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HomeResearchNCI’s Role in Cancer ResearchSpotlight on ScientistsMERIT Award Recipients Find an NCI-Designated Cancer Center Profiles in Cancer Research Outstanding Investigator Award Recipients MERIT Award Recipients MERIT Award Recipient: Mina J. Bissell, Ph.D. Sponsoring NCI Division: Division of Cancer Biology (DCB) Grant Number: R37 CA064786-14 Award Approved: January 2010 Institution: Lawrence Berkeley National Laboratory Department: Life Sciences Division The Bissell Lab Literature Search in PubMed Definition of Microenvironment in Breast Cancer All the cells in an organism have the same genetic material. The Bissell laboratory therefore wanted to learn the basis of organ- and tissue-specificity, i.e. how an organ such as the mammary gland (also referred to as breast in humans) "knows"' to be normal, and what goes wrong when it develops into breast cancer. Dr. Bissell was one of the first to propose and elucidate the important signaling role of the extracellular-matrix (ECM)—the large molecules that are outside the cells and provide many functions for the cells and organs. She also recognized the crucial role of both the microenvironment surrounding each tissue and organ, and the 3-dimensional tissue structures, as factors that determine tissue-specificity in normal differentiation and in cancer. Together with their collaborators, the Bissell lab has developed unique and versatile 3-dimensional "organotypic" in vitro models for mammary glands from both mice and women that can be used to rapidly distinguish normal and malignant cells. The Bissell lab has shown also that signaling pathways are integrated and "interpreted" by cells differently in 3D vs. 2D in vitro models, and that the 3D models are a much better surrogate for animals than 2D cultures. These models and experimental assays/techniques now are much-appreciated and widely used in basic research as well as in drug testing. Over the last three decades, through an imaginative blend of cell and molecular biology, the Bissell laboratory has utilized these experimental models to identify the critical components of ECM signaling, including a number of its key receptors that regulate mammary-specific genes. Since the mammary gland (like all tissues and organs) is composed of multiple cell types, and since the Bissell laboratory is interested in understanding not only cell biology but also tissue/organ and cancer biology, they began a long-term collaboration with the laboratory of Dr. Petersen in Denmark, who is an expert in human breast biology. The overall goal of this on-going MERIT Award project is to understand the interactions and the roles of myoepithelial cells (MEPs), which surround the luminal epithelial cells (LEPs) of the mammary gland. The Bissell/Petersen laboratories have shown that MEPs play a crucial role in keeping the LEPs functional and in proper orientation (polarity) for secretion of milk and other proteins. However, both MEPs and an important ECM molecule, laminin 111 (LN1), are lost as breast cancer progresses. As a result of this MEP and LN1 loss, and the subsequent loss of correct signaling to the LEPs, the LEPs gradually lose their polarity, become disorganized, and become malignant. Dr. Bissell has applied these findings by providing aberrant LEPs with signals that could replace the role of MEPs, and demonstrating that the LEPs can re-acquire proper polarity. Her laboratory has demonstrated as well that even breast carcinoma cells harboring many genetic alterations can still "revert" to a normal phenotype both in 3D cultures and in vivo when they are manipulated epigenetically to reestablish proper tissue polarity. These key findings could shed light on why tumor cells become dormant and on what could "awaken" them to become malignant again and become metastatic. Collectively, the experimental strategies to be utilized in this research program will address how different cell types of a tissue interact to maintain the integrity of the organ, and how this information could be used for prevention, prognosis and treatment of breast cancer.

医学

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Share: NANTICOKE PHYSICIAN NETWORK WELCOMES DR. ARTHUR JONES Nanticoke Health Services June 17, 2014 Arthur Jones, DO, Obstetrics & Gynecology Nanticoke Health Services is proud to welcome Dr. Arthur Jones, DO to its active medical staff. Dr. Jones joins Nanticoke Health Services specializing in Obstetrics and Gynecology. He is accepting new patients at 8472 Herring Run Road in Seaford. Appointments can be made by calling, 302-629-8977. Dr. Jones completed medical school at the Philadelphia College of Osteopathic Medicine in Pennsylvania. He completed his residency within the St. Health System in Detroit, Michigan. Dr. Jones is Board Certified in Osteopathic Obstetrics and Gynecology. He is a member of the American College of Osteopathic Obstetrics and Gynecology, American College of Obstetrics and Gynecology, American Osteopathic Association, Phi Sigma Gamma Osteopathic Medical Fraternity, and Omega Psi Phi Fraternity, Inc. Nanticoke Memorial Hospital has been named one of the Best 100 Places to Work in Healthcare by Becker’s Hospital Review for three years in a row. Nanticoke Memorial Hospital holds a Level III trauma status and includes an expanding interventional cardiology program. Nanticoke is nationally certified by the Joint Commission as a Primary Stroke Center and is a Gold Plus Award performer according to the American Heart/American Stroke Association’s Get With The Guidelines®. Nanticoke’s medical staff includes over 120 active and community affiliate staff physicians practicing in 40 different specialties. For more information, please visit www.nanticoke.org.

医学

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President Obama Addresses Healthcare Website Issues, Calls them "Unacceptable" Tiffany Kaiser - October 21, 2013 11:42 AM 57 comment(s) - last by chripuck.. on Oct 25 at 1:14 PM He'll do so at an event today at 11:25 a.m. U.S. President Barack Obama has called the issues with the HealthCare.gov website "unacceptable" at an event this morning. According to Reuters, Obama announced a plan to address the recent problems with HealthCare.gov at an event today in the White House Rose Garden. Consumers, pharmacists and business owners were in attendance. With the rollout of Obamacare on October 1, a key part of the program is consumer accessibility to HealthCare.gov in order to select new insurance plans. The idea behind it is to bring health insurance to Americans that have gone without, and it also doesn't prevent those with pre-existing conditions to apply. But the White House didn't expect HealthCare.gov to see the amount of traffic it did when Obamacare began. Within the first 10 days, there were over 19 million visits to the site. This led to many technical problems with the site, such as jumbled text, error messages and delays with loading pages. Obama even compared the glitchy website to iOS 7. Obama sees this as a serious issue and addressed it today, calling it unacceptable" and planning new ways for Americans to get insurance exchanges despite site issues. "The president will directly address the technical problems with HealthCare.gov - troubles that he and his team find unacceptable - and discuss the actions he has pushed for to make it easier for consumers to comparison shop and enroll for insurance while work continues around the clock to improve the website," said a White House official. According to the U.S. Department of Health and Human Services (HHS), fixes are being made to the site, but it's not all bad. It said people have been successful in other tasks on HealthCare.gov, such as verifying eligibility. "Individuals have been able to verify their eligibility for credits, enabling them to shop for, and enroll in, low- or even no-cost health plans," said HHS. "We have updated the site several times with new code that includes bug fixes. Our team has called in additional help to solve some of the more complex technical issues we are encountering." As of last Saturday night, it was reported that almost half a million Americans applied for health insurance as part of Obamacare. Source: Reuters Comments Threshold -1 RE: Bogus wookie1 I think the Dems were the ones unwilling to compromise. Something about "we will not negotiate!" and then all of the name calling, such as calling anyone that disagrees with them terrorists or hostage-takers. Why wouldn't the Dems just compromise as you suggest? Parent “You know, with a bully, you cannot let them slap you around, Because if they slap you around today, they slap you 5 or 6 six times tomorrow. We are not going to be bullied. We’ve done everything we can and we’ve done it very reasonably.” Harry Reid Truly the words of a great compromiser, am I right? Democracy = bullying... Parent President Obama Compares Glitchy Obamacare Website to iOS 7

医学

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Print Email Font ResizeFlu shot: Yes or no?By Jessica [email protected]: A person receives a flu shot at Kaiser Park Shadelands in Walnut Creek, Calif., on Friday, Oct. 11, 2013. (Dan Rosenstrauch/Bay Area News Group) DAN ROSENSTRAUCH Related StoriesOct 16:Flu 411: Five frequently asked questionsGregg Schlaman swears by his annual flu shot. For the past 20 years, Schlaman, a 51-year-old aerospace engineering specialist, has received the influenza vaccine in the comfort of his Palo Alto office, where a nurse administers it between coffee and meetings."I have noticed that I don't get sick as often as I used to," Schlaman says. "I think it's the best thing you can do to protect yourself during the winter."To say John Styles disagrees is an understatement. "I've never gotten the flu shot, and I never will," says Styles, a 39-year-old Oakland computer programmer who says he gets a cold once or twice a year but is otherwise healthy. "I just think there's too much room for error by the pharmaceutical companies. And I prefer to avoid needles when I can."Why can't we agree on a seemingly simple health precaution? Because, like everything, pricking comes with pros and cons. Despite the Centers for Disease Control and Prevention recommendation that everyone over the age of 6 months get vaccinated against influenza, only 41 percent of adults and 56 percent of children actually receive the flu shot. Why? Opponents say the vaccine is not fool-proof; they still get sick, and sometimes, within a day of receiving it. Plus, it hurts.Meanwhile, advocates, including experts, argue that even with mild side effects, the vaccine is a critical first step in protecting yourself, loved ones, and the larger population against the nasty disease, especially this year, since the CDC is offering for the first time a quadrivalent vaccine designed to protect against four different flu viruses: Two influenza A viruses (including H1N1) and two influenza B viruses. Despite the potentially broader protection, efficacy still varies, depending on how well scientists in the spring are able to identify the flu strains that will be circulating during the upcoming season, says Jeffrey Silvers, an infectious disease specialist with Sutter Health's Eden Medical Center in San Leandro. The nasal mist form of the influenza vaccine at Kaiser Park Shadelands in Walnut Creek, Calif., on Friday, Oct. 11, 2013. (Dan Rosenstrauch/Bay Area News Group) "Last year's match wasn't very good, and a lot of people got sick," he says. "But one year like that doesn't mean you shouldn't get the vaccine." Silvers says the optimal time to get the vaccine is late October or early November, since influenza typically hits the Bay Area in December or January. "Vaccine immunity wanes with time, so you don't want to get it too early," he says.Even when the government does find correct viral matches, each person responds differently to the vaccine, depending on his or her age, immune system and underlying medical conditions. As Silvers explains, efficacy might be as high as 80 percent in a healthy young adult, but plummets to 50 percent or less in older people or someone fighting cancer, he says. People over 65 are also more likely to face serious complications or even death as a result of the flu."How do you protect your 85-year-old grandfather? You get vaccinated. His wife gets vaccinated. So does the caregiver," says Silvers, describing the concept of herd immunity. When contagious diseases are transmitted from individual to individual, chains of infection are likely to be disrupted when large numbers of a population are immune or less susceptible to the disease.His overall stance on the influenza vaccine? It's not perfect, but it does help."Development of vaccines is a complex process," he says. "We measure response based on the body's ability to develop immunity toward the vaccine, but there is no perfect correlation between vaccine-induced immunity and resistance to infection."Randy Bergen, a Walnut Creek pediatric infectious disease expert, agrees. "Even if it's only 30 percent effective, which some experts believe, when you look at the number of people we vaccinate, that has huge implications for the health of our community." Still, he says, the vaccine doesn't protect you from all the other wintertime viruses, including the common cold. "It's the safest and most effective way to protect yourself against the flu," he says. "But you still have to wash your hands constantly and stay home when you're sick." That's enough for Sylvia Solis to be a vaccine believer. The 29-year-old San Jose teacher's assistant spends her days "around a lot of germs" and has received a flu shot every year for a decade. "I might have a little pain in my arm or some mild aches, but I don't mind," Solis says. "People always tell me, 'You're so lucky you don't get sick,' but I think it's the flu shot."Sarah Sohm isn't so sure. It's not that Sohm, 28, is anti-vaccine. She just really hates getting shots. And, she doesn't see an immediate need to be vaccinated against influenza. "I don't have children that could get me sick, and I'm not around people I could get sick," she says. But, every year, around this time, when Sohm calls her grandparents in Palo Alto to set up their next lunch date, her grandmother, Gayle Pena, skips hello and instead declares this into the phone: "Let's get that flu shot."Last weekend, as they have for the past 10 years, they went to Safeway together and got their matching injections. "She knows I won't go on my own," Sohm says. "And she wants me to be healthy." Standard dose trivalent shots that are manufactured using inactive virus grown in eggs. These are approved for people ages 6 months and older. There are different brands of this type of vaccine, and each is approved for different ages. However, there is a brand that is approved for children as young as 6 months old and up. A standard dose trivalent shot containing virus grown in cell culture, which is approved for people 18 and older. A standard dose trivalent shot that is egg-free, approved for people 18 through 49 years of age. A high-dose trivalent shot, approved for people 65 and older. A standard dose intradermal trivalent shot, which is injected into the skin instead of the muscle and uses a much smaller needle than the regular flu shot, approved for people 18 through 64 years of age.2. New, quadrivalent flu vaccineThis vaccine protects against two influenza A viruses (including H1N1) and two influenza B viruses. It contains a live virus and is in limited supply, so call your doctor or pharmacy to see if they're offering it this year. It is also offered with inactive strains. The following quadrivalent flu vaccines are available: A standard dose quadrivalent shot A standard dose quadrivalent nasal spray, approved for healthy people 2 through 49 years of age.Print Email Font ResizeReturn to Top Raiders rookies DeAndre Washington, Jalen Richard step upGiants fall two games behind Dodgers with 3-1 loss to BravesKawakami: Kaepernick defends his stance on national anthem • Article commenting rules of the road

医学

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> Marrow injections help kidney ... Sign Up for Free NewsLetter Email Address Published January 23, 2008 08:31 PM Marrow injections help kidney transplant success Umbilical cord blood can help metabolic disordersDecember 10, 2007 01:09 PM Gentler chemo helps patients survive lymphomaDecember 10, 2007 06:33 PM Australian girl changes blood group, immune systemJanuary 24, 2008 08:58 PM Bone marrow treatments restore nerves, expert saysMay 6, 2008 02:38 PM By Gene Emery BOSTON (Reuters) - Injecting blood or bone marrow cells into people who have just received a donated kidney can reduce the need for drugs that suppress the immune system, researchers reported on Wednesday. The stem cells in the blood and bone marrow helped trick the body into tolerating the transplants, two teams of researchers reported in the New England Journal of Medicine. In one series of experiments, researchers at Massachusetts General Hospital and Harvard Medical School in Boston tested the technique on five volunteers who received a kidney from a relative. Four were eventually weaned off their anti-suppression drugs. ADVERTISEMENT "While we need to study this approach in a larger group of patients before it is ready for broad clinical use, this is the first time that tolerance to a series of mismatched transplants has been intentionally and successfully induced," said Dr. David Sachs, who helped lead the study. Doctors have long sought a permanent and reliable way to trick the body into thinking that a transplanted organ is not a foreign invader. The drugs currently in use can have onerous side effects, including cancer and kidney damage. Bone marrow makes the body's immune system cells, and the donor's immune cells presumably took up residence in the transplant patient's body and helped create a welcoming reception for the kidney, the researchers said. This technique has been tried before under different circumstances including on multiple myeloma patients. The new study involved patients whose kidney failure was caused by other problems. Patients first had their bone marrow partially destroyed and then received a drug that kills off T cells -- immune cells that play a key role in rejecting transplanted organs. The patients ended up with bone marrow that was a temporary mix of their own cells and the cells from the donor. The first two patients did very well. After problems with a third patient, the researchers added a drug to also kill B cells, another element of the immune system. All four of the successfully transplant patients continue to have functioning kidneys two to five years later, the researchers said. In another Journal article, a research team from the Stanford University School of Medicine, led by John Scandling, reported that they were also able to eliminate the need for immunosuppressive drugs in a 47-year-old patient who received donated blood cells from his brother two weeks after getting one of his kidneys. "My body thinks my brother's kidney is mine," patient Larry Kowalski said in a statement. Six other patients given the same treatment have not been able to stop taking their immunosuppressive drugs, although their donated kidneys were not a perfect match the way Kowalski's was. In a third study, a 9-year-old girl who got a liver transplant was able to stop taking immune-suppressing drugs after the donor liver apparently seeded stem cells into her bone marrow, creating a hybrid immune system and even changing her blood type. (Editing by Maggie Fox and David Wiessler) Tweet

医学

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Public Release: 29-Dec-2008 Transcendental Meditation reduces ADHD symptoms among students: New study Dissatisfaction with medication spurs interest in meditation Maharishi University of Management VIDEO: Four middle school students with Attention Deficit Hyperactivity Disorder were interviewed prior to learning the Transcendental Meditation technique, and again 3 months later. They first describe... view more Credit: Adam Pressman, videographer The Transcendental Meditation technique may be an effective and safe non-pharmaceutical aid for treating ADHD, according to a promising new study published December 29, 2008, in the peer-reviewed online journal Current Issues in Education. The pilot study followed a group of middle school students with ADHD who were meditating twice a day in school. After three months, researchers found over 50 percent reduction in stress and anxiety and improvements in ADHD symptoms. Effect exceeds expectations "The effect was much greater than we expected," said Sarina J. Grosswald, Ed.D., a George Washington University-trained cognitive learning specialist and lead researcher on the study. "The children also showed improvements in attention, working memory, organization, and behavior regulation." Grosswald said that after the in-school meditation routine began, "teachers reported they were able to teach more, and students were able to learn more because they were less stressed and anxious." Stress interferes with the ability to learn Prior research shows ADHD children have slower brain development and a reduced ability to cope with stress. "Stress interferes with the ability to learn--it shuts down the brain," said William Stixrud, Ph.D., a Silver Spring, Maryland, clinical neuropsychologist and co-author of the study. "Medication for ADHD is very effective for some children, but it is marginally or not effective for others. Even for those children who show improved symptoms with the medication, the improvement is often insufficient or accompanied by troubling side effects," Stixrud said. "Virtually everyone finds it difficult to pay attention, organize themselves and get things done when they're under stress. So it stands to reason that the TM technique which reduces stress and organizes brain function would reduce ADHD symptoms." While in some cases a child cannot function without medication, there is growing concern about the health risks and side effects associated with the common ADHD medications, including mood swings, insomnia, tics, slowed growth, and heart problems. In 2006 the FDA required manufacturers to place warning labels on ADHD medications, listing the potential serious health risks. These high risks and growing concerns are fueling parents' search for alternatives that may be safer for their kids. The study was conducted in a private K-12 school for children with language-based learning disabilities. Participation was restricted to 10 students, ages 11-14, who had pre-existing diagnoses of ADHD. About half of the students were on medication. The students meditated at school in a group for 10 minutes, morning and afternoon. To determine the influence of the TM technique, at the beginning and end of the three-month period, parents, teachers and students completed standard ADHD assessment inventories measuring stress and anxiety, behavior and social competency, and executive function. Students were also given a battery of performance tests to measure cognitive functioning. "The results were quite remarkable" Andy and Daryl Schoenbach's daughter was diagnosed with ADHD in second grade. Like most ADHD children she was taking medication. "The medication helped but had mixed results--she still lost focus, had meltdowns, and the medications affected her sleep and appetite," said Andy, who lives with Daryl in Washington D.C. "She was not performing close to her potential and we didn't see the situation improving. So at the end of seventh grade when her doctor recommended increasing the medication, we decided it was time to take a different course--stopping the medication and using Transcendental Meditation." "The results were quite remarkable," Daryl said. "The twice daily meditations smoothed things out, gave her perspective, and enabled her to be in greater control of her own life when things started falling apart. It took some time, but it gradually changed the way she handled crises and enabled her to feel confident that she could take on greater challenges --in her own words, 'climb a mountain.'" "Everyone noticed the change," Andy added. Grosswald explained that there is substantial research showing the effectiveness of the TM technique for reducing stress and anxiety, and improving cognitive functioning among the general population. "What's significant about these new findings is that among children who have difficulty with focus and attention, we see the same results. TM doesn't require concentration, controlling the mind or disciplined focus. The fact that these children are able to do TM, and do it easily shows us that this technique may be particularly well suited for children with ADHD," she said. This study was funded by the Abramson Family Foundation and the Institute for Community Enrichment. A second, recently completed TM-ADHD study with a control group measured brain function using electroencephalography (EEG). Preliminary data shows that three months practice of the technique resulted in significant positive changes in brain functioning during visual-motor skills. Changes were specifically seen in the circuitry of the brain associated with attention and distractibility. After six months TM practice, measurements of distractibility moved into the normal range. A third TM-ADHD study, to be funded by a $2 million grant from the David Lynch Foundation (DavidLynchFoundation.org), will more fully investigate the effects of the technique on ADHD and other learning disorders. The Center for Disease Control reports that nearly 50 percent of the 4.5 million children (ages 4-17) in the United States diagnosed with ADHD are on ADHD medication--and the majority of those on medication stay on it in adulthood. The rate of prescriptions for Attention Deficit Hyperactivity Disorder in the U.S. has increasing by a factor of five since 1991--with production of ADHD medicines up 2,000 percent in 9 years. The commonly used drugs for ADHD are stimulants (amphetamines). These drugs can cause persistent and negative side effects, including sleep disturbances, reduced appetite, weight loss, suppressed growth, and mood disorders. The side effects are frequently treated with additional medications to manage insomnia or mood swings. Almost none of the medications prescribed for insomnia or mood disturbances are approved by the Food and Drug Administration (FDA) for use with children. The long-term health effects of ADHD medications are not fully known, but evidence suggests risks of cardiac disorders and sudden death, liver damage and psychiatric events. It has also been found that children on long-term medication have significantly higher rates of delinquency, substance use, and stunted physical growth. The Transcendental Meditation Technique The Transcendental Meditation technique is an effortless technique practiced 10-20 minutes twice a day sitting comfortably with the eyes closed. TM is not a religion or philosophy and involves no new beliefs or change in lifestyle. Over 350 peer-reviewed research studies on the TM technique confirm a range of benefits for mind, body and behavior. Several studies have compared the effects of different meditation practices and found that Transcendental Meditation provides deeper relaxation and is more effective at reducing anxiety, depression and hypertension than other forms of meditation and relaxation. In addition, no other meditation practice shows the widespread coherence throughout all areas the brain that is seen with Transcendental Meditation. The Transcendental Meditation technique is taught in the United States by a non-profit, educational organization. More information can be obtained by calling 888-LEARN-TM or visiting www.ADHD-TM.org, www.AskTheDoctors.com, or www.TMEducation.org. Ken Chawkin [email protected] @MaharishiU http://www.mum.edu More on this News Release Current Issues in Education Abramson Family Foundation, Institute for Community Enrichment DECISION-MAKING/PROBLEM SOLVING MEMORY/COGNITIVE PROCESSES PARENTING/CHILD CARE/FAMILY Transcendental Meditation Reduces ADHD Symptoms Among Students: New Study (IMAGE) view more Students with ADHD Before and After Learning TM (VIDEO)

医学

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How to Prevent Cold and Flu By Stacey Colino Print Why we get sick and how to stay healthy during cold and flu season. Here are some commonly asked questions and answers. Q. Can flying on an airplane make you sick? A. "Yes," says Bruce Polsky, chief of the division of infectious diseases at St. Luke’s–Roosevelt Hospital Center, in New York City. "Especially if you’re sitting within six feet of someone who is sneezing, coughing, and spewing germs into the dry air." Because the air is recirculated in the close quarters of the plane’s cabin, certain kinds of germs may stay suspended, and you can end up breathing them in. Drink lots of water, and consider using a saline nasal spray to keep your mucous membranes moist.Q. Can your toothbrush or lipstick reinfect you after you’ve been sick?A. It’s not likely. “If you’ve just come out of a cold, don’t toss it,” says Neil Schachter, a professor of pulmonary and critical care at the Mount Sinai School of Medicine, in New York City. “Once you’ve had a particular viral illness, you’re protected from it.” Q. Can you get sick from touching a doorknob?A. Yes. Germs last longer than you think. “Viruses can survive up to three days on surfaces and inanimate objects,” says Chuck Gerba, a professor of environmental microbiology at the University of Arizona in Tucson. That’s why it’s a good idea to carry your own pen. To reduce the number of germs, be sure to zap hot spots (the phone, for instance) regularly at home and at work with a disinfecting product. Q. Can you catch the same cold or flu twice in the same season?A. You can’t get exactly the same one, as your body will have developed antibodies to it. But “cold and flu viruses mutate, so there are subtly different forms of the virus,” says Caroline Rudnick, an assistant professor of community and family medicine at St. Louis University. “Getting one type doesn’t protect you from another.” Even if you’ve had the flu vaccine, if a different strain of the flu virus is going around, you could catch it.Q. Is it safe to exercise with a cold?A. "Do a 'neck check': If your symptoms are in or above your neck―say, if you have a stuffy nose, a headache, and a mildly sore throat and you’re sneezing―it’s fine to work out," Schachter says. "But if your symptoms extend below the neck―if you have a cough, a fever, body aches, or chills―take a break from exercising until you feel better."Q. Can going outside with wet hair in the winter make you sick?A. Exposure to an infection, not cold temperatures, can make you sick. “But if your body gets cold, it could get physically stressed because it’s using a lot of energy to try to stay warm, and you might be more likely to catch an infection,” Rudnick explains. To avoid stressing your body unnecessarily, dry your hair before going out in the cold, or wear a hat. ________________________________________________________________________________ More From Real Simple: 6 Allergen-Free Snacks for Kids 6 Ways to Have Healthy Holidays 6 Natural Cold-Prevention Strategies________________________________________________________________________________ What Makes You Vulnerable to Colds and FlusNormally your body’s barriers, including your skin and the linings of your airways and gastrointestinal tract, keep invaders out. But low immunity, contact with a heavy germ load, high stress, and some surprising factors can increase your chances of getting sick. Having fewer illnesses in childhood could affect your health as an adult. Paradoxically, people who were frequently sick with viral infections as children typically have greater immunity and are susceptible to fewer infections as adults. “Antibodies last a lifetime,” says James A. Wilde, an infectious-disease specialist and the director of the pediatric emergency department at the Medical College of Georgia, in Augusta. When your child is sick with her third cold of the season, remind yourself that it may be helpful to her in the long run. Cold temperatures and low humidity, indoors and out, can irritate or damage your airways. Air pollution, indoor dust, and ash from fireplaces can also act as irritants, causing inflammation and making it easier for germs to enter your system, says Russell Robertson, chair of the department of family medicine at the Feinberg School of Medicine at Northwestern University, in Chicago. Smoking can make you prone to bacterial and viral infections. “Smoking damages the linings of the nose and throat, which not only offer barrier protection but also have a coating of fine filaments, called cilia, on the surface,” says Neil Schachter, a professor of pulmonary and critical care at the Mount Sinai School of Medicine, in New York City. That’s why smokers tend to have more frequent and worse colds than nonsmokers. Exposure to secondhand smoke can also lower your natural defenses. Stress, lack of sleep, and poor nourishment can also set you up for getting sick. Stress and fatigue can lower your resistance to infection and increase the intensity of illnesses you do get. (For more on how stress can make you sick, see Manage Your Stress.) But there may be a bit of a lag between a stressful event and when you become ill. “When you’re in a period of maximal stress, you’re releasing a lot of adrenaline, which keeps you going,” says Bruce Polsky, chief of the division of infectious diseases at St. Luke’s–Roosevelt Hospital Center, in New York City. “Once that stressful stimulus is over or removed, you crash.” If you’re under long-term stress, you’re especially susceptible to illness, because chronically elevated stress hormones can suppress immune function and lower the activity of germ-fighting white blood cells. Researchers at Carnegie Mellon University found that severe chronic stress―from such things as conflicts with family or friends and unemployment―significantly increases a person’s risk of coming down with a cold. How to Stay Healthy During Cold and Flu SeasonStrengthen your body’s defenses by eating well, drinking lots of water, exercising regularly, and staying away from people who appear sick. If you do get a bug, pamper yourself.Eat antioxidant-rich foods, such as whole-grain cereals, walnuts, and artichokes, as well as foods packed with omega-3 fatty acids, such as salmon. “The antioxidants protect the body’s tissues against stress and inflammation and enhance immune function,” says Cindy Moore, a registered dietitian and the director of nutrition therapy at the Cleveland Clinic. “Omega-3 fatty acids promote blood flow and the production of anti-inflammatory substances,” which also boost immune function. Take a brisk walk every day. Any kind of moderate daily exercise―such as cycling, swimming, or working out at the gym―can improve lung and immune function. Physical activity enhances the ability of T lymphocytes (white blood cells that attack virus and cancer cells) to ramp up the immune response, says Neil Schachter, a professor of pulmonary and critical care at the Mount Sinai School of Medicine, in New York City. But don’t push yourself too hard. Some studies suggest that high-intensity exercise for two or more hours at a time increases stress hormones, which can lead to suppression of the immune system. Stay three or more feet away from people who are coughing or sneezing. This will keep you outside the immediate spray of their germs, says Chuck Gerba, a professor of environmental microbiology at the University of Arizona in Tucson. Wash your hands frequently and thoroughly. If you’re not near a sink during the day or you work in a high-germ environment, such as a school, carry an alcohol-based hand sanitizer with you. As you’ve been told millions of times, drink lots of water, don’t skimp on sleep, and get a flu shot. The tried-and-true advice still holds. Staying well hydrated keeps the tissues of the respiratory system moist and helps the immune system work properly. Sleep helps the body function at an optimum level. If you get seven to eight hours of rest a night, you’ll be less likely to become sick, and if you do catch something, you’ll recover faster. October through November is the best time to be immunized, even if you’re a healthy adult. If you can’t stand needles, ask your doctor about FluMist, a prescription nasal-spray vaccine that’s as effective as a shot. Finally, stay home from work when you first feel ill. It’s possible that work-related stress (not to mention commuting) could slow your recovery. Tell your boss that Real Simple said so. Click here to read more cold and flu stories. Advertisement

医学

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Print Close Glaucoma: Reading This Could Save Your Sight By Jessica Ryen Doyle In an effort to fight one of the leading causes of blindness, health organizations around the globe have pronounced March 6 as ‘World Glaucoma Day.’ Also known as the “sneak thief of sight,” often because there are no warning signs, the disease is a progressive loss of function. “The disease is more frequently seen in people who are 65 and older,” said Dr. Anne Louise Coleman, Frances and Ray Stark professor of ophthalmology at the Jules Stein Eye Institute at UCLA. “However, it does occur in younger individuals, especially in Hispanics and African-Americans.” Eye doctors recommend regular glaucoma screenings beginning at the age of 40, because if detected early enough, the disease can be treated and blindness can be prevented. Between 2.5 million and 3.5 million people in the United States have glaucoma, said Dr. Craig Marcus of Glaucoma Consultants of Long Island. And 50 percent of those people don’t even know they have the disease, he added. There are 120,000 people in the United States who are legally blind from glaucoma, Marcus said. There are three ways to treat glaucoma: — Medication (oral and eye drops).This is probably the most convenient way to treat glaucoma; however, you cannot stop using your eye drops, even if you feel your condition is improving. — Lasers. First, the eye is numbed; next the doctor holds a lens to the eye. A laser beam is aimed into the eye and makes small scars, which reduces the eye’s pressure. — Surgery. There are a few different kinds of surgeries, such as a trabeculectomy and the canaloplasty. Coleman said she performs a trabeculectomy on patients who cannot benefit from lasers or medication. In this procedure, a hole is created in drainage area of the eye. The opening is somewhat covered with a flap of tissue, but the new opening allows fluid to drain out of the eye and avoiding the drainage channels of the trabecular meshwork. Marcus recently began performing a newer surgery called canaloplasty, in which doctors place a micro-catheter inside the eye’s canal and dilate it with a gel-like material, tie a tiny suture to it and then pull out the catheter. Click here to watch a video on canaloplasty. “We’ve removed the middle layer of tissue and it takes about an hour,” Marcus said of the non-penetrating procedure. “It’s new and exciting.” To learn more about World Glaucoma Day, visit wgday.net. Print Close http://www.foxnews.com/story/2008/03/05/glaucoma-reading-this-could-save-your-sight.html

医学

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(Vol. 32, No. 5) Regenerative Medicine Back on Fast Track After decades of frustratingly slow progress, regenerative medicine is buoyed by optimism. Catherine Shaffer Cardio Cure from Bone Marrow? Click Image To Enlarge + Researchers from the Cedars-Sinai Heart Institute recently reported on a clinical trial that demonstrated that treating heart attack patients with an infusion of their own heart-derived stem cells helps damaged hearts re-grow healthy muscle. [luismmolina/ iStockphoto.com] Bone-marrow-derived progenitor cells for cardiovascular disease are one focus of Cardio3 Biosciences, says CEO Christian Homsy, M.D. The company is also developing a pair of protein-based therapies designed to protect heart tissue from acute injury and promote activation of resident stem cells in the setting of an acute myocardial infarction. For the cardiovascular regeneration candidate, C-Cure, stem cells are harvested from the bone marrow of patients who have had ischemic events, and processed at Cardio3’s manufacturing facility in Belgium. The bone marrow is processed over 12 weeks with a combination of different growth factors to produce the end result—progenitor cells. The progenitor cells are injected into the patient’s heart. In a Phase II clinical trial in 45 patients in 2009 through 2010, there was a “very significant” difference between the control arm and the test arm of 18.1%, according to Dr. Homsy. He says that the cells have three modes of action: direct engraftment of the cells to become heart cells, genesis of new vessels, and stimulation of neighboring cells through secretions. The protein products, C3BS-GQR-1 and C3BS-GQR-2, are being developed as a drug to stimulate regeneration using the patient’s own stem cells. C2BS-GQR-1 is intended to be used in the context of a myocardial infarction. In preclinical studies in swine, treatment with the therapy produced a 65% decrease in scar size at six weeks post-infarction, compared to 25% for control swine. The other product, C3BS-GQR-2, has potential both for myocardial infarction and heart failure. “These proteins are generally given in two phases,” Dr. Homsy explains. “One during the initial procedure, and another set 15 days later.” ACT’s Got Vision Gary Rabin presented ongoing work from Advanced Cell Technology relating to the company’s embryonic stem cell product for macular degeneration. According to Rabin, chairman and CEO, standard methods for harvesting embryonic stem cells involve removal of the inner cell mass of a blastocyst, which is destructive to the embryo. ACT developed a method that takes a single cell from the embryo at the morula stage. A morula has just four to eight cells total. This is the type of procedure used in preimplantation genetic diagnostics and is considered not to be destructive of the embryo. But ACT’s cells may have scientific advantages in addition to being embryo-friendly. “We tested our embryonic stem cell lines versus NIH approved lines,” Rabin says. “Our stem cell line was five times more efficient at creating the next germ layers.” The reason for this is that, when cells are extracted at the blastocyst stage, they are already committed to a cellular fat, such as blood cells, bone cells, etc. The earlier-stage morula cells don’t express those cell fate commitment factors, and are more malleable in their ability to create other kinds of cells in the body. ACT has developed a line of embryonic stem cell-derived retinal pigment epithelial (RPE) cells. The RPE cells reside at the back of the macula. When they decline, there’s a corresponding decline in photoreceptor cells that results in loss of vision. ACT is testing its RPE cells in three ongoing clinical trials in dry age-related macular degeneration, Stargardt macular dystrophy, and heart disease. It also has a preclinical program in disorders of the circulatory and vascular system, and expects to file an investigational new drug application to begin clinical trials in 2012. The company published Phase II clinical data in The Lancet describing the use of its RPE cells in two patients with dry AMD. In addition to showing a favorable safety profile, both patients experienced improvements in their vision that lasted for over four months, with no hyperproliferation, tumorigenicity, ectopic tissue formation, or rejection. (Those are all adverse events associated with embryonic stem cells therapy.) The cells appeared to engraft properly and resume normal RPE morphology. Stem Cells and Regenerative Medicine

医学

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news/health/behind-the-headlines Bingo Dating Holidays Public Notices World War One Pension Calculator Local Guide Sponsored Feed Sign in Horncastle 5-day weather forecast DVT flying advice reassessed “Sitting in a window seat during a long flight can increase the risk of deep vein thrombosis,” according to The Daily Telegraph. It has long been known that flying is associated with an increased risk of deep vein thrombosis (DVT), a type of serious blood clot in a major vein, but new US guidance has looked at a range of factors that could potentially raise the risk.Those of you thinking of booking your summer holiday might be interested to know that flying in cramped budget seats, while often annoying, presented no greater risk than flying in business class. And while pricey booze available during a flight can prove wallet-damaging, the guidelines say there was no firm evidence that drinking it could bring on DVT. However, sitting by a window during a long-haul flight was associated with a greater risk because of the limited opportunities for walking around. People’s age, previous DVT and recent operations were among the other factors found to raise DVT risk. The evidence-based guidelines were produced by the American College of Chest Physicians to address the risk of both DVT after long-haul flights and the potentially fatal lung clots (pulmonary embolisms) that can follow. The guidelines also include recommendations about the best ways for travellers to reduce their risk of DVT. The guidelines seem to debunk the long-held assumption that a lack of legroom causes DVT. This much-debated phenomenon is often referred to as “economy-class syndrome”. It is long established that inactivity is associated with DVT, and so some people believe that the lack of legroom when flying in economy class can increase the risk of developing a blood clot. This has led to the theoretical phenomenon being dubbed “economy-class syndrome”.Some have also suggested that dehydration is more common during economy travel and may increase the risk of DVT. However, the existence of this so-called “economy-class syndrome” is controversial and has never been proven. Deep vein thrombosis or DVT is when blood clots form in a deep vein. A clot that develops in a vein is also known as ‘venous thrombosis’. DVT most commonly affects the leg veins or deep veins in the pelvis. It can cause pain and swelling in the leg but in some cases there may be no symptoms. DVT can lead to the potentially life-threatening condition known as a pulmonary embolism. This occurs when a clot breaks off into the bloodstream and travels to the chest, where it blocks one of the blood vessels in the lungs.Experiencing DVT and pulmonary embolism together is known as venous thromboembolism (VTE), which is a condition that can be life-threatening. Each year more than 25,000 people in England die from VTE contracted in hospital. This is approximately 25 times the number of people who die from MRSA. VTE occurs in hospitals as a result of patients lying sedentary in bed for extended periods following an operation. In recent years the NHS and Department of Health have run a major programme of measures to help reduce the rates of VTE developed in hospitals. For example, many patients are now given a VTE risk assessment when being booked into hospital. In the UK each year about one person in every 1,000 is affected by DVT. Anyone can develop it but there are certain known risk factors that include: The advice comes from new evidence-based guidelines produced by the American College of Chest Physicians (ACCP). The findings were published in the February issue of the medical journal CHEST. The guidelines are extensive, running over hundreds of pages. They detail both the risk factors for DVT and measures to diagnose and prevent DVT. The evidence review that informed the guidelines looked at a range of risk factors for the development of DVT in long-distance travellers. These included the use of oral contraceptives, sitting in a window seat, advanced age, dehydration, alcohol intake, pregnancy and sitting in an economy seat compared to business class.The reviewers conclude that developing DVT or pulmonary embolism from a long-distance flight is generally unlikely, but that the following factors increased people’s risk:The finding relating to window seats was discussed further. The study authors suggest that long-distance travellers sitting in a window seat tend to have limited mobility, which is responsible for their increased risk of DVT.However, the review did not find any definitive evidence to support the theory that dehydration, alcohol intake or sitting in an economy seat (compared with sitting in business class) increases the risk of DVT or pulmonary embolism during a long-distance flight. On this basis, they conclude that travelling in economy class does not increase the risk of developing a blood clot, even during long-distance travel. However, they believe that remaining immobile for long periods of time does. Overall, the study authors say that “symptomatic DVT/PE [pulmonary embolism] is rare in passengers who have returned from long flights”, but that the association between air travel and DVT/PE is strongest for flights longer than 8-10 hours. Furthermore, most of the passengers who do end up developing a DVT/PE after long-distance travel have one or more risk factors. For travellers on flights longer than six hours who have an increased risk of DVT the new guidelines recommend:The guidelines do not recommend compression stockings for long-distance travellers who are not at increased risk of DVT.The guidelines advise against using blood-thinning aspirin or anticoagulant therapy to prevent DVT or pulmonary embolism for most people. They suggest that anti-clotting medications should be considered on an individual basis only for those at particularly high risk of DVT, as in some cases the risks may outweigh the benefits. GCSE RESULTS: Smiles all round for Horncastle area schools Captain sails off as new owners steam into Horncastle Ay up me duck! Rare Aussie bird spotted in Horncastle Call for extras ahead of ‘Just Jane’ filming Horncastle showjumper overcomes disability to win title Councillors raise concerns about Tetford development Visit this website on your mobile to start enjoying it on the move. Subscribe to the Horncastle News Get your favourite newspaper at a great low price. Sir Joseph Banks Centre 9-13 Bridge Street LN9 5HZ Email: [email protected] Horncastle News provides news, events and sport features from the Horncastle area. For the best up to date information relating to Horncastle and the surrounding areas visit us at Horncastle News regularly or bookmark this page. For you to enjoy all the features of this website Horncastle News requires permission to use cookies.

医学

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/ World Cancer Report 2014 / Meet the Editors Christopher P. Wild World Cancer Report World Cancer Report 2014 Edited by Bernard W. Stewart and Christopher P. Wild ISBN 978-92-832-0429-9 MEET THE EDITORS 14/05/2013 - Dr Christopher P. Wild, IARC Director, answers a few questions on the new edition of World Cancer Report. What is the aim of the World Cancer Report? [mp3 600KB ] The World Cancer Report is a comprehensive but not an exhaustive summary of what’s known about cancer: its occurrence, its causes, how the disease develops, how it can be prevented and managed. But it also provides information on what countries across the world are doing to minimize the effects of cancer on ordinary people. So its primary purpose is to provide a one-stop reference for scientists, health professionals, and decision-makers by giving the current state of understanding of this all-too-common disease. Why is it IARC which produces the report? [mp3 930KB ] Well, IARC is the cancer agency of the World Health Organization, and actually a core part of our mission is to disseminate information on cancer, so in that sense it falls directly into our remit. However, I think there are two features which characterize both the book and the work of this Agency. The first is that the book takes a global consideration of the disease. So we’re as interested in cancer as a consequence of infestation with parasites in rural South-East Asia as we are in the cancer risks associated with high technology, diagnostic radiation for example, in the richest countries of the world. And the second feature is its collaborative nature. So the book comprises material from leading cancer experts from around the world. And it’s bringing the best people together to address the cancer problem. Why is such information on cancer important? [mp3 1MB ] Cancer is a complex disease in many respects. There’s the geographic variation in the disease; for example, we see in Eastern Africa that among men oesophageal cancer is the most common, but in West Africa it’s cancer of the liver. It affects all organs of the body. Its causes are diverse, including chemicals, viruses, sunlight, diet, hormones, lifestyle habits like tobacco use or chewing betel quid. And also the mechanisms that lead a cell to develop into a fatal cancer are also numerous. So in bringing all this information together in one place, the World Cancer Report provides a portal, if you like, a point of entry to understanding cancer. It reveals that this disease is important in all parts of the world, not just the rich countries. And, finally, I hope it sends a message that despite the complexity and the challenges, there is progress and there is hope in combating cancer. What is the biggest challenge in gathering such data and information? [mp3 1.2MB ] Well, one problem is to turn the complexity that I’ve just been describing into a structured book that’s easy to access. We’ve done this by organizing it around individual organ sites, different risk factors, the occurrence in different parts of the world, mechanisms, and so on, full of good illustrations. But we’ve also used different approaches in the book: not only traditional chapters, but things like short text boxes, which highlight topical issues or give examples of how countries are combating cancer in the local context. And also a new feature is a series of perspectives by world authorities on cancer where they highlight areas in which the science is moving in an exciting way. So one problem is this structure, which we’ve addressed. The other, aside from the organization of the material, is that when you ask more than 150 creative and busy scientists, including three Nobel laureates, to join together to produce a book, it’s keeping everybody to schedule, and so far we’re doing remarkably well with this. News & Events

医学

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California Offers Glimpse Into Health Insurance Prices Under Obamacare By Sharon Bernstein | May 24, 2013 Email This California unveiled prices on Thursday that consumers will pay for a selection of health plans offered through the state under the Affordable Care Act, providing a glimpse into how health care reform may look as it is rolled out across the nation. Under the federal health care reform law, Californians who do not get or cannot afford health insurance through their jobs can buy coverage through an exchange, at a group rate negotiated by state regulators. The cost to a 40-year-old who needs coverage would vary from about $40 to $300 per month for a mid-level plan, depending on the person’s income. Some young adults, who are less expensive to cover, could pay nothing, depending on how much they earn. The prices in California, along with those announced in Washington, Vermont and other states, show that premiums under Obamacare can be more affordable than had previously been thought. Consumer advocates welcomed the new exchange. “It’s a revolutionary improvement to move from a broken market where people are charged by how sick they are, to a competitive market where people pay what they can afford, based on a percentage of their income, on a sliding scale,” said Anthony Wright, executive director of advocacy group Health Access. “Most consumers buying coverage in the individual market will get financial help and see their premiums go down,” he said. The sweeping federal reform law known as Obamacare seeks to extend health insurance to many of the 49 million Americans without it, and alter how care is delivered so as to curb what has been an inexorable rise in healthcare spending. Congressional Republicans who oppose the law had warned that high premiums would sink Obamacare as the uninsured would not be able to afford coverage even with federal subsidies. Even the modest rates announced Thursday do not really signal that the program will work, said California Republican Assemblyman Dan Logue. “This is like a shell game to me,” said Logue, co-chair of the assembly health committee, who predicted that taxes would go up to pay for the subsidies, forcing other prices to rise. “They’re not going to tell you that you’re going to pay for it in your gas or your food or going to the show,” he said. About a dozen states have set up these exchanges, or large group plans, which are a key element of the massive national health reform effort. Several have already released rates for monthly premiums, and most say the cost will not go up as high as skeptics had feared. In California, a 40-year-old who makes less than four times the federal poverty level – that is, $95,000 for a family of four or $46,000 for an individual – would pay as little as $40 per month for a mid-level plan in which about 70 percent of medical costs and all preventive care is covered. This excludes additional costs to cover children or a spouse. The same plan for a person who makes too much to qualify for a subsidy would run about $300 per month on average, the state said. In addition, the total amount consumers would have to pay each year for co-payments and other out of pocket costs would be limited to $6,350 or less, depending on income. Patients could choose plans that offer lower co-pays if they wished, but would pay higher premiums. In some cases, particularly for low and moderate income workers in their 20s, the premiums are free once a federal subsidy is factored in. The exchange will also offer what it calls platinum plans, in which co-payments are very low or non-existent. These plans would cost $500 for those who do not qualify for subsidies, but as little as $300 per month for low-wage earners. The biggest subsidies go to people who make less than 150 percent of the federal poverty level, or about $17,000 for a single person. Peter V. Lee, a longtime health advocate recruited by the state to help set up and run its program, said costs had been expected to skyrocket because the Affordable Care Act requires health plans to offer more benefits and cover more people than they might otherwise have done. For example, the plans must cover people with or without pre-existing conditions that would make their care more expensive. The actuarial firm Millman had predicted a 30 percent rise in the cost of monthly premiums for individuals in California under the new exchange. But Lee said that did not happen. While rates without subsidies may be moderately higher for some consumers next year, most will pay less, he said. The rates announced on Thursday must still be approved by state regulators. Democratic Congressman Henry Waxman, who backed the health reform act, said the program would protect millions from bankruptcy due to medical costs. “Californians buying coverage on their own will now have access to the same quality coverage that people get through their employers at the same or lower rates,” he said. California’s exchange will offer coverage from 13 insurers – down from more than 30 that had applied to participate. Among them are some of the biggest names, including Anthem Blue Cross, Blue Shield and Kaiser Permanente. Coverage will also be offered by some companies that had previously limited their activity to the Medicare and Medicaid markets. Paul Markovich, president of Blue Shield of California, which is offering coverage under the plan, said that to keep prices low, doctors and hospitals had lowered some of their rates. Some insurers also agreed to limit profits, Lee said. The policies vary in their provider networks, but Lee said consumers would have access to about 80 percent of doctors in the state, and some of its premier medical centers. Consumers will be able to begin signing up on Oct. 1 for plans that will go into effect in January. Next month, the California exchange will reveal plans and prices for insurance that small business owners can purchase for their employees. (Additional reporting by Caroline Humer and David Morgan; Editing by Cynthia Johnston and Richard Chang) Copyright 2016 Reuters. Click for restrictions. Get Insurance Journal Every Day Categories: West NewsTopics: Anthem Blue Cross, Blue Shield, California health exchange, California health insurance, health insurance rates, Kaiser Permanente, Obamacare, Patient Protection and Affordable Care Act Have a hot lead? Email us at [email protected] May 30, 2013 at 2:28 pm Libby says: draetish - how come the media is on your side and the defender of truth as long as it is spouting negative publicity about Obama, but as soon as it's the other way around you ... read more May 30, 2013 at 1:53 pm Celtica says: from draetish: It is not the hopeful republicans slinging around accusations, it is the truth! Benghazi, the IRS, the AP. With all that you still deny he is a liar? Oh that’... read more May 30, 2013 at 12:53 pm draetish says: As for Obama being a crook, I do not recall any convictions for that to date – only hopeful republicans slinging around accusations with little to no proof. Again, not the A... read more See all comments See Comments (51)Add a Comment Cancel reply Editors and Contributors L.S. Howard

医学

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Public Health: On the InsideOur exclusive podcast about public health practice.Listen to the Podcast Johns Hopkins Public Health VideosWatch Now Hopkins Bloomberg Public Health MagazineSummer Issue 2016Read More or SubscribeHome > News > News Releases > 2010 > Implementing Existing Interventions Could Save Lives in Sub-Saharan AfricaJune 23, 2010Implementing Existing Interventions Could Save Lives in Sub-Saharan Africa Modest increases in selected maternal, neonatal and child health interventions could save lives in sub-Saharan Africa, according to researchers at the Johns Hopkins Bloomberg School of Public Health. They reviewed several interventions such as breastfeeding counseling and emergency obstetric care in Africa and found that nearly 4 million lives could be saved by scaling up proven health interventions in a variety of health systems. The results are part of a series of maternal, neonatal and child health research in Africa featured in the June 21, 2010 issue of PLoS Medicine.“There is a significant gap between maternal, neonatal and child health research and practice,” said Ingrid Friberg, PhD, MHS, lead author of the study and an assistant scientist in the Bloomberg School’s Department of International Health. “But what we do know is that modest changes that are appropriate to a country’s health system can have a large impact. A 20 percent increase in coverage of selected community-based outreach interventions could save nearly 500,000 maternal, neonatal and child lives in these countries, while just increasing the quality of current facility births could save more than 100,000 maternal and neonatal lives.”Using the Lives Saved Tool (LiST), researchers conducted a detailed analysis of nine African countries and estimated mortality reductions and additional cost for feasible increases in coverage of selected high-impact interventions. They considered three health system contexts for maternal, neonatal and child health interventions and estimated mortality reduction for 42 sub-Saharan African countries). Researchers found that modest increases in selected outreach interventions can save lives now; addressing missed opportunities for births already occurring in health facilities can also save maternal and newborn lives now; and consideration of local data and different health system settings is necessary to identify high-impact, short-term opportunities that are appropriate and feasible for given health system environments.Despite being home to only 11 percent of the world’s population, sub-Saharan Africa has more than half of the world’s maternal, newborn and child deaths. The region is also home to two thirds of the world’s AIDS deaths and 90 percent of global malaria deaths. In 2000 the UN established the Millennium Development Goals—a series of eight international development goals that UN member states and several international organizations have agreed to achieve by 2015. Researchers believe that to achieve these goals, implementation of selected maternal, neonatal and child health interventions are critical.“With only 5 years left to meet the Millennium Development Goals, priorities need to be selected,” said Robert Black, MD, MPH, senior author of the study, chair of the Bloomberg School’s Department of International Health and the Edgar Berman Professor in International Health. “No country can scale up and implement all possible interventions at once,” he said. “But by implementing well known interventions such as emergency obstetric care, breastfeeding counseling, kangaroo mother care for preterm babies and treatment for diarrhea and pneumonia to 90 percent of the population we could reduce mortality by as much as 4 million.”“Sub-Saharan Africa’s Mothers, Newborns, and Children: How Many Lives Could Be Saved with Targeted Health Interventions?” was written by Ingrid K. Friberg, Mary V. Kinney, Joy E. Lawn, Kate J. Kerber, M. Oladoyin Odubanjo, Anne-Marie Bergh, Neff Walker, Eva Weissman, Mickey Chopra and Robert E. Black.This research was supported in part by the National Academy of Sciences, the Saving Newborn Lives Program, and the Bill & Melinda Gates Foundation.Public Affairs media contact: Natalie Wood-Wright at 410-614-6029 or [email protected] you would like to support infectious disease research or our students, you can make a contribution here.Johns Hopkins Bloomberg School of Public Health 615 N. Wolfe Street, Baltimore, MD 21205Contact Us Directions & Maps Calendars Offices & Services Online Learning & Courses Careers Accreditation Web Policies FeedbackJHSPH Alumni my.jhsph.edu CoursePlus Student Information System (SIS) my.jhu.eduLike Us on Facebook Follow Us on Twitter Watch Videos on YouTube Follow us on Instagram Connect with LinkedInJohns Hopkins University

医学

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Kaleida Health Board of Directors Endorses Move of Millard Fillmore Gates Circle Hospital to Medical Campus - KYI – Keeping You Informed – Kaleida Health Kaleida in the News Kaleida Health Board of Directors Endorses Move of Millard Fillmore Gates Circle Hospital to Medical Campus Three steering committees announced; will guide the transitionFrom left to right: Dr. Hashmat Ashraf, Dr. Ken Pearson, Edward F. Walsh, Jr., Dr. William Boden, and Dr. David Janicke discuss plans to move the clinical services and programs of Millard Fillmore Gates Circle Hospital to the Buffalo Niagara Medical Campus.BUFFALO, N.Y. � The Kaleida Health Board of Directors officially approved plans to move the clinical services and programs of Millard Fillmore Gates Circle Hospital to the Buffalo Niagara Medical Campus.The action was taken at the board�s meeting on Monday night. �We are at another exciting moment in Kaleida Health�s history,� said Edward F. Walsh, Jr., Chair of the Kaleida Health Board of Directors. �Ten years ago next month, we created the preeminent health care provider with the merger of Buffalo General, DeGraff, Millard and Children�s Hospitals. This is the next and natural evolution for our organization. We truly believe that we are on the brink of a new era for health care in Western New York.� �For the past year, we have outlined a physician-led vision to create a better health care delivery system for Western New York,� said James R. Kaskie, President and CEO of Kaleida Health. �We outlined a plan, a timetable and the need for funding. Our organization was willing to evolve if it meant making what we have today, even better. The Department of Health�s recent endorsement and $65 million in funding for that vision will now allow us to make reform, a reality.� Kaskie says that includes planning for a new academically oriented medical center on the medical campus, integrating the key programs and personnel of Buffalo General and Millard Fillmore Gates Circle Hospitals. The project is expected to exceed $100 million. A new medical center would serve as Kaleida Health�s flagship tertiary site. It would have approximately 600 patient beds with 30 operating rooms, 16 catheterization, angiography and electrophysiology labs, plus 4 CTs, 4 MRIs and a new emergency department. Kaleida Health�s �new facility� would account for more than 26,000 discharges and 63,000 emergency department visits. There would be no new capacity, rather a consolidation of services and reduction in duplication. The goal would be to renovate the tower (built in 1986) of the current Buffalo General Hospital plus build new infrastructure in the surrounding neighborhood of High, Ellicott, and Goodrich streets. �The medical executive committee has endorsed this plan and is extremely excited about the opportunity,� said Evan Evans, M.D., a general surgeon in private practice, a voluntary clinical assistant professor at SUNY-UB, a member of the Kaleida Health board of directors and the president of the 1,800 member Kaleida Health Medical-Dental staff. �Physicians have had a voice in this process and will be assisting in the transformation of our health care delivery system.� Hashmat Ashraf, MD, chief of cardiothoracic surgery for Kaleida Health and a practicing physician at Millard Fillmore Gates Circle Hospital said, �This is a golden opportunity to build a comprehensive medical campus for the Western New York community for which the coming generations will be proud. Therefore, it is our responsibility to do it right." �If the proposed complex is done right, it could very well be the most wonderful thing to happen to Western New York,� said L. Nelson �Nick� Hopkins, the chief of neurosurgery at Kaleida Health. �We are striving to build a world-class medical facility that can compete with the finest in the country." Kaleida Health also announced three steering committees that will guide the transition: � Clinical Operations � In existence for more than one year, this physician-led committee is driving the programmatic and clinical decisions of the integration. Donald Boyd, the president of Millard Fillmore Gates Circle Hospital, is chairing it. � Employee Relations - Will guide the labor issues for the affected workforces at both Millard Gates and Buffalo General hospitals. Kaleida Health�s chief operating officer, Connie Vari, will chair this committee. � Facility Re-use - Will determine the best re-use of the Millard Fillmore Gates circle site. Michael P. Hughes, Kaleida Health�s vice president for public affairs, will serve as chair. David Palmer, Area Director for the Communication Workers of America Local 1168 said, �This is an exciting vision for Western New York. CWA supports plans to relocate Millard Fillmore Gates Circle Hospital services to the Buffalo Niagara Medical Campus. Doing so will improve Kaleida Health's already strong quality of care while preserving the jobs that our area needs.� George Kennedy, Executive Vice President of 1199/SEIU, United Healthcare Workers East said, �1199/SEIU commends the management team and the system's broader community for proposing this exciting plan and we look forward to working to make it a reality. Kaleida Health has articulated a strong commitment to its workforce as part of this plan: no job loss as a result of Berger mandates. The working relationship between labor and management continues to improve and we look forward to further collaboration in the coming months.� In January, the state department of health awarded Kaleida Health $65 million toward the relocation of Millard Fillmore Gates Circle Hospital�s key services such as stroke, cardiac, and geriatrics. It was the largest HEAL-NY award in New York State. James G. Corasanti, M.D., Ph.D., a gastroenterology specialist with the Buffalo Medical Group said, �The concept of bringing together, in a new state-of-the art facility, the technologies, programs and talented physicians that have traditionally remained segregated by a few miles, is enticing to the practicing physicians at both institutions.� In July of 2007, Kaleida Health unveiled a physician-led collaborative vision that would evolve the organization -� in partnership with the community -� into an even more vibrant integrated healthcare delivery system. The plan would transform major components of the current system into centers of excellence on the Buffalo Niagara Medical Campus while developing a robust ambulatory system that improves the overall health of the community. �The relocation of Gates hospital to the Buffalo Niagara Medical Campus will further strengthen our programs and help create a first class medical center for patient care, teaching and research,� said Kevin Gibbons, MD, a neurosurgeon who is the program director and vice chair for the department of neurological surgery for University of Buffalo. �Although transitions can be difficult, the result will be better healthcare for the patients of Western New York.� �The integration of Millard Fillmore Gates Circle and Buffalo General Hospitals onto the Buffalo Niagara Medical Campus will create an unprecedented flagship health care facility in Western New York,� said Kenneth Pearson, M.D., the chief of radiology for Kaleida Health. �It will set the new standard for comprehensive clinical care, advanced research applications and academic training services.� The new healthcare delivery system would also become a strong partnership among the private practice and academic physicians, the Buffalo Niagara Medical Campus, Roswell Park Cancer Institute, local HMOs, and various community, healthcare and not-for-profit agencies. �We need a medical center in Western New York,� said John Corbelli, M.D., a cardiologist who practices at Millard Fillmore Gates Circle Hospital. �Our physicians, medical staff and administration have come together and made a commitment to see that it happens. We want to create a center of excellence that patients throughout the region will benefit from. It's going to be a tremendous effort, but we stand committed to making it a reality." Kaleida Health has been working on healthcare reform issues for more than two years. The comprehensive vision and plan was developed with the input of more than 75 physicians who are active at Millard Fillmore Gates Circle, DeGraff Memorial and Buffalo General Hospitals, as well as the University of Buffalo. In addition, the organization has worked closely over that same timeframe with labor and University of Buffalo leadership, held numerous employee focus groups, plus sought input from the business community, HMOs, not-for-profit and community leaders. The vision and strategy complements Kaleida Health�s strengthening of programs and services at Women & Children�s Hospital (planning a $100 ambulatory project), the $64 million expansion of Millard Fillmore Suburban Hospital, the continued growth of the Visiting Nursing Association, the continuation of essential services at DeGraff Memorial, the strong shared corporate services located at the Larkin Building, and other robust programs serving the community such as ambulatory care, labs and long-term care.Contact Information:Michael P. HughesPhone: (716) 859-8066

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Search Finally, Attention Switches To Progressive Multiple Sclerosis Untangling the HIE Mess It’s a Jungle Out There: The New Health Insurance Ecosystem Home MANAGED CARE October 2010Tomorrow's MedicineQuestions About Coverage Accompany New Fully Implantable Hearing SystemFor cosmetic reasons, this type of hearing system is desirable, but how much does it cost and who are the best candidates? Thomas Morrow, MDLinkedin Share ButtonTweet WidgetShare on Facebook MANAGED CARE October 2010. ©MediMedia USA For cosmetic reasons, this type of hearing system is desirable, but how much does it cost and who are the best candidates? Thomas Morrow, MD According to the National Institutes of Health, about 15 percent of all adults in the United States suffer from some level of hearing loss. The prevalence increases dramatically with age, with nearly half of all people age 75 and older reporting hearing loss. Although the cause varies, treatment consists of amplifying the incoming sound. Amplification devices have improved remarkably over the past century. At first, amplifiers were simply funnels or cones that concentrated sound into the area around the ear. The first electronic hearing aid was developed in the 1950s, and there has been continuous improvement in both function and size because of advances in the capabilities and the miniaturization of electronics. Digitization has allowed exquisite control and amplification of the incoming sound at the individual frequency level to accommodate individual differences in hearing loss. In the 1970s, a revolutionary improvement occurred with the advent of the cochlear implant, which directly stimulates the auditory nerve within the cochlea. Fully implanted In all hearing devices, at least one component is outside the body and subject to the external environment — at least until recently. A few months ago, the FDA sent Envoy Medical in St. Paul a formal premarket approval letter for its device, Esteem, the first fully implanted inner ear stimulator approved to treat moderate-to-severe hearing loss. Note that Envoy does not call the device a hearing aid, but rather, a hearing system because it does not actually amplify sound; it amplifies movement of the ear drum. The Esteem system includes three components: sensor, sound processor, and driver. These are placed under the skin behind the ear and in the middle ear, making this device independent of the external environment. The system also includes testing and programming devices that are not implanted. The sensor picks up vibrations from the eardrum and middle ear bones, and a transducer converts them into electrical signals that go to the processor for amplification and filtering to customize the device for the individual patient’s hearing loss profile. The driver then converts the enhanced electrical signal into vibrations so the inner ear can perceive them as sound. This is a different process from the typical hearing aid that amplifies sound and basically uses a small speaker to then create the sound waves that hit the eardrum. Because this device is surgically implanted, it faces challenges that a traditional hearing aid does not. Potential complications include scar tissue buildup and infections around the incision. Because of the unique nature of this device and the fact that it requires a surgeon’s order or prescription, Envoy and the FDA have created a list of indications and contraindications to help surgeons determine whether the product is right for a potential candidate (see Envoy Medical’s Web site, http://esteemhearing.com/important-safety-information/, for information about indications and contraindications.) The clinical trial that led to approval was a multicenter, one-arm, non-randomized, non-blinded study that began in early 2008. The post-implant outcomes were compared to each subject’s pre-implant baseline “hearing aided” condition. Comparatively effective Note that the outcome was not compared to the patient’s hearing without the use of a traditional hearing aid. Follow-up was scheduled for 4 months and 10 months post-op and then yearly. There were two measured primary effectiveness endpoints: The Esteem system would provide at least a 5-decibel hearing advantage over the traditional hearing aid, and word recognition would improve. In addition, secondary endpoints were pure tone average hearing, hearing of speech in a noisy environment, and quality of life. A detailed review of the improvements is beyond the scope of this article but suffice it to say that the device produced significant improvements toward both the primary and secondary endpoints. In addition, the Esteem did not lead to a decrease in cochlear function. That said, severe adverse effects occurred in 10.5 percent of patients and included severe pain and facial weakness (reported by one subject), infection at the incision site (reported by one subject), limited benefit (reported by three subjects) and incision breakdown (reported by one subject). All of these events were resolved with either medication, revision procedures with replacement of the device, or permanent removal of the implant. All three patients with limited benefits had developed extensive fibrous adhesions that interfered with the ability of the device to increase the vibrations needed for hearing improvement. There were 96 other mild and moderate adverse events. At the one-year reporting time, 70 percent of these had been resolved, with the remaining rated as unresolved. The unresolved mild and moderate adverse effects included taste disturbance, facial weakness/paralysis, tinnitus, dizziness, middle ear effusion, and ear pain. Managed care implications Hearing benefits are not uniform among the many insurance plans in the United States. They tend to be rather basic and aimed at functional improvement. Of course, cochlear implants are typically a covered benefit, but require prior authorization. Most plans do not attempt to direct members to a preferred device but allow the health care provider to direct the acquisition of a hearing aid. What subgroup of patients would benefit from the Esteem? What attributes of the Esteem will compel payers to cover this device? Obviously there are some patients who cannot tolerate a hearing aid mold because of deformities of the external ear and ear canal. Other patients may have a difficult time using an external device because of exposure to the elements; scuba divers come to mind. Many other considerations will need to be explored for answers. One thing is for sure: The Esteem Hearing System again demonstrates how engineers, physicians, and researchers are continuously searching for Tomorrow’s Medicine! Thomas Morrow, MD, is the immediate past president of the National Association of Managed Care Physicians. He has 24 years of managed care experience at the payer or health plan level. Contact him at [email protected] The author is a director in the value-based health department at Genentech. He has had no other industry affiliations in the past three years. The views expressed in Tomorrow’s Medicine are the author’s alone.

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Faculty Dean E. Morbeck, Ph.D. Rochester, Minn [email protected] Clinical Profile Dr. Morbeck is an Assistant Professor within the Division of Reproductive Endocrinology. He also is the director of the In Vitro Fertilization and Fertility Testing Laboratories. He is an active member of the College of Reproductive Biology (AAB), American Society of Andrology, and the American Society of Reproductive Medicine. As director of the assisted reproduction laboratories, Dr. Morbeck's research interests are in the area of improving the process of gamete and embryo culture and cryopreservation. Fertility preservation is a relatively new area of medicine and he has several research projects aimed at improving the efficacy of this practice. This work deals mainly with oocyte freezing and ovarian tissue cryopreservation. Dr. Morbeck is also actively pursuing more sensitive assays for testing reagents and supplies used for in vitro fertilization to assure quality. The goal is to provide the highest quality and safety for the process of IVF. See my publications PROFESSIONAL DETAILS Academic RankAssociate Professor of Laboratory Medicine And PathologyAssociate Professor of Obstetrics and Gynecology EDUCATIONSenior Research Fellowship - Molecular Basis of Polycystic Ovary Disease and Infertility, Laboratory of Patrick C. Roche, Ph.D. Department of Laboratory Medicine and PathologyResearch Fellowship - Structure/Function of human Chorionic Gonadotropin (hCG), Laboratory of Daniel J. McCormick, Ph.D. Department of Biochemistry and Molecular BiologyPhD - Major: Physiology, Minor: Animal Science, Advisor: Jack H. Britt, Ph.D. North Carolina State UniversityMS - Major: Physiology, Advisor: Jack H. Britt, Ph.D. North Carolina State UniversityBS - Dairy Science University of Wisconsin, Madison Robert and Arlene Kogod Center on Aging BIO-00084754

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NIAID > News & Events > News Releases > 2014 News Releases20162015201420132012By Topic Print this pageAdd an RSS feedGet email updatesOrder publications Media Contact Info News by Topic News From NIAID-Supported Institutions Health & Research Topics News Release Archive View NIAID news releases National Institute of Allergy andInfectious Diseases (NIAID)http://www.niaid.nih.gov MEDIA AVAILABILITY NIH Grantees Sharpen Understanding of Antibodies that May Cut Risk of HIV Infection Main Content Area​WHAT:What immune response should a vaccine elicit to prevent HIV infection? Two studies published online today bring scientists closer to answering this question by identifying previously unrecognized attributes of antibodies that appear to have reduced the risk of HIV infection in the only clinical trial to show efficacy, albeit modest, of an experimental vaccine regimen in people. Earlier analyses of the results of that trial, known as RV144, suggested that antibodies to sites within a part of the HIV envelope called V1V2 correlated with reduced risk of HIV infection. These antibodies belong to a class called immunoglobulin G, or IgG. The new studies by two independent laboratories both found that only one subclass of V1V2-directed IgG antibodies—the IgG3 subclass—is associated with antiviral responses linked to the reduced risk of HIV infection seen in RV144. The experiments were led by Georgia D. Tomaras, Ph.D., of the Duke Human Vaccine Institute, and Galit Alter, Ph.D., of the Ragon Institute, with funding in part from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. In the study led by Dr. Tomaras, scientists found that V1V2-specific IgG3 antibodies correlated with a decreased risk of infection in RV144 vaccinees and were linked to HIV-eliminating activity. The researchers also discovered that the level of V1V2-specific IgG3 antibodies in vaccinees’ blood waned rapidly, as did the efficacy of the investigational vaccines tested in the RV144 trial (from 60 percent efficacy at 12 months post-vaccination to 31.2 percent efficacy at 42 months). The study led by Dr. Alter demonstrated that RV144 vaccination induced antibodies able to direct multiple, coordinated HIV-eliminating activities, and that these activities were conducted primarily by V1V2-specific IgG3 antibodies. More research is needed to determine whether V1V2-directed IgG3 antibodies actually protected some vaccinees from HIV infection, as well as whether there was a relationship between the fast decline in IgG3 antibodies and the sharp drop in efficacy of the investigational RV144 vaccines. Information from the current and ongoing studies will help scientists refine their efforts to design and test HIV vaccines that build on the success of RV144. ARTICLES:AW Chung et al. Polyfunctional Fc-effector profiles mediated by IgG subclass selection distinguish RV144 and VAX003 vaccines. Science Translational Medicine DOI: 10.1126/scitranslmed.3007736 (2014). NL Yates et al. Vaccine-induced Env V1-V2 IgG3 correlates with lower HIV-1 infection risk and declines soon after vaccination. Science Translational Medicine DOI: 10.1126/scitranslmed.3007730 (2014). WHO:NIAID Director Anthony S. Fauci, M.D., is available for comment. CONTACT:To schedule interviews, please contact Laura S. Leifman, (301) 402-1663, [email protected]. NIAID conducts and supports research—at NIH, throughout the United States, and worldwide—to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID website. About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov. Last Updated March 19, 2014Last Reviewed March 19, 2014

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Three Parrish Medical Center Board Members Reappointed News Releases Appointments made by County Board of Commissioners and Titusville City Council At its regular meeting of the Brevard County Board of Commissioners on November 29, 2011, Mr. J.J. Parrish III was reappointed to the Parrish Medical Center board of directors for a four-year term beginning in January 2012. Parrish has been on the PMC board since January 1988. Parrish is a Realtor©, CPA and local businessman with the Pruitt Commercial Group and Jesse J. Parrish III C.P.A. respectively. He has a bachelor's of science degree in accounting from the University of Florida, and obtained certification from the Florida State Board of Accountancy as a Certified Public Accountant in 1978. At the December 13 meeting of the Titusville City Council, Mr. Jerry Noffel’s county commission reappointment was confirmed, and he was jointly reappointed for a four-year term to the PMC board by the city council. Noffel has been a joint appointee to the PMC board since January 2000. Noffel is a retired general partner of a group of freestanding ambulatory surgery centers. Prior to that, he was executive vice president of St. Joseph Hospital in Lexington, Kentucky. Noffel earned a bachelor of science degree in business administration from Murray State College in Kentucky, and a master of business administration with an emphasis in hospital administration from Xavier University in Cincinnati. At the same Titusville City Council meeting, Mr. Herman Cole was reappointed to the PMC board of directors for a four-year term. Cole was first appointed to the PMC board by the city council in January 2000. A retired air force colonel, Cole has an extensive background in directing, managing, and administering large, worldwide construction projects. He received a bachelor of architecture and a bachelor of arts in architectural science from Tuskegee University. Cole has received numerous awards and recognitions including: USAF Legion of Merit, USAF Meritorious Service Medal, Senior Civil Engineer of the Year, and USAF Commendation Medal. As a public not-for-profit medical center the nine PMC board members are appointed by the Titusville City Council and the Brevard County Board of Commissioners—three by the city, three by the county and three jointly. Other board members include Peggy Crooks, Billy Fitzgerald, Robert Jordan, Pat Manning, Lee Moore, and Maureen Rupe.

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Home - Online Bill Pay - About - Contact Us Leading the Region in Healthcare! Dedicated to serving the needs of Pratt, Kansas, Pratt Regional Medical Center is a progressive medical center serving south central Kansas and the panhandle of Oklahoma. Pay Your Bill Online PRRC Giving/ Maps & Read the full brochure. - Or - Read the fact sheet. Watch on YouTube. Kansas Statewide Electronic Health Information Exchange to Debut July 1 A statewide electronic health information exchange capability will “go live” on July 1, 2012. This new service offers simplified communications capabilities to health care providers who are involved in treating the same patient thereby promising to improve patient care. Many health care providers and hospitals, including Pratt Regional Medical Center, have signed on to participate in two electronic health information exchange services that have been approved to operate in Kansas. The two exchanges are the Kansas Health Information Network (KHIN) and the Lewis and Clark Information Exchange (LACIE). Health care providers who diagnose and treat a patient can quickly and securely access the exchanges to electronically obtain medical history from other providers who may have previously been involved in treating that same patient. This access will allow health care providers to ensure that prescriptions are compatible with medications the patient may have obtained from other health care providers. In addition, it will allow health care providers and patients to avoid inconvenience and costs that arise from repeating tests that may have been performed previously. Ready and secure access to a patient’s medical history also could prove to be a critical factor in a life-threatening emergency. Health Information Exchanges require that patient records be kept on Electronic Health Record (EHR) systems in order to be exchanged. In addition to the larger urban areas, over 1,450 medical providers in small rural practices and 95 rural hospitals have committed to implement EHR systems. Thus, Kansas providers are now positioned to take advantage of the exchanges. For more information on these initiatives, visit the website at www.khie.org. The Kansas Health Information Exchange, Inc. (KHIE) is a non-profit charitable organization created by the State of Kansas in 2010. KHIE was created for the purpose of assuring the availability of statewide health information exchange and promulgating and ensuring compliance with policies and standards that govern statewide health information exchange. For more information contact Bill Wallace at (785) 783-8984. Press & News Releases Inside PRMC by Susan Page Pratt Health Foundation News Health Scene Newsletters By the Way Newsletters Kansas Health Information Exchange PRMC Construction © 2015 Pratt Regional Medical Center - All Rights Reserved Web Babies Giving/Volunteering Healthy Living Topics Pratt Rehab & Residendence Center

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Expert tells Newtown panel there’s no link between autism, violence HARTFORD >> An expert told a commission looking into the Sandy Hook Elementary school massacre in Connecticut on Friday that there is no data linking autism with increased violent criminal behavior. “Having autism, having an autism spectrum disorder, having Asperger’s syndrome does not mean you are likely to commit a violent crime,” said Matthew Lerner, a professor of psychology at Stony Brook University. Lerner was among a group of experts who testified Friday about the autism spectrum and programs currently available to help autistic people function better in society. The commission is considering whether the state’s mental health programs, particularly in the schools, are adequate, among other things. On Dec. 14, 2012, 20-year-old Adam Lanza opened fire at Sandy Hook Elementary School, killing 20 first graders and six educators. Lanza, who had killed his mother earlier in the day, later committed suicide. Documents recently released by the state police show a Yale professor had diagnosed Lanza in 2006 with profound autism spectrum disorder, “with rigidity, isolation, and a lack of comprehension of ordinary social interaction and communications,” while also displaying symptoms of obsessive-compulsive disorder. Lerner said there are traits associated with autism that often explain behavior when those on the spectrum come into contact with the legal system. Those include impulsive and compulsive behavior and the inability to understand social motives and emotional situations. A person with autism may, for example, take a neighbor at their word when told to drop by or call “any time”. So when they call at 3 a.m., 3:30 a.m. and again at 4 a.m., they don’t understand they are doing something wrong, he said. “There is certainly no association between any of the features that we know about autism and the kind of planful mass murder as discussed here, that precipitated this commission,” Lerner said. Adam Lanza’s father, Peter, told police that his son had Asperger’s syndrome, a milder form of autism. He has indicated a willingness to share his son’s school and medical records. “We’re going back and forth now trying to come up with some of the parameters about what his involvement might entail,” Scott Jackson, the chairman of the commission, said Friday. “I know the commission really doesn’t have any interest in having him come here and present to us. That’s not what we’re looking for. What we are looking for are the documents that start to tell the more complete story of Adam Lanza and his life.” He told the committee he would have an initial meeting with Peter Lanza on Wednesday. Jackson said that autism is a very personal for him. He grew up with a severely autistic brother, and that experience shaped his decision to go into public service, he said. “This is my lived experience,” he said. “There was concern within the advocacy community about tying developmental disabilities to this great tragedy. I want to say very clearly that is not the intention. This is an issue that needs to be discussed. It deserves to be discussed in public.” The commission expects to present its recommendations around the end of March.

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Place an Ad News | Vermont News Single-payer takes on fresh debate MONTPELIER � A battle of ideas will be waged with a book of numbers as the Shumlin administration this year continues to make its case for single-payer health care.A long-awaited report unveiled by administration officials last week has become the latest touchstone in a three-year-old debate over the merits of moving to a publicly financed system of universal care. To proponents of reform, the 90-page document confirms the clarity of Gov. Peter Shumlin�s vision.�You can cover all Vermont residents with better coverage for less money in a universal system,� Robin Lunge, director of health care reform for the Shumlin administration, told a panel of lawmakers Friday morning.To skeptics, however, the study, commissioned at a cost of $300,000 from the University of Massachusetts Medical School, uses junk math to paper over the one question on which the future of the reform effort hinges: Who�s going to pay? �I would immediately challenge this analysis as being misleading, quite frankly,� said Jeff Wennberg, executive director of Vermonters for Health Care Freedom, a group that has been working since about this time last year to fight single-payer. �Any representation that there are going to be savings as a result of this reform should be looked at with the most skeptical eyes.�Wennberg�s group has little sway in the Democrat-controlled Legislature. But it lends voice to an anti-single-payer sentiment that even the most ardent reform advocates say will intensify as the movement ages.People like Lunge will try to use findings in the new report to sustain momentum long enough to make it to single-payer, something Shumlin has said he�ll accomplish by 2017.To Mark Larson, commissioner of Vermont Health Access, the �big story� out of the report is the savings waiting to be had in a reformed system. The report found that Vermont will, over the first three years of single-payer, save a cumulative total of $281 million.A 2009 study performed for lawmakers by Harvard economist William Hsiao also predicted savings under a single-payer framework. Larson said the latest analysis, however, is even more credible, since it bases its actuarial assumptions on specific provisions in Act 48, the single-payer statute enacted in 2009. �Once again, we have demonstrated that a reformed health care system could provide great value to Vermonters and reduce the cost paid by Vermonters,� Larson said.Some lawmakers, however, said they were taken aback by the scantness of the savings. Vermont will save an average of about $93 million annually over the first three years of single-payer, according to the report. But that�s in a $6.3 billion health care system, meaning the savings amount to less than 1.5 percent annually.�I�ve heard some people refer to that as a rounding error,� said Rep. George Till, a Jericho Democrat, medical doctor and member of the House Committee on Health Care. �You�re going to upend a system that big and that critical to our state for such a small benefit? It just seems like a big gamble for such a small payoff.�Lunge said price comparisons alone don�t tell the story. Not only will the reformed system be cheaper, according to Lunge, it will be of a far higher quality than the one Vermont would otherwise have. The report assumes minimum quality standards outlined in Act 48 � standards that would require the single-payer system to provide better coverage than most Vermonters enjoy now. For example, the average coverage plan for an employee getting coverage through a small business has an actuarial value of about 72 percent. That means that the insurance company will pay, on average, 72 percent of health care costs incurred by the individual. Coverage in the single-payer system envisioned in the report, meanwhile, would have an actuarial value of 87 percent.Additionally, Lunge said, the reformed system would extend coverage to the estimated 12,100 individuals who still won�t have insurance in 2017 � people who would otherwise continue to live without insurance. And the single-payer cost calculations also include guaranteed vision and dental for people under 18.She said the dollar value of perks unique to the reformed system total $547 million annually, money she said should be viewed as savings that the state is reinvesting into a better health care system.More importantly, Larson said, the reformed system allows the state to minimize the financial burden on individuals and businesses by maximizing revenue from the federal government. Without reform, according to the report, individuals and employers will collectively pay more than $2.2 billion on insurance premiums in 2017. In a reformed system, however, those same entities would have to come up only $1.6 billion in public financing, i.e. taxes.That�s a big tax, as Wennberg�s groups has pointed out � more than three times the amount raised by the income tax.The administration was accused last week of shirking its statutory duty to recommend a financing plan for raising that money. Indeed, the report fails to suggest what tax ought to be used to pay for single-payer.But Larson said the state has three years to pinpoint a precise funding mechanism. The important takeaway now, he said, is that Vermonters are already spending that money.�Individuals will pay $2.2 billion in private premiums, or we could finance it publicly for $1.6 billion,� Larson said. �So we�re not talking about new money, we�re talking about people paying in a different format, and paying less.�Wennberg said that sounds great, if you believe the numbers. But he said there�s good reason Vermonters shouldn�t. Specifically, he pointed to one of the biggest sources of alleged savings in the new system: the increased Medicaid match.Larson said the unified system will allow his office to draw down $249 million in federal Medicaid dollars that Vermont would forgo under the status quo. Wennberg said there�s no reason Vermont shouldn�t be able to maximize its Medicaid eligibility in a free-market health care system.�They have absolutely no justification for crediting that $249 million to single-payer,� Wennberg said. �They�re taking credit for things that have nothing to do with single-payer reform.�If you back the $249 million out of the report�s model, he said, then the savings not only disappear, but the single-payer system actually will increase overall health care costs.Larson said a universal system is uniquely positioned to squeeze out maximum Medicaid revenue. The uninsured and under-insured people that would remain in a for-profit model, Larson said, are the same population that a universal system could use to draw down federal aid.�If everyone is enrolled, then it becomes my office�s role to figure out for whom we can get the federal Medicaid match,� Larson said. �If someone has another proposal for how to do that, I haven�t heard it.�Another outstanding concern: whether the proposed system will pay doctors, hospitals and other providers enough to sustain a functioning health care industry. The report assumes that providers will be compensated at 105 percent of what Medicare pays. But commercial insurers currently reimburse at an average of 152 percent of Medicare. And while the reformed scheme would do away with paltry Medicaid reimbursements � that program pays only 82 percent of Medicare � it�s unclear whether the new, blended reimbursement rate would be better or worse for doctors.Conventional wisdom in Montpelier had been that the new report would be trotted out for its big reveal and then stored in the back rooms until 2015, when the Shumlin administration has said it will be more appropriate to begin pondering financing schemes.But Sen. Tim Ashe, a Chittenden County Democrat/Progressive and chairman of the Senate Finance Committee, said he plans to make significant progress this session on a financing plan. Ashe said Vermonters won�t be able to kick the tires on the single-payer proposal until they know what it means for them. And he said that means addressing the issue of cost as soon as possible.�It is my hope that at the end of this year, this comm will be able to answer to the following types of questions: I am an employer who pays 5 percent of payroll for health care � how will these different financing schemes affect me? I am a self-employed midde-income Vermonter � how will these different financing schemes affect me?� Ashe said. �We want to be able to answer those kinds basic questions, because those are the questions that people are going to be asking.�[email protected]

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Health System > Center for Virtual Care > Stem cell findings may offer answers for some ... Simulation Education Why Simulate? Center for Health & Technology Charles Casey Subscribe to the latest RSS news feeds. Stem cell findings may offer answers for some bladder defects and disease For the first time, scientists have succeeded in coaxing laboratory cultures of human stem cells to develop into the specialized, unique cells needed to repair a patient’s defective or diseased bladder. Eric Kurzrock The breakthrough, developed at the UC Davis Institute for Regenerative Cures and published today in the scientific journal Stem Cells Translational Medicine, is significant because it provides a pathway to regenerate replacement bladder tissue for patients whose bladders are too small or do not function properly, such as children with spina bifida and adults with spinal cord injuries or bladder cancer.“Our goal is to use human stem cells to regenerate tissue in the lab that can be transplanted into patients to augment or replace their malfunctioning bladders,” said Eric Kurzrock, professor and chief of the division of pediatric urologic surgery at UC Davis Children's Hospital and lead scientist of the study, which is titled “Induction of Human Embryonic and Induced Pluripotent Stem Cells into Urothelium.”To develop the bladder cells, Kurzrock and his UC Davis colleagues investigated two categories of human stem cells. In their key experiments, they used induced pluripotent stem cells (iPS cells), which were derived from lab cultures of human skin cells and umbilical blood cells that had been genetically reprogrammed to convert to an embryonic stem cell-like state.If additional research demonstrates that grafts of bladder tissue grown from human stem cells will be safe and effective for patient care, Kurzrock said that the source of the grafts would be iPS cells derived from a patient’s own skin or umbilical cord blood cells. This type of tissue would be optimal, he said, because it lowers the risk of immunological rejection that typifies most transplants.In their investigation, Kurzrock and his colleagues developed a protocol to prod the pluripotent cells into becoming bladder cells. Their procedure was efficient and, most importantly, the cells proliferated over a long period of time – a critical element in any tissue engineering application.“What’s exciting about this discovery is that it also opens up an array of opportunities using pluripotent cells,” said Jan Nolta, professor and director of the UC Davis Stem Cell program and a co-author on the new study. “When we can reliably direct and differentiate pluripotent stem cells, we have more options to develop new and effective regenerative medicine therapies. The protocols we used to create bladder tissue also provide insight into other types of tissue regeneration.”Jan NoltaUC Davis researchers first used human embryonic stem cells obtained from the National Institutes of Health’s repository of human stem cells. Embryonic stem cells can become any cell type in the body (i.e., they are pluripotent), and the team successfully coaxed these embryonic stem cells into bladder cells. They then used the same protocol to coax iPS cells made from skin and umbilical cord blood into bladder cells, called urothelium, that line the inside of the bladder. The cells expressed a very unique protein and marker of bladder cells called uroplakin, which makes the bladder impermeable to toxins in the urine.The UC Davis researchers adjusted the culture system in which the stem cells were developing to encourage the cells to proliferate, differentiate and express the bladder protein without depending upon signals from other human cells, said Kurzrock. In future research, Kurzrock and his colleagues plan to modify the laboratory cultures so that they will not need animal and human products, which will allow use of the cells in patients.Kurzrock’s primary focus as a physician is with children suffering from spina bifida and other pediatric congenital disorders. Currently, when he surgically reconstructs a child’s defective bladder, he must use a segment of their own intestine. Because the function of intestine, which absorbs food, is almost the opposite of bladder, bladder reconstruction with intestinal tissue may lead to serious complications, including urinary stone formation, electrolyte abnormalities and cancer. Developing a stem cell alternative not only will be less invasive, but should prove to be more effective, too, he said.Another benefit of the UC Davis study is the insight it may provide about the pathways of bladder cancer, which is diagnosed in more than 70,000 Americans each year, according to the National Cancer Institute. “Our study may provide important data for basic research in determining the deviations from normal biological processes that trigger malignancies in developing bladder cells,” said Nolta. More than 90 percent of patients who need replacement bladder tissue are adults with bladder cancer. Kurzrock said “cells from these patients’ bladders cannot be used to generate tissue grafts because the implanted tissue could carry a high risk of becoming cancerous. On the other hand, using bladder cells derived from patients’ skin may alleviate that risk. Our next experiments will seek to prove that these cells are safer.”The UC Davis research was supported by a grant from the California Institute for Regenerative Medicine (the state stem cell agency). Shriner’s Hospitals for Children has also provided Dr. Kurzrock with grant funds to explore pediatric bladder tissue regeneration.In addition to Kurzrock and Nolta, co-authors of the paper are Stephanie L. Osborn, Ravikumar Thangappan, Ayala Luria, and Justin H. Lee. UC Davis is playing a leading role in regenerative medicine, with nearly 150 scientists working on a variety of stem cell-related research projects at campus locations in both Davis and Sacramento. The UC Davis Institute for Regenerative Cures, a facility supported by the California Institute for Regenerative Medicine (CIRM), opened in 2010 on the Sacramento campus. This $62 million facility is the university's hub for stem cell science. It includes Northern California's largest academic Good Manufacturing Practice laboratory, with state-of-the-art equipment and manufacturing rooms for cellular and gene therapies. UC Davis also has a Translational Human Embryonic Stem Cell Shared Research Facility in Davis and a collaborative partnership with the Institute for Pediatric Regenerative Medicine at Shriners Hospital for Children Northern California. All of the programs and facilities complement the university's Clinical and Translational Science Center, and focus on turning stem cells into cures. For more information, visit www.ucdmc.ucdavis.edu/stemcellresearch. Center for Virtual Care | 4610 X Street, Room 3301 | Sacramento, CA 95817 | Phone: (916) 734-4708 | Fax: (916) 734-4711

医学

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Researchers Focus on Secondary Stroke Prevention Intervention After Study Reveals Room for Improvement WINSTON-SALEM, N.C. – September 12, 2011 – A year after hospital discharge, the majority of stroke patients are listening to doctor’s orders when it comes to taking their prescribed secondary stroke prevention medications, new data out of Wake Forest Baptist Medical Center shows. However, there is room for improvement, according to investigators. “Medication non-compliance is a major risk factor for stroke and heart disease, and we know that non-compliance with stroke prevention medications increases over the year or two after a stroke,” said Cheryl D. Bushnell, M.D., M.H.S., director of the Wake Forest Baptist Stroke Center and lead author on the study. “This study revealed that the majority of patients are compliant in taking their medications, but it also showed us specific vulnerabilities from the patient’s perspective that might explain why some patients stop medications. We found that there’s a large opening for us to focus efforts towards even better compliance. Specifically, we as providers need to continue educating patients over the long term and not just the first time a medication is started.” Although the risk of a second stroke is highest within the first three months after an initial stroke, the risk is about eight percent in the first year, and five percent per year after that, according to the study. So taking secondary prevention medications long term is critical for preventing a second stroke, which is likely to be even more devastating than the first, Bushnell added. Nearly 700,000 people in the United States have ischemic strokes each year, and about 160,000 of these events are recurrent,* according to the study, published online this week by the journal Neurology. It is scheduled to appear in the September 20 print issue. The Adherence eValuation After Ischemic stroke-Longitudinal (AVAIL) Registry aims to collect data on long-term use of secondary prevention medications for one year following stroke, assessing compliance issues from the patients’ perspective, as well as system and provider issues, such as what type of doctor the patients saw, what kind of follow up care they had and the patients’ understanding of their medications and why they were taking them. The researchers first studied 2,598 patients from the AVAIL Registry to evaluate how many stroke patients were still taking their secondary prevention medications three months after being discharged from the hospital. The three-month data appeared in the December 2010 issue of Archives of Neurology, and revealed that about 75 percent of those studied had continued with their full regimen of medications – usually including an aspirin or other type of blood thinner, blood pressure medication and cholesterol lowering medication – three months after discharge. The one-year data evaluated “persistence,” defined as continuation of all secondary stroke prevention medications prescribed at hospital discharge, and “adherence,” defined as continuation of all prescribed medications except those stopped according to healthcare provider instructions, to get a true read on whether patients no longer on their medications are discontinuing on their own, or if they are being told by their doctors to stop their secondary prevention regimen. Of the 2,457 patients who completed one-year interviews, 65.9 percent were “persistent” with their secondary prevention regimen, meaning they were still taking all of the medicines prescribed to them at hospital discharge. Even more patients – 86.6 percent – were “adherent,” following doctor’s orders and taking all of their medications except those they had been told to discontinue by their healthcare providers. Although up to one third of stroke patients were no longer taking one or more of their secondary prevention medications within one year of hospital discharge, most did not stop taking the medications on their own, the study authors noted. “Self-discontinuation of these medications is uncommon.” For the nearly 14 percent of patients who did stop taking their secondary prevention medications on their own, this analysis gave investigators important insight into the reasons why patients self-discontinue. The researchers learned that several key factors affect “non-adherence,” or self-discontinuation. These include whether or not a person has health insurance and can afford their medications, whether the patient receives detailed instructions upon discharge about their medications and understands what the medications do and why taking them is important, whether or not the patient is married to a spouse who can help them remember and motivate them to take their medications, and whether the patient is discharged to his or her home or some other location such as a nursing home or in-patient rehabilitation. These findings represent opportunities for providers and support systems to intervene with the goal of improving medication adherence, Bushnell said.As a result, Bushnell and colleagues at Wake Forest Baptist are implementing a transition coaching program, which will focus on educating stroke patients about their medications before they are discharged and directly following up with them after discharge to remind them about their doctor’s appointments, make recommendations on ways to remember taking their medicine (such as using a daily pill box), answer questions about their condition, treatment and medication, and evaluate them a few weeks after discharge for their risk of rehospitalization. The factors associated with discontinuing medications reflect the challenges many stroke patients face, Bushnell said. “Not only are many patients disabled and unable to work, but the disability from the stroke also affects medication-taking behavior. Streamlining medication regimens, emphasizing appointment-keeping, helping with insurance applications and referring to community support services are all essential to aid in this difficult transition.” Proper education about medications is also extremely important. “Where providers and pharmacists can make a difference with long-term compliance is by reiterating why medications are taken and what the side effects are,” she added. “We have incorporated these challenges into our transition coaching program, where our goal is to increase stroke prevention adherence, improve outcomes, and keep people free of a second stroke.” This study was conceived and designed by the AVAIL team, researchers at Duke Clinical Research Institute, the project executive committee and an American Heart Association representative. The AVAIL analyses were also supported in part by a grant from the Agency for Healthcare Research and Quality. *Numbers according to the 2010 Heart/Stroke Statistics, published annually by the American Heart Association. The numbers have since been updated to 795,000 people in the United States having ischemic strokes, 189,000 of which are recurrent, according to the 2011 Heart/Stroke Statistics.9/12/2011http://www.wakehealth.edu/News-Releases/2011/Researchers_Focus_on_Secondary_Stroke_Prevention_Intervention_After_Study_Reveals_Room_for_Improvement.htm Related Links Neurosurgery and Neurology Neurology Educational Programs Neurology Research Cheryl D. Bushnell, M.D. Wake Forest Baptist August Awards and RecognitionsWake Forest Baptist Serves as Official Medical Provider at Winston-Salem OpenWake Forest Baptist Names Belk Executive Chief Human Resources Officer

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Lesley Griffiths Works starts on £40m extension to Swansea's Morriston Hospital 07:33, 9 Oct 2012 Julia McWatt Work has started on a new £40m extension to Swansea's Morriston Hospital. Get daily news by email An artist's impression of the #40m Morriston Hospital extension Work has started on a new £40m extension to Swansea's Morriston Hospital. A new artist's impression shows how the three- storey building, which will house renal dialysis, dental and x-ray departments, will look when work is completed. It will also include an education centre to train staff, including post- and undergraduate doctors. The scheme involves sustainability features such as photovoltaic cells on the roof and combined heat and power. The extension is the latest stage in the overall £80m re-development of the hospital. Read more: Morriston to retain key services in proposed reorganisation In March, Health Minister Lesley Griffiths confirmed that £9.5m would be spent on a new artificial limb and rehabilitation centre, which is being built. The 750-bed hospital developed from a World War Two hospital, but most buildings on the site now date from 1981. It houses the Welsh Centre for Burns and Plastic Surgery and one of the two cardiac centres in Wales. Other services include accident and emergency, renal medicine, neurology and neurosurgery, oral and maxillofacial surgery, rheumatology and palliative care. BAM Construct UK, the contractor for the new extension, will deliver the 13,000 square metre new building for Abertawe Bro Morgannwg University (ABMU) Health Board, which runs the hospital. Boy's death prompts new measures to safeguard patients in Wales Health Minister Lesley Griffiths has outlined new measures to safeguard patients following the death of a Welsh schoolboy 22 years ago. Western Mail letters: Tuesday, 30 October 2012 Western Mail letters: Friday, 26 October 2012 Radical new measures to centralise NHS care for sick and injured patients The number of hospitals across South Wales offering certain specialist services for the most sick and injured patients could be reduced as part of new proposals to modernise the health service. ‘Cuts lunacy’ sparks petition on Facebook Action group to fight against hospital cuts

医学

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What are Ganglia? Immobilizing the wrist for a few days after surgery to remove ganglia will help ensure that there is no recurrence. Ganglia most often develop on the wrist, typically after a sprain. Ganglia often results in swollen wrists and ankles. Ice therapy may be helpful in managing ankle swelling caused by ganglia. Approximately half of all ganglion cyst cases that exist do not require treatment, as the cysts eventually disappear on their own. The cause of ganglion cysts are not known, but they are more likely to affect those with osteoarthritis or previously injured tendons or joints. Often referred to as ganglion cysts, ganglia are collections of thick fluid that collect into lesions that develop on or near a joint or tendon. Typically, most examples of ganglia develop on the wrist, although there are a number of cases reported on ankles and finger joints as well. In many cases, the presence of ganglia can create joint swelling that ranges from mildly irritating to very painful. Here is some information on what seems to be the root causes of ganglia, as well as some suggestions for treatment. While the exact cause for ganglia remains unknown, there is some evidence that overuse of the joint may help to establish conditions that are ideal for the presence of the joint swellings. In some cases, ganglia may develop after a strain or sprain, once the ankle or wrist swelling has subsided. This is because the fibrous tissue that surrounds the joints may become weaker, making the area more susceptible to the collection of fluid. The fact that ganglia often results in swollen ankles and swollen wrists whose appearance is very similar to a sprained joint, some people may assume they have one condition when it fact the opposite is true. Ad Many incidences of ganglia are relatively minor and will slowly disappear. However, ganglia that do not appear to improve should be treated immediately. While an old folk method for treating ganglia used to be striking the ganglion cyst with a heavy book, most physicians do not recommend this method. The chances of leaving lingering fluid that does not absorb back into the system is quite high, and in fact may only bring temporary relief. Instead, it is a good idea to consult a physician and investigate either aspiration or excision as a means of dealing with the condition. Aspiration is an outpatient procedure that essentially involves lancing the swollen area and allowing the collected fluid to drain. However, it is important to understand there is a relatively good chance of recurrence if this method is used. More reliable is the use of surgery to remove ganglia. Usually referred to as arthroscopy, an incision is made and the contained cyst is removed from the wrist or ankle swelling. This removes the cause of the inflammation without the chance for the fluid to infect the surrounding area, and often leads to a full recovery. Usually, choosing to immobilize the wrist or ankle for a few days after the procedure will help to further ensure that there is no recurrence of ganglia in the future. Ad What Is a Ganglion Cyst Excision? What is the Putamen? What is the Basal Ganglia? What is a Ganglion Wrist Cyst? What Should I Expect from Ganglion Surgery? What is a Ganglion Foot Cyst? What is a Ganglion Cyst? Phaedrus I actually had to have some ganglia cysts removed from my ankle after a really bad sprain. I spent several weeks in an air cast and could put weight on it, but the little nodules were causing short bursts of pain while walking. The doctor used a local anesthestic and a surgical lance to take care of the problem. Of course I couldn't stand to watch it happen! Ruggercat68 When I was working at a deli, I had to use the meat slicer a lot and I developed a bad case of tendinitis. The restaurant owner's dad happened to be a doctor, so she sent me over to his office for an after-hours exam. After he checked out my arm and wrist, he wrote me out a prescription for a strong anti-inflammatory medication and ordered me to stay off that slicer for a week or so. While I was there, I pointed out several bumps I could feel under the skin of that arm. He said they were ganglia cysts, probably triggered by the muscle strain on that arm. He said they could be lanced and drained, but it was not strictly necessary. He said they would either go away on their own or wouldn't be anything but a nuisance. A lot of people have wrist ganglia and don't even realize it. Post your comments

医学

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The Braille Monitor October, 2003 (back)(next)(contents) Medical Doctor Takes Up Braille after Retirement by Dr. Hilary Connor From The Editor: The following article first appeared in the Summer 2003 issue of the Braille Spectator, the publication of the National Federation of the Blind of Maryland. It begins with Editor Al Maneki's head note: Dr. Hilary Connor Dr. Hilary Connor is eighty-one years old and still going strong. He was born in Rhode Island and served as an officer in the Navy during World War II, where he met his future wife, a Navy nurse. He completed his medical residency after World War II. His long medical career included seventeen years in private practice as a pediatrician, followed by many years in the U.S. Public Health Service, where he began working with Native Americans on their reservations in the West. His long and distinguished career culminated in eight years of service as the director of the State Board of Medicine of Virginia. Dr. Connor tells us that after retirement he and his wife decided to live in Maryland so that they could be at the focus of their four children, who are scattered up and down the East Coast. In this poignant article Dr. Connor explains that he suddenly became blind after retirement. Although he did not know us at that time, he responded to this dramatic change in true Federation spirit. The story of his blindness can serve as an inspiration to all of us. This is what he says: I spent many years in the clinical practice of medicine. The last eight years of my full-time activity was spent as the director of the State Board of Medicine of Virginia. At the age of seventy-three, I decided to retire and move to Maryland. Shortly after retirement I realized that I couldn't sit around and just do nothing, so I agreed to work two days a week as a consultant to the State Board of Medicine of Maryland. But six months after I retired, in January of '95, I had an attack of temporal arteritis, an autoimmune disease, and in a matter of days I went from 20/20 vision to total blindness. I watched the Super Bowl Sunday night; I was totally blind on Tuesday morning. A week later, when I left the hospital, I returned to the office to close out my desk. My wife took me there, and the physicians on the board asked that I stay on, saying that they would hire a reader to read the cases to me so that I could continue to consult with them. I explained that my wife had been a nurse and that she could read the cases to me. So I continued to work for another two years, reviewing the cases, having my laptop read me the research, and then attending the sessions and meeting with the board members. But at the age of seventy-five I decided that I'd really had enough and it was time to retire, so I did. Upon retirement I realized that I needed to do more than just listen to the radio. I went to the National Federation of the Blind headquarters, where I had originally gone to get a cane two years before. This time I asked them to give me some information about how I could learn to read Braille. They referred me to Blind Industries [Blind Industries and Services of Maryland], and I again went over there and met with Ellen Ringlein, who was teaching Braille. I explained that I didn't really want to take daily lessons or be on a schedule, but, if she would give me the books they used to teach Braille, I would teach myself at home. She agreed and gave me the first of the three volumes that I used in learning Braille. I went home, and, since I had a lot of time to spend on it, I really went at it like an eager beaver and finished the first book, picked up the second, finished the second, and picked up the third. In the meantime every so often the phone would ring, and it would be Ellen checking on me to make sure that I hadn't quit, that I was still going. Eventually I finished and then headed to the Library for the Blind, where I had been going to pick up cassette books to listen to and now started getting novels in Braille. I still remember my first novel in Braille, The Secret of Snake Canyon. It was a cowboy mystery. Since that day I have never been without a Braille book or novel from the library--best-sellers, mostly spy stories and adventure stories. I've had enough technical stuff all my life that I don't need to continue with it at this point although I still take continuing medical education courses. I finally realized that, even though I know Braille, I am not a fast reader and never will be. I read with my left hand because I injured my neck years ago and the sensation in my right hand was approximately half of what it was in the left. So I read with my left hand. I decided that maybe I could use my Braille for some other purposes besides my own satisfaction. I went to the veterans hospital to see if they could use a volunteer. Since I am totally blind, I obviously couldn't wheel patients around or things like that, but I said I could teach Braille to blind people if they were interested, and they were. So I have started teaching Braille. I go over to the veterans hospital two days a week. I've been doing this for three to five years now. My students are old codgers just like me. Fortunately the number of young blind veterans is a small percentage of the older ones, and all the students I have had so far have been in their seventies. The two I have now are seventy-four and seventy-nine years old. The seventy-nine-year-old is very fortunate in that his tactile sensation is fantastic. He can feel the dots beautifully. He has no neuropathy. He has the time to spend on Braille, so he's moving along very rapidly. Some of the others have had to drop out because of illness. But we are in no hurry. We go along at our own pace. If someone's got a medical appointment, we just cancel our meeting. Frequently they call me at home if they've missed a period of time, and we spend an hour on the phone. I have the book. I pick it up, and we just sit there and read it over the telephone. We're moving along at our own pace, and I find it extremely enjoyable. I have always enjoyed teaching. I enjoyed teaching interns, residents, and medical students, and I find that these elderly men who are interested in Braille are easy students. They're anxious to learn. They're not in a tremendous hurry. They know that it's going to take a little while, and they're patient. I have enjoyed my meetings of the National Federation of the Blind. When I first became blind, the thing that saved me from falling into a deep depression was continuing to work. Let's face it: you can't become blind like that and not be unbelievably depressed. But I continued to work, and that gave me something to do so that I didn't get wound up in self-pity. When I listen to people at NFB meetings, I find people there who have other problems along with their blindness. While they may complain about transportation, mail delivery, and garbage pickup, nobody's complaining about being blind. There's not a lot of that, hardly any of that as a matter of fact, and I think that helps me considerably too. I realized that I'm not alone. Now at eighty-one it's fortunate for me that the veterans hospital is only about eleven blocks from where I live, and my wife walks there with me. It's a good way of getting exercise. She also walks with me to other places, so we average about three miles a day. This is something that we both need, because she's almost as old as I am. I also believe that there's more to Braille then just being able to sit down and read or write something, especially for the elderly. I think the elderly need Braille to keep their minds active. Reading Braille is very precise. It's not like French or other languages, where there are always exceptions to the rules. Braille is cut-and-dried. It's going to be the same tomorrow as it is today. Any blind person with average intelligence and enough tactile sensation to feel the dots should learn Braille. To my way of thinking, Braille is the second most important thing for blind people. Obviously traveling with the white cane is the most important thing there is.

医学

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Grant supports joint medical technology research, development October 31, 2008Share This StoryFacebookTwitterProfessor Dan Cavanagh in the classroom.Please note: You are viewing an archived Bucknell University news story. It is possible that information found on this page has become outdated or inaccurate, and links and images contained within are not guaranteed to function correctly.[X] Close this message.LEWISBURG, Pa. – A $71,000 matching grant will be shared by Bucknell University and a Geisinger Health System enterprise to foster collaborative medical technology research and development efforts.The state-funded Keystone Innovation Grant will be shared by the Danville, Pa.-based Geisinger Ventures and Bucknell’s Department of Biomedical Engineering in a partnership supported by the Bucknell Small Business Development Center, the only center in Pennsylvania with a focus on device prototyping.The prominent opportunity provided for by the grant will be the joint hiring of a doctoral-level staff member who will facilitate cross-institutional research and technology development efforts. The grant will also provide seed capital for projects with priority being given to Bucknell biomedical engineering senior design projects. At least five such projects are expected for 2008-09.Technology development“In recent years, technology development and transfer interactions between Bucknell and Geisinger have increased and proven progressively beneficial,” said Dan Cavanagh, associate professor of biomedical and chemical engineering and chair of the Department of Biomedical Engineering at Bucknell. Those interactions, said Cavanagh, have enhanced the professional experience for Bucknell’s engineering students, complemented Geisinger staff-driven projects, led to the development of medical technology prototypes and provided a solid foundation for future effective collaborations between the two institutions.The U.S. biomedical device industry, one of the largest in the world at $92 billion, is driven in large part by biomedical innovation at U.S. universities and medical centers.Innovative products“This grant allows us to play a larger role in moving knowledge, including innovative products and services, from the laboratory to the market, where it will best serve the needs of the people we serve,” said Denise Prince, CEO, Geisinger Ventures. “Our goal is to create new opportunities for jobs and local revenue streams.” Already, the Bucknell-Geisinger partnership has had successes including the development of an enhanced drug-injection device for use in emergency response. The device has yielded two patents, creation of a prototype and license discussions with a commercial firm.While the interaction between Bucknell and Geisinger has yielded benefits over the past two years, no formal mechanism or administrative structure for technology transfer has existed. This collaboratively written grant is the first formal effort to provide the needed resources and structure.Building bridgesBucknell President Brian C. Mitchell has expressed a deep commitment to regional economic development. One of the tenants of the University’s strategic plan, The Plan for Bucknell, is building bridges – in all their broadest forms.Contact: Division of Communications

医学

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Revision as of 15:22, 6 February 2006 by Jls (Talk | contribs) (→‎Dissecting the Line) Do not put your faith in what statistics say until you have carefully considered what they do not say. William W. Watt 1.1 Great howler for Chance News! 1.2 Alcohol is now 49% more affordable 2 Do Superfluous Medical Studies Exist? 3 Using bill-tracking data to predict epidemics 4 Hormone Replacement Therapy (HRT) 5 How to count meaningfully 6 Beauty is in the eye of the beholder 6.2 Further information 7 Making a Mint 8 Dissecting the Line Great howler for Chance News! Steven Strogatz suggested the following: Events like this send a shiver down the spine, but the math behind strange coincidences shows that most people simply have a poor grasp of statistics. The odds against meeting someone else at a party with your birthday are not 365 to 1. In a room with just 23 people, the chances that two of them will share the same birthday are better than even. William Grimes reviewing Beyond Concidence by Martin Plimmer and Brian King New York Times, 20 Jan. 2006 Alcohol is now 49% more affordable Here is a Forsooth from the January 2006 issue of RSS News with a comment by the editor. Alcohol is now 49% more affordable than it was in 1978 Sky News [readers are invited to send in their suggestions as to the exact definitions of a and b in the equation b = 1.49a] Note from JLS. The concept of an affordabiliity index is used in many fields but it is often difficulty to find a definition. Here are a couple of examples: In the Ottawa Citizen Dec 23, 2005 we read: The RBC (Royal Bank of Canada) housing affordability index, which measures the proportion of pre-tax household income needed to cover the costs of owning a home, was 24.6 per cent for a condominium, which remains the most affordable type of housing; 28.8 for a standard townhouse, 35.5 for a standard bungalow, and 41.3 for a standard two-storey home. And in the US congress College access and opportunity act of 2005 we read: The college affordability index shall be equal to (A) the percentage increase in the tuition and fees charged for a first-time, full-time, full-year undergraduate student between the first of the 3 most recent preceding academic years and the last of those 3 academic years; divided by (B) the percentage increase in the Consumer Price Index-All Urban Consumers (Current Series) from July of the first of those 3 academic years to July of the last of those 3 academic years. Do Superfluous Medical Studies Exist? In Chance News 12 can be found an item Superfluous Medical Studies, It references David Brown's articlein the Washington Post of January 2, 2006 in which he "looks at several instances where...the evidence is so convincing that no more studies need or should be done." His phrase is "What part of 'yes' don't doctors understand." In particular, "he cites the use of aprotinin in heart surgery" which since 1987 had 64 studies each conclusively showing that aprotinin reduced bleeding. Researchers were criticized for persisting in evaluating aprotinin without being fully aware of the previous research. Less than four weeks later on January 26, 2006, the New York Times and the Wall Street Journal had respective headlines, Doctors Urge Ending Use of Heart Surgery Drug and "Serious Risks Are Found In Heart Drug." The heart drug, Trasylol, is, as you might guess, aprotinin! Some 4374 patients were in the study published by the New England Journal of Medicine--"1295 were given aprotinin and 1705 one of two other drugs, both generics [of older drugs]" There was also "A control group, 1374 patients" who "had no drugs to prevent bleeding." According to the Wall Street Journal, "About 29% of the Trasylol patients suffered a stroke or heart-related complication, compared with about 21% of the patients taking the generic drugs and 19% getting no drugs." The breakdown comparison between Trasylol and the alternatives is as follows: 5% of patients on Trasylol required kidney dialysis vs. 1% of those on one of the two alternative drugs. 16% of Trasylol patients had a myocardial infarction (heart attack) vs. 12% and 13% of those on alternatives. 9% of Trasylol patients experienced heart failure vs. 6% and 5% on alternatives. Furthermore, "The researchers also found that cheaper alternatives ("$10 to $50" per patient) to Trasylol ($1000 per patient) were just as effective in limiting blood loss." The New York Times wrote, "The [New England Journal of Medicine] article said that halting aprotinin use globally would prevent 10,000 to 11,000 cases of kidney failure a year and save more than $1 billion a year in dialysis costs as well as nearly $250 million spent on the drug itself." In addition, "The study is significant because it was conducted without drug-industry funding at 69 medical centers, including many of the top U.S. hospitals." Naturally, Bayer, the manufacturer of Trasylol, a drug which "in the first nine months [of 2005]" had a "world-wide sales of just less than $200 million" and is used in 150,000 patients in the U.S., "believes that Trasylol is a safe and effective treatment." Though the study was large, Bayer points out that it was observational and not a randomized trial. According to the New York Times, the implication is, "Doctors might have assigned sicker patients to a particular drug that could make the results for that drug look bad." However, the Wall Street Journal claims that a randomized trial could not be done because "many hospitals have deemed Trasylol effective and would consider it unethical to allow a patient to get a placebo instead." The study thus resorted to " 'match' like patients across the study groups to control for other risk factors, such as age, gender and additional health problems." About the only unambiguous conclusion that can be reached is to take good care of your heart so that you avoid the need for by-pass surgery and the associated medication. Submitted by Paul Alper. Using bill-tracking data to predict epidemics Web game provides breakthrough in predicting spread of epidemics, BJS, Science Blog, 6-Jan-06. Money-tracking web-game informs mathematical model of epidemics, BoingBoing, 26-Jan-06. Statisticians Count Euros and Find More Than Money, Otto Pohl, New York Times, 2 Jul 2002. The study of how epidemics spread worldwide is critical for controlling diseases, particularly pandemics like AIDS, bubonic plague, SARS and avian flu. Scientists hope to improve their models for epidemics by unravelling the statistical laws of human travel in the United States and elsewhere using novel data gathering techniques that exploit the ubiquity of the internet. For the US source, the data is collected at the www.wheresgeorge.com bill-tracking website. This is a web-game that encourages people to track the serial numbers of dollar bills as they move around the US. Where's George? players mark their bills with WHERESGEORGE.COM then visitors to the site are encouraged to enter the serial number of the bill they've found and where they got it. In this way, the passage of a dollar-bill (or some other piece of infection) can be tracked around the country. One of the authors of the Nature article (Brockmann) says: We recognized that the enormous amount of data, as well as the geographical and temporal resolution of bill-tracking, allowed us to draw conclusions about the statistical characteristics of human travel, independent of which means of transportation people use. Movements of money is similar to phenomena like "on hold" times at call centers and stock price movements. These are systems whose development depends largely or entirely on the previous state the system was in. But how does one model this mingling? Until recently, models of the geographic spread of disease were based on the assumption that viruses disperse over geographic areas in a way similar to the diffusion of fine dust particles on the surface of water or gas molecules mixing in a room. Competing models include using a complex set of equations to describe interactions between people that depend on distance between them, the number of people involved and physical or economic constraints. Using the US game data, the Science blog claim that scientists have developed a mathematical theory that describes the observed movements of travelers amazingly well over distances from just a few kilometers to a few thousand. By analysing the data from the bill-tracking website, they found that money follows what are known as universal scaling laws (from local to regional to long-distance scales). Like money, viruses are transported by people from place to place. Because the mechanisms of transmission of diseases from human to human are already well understood, the scientists can use these novel data sources to develop better models to better explain the global spread of a disease, during an epidemic. Another of the authors (Hufnagel) explained Since we can't track people with tracking devices, like we do animals, we needed to get data that provided us with millions of movements of individuals. What is amazing about these particular scaling laws is the fact that they are determined by two universal parameters only. This result surprised us all. In Europe, a similar effort has been underway since 2002 with the introduction of the Euro. On New Year's Day, the notes and coins, all of them valid across the entire euro zone, began to spread across national borders. While the euro is worth the same in every country that uses it, each one mints its own euro notes, with a distinctive design on the reverse and each country introduced its own notes exclusively within its borders. Every time a euro note from Finland appears in Greece, for example, it provides a tiny but precise data point about the relationship between the countries. Moreover, the total amount minted was roughly proportional to each country's economy compared with the overall European economy. So Germany, an economic powerhouse, minted 32.6 percent of all notes, France about 15 percent, and tiny Luxembourg just two-tenths of 1 percent. This Euro diffusion process shows how epidemics spread, to what extent are Europeans integrating and what their travel patterns are. Dr. Dietrich Stoyan, a statistics professor at the University of Freiberg in Germany in charge of the Euro coin-counting project comments I hope that studying this process will help people studying epidemics. What makes this special is that the precise launching date of the coins is known. We know when this `epidemic' broke out. In contrast to the analysis of the US dollar data, Dr. Stoyan has gone the complex route, by assuming that the relationship between each Euro country depends on a complex set of equations between each country that considers the distance between the countries and the number of commuters, travelers and bank trucks going back and forth etc. His model is composed of 144 interdependent differential equations that take as many of the known variables into account as possible. Another group from the University of Amsterdam, has chosen a high-level model of money flow, based on a branch of probability theory called Markov chains. For example, they assume that a relatively constant percentage of Dutch Euros will leave the Netherlands each month, and that a different, smaller percentage of Dutch Euros that have already left the country will return. So far, Dr. Stoyan and the Amsterdam group have been surprised to learn that large-denomination coins for one and two euros move much faster than smaller ones. Neither knows exactly why that is. Dr. Stoyan hypothesizes that people tend to dump their small coins out of their pockets at the end of the day and are therefore less likely to take them traveling. Mr. Nuyens believes that the coins are used much more often. When will the Euro coins reach statistical equilibrium? The models have yielded different results. The Dutch group believes that half of all coins in Holland will be of foreign origin a year from now and that statistical equilibrium across Europe will be reached in five to seven years (from the 2002 launch date). Coin collectors take rare coins out of circulation disproportionately more often e.g. Luxembourg Euro coins are rare relative to German Euro coins. Is this likely to affect the overall conclusions of the Euro 'experiment'? Is there an analagous problem for US dollars? Is the self-selected group of participants who log their US dollar bills serial numbers each month a statistically representative sample? Science and math teachers have latched onto these projects as a way to illustrate their subjects. They either ask all of the students to examine the change in their pockets or buy rolls of coins at the bank and count them in class. How are the results of these class experiments likely to differ from the web-based experiments? Are people more likely to travel further in Summer, when on holidays? If so, might this cause a seasonal effect to emerge in the data and how might an adjustment be made to cater for this? The scaling laws of human travel, D Brockmann, L Hufnagel and T Geisel, Nature, 26 January 2006 (subscription required). To take part in one of the data gathering exercises: See www.eurobilltracker.com/ to take part in the Euro experiment. www.wheresgeorge.com/ for the US dollar game. And a corresponding Canadian site, called www.WheresWilly.com, after Wilfred Laurier, the man on the Canadian five dollar bill. Submitted by John Gavin. Keeping up with turnarounds in the medical field is a full-time occupation. The latest about-face can be found in the Wall Street Journal of January 24, 2006. "In a sharp reversal in thinking about the risks and benefits of menopause hormones, new research shows that early use of the drugs may actually lower a woman's risk for heart disease." An article in the Journal of Women's Health contradicts warnings issued nearly four years ago that hormone use increases risk for heart attack and stroke." The design of that earlier study "didn't necessarily apply to the typical hormone user--women who turn to the drugs to treat menopause symptoms. Most of the participants in the WHI [Women's Health Initiative] were older women who started hormones 10 or more years past menopause." The main points of the latest study: "Women who began hormone therapy near menopause had about a 30% lower risk for heart disease than women who didn't use hormones." "Older women who started taking hormones at least 10 years after menopause didn't have any heart benefit." "Whether the women took just estrogen or a combination of estrogen and progestin didn't make a marked difference in risk." As the WSJ puts it, "The newest study bolsters the theory that with hormones, timing is everything." Unfortunately, this latest study did not examine other risks--blood clots, breast cancer--of menopause hormones. It also is "not a randomized, controlled trial, proving cause and effect." However, there is current recruitment for a randomized trial known as KEEPS [Kronos Early Estrogen Prevention Study] which "hopes to better answer the question of whether timing of hormone use makes a difference in terms of risks and benefits, particularly to the heart." Completely absent from the discussion are conjectures concerning strategies for the many women who were on menopause hormones and then stopped when the bad results were publicized. As far as can be ascertained, no studies are underway to shed light on what this considerable number of women should do. Submited by Paul Alper. How to count meaningfully The Undercover Economist, Tim Hartford, FT magazine, 28 Jan 2006 Unblocking business, The Economist, 15-Sep-2005. Some economists and statisticians spend their careers producing national and international statistics by perfecting theoretical tools and software to gather and analyse noisy data in a messy world. Such datasets are often compiled by counting large samples of things such as goods sold, prices of goods and people out of work. This article higlights how carefully choosing what to count may offer a more simple and transparent alternative quantification of people’s qualitative judgments. It begins with Chicago-based economist David Galenson investigating who was the greatest artist of the 20th century? He also showed when artists reach their peak by a surprisingly simple approach. He did this by counting something meaningful, which is how frequently experts felt inclined to exhibit Picasso’s art in canonical textbooks. He worked through every major art history textbook of the past 15 years and counted whose art is reproduced most frequently. Picasso, with 395 illustrations in 33 textbooks, scores nearly as many as his three closest rivals (Matisse, Duchamp and Mondrian) put together. From his sample of books, Galenson also observed artists who made conceptual leaps (Johns, Picasso, Duchamp, Warhol) peaked far earlier than so-called “experimental” artists for whom practice made perfect (Kandinsky, Rothko, Mondrian). Johns was 25 when he produced his most-reproduced pieces; Mondrian was 71. The FT article then switches to a different question but answered with the same methodology. The World Bank have been counting how many official signatures a farmer in the Central African Republic needs to obtain before he’s able to get his bananas on a ship bound for America or Europe - 38. And how many official procedures must a businessman in Lagos go through in order to legally buy a warehouse - 21. This kind of counting - done with the help of several thousand local lawyers and public officials - shares common ground with Galenson’s work. It transforms a qualitative impression (”Nigerian bureaucracy is painful”) into a quantitative fact; it does so through the intermediation of experts, and uses a perfectly transparent process. It’s also rather more useful, by showing Central African Republic officials which of the 38 signatures are surplus to requirements in Germany. The article claims that the resulting publication, Doing Business in 2006 is, by far, the World Bank publication that is most mentioned in press reports. So much so that the Bank's indicators are helping to solve the problems they measure. In the latest report Serbia slashed more red tape last year than any of the 154 other countries in the study and, as a result, start-ups have boomed with the number of registered firms leaping by 42% in 2004. Whereas, in the past, the Bank has been coy about publishing its full league table, for fear of offending the governments at the bottom. Simeon Djankov, an author of the report, reckons that 21 different reforms over the past two years were inspired by the “Doing Business” audit, which costs just $2m to carry out and disseminate. He says It is like sports. If you keep score, no one wants to lose. You can see the statistics of your favourite economy for topics like 'Doing Business', 'Hiring and Firing' and 'Paying Taxes'. Are these business-related statistics a good proxy for the state of a whole economy? If you were deciding to move to another country what other comparative statistics would influence your decision? Doing Business, The World Bank - "This database provides objective measures of business regulations and their enforcement. The Doing Business indicators are comparable across 155 economies. They indicate the regulatory costs of business and can be used to analyze specific regulations that enhance or constrain investment, productivity and growth." Submitted by John Gavin. Beauty is in the eye of the beholder Mathematician defines beauty in new exhibition, James Randerson, science correspondent, The Guardian, February 1, 2006. Mathematical photography - beyond beauty, Justin Mullins, New Scientist, 28 January 2006 (Magazine issue 2536). Photos of mathematical equations -- London show opens Feb 1, Cory Doctorow, BoingBoing blog, 29 Jan 05. Justin Mullins is a photographer/artist who produces framed equations, with textual material explaining their meaning to everyday life. He is having his first exhibition in London from the 1st to the 12th February at Lauderdale House. The artist comments If mathematicians are explorers, then my role is that of a photographer who retraces their steps. During my journey, I photograph what I find. By that I mean frame it, record it and later present it. In the same way that an ordinary photograph is a snapshot of an area of outstanding natural beauty, a mathematical photograph is a snapshot of mathematical beauty. There is an on-line gallery that shows examples (by theme) from the fields of astronomy (starbirth - birth, The Three Body Problem - family), physics (entanglement - romance, Maxwell's equations - let there be light) and, not surprisingly, mathematics (Godel's Incompleteness Theorem - mystery, Four Colour Theorem - ugly, and Mullins' favourite, Euler's relation - beauty). But, alas, statistical equations did not make it into his selection (t-distribution, anyone?). The artist invites feedback: I would be happy to hear how visitors to this site feel about my work. If you have something to add, my contact details are http://www.justinmullins.com/contact.htm. If you were to nominate an equation from the realm of statistics, what would you choose? Most of the equations shown in the on-line gallery also include a description and further links. What text or links would you add to justify your choice? If we consider statical models rather than pure equations, then surely statisticians' most common choice would be a simple regression equation Y = a + bX + e, X and Y are the independent and dependent variables, respectively, a and b are constants and e is a random variable for white noise with a constant variance. A quick check via google returned about 269,000 hits for this statistical model. Can you do better and why? The photographs are for sale but at different prices, presumably linked to the size of the frame. What other criteria might be used to evaluate the merits of an equation? For example, if your choice is based purely on statistical grounds, what artistic or historical reasons for your choice might you add? Perhaps a better gallery for statistics would be based on graphs rather than equations. What graph would you nominate for your gallery and why? See the R Graph Gallery for some ideas. While searching (and failing) to find a snappy title for this Chance entry, I stumbled across two quotes that I can not resist including (can you suggest a catchy title for this item?) Mathematics, rightly viewed, possesses not only truth, but supreme beauty - a beauty cold and austere, like that of sculpture. Bertrand Russell (1872 - 1970) Order is the shape upon which beauty depends. Pearl Buck (1892 - 1973) This exhibition runs at Laurderdate House, an arts and education centre based in Waterlow Park in London, from 31st Jan to 12th Feb. Making a Mint Run, don't walk to get "Fortune's Formula" by William Poundstone [Hill and Wang, NYC, 2005]. It has everything: Claude Shannon, Gorgeous Gussie Moran, Ivan Boesky, Paul Samuelson, Rudy Giuliani, Michael Milken, Frank Costello and other gangsters. It also has John Kelly's famous formula, based on the even more famous Shannon's channel capacity theorem, for betting on the horses and on the stock market. I also suggest you acquire two reviews of the book: Business Week [Elwyn Berlekamp's in the American Scientist. See also Chance News 7. Most statisticians would be at least vaguely aware of Shannon and his channel capacity theorem. According to Berlekamp, " Shannon had shown that noise on a communication channel need not impose any bound on the reliability with which information can be communicated across it, because the probability of transmitting a very long file inaccurately can be made arbitrarily small by using sufficiently sophisticated coding techniques, subject to a constraint that the ratio of the length of the source file to the length of the encoded file must be less than a number called the channel capacity." The notion of a formula for fortune comes about because, " Kelly showed that the asymptotically optimum asset allocation could be determined by solving a system of equations that maximized the log of one's capital. In his horse-track jargon, Kelly also showed that the resulting optimal compound growth rate could be viewed as the capacity of a hypothetical noisy channel over which the bettor was getting the information that distinguished his odds from those of the track. Kelly's betting system, expressed mathematically, is known as the Kelly criterion." The Business Week review puts Kelly this way: " It's a system that tells you how much of your money to bet to maximize the growth rate of your wealth -- while controlling risk. Technically speaking, it says the fraction of your payroll that you bet should equal your edge divided by the odds. Although Poundstone is a good explainer, the details can be heavy going for casual readers. Here's an example from the book that, for the purpose of simplicity, omits the track's take: The tote-board odds for Secretariat are 5 to 1, so a winning $100 bet pays $600. But you have a tip that Secretariat actually has a 1 in 3 chance of winning, so you have a one-third chance (instead of one-fifth) of winning $600. Dividing $600 by 3 gives you a weighted average payout of $200. Subtracting your bet leaves you with a profit of $100. The edge is defined as the profit divided by the wager, namely $100 divided by $100, or 1. The odds are defined as 5 to 1, or simply 5. So edge/odds equals 1/5, meaning you should bet one-fifth of your bankroll on Secretariat. That's it." Famous though that Kelly's formula is to the cognicenti, the economists I have spoken to have never heard of Kelly's formula but apparently it was in vogue several decades ago and severely criticized down through the years by Paul Samuelson and other economists who claim it is nonsense; in the eyes of economists, the stock market is "efficient" and is in effect, a (geometric) random walk (prices do not go below zero and thus, the term geometric appended to random walk). For economists, successful stock pickers are lucky, not smart. On the other hand, according to Berlekamp who was Kelly's research assistant in the early 1960s, hedge fund managers such as Jim Simons, former head of the Computer Science Department at Stony Brook, and Ed Thorp, author of Beat the Dealer and Beat the Market, and others who started out as math professors, are obscenely rich and swear by Kelly. As Berlekamp contemptuously phrases it, "No one who has made a legitimate fortune in the markets believes the efficient-market hypothesis. And conversely, no one who believes the efficient-market hypothesis has ever made a large fortune investing in the financial markets, unless she began with a moderately large fortune." We do not hear about the successful applications of Kelly "presumably because financial wizards as successful as these have always been unwilling to discuss their formulas in public." Poundstone makes the case that "half Kelly"--or, set aside money from gambling -- is perhaps better because it has "much less volatility" than the straight-forward application of Kelly. Half Kelly or full Kelly, big-time hedge fund managers are hiring mathematicians who can model the system in order to beat the system. The connection to Georgeous Gussie, Milken, Giuliani, etc. makes for lively reading even though Berlekamp decries the "sensationalism." Even if you do not get rich because of the book, the pages will turn faster than you could imagine. Dissecting the Line New York Times, Play Feb. 2006 Stephen Dubner and Steven Levitt This article by Freakonomics authors Dubner and Levitt is in Play a new sports magazine being published by The Times Magazine and being destributed in the Sunday newspaper. More information about this article can be found at the website. This inaugural issue appeared on the day of the Super Bowl between the Denver Brocos and the and includes this article in which Dubner and Levitt expain the job of the bookmaker and how he sets the point spread for football games. The authors describe the spread as: The house's bookmaker sets a price in the form of a point spread — the Denver Broncos to win by at least 7 points, for instance. A bettor is then free to take either side. He can bet the Broncos minus 7 points (he'll win this bet if the Broncos win the game by more than 7 points), or he can bet the Broncos' opponent plus 7 points (he'll win if the Broncos lose outright or win by fewer than 7 points; if the Broncos win by 7 exactly, it's a "push," or tie). Actually, by game time the Steelers were generally considered a 4.5 point favorite so if you made such a bet you would have won since the Steelers won with the score 21 to 10. The authors begin their explanation of how the bookies make money by writing: The most certain way for a bookmaker to turn a profit is to balance his book — that is, to set a point spread that produces an equal number of dollars wagered on both sides of the line. Since only losers pay the house a 10 percent fee (known as the vigorish, or vig) on top of wagers, a balanced book guarantees the house a 5 percent gain. The conventional wisdom holds that bookmakers set point spreads to achieve this balance. The authors interviewed Chuck Esosito who runs the race and sports book at Caesars Palace in Las Vegas. Esposito says that is is a myth that they can control the spread so that an equal amount is bet on each team. Dubner and Levitt attribute failure to the fact that the betting public has biasis. For example they say "For every bettor smart enough to stick to home underdogs, there are 5 or 10 bettors who systematically prefer favorites or who underestimate the impact of home-field advantage". The go on to explain how the bookie can and they believe does take advantage of the public's biases. How does this work? Let's say that a bookmaker is handicapping a game between the Broncos and the Pittsburgh Steelers. He first studies every conceivable element of the game: strengths and weaknesses, momentum, injuries, tendencies, weather forecast, etc. He then decides that the true line — that is, a line that he figures will give each team a 50 percent chance of winning the bet — happens to be Denver minus 7 points. But because of bettor bias, perhaps as much as 80 percent of the money will inevitably flow to the favorite. So what if the bookie sets the line a little higher, at 9 points? Denver is still likely to draw the majority of the wagering, but its chances of winning the bet are now slightly less than 50 percent. The bookie has thus managed to tempt the majority of the wagering toward an outcome that is unlikely, even if only slightly, to happen. Over time, this pattern will yield the bookie a gross profit margin 20 to 30 percent higher than if he had simply balanced the wagering. In other words, why should a bookie play for the safe 10 percent vig when he can play it only slightly less safe and make much more money? These claims are supported by a study that Levitt made in his article How do markets function?A empirical analysis of gambling on the national football league. Obviously, it is not easy to get data for such a study but Levitt did get a large dataset that he feels reflects typical football betting. DISCUSSION How does a bookies job compare with that of a stock broker? Retrieved from "https://www.causeweb.org/wiki/chance/index.php?title=Chance_News_13&oldid=2065" Navigation menu

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Memorial Sloan Kettering Ranks First in the Nation for Cancer Care New York, NY, Tuesday, July 15, 2014 Memorial Sloan Kettering Cancer Center is proud and honored to announce it has been named the number one hospital for cancer care in the nation, according to U.S. News & World Report in its annual listing of Best Hospitals. Since the inception of the revered list 25 years ago, MSK has held either the first or second spot each year. “We are delighted and honored to once again be a top hospital for cancer,” said MSK President and CEO Craig B. Thompson, MD. “But this recognition is really a reflection of an entire community of exceptional people — our dedicated staff of almost 13,000 and our patients, who have placed their trust in our care. We may be number one in the national rankings for this year, but our patients are number one to us every day.” The rankings recognize hospitals that excel in treating the most challenging patients. In addition to its ranking for cancer care, MSK was ranked number four for gynecology, number nine for urology, and number 28 for ear, nose, and throat, and was recognized as high performing in the fields of gastroenterology and gastrointestinal surgery and geriatrics. Just 3 percent of the nearly 5,000 hospitals analyzed earned national ranking in even one specialty. Per U.S. News & World Report, hospitals that rank nationally in any specialty have the skill and experience to treat the most complex and demanding cases that can arise in that area. MSK is also ranked among the nation’s top pediatric hospitals. While competition among medical institutions in the New York metro area is high (MSK ranked number seven of all hospitals in New York City), MSK’s singular focus on cancer means the hospital far outranks its neighbors for cancer care. The U.S. News & World Report rankings are determined using a complex set of factors. These include the hospital’s reputation among board-certified physician specialists around the nation, patient survival and safety data, and adequacy of nurse staffing levels, among other criteria. For a complete list and methodology of rankings, please visit U.S. News & World Report. Journalists may contact the Department of Public Affairs for more information. Email: [email protected]

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Expand Document | Expand Chapter | Full TOC | Printable HTML version Subjects & KeywordsKeywords > national pharmaceutical policyKeywords > policy perspectivesHow to Develop and Implement a National Drug Policy - WHO Policy Perspectives on Medicines, No. 006, January 2003 (2003; 6 pages) [French] [Spanish] Table of Contents What is a national drug policy? Objectives of a national drug policy The essential medicine concept is central to a national drug policy The national drug policy process Key components of a national drug policy Selection of essential medicines Affordability Financing options Supply systems Regulation and quality assurance Rational use Research Human resources development Monitoring and evaluation Key documents Objectives of a national drug policy In the broadest sense a national drug policy should promote equity and sustainability of the pharmaceutical sector. The general objectives of a national drug policy are to ensure: • Access: equitable availability and affordability of essential medicines, including traditional medicine; • Quality: the quality, safety and efficacy of all medicines; • Rational use: the promotion of therapeutically sound and cost-effective use of medicines by health professionals and consumers. Figure 1 By the end of 1999 over 100 countries had a national drug policy The more specific goals and objectives of a national policy will depend upon the country situation, the national health policy and political priorities set by the government. In addition to health-related goals there may be others, such as economic goals. For example, an additional objective may be to increase national pharmaceutical production capacity. It is critical that all the drug policy objectives are explicit, so that the roles of the public and private sectors and of the various ministries (health, finance, trade and industry) and government bodies (such as the drug regulatory authority) can be specified. A drug policy can have a rapidly noticeable impact. For example, Chad adopted its drug policy and developed an implementation plan in 1995. Based on the results of the baseline survey carried out at that time, the national drug policy and its implementation plan focused on two strategies to improve access to essential medicines: (1) appropriate selection and use of generic drugs, and (2) improved drug procurement and management through training, central medical store, and regional bulk procurement. In six years, the policy has had a significant impact (see Figure 2). Figure 2 Impact of national drug policy in Chad, 1995-2001

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Henry Gray (1825–1861). Anatomy of the Human Body. 1918. tubercle on its posterior surface, medial to the groove for the tendon of the Flexor hallucis longus. The deep fibers (anterior talotibial) are attached, above, to the tip of the medial malleolus, and, below, to the medial surface of the talus. The deltoid ligament is covered by the tendons of the Tibialis posterior and Flexor digitorum longus. The anterior and posterior talofibular and the calcaneofibular ligaments were formerly described as the three fasciculi of the external lateral ligament of the ankle-joint. The Anterior Talofibular Ligament. (ligamentum talofibulare anterius) (Fig. 355).—The anterior talofibular ligament, the shortest of the three, passes from the anterior margin of the fibular malleolus, forward and medially, to the talus, in front of its lateral articular facet. The Posterior Talofibular Ligament (ligamentum talofibulare posterius) (Fig. 355).—The posterior talofibular ligament, the strongest and most deeply seated, runs almost horizontally from the depression at the medial and back part of the fibular malleolus to a prominent tubercle on the posterior surface of the talus immediately lateral to the groove for the tendon of the Flexor hallucis longus. The Calcaneofibular Ligament (ligamentum calcaneofibulare) (Fig. 355).—The calcaneofibular ligament, the longest of the three, is a narrow, rounded cord, running from the apex of the fibular malleolus downward and slightly backward to a tubercle on the lateral surface of the calcaneus. It is covered by the tendons of the Peronæi longus and brevis.

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Drugs in the Internet era Drugs: A Very Short Introduction Buy Now November 16th 2012 By Les Iversen When Drugs: A Very Short Introduction was published in 2001 drugs were relatively hard to obtain. Recreational users could buy illegal drugs from back-street dealers, while prescription medicines required a trip to the doctor to obtain a script. The Internet has changed all that. Nowadays in Western Europe and in North America there are dozens of website dealers offering novel psychoactive drugs (“legal highs”) and prescription medicines at modest prices. The market for designer drugs has grown hugely. The chemical structure of amphetamine By clever changes in the chemical structures of existing banned drugs these novel synthetic substances, which mimic the effects of banned drugs such as amphetamine, cannabis, cocaine, or ecstasy, escape legal prohibition. Because they are clearly marked “not for human consumption”, and labelled frivolously as “plant food”, “fish food”, or “bath salts” they avoid other laws prohibiting the sale of new substances for human use. The European Monitoring Centre for Drugs and Drug Addiction listed 49 new psychoactive substances in 2011, and have been registering a new one every week in 2012. The commonest legal highs are synthetic chemicals which mimic the intoxication caused by herbal cannabis. Ironically, many such chemicals were made and tested 40 years ago by the pharmaceutical industry, in an attempt to find medically useful mimics of cannabis which lacked its intoxicant effects. This aim was never achieved, but detailed records of the many potent synthetic cannabinoids that were made and tested are available in scientific literature. Forty years later some of these have been resurrected and incorporated into a herbal “smoking mixture” called “Spice”. Dozens of such compounds are involved in different variants of Spice, and many are also available on their own, sometimes with exotic brand names such “Black Mamba” and “Annihilation”. Chemists find it relatively easy to make new drugs, while governments struggle to keep up with the flood of new legally available substances. All this might be viewed as harmless fun, but there are very real dangers in offering new untested chemicals for human use. For a new human medicine to be approved, it requires years of careful safety assessment in animal and clinical trials, and the medicine must pass stringent standards of purity. The legal highs escape all such requirements – their safety is assessed directly in the users, who play a potentially dangerous game of Russian roulette. The harmful effects of these drugs are not always immediately apparent. For example, some long term recreational users of the illegal veterinary anaesthetic ketamine develop severe painful inflammation of the urinary system, which may require surgical removal of the bladder. The weight-loss drug d-fenfluramine, although hugely popular and used by millions, turned out to have an unexpected effect on the valves of the heart in some patients, leading to severe cardiac malfunction and in some cases death. Internet sales are not limited to novel psychoactive drugs. Many websites offer online sales of prescription medicines. Whereas such medicines were previously only available from pharmacies with a script signed by a doctor, many of these sites offer medicines either without a script or after a perfunctory online medical diagnosis. In the USA in particular the high cost of medicines has lead many patients to seek cheaper online supplies. But there is no quality control for the online medicines, and patients play a different form of Russian roulette: thinking that the supplier is a reputable US or Canadian based pharmacy, whereas in reality it may be based in China, India, or Eastern Europe and be of poor quality. Prescription medicines can also be purchased online for recreational rather than medical use. Strong pain-killers such as fentanyl or oxycodone (®Oxy Contin) can be purchased as alternatives to back street heroin. The misuse of prescription medicines has already reached epidemic proportions in USA, where in 2012 the President issued an urgent warning on the “Epidemic of Prescription Drug Abuse”. There seems very little that governments can do to regulate the Internet markets for legal highs or prescription medicines, although some attempts have been made. In 2012 the US Justice Department and the Drug Enforcement Agency announced the closure of many websites offering “legal highs” (sold commonly in the USA as “bath salts”) but it remains to be seen if this is a legally acceptable course of action. In Eire the government raided and closed virtually all of the High Street “head shops” – which offer another sources of legally available psychoactive drugs. However, regulating Internet commerce has so far eluded governments around the world. The online sale of drugs has become a huge Internet business, with an estimated size of $25 billion dollars in 2010 for prescription medicines. Sooner or later some effective means of regulating these markets will have to be found, but it may take a shocking wake-up call – such as the discovery of serious unpredicted harm associated with one or other of the legal highs. Les Iversen is Emeritus Professor of Neuropharmacology of the University of Oxford and Chairman of the Advisory Council on Misuse of Drugs The Very Short Introductions (VSI) series combines a small format with authoritative analysis and big ideas for hundreds of topic areas. Written by our expert authors, these books can change the way you think about the things that interest you and are the perfect introduction to subjects you previously knew nothing about. Grow your knowledge with OUPblog and the VSI series every Friday! Subscribe to the OUPblog via email or RSS. Subscribe to only VSI articles on the OUPblog via email or RSS. Subscribe to only health and medicine articles on the OUPblog via email or RSS. View more on this book on the Image Credit: Amphetamine structure (public domain via Wikimedia Commons) Posted In: Health & MedicinePhysics & ChemistryScience & MedicineVery Short Introductions Subscribe to the OUPblog via email: Bath salts in the emergency department June 3rd 2016 Brave new world? November 22nd 2013 Alcohol: The World’s Oldest Recreational Drug January 27th 2010 Recent Comments There are currently no comments.

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Vanda Receives Negative Opinion from CHMP on Fanaptum™ for the Treatment of Schizophrenia WASHINGTON, Dec. 13, 2012 /PRNewswire/ -- Vanda Pharmaceuticals Inc. (NASDAQ: VNDA), announced today that the European Medicines Agency's (EMA) Committee for Medicinal Product for Human Use (CHMP) has issued a negative opinion recommending against approval of Fanaptum™ (oral iloperidone tablets) for the treatment of schizophrenia in adult patients in the European Union. The CHMP was of the opinion that the benefits of Fanaptum™ did not outweigh its risks and recommended against marketing authorization at this point in time. Vanda intends to appeal this opinion and request a re-examination of the decision by the CHMP. About Vanda Pharmaceuticals Inc.: Vanda Pharmaceuticals Inc. is a biopharmaceutical company focused on the development and commercialization of products for the treatment of central nervous system disorders. For more on Vanda, please visit http://www.vandapharma.com. Company Contact:Cristina MurphySenior Communications Manager Vanda Pharmaceuticals Inc.(202) [email protected] CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTSVarious statements in this release are "forward-looking statements" under the securities laws. Words such as, but not limited to, "believe," "expect," "anticipate," "estimate," "intend," "plan," "project," "target," "goal," "likely," "will," "would," and "could," or the negative of these terms and similar expressions or words, identify forward-looking statements. Forward-looking statements are based upon current expectations that involve risks, changes in circumstances, assumptions and uncertainties. Important factors that could cause actual results to differ materially from those reflected in the company's forward-looking statements include, among others: the inability to reach agreement with the FDA regarding Vanda's regulatory approval strategy or proposed path to approval for tasimelteon; the failure of Vanda's clinical trials to demonstrate the safety and/or efficacy of tasimelteon in the treatment of Non-24-Hour Disorder or Major Depressive Disorder; Vanda's failure to obtain regulatory approval for its products, product candidates or partnered products or to comply with ongoing regulatory requirements; the extent and effectiveness of the development, sales and marketing and distribution support Fanapt® receives; Vanda's ability to successfully commercialize Fanapt® outside of the U.S. and Canada; delays in the completion of Vanda's and its partners' clinical trials; a failure of Vanda's products, product candidates or partnered products to be demonstrably safe and effective; a lack of acceptance of Vanda's products, product candidates or partnered products in the marketplace, or a failure to become or remain profitable; Vanda's expectations regarding trends with respect to its revenues, costs, expenses and liabilities; Vanda's inability to obtain the capital necessary to fund additional research and development activities; Vanda's failure to identify or obtain rights to new products or product candidates; Vanda's failure to develop or obtain sales, marketing and distribution resources and expertise or to otherwise manage its growth; limitations on Vanda's ability to utilize some or all of its prior net operating losses and research and development credits; a loss of any of Vanda's key scientists or management personnel; losses incurred from product liability claims made against Vanda; a loss of rights to develop and commercialize Vanda's products or product candidates under its license and sublicense agreements and other factors that are described in the "Risk Factors" and "Management's Discussion and Analysis of Financial Condition and Results of Operations" sections of Vanda's annual report on Form 10-K for the fiscal year ended December 31, 2011 which is on file with the SEC and available on the SEC's website at www.sec.gov. In addition to the risks described above and in Vanda's annual report on Form 10-K and quarterly reports on Form 10-Q, other unknown or unpredictable factors also could affect Vanda's results. There can be no assurance that the actual results or developments anticipated by Vanda will be realized or, even if substantially realized, that they will have the expected consequences to, or effects on, Vanda. Therefore, no assurance can be given that the outcomes stated in such forward-looking statements and estimates will be achieved.All written and verbal forward-looking statements attributable to Vanda or any person acting on its behalf are expressly qualified in their entirety by the cautionary statements contained or referred to herein. Vanda cautions investors not to rely too heavily on the forward-looking statements Vanda makes or that are made on its behalf. The information in this release is provided only as of the date of this release, and Vanda undertakes no obligation, and specifically declines any obligation, to update or revise publicly any forward-looking statements, whether as a result of new information, future events or otherwise. SOURCE Vanda Pharmaceuticals Inc.

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KHN Morning Briefing Summaries of health policy coverage from major news organizations Aug Enrollment In Exchanges Key To Health Law Success Politico notes that enrollment in online marketplaces in California, Florida and Texas will have an outsized impact on whether the Obama administration achieves its nationwide goals for expanding coverage. Other outlets report how states will market the new insurance plans and how some Americans are confused by health insurance generally and Obamacare in particular. Politico: The Swing States Of Obamacare Three states could have an outsize role in the success — or failure — of Obamacare. California, Florida and Texas are home to more than one-third of the nation's 46 million uninsured people. If the White House and its allies can't convince large chunks of the uninsured in those three states to enroll in the Affordable Care Act's new insurance exchanges, the administration could have a very hard time reaching its enrollment goals (Haberkorn, 8/21). PBS Newshour: Twitter Chat: Will Health Insurance Exchanges Be A Benefit Or A Burden? Open enrollment for health insurance exchanges begins Oct. 1. The Obama administration is hoping to enroll 7 million people in the exchanges by the end of March 2014, including 2.5 million young, healthy people. Young Americans are the key to the success of the program, but whether the exchanges will benefit them and if they will sign up for them are still big unknowns (Shirvell, 8/21). Kaiser Health News: States Use Out-Of-The-Box Approaches To Raise Awareness Of Health Exchanges Catchy jingles? Splashy videos? Multi-million-dollar public education campaigns? For the 16 states and the District of Columbia that have opted to run their own online health insurance marketplaces, these are among the tools being used to make sure residents know the exchanges will be open for business Oct. 1. … Here's an alphabetical list of state exchanges and a sampling of their strategies, ranging from clever advertising to unique health exchange names (Miller, 8/21). Stateline: State Resistance To Federal Government Goes Back To US Beginnings The Affordable Care Act is the law of the land, but that hasn’t stopped a handful of states from doing what they can to gum up its implementation. Take Missouri: The state isn’t expanding Medicaid, it isn’t opening its own health insurance exchange, and it is barring local and state officials from cooperating in any way with the federal insurance exchange (Ollove, 8/22). The Associated Press: Jobs Available Under Obama Health Law In Illinois Working on a tight timeframe, Illinois is building an 800-person army of temporary workers to help people sign up for health insurance coverage under the Affordable Care Act. The "in-person counselor" jobs, located in every corner of the state, range from a $9-an-hour part-time evening job in Clinton County to a $45,000-a-year project coordinator position in Chicago for someone with experience in community organizing and public speaking (Johnson, 8/21). Medpage Today: Young Adults Unaware Of ACA Exchanges Only 27 percent of young adults said they were aware of the Affordable Care Act's health insurance exchanges that are launching Oct. 1, a survey released Wednesday showed. Furthermore, those most likely to benefit from the ACA's exchanges and expanded coverage are the least likely to be aware of the exchanges, the liberal Commonwealth Fund said in the survey "Covering Young Adults Under the Affordable Care Act." Just 19 percent of young adults who were uninsured in the last year and 18 percent of low-income adults were aware of the exchanges -- or marketplaces, as they are sometimes called -- according to the survey (Pittman, 8/21). California Healthline: Obamacare Obstacle: Consumers’ Confusion When Picking A Plan HealthCare.gov would like you to answer a few questions before considering policies offered through the new health insurance exchanges. For many, the problems start there. Recent surveys show that U.S. residents are confused by Obamacare -- and, more generally, by health insurance -- which has led some observers to question whether the exchanges' open enrollment period will proceed smoothly or be too overwhelming for those who would benefit most from the reform law (Wayt, 8/21). Health News Florida: Navigator Fears Called Political 'Hype' Supporters of the Affordable Care Act say Florida officials' concern about a program that will help uninsured people sign up for coverage has no foundation in fact. There is no danger that so-called "navigators" will steal people's identities or feed information into a giant federal database, said Greg Mellowe, policy director for the consumer group Florida CHAIN. The group is one of the non-profits that will get a share of federal grant money for the "navigator" program (Gentry, 8/21). Previous From Cost and Quality First Edition: August 22, 2013 Next From Cost and Quality New Studies Indicate The Law’s First Year Will Be Marked By Slightly Higher Costs, More Wellness Incentives Recent Morning Briefings

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Giving to Laboratory Medicine Yale's Laboratory Medicine team has been at the forefront of advancing laboratory-based clinical care since the beginning of the modern era of medical laboratory science in the 1920's and 30's. Our physicians and scientists have broken new ground in understanding the basic cause of many diseases and translating this into new diagnostic tests and into new cellular-based therapies. We are especially interested in making "personalized medicine" a reality – devising tests that make it easier to pick the right drug and the right dose for the right patient rather than using the same drug at the same dose for everyone. We have the same goal when it comes to therapy – devising "personalized" cellular therapy for diseases like cancer. In order to further advance this research and to support our educational mission in training the next generation of these "clinician-scientists", we ask our friends to help support us through their generous donations.These activities to "push the envelope" are not funded by clinical care reimbursements. Donations to our "Research & Education Fund" go to support many ongoing efforts in these areas and are critical to funding innovative "pilot projects" and other activities that may eventually lead to further funding by large national organizations. In this way, your donation is leveraged for the future. For those who may be interested in larger giving and named opportunities, there are several other possibilities such as endowing a Lecture Series, a Professorship or Fellowship, or a Center of Excellence in Cellular Therapy or in Personalized Medicine.To make an online donation:Click: Give OnlineSelect "New Gift" under "Gift type" Select "School of Medicine" under "I would like to Support"Under "Area of Support" click "Other" at bottom of the listThen type “Laboratory Medicine” into the box marked “Other Designation.”If you have any questions or would like more information on giving opportunities and how they can benefit Yale Laboratory Medicine, please contact either Mr. Richard Galiette, Area Director, Office of Development, Yale University School of Medicine at 203-436-8529 or [email protected], or contact us directly at [email protected]. Giving Our faculty have developed methodologies for many different clinical tests with the aim of obtaining critical health information without requiring major invasive procedures. Clinical and Translational Research Translational research is defined as research that takes observations from basic medical research and translates that into direct patient care. Education In addition to our clinical and research work, the Department also has a major educational mission, training the next generation of physicians and clinical laboratory scientists. Yale has been particularly active in this regard, holding one of the few NIH-sponsored training programs specifically in the field and proposing curricula along with our colleagues across the country, to optimize training. Ann Haberman, Ph.D. studies how a patient's immune response provides defense against infections and tumors. She uses in vivo microscopy to observe how the immune cells travel throughout the lymph node. This is a video of the cell's migrating in the lymph node.

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What Is the Scientific Evidence for Detoxification? The concept of detoxification plays a major role in many schools of alternative medicine, including . In this context, the term refers to a belief that toxins accumulated in the body are a major cause of disease, and that health can be promoted by removing them through various means. The toxins referred to in this theory are said to have several major sources: Chemicals added to processed foods, such as preservatives Chemicals that enter the food chain through the use of pesticides, artificial fertilizers, and drugs given to food animals Toxins produced in the intestines due to improper digestion Toxins produced in the bloodstream due to stress Pharmaceutical medications, nearly all of which are regarded as essentially toxic by proponents of detoxification Toxins present in the general environment, such as automobile exhaust, cigarette smoke, the aluminum in antiperspirants, and the formaldehyde released by new carpet Toxins in water Toxins introduced through the use of mercury fillings and other medical procedures These toxins are said to cause a wide variety of chronic illnesses, from to cancer and , and alternative practitioners use various methods with the intention of removing the toxins. One such recommendation has made it into conventional wisdom: drinking at least a quart (or a half-gallon) of water per day. Other detoxification methods include fasting (on juice, water, fruit, or brown rice), using “cleansing” herbs and supplements (such as olive oil and lemon juice to flush the liver, dandelion root to purge the gallbladder, or psyllium seed to cleanse the colon), taking high colonics, receiving intravenous , and/or removing mercury fillings. Removing toxins is often said to cause a temporary flare-up of illness. This reaction is generally interpreted as a positive sign, but also as a call for careful medical management to avoid causing harm on the way to healing. In general, there is little to no scientific support for detoxification methods. Aside from specific toxicities such as lead or arsenic, medical researchers have observed no general phenomenon of toxification. For this reason, it is difficult to scientifically validate whether detoxification methods actually work. Most detoxification approaches essentially remain unexamined, rather than proven or disproven, and rely on reasonable concepts but no hard evidence for their justification. Mercury-filling removal is a typical example. Many alternative practitioners believe that the mercury in silver fillings is a cause of numerous health problems and should be removed to prevent or treat disease. However, although it is a matter of indisputable fact that mercury can be toxic, scientific evaluation generally indicates that mercury levels in people with mercury fillings are far below those necessary to cause toxic symptoms. Anti-mercury advocates respond that some people are sensitive to mercury in very low amounts, and that those people will therefore benefit from filling removal even if they are not experiencing actual toxicity. This could certainly be true. However, despite numerous unreliable anecdotes, there is as yet no meaningful evidence that removing mercury fillings can treat or prevent any disease. (For information, see Much the same can be said about all of the other popular detoxification methods. However, in the case of one form of detoxification, colon cleansing, the theory behind the technique is definitely wrong. According to this nineteenth-century theory known as “colon health” or “colon hygiene,” years of bad diet cause the colon to become caked with layer upon layer of accumulated toxins. This accumulation is said to resemble sedimentary rock. High colonics, which are essentially enemas that reach far up into the large intestine, are said to release the accumulated buildup and thereby restore health. However, in recent decades, physicians have performed colon examinations to search for colon cancer in millions of patients, and their findings do not support the theory. Most of the patients given these examinations are at least middle-aged, and not very many have devoted their lives to healthy diets and clean colons. According to the colonic hygiene theory, colon examinations on such patients should turn up concrete-like deposits. However, all that shows up during a typical colonoscopy is fresh, pink flesh. Unfortunately, proponents of colonics do not seem to have assimilated this information; they continue to recount theories about the colon that were shown to be untrue decades ago. The safety of detoxification methods varies widely. While drinking a quart of water a day is undoubtedly benign and mercury-filling removal is unlikely to harm anything but one’s pocketbook, other methods might be risky. High colonics have occasionally resulted in serious internal injury, and intravenous therapies, being highly invasive, must be handled with a certain degree of sophistication to avoid causing harm. Considering that detoxification has not been proven useful, we recommend sticking to the more moderate of its various methods if you wish to try it at all. Dodes JE. The amalgam controversy. An evidence-based analysis.

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Plarr's Lives of the Fellows Online Skip to content Library Homepage || Library Services | Change text: Site navigation Home Browse Search Browse Fellows www Lives Biographical entry Clark, Henry (1801 - 1861) MRCS Aug 4th 1827; FRCS Dec 11th 1843, one of the original 300 Fellows. Died10 May 1861Bristol, UK OccupationGeneral surgeon Clark's parentage is unknown, but he appears to have settled in Bristol as soon as he was qualified, perhaps as Surgeon-Apothecary at the Bristol Infirmary. The first notice of him is in 1826, when he put a notice in the local papers that his 'Theatre of Anatomy' would be opened immediately. It soon became popular, and its title was changed to that of the 'Bristol Medical and Surgical School'. His colleagues were William Herapath, the chemist, Adam Chadwick, John Braithwaite Taylor, and Nathaniel Smith. By 1830 the school was recognized by the Court of Examiners at the Royal College of Surgeons and at the Society of Apothecaries. The school remained in existence until 1840. Clark, writing about it in 1833, says: "At that time [the autumn of 1826] the anatomical department was at a very low ebb, indeed I think I had no more than seven or eight pupils who entered to my list, though I had my full proportion of the number of pupils then in attendance on Anatomical Lectures." In 1827 the lecture theatre was enlarged, the dissecting-room was improved, and eleven pupils were attracted. Clark entirely rebuilt his anatomical theatre in 1828, and the class rose to twenty-four. In the autumn of 1833 he amalgamated with a School of Anatomy and Medicine which had been established at Bristol in 1807 and thus originated the Bristol Medical School, teaching at first anatomy with forty-nine pupils, and chemistry with a class of thirty or forty. It was not, however, until 1876 that the Medical School was affiliated to the newly formed University College of Bristol. Henry Clark was elected Surgeon to the Infirmary on Feb 23rd, 1843, with a majority of 230 votes over Thomas Green, the other candidate, in succession to Richard Smith, junr, and he held the post until Aug 18th, 1857. He died at 31 Berkeley Square, Bristol, on May 10th, 1861, and his name is perpetuated by 'The Clark Prize', for he left £500 to the Infirmary, the interest of which was to be given annually to the best third-year student at the Medical School. He appears as the first sitting figure on the left of a group of the surgeons taken in 1857. Henry Clark was a noted lecturer and teacher who did much to establish the reputation of the Bristol School of Medicine. As a lecturer, especially on anatomy, he was clear and very impressive, readily imparting information to his pupils. He was also a good surgeon, though rather nervous as an operator. He acquired a large practice and was generally considered the most eminent surgeon in Bristol. It is said that he never took a holiday, and the amount of work he got through was so great that this seems highly probable. He was President of the local branch of the British Medical Association in 1853. "An Address delivered to the Members of the Bath and Bristol Branch of the Provincial Medical and Surgical Association on June 30th, 1853," 8vo, London, 1853. Sources used to compile this entry: [A History of the Bristol Royal Infirmary, by G. Munro Smith, M.D., 8vo, Bristol, 1917. There is a portrait of Henry Clark - Fig. 62, facing p.306]. The Royal College of Surgeons of England Created: 2 June 2011 Site-wide utilities [email protected] Cite this: http://livesonline.rcseng.ac.uk/biogs/E001191b.htm © The Royal College of Surgeons of England Reg Charity no: 212808 Terms & conditions of the Royal College of Surgeons apply

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Search Tuning in to Telemedicine Claire McAndrew For Narrow Networks, Fresh Scrutiny: Can They Pass the Adequacy Test? Shelley Slade Boosting a Drug’s Market Share Can Cross a Dangerous Line Home MANAGED CARE January 2002News and CommentaryHeadlines On Deadline ... Linkedin Share ButtonTweet WidgetShare on Facebook Enrollment in national HMOs operating in two or more states grew by 14.6 percent, while the number of such companies dropped by 17.4 percent over the last five years, says InterStudy Publications. It's a sign of mergers, acquisitions, and consolidations in the industry.... Pharmaceutical companies employ 81 percent more people in their marketing departments than in their research and development departments, according to a survey by the Boston University School of Public Health.... Forty-three percent of the elderly who lack prescription drug coverage and who are minorities, have annual incomes of less than $10,000, or have out-of-pocket prescription drug costs of greater than $100 a month say they restrict their use of medication because of cost, according to the University of California-San Francisco Department of Medicine.... The American College of Physicians-American Society of Internal Medicine has called on Congress to enact universal coverage. ACP-ASIM is seeking input on a proposal that would implement it, incrementally, over seven years.

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Bristol-Myers Squibb to Acquire Inhibitex Strategic Acquisition Supports Long-Term Growth Potential of the Company Builds on Company’s Strong Legacy and Commitment in Virology Enhances Company’s Broad HCV Portfolio with Addition of INX-189, a potent NS5B Nucleotide Saturday, January 7, 2012 9:13 pm EST Dateline: NEW YORK & PRINCETON, N.J. & ATLANTA EmailPDFPrintRSS Public Company Information: NYSE:BMY NEW YORK & PRINCETON, N.J. & ATLANTA--(BUSINESS WIRE)--Bristol-Myers Squibb Company (NYSE:BMY) and Inhibitex, Inc. (Nasdaq:INHX) announced today that the companies have signed a definitive agreement under which Bristol-Myers Squibb will acquire Inhibitex for $26.00 per share in cash pursuant to a cash tender offer and second step merger. The transaction, with an aggregate purchase price of approximately $2.5 billion, has been approved by the boards of directors of both companies. The board of directors of Inhibitex has agreed to recommend that Inhibitex’s shareholders tender their shares in the tender offer. In addition, shareholders with beneficial ownership of approximately 17% of Inhibitex’s common stock have entered into agreements with Bristol-Myers Squibb to support the transaction and to tender their shares in the tender offer. Inhibitex is a clinical-stage biopharmaceutical company dedicated to the development of innovative products that can treat or prevent serious infections, whose primary focus is on the development of nucleotide/nucleoside analogs for the treatment of hepatitis C virus (HCV). Its lead HCV asset is INX-189, an oral nucleotide polymerase (NS5B) inhibitor in Phase II development that has exhibited potent antiviral activity, a high barrier to resistance and pan-genotypic coverage. Nucleotides/nucleosides are emerging as an important class of antivirals that may play a critical role as the backbone of future direct-acting antiviral-only combination approaches to HCV treatment. “The acquisition of Inhibitex builds on Bristol-Myers Squibb’s long history of discovering, developing and delivering innovative new medicines in virology and enriches our portfolio of investigational medicines for hepatitis C,” said Lamberto Andreotti, chief executive officer, Bristol-Myers Squibb. “There is significant unmet medical need in hepatitis C. This acquisition represents an important investment in the long-term growth of the company.” “This transaction puts INX-189 and the Company’s other infectious disease assets in the hands of an organization that can more optimally develop them and which believes as strongly as we do in INX-189’s potential in the treatment of chronic HCV,” said Russell Plumb, President and Chief Executive Officer of Inhibitex. “Bristol-Myers Squibb’s expertise in antiviral drug development, and its existing complementary portfolio, will assure that the potential of INX-189 is realized as part of future oral combination therapies for millions of patients in need around the world.” “Bristol-Myers Squibb continues to drive advances in the field of hepatitis C research and development through internal development and selective partnerships,” said Elliott Sigal, M.D., Ph.D., executive vice president, chief scientific officer and president, R&D, Bristol-Myers Squibb. “The addition of Inhibitex’s nucleotide polymerase inhibitor to our own promising portfolio, which includes other direct-acting antivirals, brings additional options to develop all-oral regimens with better cure rates, shorter duration of therapy and lower toxicity than the current standard of care.” The transaction is expected to be dilutive to earnings for Bristol-Myers Squibb through 2016, with an expected impact on earnings per share of approximately $0.04 in 2012 and approximately $0.05 in 2013. Under the terms of the definitive agreement, Bristol-Myers Squibb will commence a cash tender offer to purchase all of the outstanding shares of Inhibitex’s common stock for $26.00 per share. The closing of the tender offer is subject to customary terms and conditions, including the tender of a number of shares that constitutes at least a majority of Inhibitex’s outstanding shares of common stock (on a fully diluted basis) and expiration or termination of the waiting period under the Hart-Scott-Rodino Antitrust Improvements Act. The agreement also provides for the parties to effect, subject to customary conditions, a merger to be completed following the completion of the tender offer which would result in all shares not tendered in the tender offer being converted into the right to receive $26.00 per share in cash. The merger agreement contains a provision under which Inhibitex has agreed not to solicit any competing offers for the company. Bristol-Myers Squibb will finance the acquisition from its existing cash resources. The companies expect the tender offer to close approximately thirty days after commencement of the tender offer. Citi is serving as financial advisor to Bristol-Myers Squibb in connection with the acquisition and Kirkland & Ellis LLP is its legal advisor. Credit Suisse Securities (USA) LLC is serving as financial advisor to Inhibitex in connection with the acquisition and Dechert LLP is its legal advisor. About Bristol-Myers Squibb Bristol-Myers Squibb is a global biopharmaceutical company whose mission is to discover, develop and deliver innovative medicines that help patients prevail over serious diseases. For more information, please visit http://www.bms.com or follow us on Twitter at http://twitter.com/bmsnews. About Inhibitex Inhibitex, Inc. is a biopharmaceutical company focused on developing products to prevent and treat serious infectious diseases. The Company’s clinical-stage pipeline includes three Phase 2 development programs: INX-189, a nucleotide polymerase inhibitor in development for the treatment of chronic hepatitis C infections, FV-100, a nucleoside inhibitor in development for the reduction of shingles-associated pain, and Aurexis, a humanized monoclonal antibody in development for the treatment of serious S. aureus bloodstream infections. The Company also has other HCV nucleotide polymerase inhibitors in preclinical development and has licensed the use of its proprietary MSCRAMM® protein platform to Pfizer for the development of a staphylococcal vaccine, which is currently being evaluated in a Phase 1/2 clinical trial. For additional information about the Company, please visit www.inhibitex.com. Inhibitex®, MSCRAMM® and Aurexis® are registered trademarks of Inhibitex, Inc. Bristol-Myers Squibb Forward-Looking Statements This press release contains "forward-looking statements" relating to the acquisition of Inhibitex by Bristol-Myers Squibb and the discovery, development and commercialization of certain biological compounds. Such forward-looking statements are based on current expectations and involve inherent risks and uncertainties, including factors that could delay, divert or change any of them, and could cause actual outcomes and results to differ materially from current expectations. No forward-looking statement can be guaranteed. Among other risks, there can be no guarantee that the acquisition will be completed, or if it is completed, that it will close within the anticipated time period or that the expected benefits of the acquisition will be realized. The actual dilutive impact on earnings per share in the near- and mid-term may differ from the expected impact described in this release. In addition, the compounds described in this release are subject to all the risks inherent in the drug development process, and there can be no assurance that these compounds will receive regulatory approval or be commercially successful. Forward-looking statements in the press release should be evaluated together with the many uncertainties that affect Bristol-Myers Squibb's business, particularly those identified in the cautionary factors discussion in Bristol-Myers Squibb's Annual Report on Form 10-K for the year ended December 31, 2010, its Quarterly Reports on Form 10-Q, and Current Reports on Form 8-K. Bristol-Myers Squibb undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future events, or otherwise. Inhibitex Forward-Looking Statements This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 that involve substantial risks and uncertainties. All statements, other than historical facts included in this press release, including statements regarding the timing and the closing of the tender offer and merger transactions; the ability of Bristol-Myers Squibb to complete the transactions considering the various closing conditions; and any assumptions underlying any of the foregoing, are forward looking statements. These intentions, expectations, or results may not be achieved in the future and various important factors could cause actual results or events to differ materially from the forward-looking statements that Inhibitex makes, including uncertainties as to the timing of the tender offer and merger; uncertainties as to how many of Inhibitex's stockholders will tender their stock in the offer; the possibility that competing offers may be made; the possibility that various closing conditions to the transactions may not be satisfied or waived, including that a governmental entity may prohibit, delay or refuse to grant approval for the consummation of the transaction; that there is a material adverse change of Inhibitex; other business effects, including the effects of industry, economic or political conditions outside of the companies' control; transaction costs; actual or contingent liabilities; as well as other cautionary statements contained elsewhere herein and in time in the companies' periodic reports filed with the Securities and Exchange Commission, including current reports on Form 8-K, quarterly reports on Form 10-Q and annual reports on Form 10-K. Given these uncertainties, you should not place undue reliance on these forward-looking statements, which apply only as of the date of this press release. There may be events in the future that the companies are unable to predict accurately, or over which they have no control. Inhibitex’s business, financial condition, results of operations and prospects may change. Inhibitex may not update these forward-looking statements, even though its situation may change in the future, unless it has obligations under the Federal securities laws to update and disclose material developments related to previously disclosed information. Inhibitex qualifies all of the information contained in this press release, and particularly these forward-looking statements, by these cautionary statements. Additional Information The tender offer described in this release has not yet commenced, and this release is neither an offer to purchase nor a solicitation of an offer to sell securities. At the time the tender offer is commenced, Bristol-Myers Squibb will cause a new wholly owned subsidiary, Inta Acquisition Corporation, to file with the SEC a tender offer statement on Schedule TO. Investors and Inhibitex shareholders are strongly advised to read the tender offer statement (including an offer to purchase, letter of transmittal and related tender offer documents) and the related solicitation/recommendation statement on Schedule 14D-9 that will be filed by Inhibitex with the SEC, because they will contain important information. These documents will be available at no charge on the SEC’s website at www.sec.gov. In addition, a copy of the offer to purchase, letter of transmittal and certain other related tender offer documents (once they become available) may be obtained free of charge by directing a request to Bristol-Myers Squibb at www.bms.com or Office of the Corporate Secretary, 345 Park Avenue, New York, New York 10154-0037. A copy of the tender offer statement and the solicitation/recommendation statement will be made available to all shareholders of Inhibitex free of charge at www.inhibitex.com or by contacting Inhibitex, Inc. at 9005 Westside Parkway, Alpharetta, Georgia 30009, Telephone Number (678) 746-1100. In addition to the offer to purchase, the related letter of transmittal and certain other offer documents, as well as the solicitation/recommendation statement, Bristol-Myers Squibb and Inhibitex file annual, quarterly and special reports, proxy statements and other information with the SEC. You may read and copy any reports, statements or other information filed by Bristol-Myers Squibb or Inhibitex at the SEC public reference room at 100 F Street, N.E., Washington, D.C. 20549. Please call the SEC at 1-800-SEC-0330 for further information on the public reference room. Bristol-Myers Squibb’s and Inhibitex's filings with the SEC are also available to the public from commercial document-retrieval services and at the website maintained by the SEC at www.sec.gov. Contact: Bristol-Myers SquibbMedia:Sonia Choi, [email protected] Fron Mauer, [email protected]:Teri Loxam, [email protected] Power, [email protected]:Investors:The Trout GroupLee M. Stern, CFA, [email protected] Search Press Releases KEYWORDS: Filter Category Financial NewsPhilanthropy NewsR&D NewsPartnering NewsInvestigational Compound News-Hepatitis C-HIV-Oncology Filter Year Subscribe to E-Mail Alerts Business Wire NewsHQ℠

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Radiant Healing Siddha History We can only begin to trace the Siddha tradition from the earliest writings found in the first century A.D. There was a country known as Kumari nadu that extended beyond what is now known as Kanyakumari, the southern most tip of India. Kumari Nadu is now lying submerged in the Indian Ocean and has been identified as Lemuria, "the sunken continent." It occupied a large area of the Indian Ocean and touched Australia in the South and Africa in the West. How did it sink? It is said that from 30,000 BC to 2,700 BC, earthquakes and volcanic eruptions caused landslips affecting the earth and the ocean beds. The Lemurians migrated to Asia, Australia, North and South America, the Nile Valley where they founded the Egyptian civilization and the continent of Atlantis between Europe and North America. Ayurveda History According to Geology, this southern end of India, particularly Tamil Nadu, is among the oldest land mass in the world and has never been covered by the ocean. When the earth began to erupt and change, a great Siddha named Agastyar moved to an area north of what is now Trivandrum in Kerala. This is where the civilization of the Yoga Siddhas was born. The earliest picture of India's past is the Indus Valley civilization. This was a highly developed culture. It is observed as a civilization of pre-vedic people of ancient India that existed 8,000 to 10,000 years before the Christian era and identify it as that of the Dravidians- the world's oldest civilization. This also shows the history of Saivism (worship of the Shiva) as being the most ancient living faith in the world, first developed by the Dravidians in southern India. According to Indian mythology, Ayurveda was first perceived by Brahma (the Supreme God) and then handed down through the years to various stages. Dhanvantri (patron God of physicians) is noted by some, to be the Father of Ayurveda, bringing the information back from the Gods to relieve human suffering. The history of Ayurveda goes back as far as the Indus Valley Civilization as does the Siddha Tradition. This shows their symbiotic relationship and even proof that they are one and the same, even they don't like to admit it. It is possible that the separation came because of religion. Ayurveda followed Brahma and the Vedic philosophy, Siddha followed Shiva and Shaivism philosophy. This is considered the Pre-Vedic Era between 3000 BC and 1500 BC. In 2000 BC a group of hunter-gatherers called Aryans moved into the Indus region from the northwest bringing with them a religion and a mind-expanding elixir called soma. Their religious concepts were recorded as the Vedas and were divinely inspired. Known as the Rishis, these holy men received information from the Supreme Source. They recognized the unity of all that is and were able to transcend the human sense of duality. They fostered a deep relationship with nature and held great respect for the plants they used. Between 1500 BC and 800 BC, the most respected texts on Ayurveda, Charaka Samhita and Sushruta Samhita, were written. The Charaka is the earliest Ayurvedic text and begins by telling of the gathering of all the holy men and healers in the Indus Valley. Their intention was to gather divine information which would end disease and suffering so the population could concentrate on reaching enlightenment. The information was transmitted from Brahma. The Sushrita is a classic text on surgeries. These surgeries were not successfully performed in the west until the late 1800's AD. In this text Dhanvantri brings information back from the Gods. Between 500 BC and 1000 AD, Ayurveda reached the heights of its development. During the medieval period, India was invaded by Alexander the Great and Ayurvedic concepts filtered back to Greece and evolved into the four humor theory based upon the four elements and was practiced in Europe for the next 2000 years. For a period of time, medicine in Europe was very similar to Ayurveda. It is thought that the fourth humor was added by Hippocrates, the blood- for its importance in surgery. India was exposed to frequent foreign invasions during this time and new discoveries in science came to a standstill. During these times of war, many original works were destroyed. Whatever remained had to be handed down orally. Individuals received the information and in their own interpretations have created many avenues of Ayurveda, but the foundation of basic philosophy is strong among all lineages. In the late 19th century and early 20th century, Ayurveda was given a new life. Currently, Ayurveda is the vogue alternative medicine, affecting western medicine for a third time. A great possibility exists that Ayurveda can be combined with other schools of thought to make all treatment methods more effective, becoming part of a global medical system.Contact Us [email protected] Ayurveda & Siddha Theory Ayurveda & Siddha History Pancha Karma Home || About the Center || Radiant Healing || Testimonials || Contact Us Ayurveda & Siddha Theory || Ayurveda & Siddha History || Pancha Karma || Treatments || Programs Consultations || Classes Copyright © 2008-2012 Akash Ayurveda of Hawaii. All rights reserved. Custom Site Design & Development by Nisa WebDesigns.

医学

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Contact Us ASIP MEMBER ACCESS Become a Supporter News Job Seekers/Employers More Information To contribute your point of view on any issue, please contact the ASIP Public Affairs Working Group through Jennifer Dreyfus at [email protected]. Thank you! ASIP Public Affairs 1998 Patricia Backlar: Access to Archived Human Tissue (EB98) Access to Archived Human Tissue: Are Current Procedures going to Change (Concerns about the privacy of medical/genetic information when archived human tissues and medical information are used for research.) Patricia Backlar Senior Scholar Center for Ethics in Health Care Oregon Health Sciences University Experimental Biology '98 Annual Meeting of Professional Research Scientists Moscone Convention Center American Society for Investigative Pathology (ASIP) It is an honor to be invited to participate in this panel, and I thank Mark Sobel, Richard Lynch and the American Society for Investigative Pathology for inviting me. The program notes indicate that I am to speak about patient advocacy and the use of human tissues. I confess it is daunting to be expected to speak on behalf of patients generally and represent the vast array of interests and concerns that may be involved; I suspect that no one accurately may be able speak for all the individual members of a collective or community - let alone, be able to precisely define a community. Therefore, I speak only from my perspective as a patient and as a member of the National Bioethics Advisory Commission, I speak for myself - not for the Commission. Last summer, I had a surgical procedure. A few days prior to the surgery, I had some tests. I was admitted to the hospital early in the morning, and a woman behind the desk asked me to sign a consent form. I read it through and one sentence caught my eye. As I remember it was something to the effect that "You give us permission to dispose of your tissue." A few years ago - before I had read the Moore case at UCLA - I probably never would have even noticed a sentence that referred to tissue disposal. Or if I did, I might have surmised that the hospital was being sensitive to persons who had certain traditional or religious beliefs about disembodied parts of their person. But now being keenly aware of the "tissue issue," I pointed to the sentence and asked: "what do you mean by 'dispose'?" "I dunno," was the response, "I guess they mean 'throw away'." Next, I was escorted into a small room where a nurse prepared me for the test. I asked her about the consent form. She eyed me somewhat askance, and said she had no idea what I was talking about. She wheeled me into a room where the procedure was to take place. There were a few people in the room - nurses and technicians - and for a third time, I started to ask my question. But just as I was framing it, the doctor bustled in, and I thought to myself, "well, now I'm going to get a precise answer." No, he wasn't sure either. And furthermore it was clear that he wanted me to be quiet so he could get on with his work. I did not sense that any of these people were intending to deceive me. My feeling is that they were as ignorant as I about what might be done with my tissue. So, how do I feel about collection and use of my human biological material? Well, I feel very different about myself as an 'intact person' than I do about disconnected part of me. If something is going to affect my 'intact body' - whether it may be beneficial, may cause some harm, or even be indeterminate - I want to know about it. I want to be able to consent to or refuse the procedure - whatever the procedure may be. And that, of course, includes, taking my biological material from me. However, once those 'biological materials' are not longer connected to me, the urgency to control the uses of the materials is somewhat diminished. But not completely, because, as we now well know, these disconnected pieces of myself contain my story, my medical information. And not only my medical information but also medical information that may be about my parents, about my children, about my grandparents, about my grandchildren, my uncles, my nephews, and "my sisters and my cousins and my aunts...," Like a pebble thrown skillfully into a placid pond, the ripples, which contain medical information gleaned from my biological material, may eventually touch near and distant shores. This medical information may be a two-edged sword. One side may cause risks of wrongs or harms and the other side may bring about benefits. In our society - in our country - the most immediate risks that come to mind are those that are connected to the way in which we achieve, or do not achieve, access to healthcare - in other words, our discriminatory insurance practices. Will public knowledge about this medical information cause me, and my family, to be denied health insurance? Will public knowledge about this information cause me to lose my job? And, therefore also lose my health insurance? Will public knowledge about some particularity embedded in this medical information have the power to stigmatize a specific group that I may be a member of - African American, Asian, Ashkenazi Jewish- thereby creating job and insurance risks not only for me but also for a now identified population. But as we know, medical histories are difficult to hide. I have an adult son who suffers from schizophrenia. His brothers and sisters can't pretend that he isn't ill. We don't hide him upstairs in our attic. He is a part of our every day lives, and we love him dearly. But don't think I am not aware that perhaps other families are not so keen to have their children marry one of his siblings for fear that their grandchildren may be so afflicted. I believe, that even as things now stand, it is unlikely that we can contain and hold private much of our bad or good news. On the other hand, I consider that there may be important benefits to be reaped from research with my biological materiel. I want to be informed if researchers garner knowledge that may be significant for my health and/or my family's health. I want to be informed if research on my biological materials reveals knowledge consequential to my and to my family's health. I don't want to be left out of the loop. Of course, being kept in the loop is just the beginning. According to this past week's report as was noted in the NY Times: more than 100,000 hospital patients die each year from adverse drug reactions (more than from diabetes, pneumonia, or other serious illnesses), being kept in the loop may not do me much good. As Roy Porter, dryly notes: "The prominence of medicine has lain only in small measure in its ability to make the sick well" (The Greatest Benefit to Mankind, New York: Norton & Company; 1997, p. 6). Furthermore, you are likely to have noticed that "the more medicine achieves, the less it satisfies" (p. 3). But that is another story.

医学

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Follow Us! Kelley Faust (holding a sign over her head) on parade with children in Ocean City Maryland's Doo Dah Parade. Faust was honored with a "Doo Dah Appreciation Award" for her organization's support of humanitarian efforts. It might be possible that our thoughts affect our health. The concept is called psychoneuroimmunology (PNI) and it refers to the interaction between psychological processes and the nervous and immune systems of the body. With her organization Sunshine Hope, Maple Glen resident and Mount Saint Joseph’s (’87) graduate Kelley Faust is taking PNI, the science she learned from talking with doctors and medical experts while working as a pharmaceutical salesperson for Pfizer for 13 years, and simplifying it into something almost like child’s play. Founding the group in 2007, she now is in the process of transforming it into the nonprofit Sunshine Hope Foundation. Faust has visited schools and presented her message of hope and positivity through assemblies and author visits. Her message is simple: It’s about spreading hope, and it’s about teaching children at a young age that difficulty, struggle and despair can be overcome by something as simple as positive thinking. “If we can inspire the kids, the kids can inspire the family,” Faust said. “And the family inspires the workplace and the community.” It’s something like the proverb, “the son is father to the man.” “If we can impact the children,” Faust said, “the kids can go home with tips and tools they can apply at home when things get off-balance.” And Faust knows what it’s like to be affected by negative thinking and a lack of balance. According to a 1992 article in the Journal of the American Medical Association, stress is thought to affect immune function through emotional and/or behavioral manifestations such as anxiety, fear, tension, anger and sadness, and physiological changes such as increased heart rate, blood pressure and sweating, Stress is what Faust experienced when she became pregnant with her second set of twins in 2002. Nineteen weeks into a pregnancy supposed to last around 40 weeks she went into preterm labor. Then, to compound the problem, before she went into preterm labor doctors thought the second twin in her uterus had a tumor on her heart. Faust’s preterm labor started during a visit to Thomas Jefferson University Hospital in Center City about the possible cancer, but her family obstetrician, Dr. Blair Bergen, whom she highly praised, recommended Faust return closer to home. The family had moved from Philadelphia to Atlantic City in 1999. Faust underwent 119 days of bed rest in 2003 at the Atlanticare Regional Medical Center in Atlantic City. During this time Faust also learned that her brother-in-law’s younger sister had been diagnosed and was undergoing treatment for cancer, an aggressive form that took her life a year later. Also, around that time, her brother, Frank Osborne, experienced intense eye difficulty. He had a condition that should have prohibited him from receiving Lasik eye surgery. But the ailment failed to be diagnosed before he had the surgery. He attempted the surgery twice, unaware of his condition and later had to receive corneal transplants to allow him to see. And more, her sister, Collen Mook, who is married to Faust’s brother-in-law, Brad Mook, who lost his sister, gave birth to a baby diagnosed with a rare chromosome abnormality. During bed rest, Faust did her best to stay positive and avoid thinking about the struggles facing her and her family. Twice during the time when she started to get negative, she again went into preterm labor. Realizing how much her thoughts had affected her physical existence, she resolved to dedicate her life to spreading a message of positive thinking and hope in dark times. Her second set of twins (she has all girls) was eventually born April 12, 2003, 35-and-one-half weeks into the pregnancy. The girls, Annie and Maggie (Kerry and Christie are her first two) were born healthy and are now healthy, active 9-year-olds. It’s the optimism Faust learned to balance and propel herself with and that she strives to emanate and teach students during her visits to schools. But, behind that, is her affinity for PNI. “It’s not just sunshine,” said Faust, referring to the book “The Psychology of Hope,” by C.R Snyder, editor of the Journal of Social and Clinical Psychology. “I needed to find the science behind it.” Faust applies the psychology of hope in her work, and teaches kids things like how to find their own personal mantra to repeat when they find themselves in times of trouble. One can imagine the variety of mantras she has received from children and posted on her website. “Light shines brightly in the dark,” is one. “Grow like a flower and don’t get squished,” is another. And her message has inspired Colleen and Brad Mook, and Frank Osborne and others to become part of the Sunshine Hope team. At her presentations, Faust asks kids to make a seven-step possibility promise. In this way, she serves during her school visits as one of the people working to open children’s imaginations to the goals they have within. Faust and Sunshine Hope have recently self-published “The Superpower of Me,” a book stressing the message of hope and positivity. And she’s also undertaking innovative relationships in the business arena. She envisions a business model where nonprofits are sponsored by larger corporations. It’s a model that enabled her to appear at Pine Run Elementary School in the Central Bucks School District in February. Merck Federal Credit Union (MFCU) sponsored the event, and Faust brought her optimistic holistic message to students through someone else’s funding. And MFCU appeared on the front page of Credit Union Times, an industry newsletter, demonstrating a relationship in which both parties benefitted. Since Sunshine and Hope’s inception, Faust and her team have funded the initiative. Faust, a 1991 Villanova University graduate who worked in D.C. for a year as a volunteer with the Catholic group Teacher Service Corps, has decided to focus much of her work in Camden, where she presented this month, and in North Philadelphia. She aims to one day donate $1 from the sale of each book to the community. But her vision reaches beyond the limits of the City of Brotherly Love. “I want to go global with this,” she said. For more information, or to purchase “The Superpower of Me,” visit www.sunshinehope.com. ← Chestnut Hill College professor creates blood cancer cell model Musical inspired by battle against anti-Semitism → FYI, Parade is in Ocean City NJ, Not Ocean City Maryland. Great story! Kelley sounds like a pretty neat lady. Good luck to her! BlindsShadeandShutterFactory “Light shines brightly in the dark,” …. think positive!

医学

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Gerson Therapy (PDQ®): Complementary and alternative medicine - Patient Information [NCI] | Cigna Gerson Therapy (PDQ®): Complementary and alternative medicine - Patient Information [NCI] Overview Questions and Answers About the Gerson Therapy Changes to This Summary (01 / 07 / 2015) About This PDQ Summary General CAM Information Evaluation of CAM Approaches Questions to Ask Your Health Care Provider About CAM To Learn More About CAM Gerson Therapy (PDQ®): Complementary and alternative medicine - Patient Information [NCI] Skip to the navigation This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER. NOTE: The information in this summary is no longer being updated and is provided for reference purposes only. The Gerson therapy is a complex regimen that has been used to treat people with cancer and other diseases (see Question 1). The key parts of the Gerson therapy are a strict diet, dietary supplements, and enemas (see Question 1). The theory is that disease can be cured by removing toxins from the body, boosting the immune system, and replacing excess salt in the body's cells with potassium (see Question 3). The Gerson therapy requires that the many details of its treatment plan be followed exactly (see Question 4). Few clinical studies of the Gerson therapy have been published (see Question 6). Taking too many enemas of any kind can be harmful (see Question 7) The US Food and Drug Administration has not approved the Gerson therapy for the treatment of cancer or other diseases (see Question 8). Cancer patients should talk with their health care providers about an appropriate diet to follow (see Question 8). Questions and Answers About the Gerson Therapy What is the Gerson therapy?The Gerson therapy has been used by some people to treat cancer and other diseases. It is based on the role of minerals, enzymes, and other dietary factors. There are 3 key parts to the therapy: Diet: Organic fruits, vegetables, and whole grains to give the body plenty of vitamins, minerals, enzymes, and other nutrients. The fruits and vegetables are low in sodium (salt) and high in potassium. Supplementation: The addition of certain substances to the diet to help correct cell metabolism (the chemical changes that take place in a cell to make energy and basic materials needed for the body's life processes). Detoxification: Treatments, including enemas, to remove toxic (harmful) substances from the body. What is the history of the discovery and use of the Gerson therapy as a complementary or alternative treatment for cancer?The Gerson therapy was named after Dr. Max B. Gerson (1881-1959), who first used it to treat his migraine headaches. In the 1930's, Dr. Gerson's therapy became known to the public as a treatment for a type of tuberculosis (TB). The Gerson therapy was later used to treat other conditions, including cancer. What is the theory behind the claim that the Gerson therapy is useful in treating cancer?The Gerson therapy is based on the idea that cancer develops when there are changes in cell metabolism because of the buildup of toxic substances in the body. Dr. Gerson said the disease process makes more toxins and the liver becomes overworked. According to Dr. Gerson, people with cancer also have too much sodium and too little potassium in the cells in their bodies, which causes tissue damage and weakened organs. The goal of the Gerson therapy is to restore the body to health by repairing the liver and returning the metabolism to its normal state. According to Dr. Gerson, this can be done by removing toxins from the body and building up the immune system with diet and supplements. The enemas are said to widen the bile ducts of the liver so toxins can be released. According to Dr. Gerson, the liver is further overworked as the treatment regimen breaks down cancer cells and rids the body of toxins. Pancreatic enzymes are given to decrease the demands on the weakened liver and pancreas to make enzymes for digestion. An organic diet and nutritional supplements are used to boost the immune system and support the body as the regimen cleans the body of toxins. Foods low in sodium and high in potassium are said to help correct the tissue damage caused by having too much sodium in the cells. How is the Gerson therapy administered?The Gerson therapy requires that the many details of its treatment plan be followed exactly. Some key parts of the regimen include the following: Drinking 13 glasses of juice a day. The juice must be freshly made from organic fruits and vegetables and be taken once every hour. Eating vegetarian meals of organically grown fruits, vegetables, and whole grains. Taking a number of supplements, including: Lugol's Solution (potassium iodide, iodine, and water). Coenzyme Q10 injected with vitamin B12. (The original regimen used crude liver extract instead of coenzyme Q10.) Vitamins A, C, and B3 (niacin). Flaxseed oil. Pancreatic enzymes. Pepsin (a stomach enzyme). Taking coffee or chamomile enemas regularly to remove toxins from the body. Preparing food without salt, spices, or oils, and without using aluminum cookware or utensils. Have any preclinical (laboratory or animal) studies been conducted using the Gerson therapy?No results of laboratory or animal studies have been published in scientific journals. Have any clinical trials (research studies with people) of the Gerson therapy been conducted?Most of the published information on the use of the Gerson therapy reports on retrospective studies (reviews of past cases). Dr. Gerson published case histories (detailed reports of the diagnosis, treatment, and follow-up of individual patients) of 50 of his patients. He treated several different types of cancer in his practice. The reports include Dr. Gerson's notes, with some X-rays of the patients over time. The follow-up was contact with patients by mail or phone and included anecdotal reports (incomplete descriptions of the medical and treatment histories of one or more patients). In 1947 and 1959, the National Cancer Institute (NCI) reviewed the cases of a total of 60 patients treated by Dr. Gerson. The NCI found that the available information did not prove the regimen had benefit. The following studies of the Gerson therapy were published: In 1983-1984, a retrospective study of 38 patients treated with the Gerson therapy was done. Medical records were not available to the authors of the study; information came from patient interviews. These case reviews did not provide information that supports the usefulness of the Gerson therapy for treating cancer. In 1990, a study of a diet regimen similar to the Gerson therapy was done in Austria. The patients received standard treatment along with the special diet. The authors of the study reported that the diet appeared to help patients live longer than usual and have fewer side effects. The authors said it needed further study. In 1995, the Gerson Research Organization did a retrospective study of their melanoma patients who were treated with the Gerson therapy. The study reported that patients who had stage III or stage IV melanoma lived longer than usual for patients with these stages of melanoma. There have been no clinical trials that support the findings of this retrospective study. A case review of 6 patients with metastatic cancer who used the Gerson therapy reported that the regimen helped patients in some ways, both physically and psychologically. Based on these results, the reviewers recommended that clinical trials of the Gerson therapy be conducted. Have any side effects or risks been reported from use of the Gerson therapy?Reports of three deaths that may be related to coffee enemas have been published. Taking too many enemas of any kind can cause changes in normal blood chemistry, chemicals that occur naturally in the body and keep the muscles, heart, and other organs working properly. Is the Gerson therapy approved by the U.S. Food and Drug Administration (FDA) for use as a cancer treatment in the United States?The Gerson therapy has not been approved by the FDA for use as a treatment for cancer or any other disease. For most cancer patients, nutrition guidelines include eating a well-balanced diet with plenty of fruits, vegetables, and whole-grain products. However, general guidelines such as these may have to be changed to meet the specific needs of an individual patient. Patients should talk with their health care providers about an appropriate diet to follow. Information about diet during cancer treatment is also available from the Cancer Information Service (1-800-4-CANCER) and in the PDQ summary on Nutrition in Cancer Care. Changes to This Summary (01 / 07 / 2015) The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above. Changes were made to this summary to match those made to the health professional version. About This PDQ Summary About PDQ Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish. PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government's center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH. Purpose of This Summary This PDQ cancer information summary has current information about the use of Gerson therapy in the treatment of people with cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care. Reviewers and Updates Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Cancer Complementary and Alternative Medicine Editorial Board. Clinical Trial Information A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. Clinical trials are listed in PDQ and can be found online at NCI's Web site. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237). Permission to Use This Summary PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as "NCI's PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary]." The best way to cite this PDQ summary is: National Cancer Institute: PDQ® Gerson Therapy. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: http://www.cancer.gov/about-cancer/treatment/cam/patient/gerson-pdq. Accessed <MM/DD/YYYY>. Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 2,000 scientific images. Disclaimer The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page. More information about contacting us or receiving help with the Cancer.gov Web site can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the Web site's E-mail Us. General CAM Information Complementary and alternative medicine (CAM)—also referred to as integrative medicine—includes a broad range of healing philosophies, approaches, and therapies. A therapy is generally called complementary when it is used in addition to conventional treatments; it is often called alternative when it is used instead of conventional treatment. (Conventional treatments are those that are widely accepted and practiced by the mainstream medical community.) Depending on how they are used, some therapies can be considered either complementary or alternative. Complementary and alternative therapies are used in an effort to prevent illness, reduce stress, prevent or reduce side effects and symptoms, or control or cure disease. Unlike conventional treatments for cancer, complementary and alternative therapies are often not covered by insurance companies. Patients should check with their insurance provider to find out about coverage for complementary and alternative therapies. Cancer patients considering complementary and alternative therapies should discuss this decision with their doctor, nurse, or pharmacist as they would any therapeutic approach, because some complementary and alternative therapies may interfere with their standard treatment or may be harmful when used with conventional treatment. Evaluation of CAM Approaches It is important that the same rigorous scientific evaluation used to assess conventional approaches be used to evaluate CAM therapies. The National Cancer Institute and the National Center for Complementary and Integrative Health (NCCIH) are sponsoring a number of clinical trials (research studies) at medical centers to evaluate CAM therapies for cancer. Conventional approaches to cancer treatment have generally been studied for safety and effectiveness through a rigorous scientific process that includes clinical trials with large numbers of patients. Less is known about the safety and effectiveness of complementary and alternative methods. Few CAM therapies have undergone rigorous evaluation. A small number of CAM therapies originally considered to be purely alternative approaches are finding a place in cancer treatment—not as cures, but as complementary therapies that may help patients feel better and recover faster. One example is acupuncture. According to a panel of experts at a National Institutes of Health (NIH) in November 1997, acupuncture has been found to be effective in the management of chemotherapy-associated nausea and vomiting and in controlling pain associated with surgery. In contrast, some approaches, such as the use of laetrile, have been studied and found ineffective or potentially harmful. The NCI Best Case Series Program which was started in 1991, is one way CAM approaches that are being used in practice are being investigated. The program is overseen by the NCI's Office of Cancer Complementary and Alternative Medicine (OCCAM). Health care professionals who offer alternative cancer therapies submit their patients' medical records and related materials to OCCAM. OCCAM conducts a critical review of the materials and develops follow-up research strategies for approaches deemed to warrant NCI-initiated research. Questions to Ask Your Health Care Provider About CAM When considering complementary and alternative therapies, patients should ask their health care provider the following questions: What side effects can be expected? What are the risks associated with this therapy? Do the known benefits outweigh the risks? What benefits can be expected from this therapy? Will the therapy interfere with conventional treatment? Is this therapy part of a clinical trial? If so, who is sponsoring the trial? Will the therapy be covered by health insurance? To Learn More About CAM National Center for Complementary and Integrative Health (NCCIH) The National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health (NIH) facilitates research and evaluation of complementary and alternative practices, and provides information about a variety of approaches to health professionals and the public. NCCIH Clearinghouse Post Office Box 7923 Gaithersburg, MD 20898–7923 Telephone: 1–888–644–6226 (toll free) 301–519–3153 (for International callers) TTY (for deaf and hard of hearing callers): 1–866–464–3615 E-mail: [email protected] Web site: https://nccih.nih.gov/ CAM on PubMed NCCAM and the NIH National Library of Medicine (NLM) jointly developed CAM on PubMed, a free and easy-to-use search tool for finding CAM-related journal citations. As a subset of the NLM's PubMed bibliographic database, CAM on PubMed features more than 230,000 references and abstracts for CAM-related articles from scientific journals. This database also provides links to the Web sites of over 1,800 journals, allowing users to view full-text articles. (A subscription or other fee may be required to access full-text articles.) CAM on PubMed is available through the NCCIH Web site. It can also be accessed through NLM PubMed bibliographic database by selecting the "Limits" tab and choosing "Complementary Medicine" as a subset. Office of Cancer Complementary and Alternative Medicine The NCI Office of Cancer Complementary and Alternative Medicine (OCCAM) coordinates the activities of the NCI in the area of complementary and alternative medicine (CAM). OCCAM supports CAM cancer research and provides information about cancer-related CAM to health providers and the general public via the NCI Web site. National Cancer Institute (NCI) Cancer Information Service U.S. residents may call the NCI Cancer Information Service toll free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 8:00 am to 8:00 pm. A trained Cancer Information Specialist is available to answer your questions. Food and Drug Administration The Food and Drug Administration (FDA) regulates drugs and medical devices to ensure that they are safe and effective. Food and Drug Administration 5600 Fishers Lane Rockville, MD 20857 Telephone: 1–888–463–6332 (toll free) Web site: http://www.fda.gov/ Federal Trade Commission The Federal Trade Commission (FTC) enforces consumer protection laws. Publications available from the FTC include: Who Cares: Sources of Information About Health Care Products and Services Fraudulent Health Claims: Don't Be Fooled Consumer Response Center CRC-240 Telephone: 1-877-FTC-HELP (1-877-382-4357) (toll free) TTY (for deaf and hearing impaired callers): 202-326-2502 Web site: http://www.ftc.gov/ Last Revised: 2015-01-07 If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions. Top of Page This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use . Learn how we develop our content .

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Examining the cost of health care reformIncreased expenses, administration and confusion: How the Affordable Care Act has affected midstate businesses By Holly White, Health care reform has reached its terrible twos, and the growing pains are only set to continue. In the two years since the Patient Protection and Affordable Care Act was signed into law, much has changed for businesses in health care and surrounding industries. And much is still to change, provided some or all of the law is upheld by the U.S. Supreme Court. For businesses throughout the midstate, the regulations have spawned confusion, administrative burdens and health benefit re-evaluations, health care experts here said. The law also spurred changes in workforce size and wellness plans, they said. The act, known as PPACA, has affected many Central Pennsylvania industries in different ways. The insurance industry is preparing for hefty cost increases as more lives are covered because of the law, administrators said. Insurers also are shifting to focus on consumers, they said. For health care providers, updating policies and technology and beginning intense preparation for mandates in the next several months have dominated operations, executives said. Benefit brokers and specialist businesses have faced constricted commissions, perhaps necessitating a different company strategy for the future, they said. In the legal advising field, PPACA has increased business but also required large amounts of time and energy that might not be billable, attorneys said. How employers have been affected: Benefits as a whole comprise about 40 percent of any business payroll at this point, said Mark Smith, partner at Lancaster-based Barley Snyder law firm. One of the earliest mandates applicable to employers was the requirement to cover dependents up to age 26. Also part of the act has been acceptance of pre-existing conditions on insurance plans and removal of maximum costs members could incur, he said. Annual limits on costs for insurance also are being phased out. "Really there are a lot of changes in health care reform that are going to significantly increase the cost of providing coverage," causing employers to think hard about what they can afford, he said. The preparation for future sections of the law, whether they're postponed or not, has added an administrative burden to companies, said Mike King, partner at York-based law firm Stock and Leader. For example, this year insurance carriers and companies with self-funded health benefits will have to provide a summary of benefits. The document has gone through several regulatory updates on length, information necessary to include and text size. It started as four pages with 12-point font and has morphed to four pages front and back with a separate two-page glossary defining terms within the summary. Preparing and then reformatting and changing the document to be used with this year's renewal of benefits has been very challenging, he said. W-2 reporting also will go into effect this year for 2013 tax forms, requiring businesses issuing more than 250 W-2 forms to include the value of health benefits provided. Many companies have begun to put in legwork to change software and administrative layers for the regulation, King said. Many mandates require increased data management, record-keeping and reporting, said Scott Radcliffe, vice president at insurance broker Engle-Hambright & Davies Inc., based in Lancaster. "Who's responsible for it and when and how does all that work?" are questions businesses have to set up operational structure for, he said. The law will provide some expanded incentives for wellness programs to help start decreasing employers' costs of providing health care coverage, King said. PPACA increases the credit employers can offer an employee who is meeting certain wellness criteria to between 30 and 50 percent of the cost of premiums, he said. The wellness incentive update is scheduled to be effective Jan. 1, 2014. With all of the legislative changes, there's been a revived interest for midsize companies to become self-funded for their health insurance benefits, Radcliffe said. "They're looking closely at self insurance as a way to take better control over their plan," he said. "There's been an emergence of stop-loss consortiums, benefit captives and programs trying to make it easier for a small and midsize employer to take the leap into self insurance." With increasing health benefit costs and administrative work and confusion over what mandates are going into effect and when, businesses are taking a look at what their workforce will look like come 2014 if the individual mandate is upheld by the Supreme Court, King said. Many employers are considering dropping health insurance benefits entirely and weighing the cost of the penalty for not providing coverage, he said. For companies larger than 50 full-time employees, the penalty for not providing health insurance is about $2,000 per employee, which small business owners have said might be more affordable than providing benefits, said Joanne Corte Grossi, a regional director for the U.S. Department of Health & Human Services. Companies are examining, "If we don't provide coverage, are we going to be able to maintain the workforce that we need?" King said. How health insurers have been affected: The major impact to health insurance carriers has been in a shift of focus to consumers rather than businesses, said Mike Fiaschetti, senior vice president of provider strategy for Pittsburgh-based Highmark Inc. "Up until now, ourselves and other health insurance companies are mostly focused around the group employer," he said. "We believe many more individuals will be responsible for the (health benefits) decisions after PPACA." More consumers will be part of Highmark's strategy both because more people will have health insurance under the individual mandate and because many employers might stop offering health insurance, he said. Highmark has been working on changing its marketing, billing systems and service lines to be directed at consumers mainly by interfacing with health insurances, he said. The insurer is developing its own health insurance exchange for small businesses, aimed at employers with up to 99 employees who want to offer plans with a defined contribution, Fiaschetti said. By reformulating their business operations per PPACA, insurers are incurring more and more costs, he said. The mandate to cover individuals up to age 26 alone increased Highmark's costs between 2 and 3 percent, he said. "That's an issue; that's not making (health benefits) more affordable," Fiaschetti said. Updating policies and procedures to be compliant has come with its own challenges and costs, such as PPACA's updated external appeals process, said David Vassilaros, director of health care reform and regulatory affairs for Dauphin County-based Capital BlueCross. The company had to modify its policies on what types of appeals were allowed and put in place triggers for the right paperwork to be filed when an appeal is submitted, he said. Adding to the cost of research and system changes, beginning in 2014 there will be an excise tax levied on insurers annually based on market share, he said. The money will be used to offset subsidies flowing through the government's health insurance exchanges. "We've estimated right now at between $35 million and $40 million cost to us in the first year," Vassilaros said. "That is going to have to be passed through in some portion to our customers, as is any tax on goods and services." A benefit of PPACA has been health care and health insurance becoming a conversation topic, he said. One of the insurance industry's biggest challenges is helping people understand its products and services, and PPACA has provided a platform for discussion, he said. The advent and continuation of PPACA regulations have brought up many questions for insurers, including, "What benefits are we implementing? How do we implement them? How do we market them? How do we market them on an exchange? How do we maintain our own balance sheets? Because we're all taking on a lot more risk because there will be no underwriting in this thing," Fiaschetti said. How PPACA affects health care providers: The main result of PPACA for health care providers is more and more administrative time, energy and expense, said Dr. Marilyn Heine, president of the Harrisburg-based Pennsylvania Medical Society. "The medical profession is one of the most highly regulated professions, and we're already burdened by significant administrative requirements," she said. Although most of the provisions already in effect don't change hospital and health system operations, the preparation for many scheduled for the next two years is happening now, said William Pugh, senior vice president of corporate finance and chief financial officer for PinnacleHealth System in Harrisburg. One of the most time-consuming steps has been the community needs assessment, he said. PPACA mandated each health care organization to complete a community health needs assessment every two years — Pinnacle partnered with Holy Spirit Health System and Penn State Milton S. Hershey Medical Center to conduct their assessments together, he said. Another administrative chore was reviewing and updating its charity care and financial assistance policies to be in line with the act, Pugh said. PPACA will eventually influence payment model changes through intense tracking of quality measures, he said. To prepare for that, many health systems have been working on their information technology infrastructure, readying themselves to participate in health information exchanges, he said. Systems and providers also are working on partnering with each other and private insurers to develop accountable-care partnerships — allowing the health care businesses to share risk, help lower costs and improve quality, Pugh said. "The human capital that's required to put all of this into place oftentimes is an additional cost not reimbursed," he said. "We've incurred significant cost on these things. We believe it's money well spent; we're seeing tremendous improvement in patient satisfaction surveys and the atmosphere among our whole employee group." PPACA has contributed to many health care organizations exploring more ways to raise the quality of care, said Maria Royce, senior vice president of planning and community development for York County-based WellSpan Health. The system already had been working on several initiatives to coordinate care and has continued those efforts with inclusion of PPACA regulations, she said. WellSpan has partnered with other businesses to open retail health centers for people needing immediate but not emergency care. It's also worked to develop patient-centered medical homes at its medical group practices, changing how care is coordinated to fill gaps in health care, she said. Both are projects many health care operations are pursuing in the ongoing quest to lower cost while improving care, she said. The care changes and partnerships are allowing health care providers to "learn what has the overall impact, what can impact access in a positive way, the quality of a person's health, and what can be done in a less costly setting to bring all those together," Royce said. PPACA is not designed to offer health care providers more funding in the future, she said. As payment reform linked to quality and value are coming, health care providers are focusing on expense reductions, she said. "I think as an industry (PPACA) has focused us to recognize that change is not only inevitable, it is necessary," said John Holmes, chief financial officer for Ephrata Community Hospital. How PPACA has affected the compliance industry of benefit brokers and attorneys: Benefit specialists and brokers are facing a change in revenue streams because of PPACA, several businesses in the midstate said. The act's Medical Loss Ratio requirements mandate health insurance companies to spend 80 to 85 percent of money collected for insurance on health care costs and improving health care quality. Under that provision, commissions paid to brokers and specialists cannot be included in the 80 to 85 percent, which will force them to look for fee payments elsewhere, they said. "What I think you'll see over the next few years is the thinning of the herd," said TJ Morrison, sales and marketing manager for Benefit Design Specialists Inc. in Cumberland County. "The broker-agent marketplace is overpopulated; the good ones will survive." Revenue will likely move to fee-basis from employers instead of commissions from insurers, he said. The ratio mainly will affect brokers working with businesses of one to 99 employees, as most larger businesses they work with pay them on a fee basis already, he said. Some might think with the advent of health insurance exchanges, the need for health benefits brokers, administrators and consultants will be eliminated, said Matthew Kirk, president of Lancaster County-based The Benecon Group Inc. "There will still be a very valuable role for them to play, given the complexity of this law and the multitude of changes that will come into effect," he said. "Employers might even need the services of consultants and brokers more than they do now." Benefit specialists will probably begin providing services for consumers along with companies, Morrison said. "Employees have never been involved in any decision-making process with benefits," he said. Confusion will permeate the marketplace, giving benefit specialists and brokers the opportunity to expand their services to a new audience of individuals, he said. Some of the dependence on benefit specialists already has begun, said Radcliffe, of Engle-Hambright & Davies. His firm has seen a significant increase in compliance questions asked from clients, he said. The business does monthly webinars for clients, and three out of four of the most recent topics have been on health care reform, he said. More information sessions also have been a result of PPACA for legal firms, King, of Stock and Leader, said. His company holds regular seminars on a variety of topics, he said. "Health care reform has occupied that agenda in the last two years more than any other topic," he said. "I don't think a day goes by that I don't get an email from an organization communicating what the latest update to the law is." The complexity of the law has added another layer of compliance issues for attorneys to constantly keep up with, he said. "There's an enormous time commitment in learning the details as well as staying abreast of all the developments and the changes," said Smith, of Barley Snyder. "It's not necessarily work that you're billing clients for." All of the preparations and operational changes under PPACA are a tight balancing act, especially since all or part of PPACA might not be upheld in a few weeks, said administrators at three area hospitals owned by Florida-based Health Management Associates Inc. Businesses must be ready to move quickly if the Supreme Court upholds the law, said leadership members at Lancaster-based Heart of Lancaster Regional Medical Center, Warwick Township, Lancaster County-based Heart of Lancaster Regional Medical Center and South Middleton Township, Cumberland County-based Carlisle Regional Medical Center. "But (we) must, at the same time, be careful with the usage of our resources on a law that may ultimately not become reality," they said in a joint statement. Editor's note: This item has been modified from its previous version to clarify Joanne Corte Grossi’s statement on the penalties for not providing health care to employees being more affordable than actually providing benefits.What small businesses need to know about PPACA Some parts of the act are not widely known by businesses, said Joanne Corte Grossi, regional director for the U.S. Department of Health & Human Services. In particular, small businesses might not realize that if they have fewer than 50 employees, they are not required to provide health insurance, she said. If a small business of fewer than 25 employees does choose to offer health care benefits, it can receive up to a 35 percent tax credit, she said. In 2014, the tax credit available increases to 50 percent of the cost. "It's estimated that 180,000 small businesses are eligible for the tax credit — they can each save about $350 per year per employee," Grossi said. There will be a health insurance exchange designed just for small businesses, she said. Editor's note: This item was modified from its previous version to correct the number of employees needed to receive a tax credit.Defining the plans Fully insured plan: A plan in which the employer contracts with another organization to assume financial responsibility for the enrollees' medical claims and for all incurred administrative costs. Self-insured plan: A plan offered by employers who directly assume the major cost of health insurance for their employees. Some self-insured plans bear the entire risk. Other self-insured employers insure against large claims by purchasing stop-loss coverage. Some self-insured employers contract with insurance carriers or third-party administrators for claims processing and other administrative services; other self-insured plans are self administered. Source: U.S. Bureau of Labor StatisticsEmployers: Confusion over nondiscrimination policies Nondiscrimination policies also were a concern for many businesses. Under PPACA, the nondiscrimination rules that apply to self-insured health care benefit plans were going to be applied to fully insured plans, said Mark Smith, partner at Barley Snyder law firm. The nondiscrimination rules do not allow highly compensated individuals a better employer subsidy for health care benefits than the rest of the employee base. Any business breaking that rule faces significant tax consequences, he said. However, the Internal Revenue Service delayed subjecting fully insured plans to the regulation and tax until further guidance is released by regulatory agencies, he said.Insurers: Lack of regulatory guidance A challenge for insurers is the lack of regulations clarifying the many mandates they're now subject to, said David Vassilaros, director of health care reform and regulatory affairs for Dauphin County-based Capital BlueCross. The company has put together teams of people to address several of the different requirements but often doesn't know what operational changes are needed to be in compliance, he said. Some mandates the company worked hard to meet were moderated after Capital was ready to go with its new processes, such as returning medical loss ratio rebates directly to consumers, he said. After nine months and 40 people working on a solution and rolling out the new procedure, the federal government released a regulatory update outlining that insurers didn't have to return rebates directly to individuals but could provide them to their employer instead. Earning Medicare dollars back Coming this year for hospitals as a part of PPACA is a reduction in Medicare reimbursements under the value-based purchasing rule, said William Pugh, chief financial officer and senior vice president of corporate finance for Harrisburg-based PinnacleHealth System. In 2013, 1 percent of all Medicare inpatient operating payments will be withheld. The amount will increase to 2 percent by 2017, according to the rule. Hospitals will have to earn the funding back through a combination of quality of care measures and patient satisfaction data, he said. In the past two years, hospitals have been participating in reporting to establish baselines, which will drive the reimbursement for the future, he said.

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European Court of Justice Rules Embryonic Stem Cell Research Not Patentable Tiffany Kaiser - October 19, 2011 9:47 AM 25 comment(s) - last by Nyu.. on Oct 20 at 2:47 PM (Source: newsone.com) European scientists worry that their research will instead flourish overseas Embryonic stem cells have shown that they could eventually be very useful in the treatment of a range of currently incurable diseases such as diabetes, stroke and heart disease. But such research may be threatened, or even halted, in Europe due to a recent court decision. Embryonic stem cells have the ability to transform into any human body tissue. For instance, earlier this year, the first eye was grown from embryonic stem cells in mice. But to grow these tissues, stem cells must be removed from a human embryo at the blastocyst stage, which destroys the embryo, and this has raised ethical questions regarding the process. Greenpeace in Germany triggered a lawsuit saying that it is unethical to issue a patent based on stem cells from a human embryo that is destroyed afterward. The Court of Justice, Europe's highest court, ruled in favor of the group. The ruling focused on a technique involving the conversion of human ambryonic stem cells into nerve cells. "The use of human embryos for therapeutic or diagnostic purposes which are applied to the human embryo and are useful to it is patentable," said the European Court of Justice. "But their use for purposes of scientific research is not patentable. A process which involves removal of a stem cell from a human embryo at the blastocyst stage, entailing the destruction of that embryo, cannot be patented." The decision has many European researchers outraged. This ruling could either halt stem cell research in Europe or send it overseas. "This unfortunate decision by the court leaves scientists in a ridiculous position," said Professor Austin Smith of the Wellcome Trust Centre for Stem Cell Research at the University of Cambridge. "We are funded to do research for the public good, yet prevented from taking our discoveries to the marketplace where they could be developed into new medicines. One consequence is that the benefits of our research will be reaped in America and Asia." Source: BBC Comments Threshold -1 RE: European Court of Justice? I just wonder from where did your ancestor came from... Parent Stem Cell Technique Produces Colonies of Blood Cells from Patient's Existing Cells First Eye Grown from Embryonic Stem Cells in Mice Researchers Announce First Clinical Trial for Stem Cell Therapy

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Follow us on TwitterJoin us on FacebookJoin us on LinkedinFind us on YouTube Follow us on Instagram Ronald Dahl, M.D., is professor of psychiatry and pediatrics at the University of Pittsburgh Medical Center. He has served as a core scientific member of the MacArthur Foundation Researcher Network on the Development of Psychopathology and the Robert Wood Johnson Foundation Research Network on the Etiology of Nicotine Dependence, and he currently directs a program of research on emotion regulation and adolescent brain development. © 2016 The Dana Foundation. All Rights Reserved.

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Second Series of Statewide Town Hall Meetings 4/3/2008 Governor Rod R. Blagojevich and Illinois Department of Human Services (IDHS) Secretary Carol L. Adams, Ph.D. today announced the commencement of a second series of community forums on alcohol to be held in more than 50 Illinois communities. The forums will be held this week from March 31 through April 4. "Alcohol continues to be the number one drug problem in Illinois and is a serious threat to the health and safety of our young people," said Gov. Blagojevich. "We encourage all citizens to become involved and join in the town hall meetings in their communities. Together we can find solutions to underage drinking and help prevent the senseless tragedies that happen when young people drink alcohol." Officially called, Underage Drinking Prevention: Town Hall Meetings, the forums are part of a national effort to increase understanding and awareness of underage drinking and its consequences, and to encourage individuals, families and communities to address the problem. These local meetings will give communities the opportunity to come together and discuss the extent and nature of the problem, discuss the latest research on underage drinking and its impact on both individuals and communities and to discuss how their community can implement the recommendations in The Surgeon General's Call to Action to prevent underage alcohol use. The IDHS Division of Community Health and Prevention is organizing the 58 town hall meetings with assistance from local community leaders and substance abuse prevention experts. The town meetings are being funded through a grant from the Substance Abuse Mental Health Services Administration (SAMHSA). All participating communities will receive a $500.00 stipend and the Community Briefing Prevention Toolkit: Town Hall Meetings and collateral DVD training on how to conduct a town hall meeting, a facilitator's guide, and informational handouts. "We want to build on the results of the previous town hall meetings and be proactive in engaging youth and families as well as community members in prevention," said IDHS Secretary Carol L. Adams, Ph.D. "Whether you are a parent, teacher, coach, retailer, clergy member or just a concerned citizen, you can help us in developing comprehensive and consistent interventions to reduce underage drinking." According to IDHS statistics, more than 48,000 Illinoisans including 3,100 youth received treatment for alcohol addiction at state-funded programs last year. More than two-thirds of Illinois teenagers report use of alcohol and one quarter of Illinois high school seniors admit they have driven a car while under influence of alcohol. Half of all fatal automobile crashes involving teenagers are alcohol-related. The mission of the DHS Division of Community Health and Prevention Office of Prevention is to promote and implement coordinated, innovative community-based prevention strategies and provide a wide range of comprehensive prevention efforts designed to prevent domestic violence; alcohol, tobacco, and other drug abuse; and juvenile delinquency. For a list of the Illinois communities participating in the town hall meetings, visit www.stopalcoholabuse.gov.

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Category: Cardiology | Family Medicine | Gynecology | Surgery | Critical Care | News Back to Health News Women Don’t Fare as Well as Men With Implanted Defibrillators: Study Last Updated: November 07, 2012. They were more likely to have complications, die after the heart rhythm devices were implanted.By Kathleen DohenyHealthDay Reporter They were more likely to have complications, die after the heart rhythm devices were implanted WEDNESDAY, Nov. 7 (HealthDay News) -- Women are more likely than men to experience complications and to die within six months of getting an implantable cardioverter defibrillator, according to new research that looked at nearly 39,000 patients. "Women, when they come for treatment, are much sicker in general," said study author Dr. Andrea Russo, a cardiologist at Cooper Medical School of Rowan University in Camden, N.J. "That may be one of the reasons why their results are different." Russo is scheduled to present the findings Wednesday at the American Heart Association's annual meeting, in Los Angeles. For the study, Russo's team looked at the results of ICD implants given to 38,912 patients, 25 percent of them women, between 2006 and 2009. The researchers retrieved the information from the ICD registry, which is part of the National Cardiovascular Data Registry. This registry includes about 90 percent of all ICDs implanted in the United States. About 10,000 ICDs a month are implanted, according to registry records, Russo said. When the heart rhythm becomes abnormal, the device can help restore normal rhythm. It is implanted under the skin, typically in the chest, and has wires with electrodes on the end that connect to the chambers of the heart. If an irregular rhythm is detected, the device sends out low energy electrical pulses. "It shocks the heart back to normal," Russo explained, and can help prevent sudden cardiac death. Sudden cardiac arrest occurs about 295,000 times a year in the United States, according to the heart association. Russo's team looked at results 30 days, 90 days and six months after the ICD was implanted. They wanted to see if there were any differences between men and women in terms of complications, such as surgical problems or device-related problems, in hospital readmissions due to heart failure or in death rates. Women fared worse by every measure, the investigators found. "Fourteen percent of women were re-hospitalized for heart failure, compared to 10 percent of men, after six months," Russo said. "Device-related complications occurred in 5.9 percent of the women, compared to 3.8 percent of the men," she noted. In addition, women were also more likely to die in the six months after the ICD was implanted. "Women had a mortality rate of 6.5 percent compared to 5.6 percent in men," Russo said. Another expert, Dr. Gregg Fonarow, chief of the division of cardiology at the University of California, Los Angeles, David Geffen School of Medicine, said that additional studies are needed to figure out why the gender differences exist. Fonarow, who was not involved with the study, said the findings echo some previous research. "Placement of an ICD for primary prevention has been shown to reduce sudden death and all-cause mortality in eligible men and women in randomized clinical trials, and are recommended in national and international guidelines," Fonarow said. "However, prior studies have suggested that women having an ICD placed may be at higher risk for complications and less likely to receive appropriate shocks compared to men," he noted. "These findings may reflect that women undergoing ICD placement are often older, have more severe heart disease and have more [coexisting] conditions at time of ICD implantation. The mechanisms behind these findings may also be related to differences in body size or other differences in physiology," Fonarow suggested. Until more is known, Russo said, she advised that women pay attention to their heart health. "If they develop any chest pain, lightheadedness or dizziness, they should seek medical attention early rather than later," she stressed. Russo's study was not funded by any device makers; it was supported by the American College of Cardiology Foundation's National Cardiovascular Data Registry. Russo reports receiving research grants or honoraria from Cameron Health, Medtronic, Boston Scientific, St. Jude Medical and Biotronik. Fonarow serves on the clinical trial steering committee for a trial sponsored by Medtronic, which makes ICDs and other devices. Research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal. To learn more about sudden cardiac death, visit the U.S. National Heart, Lung, and Blood Institute. SOURCES: Andrea Russo, M.D., cardiologist and professor, medicine, Cooper Medical School of Rowan University, Camden, N.J.; Gregg Fonarow, M.D., professor, cardiology, University of California, Los Angeles, David Geffen School of Medicine; Nov. 7, 2012, presentation, American Heart Association annual meeting, Los Angeles Previous: Programming Change in Defibrillator Implants May Lower Death Risk: Study Next: Report Details Start of Steroid Meningitis Outbreak

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Print Email Font ResizeBill Gates, 5 scientists win Lasker medical prizesBy Malcom Ritter Associated PressPosted: 09/09/2013 08:13:54 AM PDTNEW YORK -- Two scientists who illuminated how brain cells communicate, three researchers who developed implants that let deaf people hear and philanthropists Bill and Melinda Gates have won prestigious Lasker Awards for medical research and contributions to public health. The Albert and Mary Lasker Foundation announced the recipients of the $250,000 prizes on Monday. The awards will be presented Sept. 20 in New York City. The Gateses won the public service award "for leading a historic transformation in the way we view the globe's most pressing health concerns and improving the lives of millions of the world's most vulnerable," the Lasker foundation said. They have donated more than $26 billion to their philanthropic foundation. They often team up with agencies that can provide diverse expertise, the Lasker foundation said, noting that they supported an international partnership that has helped immunize hundreds of millions of children against killer diseases. Their current priorities include polio, agriculture and family-planning information and services. The Lasker clinical medical research award will be shared by Graeme Clark, an emeritus professor at the University of Melbourne in Australia, Ingeborg Hochmair of the company MED-EL in Innsbruck, Austria, and Blake Wilson of Duke University in North Carolina, for developing the modern cochlear (KAH'-klee-er) implant. More than 320,000 people around the world use the implants for severe hearing loss, the foundation said. Advertisement The devices stimulate the auditory nerve with electric signals. Hochmair and Clark worked independently, in the face of scientific skepticism that electrical stimulation could produce meaningful hearing. The implants were approved in the U.S. in 1985. Wilson later designed a new way for implants to process speech, which has allowed most users to understand words and sentences with no visual cues. The advance fueled a growth in implant use that began in the early 1990s, the foundation said. The Lasker award for basic medical research will be shared by Richard Scheller of the biotech company Genentech and Dr. Thomas Sudhof of Stanford University. With research they began independently in the late 1980s, they unraveled details of how brain cells release chemical messengers to communicate with each other. Scientists are beginning to find connections between the molecular equipment they studied and serious illnesses like Parkinson's disease, the foundation said. ------ Online: Lasker Foundation: http://www.laskerfoundation.org Print Email Font ResizeReturn to Top • Article commenting rules of the road

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"Last year's match wasn't very good, and a lot of people got sick," he says. "But one year like that doesn't mean you shouldn't get the vaccine." Silvers says the optimal time to get the vaccine is late October or early November, since influenza typically hits the Bay Area in December or January. "Vaccine immunity wanes with time, so you don't want to get it too early," he says.Even when the government does find correct viral matches, each person responds differently to the vaccine, depending on his or her age, immune system and underlying medical conditions. As Silvers explains, efficacy might be as high as 80 percent in a healthy young adult, but plummets to 50 percent or less in older people or someone fighting cancer, he says. People over 65 are also more likely to face serious complications or even death as a result of the flu."How do you protect your 85-year-old grandfather? You get vaccinated. His wife gets vaccinated. So does the caregiver," says Silvers, describing the concept of herd immunity. When contagious diseases are transmitted from individual to individual, chains of infection are likely to be disrupted when large numbers of a population are immune or less susceptible to the disease.His overall stance on the influenza vaccine? It's not perfect, but it does help."Development of vaccines is a complex process," he says. "We measure response based on the body's ability to develop immunity toward the vaccine, but there is no perfect correlation between vaccine-induced immunity and resistance to infection."Randy Bergen, a Walnut Creek pediatric infectious disease expert, agrees. "Even if it's only 30 percent effective, which some experts believe, when you look at the number of people we vaccinate, that has huge implications for the health of our community." Still, he says, the vaccine doesn't protect you from all the other wintertime viruses, including the common cold. "It's the safest and most effective way to protect yourself against the flu," he says. "But you still have to wash your hands constantly and stay home when you're sick." That's enough for Sylvia Solis to be a vaccine believer. The 29-year-old San Jose teacher's assistant spends her days "around a lot of germs" and has received a flu shot every year for a decade. "I might have a little pain in my arm or some mild aches, but I don't mind," Solis says. "People always tell me, 'You're so lucky you don't get sick,' but I think it's the flu shot."Sarah Sohm isn't so sure. It's not that Sohm, 28, is anti-vaccine. She just really hates getting shots. And, she doesn't see an immediate need to be vaccinated against influenza. "I don't have children that could get me sick, and I'm not around people I could get sick," she says. But, every year, around this time, when Sohm calls her grandparents in Palo Alto to set up their next lunch date, her grandmother, Gayle Pena, skips hello and instead declares this into the phone: "Let's get that flu shot."Last weekend, as they have for the past 10 years, they went to Safeway together and got their matching injections. "She knows I won't go on my own," Sohm says. "And she wants me to be healthy." Standard dose trivalent shots that are manufactured using inactive virus grown in eggs. These are approved for people ages 6 months and older. There are different brands of this type of vaccine, and each is approved for different ages. However, there is a brand that is approved for children as young as 6 months old and up. A standard dose trivalent shot containing virus grown in cell culture, which is approved for people 18 and older. A standard dose trivalent shot that is egg-free, approved for people 18 through 49 years of age. A high-dose trivalent shot, approved for people 65 and older. A standard dose intradermal trivalent shot, which is injected into the skin instead of the muscle and uses a much smaller needle than the regular flu shot, approved for people 18 through 64 years of age.2. New, quadrivalent flu vaccineThis vaccine protects against two influenza A viruses (including H1N1) and two influenza B viruses. It contains a live virus and is in limited supply, so call your doctor or pharmacy to see if they're offering it this year. It is also offered with inactive strains. The following quadrivalent flu vaccines are available: A standard dose quadrivalent shot A standard dose quadrivalent nasal spray, approved for healthy people 2 through 49 years of age.Print Email Font ResizeReturn to Top Raiders rookies DeAndre Washington, Jalen Richard step upGiants fall two games behind Dodgers with 3-1 loss to BravesKawakami: Kaepernick defends his stance on national anthem • Article commenting rules of the road

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Calif. Clinic Brings Free Dental Care to Developmentally Disabled 0 Updated at 6:33 pm, January 18th, 2012 By: ABC Digital Share This Story We MatchedComstock/Thinkstock(MORENO VALLEY, Calif.) — For most adults, a cavity calls for a quick prick of novocaine and a 20-minute filling. But for 40-year-old Tina Lumbley of Moreno Valley, Calif., the routine procedure was a day-long ordeal. Lumbley has autism, a developmental disorder that makes the sounds, smells, tastes and bright lights of the dentist’s office overwhelming. “She would get so anxious and have meltdowns,” Lumbley’s mom, Marjorie, told ABC News. “When she was a child, we had a great pediatric dentist and she was fine. But as she got older, it just wasn’t working.” Most dentists refused to take Lumbley after she turned 18. And the few who were willing would only treat her under general anesthetic, which raises the risk and price of the procedure. Lumbley is not alone. Across the country, adults with intellectual disabilities suffer from a lack of access to dental care. “It’s the biggest health care problem in the country today,” said Dr. Steven Perlman, professor of pediatric dentistry at Boston University School of Dental Medicine. “People with intellectual disabilities are the most medically underserved population we have, and dental care is by far the most unmet need.” Adults with disabilities are usually covered by Medicaid. But the reimbursement rate is so “pathetically low that no dentist wants to participate in the program,” Perlman said. And they don’t have to. Dental schools are not even required to teach students how to treat disabled patients. “These kids are coming out of school with huge loans,” said Perlman. “What are they going to do when they get out? I’ll tell you who they’re not going to treat: people who are poor or disabled.” In 2009, California dropped dental coverage for all adults on Medicaid. That prompted Marianne and Russell Benson to open We Care, a nonprofit that brings free dental care to people with disabilities. Now Lumbley, with her parents, makes the hourlong trip to the Rancho Mirage-based dental clinic where she gets cleanings and fillings like any other patients, without general anesthetic. The clinic has four dentists and student volunteers from nearby Western University of Health Sciences College of Dental Medicine. “They treat her with dignity and respect and expect her to come out with a beautiful smile,” said Marjorie Lumbley. Other dentists, she recalled, suggested pulling her daughter’s teeth. “Yes, Tina has a lot of challenges but she has a right to have decent teeth.” Having healthy teeth and gums not only looks good; it also guards against disease. And for people with disabilities who are unable to communicate, a minor toothache can quickly evolve into a major emergency. Marjorie Lumbley said she’s grateful for We Care but worries about the future, as her daughter’s dental and medical needs will surely grow. “They have all the same things that go along with people getting older, but they still have these needs that can’t be met any other way,” she said. “I think people forget what happens to them after they grow up. They’re not cute anymore. She’s 40 years old and she deserves good care.” Stories You May Be Interested In:Calif. Clinic Brings Free Dental Care to Developmentally DisabledCalif. Clinic Brings Free Dental Care to Developmentally DisabledCalif. Clinic Brings Free Dental Care to Developmentally DisabledCalif. Clinic Brings Free Dental Care to Developmentally Disabled Images in the news

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Vaccine against HER2-positive breast cancer offers complete protection in lab PHILADELPHIA - Researchers at Wayne State University have tested a breast cancer vaccine they say completely eliminated HER2-positive tumors in mice - even cancers resistant to current anti-HER2 therapy - without any toxicity. The study, reported in the September 15 issue of Cancer Research, a journal of the American Association for Cancer Research, suggests the vaccine could treat women with HER2-positive, treatment-resistant cancer or help prevent cancer recurrence. The researchers also say it might potentially be used in cancer-free women to prevent initial development of these tumors. HER2 receptors promote normal cell growth, and are found in low amounts on normal breast cells. But HER2-positive breast cells can contain many more receptors than is typical, promoting a particularly aggressive type of tumor that affects 20 to 30 percent of all breast cancer patients. Therapies such as trastuzumab and lapatinib, designed to latch on to these receptors and destroy them, are a mainstay of treatment for this cancer, but a significant proportion of patients develop a resistance to them or cancer metastasis that is hard to treat. This treatment relied on activated, own-immunity to wipe out the cancer, says the study's lead investigator, Wei-Zen Wei, Ph.D., a professor of immunology and microbiology at the Karmanos Cancer Institute. "The immune response against HER2-positive receptors we saw in this study is powerful, and works even in tumors that are resistant to current therapies," she said. "The vaccine could potentially eliminate the need to even use these therapies." The vaccine consists of "naked" DNA - genes that produce the HER2 receptor - as well as an immune stimulant. Both are housed within an inert bacterial plasmid. In this study, the researchers used pulses of electricity to deliver the injected vaccine into leg muscles in mice, where the gene produced a huge quantity of HER2 receptors that activated both antibodies and killer T cells. "While HER2 receptors are not usually seen by the immune system when they are expressed at low level on the surface of normal cells, a sudden flood of receptors alerts the body to an invasion that needs to be eliminated," Wei said. "During that process, the immune system learns to attack cancer cells that display large numbers of these receptors." They also used an agent that, for a while, suppressed the activity of regulatory T cells, which normally keeps the immune system from over-reacting. In the absence of regulatory T cells, the immune system responded much more strongly to the vaccine. Then, when the researchers implanted HER2-positive breast tumors in the animals, the cancer was eradicated. "Both tumor cells that respond to current targeted therapies and those that are resistant to these treatments were eradicated," Wei said. "This may be an answer for women with these tumors who become resistant to the current therapies." Wei's lab is the first to develop HER2 DNA vaccines, and this is the second such vaccine Wei and her colleagues have tested more extensively. The first, described in a study in 1999, formed the model of a vaccine now being tested by a major Pharmaceutical company in early phase clinical trials in the U.S. and in Europe in women with HER2-positive breast cancer. In order to ensure complete safety, Wei says the current test vaccine uses HER2 genes that are altered so that they cannot be oncogenic. The receptors produced do not contain an "intracellular domain" - the part of the receptor that is located just below the cell surface and transmits growth signals to the nucleus. The first vaccine was also safe, she says, but contained a little more of the native HER2 receptor structure. "With this vaccine, I am quite certain the receptor is functionally dead," she said. "The greatest power of vaccination is protection against initial cancer development, and that is our ultimate goal with this treatment," Wei said. The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, AACR is the world's oldest and largest professional organization dedicated to advancing cancer research. The membership includes more than 28,000 basic, translational and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and 80 other countries. AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants. The AACR Annual Meeting attracts more than 17,000 participants who share the latest discoveries and developments in the field. Special conferences throughout the year present novel data across a wide variety of topics in cancer research, treatment and patient care. AACR publishes five major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; and Cancer Epidemiology, Biomarkers & Prevention. Its most recent publication and its sixth major journal, Cancer Prevention Research, is dedicated exclusively to cancer prevention, from preclinical research to clinical trials. The AACR also publishes CR, a magazine for cancer survivors and their families, patient advocates, physicians and scientists. CR provides a forum for sharing essential, evidence-based information and perspectives on progress in cancer research, survivorship and advocacy. [email protected] @aacr http://www.aacr.org More on this News Release IMMUNOLOGY/ALLERGIES/ASTHMA

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Public Release: 28-Feb-2011 Gene variant affects stroke prognosis in humans Rockefeller University Press A small difference in DNA sequence predicts the degree of disability after a stroke, according to a paper published online on February 28 in the Journal of Experimental Medicine (www.jem.org). Stroke, the consequence of disturbed blood flow to the brain, can impair speech, movement and vision, but it is currently difficult for clinicians to predict the severity of these side effects or the long-term prognosis. Strokes result in the death of brain cells called neurons. Angeles Almeida and co-workers found that variations in a gene known to control cell death--Tp53--influence stroke outcome. Tp53 comes in two flavors in humans: R and P. The R variant triggers cell death more efficiently. In two distinct groups of stroke patients, those exclusively expressing the R variant suffered more severe disability several months after the stroke. Neurons expressing the R variant were more vulnerable to death caused by oxygen deprivation, a condition that mimics the brain environment during stroke. Future work is needed to determine if this Tp53 variation can also predict prognosis of patients with other disorders characterized by neuronal death, such as Alzheimer's or Parkinson's disease. ### About The Journal of Experimental Medicine The Journal of Experimental Medicine (JEM) is published by The Rockefeller University Press. All editorial decisions on manuscripts submitted are made by active scientists in conjunction with our in-house scientific editors. JEM content is posted to PubMed Central, where it is available to the public for free six months after publication. Authors retain copyright of their published works and third parties may reuse the content for non-commercial purposes under a creative commons license. For more information, please visit www.jem.org. Gomez-Sanchez, J.C., et al. 2011. J. Exp. Med. doi:10.1084/jem.20101523 Rita Sullivan [email protected] http://www.rupress.org/ More on this News Release

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7 Famous People With Cerebral Palsy Is It Wrong to Reveal a Relative's Suicide? Son to Sisters: Please Help With Caregiver Duties When It Comes to Dad 10 Cities With Famous Fattening Foods How To Lead a Well-Balanced Life Avoiding Pesticides for ADHD Prevention By Chris Iliades, MD | Medically reviewed by Pat F. Bass III, MD, MPH Pesticides may double a child's risk for developing ADHD, according to a recent study. Find out why using organic produce may help with ADHD prevention. My 2-Year-Old Learned How To Dial 911 7 Ways to Conquer Clutter Could exposure to pesticides have anything to do with attention deficit hyperactivity disorder (ADHD)? A recent study suggests that it might. According to the study, children with higher-than-normal exposure to organophosphate pesticides are more likely to have ADHD than children with lower or undetectable levels of pesticides. The study, published in the journal Pediatrics, supports other research suggesting that avoiding foods exposed to pesticides is a wise ADHD prevention strategy for pregnant women and young children. Organophosphate pesticides are the most widely available pesticides. In 2001, 73 million pounds of this type of pesticide was used on U.S. farm fields, gardens, and lawns. "Since this pesticide works by attacking the nervous system of pests, it is not surprising that it may have similar effects in humans," said Marc G. Weisskopf, PhD, of the Harvard School of Public Health, one of the authors of the study. "Previous small studies in humans have shown that exposure to these pesticides may lower children's IQ scores," Weisskopf said. "In animal studies, they have been shown to produce hyperactivity." Organophosphate pesticides break down in the body into chemicals that can be measured in urine. In Weisskopf's study, urine tests were done on 1,139 children 8 to 15 years old throughout the country. The study concluded that pesticide exposure at levels commonly found in American children may contribute to ADHD risk. ADHD Prevention With Organic Produce The exact cause of ADHD is not known, but experts think it is a combination of genes that are passed down through families and something in the environment that triggers those genes. Pesticide exposure may be one of triggers. "Although it is too early to say that pesticides cause ADHD, it absolutely makes sense for families to cut down ADHD risk by using organic foods when possible," Weisskopf said. The U.S. Department of Agriculture (USDA) strictly enforces organic food labeling. When a food has a USDA Organic label, at least 95 percent of its ingredients are organically produced, meaning: Only natural fertilizers have been used. No pesticides have been used to control pests. No chemicals have been used to control weeds. Animals have not been given any feed that contained pesticides. Tips for Buying Organic Produce Organic foods are more expensive and harder to find, but they are a growing part of the food market. The Environmental Working Group puts out a list each year of the 12 organic produce items with the highest pesticide residue. This year apples topped the list. "The purpose of the ranking is to assist consumers in deciding which produce is worth paying extra for organic," said Kari Kooi, MS, RD, a clinical dietitian specialist at the Methodist Hospital in Houston. Here are the rest of the "dirty dozen": Nectarines (imported) Grapes (imported) Sweet bell peppers Blueberries (domestic) Kale and collard greens The Environmental Working Group also has a list called the "clean 15," composed of produce with the least pesticide residue. "It really doesn't matter whether you purchase them conventionally grown or organically grown because the pesticide exposure is minimal," Kooi said. "They say that you can reduce pesticide exposure by 92 percent by choosing the recommended five daily servings of fruits and vegetables from the clean 15 list instead of the dirty dozen." But given that apples, grapes, and strawberries are among kids' favorite foods, you can save money by buying organic versions of the "dirty dozen" and buying conventionally farmed versions of the 15 fruits and vegetables with the least pesticide residues. The clean 15 consists of onions, sweet corn, pineapples, avocado, asparagus, sweet peas, mangoes, eggplant, cantaloupe (domestic), kiwi, cabbage, watermelon, sweet potatoes, grapefruit, and mushrooms. Experts can't say for sure that pesticides cause ADHD, but there is mounting evidence that you need to be cautious. This is especially true for young children and pregnant women. Avoid pesticides in your yard and garden, buy organic when you can, avoid nonorganic produce that is high in pesticide residue, and wash all produce completely, especially if it is not organic. Top 5 Doctor-Recommended Weight-Loss Plans

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Newsroom Press Announcements FDA News Release FDA takes action against three tobacco manufacturers for making “additive-free” and/or “natural” claims on cigarette labeling Today the U.S. Food and Drug Administration issued warning letters to three tobacco manufacturers — ITG Brands LLC, Santa Fe Natural Tobacco Company Inc., and Sherman’s 1400 Broadway N.Y.C. Ltd. — who describe their cigarettes on product labeling as “additive-free” and/or “natural.” The warning letters are for violations of section 911 of the Federal Food, Drug, and Cosmetic Act (FD&C Act).The action marks the first time the FDA has used its authority under the Family Smoking Prevention and Tobacco Control Act of 2009 to pursue regulatory action regarding the use of “additive-free” or “natural” claims on tobacco product labeling.“The FDA’s job is to ensure tobacco products are not marketed in a way that leads consumers to believe cigarettes with descriptors like 'additive-free' and 'natural' pose fewer health risks than other cigarettes, unless the claims have been scientifically supported,” said Mitch Zeller, J.D., director of the FDA’s Center for Tobacco Products. “This action is a milestone, and a reminder of how we use the tools of science-based regulation to protect the U.S. public from the harmful effects of tobacco use.”The FD&C Act, amended by the Tobacco Control Act, gives the FDA the authority to regulate cigarettes, cigarette tobacco, roll-your-own tobacco, and smokeless tobacco. It also created a process for the FDA to evaluate requests from companies seeking to market their products as modified risk. Under section 911(b)(1) of the FD&C Act, a “modified risk tobacco product” is “any tobacco product that is sold or distributed for use to reduce harm or the risk of tobacco-related disease associated with commercially marketed tobacco products.” This includes products, the label, labeling, or advertising of which represents implicitly or explicitly that the product or its smoke does not contain or is free of a substance and/or that the product presents a lower risk of tobacco-related disease or is less harmful than one or more other commercially marketed tobacco products.A manufacturer who seeks to claim that a product poses fewer risks than other tobacco products may submit a modified risk tobacco product (MRTP) application to the FDA with scientific evidence to support that claim. To date, the FDA has not issued any orders permitting the introduction of modified risk tobacco products into interstate commerce.The companies received warning letters for the following products and their related modified risk claims:ITG Brands LLC: Products – Winston cigarettes with the MRTP claim “Additive-free”Santa Fe Natural Tobacco Company Inc.: Products – Natural American Spirit cigarettes with the MRTP claims "Natural” and “Additive-free”Sherman’s 1400 Broadway N.Y.C. Ltd.: Products – Nat Sherman cigarettes with the MRTP claim “Natural”The FDA has determined that these products, described as “natural” and “additive-free” on their labeling, need an FDA modified risk tobacco product order before they can be legally introduced as such into interstate commerce.The manufacturers are requested to respond to the warning letters within 15 working days and explain what actions they plan to take to remedy the violation and come into compliance with the law or, if they do not believe that they are in violation, to provide reasoning and supporting information to the FDA. Failure to obey federal tobacco law may result in the FDA initiating further action, including, but not limited to, civil money penalties, criminal prosecution, seizure, and/or injunction.Consumers and other interested parties can report a potential tobacco-related violation of the FD&C Act by using the FDA’s Potential Tobacco Product Violation Reporting Form.The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products. ### Media Michael Felberbaum 240-402-9548Consumers 888-INFO-FDA Follow FDA Follow @US_FDA on Twitter Follow FDA on Facebook Follow @FDAmedia on Twitter More in Press Announcements

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Incredible Health Doctor in audience saves dancer who collapsed during show Print Thank goodness there actually was a doctor in the house. Dr. Andrew Wollowitz, 54, was sitting in the audience of a dance performance at Baryshnikov Art Center in New York City when a 22-year-old male dancer collapsed onstage, according to the New York Daily News. As a director of emergency medicine at Montefiore Medical Center, Wollowitz knew something was wrong and rushed to the stage from the fifth row. When he found the dancer had no pulse, he immediately start CPR . “He wasn’t alive, so I started compressions – 80 to 100 a minute,” Wollowitz told the New York Daily News. The dancer was able to take a few breaths on his own, but then faded again. Wollowitz continued to perform CPR for five minutes until firefighters arrived, who were then able to resuscitate the dancer with a defibrillator. Paramedics then took the dancer – who asked the Daily News to withhold his name – to the hospital where he spent five nights. His doctors believe he suffered a rare arrhythmia, a condition they said is more prevalent in young athletes than previously thought. According to Wollowitz, if the dancer had gone a minute or two more with reduced oxygen levels, he may have suffered from severe brain damage. Click here to read more from the New York Daily News. Advertisement

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The Mind of the News Leading psychiatrists question psychiatry's diagnostic manual By Dr. Keith Ablow Print Digital Image by Sean Locke Digital Planet Design www.digitalplanetdesign.com With the new American Psychiatric Association Diagnostic and Statistical Manual V (DSM V) slated for publication next year, leaders in American psychiatry are criticizing the volume as unreliable. The DSM is the compendium of conditions psychiatrists use to diagnose their patients and, to a great extent, determine what treatments would benefit them. The DSM also has extremely important implications for what kinds of psychiatric problems insurers will cover and even which ones schools and employers will consider disabilities. Dr. Allen Frances, professor emeritus at Duke University, who was actually the chairman of the DSM-IV task force, asserts in a recent blog published that the clinical trials that supposedly determined whether the new DSM V is a good and accurate guide “have been a pure disaster from start to finish.” He calls the trials a “fiasco” and accuses the American Psychiatric Association of having “lost its competence and credibility.” Frances is by no means the only critic of the DSM-V. I have written before that advocates for those with autism have expressed grave concerns that the new guidelines proposed to diagnose that condition could leave out 10 to 45 percent of those currently diagnosed with the condition, leading to millions of children having no insurance coverage related to it. But Frances alleges much more. He cites data that indicates that the DSM V signs and symptoms that are proposed to define Major Depression and Generalized Anxiety Disorder are unacceptably inaccurate. And he worries that the official journal of the American Psychiatric Association, the American Journal of Psychiatry, which published a positive review of the DSM V has been “forced into the role of a cheerleading house organ, not an independent scientific journal.” Given the concerns of leading psychiatrists like Frances, with whom I happen to agree, it is time to give real consideration to fundamentally changing the way psychiatrists use the DSM and encouraging them to think much more about what caused the disorders they are diagnosing. This is the proposal of one of the most influential psychiatrists of our time, Dr. Paul McHugh. McHugh is Chairman Emeritus of Psychiatry at Johns Hopkins. He and his esteemed colleague Dr. Phillip Slavney have written in the New England Journal of Medicine that the DSM is just a list of conditions with signs and symptoms and offers “no way of making sense of mental disorders.” Making sense of mental illnesses—describing the patient’s actual suffering and disability—is imperative because pretending that people can be understood by giving them a label like major depressive disorder misses the fact that many actually complain mostly about anxiety, many others are actually grieving the loss of a loved one, and many others have pervasive low mood, low energy and low self-esteem that came “out of the blue.” McHugh and Slavney correctly wonder whether this sloppiness in simply labeling rather than truly understanding patients explains why antidepressant medicines—if they are being given to a very diverse group of people artificially lumped together by the DSM—don’t seem to work much better than placebo. Why would they, if half the people who meet the criteria for major depression actually have other, central issues to address? Focusing on causes would reawaken psychiatry’s commitment to looking at people’s life stories as relevant to their suffering. It seems strange to say it about a profession based on insight, but too many psychiatrists practicing today don’t know a lot about their patients’ lives; they choose diagnoses from the DSM and pick which medicines corresponds to it. That isn’t treating the person. McHugh and Slavney say it is time to enrich and augment the checklist method of making diagnoses by starting to group mental disorders into the underlying causes: [roughly translated from their wording] brain diseases, personality problems, behavioral problems and life stresses. The McHugh and Slavney perspective is a valuable one. Given the rising chorus of concern about DSM V, their thoughts, as well as those of Dr. Frances and of autism advocates and of many others should translate into delaying publication of the DSM-V, until it can incorporate a new respect (which is a very old idea, indeed) for how patients got sick, to begin with, and how, therefore, they can get well. Dr. Keith Ablow is a psychiatrist and member of the Fox News Medical A-Team. Advertisement

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New Animal Models for Two Prion Diseases A team of investigators at several institutions, including the Whitehead Institute for Biomedical Research, the Howard Hughes Institute, MIT, and the University of Massachusetts Medical School, have developed novel mouse models for two fatal human prion protein (PrP) diseases, fatal familial insomnia (FFI) and Creutzfeldt-Jakob disease (CJD). The results of their study were published online this week in the Proceedings of the National Academy of Sciences. To date, these fatal neurodegenerative diseases have been extremely difficult to study because of the lack of animal models that recapitulate the pathology and features of the diseases. The study's first author is Walker S. Jackson, Ph.D., of the Whitehead Institute. “Walker’s work provides two extraordinary models of neurodegeneration,” said Susan Lindquist, Ph.D., who is a professor of biology at MIT and in whose lab part of the work was performed. “Most mouse models produce pathology that only distantly resembles human diseases. These nail it, for two of the most enigmatic human diseases in the world.” The prion hypothesis, which originated in 1982 with Stanley B. Prusiner, M.D., of the University of California School of Medicine at San Francisco, holds that prion diseases, including “mad cow” disease (bovine spongiform encephalopathy) and scrapie in sheep, are caused by a protein that has adopted an abnormal form. According to the prion hypothesis, PrPs infect by passing along their misfolded shape in templated fashion, unlike viruses or bacteria, which depend on DNA or RNA to transmit their information. Certain changes to the prion create a misshapen structure, which is replicated by contact. The misfolded proteins accumulate, creating clumps that are toxic to surrounding tissue. Characterized by long incubation periods, these diseases cause spongiform changes in the brain and are associated with neuronal loss and a failure to induce inflammatory response. In humans, the investigators explained, mutations in different regions of the PrP are associated with infectious neurodegenerative diseases with “remarkably” different clinical signs and neuropathological lesions. To explore the basis of this phenomenon, the investigators said, they made a CJD mouse that was exactly analogous to a previous knock-in model of a different prion disease, that is, FFI. Including the wild-type (WT) parent, they then had an allelic series of three lines, each expressing the same protein with a single amino acid difference, and with all native genetic regulatory elements intact. To generate the models, Dr. Jackson and his colleagues created two mutated versions of the PrP-coding gene by changing a single codon. One mutation is known to cause FFI, while the other induces CJD. Unlike previous models that randomly inserted the mutations into the genome, occasionally increasing PrP expression, Jackson’s models faithfully mimic the human disease—from disease onset, to PrP production, to infectiousness. In the brain, his FFI mice develop neuronal loss in the thalamus, and his CJD mice experience spongiosis in the hippocampus and the cerebellum, reflecting the damage seen in the brains of human patients. The FFI mice, the investigators said, developed neuronal loss and intense reactive gliosis in the thalamus, as seen in humans with the disease. In contrast, CJD mice had the hallmark features of CJD, including spongiosis and proteinase K-resistant PrP aggregates, initially developing in the hippocampus and cerebellum but absent from the thalamus. The investigators concluded conclude that the diseases occurred spontaneously. Importantly, they said, both models created agents that caused a transmissible neurodegenerative disease in WT mice. Based on their observations, they concluded that single codon differences in a single gene in an otherwise normal genome can cause remarkably different neurodegenerative diseases and are sufficient to create distinct protein-based infectious elements. Their work, they say, establishes that spontaneous mutations in the endogenous PrP gene can readily produce not only disease, but also infectious agents. Alzheimer’s Protein Not All Bad, Says MassGen Study New PCR-Based Health Testing Is Changing the Game

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Insight & Intelligence™ : Feb 27, 2012 How Provenge Laid the Groundwork for Developing and Regulating Cancer Vaccines FDA’s recently issued guidelines pull from more than 20 years of research and clinical experience. Cancer immunotherapy has come a long way in the past few decades. When researchers began working on this technology, there were no FDA regulations in place to direct R&D. Over time the agency drafted and issued guidelines for various areas of cell therapy, and finally in October 2011, put forth guidance specific to cancer vaccine development. FDA’s move came over a year after a significant milestone was reached in the field of cancer immunotherapies. In May 2010, the first cell-based autologous cancer vaccine was sanctioned in the U.S.: Dendreon’s Provenge (Sipleucel T) for advanced prostate cancer. “When I started this work in the early 1990s, no IND was required because cellular therapy was not regulated by the FDA,” Edgar Engleman, M.D., co-founder of Dendreon, told GEN; Dr. Engleman discovered the potential of harnessing the body’s immune cells to treat cancer while he was at Stanford University School of Medicine. “I did apply for and received IRB approval at Stanford, but this was before the company got going,” he recalled. “We were performing very small clinical studies with dendritic cells in patients with cancer. Because we were giving patients back their own cells, the general expectation was that the approach was going to be safe, and this proved to be the case.” Subsequent to these early experiments, he explained, the FDA decided to regulate cellular therapies and created new guidelines intended primarily to assure product sterility. “While the guidelines may be welcome by some and certainly provide an additional measure of safety, as a consequence of these regulations the cost of preparing cellular therapies has skyrocketed, making it impossible for most academic-based investigators including ourselves to perform the types of clinical experiments we did almost 20 years ago.” Dr. Engleman was referring to one aspect of the fairly agonizing regulatory process that would eventually be required for FDA’s approval of Provenge: preparation of autologous cells under GMP conditions. Differentiating Immunotherapies from Chemotherapies The agency’s approval of Dendreon’s vaccine marked a significant turning point for cancer vaccines, a treatment modality that had developed a bad reputation after repeated high-profile clinical failures. Provenge as well had its shares of clinical trial agony. In 2007, FDA declined to approve the vaccine based on results from a 127-patient Phase III trial (D9901) in which Provenge improved median survival by 4.5 months and reduced risk of death by 41%. That decision contravened a 17–0 vote in favor of approval from FDA’s Cellular, Tissue and Gene Therapies Advisory Committee. Provenge was eventually approved, three years later, based on a separate Phase III study (IMPACT) that involved 512 men. It showed that Provenge extended median survival by 4.1 months and reduced the risk of death by 22.5%. In commenting on the long path to approval that Dendreon has had, Manish Singh, Ph.D., president and CEO of Immunocellular Therapeutics, told GEN, “immunotherapy is inherently different from chemotherapy drugs that have been developed in the past. While chemotherapy has typically relied on tumor reduction to demonstrate activity, immunotherapy treatments have different biological effects and therefore require different measures of antitumor effect.” He felt that the guidance will prove “very helpful as it differentiates between the immunotherapy and chemotherapy paradigms, focusing on a clear approval pathway for immunotherapy products.” Leveraging FDA Guidelines Provenge’s development path provided a basis, in large part, for vaccine developers and regulators struggling to understand appropriate endpoints and biological markers for therapeutic cancer vaccine trials. FDA’s “Guidance for Industry: Clinical Considerations for Therapeutic Cancer Vaccines” was issued in October 2011, a year and five months after Provenge’s approval. “Although the FDA guidelines are new,” Dr. Singh remarked, “they are backed by more than two decades of research and clinical experience, to which members of our scientific leadership meaningfully contributed.” Dr. Singh offered these tips based on the guidelines: “We believe that conducting a randomized Phase II clinical trial early on is important to understanding clinical outcomes. We also agree that while progression-free survival is an important secondary endpoint, overall survival ought to be the primary indicator of therapeutic efficacy in most immunotherapy trials. “Our current Phase IIb trial for glioblastoma adheres to these guidelines as we are primarily evaluating overall survival, using disease-free survival as a secondary endpoint.” ImmunoCellular Therapeutics’ lead product candidate, ICT-107, is an autologous dendritic cell-based vaccine. Carlos F. Santos, Ph.D., svp, product development and regulatory affairs for cancer vaccine developer Biovest told GEN, “We’re encouraged with regard to the current U.S. regulatory environment for targeted oncology therapies with the FDA seemingly becoming increasingly flexible, evidenced by multiple recent approvals, even approving such drugs based on highly positive Phase II data alone. “Our targeted cancer therapy, BiovaxID, is an autologous active immunotherapy,” Dr. Santos explained. “We are prepared to present what we believe is a compelling case in favor of its approval for the treatment of non-Hodgkin lymphoma.” Besides Biovest, Immunocellular Therapeutics, and Dendreon, significant players in the cancer vaccine field include Bavarian Nordic and Prima BioMed. Bavarian Nordic’s Prostvac is a nonautologous candidate for advanced prostate cancer in Phase III development. Prima BioMed is investigating CVac, a personalized autologous dendritic cell therapy, as a treatment for ovarian cancer in Phase II. These companies as well as researchers in earlier stages of R&D for cancer vaccines will fair best if they follow the regulatory guidance provided by the FDA. By lessening the uncertainty that surrounds the development path for this completely novel class of cancer therapies, the agency hopes to incentivize more innovation. On the flip side, though, scientists will have to bear the financial burden associated with increased regulation. Nonetheless, as evidence mounts with regard to biomarkers for clinical response to cancer immunotherapies, developers will have another piece of the puzzle to help make better decisions on clinical development as well as design.

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MN health insurance exchange to cost $58.1 million in 2014Star Tribune, May 31, 2013 The newly named board overseeing Minnesota's health insurance exchange got its first view into the finances of the operation on Wednesday, including the years 2015 and beyond when federal money dries up and the exchange must be fully self-supporting. Known as MNsure, the online marketplace is expected to cost $58.1 million to operate in 2014, with a heavy front-end investment in technology. The state will fund the operation with federal grants, a tax on premiums and matching federal funds that help pay for health care for poor and moderate-income families. It also could consider a one-year loan from the state, MNsure executive director April Todd-Malmlov told the board.Full story

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From HealthNewsDigest.com In Fracking Fight, How to Measure Health Threats? By Apr 1, 2014 - 1:42:49 PM (HealthNewsDigest.com) - There are more than 6,000 active gas wells in Pennsylvania. And every week, those drilling sites generate scores of complaints from the state's residents, including many about terrible odors and contaminated water. How the Pennsylvania Department of Environmental Protection handles those complaints has worsened the already raw and angry divide between fearful residents and the state regulators charged with overseeing the burgeoning gas drilling industry. For instance, the agency's own manual for dealing with complaints is explicit about what to do if someone reports concerns about a noxious odor, but is not at that very moment experiencing the smell: "DO NOT REGISTER THE COMPLAINT." <script type="text/javascript" src="http://pixel.propublica.org/pixel.js" async="true"></script> When a resident does report a real-time alarm about the air quality in or around their home, the agency typically has two weeks to conduct an investigation. If no odor is detected when investigators arrive on the scene, the case is closed. "The time that it takes them to respond is something people are concerned about," said Matt Walker, a community outreach director for the Clean Air Council in Pennsylvania, an environmental advocacy organization. Waiting a few days to two weeks to respond to odor complaints, he said, is "way too long." George Jugovic, who served as a regional director for the DEP until 2012, agrees. Jugovic said the department is only set up to respond quickly to potential emergencies. "It's a problem," said Jugovic, who since leaving the department has served as counsel to a local environmental group. Rebecca Roter said she experienced the problem first hand last year. On a cool April evening in 2013, Roter said she was cooking dinner in her Susquehanna County home when a "nauseating" smell overwhelmed her. Roter said she walked out to her front porch, pulled her gray hoodie over her nose and mouth and quickly drove her car to the site of a nearby gas well being fracked. Roter said she saw plumes of dust rising into the air. That evening, Roter said she wrote to the DEP, recounting the events of the day and requesting that they send out a field agent to follow up. Four days later, the agency sent out an investigator. The DEP later notified Roter in writing that the investigator had found "nothing out of line" and that it had concluded that "the operation appeared to be conducted as per standard procedure." Roter said she is convinced the investigator simply didn't detect any smell when he responded 96 hours after her report. The odor has recurred repeatedly in the months since, she said, and she has no idea how alarmed to be. The concerns of residents like Roter are not likely to be eased by a study published today in Reviews on Environmental Health, a peer reviewed journal. The study, researchers say, confirms what they have long suspected about natural gas operations - that emission levels from these sites spike drastically over short periods of time, making it hard to assess the true threat to people's health. Researchers at the Southwest Pennsylvania Environmental Health Project collected real-time readings of particulate matter - soot, dust and chemicals - in 14 homes in Washington County, a heavily drilled part of the state. They found repeated episodes during which measures of contaminated dust rose sharply, to dangerous levels in the course of a day. David Brown, the lead researcher on the study, said that a person in such circumstances could get what amounted to a full day's exposure in half an hour. The American Petroleum Institute did not respond to repeated requests for comment. The Pennsylvania Independent Oil and Gas Association declined to comment on the Environmental Health Project's study but said that the oil and gas industry is "heavily regulated" and that the association's member companies "strive to comply with numerous federal and state air quality related rules, regulations, and reporting requirements." Still, residents like Roter, who has over 20 gas wells within a mile of her house, fear that the exposure to contaminants could quickly add up. It's one of the reasons, she says, she is frustrated by the DEP's response to her complaints. DEP spokeswoman Lisa Kasianowitz defended the department's performance on complaint investigations. "DEP has been prompt and responsive in regards to air quality concerns surrounding the natural gas industry," she said in response to questions from ProPublica. She added that the department had recently toughened oversight of the industry, and that oil and gas companies were no longer exempt from complying with basic permitting requirements. Kasianowitz provided ProPublica with some recent statistics on complaints and inspections, and she promised to make department's officials available to be interviewed. Later, after ProPublica filed a freedom of information request seeking more detailed information on dozens of the department's investigations, Kasianowitz said the officials could not be interviewed. The information provided by the DEP shows that between 2011 and 2014, the department received over 2,000 complaints about oil and natural gas operations. Water quality issues featured prominently in the list of complaints. The DEP also registered 110 of the complaints as odor issues. In Southwestern Pennsylvania, a corner of the state that has seen extensive fracking operations, there were 617 registered complaints over those years, including 47 involving troubling odors. In one-third of the cases that were investigated, inspectors reported that no odors were detected at the time of inspection and closed the case. Inspectors typically visited residents within a week of filing the complaint. In only a handful of cases did the inspectors detect odors during their visit and follow up by citing the company involved. The citations, known as a Notice of Violation, required the operators to correct the problem, but did not carry fines. ProPublica's request for more details on the investigations and violations is still pending. John Quigley, a former director of the Pennsylvania Department of Conservation and Natural Resources, said the need for greater transparency in the oversight of the fracking industry was real and urgent. In 2007, Pennsylvania produced close to 10,000 million cubic feet of gas from the Marcellus formation. By 2012, that number had grown to over two trillion cubic feet. With this dramatic increase in gas production, concerns about environmental pollution and public health have risen sharply and the DEP has become a target for anger among worried residents. Activists and environmental groups have accused the agency of being overly deferential to the gas industry, and defensive and slow moving in its dealings with the public. "It was very top down, very secretive and paranoid about who the enemies were," said Jugovic, the former agency official, who left the department when Corbett succeeded Rendell as governor. "The control on information was significant." Earlier this month, Chris Abruzzo, the current head of the DEP, publicly acknowledged criticism about the agency's transparency issues and said he wanted to change public perception of the agency. Critics of the state's dealings with the gas industry have long highlighted the history of financial ties between the industry and state officials, including former Democratic Gov. Ed Rendell and current Republican Gov. Tom Corbett. Last year the Public Accountability Initiative, a nonprofit watchdog organization focused on the intersection of government and business, released a report on what it calledPennsylvania's revolving door between the government and the gas industry. It concluded that at least 20 DEP employees have also held energy industry jobs either before or after their agency jobs. Gov. Corbett's office did not respond to a request for comment. ProPublica obtained an internal complaints manual used by the DEP to maintain a consistent approach in dealing with environmental complaints. The manual directs staff to assign routine air quality issues a priority level of 2. The category comprises complaints that are "serious but not likely to escalate within 7-10 days but pose an existing or potential adverse impact on the environment or public health." According to the internal complaint manual, DEP complaint coordinators, who answer calls on regional complaint hotlines, are responsible for assigning response priority levels. In 2012, the Clean Air Council, which has been tracking the DEP's enforcement of regulations related to air quality, sent a letter to the U.S. Environmental Protection Agency, complaining about the alleged shortcomings of Pennsylvania's oversight. The council said it had been contacted by many residents who asserted that complaints they had filed with the DEP had never been fully investigated. In some cases, the council claimed, residents had said the DEP's complaint hotline had not been working when they called. "People have been told things like ‘stop calling' and ‘if you're air is bad, then maybe you shouldn't go outside,'" said Walker, the council's community outreach director. Kasianowitz did not respond to ProPublica's questions about allegations of inadequate or unprofessional behavior by agency staff. Gas drilling operations include several processes that release toxic chemicals into the air. The type and level of chemicals released varies from hour to hour depending on the type of activity taking place on the well pad. Despite this, researchers and regulators seeking to assess the health threat of fracking operations have typically used measurement devices that capture air emissions over longer periods of time, often 24 hours. These levels are then, in many cases, compared to the EPA's National Ambient Air Quality Standards, which were created over 40 years ago at a time when large, 24-hour-a-day sources of pollution such as coal fire plants and steel mills were dominant. "You can't use 24-hour standards if the health effect occurs within a few minutes," said Brown, the lead author of the study released Friday. The question of whether episodic bursts of contaminated air from fracking could pose an unappreciated but real health menace was first explored in West Virginia in 2010. West Virginia's Department of Environmental Protection asked Michael McCawley, then a professor at West Virginia University's Health Sciences Center, to study air emissionsfrom fracking operations in the state. McCawley found the contaminants he detected at fracking sites fluctuated over a wide range. Those findings mirror those in the Pennsylvania study published on Tuesday. Research has shown that fracking operations can release an array of toxic chemicals - some carcinogenic, others capable, at significant enough levels, of causing serious neurological and respiratory damage. The worry, Brown says, is that these chemicals are attached to the microscopic dust particles that he detected and can reach the bloodstream after being inhaled. McCawley and Brown say that the wide fluctuations that they're picking up on are also attributable to operators not using the best available technology to limit possibly harmful emissions. State and federal regulations, for instance, do not require operators to use equipment that would capture all emissions during drilling. Often, gases are vented or flared into the air. The regulations also don't consider activities, like diesel truck traffic, that degrade air quality at the fracking site. "The law requires best technology," said McCawley, and the data, he says, is telling us that the gas drilling industry is "not working according to the strict definition of the law." Correction: An earlier version of this story mistakenly said that the Marcellus shale formation had produced two million cubic feet of gas by 2012. In fact, it had produced two trillion cubic feet of gas. For advertising and promotion on HealthNewsDigest.com, call Mike McCurdy: 877-634-9180 or [email protected] We have over 7,000 journalists as subscribers. © Copyright by HealthNewsDigest.com

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Medicare/Medicaid fraud whistleblowers could earn nearly $10 million under proposed rule The Department of Health and Human Services might not have the manpower to deal with all the cases the rule will bring By Julie BeckApril 29, 2013 A new rule announced by the Department of Health and Human Services (HHS) on Wednesday would increase whistleblower payouts for people who shed light on healthcare fraud. The Centers for Medicare and Medicaid Services, a division of HHS, proposed raising the ceiling for such payments from the current cap of $1,000. Under the new rule, if it is approved, whistleblowers could receive up to 15 percent of any recovery resulting from their tip, up to $9.9 million. The proposed rule is a "signal to Medicare beneficiaries and caregivers, who are on the frontlines of this fight, that they are critical partners in helping protect taxpayer dollars,” said HHS Secretary Kathleen Sebelius in a statement. As with any whistleblower program, the proposed rule raises concerns that the money will be a strong incentive for people to report to the government first, instead of going through internal channels at companies to report suspected Medicare or Medicaid fraud. Thomson Reuters reports that another pressing concern is that HHS simply won’t have enough manpower to sift through the tens of thousands of cases that are likely to result from the rule change. Experts are predicting a backlog of cases that could slow down the finding of fraud. Read more about whistleblowers on InsideCounsel: Penn State whistleblower suit will move forward Meritless whistleblower retaliation claims are on the rise Judge dismisses $30 million whistleblower suit against Huron Norfolk Southern will shell out $1.1 million to three whistleblowers « Prev Regulatory 2921 Thomson Reuters 456 fraud 163 whistleblowers 59 Department of Health and Human Services 42 medicare 14 medicaid 11 Kathleen Sebelius 8 Join the Conversation

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Rabid skunk attacks family's puppies in Norman Health officials urge families to get pets vaccinated NORMAN, Okla. - A Norman couple say their two puppies were attacked by a rabid skunk.The Lewis family said the skunk, when it was taken to the state health department, tested positive for rabies, so they had to put down their two 6-week-old puppies.The couple's daughter, Willa, had just named the puppies the night before they were attacked. The couple said the puppies were on the back porch for a few minutes, but by the time they heard the crying, it was too late."It was a rabid skunk. It was just going crazy on them and attacking them, wouldn't let up, even after (my husband) started hollering at it and trying to shoo him off," said Kelsie Lewis.The puppies were not old enough to have rabies shots. The couple said it was a heartbreaking lesson to learn, but they're keeping an even closer eye on their daughter."I really wasn’t expecting it so close to town. It doesn’t really feel that rural to me out here," said Kelsie Lewis.According to the state health department, rabies cases have been on the rise over the spring season. It's not uncommon and even though it wouldn’t have helped the Lewises, officials said the best way to protect the family is to get the pets vaccinated."Every year, when you take your cat or your dog in to get their yearly checkup, make sure that they're current on their rabies vaccine and that they don’t need a booster," said epidemiologist Kendra Dougherty.Health officials said animals can start getting the rabies vaccine when they're 4 months old. Until then, it’s best to keep them indoors.

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Smoking Cessation Articles Kids who smoke menthol more likely to get hooked Smokers miss work more often, cost UK billions NEW YORK (Reuters Health) - Kids who experiment with menthol cigarettes are more likely to become habitual smokers than their peers who start out with the regular variety, new research findings suggest.In a study of tens of thousands of U.S. students, researchers found that kids who were dabbling with menthol cigarettes were 80 percent more likely to become regular smokers over the next few years, versus those experimenting with regular cigarettes.Menthol is added to cigarettes to give them a minty "refreshing" flavor. Critics have charged that menthol makes cigarettes more palatable to new smokers - many of whom are kids - and may be especially likely to encourage addiction."This study adds additional evidence that menthol cigarettes are a potential risk factor for kids becoming established, adult smokers," said study leader James Nonnemaker, of the research institute RTI International in Research Triangle Park, North Carolina.Still, the findings, which appear in the journal Addiction, do not prove that menthol cigarettes are to blame."The study's subject to a number of limitations," Nonnemaker said. "This shows an association, not cause-and-effect."One issue, he said, is that the study was not set up specifically to answer the question of whether menthol might encourage habitual smoking.The findings come from three years' worth of surveys of over 47,000 U.S. middle school and high school students. That included almost 1,800 kids who had just started smoking during the first or second survey - one-third of whom had opted for menthol cigarettes.By the third-year survey, more than half of those experimenters had quit smoking. Another third were still occasional smokers, and 15 percent had become habitual smokers.The odds of becoming a regular smoker, the study found, were 80 percent higher for kids who'd started off with menthol cigarettes. That was with the kids' age, gender and race taken into account.The results are consistent with the idea that menthol cigarettes encourage kids to get hooked because of menthol's "sensory properties," according to Nonnemaker. But, he said, more studies are needed. One question is whether the findings might vary by race. This study included mostly white students. But it's known that young African Americans and Asian Americans are especially likely to smoke menthol varieties.Last year, an advisory committee to the U.S. Food and Drug Administration said taking mentholated cigarettes off the shelves may benefit public health.But studies have varied on the possible effects of the cigarettes versus regular ones.One recent study found that menthol smokers had a higher stroke rate than those who favored the non-menthol variety. Another, however, found no higher risk of lung cancer, and no evidence that menthol fans had a harder time kicking the smoking habit.Of course, not smoking at all is the wisest choice. The risks of the habits go beyond lung cancer, and include a range of other cancers, emphysema and heart disease - the number-one killer of Americans. According to the U.S. Centers for Disease Control and Prevention, smoking any type of cigarettes increases a person's risk of heart disease two- to four-fold compared to non-smokers.SOURCE: http://bit.ly/tlbpp3 Addiction, online October 18, 2012.

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Live ScienceHealth Hidden Secondhand Smoke Risk Revealed By Karen Rowan, Health Editor | April 29, 2012 09:55am ET Credit: Apartment buildings photo via Shutterstock People who live in apartment buildings, especially those with children, breathe in tobacco smoke even if no one in their own household smokes, a new study shows. Researchers found that about one third of study participants living in apartment buildings, condominiums and other multi-unit housing reported smelling smoke in their buildings, and about half of those residents reported smelling smoke in their own units. People were only eligible to participate in the study if no members of their household smoked in the home. The findings also showed that 41 percent of people with children reported smelling smoke in their building, whereas 26 percent of people with no children said the same. That may be because people with children, on average, are poorer than people without children, so they tend to live in buildings with larger numbers of other people who are smoking, said study researcher Dr. Jonathan Winickoff, an associate professor in pediatrics at MassGeneral Hospital for Children in Boston. There is a general association between being poorer and smoking, he said. But taken together with another recent study, the findings mean that half of parents whose children are exposed to tobacco smoke don't know it, Winickoff said. In that earlier study, Winickoff and his colleagues found that nine out of 10 children living in apartments had a chemical called cotinine in their blood. Cotinine is an indicator that a person has breathed in tobacco smoke. "We know that if you smell it, you child will have evidence of tobacco smoke exposure in their blood. But just because you don't smell it, doesn't mean you're not exposed," Winickoff said. Exposure to secondhand tobacco smoke has been linked with higher rates of asthma, pneumonia and ear infections in children, even when researchers take into account other factors linked to these conditions, such as poverty and race, he said. Some policy makers are making efforts that could improve the health of children living in apartment buildings, Winickoff said. Public housing authorities in Maine and in Boston, for example, will soon implement mandates that buildings become smoke-free, and in New York City, Mayor Michael Bloomberg is advocating for disclosure rules, which would require all multi-unit buildings to clearly state whether smoking is permitted in the building. "People will have a choice to live in a building that has clean air, and I think we want people to have choices," Winickoff said. The next step in his research, Winickoff said, is to look at how best to raise awareness among people living in multi-unit housing of the impact of allowing smoking in buildings. Follow MyHealthNewsDaily on Twitter @MyHealth_MHND. Find us on Facebook. Anatomy of Addiction: Why It's So Hard to Quit Smoking Why Women Find it Harder to Quit Smoking Top 10 Leading Causes of Death Author Bio Karen Rowan, Health Editor Karen came to LiveScience in 2010, after writing for Discover and Popular Mechanics magazines, and working as a correspondent for the Journal of the National Cancer Institute. She holds an M.S. degree in science and medical journalism from Boston University, as well as an M.S. in cellular biology from Northeastern Illinois University. Prior to becoming a journalist, Karen taught science at Adlai E. Stevenson High School, in Lincolnshire, Ill. for eight years. Karen Rowan, Health Editor

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Idle Thoughts From Mt. WaasThe first 'liar'... Ollie Harris Apr 04, 2013 | 937 views | 0 | 5 | | My friends and I are fond of joking that the first liar doesn’t stand a chance. The way it goes is that someone will tell a good story, which will remind someone else of a better story, which reminds someone else of a still better story. All of this leaves the guy who told the first story, the first “liar,” far in the dust. This doesn’t mean that any of the stories were actual lies. My friendships are formed with people who would not intentionally set out to deceive. If an occasional exaggeration is slipped into the story, it must be noted. Here is an example of what I mean. Last week, Barbara and I got up early and drove to the hospital up north. We went for what I thought was an unnecessary follow-up to eye surgery. It turned out, though, that some swelling was discovered in the site of the surgery. The Doctor said that he wanted to give me some sort of shot in the eye to reduce the swelling. My toes curled. So, a nurse put some drops into my eye to deaden it. Then, the Doctor came in and put an apparatus in my eye to keep the eyelids open. He brushed the surface of my eyeball with a little brush to disinfect the site, said, “You will feel a little pinch,” and stuck a needle in there. I watched from the inside as black stuff came billowing out of the needle in my eye. When I tell the story, I like to say that I saw the needle enter my eye, but of course, I didn’t see the needle, and I have to note the exaggeration. But, it’s a pretty good story, don’t you think? It ought to be able to withstand the assaults of subsequent “lies,” at least for a little while. But it couldn’t and it didn’t. A couple of days after the needle-in-the-eye incident, we were packed and ready to head for home when we got a phone call from one of our daughters. She told Barbara that a donor had been found for a liver transplant for her six-month-old grandson, Zander. She was on her way to the Primary Children’s Medical Center and she wanted her mommy to be with her. We carefully made our way to the hospital. Our daughter and grandson, Chad, were waiting outside for us. They took us into a waiting room where we spent the next nine hours. Then we went to another waiting room for six more hours. At the end of that time, after a three-hour surgery, Dr. Kim came in to tell us that all was well, that Zander had a new liver and was on his way to ICU for recovery. Barbara and I went out to the big Dodge at 1:30 a.m. I was so jacked up that I thought I could drive home. We made it as far as Price when Barbara cast her vote to spend what little remained of the night there in a motel. She was nearly sick with fatigue and worry. See what I mean? A liver transplant trumps a needle in the eye every time. As good as my story was, being the first liar, I didn’t stand a chance. While we were up north, I got to run some errands with my granddaughter, Kayla June, who is now in college but used to be my little “June Bug” or “Boon Jug.” She told me that when she got married she wanted a husband who was a good storyteller, like me or uncle Joaquin. She said that she had been on a date with a young man who tried to tell stories but just didn’t have the rhythms or the flow of good storytelling. I hope she finds a good storyteller, but it isn’t enough to just be good. You have to somehow avoid being the first storyteller, the first “liar,” in order to make any sort of lasting impression. High Desert Hoofbeats So long... Gardening and Living in Grand Style Insects recently seen in the garden... Michael Johnson, Utah State University Extension Agent, Grand County

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N.J. CEO leads study to reduce costs of home health care Though he's less than a year into his role as the head of New Jersey's largest home health care provider, Dr. Steven Landers has been chosen to lead a national research alliance of for-profit, not-for-profit and academic home health care stakeholders that will study ways to reduce the costs and improve the quality of care delivered at patients' homes. "Home-based care models are already a win-win-win. Helping high-risk patients stay home lowers costs because it keeps them out of hospitals and other institutions, which is what people want and what the system wants," Landers said. "But I think a challenge in the home health community is finding good quality evidence to guide our care model. We're still trying to figure out the best evidence for home-based care, and there's a need for better science and research to do everything we can to get better patient outcomes."Landers, who has served as president and CEO of Red Bank-based Visiting Nurses Association Health Group since June, will chair the board of the national Alliance for Home Health Quality and Innovation, which recently enlisted a slew of nonprofit and academic leaders in the home health community to demonstrate through evidence-based research how new care models and technologies can improve patient outcomes while reducing high health care costs.To jumpstart that mission, Landers said he will leverage the strides VNA Health Group has made at the local level through its integrated approaches to "providing successful transitions from the hospital to the home and using tele-health remote monitoring to help patients have successful health outcomes in place."But Landers said he will first focus his efforts on digging through Medicare and Medicaid claims data and other national research "to understand where home care is successful and where it's not," and then investigate methods that can help improve home health care across the country."The programs we've been doing throughout the VNA Health Group in New Jersey are on the edge of new technology and the new care model, but the main things we need to figure out are, how do we help more people stay healthy at home, and what are the care concepts that can best achieve that goal?" Landers said. "Being part of the national charge to find out the answers is something I'm excited about."

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AdvoCare and RCR Team up to Donate More Than $30,000 to National Breast Cancer Foundation AdvoCare International, LP® (AdvoCare), a premier health and wellness company celebrating 20 years, today announced a generous donation of $30,827 to the National Breast Cancer Foundation, Inc.® (NBCF). The donation was a combination of proceeds collected through the sale of the Pink Lemonade flavor of AdvoCare Spark® Energy Drink Mix, and the auctioning of Austin Dillon’s autographed and race-used AdvoCare Spark® Firesuit and pink-trimmed Cowboy Hat. “AdvoCare is excited to make this contribution to the National Breast Cancer Foundation in support of Breast Cancer Awareness Month,” said Allison Levy, Vice President and Chief Legal Officer for AdvoCare. “We are honored to help increase awareness of the importance of preventative methods to detect breast cancer and support those in need.” In support of NBCF’s mission, AdvoCare donated $1 for every canister of the Pink Lemonade flavor of AdvoCare Spark® Energy Drink Mix sold in October, totaling to $28,602. Austin Dillon’s pink firesuit and cowboy hat sold at auction for $2,225. Dillon wore both of these items during the NASCAR® Nationwide race at Kansas Speedway on Oct. 5. “We are thrilled that AdvoCare has made such a generous donation to our organization, which will greatly help us in our mission to help women facing breast cancer now,” said Janelle Hail, Founder and CEO of NBCF. AdvoCare Spark® Energy Drink Mix contains 21 vitamins, minerals and nutrients that work synergistically to provide a healthy, balanced and sugar-free source of energy. For more information about AdvoCare, its products or how to become an AdvoCare Independent Distributor, please visit www.advocare.com. Back to top

医学

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Home > Archives (May 19, 2014) > Pearls of Wisdom Pearls of Wisdom "Imagine if you're in a VA hospital in Arizona, and you've been promised you're on a special waiting list where you are going to get advanced treatment, preferential treatment. You wait, and you wait, and you wait -- and you see the owners of the horse get their request answered in two days -- and you die before getting treatment." "You know, it's no wonder college graduates are booing if a commencement speaker tells 'em to get out there and work hard. They're looking around and saying, 'Why? Who else is?'" "If you want to treat this VA thing seriously, this is exactly where we're all headed. This is what Obamacare's gonna be for everybody. The VA is just one small bureaucracy." "Imagine if, say, 40 people on an Obama secret food stamp list died of starvation. That's kind of what we're talking about here with the VA." "I offered to move to Rio Linda if they would rename it Limbaugh, California. They didn't. I tried the same thing with West Sacramento. They refused the offer. They're still paying the price, both places." "The president's really mad about the VA hospital, folks. He was just as mad about the IRS scandal. And he was just as mad when he found out that you couldn't keep your doctor. Mad about Benghazi, when he found out that the ambassador in Benghazi got killed. . He's gonna get to the bottom of this. This is unconscionable." "If I did a hologram of myself, like they did in Vegas for Jacko, I could make speeches all over the place and never really go. Yeah. That's not a bad idea: Do a hologram. Well, I'm going to look into that. Yep, absolutely." "The government is allowed to totally bollix everything it does because they're trying to help, and that's how Obama escapes accountability in many ways." "Do you know what the minimum wage in Switzerland is? Anybody in there want to take a guess? What is the minimum wage in Switzerland? Zero. There is no minimum wage." "You know where they got Tommy Vietor? He was a driver. He was a driver during the campaign. Vietor drove a van in the Obama campaign, and he ends up in the Situation Room on the night Benghazi's taking place with Obama nowhere to be found. Vietor's in there because of total loyalty, which, believe me, when you're running scam after scam after scam, you need people loyal to you."

医学

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Sify.comNewsInternationalLondon expert to head Savita death probe in Ireland London expert to head Savita death probe in Ireland Source : Last Updated: Tue, Nov 20, 2012 22:11 hrs London: Sir Sabaratnam Arulkumaran, a Sri Lanka−born expert on maternal care based at the University of London, has been appointed by Ireland's health authorities to head the investigation team into the death of Savita Halappanavar. The Indian woman died Oct 28 at University Hospital Galway in circumstances that sparked a world−wide protest against abortion laws in Ireland. An internationally recognised expert at St George's, the University of London's healthcare institution, Arulkumaran is also a honorary fellow of the Indian College of Obstetricians and Gynaecologists among other colleges in various countries. He is currently professor and head of obstetrics and gynaecology and deputy head of clinical sciences at the institution and president of the International Federation of Obstetrics and Gynaecology, the global body dedicated to improving women and newborns' quality of life. The inquiry headed by Arulkumaran will aim to determine the facts of Halappanavar's death, identify contributory factors and make recommendations to try to prevent a similar incident from occurring again, Irish officials said. According to Ireland's minister for health, James Reilly, having the inquiry done properly and completely was key to getting the whole truth that Halappanavar's family would want. Three months was a realistic timeframe for the inquiry to be completed, he said. Arulkumaran has led a similar inquiry in Britain in 2005 when the then health secretary, John Reid, appointed him to lead a review into the safety and quality of maternity services at Northwick Park Hospital in London after 10 mothers died there in the preceding three years. Arulkumaran obtained his MD and PhD by research and Membership of the Royal College of Obstetricians and Gynaecologists (MRCOG) and fellowship of the Royal College of Surgeons by examination, according to St George's, where he is based. Among his key achievements listed is the development of a 'clinical dashboard' to provide clinicians with the relevant and timely information they need to inform decisions that improve the quality of patient care. Arulkumaran has published 24 books as author or editor, 240 indexed articles and more than 150 book chapters. He has also been editor in chief of Best Practice and Research Clinical Obstetrics and Gynaecology since 1998. SEARCH More from Sify:

医学

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Carers Forum Succeed Blog Succeed Vodcast Succeed Vodcast12 August 2013 The Succeed Vodcasts are an innovative form of guided self-help to support individuals with eating disorders to improve mood and overcome negative reactions to food. The Vodcasts are being designed and developed in partnership with Professor Janet Treasure, Valentina Cardi and The Institute of Psychiatry at Kings College, London.They consist of a series of short video clip interventions played on a handheld media device, such as a smart phone, tablet or mobile phone and were developed in consultation with individuals who have recovered from Anorexia Nervosa. They include: Recovered patients describing the steps involved in making the decision to change and how they implemented change plans. A description of factors that maintain illness (cognitive rigidity, over-attention to detail, appetite, body image and interpersonal difficulties) and strategies to change these. Implementation interventions to assess and address unhelpful internal states such as craving, negative emotions or self-defeating thoughts. To supplement the vodcasts there will be an introduction describing the content and learning objectives of each vodcast and a workbook to provide a written summary of the processes described in the vodcasts. It will also include exercises to re-enforce the behaviours and suggestions on when the vodcasts should be watched. Individuals with eating disorders show abnormal reactions to food, mainly marked by anxiety, fear, disgust and avoidance. The Succeed Vodcasts use visual and aural imagery to reduce these emotional reactions as well as to reduce food cravings. Used during day-to-day life, the vodcasts will support individuals to develop self-support strategies, such as cognitive reappraisal of the anxiety related to food and positive emotional regulation. Some of the vodcasts describe the underpinning mechanisms and suggest strategies to interrupt the vicious cycle of impulsive behaviours such as the craving, binging and vomiting sequence. Users are guided towards accepting food as a necessary part of caring for the body and a key step in the recovery process. How do we know it works? The Succeed Vodcasts are based on studies that show interventions employing audio and visual elements to be effective in reducing food craving and emotional reactions. Preliminary studies at Kings College, London, working with individuals with Anorexia Nervosa have shown that in comparison to no support or just music, the vodcast was associated with greater consumption of a fruit smoothie test meal and with reduced anxiety, intrusive thoughts and body dissatisfaction. Also, it was associated with increased positive mood. Furthermore, study participants elected to use the vodcast at home for continuing support and motivation. For more information on the on-going research, please see Research and Evaluation The Succeed Foundation is working with The Institute of Psychiatry, Kings College London, to further evaluate the effectiveness of the vodcast interventions. Plans are also underway to adapt the vodcasts into an “app” format, increasing the accessibility of the intervention. Anthony WallerWeb and Marketing Assistant Send Email Accessibility © 2013 The Succeed Foundation. All Right Reserved. Charity Number 1136289

医学

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news/health Bingo Buy A Photo Digital Editions Holidays Leaflets Public Notices Virtual Thame Reception World War One Pension Calculator Local Guide Sponsored Feed Sign in Thame 5-day weather forecast Pulse checks could prevent thousands of strokes The Daily Mail reports that, if doctors checked the pulse of every patient they see, this measure could “prevent 12,000 strokes a year”.The aim of the pulse checks would be to pick up cases of atrial fibrillation, a common heart rhythm disorder that increases the risk of a stroke. The figure comes from a report released by the Atrial Fibrillation Association (AFA) and Anticoagulation Europe (ACE), which warn that there is a “silent epidemic” of atrial fibrillation and that this will worsen in the UK as the population ages. The report also sets out a number of ways that might improve the diagnosis and treatment of atrial fibrillation, including campaigns to raise awareness, further training for GPs and improved access to heart monitoring when a case is suspected. Atrial fibrillation is a heart rhythm disorder where the upper chambers of the heart (the atria) contract in a faster and shallower way than normal, causing an irregular heartbeat. While this is happening the heart is less effective at pumping blood around the body.There are three different forms of atrial fibrillation, based on how long the fibrillation lasts:The AFA/ACE report estimates that 1.5 million people in the UK have atrial fibrillation but that currently up to half of these cases remain undiagnosed. Not all people with the condition will show symptoms of atrial fibrillation. In people who do have symptoms, these can include: With atrial fibrillation you may also have an irregular pulse. NICE recommends that people going to their doctor with any of the signs described above, or who have had a stroke or mini-stroke, should have their pulse checked manually to see if it’s irregular. People who have no symptoms may also have an irregular pulse detected just by chance, when visiting their doctor for another reason.NICE suggest that an electrocardiogram (ECG) should be performed in all patients who have an irregular pulse and are suspected to have atrial fibrillation, even without symptoms. Blood does not flow smoothly out of the heart during an episode of atrial fibrillation, and this increases the risk of blood clots forming. Because of this, people with atrial fibrillation are at an increased risk of having a stroke (where a blood clot lodges in the brain). Atrial fibrillation can also lead to heart failure. The factors reported to increase the risk of stroke in people with atrial fibrillation include: There are various ways of treating atrial fibrillation, depending on the form it takes and other factors. Possible treatments include drug treatment, electrical treatments and surgery. People with atrial fibrillation who also have other risk factors for stroke should also take an anticoagulant to reduce their risk. The AFA and ACE recommend the following measures: Screening is a process of identifying apparently healthy people who may be at an increased risk of a disease or condition. The screening process does not include testing people who already have symptoms.The UK National Screening Committee (NSC) advises government ministers and the NHS on all aspects of screening and supports implementation of screening programmes. National screening programmes for healthy people can be expensive and potentially lead to an increase in investigations and treatments for people who might not necessarily have developed symptoms or problems. The committee regularly assesses the evidence about new screening programmes that could be offered, to determine whether they would do more good than harm at a reasonable cost. Currently, the NSC’s recommendation is that routine screening for atrial fibrillation in adults should not be offered. This policy is being reviewed. This review involves identifying any relevant new evidence published since the policy was made and assessing whether this evidence suggests that the policy should be changed. The review began in January 2010 and is expected to be completed by March 2012. The AFA and the ACE’s extensive report also calls for: Celebrations at Lord Williams’s School for best ever GCSE results Family trio hope for a big lift in the Big Apple with a quirky new sporting event Liverpool accept Crystal Palace offer for striker Christian Benteke Place your Ad online Create your own advertisement or send someone a special message. You can sell your car, unwanted items or place a family announcement through our newspapers and websites at really low prices. Click here to place your advert now. Email: [email protected] Thame Gazette provides news, events and sport features from the Thame area. For the best up to date information relating to Thame and the surrounding areas visit us at Thame Gazette regularly or bookmark this page. For you to enjoy all the features of this website Thame Gazette requires permission to use cookies.

医学

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‘Be vigilant': County warns residents of lingering West Nile Virus threat Andrew Kidd, The Oakland Press A mosquito bites a human arm in Ludington, Mich. (AP Photo/Ludington Daily News, Andy Klevorn) Local health officials are warning residents to stay vigilant in the coming weeks as cooler weather and earlier sunsets cause people to drop their guard against mosquitoes carrying West Nile Virus. The Oakland County Health Division issued the warning Tuesday that the disease is still a threat until freezing overnight temperatures become more commonplace. Oakland County Health Division Manager and Health Officer Kathy Forzley said residents should be cautious at this time of year when most people either no longer expect mosquitoes � or the communicable diseases they carry � to be a problem. �As it's getting darker earlier, people are out walking at their normal time,� she said. �We find this time of year people thinking that we�re out of the woods, that it's over, that precautions we've been taking all summer long aren't needed anymore. �That's simply not the case � you still need to be diligent.� West Nile Virus is a communicable disease spread by certain varieties of mosquitoes. Of the more than 60 mosquito species in Michigan, Culex pipiens (the common house mosquito) is responsible for 70 percent of all positive samples of West Nile Virus among mosquitoes. The disease can potentially be deadly, but shows no symptoms in 80 percent of cases. The remaining 20 percent show symptoms such as fever, headaches, body aches, nausea, vomiting and the like. These symptoms can last a few days to several weeks. It�s when a serious case pops up that health officials are usually notified, Forzley said. About one in 150 infected people will become severely ill from the disease, causing such symptoms as disorientation, tremors, stupor, convulsions, muscle weakness, loss of vision, numbness and paralysis � with lasting neurological effects. So far, there have been 28 cases of West Nile Virus and one death reported in 2013. In 2012, there were 240 reported cases with 17 deaths in Michigan. But these reported cases typically represent those afflicted with the more severe symptoms of the disease, as well as those who found out they carried the disease following a blood test or post-donation blood screening � one this year and 38 last year, according to Angela Minicuci with the Michigan Department of Community Health. �Unfortunately there's not an estimate out there,� she said. �The majority of people don't show signs that they hosted it. It's just in their system and their body's fighting it off.� Minicuci added that most people who contract the disease, which thrives in densely populated areas, might shrug it off as something unrelated that typically doesn�t cause people to take a trip to their physician, such as influenza or the common cold � but every confirmed case likely indicates many more going unreported. �We do know that it's circulating in the environment much more than in the cases we have,� she said. �When we see a high volume of cases in one area, all it takes is one bite of an infected host and they can transmit it to everyone they bite after that.� Recent years pale in comparison to 2002, when the disease was first reported in humans in Michigan. That year, there were 644 cases reported with 51 deaths total. Minicuci said that this year�s numbers are what the state typically observes. �We've learned a lot that we can do to prevent West Nile,� Minicuci said, �So whether it�s just testing and creating awareness or potentially baiting the water to kill mosquitoes, we've come a very long way in Michigan.� Forzley said that the reduced number of reported cases from last year has a lot to do with Michigan�s ever-so-fickle weather patterns. �Last year was a very hard year because we had many weeks of warm dry weather, which is something that this mosquito needs to mature and become a problem for transmitting West Nile Virus,� she said. �We had a very stormy, volatile season this year. Short-duration storms tend to knock out mosquito egg rafts.� It could also have something to do with a combination of several factors. �Strong prevention campaigns have made a difference in Oakland county,� Forzley said. �Our numbers were lower; I think people are being more diligent throughout the season in protecting themselves. It's probably a combination of a lot of things, as well as the immunities built up in people.� Forzley said that despite the risk of West Nile Virus, it shouldn�t keep people indoors during the last few days of warm weather. �We want people to go outside and get exercise and be healthy,� she said, �but just be cautious.� West Nile Virus can be prevented by simply avoiding mosquito bites. Try practicing these safety tips from the Oakland County Health Division: Use insect repellent containing active ingredients registered with the EPA. Wear protective clothing such as long-sleeved shirts and pants. Limit outdoor activity between dusk and dawn when mosquitoes are most active. Avoid areas where mosquitoes may be present, such as in the shaded or wooded areas. Maintain and repair window and door screens to keep mosquitoes out of buildings. Get rid of mosquito breeding sites by emptying standing water in things like birdbaths, boats, buckets, tires, pools and gutters. Andrew was an online coordinator, multimedia journalist and editorial page contact for The Oakland Press. Reach the author at [email protected] or follow Andrew on Twitter: @AndrewJKidd. Full bio and more articles by Andrew Kidd

医学

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Clinical and Translational Science Center Clinical and TranslationalScience Center Home Request Services Investigator Resources UC Davis Research News Releases Health SystemClinical and Translational Science Center In-hospital formula use deters ... Tricia Tomiyoshi Other News Resources Search news releases » Follow us on social media » NEWS | February 14, 2014 In-hospital formula use deters breastfeeding Mothers who expressed a strong intent to breastfeed did so far less when their babies received formula Editor's note:View this release en español or 中文 Chinese When mothers feed their newborns formula in the hospital, they are less likely to fully breastfeed their babies in the second month of life and more likely to quit breastfeeding early, even if they had hoped to breastfeed longer, UC Davis researchers have found. Caroline Chantry “We are a step closer to showing that giving formula in the hospital can cause problems by reducing how much women breastfeed later,” says Caroline Chantry, lead author and professor of clinical pediatrics at UC Davis Medical Center. “Despite being highly motivated to breastfeed their babies, in-hospital formula use limits this important practice. Given the benefits of breastfeeding for both mother and baby, this is a public health issue.”“In-Hospital Formula Use Shortens Breastfeeding Duration” was published online in The Journal of Pediatrics today. The study only included women who intended to exclusively breastfeed their babies for at least a week, meaning they did not plan to use formula in the hospital.While previous studies have examined the relationship between formula use and breastfeeding, some have questioned the results, wondering if mothers using formula were simply less committed to breastfeeding. To examine this objection, the UC Davis team surveyed expectant mothers to determine their intentions toward breastfeeding and then followed them closely after delivery to see how they fared.In the study, 210 babies were exclusively breastfed in the hospital (UC Davis Medical Center), while 183 received at least some formula. Over the next two months, breastfeeding dropped dramatically in the formula group. Between the first and second month, 68 percent of the babies receiving in-hospital formula were not fully breastfed, compared to 37 percent of babies who were exclusively breastfed in the hospital. After two months, 33 percent of the formula babies were not being breastfed at all. By contrast, only 10 percent of the hospital breastfed group had stopped breastfeeding.Perhaps most significant, in-hospital formula feeding dramatically reduced the likelihood of later fully breastfeeding as well as any breastfeeding, even after adjusting for the strength of the mothers’ intention to continue these practices. Early formula use nearly doubled the risk of formula use from the first to the second month and nearly tripled the risk of ending all breastfeeding by the end of the second month.Mother breastfeeding her infant.The study also found that breastfeeding deterrence was dose dependent. In other words, the more formula given to babies during their hospital stay, the less likely the mother would continue breastfeeding. This is the first time researchers have found a relationship between in-hospital formula doses and breastfeeding behavior.Mothers indicated a number of reasons for giving their babies formula in the hospital. Many thought they weren’t producing enough milk. Some thought their babies weren’t getting enough nutrition or were not latching on properly. Chantry notes that sometimes formula is medically necessary and research is needed to better understand how to minimize its negative effects on breastfeeding.Chantry believes this research highlights the value of The Ten Steps to Successful Breastfeeding — evidence-based guidelines to help mothers breastfeed. These include educating women about the benefits of breastfeeding, teaching them how to breastfeed and limiting formula use unless medically necessary.“These results underline the importance of providing comprehensive support for women who wish to breastfeed,” says Chantry. “Doctors and nurses must be trained to help, and lactation consultants must be readily available. We need to do more to help mothers overcome breastfeeding obstacles and limit formula use.”Breastfeeding exclusively — rather than using infant formula — is recommended for the first six months after birth by the American Academy of Pediatrics because of the risks of using formula to the health of both infants and moms. For more information, visit the academy’s breastfeeding policy website.Other authors included Kathryn G. Dewey and Janet M. Peerson, of UC Davis, and Erin A. Wagner and Laurie A. Nommsen-Rivers, of Cincinnati Children's Hospital.This work was supported by Maternal and Child Health Research Branch, DHHS R40MC04294 and NIH 1R21HD063275-01A01. UC Davis Children's Hospital is the Sacramento region's only nationally ranked, comprehensive hospital for children, serving infants, children, adolescents and young adults with primary, subspecialty and critical care. It includes the Central Valley's only pediatric emergency department and Level I pediatric trauma center, which offers the highest level of care for critically ill children. The 129-bed children's hospital includes the state-of-the-art 49-bed neonatal and 24-bed pediatric intensive care and pediatric cardiac intensive care units. With more than 120 physicians in 33 subspecialties, UC Davis Children's Hospital has more than 74,000 clinic and hospital visits and 13,000 emergency department visits each year. For more information, visit children.ucdavis.edu. A U.S. News & World Report best hospital in cancer, cardiology & heart surgery, ENT, geriatrics, gynecology, nephrology, neurology & neurosurgery, orthopaedics, pulmonology and urology » A U.S. News best children’s hospital in neonatology, diabetes & endocrinology, neurology & neurosurgery, *orthpaedics and *urology (*- together with Shriners Hospital for Children — Northern California) » High-performing in abdominal aortic aneurysm repair, heart failure, colon cancer surgery, COPD, hip replacement, knee replacement, lung cancer surgery, and gastroenterology & GI surgery » UC Davis School of Medicine ranks among nation’s best in primary care, research » Betty Irene Moore School of Nursing ranks among the best in the country for master’s-degree nursing programs » UC Davis Medical Center earns 'A' grade for patient safety for sixth time in a row » A Leapfrog Top Hospital for quality and safety, fourth consecutive year » Nation’s highest recognition for nursing excellence » "Most Wired" designation » Read Consumer Choice story » One of only 41 of the country’s 6,500-plus cancer centers to have earned National Cancer Institute (NCI) comprehensive designation » For the fifth consecutive year, UC Davis Medical Center recognized as a "Leader in LGBT Healthcare Equality" » Annual Report (PDF) UC Davis Health System Encompasses Connect with Us Stay connected with what′s happening at UC Davis Health System. Back to top Clinical and Translational Science Center 2921 Stockton Blvd. Suite 1455 | Sacramento, CA 95817 | Telephone: 916-703-9184 © 2014 UC Regents. All Rights Reserved

医学

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UNICEF WCARO - Media Centre - Mali: clean water for a hostile environment – an end to Guinea worm disease? Home Overview Countries Media Centre Resources Français Media Centre Senegal Senegal Sierra Leone Highlights from the region EBOLA Outbreak in West Africa Crisis in the Sahel Mali Emergency Photo essays Photo essays Facts and Figures Mali: clean water for a hostile environment – an end to Guinea worm disease? © UNICEF/Mali/2009/Pirozzi Women fetching water from one of the community’s boreholes in the village of Golombo, Mopti region, central Mali. Bamako, Mali, 23 October 2009 - "I fetch water with my daughters and the other women in the household. Sometimes we have to queue for as longs as two hours at the pump." Swirls of sand and dust engulf the girls as they draw water from a traditional well surrounded by a mud wall. Accessing safe water remains a challenge Once their buckets are full, they put them on their heads and gracefully venture into the endless stretches of dry arid land, seemingly oblivious to the sand blowing into their eyes and up their nostrils. Golombo village, in the semi-desert region of Mopti in central Mali, is a hostile environment, and its population of around 2,300 people have had to learn ways to survive. Their biggest problem is water. The women and girls spend huge amounts of time and energy fetching water, and until the installation of a protected well, that very water was the cause of deadly diarrheal disease, including cholera, and crippling guinea worm infection. Guinea worm infection is caught by drinking standing water or bathing in water that has been contaminated with small fleas infected with the tiny larvae of the guinea worm. On average it takes one year for an infected person to show the symptoms of infection, when the worm, which can grow up to three feet, begins to protrude from the person’s body, most typically from their foot or leg. When it begins to emerge, it causes swelling, fever, possible infection and debilitating pain. There is no cure and the only solution is to assist the worm to slowly wriggle its way out of the person’s body by winding it around a stick, pulling it out a bit at a time. This agonizing process can take weeks. The scourge of the guinea wormThe village head, Amadou Kassambara, can bear testimony to that. "Almost all of us in the village have had guinea worms at least once," he says showing a deep scar on his leg where the worm came out. "I couldn’t walk for six months." Aissata Tangara is fortunate to be one of the few that has never suffered a guinea worm infection, but she has still grown weary from fetching water. She goes to the well five times a day for her extended family household of 62 people. "I fetch water with my daughters and the other women in the household. Sometimes we have to queue for as long as two hours at the pump." But soon the agony of guinea worm infection and the many hours and high level of energy spent on fetching water could be a distant memory. There has been no case of guinea worm in Mopti for the past two years following a successful campaign run by the government, with UNICEF support. The campaign has involved educating the population about how to avoid infection, treating water sources and distributing filters to communities. It is hoped that by 2012 guinea worm will be eradicated from the country. UNICEF supports the eradication campaignAnd gradually, with support from UNICEF and its partners, the Government is providing potable water to more communities. Today, only half of rural communities have access to safe water. The community living in Golombo village recently approached UNICEF to assist in installing a solar-powered potable water supply piped network which will improve water distribution throughout the village so that they will no longer have to pump and queue for long hours. The main challenges are to ensure proper operation and maintenance of the system and to establish a sound pay-as-you-fetch system which will allow setting aside sufficient funds to buy spare parts, pay for repairs and to extend the system as the village grows. According to Dr Moussa Saye, the regional coordinator of the guinea worm eradication campaign in Mopti, maintenance of the new solar water supply system is feasible in a sustainable way. "This community is well organized," he says. "They always manage to cover the maintenance costs of the well they use now. The longest they have had to wait for spare parts for the pump is just one week." This is commendable in a country where communities are poor, spare parts can be scarce and transport is difficult. A community commitment against guinea wormThe 12 committee members, who were elected by their community, explain how they ensure that their current well is maintained. They hope that with more UNICEF supported training they will be able to improve their management skills. The Treasurer, Malik Diallo, explains that each of the 212 households pays 600 francs ($1.10) each year to use the traditional well, which he says, has covered the purchase of spare parts or repairs, usually necessary once a month. Djamina Kassambara, the president of the village women’s group, organizes the women and girls in the village to clean the area around the well every Friday. And if any of the users do not take off their shoes before entering the well enclosure, they have to pay a fine of 100 francs (20 cents) to the committee, which is also put into the kitty for repairs. Kassambara adds that the next management committee should have more women. The present 12-member committee has only two women. "I think the well will be better managed if there are more women on the committee. We women are used to having lots of different responsibilities in our households," she says emphatically. The men in the group nod in agreement. By Ismael Maiga More UNICEF in Mali Resources Search: Email this article

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CONTACT: Susanne Hartman [email protected] Penn Lab Performs Its 2500th Endomyocardial Biopsy Procedure 2-year-old Biopsy Procedure Lab Has Highest Patient-Volume in Philadelphia (Philadelphia, PA) - Another milestone has been reached in the Heart Failure and Transplantation Program of the University of Pennsylvania Health System. In continuing to meet the goals of providing centralized outpatient care services for heart failure and cardiac transplant patients -- a procedure area was built and opened in July 2003 in the Penn Tower building. It was built in this location to accommodate our patients who were already receiving cardiac care services including physician and nursing visits, echocardiography, phlebotomy, exercise testing, financial counseling, social services and research. On September 13, 2005, the heart transplant staff performed the 2500th endomyocardial biopsy procedure at this site. This effort involves coordination of services by staff from the heart failure and transplantation program, the catheterization lab, as well as radiology. Prior to the opening of the procedure area, patients went to the HUP cardiac catheterization laboratory located in the hospital for their biopsy. About the Biopsy… The biopsy procedure is unique to heart transplant patients. Other transplant patients can simply undergo blood or breathing tests to make sure their body is still accepting the donated organ. However, heart transplant patients must, for the rest of their lives, take immune suppression medication and have routine biopsies conducted. During this procedure, a catheter is inserted into a vein in the neck and routed into the right side of the heart. Once in the right ventricle, technicians remove about 4-5 tiny pieces (about the size of a tip of a pencil). These pieces are then sent to pathology to be studied to see if there is any problem with the immune system and rejection of the heart. This is an ongoing process for heart transplant recipients… done weekly, then monthly for approximately 5 years. About the Patient…. He’s 66 years young! After three heart attacks and two operations, Anthony Branco waited a year for his new heart -- and received it in March of 2000. This former Philadelphia police officer and now part-time hospital security guard lives in Northeast Philadelphia. His wife, Linda, is a technician in HUP’s cardiac stress lab. Branco, who earned the nickname of “the Mayor” after spending so much time in the heart failure and transplantation hospital unit while waiting for his donor heart, said “I truly wouldn’t be alive today if it weren’t for the wonderful team here and the donor who gave me his heart.” ### PENN Medicine is a $2.7 billion enterprise dedicated to the related missions of medical education, biomedical research, and high-quality patient care. PENN Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System. Penn’s School of Medicine is ranked #2 in the nation for receipt of NIH research funds; and ranked #4 in the nation in U.S. News & World Report’s most recent ranking of top research-oriented medical schools. Supporting 1,400 fulltime faculty and 700 students, the School of Medicine is recognized worldwide for its superior education and training of the next generation of physician-scientists and leaders of academic medicine. The University of Pennsylvania Health System includes: its flagship hospital, the Hospital of the University of Pennsylvania, consistently rated one of the nation’s “Honor Roll” hospitals by U.S. News & World Report; Pennsylvania Hospital, the nation's first hospital; Penn Presbyterian Medical Center; a faculty practice plan; a primary-care provider network; two multispecialty satellite facilities; and home health care and hospice. This release is available online at http://www.uphs.upenn.edu/news/News_Releases/sep05/endobiop.htm

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Rice Hospital in Willmar, Minn., projects ongoing to offer safe care WILLMAR -- When Rice Memorial Hospital conducted a hospital-wide survey late in 2010 on the organization's patient safety culture, one of the things learned was that information about errors in patient care wasn't being fully captured. Compared to other hospitals of similar size, "our staff tended to report fewer safety events," said Wendy Ulferts, chief nursing officer.Over the past year, Rice has been taking steps to change this and to increase the hospital's ability to collect and act on patient-safety data.It's one of several areas being addressed in Rice's ongoing efforts to provide safe, quality care to patients.Safety is "part of everything we do here at the hospital," Ulferts told the hospital board in a report this past week on the state of safety projects at Rice Hospital."Safety and quality really go hand in hand. It's something we think about in everything we do."From safety reporting to reducing the risk of pressure ulcers and hospital-acquired infections, Rice tackled multiple projects last year aimed at avoiding preventable harm to patients.Statistics bear out the results. According to the hospital's value-based purchasing scorecard, a collection of key measures of safety performance, Rice averaged less than one surgical site infection per 100 surgery cases throughout 2011. No bloodstream infections associated with the use of a central line were reported. The rate of hospital-acquired pressure ulcers was at or below the national benchmark of 9 percent for most of 2011 with the exception of the first quarter, when it was 13.6 percent.Reporting safety-related incidents is just one aspect of Rice's patient safety efforts but it's an important one for the data it provides and the ability to analyze the information in more detail, Ulferts said.A landmark report issued more than a decade ago by the Institute of Medicine estimated that 98,000 Americans die each year due to medical error. The true number is difficult to pin down, however, nor does it include serious injuries, errors that resulted in no injury or close calls. Many patient-safety experts maintain that medical errors are often underreported and hence might not be fully recognized or addressed.Although it's not entirely clear why Rice staff were less likely to report incidents than staff at other hospitals, hospital leaders believed at least part of the reason was the paper-based system being used.One of the hospital's goals last year was to investigate software systems that are easier and do a better job of collecting data, Ulferts said."We really want a system that's electronic, that eliminates paper, that gets to the right people in a timely manner," she said. "We want to give our staff the ability to tell the story about what happened and why it happened, so we can understand."Once the system is in place, it will allow staff to make confidential reports about errors, she said. It also will give hospital leaders the ability to track actual numbers, identify trends or patterns, and analyze more deeply what might be contributing to particular types of errors -- for instance, medication mistakes.As the database grows, it also will enhance the hospital's ability to monitor how specific safety initiatives are faring and whether they're making a difference.Rice also stepped up its staff education last year on safety reporting.Safety reporting continues to be a focus this year but several other projects are under way as well, Ulferts said.One will involve an in-depth analysis of hand hygiene, one of the key ways to avoid spreading infection within the hospital, she said. "How can we get every person in our system to be compliant with hand hygiene?"Another project aims to study interruptions, their impact on safe processes and effective ways to reduce interruptions at critical times.This project is being launched in the pharmacy to start with, and will eventually be expanded to other departments, Ulferts said. "We plan to share this learning across our organization." Explore related topics:NewslocalBusinessNewsLocallocalBusinessbusinessbusinessRiceHealthAnne PoltaAnne Polta covers health care, business/economic development and general assignment. Her HealthBeat blog can be found at http://healthbeat.areavoices.com. Follow her on Twitter at @AnnePolta.

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HealthCorps workers will help with community health programs Two young women, Lucy Shapiro and Jessica Ohland, will be helping out with community health programs in Mendocino County for 10 months this year, thanks to the Community HealthCorps program. Community HealthCorps is a national AmeriCorps program similar to the international Peace Corps program. HealthCorps members work 1,700 hours over about 10 months, while receiving a modest stipend and earning $5,500 in grant funds for education. HealthCorps' mission is to improve access to health care for underserved Americans and also to enhance workforce development for community health centers. This year's HealthCorps members Shapiro and Ohland will be working with the Mendocino Community Health Clinics in Willits, Ukiah and Lakeport on a couple of different projects. The first project is the SMILES school-based dental outreach program. The SMILES team, including licensed dental employees with the three local clinics, goes to local classroom in Lake and Mendocino counties to educate students about dental hygiene. The age-appropriate education focuses on the importance of brushing and the effect of sugar on teeth. This spring, Shapiro and Ohland will be working on MCHC's "patient-centered health home initiative," which works with patients to create care plans to address both acute and chronic problems. This proactive model helps assure that patients get the education and screenings they need to treat health issues before they reach a crisis point. MCHC is working toward national recognition as a pioneering clinic in this new approach. This year's two HealthCorps members have different backgrounds, but a similar dedication to community health. Shapiro is returning for her second year of HealthCorps this year. Originally from the Washington, D.C., suburb of Alexandria, Virginia, Shapiro fell in love with Mendocino County. "I had never been in a place where people recognize you, and you can really make a difference. I feel like I can be part of important changes here," she said. Shapiro attended college in Colorado, but before finishing felt she needed a little real-world experience to guide decisions about her future. HealthCorps provided just that. "I want to do something with nutrition and education, but I'm not sure exactly what," she said. She'll be applying to colleges to begin again next fall, and plans to attend graduate school after that. Ohland was born in South Africa, but she has lived in Mendocino County for the past 10 years. She recently graduated from Sonoma State with a bachelor's degree in cellular and molecular biology, after first attending Mendocino College. Her husband works at the Savings Bank of Mendocino County in Ukiah, so when she finished school, she applied for a position at MCHC. When the MCHC interviewer saw Ohland's impressive resume, she recommended Ohland apply for the HealthCorps position. Ohland plans to attend graduate school to pursue a master's degree in Public Health after her year with HealthCorps. Ohland will be in Willits on October 7 at the Little Lake Health Center table at the HomeTown Healthy Fair at the Willits Community Center.

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How are vaccines produced? UPDATED 10:55 AM CDT Aug 23, 2013 JurgaR/iStock Before we can receive a vaccine it takes many years of research and testing to develop it. Can ovarian cancer vaccines prevent... Should you get the shingles vaccine? Tough questions and straight answers... What vaccinations should your pets get? According to the Centers for Disease Control and Prevention it can take between 10 and 15 years of research and testing before a vaccine is available to the public.The CDC said the first stage in creating a vaccine is for scientists to develop an antigen that can prevent a disease. Once the initial vaccine is created it has to be cleared by the U.S. Food and Drug Administration for more investigation. According to the CDC, at least three more intense clinical trials over the course of several years are conducted to ensure the vaccine is effective and to determine dosage. Researchers also watch for any side effects.In the final phase of testing the vaccine is given to a large test group of tens of thousands of human volunteers, according to the CDC.If the vaccine passes all of the test phases it will await FDA approval. Once this approval is obtained the FDA will ensure the vaccine is safe by testing it and monitoring its production facilities, according to the CDC and the FDA. The FDA says it also monitors the vaccine long-term to document any reactions to the vaccine.

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/ Health Care Reform UPDATED 10:53 AM EDT Sep 20, 2013 Wyoming State Affordable Care Act overview The Affordable Care Act is the nation's health reform law enacted in March 2010. It contains numerous provisions designed to expand health coverage to 30 million Americans; increase benefits and lower costs for consumers; provide new funding for public health and prevention; bolster our health care and public health workforce and infrastructure; foster innovation and quality in our system, and more.Many Americans have misgivings about the Affordable Care Act. A CNN/ORC poll conducted in September 2013 showed support for the law at 39 percent, down from 51 percent in January 2013. Opponents say the country can't afford the ACA. They say it won't cut the cost of health care, but will expand the deficit, weaken the economy and cause employers to cut jobs. The Republican-led House of Representatives has voted dozens of times to repeal all or part of the law, but those efforts have gone nowhere in the Senate, where Democrats have the majority. President Barack Obama has postponed implementation of the so-called employer mandate until 2015, but shows no indication he will back down on what many consider to be the signature accomplishment of his first term. The law consists of two pieces of legislation: the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act (HCERA). Jointly they are referred to as the Affordable Care Act or ACA. The information below comes from the U.S. Department of Health & Human Services.How the ACA may affect WyomingBecause of the Affordable Care Act, the 83 percent of Wyomingites who have insurance will have more coverage choices than before. And for the 17 percent of Wyomingites who don't have insurance, or Wyoming families and small businesses who buy their coverage but aren't happy with it, change is coming.Soon, the new online Health Insurance Marketplace will provide families and small businesses that currently don't have insurance, or are looking for a better deal, a new way to find health coverage that fits their needs and their budgets. Open enrollment in the Marketplace starts Oct. 1, with coverage starting as soon as Jan. 1, 2014. But Wyoming families and small businesses can visit HealthCare.gov right now to find the information they need to prepare for open enrollment.The ACA provides Wyomingites:Cheaper prescription drugs for people with Medicare$3,550,375 in total savings for 5,540 seniors, averaging $640.86 in savings per person in 2011Free preventive services102,000 people and 48,673 seniors with Medicare get preventive services for freeNo more lifetime limits on care196,000 people no longer have a lifetime limit on their careHealth insurance on your parents' plan5,481 more young adults under age 26 now have insurance on their parents' planNew rules on how insurers spend premiums152,000 people protected by the 80/20 rule that requires insurers to spend 80 percent of premiums on care and qualityCoverage through a pre-existing condition insurance plan137 people who were uninsured because of a pre-existing condition now have coverageAffordable Insurance Exchange$800,000 to help states build new marketplaces where consumers will have the same kinds of choices as members of CongressMoney for public health$2,300,000 in grants to improve public healthCommunity health centers$13,700,000 to support and expand community health centers International Foundation of Employee Benefit Plans

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Production puts care in spotlight Kevin Horrigan, St. Louis Post Dispatch “Perhaps not surprisingly in a country where health care reform is so controversial, it was the high-profile presence of the NHS that stunned many American writers. ... Certainly the U.S. equivalent, which would be dancing health insurance corporate executives, was hard to imagine.” — Paul Harris, in The Guardian, July 28 Hah, hah, hah. Very funny. It’s not hard at all to imagine what the “U.S. equivalent” to your Olympic Opening Ceremony’s salute to Britain’s National Health Service would look like. I’m already working on it. Sure, “dancing health insurance corporate executives” will be part of it. If you’d made that much money last year, you’d want to dance, too. “Executives in the top spots at the country’s seven largest publicly traded health plans were paid a collective $87 million for their services in 2011,” American Medical News reported in May. Picture this: It’s night in Florida. We’re in a darkened Raymond James Stadium in Tampa, jammed with 66,000 delegates to the Republican National Convention and their guests. A spotlight illuminates the stage. The seven top health care CEOs, carrying canes and dressed in white top hats and tails, prance on stage as the Mormon Tabernacle Choir sings “Puttin’ on the Ritz.” Pretty nice, huh? And that’s just the start. The spotlight widens to show 94 primary care doctors, in multi-colored scrub suits, forming a ring around David Cordani, the CEO of Cigna Health Care, bowing and scraping to honor the fact that at $19.1 million, Cordani made more in 2011 than all 94 of them combined. The orchestra breaks into Gershwin’s “It Ain’t Necessarily So” as the stadium floor is lighted, revealing 400 actual health insurance bureaucrats wearing telephone headsets and sitting at small desks. They shake their heads back and forth in our “Salute to Rescission.” The crowd erupts, because fans know that if Republicans repeal the Affordable Care Act, God will be in his heaven, all will be right with the world and insurance companies once again will be allowed to retroactively cancel coverage when someone needs it. But now! What’s that? Lights around the stadium’s upper tier are forming a large donut, signifying the “Medicare donut hole” that will return once “Obamacare” is eliminated, thus insuring that drugs for anything between basic coverage and catastrophe are not covered. The orchestra swings into “Live and Let Die.” Cannons in the end zones fire clouds of pills into the sky. As they fall to the floor, out of the stadium tunnels limp thousands of senior citizens who are allowed to scrounge for the pills. But only for three minutes, because it’s time for our.... Tribute to the ER! Giant video boards flash the image of former President George W. Bush uttering these immortal words in 2007: “I mean, people have access to health care in America. After all, you just go to an emergency room.” The theme from the TV show “ER” comes up as sirens wail, ambulances and EMS trucks tear around the stadium floor, disgorging patients into the busy “emergency department” on center stage, already jammed with insured adults and children who have no primary care doctors. Our ER “treats” them and send them on their way with big weights (symbolizing hospital bills) strapped to their backs, which they then pass to the people in the crowd — who are delighted to get them! On guy-wires stretched across the top of the stadium a huge number “17.6” sparkles in gold and silver lights. It represents the percentage of the gross domestic product devoted to health care — 8 percent higher than the Brits. The music swells into Creed’s “Can You Take Me Higher?” The crowd sings along, waving 66,000 foam “We’re Number 1” fingers, signaling America’s status as the nation with the most expensive health care in the world — 2.4 times more expensive than the silly Brits. KA-BOOM! go the fireworks. We crane our heads skyward to see a giant figure “37,” symbolizing the World Health Organization’s ranking of the American health care system. The big finale: With the crowd’s attention diverted skyward, volunteers—all of them from health insurance companies—have erected cardboard cutouts of men, women, children and babies around the floor of the stadium. There are so many of them — 45,000 — that they loop around the field in a squiggly line almost a mile long. They represent the 45,000 Americans whose lack of health insurance contributes to their premature death each year, according to a 2009 study by the Harvard Medical School. Now riding into the stadium atop Rafalca, his wife’s Olympic dressage horse, is Mitt Romney, who will be nominated for president on the following night. He guides the mare’s nose to the first cardboard figure. A simple nudge and, like dominoes, they topple over in spectacular sequence. The crowd goes wild. — Kevin Horrigan is a columnist for the St. Louis Post-Dispatch. His email address is [email protected]. Health care overhaul may mean longer ER waits Opinion: U.K.’s NHS is warning for U.S. A step toward inhumanity This is not funny, at all. Everyone knows that Americans can't be truly free unless we have the most expensive healthcare in the world, and deny access to care to millions upon millions of people. Freedom only comes with massive die-offs of poor and working class people, and $multimillion pay packages to CEO's. God told me. Do a search on "NHS scandals" & see how rosy everything looks across the pond. 0 Paul R Getto Good column. weeslicket how in the dolph simons' worldview did this editorial even see the light of day?? geeze. i think i'll tune in for all of that.

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Log into HealthPathways Hunter New England Live Remember my login details How to access Hunter & New England HealthPathways If you are a health professional in Hunter & New England and would like to have access to the Hunter & New England HealthPathways website, please contact the Hunter & New England HealthPathways Team who will provide you with a username and password. The Team can be contacted via email What is HealthPathways? HealthPathways is web-based information portal supporting primary care clinicians to plan patient care through primary, community and secondary health care systems within Hunter & New England. It is like a 'care map', so that all members of a health care team – whether they work in a hospital or the community - can be on the same page when it comes to looking after a particular person. HealthPathways are designed to be used at the point of care, primarily for General Practitioners but is also available to Hospital Specialists, Nurses, Allied Health and other Health Professionals within Hunter & New England. Please read this disclaimer before using the information on this site. Please note that this site contains two types of pathways: Localised pathways, for the care and management of patients within the Hunter and New England Region, have been developed jointly by local general practitioners, specialists and other health care providers. Canterbury Initiative (New Zealand) pathways, indicated with a silver fern in the background, have been developed jointly by NZ primary and secondary care clinicians for care of people in the Canterbury Region. The information in the Canterbury Initiative pathways have not yet been localised and there is some content that will not be relevant to the local Hunter and New England Region. The pathways are designed for use by all clinicians with an emphasis on primary care. They are not designed for access or use by non-regulated health service providers or patients. The pathways are intended for use as a guide only and are not intended to replace clinical decision making. You should exercise your own clinical judgement and use other pertinent clinical data when treating your patient. However, in view of the possibility of human error or changes in medical sciences, neither the editors, nor the publisher, nor any other party who has been involved in the preparation or publication of this website, warrants that the information provided is in every respect accurate or complete, and shall have no liability for any loss or damage arising from reliance on this information. The inclusion of links to websites or health providers in HealthPathways is not a recommendation or endorsement of any health provider, health professional, or their services. Use of services featured in these websites is undertaken at the user's own risk. Information about qualifications and registration status of health providers may be found on the Australian Health Practitioner Regulation Agency website. This site is intended to be responsive to the needs of clinicians and their patients and is frequently updated. While every effort has been made to ensure accuracy, currency cannot be guaranteed and all information should be verified before use.

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HomeLabs / ProjectsVaccine and Infectious Disease DivisionNewsFaculty Stories A look at computational methods for analyzing large amounts of data with Raphael Gottardo Vaccine and Infectious Disease Division Rachel Tompa VIDD associate member Dr. Raphael Gottardo came to the Pacific Northwest from Lyon, France, to complete a PhD in Statistics at the University of Washington. He spent the last five years in Canada, as an Assistant Professor of Statistics at the University of British Columbia in Vancouver, and leading a group of computational biology researchers at the Institut de Recherches Cliniques de Montréal, before moving back to Seattle in August to join VIDD. Photo by Phil Meadows. Biologists are often faced with daunting amounts of numbers, and have to find ways to sift through these piles of data before being able to understand the results of their experiments. In some cases, scientists turn to statistics to interpret large sets of results. In other cases, the type of experiment necessitates some mathematical or computational manipulation before the results are even available. New VIDD associate member Dr. Raphael Gottardo is developing computational tools to help in the latter case, methods that will help scientists better extract answers from their experiments. “We’re trying to develop new tools to help scientists better analyze their data and answer biological questions in these very large data sets,” Gottardo said. Specifically, his group focuses mainly on flow cytometry, an experimental technique that can detect subtle differences in a large group of mixed cell types or other particles by passing the cells in liquid one at a time past a source of light and an instrument that measures how that light bends around each passing cell. VIDD and other immunology researchers rely heavily on flow cytometry in much of their work, as it is a useful technique to learn about the myriad different types of immune cells present in a given patient’s blood. Often, these cells are first marked with different fluorescent dyes that react only with specific proteins, and then the flow cytometer reads how many cells in the overall sample have that protein present. Modern techniques allow scientists to use many different dyes that react to different wavelengths of light, enabling them to concurrently detect the presence of many types of immune or other cells in a sample. The problem comes when “gating” the results, or determining from the raw data the machine produces which groups of cells truly have or don’t have that fluorescent marker. Where to place these cut-offs is not always straightforward, Gottardo said, and different scientists may gate the same experiment in different ways. Gottardo came to VIDD in August from a faculty position in the Department of Statistics at the University of British Columbia and is new to the field of infectious diseases. At VIDD, Gottardo makes use of his computational background to develop novel tools and methods for high throughout biological assays used in immunological and vaccine research, such as antigen microarrays and flow cytometry. One of his group’s main areas of focus is the development of automated algorithms that could be used to gate flow cytometry data. This approach is challenging in part because of the lack of precision. “It’s hard to know if the tool works, because there’s no agreement among the scientists on what the correct answer should be,” Gottardo said. Additionally, since scientists using flow cytometry are traditionally used to gating their experiments by hand, some are resistant to trying out Gottardo’s computational methods. However, as the technology advances, researchers are able to use many more types of dyes in a single experiment and search for many more types of cells, making the piles of resulting data much larger and the time to manually gate all the results longer. Gottardo feels his methods could save scientists significant chunks of time. To help convince scientists to try out his approach, Gottardo and colleagues from four other institutions are leading the Flow Cytometry Critical Assessment of Population Identification (FlowCAP) project. The goal of FlowCAP is to advance the development of computational methods for the identification of cell populations of interest in flow cytometry data. FlowCAP will provide the means to objectively test these methods, first by comparison to manual analysis by experts using common datasets, and second by comparison to synthetic data sets having known properties. Along with other FlowCAP committee members, Gottardo organized a special flow cytometry meeting this past September, sponsored by the National Institutes of Health. The meeting allowed the computational scientists to demonstrate to other researchers how their methods compared to manual gating. Gottardo and his colleagues collected many different flow cytometry data sets from past experiments and used the consensus of the manual gating on these sets to calibrate his computational tools, then allowed the flow cytometry experts to try their hand at gating the same sets in comparison to the automatic gating. The meeting was a success, Gottardo said. Many of the attendees were convinced that the computational methods were just as good as manual gating, but faster, and he drummed up so much interest in the methods that FlowCAP2 is already in the works for Summer 2011. Gottardo stresses that these computational methods may never surpass what a trained human can do by hand, but the overall goal is to make the scientists’ lives easier. “What I’m hoping is that we’ll get to the level where people will use our algorithms, and they will still have to sit in front of the computer, but will only have to review a handful of the samples,” Gottardo said. “Hopefully this will save them a lot of time at the end of the day.” For more information on Gottardo’s work, visit the Gottardo lab website here.

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An Interview with Dr. David Altchek David W. Altchek, MD Attending Orthopaedic Surgeon, Hospital for Special Surgery Co-Chief Emeritus, Sports Medicine & Shoulder Service, Hospital for Special SurgeryProfessor of Clinical Orthopaedic Surgery, Weill Cornell Medical College In the general population, injuries to the elbow are rarely caused by stress inflicted on the joint while throwing. But for serious amateur pitchers and their professional counterparts, who may be throwing the ball between 70-100 miles an hour, each pitch places a high degree of force on the joint. Over time, this repetitive motion can lead to inflammation, cartilage injuries, the development of bone spurs, and eventually tearing of the medial collateral ligament (MCL). The MCL is part of a complex of ligaments and tendons that attach and stabilize the bones of the lower and upper arm where they meet at the elbow. Specifically, the MCL attaches the ulna - which, together with the radius, make up the bones of the lower arm - with the humerus, the bone in the upper arm. When the MCL is torn, the individual retains full range of motion in the joint and the ability to throw, but cannot exert significant force. MCL tears are often the result of a gradual process of attenuation; it may not be immediately apparent that the ligament is torn. However, some people report hearing a pop at the time of injury. Medial collateral ligament (MCL) Fortunately, surgical treatment of MCL tears often yields excellent results. Known by baseball fans everywhere as the "Tommy John surgery" - named for the pitcher with whom it is most frequently associated - construction of the medial collateral ligament benefits both professional and amateur athletes. The surgery used to reconstruct the MCL in Tommy John's left arm almost thirty years ago, was developed by Dr. Frank Jobe. Since then, hundreds of athletes have undergone the procedure in which a tendon is taken from another part of the body and acts as a replacement for the injured ligament. The usual source for the tendon is the palmaris longus, a vestigial structure in the forearm. A second choice is the accessory hamstring tendon. Palmarus longus "Before Dr. Jobe developed this surgical technique, an MCL tear was often a career-ending injury," says David W. Altchek, MD, who is an associate attending orthopaedic surgeon at HSS. "Today, athletes that undergo MCL reconstruction often play as well as they did before the surgery, and, in some cases even better." It should be noted, Dr. Altchek adds, that non-athletes may also develop a full or partial tear to the MCL. However, because their daily activities are seldom affected, there is usually no need to undergo surgical treatment. Today, athletes with MCL tears can benefit from refinements to Dr. Jobe's techniques that have been developed by Dr. Altchek and his colleagues at HSS. Dr. Altchek begins treatment with an arthroscopic examination of the affected area. (For more information on elbow arthroscopy, please see the link at the end of the article under Further Reading.) After addressing any other conditions that are present in the joint, such as bone spurs, the orthopaedic surgeon makes an incision to reveal the medial or inner aspect of the elbow joint. If possible, he or she then reattaches the remaining portion of the MCL. The harvested tendon graft is threaded through holes created in the ulna and humerus and sutured to stabilize the joint. Illustration showing insertion of the tendon graft. Dr. Altchek's technique differs from Dr. Jobe's in that only one hole is made in the humerus bone versus the three Dr. Jobe used. This offers a protective benefit to the bone which is more vulnerable to fracture if it has multiple holes in it. Dr. Altchek also found a way to simplify the tensioning of the graft and developed a special stitch that provides more secure fixation of the tendon to the bone. During the original procedure, the orthopaedic surgeon took off the overlying muscles and moved the nerve away from the site in an effort to reduce the chance of injury. However, this approach carried the risk of trauma to both muscles and nerves. Today, orthopaedic surgeons are able to use a safer muscle-splitting technique that minimizes trauma to the muscles. Moreover, in most cases when Dr. Altchek performs the surgery, he does not find it necessary to move the ulnar nerve. Adding to the safety of the newer technique is the shorter operative time. Traditionally, MCL reconstruction was performed over a period of about four hours; it can now be completed in about 30 minutes, thus reducing the chance of infection. Recovery from MCL reconstruction is lengthy. The patient must wait 9-12 months for the ligament to be healed into the bone. During this period, he or she participates in a rehabilitation program in which an increasing amount of force is gradually applied to the elbow and the muscles are strengthened. Most athletes can return to competitive play in a year. Results of the surgery are generally excellent. In a recent study in which Dr. Altchek used the modified technique, 30 out of 31 patients who underwent surgery were able to return to their previous level of competition over an 11-month period. While the incidence of MCL tears is high among elite major league baseball pitchers, Dr. Altchek points out that this is not the only population that experiences the injury. Women softball players may injure the ligament while playing catcher or short stop. Javelin throwers, lacrosse and tennis players, and golfers are also vulnerable, especially those who are middle-aged or older and may have some long-term degeneration of the ligament. In addition, children who participate in little league may injure the ligament. These tears are less frequent than in adults because young people do not throw as hard and their ligaments are more elastic; however, they do occur sporadically. Treatment in children may be modified owing to concern over protecting the growth plate in the joint. Reviewed: 12/7/2009 Summary Prepared by Nancy Novick *Illustration of (MCL) provided courtesy of Bartleby.com Related Patient Articles SPECIAL REPORT: Use of Tommy John Surgery for Young Elbows on the Rise Modifications to "Tommy John Surgery" Improve Outcomes for Baseball Pitchers, Other Athletes

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You are hereHome » Institutes at NIH » NIH Office of the Director » Office of Communications & Public Liaison Office of Communications & Public Liaison Office of Communications & Public Liaison OCPL Organization Chart OCPL Staff Directory Freedom of Information Act Office Clear Communication How NIH Brings Health and Science to the PublicNIH communicates science and health to patients, families, scientists, industry, teachers and students, health professionals, and the press. As a public agency, NIH is committed to ensuring that accurate information reaches the diverse American public. Where can I find NIH resources on science and health? NIH Health Information has health tips, podcasts, and fact sheets on diseases and many science/health topics. Research Matters puts breaking science in context, in an understandable format. The NIH News in Health free monthly newsletter gives practical health information. The NIH YouTube channel hosts videos and interviews about health and science. The NIH Twitter Feed, @NIH, provides news releases and special announcements in 140 characters or less. Find out what's happening at the National Institutes of Health through the NIH Facebook Page. Access free research articles and consumer health information through NIH’s National Library of Medicine, the world's largest medical library. Subscribe to NIH newsletters, page updates, bulletins, and RSS feeds. NIH's 27 Institutes and Centers produce easy-to-understand educational materials about health and science, and many of these resources are available in Spanish and other languages. Does NIH provide health advice for patients with specific diseases? No, the NIH web site does not offer personalized medical advice to individuals about their condition or treatment and urges online visitors to work with medical care providers for answers to personal health questions. Visit the FDA web site for answers to questions about specific foods, prescriptions, or over-the-counter medicines. I am a student. Can I do research at NIH? Yes, NIH sponsors summer internships for high school and college students, and various other programs for graduate and medical students. How does NIH interact with students and teachers? The free NIH Curriculum Supplement Series is a set of K–12 interactive teaching units that combine cutting-edge NIH research discoveries with state-of-the-art instructional materials. These 2-week lesson plans on science and health are aligned with state and national science education standards and incorporate real scientific data. How does NIH interact with the press? NIH works directly with the press every day, answering questions about health, the latest scientific findings, and science policy issues. Some reporters work regularly with science and/or health information and are constantly looking for new stories with health implications. Other reporters do not have a science background, and NIH works hard to give them accurate and understandable explanations of complex science and health information. What about scientists — should they talk to the press? Yes, it is important for medical scientists to convey to the public the meaning and implications of taxpayer-funded research. NIH works regularly with a community of scientists who are extremely engaged in this process and who want to share their knowledge of science and health with the public. While some researchers are better at talking directly with the press or with the public, others help in different ways, by developing health resources, participating in meetings, or in reviewing materials for accuracy. How can reporters learn more about science and medicine at NIH? With the public's increasing appetite for health news and information, it is more important than ever that journalists covering health and medical science have the skills to critically evaluate and translate research reports into meaningful messages for the public. Keep track of developments in science, personnel, and policy at NIH by subscribing to the online version of the NIH Record. How can I find NIH-sponsored educational programs across the U.S.? NIH's Science Education Partnership Award (SEPA) program, which brings together researchers, educators, community groups, and other interested organizations in partnerships to create K–12 educational materials. This page last reviewed on July 14, 2016 Connect with Us

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A record month for hospital’s OR May 31, 2012 7:45 p.m. Effingham Health System announced that Surgical Services (OR) had a record-breaking month in April. The hospital campus underwent an expansion and modernization project last year, and the new facility officially opened its doors in February. The two new state-of-the-art operating suites were well utilized by EHS’ visiting surgeons, and the staff is hoping for another record-breaker in May. The surgery department provides the growing complement of specialists with plenty of space to perform a wide variety of surgeries and procedures, all close to home. In addition to the new operating suites, the facility has seven larger, private surgery preparation bays which offer comfortable spaces to patients and family members. Three well-appointed recovery suites provide privacy to help patients make the transition to discharge, or an overnight stay, as needed. "We are so proud of our OR staff for the smooth transition to the new space," said Patricia Parrish, OR manager. "These new operating suites are a dream come true for those of us who were making do with the old OR. You can see that the differences are really appreciated by the physicians familiar with our former arrangements, and new physicians are impressed when they get a chance to tour. We are attracting new physicians every day and expanding the services we can provide right here close to home. We’re especially excited about our new orthopaedic surgeon, Dr. Mark Mudano, and we hope people will remember we’re here when they have need for joint replacement or repair." The new surgery department and the additional surgeons traveling to Effingham County to provide care are just a couple of the many ways Effingham Health System is advancing medicine in the community. "We congratulate the surgical staff as well as our valued physicians for this record-breaking month," said Norma Jean Morgan, CEO of Effingham Health System. "It’s our doctors, nurses and supporting staff that make EHS a great place to access healthcare services, and we always want to be your first choice."

医学

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Section Menu Alzheimer's Disease NYS Reports/Data Where Can I Get Help? Resources for Caregivers Clinical Trials and Research Alzheimer's Disease and Other Dementias > FAQ's What is Dementia? Dementia is a gradual and progressive loss of memory, thinking and reasoning skills, as well as physical function. Alzheimer's disease is the most common cause of dementia. What is Alzheimer's Disease? Alzheimer's disease is a progressive, irreversible brain disorder that gradually destroys a person's memory, ability to learn, reason, make judgments, communicate, and carry out daily activities. As the disease progresses, individuals may develop changes in personality and behavior and become anxious, suspicious or agitated. They also may suffer from delusions or hallucinations. Who is Affected by Alzheimer's Disease? Alzheimer's disease primarily affects individuals over age 65. One in 10 people over age 65 and nearly half of all individuals who reach the age of 85 will develop Alzheimer's disease. Because of the nature of the disease, Alzheimer's has a tremendous impact not only on those diagnosed with it, but also greatly affects their families and caregivers. How Widespread is Alzheimer's Disease? An estimated 5.4 million Americans of all ages have Alzheimer's disease in 2011. This figure includes 5.2 million people aged 65 and older and 200,000 individuals under age 65 who have younger-onset Alzheimer's. In New York State, an estimated 320,000 residents have Alzheimer's disease and related disorders. Given the increase in the older population, especially the proportion of the population over 80 years of age, it is anticipated that the number of individuals with Alzheimer's disease in New York State will increase to 350,000 by 2025. What Causes Alzheimer's Disease? Alzheimer's disease is caused by abnormalities that disrupt the ability of nerve cells in the brain to communicate with each other. While there is no single event that triggers the disease, there seem to be a number of factors that play a role in its development. There are certain genetic, non-genetic and biologic factors that increase the risk of developing Alzheimer's disease. Studies have begun to identify relationships between physical activity levels, dietary factors, inflammation, cardiovascular conditions, brain health, and control of chronic diseases like diabetes to name a few. Does My Family History Increase My Risk for Alzheimer's Disease? Yes. Researchers have discovered a number of genes that increase the risk of developing Alzheimer's disease. Although people with a family history of Alzheimer's disease are generally considered to be at heightened risk of developing the disease themselves, many people who have relatives with Alzheimer's disease never develop the disease, and many without a family history of the disease do get it. In most cases, it is impossible to predict a specific person's risk of the disorder based on family history alone. Those who have a parent, brother, sister or child with Alzheimer's are more likely to develop the disease. The risk of Alzheimer's does increase if more than one family member has the illness. When diseases tend to run in families, either heredity (genetics) or environmental factors, or both, may play a role. What Are the Symptoms of Alzheimer's Disease? Symptoms vary widely; however, the first sign of the disease is most often forgetfulness that begins to affect an individual's daily routine. Other warning signs include: difficulty performing familiar tasks like cooking; problems with language; disorientation to time and place; poor or decreased judgment, misplacing things; and changes in mood or behavior. There also can be changes in personality and loss of initiative, such as no longer being interested in previous hobbies or activities. Another common symptom is reduced capacity to grasp ideas that do not relate to an individual's personal experiences. Can Alzheimer's Disease be Prevented? While scientists are uncertain what causes Alzheimer's disease, some preliminary research suggests that general strategies for healthy aging reduce the risk. Some studies support the value of lifelong learning and engaging in activities that are mentally stimulating. There is clinical evidence that suggests physical and mental function improves with aerobic fitness. Some healthful actions include lowering cholesterol levels, controlling blood pressure, weight and diabetes, and exercising the body and mind. Read more: Alzheimer's Association - Prevention Alzheimer's Disease - Memory Games HBO Series on Alzheimer's Disease How is Alzheimer's Disease Diagnosed? Early diagnosis can improve the quality of life and may help resolve anxiety related to wondering what is wrong when the disease begins to interfere with an individual's daily life. However, with the exception of an autopsy after death, no single test can determine whether an individual has Alzheimer's disease. Diagnosis involves a complete physical and neurological examination, including laboratory tests, and a psychiatric assessment. The tests take more than one day and are usually performed on an outpatient basis. In addition to the individual for whom the diagnosis is being made, other family members may be interviewed in order to gather information about the patient's behavior. How Is Alzheimer's Disease Treated? There are approved drugs that help treat the symptoms of Alzheimer's disease. Some drugs may temporarily delay memory decline in some individuals and other drugs help treat the emotional and behavioral symptoms. Additionally, there may be individualized mental health interventions that go beyond drugs or using restraints to treat aggression sometimes associated with Alzheimer's disease. Clinical trials that compare a potential new strategy with a standard one or with a placebo may be yet another approach to treatment. Is There A Cure? While scientists are continually seeking new treatments for Alzheimer's disease, there currently is no cure available for this degenerative condition. Revised: August 2013

医学

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History of Hom�opathy Presented by Sylvain Cazalet HOMAS, AMOS RUSSELL, M. D., of Philadelphia, Pa., was born at Watertown, Jefferson county, N. Y., on the 3d of October, 1827. His father was Colonel Azariah Thomas, who served under General Jacob Brown, on the Northern Frontier, in the war of 1812. Thrown upon his own resources at an early age, Dr. Thomas acquired his education, both literary and professional, by his unaided individual efforts. Living in the country until nearly twenty years of age, by manual labor upon a farm, he acquired a robust and vigorous physical constitution. His love for books led him to devote his evenings and other intervals of leisure to study, and in this manner he qualified himself, and commenced teaching school in the western part of New York, in 1846. In 1850, he engaged in mercantile pursuits in the village of Ogdensburgh, N. Y. Finding this employment an uncongenial one, his predilection for the Medical profession was strong. By getting possession of an old Indian skull which was exhumed in making the excavation for a cellar near his place of business, and borrowing a work on anatomy for the purpose of studying this skull, he became so interested in the subject, as to abandon his previous plans, and engage at once in the study of medicine. Entering the Syracuse Medical College in 1852, he graduated in February, 1854. Coming immediately to Philadelphia, he took another course of lectures, and graduated at the Pennsylvania Medical University. Being offered the position of Demonstrator of Anatomy in that institution, he concluded to make Philadelphia his future home, and in 1856 ; he was appointed to the chair of Anatomy, which position he filled for ten years. In 1856, he was appointed lecturer on Artistic Anatomy, in the Pennsylvania Academy of Fine Arts, where he gave annual courses of lectures to artists and art students, up to the time of the sale of the old Academy building in Chestnut Street, with the exception of two years during the war. These lectures were the first of the kind ever given to art students in America. In 1863, he was appointed lecturer upon the same subject in the School of Design for Women, where he has since given annual courses of lectures. After the second battle of Bull Run in the late war of the rebellion, Dr. Thomas volunteered his services as surgeon, and was assigned a position in the Armory Square Hospital at Washington, where he remained in charge of one of the wards until the wounded from that disastrous field were cared for. Becoming interested in an examination of the merits of hom�opathy soon after settling in Philadelphia, he was led to adopt that system of practice. In 1867, he was appointed to the chair of Anatomy, in the Hahnemann Medical College of Philadelphia, which position he still holds. As a lecturer on anatomy he has acquired a reputation for clearness and accuracy, and for an impressive manner which at once attracts and retains the attention of the student. In addition to attending to a large professional business, Dr. Thomas has found time to contribute a number of papers to the medical journals, besides writing a work on "Post Mortem Examinations and Morbid Anatomy," which is just ready for the press, and to act as General Editor of the American Journal of Hom�opathic Materia Medica. Source : Cleave's Biographical Cyclop�dia of Hom�opathic Physicians and Surgeons By Egbert Cleave Copyright � Sylvain Cazalet 2002 HOMAS, AMOS RUSSELL, professor of anatomy in Hahnemann Medical College of Philadelphia and its predecessor institutions for full forty years, dean of the faculty for more than twenty years, and one of the most loyal friends any school of medicine ever had, was born in Watertown, Jefferson county, New York, October 3, 1826, and died at his country home, Llangollen, Devon, Pennsylvania, October 31, 1895. During the period of his long and useful life in the ranks of the medical profession no man contributed more than he in elevating the standard of the hom�opathic school ; no man taught with more earnestness or better results, and no man gave more abundantly or freely in advancing the interests of the hom�opathic profession in general, whether in teaching, writing, or personal endeavor without the hope of recompense. Still, Dr. Thomas' endeavors in behalf of hom�opathy were not unrewarded, for no man in the profession was more universally respected than he, and none enjoyed a wider circle of friendships ; and withal his professional life was successful and he was enabled to live in comfort to the end of his allotted three-score years and ten. Best of all, he was a self-made man, having carved his own way in life from the days of his young manhood. His father was Colonel Azariah Thomas, of an old family in the St. Lawrence region in Northern New York and who served as an officer under Major General Jacob Brown during the second war with Great Britain. He was of Welsh descent, but his American ancestors were among the early families of Massachusetts. His young life was spent on the farm, and he was brought up to hard work. His education, both elementary and professional, vas the result of his own unaided effort, and was acquired largely by study at home, frequently at night. He taught school for a time, but in 1850 engaged in mercantile pursuits in Ogdensburg, St. Lawrence county, New York. Two years later, 1852, he entered Syracuse Medical College, and graduated M. D., 1854. He then went to Philadelphia and attended lectures at the Pennsylvania Medical University, where he graduated, and for the next three years he was demonstrator of anatomy. As a teacher of anatomy his work soon attracted attention and other schools began to draw on him for service. In 1856 he was appointed to the professorship of artistic anatomy in the Pennsylvania Academy of Fine Arts, which position he held fourteen years. In 1863 he was appointed to a similar position in the School of Design for Women, Philadelphia, and served in that capacity eight years. During the war of 1861-1865, after the second Bull Run battle, he offered his services to the government as surgeon and was stationed for a time in the Armory Square hospital in Washington. During these early years of his professional life Dr. Thomas had given much serious thought to the subject of hom�opathy, and as his investigations proceeded he became convinced of the superior worth of the teachings and principles of the Hahnemannian school, and he accepted them, freely and fully, and arrayed himself unequivocally with those who held to the theory of similia similibus curantur. In 1860 Dr. Thomas was called to the chair of anatomy in the Hahnemann Medical College of Philadelphia, and from that time to 1895 he held that professorship and performed its duties ; from that time he was an important factor in the life of the school, and by his determined force of character sustained and upheld it. He was a tower of strength in the faculty, and possessed excellent business qualities, hence his appointment to the deanship in 1874 was only a natural result. This office he held until the time of his death, a period of twenty-one years. In the early part of 1894 Dr. Thomas was impelled by failing health to relinquish active professional work and to remove from Philadelphia to his country home at Llangollen, Devon, away from the busy life of the great city ; but he continued his course of lectures until the middle of November of the year mentioned, when he was stricken with a complicated malady from which he never recovered. In May, 1895, he was removed to his home in Devon, where he was confined to his bed until death relieved his sufferings, October 31, 1895. On May 8, 1894, the alumni of the college celebrated the fortieth anniversary of Dr. Thomas as professor of anatomy, and on that occasion the loyal sons of the institution raised a fund of five thousand dollars for the endowment in perpetuity of "The Amos Russell Thomas Free Bed" in the Hahnemann Hospital in Philadelphia. Dr. Thomas was interested in the institutions of hom�opathy and others of varied character. He was a member and a conspicuous figure in the work of the American Institute of Hom�opathy, the Pennsylvania State and Philadelphia County Hom�opathic Medical societies, the Fairmount Park Association of Philadelphia, the Pennsylvania Horticultural Society, the Academy of Natural Sciences, the Historical Society of Pennsylvania, and of the anatomical board of the state of Pennsylvania. His contributions to the literature of hom�opathy include many monograph articles in published magazines and pamphlets, and for five years he was general editor of the "American Journal of Hom�opathic Materia Medica." He was author of "Post-Mortem Examinations and Morbid Anatomy," a work which was highly commended in hom�opathic medical circles ; "Diseases of the Pancreas," "Evolution of Earth and Man," "History of Anatomy," "History of the Descendants of William Thomas of Hardwick, Mass. (1678-1890," "A New Preparation of the Nervous System," etc. His writings, like his lectures and public addresses, were always clear, clean, free of verbiage and perfectly consistent, reflecting the man himself, who was devoid of vanity or ostentation, yet always courteous and dignified -a gentleman of the best type, and, withal, of splendid personal appearance and strikingly handsome face. Dr. Thomas married Elizabeth Bacon, of Watertown, New York, who bore him two children, Charles M. Thomas, A. M., M. D., of Philadelphia, professor of ophthalmology and otology and dean of the faculty of Hahnemann Medical College and Hospital of Philadelphia ; and Florence Thomas, who married Dr. J. Nicholas Mitchell, and died in 1880. Source : History of Hom�opathy by William Harvey King

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How Some Parents Could Learn Adult Daughters' Birth Control Habits By editor Oct 2, 2012 ShareTwitter Facebook Google+ Email An insurer's note could tip parents to their adult daughter's use of the pill. Originally published on October 4, 2012 8:53 am The 2010 health law removes one of the big barriers to contraception for many young women: cost. But if they don't feel confident that the care they will receive is confidential, these women may not take advantage of it. Under the health care overhaul, most new health plans and those that lose their grandfathered status have to cover many women's preventive benefits, including contraception without out-of-pocket costs. Copayments for monthly packs of brand-name birth control pills can run as much as $40 or $50. A thicket of federal and state laws protect patients' confidentiality. Yet insurers billing practices — especially the sending of so-called explanation of benefits notices to the parents of children covered by family plans — routinely violate teenagers' and young adults' privacy. The companies send EOB notices to the primary policy holder, generally a parent, according to a recent analysis published by the Guttmacher Institute, a reproductive services research and education organization. This problem may grow as more young adults stay on their parents' health plans after they finish school and move out on their own. Under the health law, adult children can remain on parents' plans until they reach age 26. So far, more than 3 million young adults have gotten coverage because of the law, according to the Department of Health and Human Services. As a practical matter, though, young women may be reluctant to take advantage of the new benefits if they worry that their parents will receive an insurance form alerting them that they went to a gynecologist and got a prescription for birth control or got tested for HIV. In fact, only 68 percent of teenagers and 76 percent of young adults with private insurance used it to get contraceptive services, "likely at least in part because of confidentiality concerns," according to a Guttmacher Institute analysis of data from the National Survey of Family Growth. In contrast, 90 percent of women over 30 used their insurance coverage to pay for such services. Young women concerned about their parents' reaction may shell out for their preferred pills, perhaps switching to cheaper generics to save money. They may also go to publicly funded family planning clinics. But those clinics are already stretched thin trying to meet the needs of uninsured and low-income young women. "It's a burden on family planning clinics," says Abigail English, director of the Center of Adolescent Health and Law and lead author of the recent analysis.Copyright 2014 Kaiser Health News. To see more, visit http://www.kaiserhealthnews.org/. © 2016 Iowa Public Radio

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Texoma Gives is 9/15/16 Big Weight Loss For Diabetics, But No Drop In Heart Risk By Nancy Shute Jun 25, 2013 ShareTwitter Facebook Google+ Email Weight loss has been a key component of diabetes treatment for centuries. Originally published on June 25, 2013 3:23 pm Hundreds of overweight or obese people with diabetes have been able to do something very few Americans have done: lose a big chunk of weight and keep it off for 10 years. So should it matter if that epic weight loss didn't reduce the risk of heart disease? Maybe not. That's one response to the results of the Look AHEAD clinical trial, which checked to see if losing weight reduced heart disease risk in people with Type 2 diabetes. Maintaining a healthful weight is an important way to prevent and manage diabetes. It's also helps reduce heart disease risk. So the researchers were surprised to find that even though the study participants lost weight and kept it off, they didn't reduce their risk of heart attacks, stroke and chest pain. Researchers at 16 institutions had organized a long-running clinical trial to measure the effect of weight loss, enrolling more than 5,000 obese or overweight people ages 45 to 75 with Type 2 diabetes. They averaged about 200 pounds. Half of the group was assigned to an intensive lifestyle intervention that involved eating less — 1,200 to 1,800 calories a day — and putting in at least three hours of moderate exercise a week. They got counseling and attended meetings to help them stick with the program. Those people lost an average of 8.6 percent of their body weight in the first year, which isn't easy to do. Most weight-loss studies can eke out only a few percentage points of change in that time. The people in the control group, who didn't get the lifestyle help, lost almost 1 percent of body weight in the first year. Both groups managed to avoid major backsliding, which typically happens with weight-loss trials. The intervention group gained some weight back in years two through five, but ended up with a 6 percent loss over 10 years. The control group lost weight gradually, and was down about 4 percent at the end. All told, 1,193 people stayed with the trial throughout. Excess weight is considered a risk factor for both cardiovascular disease and diabetes, so the researchers figured they'd see improvements in both. Instead, they had to stop the trial early, after almost 10 years, when it was clear that the people in the weight-loss group weren't getting any extra protection from heart attacks, strokes, or angina. But the trial wasn't a failure, the the researchers say. It shows that people with diabetes "can lose weight and maintain that weight loss," lead author Rena Wing, a professor of psychiatry at Brown University, reported at the American Diabetes Association meeting in Chicago. The results were published online in the New England Journal of Medicine. The weight-loss group also had better glycemic control and lower systolic blood pressure, spent less money on medications, had less sleep apnea, and was more likely to have a partial remission of diabetes. They were less likely to land in the hospital. And they also felt better. "This study in no way disproves the important of weight reduction and exercise," says Dr. Douglas Zipes, a distinguished professor emeritus at the Indiana University School of Medicine and past president of the American College of Cardiology. "There were significant benefits achieved." The control group took more statins and other drugs to reduce cardiovascular risk, Zipes notes, which could have clouded the study's findings. And he says that years of evidence showing that eating well and exercising reduce heart disease risk still stand. "We've been able to reduce mortality from heart disease by 60 percent over the past three decades," he said.Copyright 2013 NPR. To see more, visit http://www.npr.org/. Our Partners

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UOK? 'Dystextia' Alerts Doctors To Neurological Problems By editor Doctors used a type of MRI test to look at the blood vessels in the brain of a woman with dystextia. The test confirmed she was suffering from a stroke on the right side of her brain Archives of Neurology Another MRI of the woman's brain showed signs of a stroke in a region involved with language. A young, pregnant woman went for a routine doctor's visit to find out her due date. As she was leaving the office, she got a text message from her husband: Husband: So what's the deal? Wife: Every where thinging days nighing Wife: Some is where! Husband: What the hell does that mean? Husband: You're not making any sense. Turns out the woman was having a stroke. And her garbled texting — something doctors are now calling 'dystextia' — was an early clue to the problem. Concerned by the nonsensical messages, the husband met up with his wife and rushed her to the emergency room. Neurologists quickly realized that a region of her brain involved with language was damaged. "The dystextia was the first clinical sign that we had that she was having a stroke," Dr. Joshua Klein at the Brigham and Women's Hospital in Boston, Mass., tells Shots. Impaired speech is a common sign of a stroke, he says. But in this case, the woman had lost her voice because of a cold. So the series of mangled messages were the smoking gun of a language problem. He and his colleagues describe the case in the Archives of Neurology. The dystextia wasn't essential to diagnosing the stroke, Klein says. They would've figured it out from tests they ran and other symptoms, such as numbness in the woman's right arm. "But it [the dystextia] was an unusual piece of data that fit with the other clinical findings," he says. "It helped us understand the nature of the problem." The woman luckily suffered no permanent damage and quickly recovered her ability to speak and to text. Klein thinks text messages will become increasingly important for neurologists as electronic conversations replace a lot of verbal communication. Dystexia has been linked to a stroke at least once before. And it's been seen in a patient with a complex migraine, which can cause a variety of neurological symptoms, such as difficulty speaking and vision loss. But there are many reasons why people mess up texts messages: You can be walking, driving, drinking or just generally distracted. So how do you know when dystextia is cause for concern? Everything has to be taken in context, Klein notes. But he says if someone is having a problem communicating for some unknown reason, whether it be talking, texting or even reading, they should get checked out by a doctor. In particular, Klein says, some warning signs of stroke include problems formulating the words you want to text, trouble typing the text because your fingers are numb or weak, or sudden vision loss. As you probably know, though, many smartphones have an autocorrect function that can introduce erroneous word substitutions in messages. "This can give the false impression of a language disorder," Klein says. "In our patient's case, autocorrect had been previously disabled on her mobile device."Copyright 2013 NPR. To see more, visit http://www.npr.org/. © 2016 KENW

医学

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Health/Fitness » HealthPerry Wrestles With His Own Health Care Approachby Ricardo Alonso-ZaldivarAssociated PressMonday Aug 22, 2011 PRINT Texas would be among the biggest beneficiaries of President Barack Obama's health care overhaul, standing to gain coverage for nearly 4 million uninsured residents.But Gov. Rick Perry blocked moves to lay the groundwork for that expansion of coverage, and among the alternatives he's supported is an untested regional solution that could prove as controversial as Obama's remake.With Perry running for the Republican presidential nomination, health care in Texas and his own ideas as governor will get fly-speck scrutiny on the national stage. His state is a study in contrasts, boasting world-renowned facilities like the MD Anderson Cancer Center in Houston, along with the highest proportion of uninsured residents of any state - 26 percent.As a national candidate Perry has made total repeal of "Obamacare" central to his fledgling campaign. But it's unclear what he would put in its place. And if the Supreme Court ultimately upholds all or parts of the law, Perry has signaled that he would help carry out key provisions to avoid defaulting to the federal bureaucracy.Texas has received various grants under Obama's law for planning, insurance regulation and consumer education. The state employee benefits system says it expects to draw $60 million in federal subsidies this year to help cover its early retirees, cashing in on a provision of the law.But when Republican state Rep. John Zerwas tried to move legislation to set up an insurance purchasing pool required by the national overhaul, he ran into a veto threat from Perry.The purchasing pools - called exchanges - are one of the key features of Obama's law. Run by the states, they would let consumers buy coverage from a choice of private plans. Most individuals and families in the exchanges would be eligible for federal tax credits to lower their premiums.Exchanges are supposed to open in 2014. If a state doesn't act in advance, the law authorizes the federal government to set up and run its exchange. And since the Texas legislature meets only every other year, this past session was seen as perhaps the state's only opportunity.But Zerwas said Perry told him he was concerned that moving ahead with the exchange legislation would undermine a multistate lawsuit against the federal overhaul that Texas is part of, not to mention creating other political problems. The lawsuit challenges the constitutionality of the law's requirement that Americans obtain health insurance - the so-called individual mandate - an issue on which lower courts have split."Unfortunately, whether we like it or not, health insurance exchanges have become synonymous with Obamacare," said Zerwas. An anesthesiologist from the Houston suburbs, Zerwas said he believes it's worth taking the flak to guarantee that Texas will retain control of its insurance market. The governor disagreed."The position (Perry) was taking veers into some political considerations," said Zerwas. "He felt it would not ring well with some of the constituents and grassroots out there, and frankly, he was concerned it could potentially weaken the arguments in the lawsuit."In the end, Zerwas said Perry reassured him that as governor he could put the exchange legislation into place through an executive order, should that become necessary. A spokeswoman for the federal Health and Human Services department said that would be possible under a newly flexible approach the feds are taking.A spokeswoman for the governor, Lucy Nashed, said Perry believes there are too many unknowns about the federal law to move ahead. "It's premature to be setting up anything that has to do with the federal health care bill because so much of it is still up to the courts with regard to its constitutionality," she said.That still leaves Texas with the nation's lowest rate of insurance coverage, even when compared to other states that have high immigrant populations. Experts say one of the key problems is a relatively low level of employer-sponsored private coverage. Many of the Texans who would gain coverage under Obama's law would be middle-class workers and their families, newly eligible to join the exchange.Nashed said Perry has advocated a range of health care fixes, including national caps on malpractice lawsuits, conversion to electronic medical records and efforts to keep patients healthy and out of hospitals. He also signed legislation this year that would clear the way for Texas to explore a health care overhaul in conjunction with other states.That may sound like an innocuous proposal, but it could turn out to be more controversial than Obama's overhaul.The idea behind so-called state compacts is for the federal government to turn over Medicare and Medicaid funds to a group of states to use as they deem best for their citizens' needs. It would be the biggest re-engineering since the giant health care programs were created in the 1960s - assuming that groups of states could actually agree on what to do and Congress would give its consent."How could any one state control its costs?" asked Bob Laszewski, a health policy consultant to industry. It's like the Euro zone, he added, referring to Europe's troubled economies. "It's not states' rights anymore. These states would have to cede a lot of authority to a new entity."Copyright Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. Comments Related StoriesAnti-Gay Pols to Headline GOP DebatePOLITICS | By Kasie Hunt and Michael R. Blood | Sep 7Rick Perry is looking to make a strong first impression on the national stage. Mitt Romney is hoping for another flawless debate performance. And Michele Bachmann, perhaps, is shooting for relevance in what increasingly appears to be a two-man race.Debt Commission Members Rake In Health MoneyHEALTH | By Ricardo Alonso-Zaldivar | Sep 8Doctors, drugmakers, hospitals and health insurers have spent millions over the years wooing lawmakers who now are on the powerful congressional panel charged with finding a formula to control deficits and debt, a new analysis finds.Pro Wrestler Tweets to Homophics: ’Drink Bleach’CULTURE | By Jason St. Amand | May 11WWE superstar C.M. Punk tweeted his support for same-sex marriage after North Carolina voters amended a constitution baned marriage equality from the state. Punk also viciously lashed out at followers who disagreed with his views.Ask the Doc: Secondhand 'Smoke' From e-Cigarettes In this installment of Ask the Doc, Dr. Howard Scheiner takes a look at e-cigarettes, and the possible dangerous of secondhand 'smoke' from those who vape. More» INSIDE EDGE

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Low vitamin D linked with lower kidney function after transplantation March 28, 2013 in Medicine & Health / Other Vitamin D deficiency may decrease kidney function in transplant recipients, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). The finding suggests that vitamin D supplementation may help improve the health of kidney transplant recipients. Vitamin D deficiency is prevalent in patients with kidney failure. It's not clear how this affects patients after they receive a kidney transplant. To investigate, Frank Bienaimé, MD (Université Paris Descartes and INSERM and Assistance Publique Hopitaux de Paris) and his colleagues studied a group of 634 kidney recipients who underwent transplantation between January 2005 and June 2010. The researchers found that low vitamin D levels measured at three months after transplantation were linked with lower kidney function and increased kidney scarring at 12 months post-transplant. Other hormones involved with mineral metabolism were not predictors of kidney function or scarring after one year. "This result suggests that maintaining vitamin D concentration within the normal range would prevent renal function deterioration after renal transplantation," said Dr. Bienaimé. "Vitamin D supplementation, a simple and inexpensive treatment, may improve transplantation outcomes." He encouraged the design of randomized controlled trials to evaluate the potential of vitamin D supplements to maintain kidney function following transplantation. The article, entitled "Vitamin D Status and Outcomes After Renal Transplantation," will appear online on March 28, 2013, doi: 10.1681/ASN.2012060614 Provided by American Society of Nephrology "Low vitamin D linked with lower kidney function after transplantation" March 28, 2013 http://medicalxpress.com/news/2013-03-vitamin-d-linked-kidney-function.html

医学

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| Regulation of other practitioners A-Z INDEX SEARCH You are in: Health News Front Page Friday, 7 June, 2002, 15:36 GMT 16:36 UK Regulation of other practitioners Some health professionals have been subject to statutory regulation for decades; others are set to follow in the coming years. British Psychological Society The British Psychological Society was established in 1901. It can investigate complaints against any of its members or any chartered psychologists on its register. However at the moment psychologists are not legally required to be on the register before they can practise in the UK and as a result the BPS is powerless to act against individuals who are not members of the society. The society can take action against any member who has breached its code of conduct or who has been found guilty of professional misconduct. A disciplinary committee hears cases in private and considers evidence from witnesses including the psychologist involved. The committee publishes its decision and can reprimand the individual or strike them off its register throwing them out of the society. The BPS is pressing the government to introduce legislation requiring all psychologists to be on its register and, thus, open to investigation. Council for Professions Supplementary to Medicine The CPSM has been regulating professions allied to medicine - such as physiotherapists, speech therapists, dieticians, clinical scientists and paramedics - since 1960. It is responsible for dealing with complaints relating to any of the 120,000 individuals working in these professions. It can take action against any practitioners who have been found guilty of a criminal offence or any individual who has been found guilty of "infamous conduct in a professional respect". Under existing law, the only action the CPSM can take against such practitioners is to strike them off its register which aims to prevent them from working in the UK. The government has put forward plans to replace the CPSM with a new body the Health Professions Council. Under the plans, the HPC would be given stronger powers to deal with practitioners who fail to meet appropriate standards of work or behaviour. The change is also aimed at allowing the HPC to regulate other professions who are not currently being regulated. General Chiropractic CouncilThe GCC was established under 1994 legislation and is responsible for regulating chiropractors in the UK. In 1999, it established a register of chiropractors and by 2001 anyone who describes themselves by that term must be on the register. The GCC investigating committee examines complaints concerning individual chiropractors. These complaints can be forwarded on to its health committee or professional conduct committee. These committees can place conditions on an individual's practise, suspend them or strike them off the register preventing them for carrying on working. The GCC, which is run by a 20-member Council, is also responsible for maintaining high standards of education for chiropractors. General Optical Council The GOC is responsible for regulating optometrists and opticians in the UK. Only individuals who have completed a recognised training are allowed to register with the Council and subsequently work in the UK. Any individual who practices as an optician or optometrist without being registered can be fined �2,500. The GOC is responsible for ensuring high standards of education on optical courses. It is also responsible for dealing with complaints about individual optometrists or opticians. However, it is unable to consider consumer complaints such as the standard or cost of spectacles or services provided by a specific practice. It can consider complaints relating to malpractice or professional misconduct. Its disciplinary committee is similar to a court of law and after hearing evidence decides whether an individual has committed an offence. It can impose a fine or suspend an individual's registration stopping them from practising in the UK for at least 12 months. In serious cases, it can strike an individual off the optical register. It can also impose the same sanctions on a company if it has contravened the GOC's code of conduct. General Osteopathic Council Under legislation introduced in 1993, all osteopaths working in the UK must be registered with the GOsC. It has been illegal since May 2000 for any individual who is not registered to call themselves an osteopath. The GOsC is responsible for taking action against any osteopath who is found guilty of unacceptable conduct or professional misconduct, anyone who has been convicted of a criminal offence and anyone whose health problems prevent them from practising properly. Its code of practise lays down the standards expected of all osteopaths on the register. Complaints against individual osteopaths are assessed by a screener or investigator who decides whether the case should be referred to the GOsC investigating committee. This committee re-examines the evidence and decides whether the case should be referred to a public hearing of its professional conduct committee (PCC). The PCC hears evidence from witnesses and can take action against individuals if it believes the professional misconduct has occurred. In this instance, it can decide to formally admonish the individual; impose conditions on an their practice; or suspend the from practising for a limited period. General Social Care Council The government is planning to establish the new GSCC in October 2001 as part of its efforts to strengthen the regulation of social workers. At the moment there is no statutory regulation of social workers. However, many are members of the British Association of Social Workers and are required to adhere to its code of ethics. But under government plans all social workers will have to be registered with the GSCC from 2001. The GSCC will be responsible for drawing up a code of conduct and ensuring that social workers across the UK meet high standards of care and disciplining those that fall below these standards. The body will be run by a Council which will include social workers and a majority of lay representatives. There will be separate councils in each of England, Scotland, Wales and England. Royal Pharmaceutical Society The Royal Pharmaceutical Society of Great Britain was founded in 1831 and has been responsible for regulating pharmacists working in the UK since 1954. Only those who are on the society's register are allowed to practise. The society's statutory committee can take disciplinary action against any individuals who have been convicted of a criminal offence or who have been found guilty of professional misconduct. It can erase individuals from its register stopping them from practising in the UK and it can also decide whether pharmacy premises can remain registered. The government is planning to introduce legislation to strengthen regulation of pharmacists. UK Council of Health Regulators This body was proposed by the government in its national plan for the NHS in 2000. Under the plans, the Council will be an umbrella body which will oversee the work of all of the health regulatory bodies. It will be responsible for ensuring formal co-ordination between the various regulatory bodies and will act as a forum for all sectors to share views and ideas. The Council is expected to work to establish common procedures across the health service for dealing with complaints against practitioners. The government has indicated that if concerns about the ability of the existing regulatory bodies to protect the public continue, this Council could evolve and take over responsibility for regulating all health practitioners. See also: 16 Nov 00 | Health GDC: Supporting dentists NMC: Protecting the public The GMC: Guiding doctors How the NHS deals with complaints British Psychological SocietyCouncil for Professions Supplementary to MedicineGeneral Chiropractic CouncilGeneral Optical CouncilRoyal Pharmaceutical Society General Osteopathic Council Top Health stories now: Heart risk link to big families Back pain drug 'may aid diabetics' Congo Ebola outbreak confirmed Vegetables ward off Alzheimer's Gene defect explains high blood pressure Botox 'may cause new wrinkles' Alien 'abductees' show real symptoms Links to more Health stories are at the foot of the page. Links to more Health stories How sperm wriggle Bollywood told to stub it out Fears over tuna health risk to babies Public can be taught to spot strokes

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High-res technology shows significant differences in stem cell lines April 3, 2008 UCLA stem cell researchers using a high-resolution technique to examine the genome of a pair of human embryonic stem cell lines have found that while both lines could form neurons, they differed in the numbers of certain genes that could control such things as individual traits and disease susceptibility. The study appears in the April issue of the peer-reviewed journal Stem Cells. The researchers used a technique known as array CGH (comparative genomic hybridization) to study the total DNA content of the lines, all the genes on 46 chromosomes. The use of higher-resolution techniques like array CGH and, soon, whole-genome sequencing will enhance the ability of researchers to examine stem cell lines to determine which are best — or least likely to result in diseases and other problems — for creating therapies for use in humans. Array CGH provided a much better look at the gene content on the chromosomes, with a resolution about 100 times better than standard clinical methods. Clinical specialists commonly generate a karyotype — a technique involving the staining and photographing of a cell sample — to examine the chromosomes of cancer cells or for amniocentesis in prenatal diagnosis; karyotyping has a much lower resolution than array CGH, said Michael Teitell, a researcher with the Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research at UCLA and the senior author of the study. Small defects that could result in big problems later on could be missed using karyotyping for stem cells. "Basically, this study shows that the genetic makeup of individual human embryonic stem cell lines is unique in the numbers of copies of certain genes that may control traits and things like disease susceptibility," said Teitell, who also is an associate professor of pathology and laboratory medicine and a researcher at UCLA's Jonsson Comprehensive Cancer Center. "So, in choosing stem cell lines to use for therapeutic applications, you want to know about these differences so you don't pick a line likely to cause problems for a patient receiving these cells." Differences between individual DNA sequences provide the basis for human genetic variability. Forms of variation include single DNA base-pair alterations, duplications or deletions of genes or sets of genes, and translocations — chromosomal rearrangements in which a segment of genetic material from one chromosome becomes heritably linked to another chromosome. These changes can be benign, but they can also promote diseases, such as certain cancers, or confer increased risk to other diseases, such as HIV infection or certain types of kidney ailments. In this study, Teitell and his team sought to determine copy number variants (CNVs), or differences in the numbers of certain genes, in the two embryonic stem cell lines. The CNVs provide a unique genetic fingerprint for each line, which can also indicate relatedness between any two stem cell lines. Teitell used embryonic stem cell lines that made different types of neurons and studied them with array CGH for comparison. His team found CNV differences between the two lines in at least seven different chromosome locations — differences that could not have been detected using standard karyotype studies. Such differences could impact the therapeutic utility of the lines and could have implications in disease development. More studies will be required to determine the effect of specific CNVs in controlling stem cell function and disease susceptibility, he said. "In studying embryonic stem cell lines in the future, if we find differences in regions of the genome that we know are associated with certain undesirable traits or diseases, we would choose against using such stem cells, provided safer alternative lines are available," Teitell said. Large genome-wide association studies are underway in a variety of diseases to determine what genetic abnormalities might be at play. When the genetic fingerprint, or predisposing genes, for a certain disease is discovered, it could be used as key information in screening embryonic stem cell lines. Source: UCLA Explore further: Genetic mutation during embryonic development could hold the key to a lifetime living with diabetes Genetic mutation during embryonic development could hold the key to a lifetime living with diabetes Personalized treatment for people with diabetes could be a step closer after researchers discovered how a single gene mutation fundamentally alters pancreatic development. Nanofiber scaffolds demonstrate new features in the behaviour of stem and cancer cells Novel scaffolds are shown enabling cells to behave in a different but controlled way in vitro due to the presence of aligned, self-assembled ceramic nanofibers of an ultra-high anisotropy ratio augmented into graphene shells. Heroic firefighter who underwent most extensive face transplant is thriving The severely burned Mississippi firefighter, who captivated the world when he successfully underwent the most extensive face transplant ever performed, is thriving one year after his historic surgery, according to his medical ... Researchers at the Johns Hopkins Kimmel Cancer Center say they have developed a system that uses transformed human stem cells to speed up screening of existing drugs that might work against rare brain and other cancers. Bipolar research to benefit from sharing of patients' stem cells Stem cells from patients with bipolar disorder are being made available to scientists around the world to boost research into the condition. First report on efficient reprogramming of diabetic foot ulcer cells to create therapeutic stem cell The potential to use a patient's own cells to treat non-healing chronic wounds - a serious complication of diabetes - took an important step forward as researchers successfully reprogrammed skin cells taken from diabetic ...

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Risk Factors for Cirrhosis It is possible to develop cirrhosis with or without the risk factors listed below. However, the more risk factors you have, the greater your likelihood of developing cirrhosis. If you have risk factors for cirrhosis, ask your doctor what you can do to reduce your risk. Even 1-2 risk factors is reason enough talk with your doctor. Excessive Alcohol Consumption Increased consumption of alcohol over a long period of time puts you at a higher risk for developing cirrhosis. Alcohol is toxic to liver cells. It also damages the liver by changing how your body breaks down food. People who have problems controlling alcohol also tend to have poor diets, which may also contribute to cirrhosis. Cirrhosis does not develop in everyone who drinks, but most cirrhosis develops because of problem drinking. Chronic Infection with Hepatitis B, C, or DSome acute viral hepatitis infections become chronic, leading to liver inflammation and injury that. Over time, this can progress to cirrhosis. Common viral infections include: Infection with the hepatitis B virus—World Health Organization (WHO) statistics show that 2 billion individuals are initially infected with hepatitis B virus and 350 million remain infected chronically and become carriers of the virus. The rate of hepatitis B infection is highest among Asians and Pacific Islanders and second highest among non-Hispanic blacks. Acute infection with hepatitis C—Becomes chronic in about 80% of infected adults. About 10%-15% of people with chronic hepatitis C will develop cirrhosis, usually over many years. The rate of hepatitis C infection is highest among non-Hispanic blacks. Hepatitis D—Infects people who are already infected with hepatitis B. Nonalcoholic Fatty Liver DiseaseWith nonalcoholic fatty liver disease (NAFLD), fat cells build up in the liver and eventually lead to scarring. This type of hepatitis is associated with: High triglyceride levels in the blood Intestinal bypass surgery Long-term treatment with corticosteroids Secondary Bilary CirrhosisBlockage of the bile ducts causes bile to back up and damage liver tissue. In adults, this can occur with a condition called primary biliary cirrhosis, in which the bile ducts become inflamed, blocked, and scarred. Bile ducts may also be blocked due to a disease called primary sclerosing cholangitis. It can also occur as a result of gallstones, or as a complication of gallbladder surgery if the ducts are accidentally tied off or injured. It can result from inflammation of the pancreas, called pancreatitis. In infants, blocked bile ducts may result from biliary atresia, a condition in which the bile ducts are injured or totally absent from birth. Hepatic CongestionConditions such as heart failure or constrictive pericarditis can cause congestion within the liver and eventually lead to scarring. Inherited DisordersNumerous inherited disorders interfere with the way the liver produces, processes, and stores enzymes, proteins, metals, and other substances necessary for proper functioning of the body. —an inherited disorder that causes the body to absorb and store too much iron, which builds up in various organs, including the liver, and causes damage Wilsons disease —an inherited disorder that results in excessive copper accumulation in the body, which also can produce liver damage Alpha-1 antitrypsin deficiency—an inherited deficiency of a protein produced in the liver that normally functions to block the destructive effects of certain enzymes; may lead to liver disease and Galactosemia—an inherited disorder characterized by the inability of the body to use the simple sugar galactose; leads to an accumulation of galactose 1-phosphate, which causes damage to the liver, central nervous system, and various other body systems Glycogen storage diseases—a group of inherited disorders caused by a lack of one or more enzymes that results in excessive storage of glycogen in the liver and eventual liver damage Cystic fibrosis—a genetic disorder the can result in liver damage Budd-Chiari syndrome—a condition caused by a blood clot which blocks the veins that carry blood from the liver into the inferior vena cava. The vena cava is the large vein which carries blood from the left side of our body back to the heart. Autoimmune HepatitisThis is a condition in which immune cells mistake normal liver cells as invading cells and attack them. The following factors can lead to liver damage include : Severe adverse reactions to prescription drugs, such as isoniazid and methotrexate Chronic exposure to environmental toxins, such as arsenic Repeated episodes of heart failure with liver congestion The parasitic infection schistosomiasis Hepatitis B. World Health Organization website. Available at: http://www.who.int/immunization/topics/hepatitis%5Fb/en. Updated July 12, 2012. Accessed April 24, 2013.

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Health/Fitness » HealthWhat Heals Traumatized Kids? Answers are Lacking by Lindsey TannerAssociated PressMonday Feb 11, 2013 PRINT Shootings and other traumatic events involving children are not rare events, but there's a startling lack of scientific evidence on the best ways to help young survivors and witnesses heal, a government-funded analysis found.School-based counseling treatments showed the most promise, but there's no hard proof that anxiety drugs or other medication work and far more research is needed to provide solid answers, say the authors who reviewed 25 studies. Their report was sponsored by the federal Agency for Healthcare Research and Quality.According to research cited in the report, about two-thirds of U.S. children and teens younger than 18 will experience at least one traumatic event, including shootings and other violence, car crashes and weather disasters. That includes survivors and witnesses of trauma. Most will not suffer any long-term psychological problems, but about 13 percent will develop symptoms of post-traumatic stress, including anxiety, behavior difficulties and other problems related to the event.The report's conclusions don't mean that no treatment works. It's just that no one knows which treatments are best, or if certain ones work better for some children but not others."Our findings serve as a call to action," the researchers wrote in their analysis, published online Monday by the journal Pediatrics."This is a very important topic, just in light of recent events," said lead author Valerie Forman-Hoffman, a researcher at the University of North Carolina-Chapel Hill.She has two young children and said the results suggest that it's likely one of them will experience some kind of trauma before reaching adulthood. "As a parent I want to know what works best," the researcher said.Besides the December massacre at Sandy Hook Elementary School in Connecticut, other recent tragedies involving young survivors or witnesses include the fatal shooting last month of a 15-year-old Chicago girl gunned down in front of a group of friends; Superstorm Sandy in October; and the 2011 Joplin, Mo., tornado, whose survivors include students whose high school was destroyed.Some may do fine with no treatment; others will need some sort of counseling to help them cope.Studying which treatments are most effective is difficult because so many things affect how a child or teen will fare emotionally after a traumatic event, said Dr. Denise Dowd, an emergency physician and research director at Children's Mercy Hospitals and Clinics in Kansas City, Mo., who wrote a Pediatrics editorial.One of the most important factors is how the child's parents handle the aftermath, Dowd said."If the parent is freaking out" and has difficulty controlling emotions, kids will have a tougher time dealing with trauma. Traumatized kids need to feel like they're in a safe and stable environment, and if their parents have trouble coping, "it's going to be very difficult for the kid," she said.The researchers analyzed 25 studies of treatments that included anti-anxiety and depression drugs, school-based counseling, and various types of psychotherapy. The strongest evidence favored school-based treatments involving cognitive behavior therapy, which helps patients find ways to cope with disturbing thoughts and emotions, sometimes including talking repeatedly about their trauma.This treatment worked better than nothing, but more research is needed comparing it with alternatives, the report says."We really don't have a gold standard treatment right now," said William Copeland, a psychologist and researcher at Duke University Medical Center who was not involved in the report. A lot of doctors and therapists may be "patching together a little bit of this and a little bit of that, and that might not add up to the most effective treatment for any given child," he said.Copyright Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. Comments Popular Stories in Health/Fitness Cruising Toward An End to HIV/AIDSRhode Island Foundation Awards $50K In Grants To RI's LGBTQsCelebrate National Dog Day With Life-Saving TechAsk the Doc: Secondhand 'Smoke' From e-Cigarettes In this installment of Ask the Doc, Dr. Howard Scheiner takes a look at e-cigarettes, and the possible dangerous of secondhand 'smoke' from those who vape. More» INSIDE EDGE

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Six vying for hospital board seat Six vying for hospital board seatMichele EllsonWednesday, July 10, 2013 - 00:05CORRECTION, 2:09 p.m. Thursday, July 18: The Alamedan inaccurately listed Alameda Health Care District Board candidate Jon Murphy's job title as "Director of VN and RN programs, Merritt College"; he is an instructor at the college, an official with the Peralta Community College District confirmed. The Alamedan regrets the error. An attorney, two nurses and a political staffer are among the half-dozen people who have applied for the Alameda Health Care District Board seat vacated by Alameda Hospital critic Elliott Gorelick – a job whose description could see some dramatic changes if a proposed affiliation deal with the county’s medical system is finalized. The board is slated to interview the candidates and appoint a new member at a special meeting to be held on July 18. The board will receive an update on the appointment process from president J. Michael McCormick at a meeting scheduled to take place tonight. The candidates include Lynn Bratchett, a longtime nurse and health care administrator-turned-real estate broker who was in the running for the seat Jensen got; Jon Murphy, a recent school board candidate who is also a nurse and, like Bratchett, an instructor at Merritt College; James H. Oddie, an attorney and accountant who now serves as district director for state Assemblyman Rob Bonta; Carmelo L. Roco, a physician for more than 20 years; health care consultant Scott E. Vrchota; and Lily Wong, a deputy district attorney in the Marin County District Attorney’s Office. All six candidates said they’d bring their skills and experience to bear – legal, political, medical – to preserve the services now provided by Alameda Hospital; opinions differed – or weren’t expressed – regarding the in-the-works deal to affiliate with Alameda Health System, the county’s medical system. Gorelick, who resigned in June after two and a half years on the board, believes the hospital should be closed and the parcel tax property owners pay to support it discontinued; he sought to put the affiliation question before voters. “The next few months are a critical time for the future of Alameda Hospital with the potential affiliation with Alameda Health Systems (sp),” wrote Oddie, who supports the affiliation plan. “The Board needs a Director who is committed not only to making the correct decision on affiliation, but committed to serving the Board and representing the taxpayers of Alameda beyond the next election cycle should the affiliation be approved.” Jon Murphy, a nurse who worked at Alta Bates Summit Medical Center for 18 years and has a doctorate in educational leadership from Argosy University, said he’d like to look at “all sides” of the discussion around affiliating with Alameda Health System and whether the deal is in residents’ best interests. “My vision is that the hospital could become self-sustaining and remain on the island to serve our future generations,” Murphy wrote. Bratchett, who received high marks from board members in his prior try for a seat and has since joined the hospital’s finance and management committee, said he’s familiar with the county hospital’s practices and policies “and can be instrumental in bridging any gaps that may arise in the new venture.” Roco, who has a private practice in San Francisco and serves as medical director of the Alameda Healthcare & Wellness Center, didn’t offer any comment on the proposed affiliation in his application packet; Vrchota, who worked as a medical device salesman and at a Midwestern hospital system before going into consulting, also didn’t speak to the deal. Wong, who said it’s “imperative” the hospital remain open, was also silent on the proposed affiliation deal. She called Alameda Hospital “a critical component of Alameda’s economic and social fabric” makes Alameda a more attractive place to settle and is a major employer. The successful candidate will fill out the remainder of Gorelick’s term, which ends in 2014. The vacancy is the second one the board will have had to fill this year; onetime school board trustee Tracy Jensen, who works as a senior services administrator for the City of Oakland, joined the board in February after Stewart Chen left for a seat on the City Council. If the affiliation deal is completed, the local board’s chief responsibilities would include signing off on Alameda Health System management’s proposed annual budget for the parcel tax funds, which are to be spent in Alameda, and to manage property and leases the health care district holds. But one representative from Alameda would be added to the county health system’s board of trustees. In addition to the vacancy update, the board is slated to consider approval of an agreement with the Alameda Hospital Foundation to co-sign for the $1.5 million line of credit Alameda Health System is extending to Alameda Hospital in advance of the proposed affiliation deal, to help the hospital pay overdue bills and cover other expenses. If the deal is not closed within 366 days of the line of credit being issued, the hospital must pay it back. Under the terms of the proposed agreement, the foundation would not be responsible for repaying the money if it became due; the credit line would become a priority obligation to be repaid out of hospital parcel tax funds. The board is also being asked to extend the hospital’s spending authority in lieu of a budget for the new fiscal year, which began on July 1. A budget is expected to be approved in August. The board’s public session will begin at 7:30 p.m. today in the Dal Cielo Conference Room at Alameda Hospital, 2070 Clinton Avenue. Here’s the quick and dirty on the half dozen candidates who have applied for a vacant Alameda Health Care District Board seat. LYNN BRATCHETT Occupation: Assistant director of nursing, Merritt College; broker associate, Community Realty Property Management Inc. Education: Master of business administration, Northeastern University; bachelor of nursing science, University of Massachusetts Vision: Affiliation with county system could protect the hospital financially and maintain services, and could also help the hospital attain new technology and undertake health promoting activities and innovative care for the elderly Quote: “In this potential time of change for the hospital, I think it appropriate I apply for the position as I am familiar with many of AHS practices and policies and can be instrumental in bridging any gaps that may arise in the new venture.” JON MURPHY Occupation: Instructor, Merritt College; director and curriculum developer of RN program, APNI University Education: Doctorate in leadership in higher education, Argosy University; master of science, family nurse practitioner program, Sonoma State University; associate of science in nursing, Merritt College; bachelor of arts, English literature/liberal arts. St. Mary’s College Vision: The hospital would be self-sustaining and remain on the Island for future generations. Quote: “My vision is that the hospital could become self-sustaining and remain on the island to serve our future generations.” JAMES H. ODDIE Occupation: District director for state Assemblyman Rob Bonta; board president McCormick works in Bonta’s office, and Oddie is his direct supervisor. Education: University of San Francisco School of Law, juris doctor; master of business administration, Loyola University; bachelor of science in finance, Indiana University; certified public accountant, state of Illinois. Vision: The hospital needs to maximize use of its surgical and acute care capacity and partner with other health care organizations, things the proposed affiliation deal appears to do; the hospital must also meet seismic retrofit requirements. The hospital should also play a regional role in providing health care, and has been by adding services such as the wound care center, orthopedics program and the Waters Edge nursing home. Quote: “The AHS affiliation provides Alameda Hospital with the opportunity to be part of expanded AHS network and serve patients countywide who might otherwise be unable to obtain timely medical care in the county system.” CARMELO L. ROCO Occupation: Physician surgeon, Napa State Hospital; medical director, St. Francis Pavilion; medical director, subacute ventilator unit, Alameda Healthcare & Wellness Center; solo practitioner Education: University of the East Ramon Magsaysay Memorial Medical Center, doctor internal medicine; University of the Philippines, bachelor of science in pre-medicine; University of Santo Tomas, general education Vision: The hospital should provide excellent, competitively priced care, full-service preventive care and aggressive community education. The hospital should also consider more services for seniors. Quote: “I believe that as a medical practitioner enhanced by my desire to help, to learn and to partner with all stakeholders, will enable me to assist the Alameda Hospital as it enters a new era of health care delivery. It is my conviction that high quality medical care could still be attained given an innovative approach that maximizes limited human and financial resources.” SCOTT E. VRCHOTA Occupation:Principal, ZIA Healthcare Consultants Education: Master of business administration, University of Minnesota; bachelor of science, University of Oregon Vision: Alameda Hospital should become a financially viable health care organization that provides high quality care and patient satisfaction around a positive work environment. Quote: “I consider U.S. Health care to be a major issue in this country, not only for the medical industry, healthcare providers and government, but also for families and patients that seek medical help.” LILY WONG Occupation: Special deputy district attorney, Marin County Office of the District Attorney Education: Lewis and Clark School of Law, juris doctor; University at California, Davis, bachelor of arts, political science Vision: The hospital should set the standard for excellence in the delivery of patient care, patient safety and quality of experience – and remain solvent. Quote: “I believe that it is imperative to keep the only hospital, with paramedic services, within the city boarders (sp) open, accessible and functioning.” Alameda Hospital

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UK dials up "virtual doctors" in big telehealth push Thu Dec 6, 2012 12:33pm GMT By Ben Hirschler | LONDON LONDON Shirley Silvers thinks the "virtual doctor" who monitors her chronic lung condition via mobile phone is wonderful."It is like having my doctor sitting on my sofa," said the 64-year-old from Stoke-on-Trent in central England, explaining how her temperature, oxygen levels and sputum colour - a barometer for infection - are now checked daily from home.She sends her readings by text message and gets a reply within minutes, removing the need for regular trips to the doctor.British health minister Jeremy Hunt is equally enthusiastic.He announced plans in November to roll out telehealth to 100,000 people with long-term conditions in 2013 and have 3 million on the system by 2017.It will make Britain second only to the United States as an adopter of technology to monitor patients at home, luring technology and telecoms firms looking for somewhere to test ideas in a global market that may soon be worth tens of billions of dollars.Remote monitoring has the potential to save money by keeping people like Silvers - who suffers from chronic obstructive pulmonary disease (COPD) - healthy and out of hospital.Indeed, the department of health claims it could save up to 1.2 billion pounds ($1.9 billion) over five years.Savings of that scale are hard to ignore in an age of austerity, and other governments across Europe are also exploring the concept.A range of options are now available to keep tabs on patients at a distance, including home health computers, smartphone applications and video check-ups, while more futuristic projects involve wiring homes with sensors to feed medical and behavioural data to a central server. NOT A PANACEA But telehealth is not a panacea - and a fierce debate has sprung up in Britain since the government outlined results a year ago from the world's largest telehealth trial, involving 6,000 patients, which triggered its commitment to the concept."Headline" data highlighted by officials from the so-called Whole System Demonstrator programme suggested that using telehealth could cut emergency admissions to hospitals by 20 percent and slash mortality rates by 45 percent.Those reductions, however, were relative - in other words, how much better patients on telehealth fared compared with those on standard care.When detailed results were published in June, the absolute reduction in mortality came in at a less compelling 3.7 percent, representing 59 lives saved among the 3,000 patients on telehealth who were followed for 12 months.What is more, researchers wrote in the British Medical Journal that the positive findings could have arisen by chance and the scale of potential cost savings was unclear.Other research paints a mixed picture.Some studies looking at specific diseases like heart failure and diabetes have made a strong case for telehealth, but a 200-patient U.S. study published earlier this year in the Archives of Internal Medicine linked telehealth to more deaths, for unknown reasons.The muddy picture probably reflects the interplay of multiple factors and indicates that telehealth cannot be viewed in isolation, since overall management of patients is likely to be just as important as use of technology, if not more so.That makes integrating technical solutions within care systems a key challenge for firms in the telehealth space."To make telemedicine truly work you need to have an integrated offering that has technology which stands alongside traditional delivery of healthcare," said Christian Mazzi, a partner with consultancy Bain & Co. $23 BILLION MARKET With mobile technology now cheap enough and good enough to monitor patients at home and offer consultations over the Internet, Mazzi believes telehealth's time has finally arrived and the British commitment is an important stimulus in Europe."Putting incentives and structures in place is beginning to remove some of the barriers to a broader roll out," he said.Many players, from medical equipment firms to developers of smartphone apps, are already vying for a piece of a market that has been talked about for 20 years but is now finally gaining momentum.According to PricewaterhouseCoopers, the worldwide market for mobile communications and devices used in healthcare will reach about $23 billion by 2017, up from $4.5 billion forecast for next year.Telecom operators will be the biggest winners, grabbing roughly half of those sales, which explains their growing focus on healthcare.The balance will be shared by a raft of other companies, such as General Electric, Microsoft, Cisco, Intel, Philips, Siemens and Bosch.The clinical data may not be as clear as some would like - and winning doctors' acceptance may be a challenge - but companies are honing arguments to show how telehealth can help put a lid on costs that would otherwise spiral out of control.It makes sense, too, for former bakery assistant Silvers, who has not had a chest infection for nearly a year since starting on her telehealth adventure.($1 = 0.6214 pound)(Editing by Will Waterman)

医学

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Institute of Medicine Admits Vaccine Dangers After Review Andre Evans Natural health practitioners have long been raising the alarm over the risks of vaccinating, and now the prominent Institute of Medicine (IOM) is agreeing with the claims of top experts that vaccines are not free of dangerous side effects. Accounts of adverse reactions that have resulted in hospitalizations and even cases of death have been reported after vaccine use. Such is the case with the Gardasil vaccine, linked to over 49 deaths. Yet, California legislatures, paid by the manufacturer of Gardasil, are still trying to make it mandatory for all young boys and girls. Still, we’re constantly reassured by medical ‘experts’ that vaccines are not dangerous, despite the vaccine inserts admitting to a slew of adverse side effects, and in some cases even death. These mainstream medical talking heads assure you that vaccination poses no threat to you or your family, and avoiding vaccination is only putting others who have been vaccinated at risk. Of course that makes no sense, considering that if others are vaccinated they should be protected from the disease in question. They say that vaccination is not an option, it’s a duty. Who could forget the H1N1 scare in 2009? Or the massive ad promotion that came with it, despite the virus being an overhyped threat? Piggybacking on the pandemic scare, clinics and even local pharmacies began to advertise convenience based ‘swine flu shots.’ Even today, you can go to your local Walgreens or CVS and find them ready to administer some form of immunization with little hassle or preparation. Amazingly the seasonal flu shot now contains the H1N1 vaccine as well, despite its links to deadly nerve disease and narcolepsy. The campaign perpetuates itself through social media charities on Facebook, promising to distribute over $6 million worth of these flu shot vouchers everywhere. Fans actually donated to ensuring that these side-effect-ridden shots were distributed to over 6 million individuals. Media outlets continue to assure citizens that vaccination is sensible, and that the makers would never intentionally cause harm to its users, but how can vaccine manufacturers be trusted? Knowing that these companies admit that their products can produce numerous adverse reactions, introduce the possibility of serious impairment or death, even that their own products contain the deadly SV40 virus? Furthermore, vaccine manufacturers are immune to legal repercussions, so they simply do not have to care about the health implications of their products! Now even the IOM, a mainstream medical establishment, is speaking out against the dangers of vaccination. Recently the IOM released a comprehensive report, admitting that vaccines are not free from adverse side effects. In the safety review, evidence suggested that a causal relationship between certain vaccines and adverse health complications does exist. These vaccines, including MMR, chickenpox, influenza, hepatitis B, meningococcal, and tetanus were all linked to causing anaphylaxis, a potentially life threatening allergic reaction, as well as specific immunizations being responsible for other effects including brain inflammation, fainting, seizures, and potentially life threatening infections like pneumonia, hepatitis and meningitis. Despite this, the IOM states that “Few health problems are caused by vaccines.” Their conclusion is that there is not enough conclusive evidence to suggest that vaccines are significantly dangerous to use. This is because there are apparently so many other side effects from these vaccines that they can’t determine what is actually causing these adverse reactions, although it seems pretty obvious that there is some bad science involved with these vaccines. The paradigm becomes frightening when you realize that these vaccines are highly dangerous, and the full extent of their effects has not been conclusively determined. Despite this, vaccines are being portrayed as safe, helpful, and even 100% necessary. Parents are pressured to get the vaccines for their children, and some officials are going as far as to ban unvaccinated children from classes and drive to their homes with a vaccine-equipped nurse. Its disingenuous to paint the image that these vaccinations are safe when studies are showing that they are arguably the cause for many of the prevailing health issues we now face. The IOM may not be able to make a conclusive analysis, but you as an individual can draw your own conclusions based on the research to help protect yourself and your family. Please visit Natural Society for more great health news and vaccine information. Activist Post Daily Newsletter Email address: Subscription is FREE and CONFIDENTIAL

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