filing later this year and potential approval in this serious disease." The FDA states that Breakthrough Therapy Designation is intended to expedite the development and review of drugs for serious or life-threatening conditions. The criteria for Breakthrough Therapy Designation require preliminary clinical evidence that demonstrates the drug may have substantial improvement on at least one clinically significant endpoint over available therapy. A Breakthrough Therapy Designation conveys all of the fast-track program features, more intensive FDA guidance on an efficient drug development program, an organizational commitment involving senior managers, and eligibility for rolling review and priority review2.
In the U.S. alone, it is estimated that over 6,000 cases of ALL were diagnosed in 2013, and in the European Union, more than 7,000 cases of ALL are diagnosed each year3,4. In adult patients with relapsed or refractory ALL, median overall survival is just three to five months5. About BiTE® Technology
Bispecific T cell engager (BiTE®) antibodies are a type of immunotherapy being investigated for use in fighting cancer by helping to engage the body's immune system to detect and target malignant cells. The modified antibodies are designed to engage two different targets simultaneously, thereby juxtaposing T cells (a type of white blood cell capable of killing other cells perceived as threats) to cancer cells. BiTE antibodies help place the T cells within reach of the targeted cell, with the intent of allowing it to inject toxins and trigger the cell to die (apoptosis). BiTE antibodies are currently being investigated for their potential to treat a wide variety of cancers. For more information on BiTE antibodies, visit www.biteantibodies.com. About Blinatumomab
Blinatumomab is an investigational BiTE® antibody designed to direct the body's cell-destroying T cells against target cells expressing CD19, a protein found on the surface of B-cell derived leukemias and lymphomas. Blinatumomab is the first of the BiTE antibodies and Amgen has received orphan drug designation from the FDA for the treatment of ALL, chronic lymphocytic leukemia (CLL), hairy cell leukemia, prolymphocytic leukemia and indolent B cell lymphoma and from the European Medicines Agency for the treatment of indolent B cell lymphoma, ALL, CLL and mantle cell leukemia (MCL). Blinatumomab is also being investigated for its potential to treat pediatric relapsed/refractory ALL, relapsed/refractory Philadelphia positive (Ph+) B-precursor ALL, minimal residual disease positive (MRD+) B-precursor ALL, relapsed/refractory non-Hodgkin's lymphoma (NHL), including relapsed/refractory diffuse large B-cell lymphoma (DLBCL).
About ALL Acute lymphoblastic leukemia (ALL) is an aggressive cancer of the blood and bone marrow — the spongy tissue inside bones where blood cells are made1. The disease progresses rapidly and affects immature blood cells, rather than mature ones1. Worldwide, ALL accounts for more than 12 percent of leukemia. Of the 42,000 people diagnosed worldwide, 31,000 will die from the disease. Patients with ALL have abnormal white blood cells (lymphocytes) that crowd out healthy white blood cells, red blood cells and platelets, leading to infection, anemia (fatigue), easy bleeding and serious side effects6.
About Amgen
Amgen is committed to unlocking the potential of biology for patients suffering from serious illnesses by discovering, developing, manufacturing and delivering innovative human therapeutics. This approach begins by using tools like advanced human genetics to unravel the complexities of disease and understand the fundamentals of human biology. Amgen focuses on areas of high unmet medical need and leverages its biologics manufacturing expertise to strive for solutions that improve health outcomes and dramatically improve people's lives. A biotechnology pioneer since 1980, Amgen has grown to be the world's largest independent biotechnology company, has reached millions of patients around the world and is developing a pipeline of medicines with breakaway potential. For more information, visit www.amgen.com and follow us on www.twitter.com/amgen. Forward-Looking Statements
This news release contains forward-looking statements that are based on the current expectations and beliefs of Amgen Inc. and its subsidiaries (Amgen or us) and are subject to a number of risks, uncertainties and assumptions that could cause actual results to differ materially from those described. All statements, other than statements of historical fact, are statements that could be deemed forward-looking statements, including estimates of revenues, operating margins, capital expenditures, cash, other financial metrics, expected legal, arbitration, political, regulatory or clinical results or practices, customer and prescriber patterns or practices, reimbursement activities and outcomes and other such estimates and results. Forward-looking statements involve significant risks and uncertainties, including those discussed below and more fully described in the Securities and Exchange Commission (SEC) reports filed by Amgen Inc., including Amgen Inc.'s most recent annual report on Form 10-K and any subsequent periodic reports on Form 10-Q and Form 8-K. Please refer to Amgen Inc.'s most recent Forms 10-K, 10-Q and 8-K for additional information on the uncertainties and risk factors related to our business. Unless otherwise noted, Amgen is providing this information as of July 1, 2014, and expressly disclaims any duty to update information contained in this news release.
No forward-looking statement can be guaranteed and actual results may differ materially from those we project. Discovery or identification of new product candidates or development of new indications for existing products cannot be guaranteed and movement from concept to product is uncertain; consequently, there can be no guarantee that any particular product candidate or development of a new indication for an existing product will be successful and become a commercial product. Further, preclinical results do not guarantee safe and effective performance of product candidates in humans. The complexity of the human body cannot be perfectly, or sometimes, even adequately modeled by computer or cell culture systems or animal models. The length of time that it takes for us and our partners to complete clinical trials and obtain regulatory approval for product marketing has in the past varied and we expect similar variability in the future. We develop product candidates internally and through licensing collaborations, partnerships and joint ventures. Product candidates that are derived from relationships may be subject to disputes between the parties or may prove to be not as effective or as safe as we may have believed at the time of entering into such relationship. Also, we or others could identify safety, side effects or manufacturing problems with our products after they are on the market. Our business may be impacted by government investigations, litigation and product liability claims. If we fail to meet the compliance obligations in the corporate integrity agreement between us and the U.S. government, we could become subject to significant sanctions. We depend on third parties for a significant portion of our manufacturing capacity for the supply of certain of our current and future products and limits on supply may constrain sales of certain of our current products and product candidate development.
In addition, sales of our products (including products of our wholly-owned subsidiaries) are affected by the reimbursement policies imposed by third-party payers, including governments, private insurance plans and managed care providers and may be affected by regulatory, clinical and guideline developments and domestic and international trends toward managed care and healthcare cost containment as well as U.S. legislation affecting pharmaceutical pricing and reimbursement. Government and others' regulations and reimbursement policies may affect the development, usage and pricing of our products. In addition, we compete with other companies with respect to some of our marketed products as well as for the discovery and development of new products. We believe that some of our newer products, product candidates or new indications for existing products, may face competition when and as they are approved and marketed. Our products may compete against products that have lower prices, established reimbursement, superior performance, are easier to administer, or that are otherwise competitive with our products. In addition, while Amgen and its partners routinely obtain patents for their products and technology, the protection of our products offered by patents and patent applications may be challenged, invalidated or circumvented by our or our partners' competitors and there can be no guarantee of our or our partners' ability to obtain or maintain patent protection for our products or product candidates. We cannot guarantee that we will be able to produce commercially successful products or maintain the commercial success of our existing products. Our stock price may be affected by actual or perceived market opportunity, competitive position, and success or failure of our products or product candidates. Further, the discovery of significant problems with a product similar to one of our products that implicate an entire class of products could have a material adverse effect on sales of the affected products and on our business and results of operations. Our efforts to integrate the operations of companies we have acquired may not be successful.
The scientific information discussed in this news release related to our product candidates is preliminary and investigative. Such product candidates are not approved by the U.S. Food and Drug Administration (FDA), and no conclusions can or should be drawn regarding the safety or effectiveness of the product candidates. CONTACT: Amgen, Thousand OaksKristen Davis, 805-447-3008 (media)Arvind Sood, 805-447-1060 (investors)
Mayo Clinic. "Acute lymphocytic leukemia." Available at: http://www.mayoclinic.com/health/acute-lymphocytic-leukemia/DS00558. Accessed on May 28, 2014. U.S. Food and Drug Administration. "Frequently Asked Questions: Breakthrough Therapies." Available at: http://www.fda.gov/RegulatoryInformation/Legislation/FederalFoodDrugandCosmeticActFDCAct/SignificantAmendmentstotheFDCAct/FDASIA/ucm341027.htm. Accessed on May 28, 2014. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. Ca Cancer J Clin. 2013;63:11-30. Gatta G, Maarten van der Zwan J, Casali P, et. al. Rare cancers are not so rare: The rare cancer burden in Europe. Eur J Cancer. 2011;47:2493-2511. Advani A.S. New immune strategies for the treatment of acute lymphoblastic leukemia: Antibodies and chimeric antigen receptors. Hematology Am Soc Hematol Educ Program. 2013;2013:131-7. Retrieved from: http://asheducationbook.hematologylibrary.org/content/2013/1/131.long. Mayo Clinic. "Acute lymphocytic leukemia: symptoms". Available at: http://www.mayoclinic.com/health/acute-lymphocytic-leukemia/DS00558/DSECTION=symptoms. Accessed on May 28, 2014.
Logo - http://photos.prnewswire.com/prnh/20081015/AMGENLOGO SOURCE Amgen
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2014-42/1179/en_head.json.gz/24621 | First Annual Kids Run for Pediatric Cancer Research
Written by Pat Grace Friday, 25 June 2010 00:00 The first time an event is held is rarely its best showing, but it will be difficult to top the First Annual Philanthropic Children’s Fun Run held Saturday, June 19, that began and ended at Waldmann/Polliwog Pond, for all children in town ages 2-12. There were 150 runners, although it seemed like more, and the run raised over $5,000. Those funds will primarily benefit The Max Cure Foundation for pediatric cancer research.The Max Cure Foundation was begun about 3 years ago by the Plotkin family. David and Annemarie Plotkin had two children then, Alexander and Max, who, in May 2007, was diagnosed with a rare lymphomia just one day before his 4th birthday. Max spent that birthday in Sloan Kettering and for two years underwent intensive chemotherapy, but since June of 2009 his cancer has been in remission.
What the Plotkins learned following their son’s diagnosis is that pediatric cancer is under funded, that public money is directed to more prevalent cancers, so they launched a foundation to raise awareness, raise money and inspire people to get involved. In less than 3 years their foundation has raised more than $3 million for pediatric cancer research, in one of the toughest economic climates in years.They decided to reach out to the world through the media—not just to raise funds but to build a brand—”Be Brave”—that would enjoy the same recognition as “Livestrong” does promoting fundraising for testicular cancer with Lance Armstrong as spokesman, and the pink ribbon brand does for breast cancer.The Max Cure Foundation’s primary beneficiary is The Max Cure Fund at Memorial Sloan-Kettering Cancer Center (MSKCC) in New York. The fund was established by the Plotkin family to underwrite a one-of-its-kind cell therapy lab for alternative treatments and innovative research for pediatric cancer patients. Plotkin was “grateful to The Munsey Park Women’s Group for choosing us to be the beneficiary of the day’s event. It was a great start to Father’s Day, and seeing all the kids smiling is a reminder of how blessed we all are.”Exactly how did the Munsey Park community decide to support this cause? Co-chair Lisa Avena explained that they have been friends with the Plotkins for over 15 years and knew of the newly formed foundation, were aware of the need for pediatric cancer research and determined to do what they could to help.The event was sponsored by the Munsey Park Women’s Group and co-chaired by Missy Leder and Lisa Avena. “We had a great committee,” Leder said, and listed each woman and her responsibility: Rachel Titus-Water Stations; Moriah Heuer-Bake Sale; Kim Haggerty-Carnival Games, Raffle; Amy Hill-Clock, Bullhorn, various other things; Brandee Hickis–Treasurer; and Amy Keogh-Start/Finish Line Balloons.Additionally 35 Manhasset High School National Honor Society students volunteered from 8:30 a.m. to noon, from set-up to clean-up, and Leder attests “we could never have done it without them.” Avena added that they were lucky to have lots of help from other moms in the community who volunteered their time and talent.Trophies went to the first three girl finishers: first, Ryann Kenny; second, Sarah Phillips; third, Casey Kenny. The first three boys to finish were: first-Lucas Ferraro; second-Owen Sheehan, and third-Jack Corwen. Many other participants received beautiful ribbons. Following the run the MPWC hosted a neighborhood fair, featuring a jumping castle, a super slide, games, face painting, a bake sale and more. It was a perfect day for the enjoyable, well run, philanthropic event. | 医学 |
2014-42/1179/en_head.json.gz/24690 | Imaging and RadiologyBaylor University Medical Center at Dallas
Text Size: Share This Page | Baylor Health Care System > Physicians & Locations > Dallas > Specialties & Services > Imaging & Radiology > DaTscan™ as SPECT Imaging Aid Imaging & Radiology
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Find a Physician Find a Location Find a Class or Event For Physicians and CliniciansTo schedule a patient at the radiology department at Baylor Dallas, please call 214.820.3216.
DaTscan™ as SPECT Imaging Aid Parkinson’s disease, a degenerative neurological disease affecting balance, movement and agility, affects approximately 1 percent of the population over 60 years of age. Although recent years have brought increased awareness of this disorder, the lack of a test to detect this condition can lead to misdiagnosis of Parkinson’s disease and related syndromes. In many cases, especially early in the course of the disease, an important step in diagnosis is to distinguish Parkinson's syndrome (PS) from essential tremor (ET). Patients with ET may have some of the same symptoms as those with PS, but have a much better prognosis and generally undergo different types of medical therapy than PS patients. Sometimes, it can take years of clinical follow-up to distinguish PS symptoms from ET symptoms.
However, a new radiopharmaceutical called DaTscan™ has been approved by the FDA to be used in nuclear medicine SPECT imaging to help distinguish Parkinsonian syndromes (PS) from essential tremor (ET). This agent detects the amount or lack of neurons in the brain that act as dopamine transporters. “DaTscan imaging is not the ultimate test for Parkinsonian syndromes, but can be a valuable adjunct to the clinical evaluation and to any other testing that the physician feels necessary to help confirm or exclude the diagnosis,” he said. “The value of DaTscan is often to either increase the physician’s confidence in the diagnosis, especially early in the course of the disease, or to give the physician more cause to investigate other possible causes of the patient’s symptoms.”
Although similar agents have been available in other countries for several years, DaTscan only recently obtained FDA approval for use in the United States. The Nuclear Medicine Department at Baylor Dallas and the seven nuclear imaging radiologists on the medical staff were among the first group in the country to complete the credentialing requirements for optimal techniques in performing and interpreting the DaTscan imaging. Baylor Dallas imaged its first patient with DaTscan on July 19, 2011 and has imaged a number of patients since then. “For patients with essential tremor, DaTscan can help them avoid being incorrectly diagnosed with Parkinson’s disease, so they can anticipate a much better prognosis and can generally be treated with a drug regimen that has fewer side effects,” Dr. Griffeth said. Read more information on nuclear medicine imaging. My Account | 医学 |
2014-42/1179/en_head.json.gz/24911 | High-tech cancer center opens doors
Feb 9, 2005 at 12:00AM updated Apr 30, 2009 at 2:14PM The newly completed Good Samaritan Cancer Center uses nature to create a supportive setting for patients. Photo by Teresa McCallion— image credit: By Teresa McCallion
The new Good Samaritan Cancer Center is designed not only to bring cancer care departments and services under one roof, but to do it in an environment that is conducive to healing.
The public will have an opportunity to view the results of the $16 million project Saturday from 10 a.m. to 2 p.m. The facility, located at 400 15th Avenue S.E in Puyallup, is part of Good Samaritan Hospital's multi-phase, $220 million development plan. In December, the hospital opened a new West Wing Clinical Unit, featuring four surgery suites and a 14-bed intensive care unit. The next project involves expanded cardiovascular services and a new 150,000-square-foot emergency department and patient care pavilion.
The hospital is a comprehensive, private not-for-profit medical center serving the growing population of the greater Puget Sound region.
"We've always done a great job treating cancer, now we can do it in a state-of-the-art center," said George A. , president and chief executive officer of Good Samaritan Hospital.
Some of the world's most advanced cancer diagnostic technology, chemotherapy and radiation treatment services will be housed within the 37,000-square-foot facility. The integrated center will also include an expanded cancer research laboratory and extensive support services for both patients and their caregivers.
The project represents the culmination of 15 to 20 years of effort, oncologist and hematologist Dr. Richard Ostenson said.
"It is an enormous step forward," he added, recalling the cramped office space and multiple locations the new center replaces. The new research lab, previously located in a small house, will provide access to clinical trials.
Jason McCleary, architect and designer for Kaplan McLaughlin Diaz, said the prevailing concept for the cancer center is hope. Extensive research into the physical environment of a hospital provided the basis for numerous design decisions meant to bring order out of the "dis-order" of cancer.
From the water feature at the entrance to the numerous windows providing sweeping vistas of the valley, the center creates a supportive setting that designed to have a positive effect on patient's outcomes and improve overall healthcare quality, McCleary said. More than 50 pieces of artwork, provided at a discount by local artisans, grace the walls and alcoves.
Chemotherapy patients are already receiving treatments in the warm, sun-filled infusion center. Evidence suggests natural light, calming nature views and a communal environment can be effective in reducing stress and provide a positive benefit for patients. Of the 100 to 125 patients a day treated in the west-facing lounge, approximately 40 are receiving chemotherapy. In addition to Good Samaritan Hospital, the new center combines several of the region's leading cancer care providers under one roof. Advanced technology such as the combined PET/CT (positron emission tomography/computerized tomography) scanner, allows doctors to merge anatomic images with physiological and metabolic data. Offered as part of Rainier Oncology Professional Services and Tacoma Valley Radiation Oncology, it is the first of its kind in the South Sound. In addition, two linear accelerators, used primarily to treat prostate cancer, will increase the number of patients the providers can see from approximately 50 a day to 80. Much of the money to build the facility was raised by the Good Samaritan Foundation. Although the group has already contributed $5 million, they are still working to raise the final $850,000 for the center.
For more information about the open house, go to www.goodsamhealth.org or call 253-697-4040.
High tech is poised to lead recovery
Stage Door opens musical auditions
Everything smooth as St. Elizabeth doors open | 医学 |
2014-42/1179/en_head.json.gz/24940 | CureSearch for Children's Cancer funds and supportstargeted and innovative children's cancer research with measurableresults, and is the authoritative source of information and resourcesfor all those affected by children's cancer. Home > Coping With Cancer > Meet the Children > Sheridan Bautista
Community Support School Support How Will We Get Through This Grieving and Palliative Care Informed Consent Meet the Children Meet the Supporters Child Life Specialist Webinars Parents Webinars School Personnel Webinars Sheridan BautistaOsteosarcoma
7 Years Old at Diagnosis
In March of 2011, Sheridan Bautista was diagnosed with osteosarcoma at the age of seven. Doctors found a tumor located above her left knee that encompassed 75% of her femur. She immediately started chemotherapy in preparation for a revolutionary limb salvage surgery where 75% of her femur was removed and replaced with an implant that would grow with her, without the need for lengthening surgeries. The surgery was a complete success and started her road to recovery. Through physical therapy and a lot of determination, Sheridan was able to walk just 3 months after her surgery.
Before her diagnosis Sheridan was an active girl who was involved with competitive dance, gymnastics, and softball. She always strove to be kind and say what was on her mind. Even throughout her treatment, this spirit continued. Sheridan was also someone who wanted to help others and would do whatever she could to make them smile.
While at the hospital, Sheridan and her family learned about the CureSearch Walk and Sheridan immediately knew she wanted to get involved. She worked hard to recruit team members and raise funds - her determination lead to her team raising $7,000. The day after her 8th birthday, Sheridan walked in the Oklahoma City CureSearch Walk, an incredible feat just months after surgery. She was so excited to be a part of the event and receive her survivor medal.
Unfortunately, several months later, Sheridan's cancer returned and on the 8th of December 2011, Sheridan lost her battle with osteosarcoma. Her family decided to honor Sheridan's memory by walking in the 2012 Oklahoma City CureSearch Walk and raised more than $10,000 for children's cancer research. This year, they hope to do even more through school fundraisers, social media, and word of mouth. With the motto that every little bit helps, Sheridan's family plans to make a big impact on children's cancer research so that one day, every child is guaranteed a cancer free future. < Meet the Children Meet the Next Child > http://www.curesearch.org/ArticleView2.aspx?id=10747 | 医学 |
2014-42/1179/en_head.json.gz/24954 | New Compound Could Protect Brain Cells, Fight Neurodegenerative Diseases
Tiffany Kaiser - December 8, 2010 10:09 AM
11 comment(s) - last by Lugaidster.. on Dec 9 at 10:01 AM
Edward R. Biehl, co-discoverer of the HSB-13 compound (Source: vvoice.vo.llnwd.net)
HSB-13 compound could halt diseases like Alzheimer's, Huntington's and Parkinson's
Southern Methodist University (SMU) and University of Texas at Dallas researchers have found hope for those suffering from diseases like Alzheimer's, Parkinson's and Huntington's through the discovery of a group of molecules which could help protect the brain.
Edward R. Biehl, study leader and a synthetic organic chemist at SMU, and Santosh R. D'Mello, co-author of the study and a biology professor at UT Dallas, have developed the compounds in an effort to halt the onset of nerve-degenerative diseases and relieve symptoms. Alzheimer's, Parkinson's and and Huntington's are neurodegenerative diseases in the central nervous system, and afflict more than five million Americans (mainly senior citizens). These diseases are caused by the immoderate loss of neurons in an area of the mid-brain, which leads to a decline in motor skills, such as walking and speaking, as well as memory loss and behavior problems. Previous treatments cannot halt or reverse these types of nerve-degenerative diseases. They only relieve symptoms, and sometimes even fail at that due to the severe side effects of these medications. But now, Biehl and D'Mello have worked together to develop compounds that could potentially protect the brain from nerve-degenerative diseases. They came upon this discovery when developing synthetic chemicals that contained a class of heterocyclic organic compounds. One particular compound in the heterocyclic class proved to be protective of neurons in tissue culture models. Furthermore, this same compound, named HSB-13, has also proven to be effective in fighting neurodegenerative diseases in animal models. "Our compounds protect against neurodegeneration in mice," said Biehl. "Given successful development of the compounds into drug therapies, they would serve as an effective treatment for patients with degenerative brain diseases."
HSB-13 not only decreased degeneration in the forebrain, but also corrected behavioral problems. It has also proved to be nontoxic while remaining "extremely potent."
Biotechnology and therapeutics company EncephRx, which is based in Dallas, is looking to create drug therapies based on this new class of compounds. The company was granted worldwide license to the "jointly owned compounds," and when the research is complete, EncephRx's pharmaceuticals made of these small compounds will be the first therapeutic tools capable of protecting brain cells and keeping them from dying. "Additional research needs to be done, but these compounds have the potential for stopping or slowing the relentless loss of brain cells in diseases such as Alzheimer's and Parkinson's," said D'Mello. "The protective effect that they display in tissue culture and animal models of neurodegenerative disease provides strong evidence of their promise as drugs to treat neurodegenerative disorders."
This study was published in the Journal of Neuroscience Research.
RE: Nootropics
geddarkstorm
Nootropics like piracetam are very fascinating. They are indeed a highly different mechanism, seemingly mediated by changing the membrane fluidity of neurons, and thus their action potential parameters (piracetam does not affect neural transmitter balance, which is a very important feature for safety and what distinguishes it from drugs). Somehow, this also upregulates neurogenesis, which is where the cognitive enhancements may stem (along with the better synchrony of ECG waves and hemisphere communication).But yes, just like you say, they can't stop these diseases; they are meant for healthy individuals. They may lower the chance to acquire, but once it's there the nootropics can only slightly (maybe) decrease severity of symptoms but not alter the cause. That's what makes this new compound so exciting--and it'll likely not affect cognitive functions and IQ in healthy individuals. Parent
Study: Prenatal Cell Phone Exposure May Lead to Childhood Behavioral Problems
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Scientists Find Brain Cell Suicide May Be Alzheimer's Culprit | 医学 |
2014-42/1179/en_head.json.gz/25004 | Dr. Greene > Articles > Tay-Sachs Disease: A-to-Z Guide from Diagnos... Tay-Sachs Disease: A-to-Z Guide from Diagnosis to Treatment to Prevention
Dr. Alan GreeneJanuary 07, 2014Leave a comment Related concepts:
Gangliosidosis, TSD
Introduction to tay-sachs disease:
The story of Tay-Sachs disease is one of heartbreaking poignancy. The magical experience of a wonderful, normal baby gives way to a desperate, heroic challenge of love and loss as developmental milestones begin to slip away.
The normal human lifespan, from infancy to senility, is compressed into an exquisitely brief window.
What is tay-sachs disease?
Tay-Sachs disease is a fatal genetic disease. A fatty substance called GM2 ganglioside gradually accumulates in the brain. As the brain cells become engorged with this fat, mental and physical abilities disappear, never to be regained.
The great majority of those with Tay-Sachs disease have the infant-onset form. Very rarely the symptoms begin in later childhood, or even in the twenties or thirties.
Who gets tay-sachs disease?
This is a recessive genetic disease. Both parents must be carriers for the child to be affected. When both parents are carriers, about one fourth of their children will have the disease. Half will be carriers.
The trait is fairly rare, expect in the Ashkenazi Jewish population where as many as 1 in 25 are carriers. With aggressive carrier screening programs within the Ashkenazi Jewish population, the incidence of children being born with Tay-Sachs within this population has decreased significantly.
What are the symptoms of tay-sachs disease?
Most babies with classic Tay-Sachs disease are born happy and healthy, a dream come true. The first 5 or 6 months or so of the first year have all of the ups and downs familiar to most parents: smiling, crying, sleepless nights, tender late-night feedings, learning to roll over, the adventure of starting solids, lighting up when the parents walk in the room, laughing with delight, and cooing peacefully.
Then, at about 5 or 6 months of age, the baby begins to make less and less eye contact with the parents. There is an exaggerated startle response to noise. In retrospect, many parents recall that their baby had always been sensitive to loud noises.
The babies, who had been developing normally, now begin to lag behind. They still grow and develop, but the milestones all come a bit late. This is usually when parents worry that something is wrong.
They usually learn to stand, but for these babies this is the pinnacle, the peak.
By the first birthday, when most parents of other children are celebrating achievement, these parents are grieving loss. By now their babies have lost the ability to stand, to sit, and even to vocalize.
From there, the deterioration is relentless. Seizures begin in the second year. Before long, the ‘toddler’ is completely blind, deaf, and unable to speak. Progressive spasticity is interrupted by convulsions. The spasticity gives way only as the muscles atrophy. Paralysis sets in. Some can’t even swallow.
Even with the best of care, most have died by the time their peers are skipping off to kindergarten. Death usually comes from inhaling vomit and developing pneumonia.
Far less common is the juvenile form of Tay-Sachs. Here, children appear normal until middle childhood. Clumsiness is the usually the first sign, but this is often dismissed until it can’t be ignored. Coordination continues to slip away even as uncontrolled, unwanted movements begin. Children lose the ability to speak while they are still grappling with their loss, often before the seizures begin. Eyesight darkens very gradually. Most die before their peers have gotten their driver’s licenses.
Even rarer is the adult form, which doesn’t begin until the twenties or thirties.
Is tay-sachs disease contagious?
How long does tay-sachs disease last?
This is a relentless juggernaut, killing most infants by age 3 to 5 and most older children by age 15.
How is tay-sachs disease diagnosed?
The disease and the carrier state can be diagnosed with a simple blood test.
How is tay-sachs disease treated?
Tay-Sachs disease is treated with supportive care for the child and for the family. Sadly there is still no cure.
How can tay-sachs disease be prevented?
Carrier tests, 1st trimester prenatal tests, and screening tests are easily available and inexpensive. Anyone who may be related to the Ashkenazi Jewish population should know his or her carrier status.
Because of aggressive carrier screening in the Ashkenazi Jewish population, the incidence of Tay-Sachs in Jews of North America and Israel has plummeted. In these regions, Tay-Sachs is now most commonly diagnosed in Pennsylvania Dutch, Louisiana Cajun, and French Canadian populations. (Sutton VR. Obstet Gynecol Clin North Am 2002; 29:287–296 and Traubman, Tamara, “Tay-Sachs, the ‘Jewish Disease,’ Almost Eradicated”, Haaretz)
Related A-to-Z Information:
Amblyopia (Lazy eye), Cerebral Palsy, Deafness, Depression, Epilepsy, Muscular Dystrophy, Nightmares, Phenylketonuria (PKU), Rabies, Sickle Cell Anemia, Tetanus
Alan Greene MD FAAP
Khanh-Van Le-Bucklin M.D. & Liat Simkhay Snyder M.D.
Reviewed by: Khanh-Van Le-Bucklin, Liat Simkhay SnyderLast reviewed: January 07, 2014 Article written by Dr. Alan Greene
Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show. Get DrGreene's New Ebook for Free
Recipe of the Day!Gluten Free Chicken, Cashew, and Chickpea Curry Recipe Ready in: 57 minsSubmitted by: Katie Newell Toddlers understand much more than they can say! Tap to talk. Swipe to explore. Now available at App Store. | 医学 |
2014-42/1179/en_head.json.gz/25082 | ... Missouri reports case of mosquito-borne virus
ST. LOUIS (AP) — Missouri health officials have reported the state's first case of a mosquito-borne virus that has been spreading to the U.S. from the Caribbean.The St. Louis County Health Department announced Tuesday that a 38-year-old resident was infected with chikungunya, which cannot be passed from human to human, while traveling in the Caribbean.The virus causes symptoms such as fever and joint pain within a week after a person is bitten by an infected mosquito. Patients can also develop severe headaches, muscle pain and swollen joints.There is no vaccine and no specific treatment for the virus, which typically is not fatal. Mosquitoes in the St. Louis region are not known to carry the virus.About 300 other travel-related cases have been reported nationwide, including one in Illinois, the St. Louis Post-Dispatch reported. Florida has had reported 107 chikungunya cases.According to the Centers for Disease Control and Prevention, travelers were bitten by infected mosquitoes in tropical destinations, including Anguilla, the Dominican Republic, Guyana, Haiti, Indonesia, Tonga and the U.S. Virgin Islands.The CDC recommends insect repellent and checking if door and window screens are intact to avoid mosquito bites.Chikungunya is derived from an African word that loosely translates to "contorted with pain." It has infected tens of thousands of people in the Caribbean islands since December. | 医学 |
2014-42/1179/en_head.json.gz/25185 | Marinus Pharmaceuticals, Inc. Enters Into Use Agreement With CyDex Pharmaceuticals, Inc. for Use of Captisol(R) for Ganaxolone IV
| Source: Marinus Pharmaceuticals, Inc. NEW HAVEN, Conn., Aug. 12, 2014 (GLOBE NEWSWIRE) -- Marinus Pharmaceuticals, Inc. (Nasdaq:MRNS), a biopharmaceutical company dedicated to the development of innovative neuropsychiatric therapeutics, today announced that it has entered into an agreement with CyDex Pharmaceuticals, Inc., a wholly owned subsidiary of Ligand Pharmaceutical Incorporated, for the clinical use of Captisol, a patent protected, uniquely modified cyclodextrin, whose chemical structure was designed to improve solubility, stability, bioavailability and dosing of active pharmaceutical ingredients. Marinus intends to evaluate optimizing its intravenous (IV) dose form of ganaxolone with Captisol.
"We are pleased to announce this important step towards optimizing our IV formulation of ganaxolone for inpatient, acute care treatment situations," said Christopher M. Cashman, President and CEO of Marinus Pharmaceuticals, Inc. "Ganaxolone IV is planned to be available for human clinical testing next year and complements our existing capsule and liquid suspension dose forms presently in the clinic."
About Marinus Pharmaceuticals
Marinus Pharmaceuticals, Inc. is a biopharmaceutical company dedicated to the development of innovative neuropsychiatric therapeutics. The Company's clinical stage drug candidate, ganaxolone, is a novel synthetic analog of the endogenous neurosteroid, allopregnanolone. Ganaxolone is known for its anticonvulsive and antianxiety effects, and has been designed to avoid hormonal side-effects associated with endogenous neurosteroids. Ganaxolone is presently being studied in a multinational, randomized, placebo-controlled, Phase 2B/3 clinical trial in adult subjects for adjunctive treatment of partial-onset seizures. The Company currently has a Phase 2 proof-of-concept pediatric clinical trial in progress for ganaxolone as a treatment for behaviors in Fragile X Syndrome and plans to initiate a Phase 2 proof-of-concept clinical study later this year for the treatment of PCDH19 female pediatric epilepsy. Both Fragile X Syndrome and PCDH19 female pediatric epilepsy are potential orphan disorders that have been related to mutations affecting neurosteroid signaling at extrasynaptic GABAA receptors. For additional information, please visit the Company's website at www.marinuspharma.com.
To the extent that statements contained in this press release are not descriptions of historical facts regarding Marinus, they are forward-looking statements reflecting the current beliefs and expectations of management made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Words such as "may," "will," "expect," "anticipate," "estimate," "intend," and similar expressions (as well as other words or expressions referencing future events, conditions or circumstances) are intended to identify forward-looking statements. Examples of forward looking statements contained in this press release include, among others, statements regarding our expectations regarding our development plans for our product candidate, including optimizing a product's formulation and the clinical trial testing schedule. Forward-looking statements in this release involve substantial risks and uncertainties that could cause our clinical development programs, future results, performance or achievements to differ significantly from those expressed or implied by the forward-looking statements. Such risks and uncertainties include, among others, the uncertainties inherent in the conduct of future clinical trials, the timing of the clinical trials, enrollment in clinical trials, availability of data from ongoing clinical trials, expectations for regulatory approvals, and other matters, including the development of formulations of ganaxolone, that could affect the availability or commercial potential of our drug candidates. Marinus undertakes no obligation to update or revise any forward-looking statements. For a further description of the risks and uncertainties that could cause actual results to differ from those expressed in these forward-looking statements, as well as risks relating to the business of the Company in general, see filings Marinus has made with the Securities and Exchange Commission. Edward F. Smith
Vice President, CFO, Secretary and Treasurer
Marinus Pharmaceuticals, Inc.
other press releases by Marinus Pharmaceuticals, Inc.
Marinus Pharmaceuticals, Inc. to Present at the 21st Annual BioCentury Newsmakers Conference on Friday, September 26, 2014
Marinus Pharmaceuticals, Inc. Announces Exercise of Over-Allotment Option in Public Offering of Common Stock
Marinus Pharmaceuticals, Inc. to Ring the Opening Bell of the NASDAQ Stock Market
Marinus Pharmaceuticals, Inc. Announces Pricing of Initial Public Offering
Financing Agreements
http://www.marinuspharma.com
Edward F. Smith
Marinus Pharmaceuticals logo | 医学 |
2014-42/1179/en_head.json.gz/25282 | Home About Us Community Magazines Patient Stories Bariatric Surgery Bariatric Surgery: Jack and Muriel's Story
Bariatric Surgery: Jack and Muriel's Story
Big Losses, Even Bigger Gains
"We are delighting in our second childhoods," says Muriel Alexander about herself and her husband, Jack, since they lost a combined 258 pounds. She wants to go skydiving, he is wearing his Civil War reenactment uniform that hasn't fit since 1986, and together they renewed their wedding vows.
This new lease on life is thanks to weight-loss surgery and lots of hard work and determination. The Alexanders agree that the road has not been easy, but it has been worth it.
"We took this journey together and have supported one another every step of the way," Muriel says. Her surgery was in December 2008; Jack had his the following month.
Brian Cantor, MD, medical director, Bariatric Surgery Program, Holy Cross Hospital, performed Roux-en-Y gastric bypass surgery for both Muriel and Jack.
"This surgery creates a shortcut around a portion of the small intestine to bypass the nutrient-absorbing area," Dr. Cantor says. "This surgery helps in two ways. First, it restricts the amount of food that the patient can eat. Second, it alters the patient's ability to digest food."
Surgeons at Holy Cross Hospital also perform:
laparoscopic adjustable gastric band surgery, which involves implanting an adjustable gastric band that reduces stomach capacity without stapling the stomach or changing normal digestion gastric sleeve laparoscopic surgery, which is the removal of a little more than half of the stomach so that it takes the shape of a tube or sleeve Around-The-Clock ExpertiseHoly Cross Hospital's Bariatric Surgery Program is accredited by the American College of Surgeons Bariatric Surgery Center Network as a Center of Excellence. This means the program has met the highest standards of surgical care.
All of our laparoscopic bariatric surgeons meet the qualifications set forth by the American Society for Metabolic and Bariatric Surgery. And the hospital has more than 20 years' experience helping bariatric patients with an outstanding team of cardiologists, anesthesiologists, pulmonologists, gastroenterologists, interventional radiologists and nutritionists.
Physician assistants work hand-in-hand with bariatric surgeons during and after surgery. They are available 24 hours a day in the hospital to help make each patient's stay as smooth and comfortable as possible.
Continuous Support Weight-loss surgery patients may lose a large amount of weight quickly after surgery. For about half of the patients, the rapid weight loss results in excess abdominal skin. These patients may be candidates for body-contouring plastic surgery to remove the extra skin.
As for Jack and Muriel, they still find support from Holy Cross Hospital.
"Muriel and I still participate in Holy Cross Hospital's postsurgical support group," Jack says. "The group is so important to us, because it gives us the opportunity to share and learn."
Two bariatric support groups meet at Holy Cross Hospital - one for people who are considering weight-loss surgery and one for people who have had it.
"It's amazing to think about all of the people whose lives have been improved and extended because they took this journey," Muriel says. "Holy Cross Hospital's program is so complete. If you are considering weight-loss surgery, use it!" | 医学 |
2014-42/1179/en_head.json.gz/25337 | Diabetes May Be Linked to Risk of Alzheimer's 09/19/2011 04:02 PM
Diabetes May Be Linked to Risk of Alzheimer's By Associated Press
Diabetes May Be Linked to Risk of Alzheimer's Study Shows Greater Dementia Risk for People With Diabetes and Prediabetes WebMD Health News By Denise Mann Reviewed by Laura J. Martin,...
Diabetes May Be Linked to Risk of Alzheimer'sStudy Shows Greater Dementia Risk for People With Diabetes and PrediabetesWebMD Health News
Low Vitamin D May Raise Diabetes Risk in KidsBrain Abnormalities in Obese Kids With DiabetesKids' Diabetes Drug Use DoublesDiabetes Alert: ReliOn Insulin Syringes RecalledSept. 19, 2011 -- People with diabetes may be twice as likely to develop memory problems and dementia as they age, including Alzheimer's disease, a study shows.This risk also appears to be heightened among people with prediabetes -- people who are on the verge of developing diabetes.Exactly how diabetes and dementia are linked is not fully understood. But the new findings add to growing evidence that what is good for our hearts may also be good for our brains.The study is published in Neurology.In the study, 1,017 people 60 and older were given a glucose tolerance test to see if they had diabetes or prediabetes. Researchers from Kyushu University in Fukuoka, Japan, followed the participants for around 11 years and then tested them for dementia.In that time, 232 people developed Alzheimer's disease and other forms of dementia.Forty-one of 150 people with diabetes developed dementia. By contrast, 115 of the 559 people without diabetes developed dementia. An increased risk of dementia was also found in people with prediabetes.The Diabetes-Dementia ConnectionZoe Arvanitakis, MD, says many questions remain regarding the "intriguing" relationship between diabetes and dementia. Arvanitakis is a neurologist at the Alzheimer's Disease Center at Rush University Medical Center in Chicago.For starters, how are the two conditions linked? There are some plausible explanations, she says. Diabetes is known to increase stroke risk, and strokes can lead to mental problems and dementia.If you lower your risk for diabetes, might you prevent the onset of Alzheimer's disease or other types of age-related dementia?It is too early to say that, but "food that is good for the heart is also good for the brain," Arvanitakis says.Some of the same heart-healthy habits that help lower diabetes risk, such as getting regular exercise and not smoking, may also improve the health of your brain. "It's too premature to say if you prevent diabetes, you would not develop dementia," she says.There are other things beside diabetes and prediabetes that may increase risk for dementia, such as family history. "The mechanism linking diabetes and dementia still needs to be sorted out," Arvanitakis tells WebMD. "It is important to stay healthy and prevent vascular risk factors from getting out of hand. If you have diabetes, get your blood sugar under control."Other vascular (heart disease and stroke) risk factors include high blood pressure, high cholesterol, heart disease, and obesity.Exercise regularly and eat a balanced diet, too. "Hopefully, this will help in the long run," she says. Role of CholesterolRachel Whitmer, PhD, says that it's not just diabetes and blood sugar abnormalities that may increase dementia risk either. She is a research scientist and epidemiologist at Kaiser Permanente Northern California Division of Research in Oakland, Calif.Previous studies have shown that high blood cholesterol levels also raise a person's risk for developing Alzheimer's disease and other types of dementia."The silver lining to the cloud is that yes, vascular risk factors are also associated with dementia, but they are modifiable," she says. "You can change your cholesterol levels with exercise and diet." The same holds true for diabetes and prediabetes. "Understand that what is good for the heart is good for the brain and even though dementia shows up late in life, you need to start thinking about it sooner," Whitmer tells WebMD.SOURCES:Ohara, T. Neurology, 2011; vol 77: pp 1126-1134.Zoe Arvanitakis, MD, neurologist, Alzheimer's Disease Center, Rush University Medical Center, Chicago.Rachel Whitmer, PhD, research scientist and epidemiologist, Kaiser Permanente Northern California Division of Research, Oakland.© 2011 WebMD, LLC. All rights reserved. | 医学 |