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IndustryCorpus_medicine

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2016-36/3165/en_head.json.gz/2069

Home > Service Areas > Heart-Cardiology and Cardiovascular ... > Patient Stories > An Irregular Heartbeat Stabilized at Mount Sinai Heart-Cardiology and Cardiovascular Surgery Heart Imaging Lauder Family Center Mount Sinai-Crystal Run For Cardiology Professionals and Students An Irregular Heartbeat Stabilized at Mount SinaiWhen Lucretia Jones, a mother of two holding a full-time job, felt her heart race out of control, Mount Sinai was there to stabilize her heartbeat. As Lucretia Jones washed dishes one late Christmas eve, a frightening sensation took her by surprise. "My heart just went crazy. It was racing and irregular," she recalls. The New York City epidemiologist, then 50, was experiencing her first attack of arrhythmia. Lucretia led a busy life, with no time for health crises. A former emergency medical technician, she had just earned her master's degree in public health and was leading a Department of Health unit on communicable diseases. At the same time she was raising two children, caring for her elderly mother, and volunteering for a grassroots organization she had helped found in her South Bronx community. Lucretia's partner, Jesse, was with her when her heart began to race. An emergency medical technician himself, he drove her to Mount Sinai Heart, where Lucretia was diagnosed with atrial fibrillation. Atrial Fibrillation: A Treatable Condition In atrial fibrillation, an irregular heartbeat prevents blood from moving from the atrium into the ventricle. The condition can revert to normal in minutes or hours, but sometimes it persists. In each case, the blood that pools in the atrium is at risk for clotting. The clots can break off and cause a stroke. The Mount Sinai Heart Telemetry Unit admitted Lucretia for monitoring. There, she and her family met Bruce Darrow, MD, PhD, Director of the Telemetry Unit and Assistant Professor of Cardiology. Dr. Darrow prescribed medication that stabilized Lucretia’s heartbeat. Lucretia was released within just a few days. Three times over the next few months, though, Lucretia's arrhythmia returned. After the third time, Dr. Darrow referred Lucretia to Avi Fischer, MD, Director of Pacemaker and Defibrillator Therapy and Assistant Professor of Cardiology. Although the cardiologists discussed performing a minimally invasive catheter ablation procedure, a last-minute adjustment to Lucretia’s medication stabilized her heartbeat. Personable Health Care About a year after Lucretia experienced her first arrhythmia, she brought her mother to Mount Sinai for medical treatment and ran into Dr. Darrow. "He immediately recognized me and said, 'What are you doing here?'" Lucretia says. "Some places you can walk past your doctor and they might not know you. Dr. Darrow actually comes in to sit down and talk. He makes me feel like I am his only patient." Her health back on track, Lucretia has returned to her usual hectic schedule. "Who would have thought that I would be going for my PhD at my age?" she says. "There is still so much to do."

医学

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U.S. Department of Health and Human Services • National Institutes of Health Temas de Salud Search Text Field Leading research to understand, treat, and prevent infectious, immunologic, and allergic diseases NIAID HomeHealth & Research TopicsLabs & Scientific ResourcesFundingAbout NIAIDNews & EventsVolunteer NIAID > About NIAID > Mission and Planning > History About NIAIDAbout the DirectorCareers at NIAIDMission and PlanningResearch PortfolioPlanning and PrioritiesCouncil and CommitteesBudgetNIAID Gift FundHistory60th AnniversaryDr. Joseph J. KinyounProfile, Year in Review, and Fact BookOrganizationFinding PeopleVisitor Information Skip Website Tools Print this pageGet plug-ins and viewersOrder publications FY 2017 Budget Congressional Justification (PDF) ​​​​​​ ​​​​​​​​ Javascript Error Your browser JavaScript is turned off causing certain features of the NIAID Institute of Allergy and Infectious Diseases web site to work incorrectly. Please visit your browser settings and turn JavaScript on. Read more information on enabling JavaScript. Skip Content Marketing Main Content AreaHistory of NIAID The National Institute of Allergy and Infectious Diseases traces its origins to a small laboratory established in 1887 at the Marine Hospital on Staten Island, New York. In the 1880s, boatloads of immigrants were heading towards America, some of them unknowingly bringing with them cholera and other infectious diseases. No one knew what caused most of these diseases, and physicians relied on clinical signs alone to determine whether someone might be carrying an infectious agent. Dr. R. R. Parker and his wife working on Rocky Mountain spotted fever, 1916.​ During this time, Dr. Joseph J. Kinyoun, a young medical officer with the Marine Hospital Service, was learning about the new science of bacteriology. Dr. Kinyoun set up one of the first bacteriologic laboratories in the United States. Using his microscope and newly acquired medical research techniques, Dr. Kinyoun was able to isolate the cholera organism from an arriving passenger in New York. For the first time, American physicians could actually see the organisms causing the disease. Dr. Kinyoun's Laboratory of Hygiene was renamed the Hygienic Laboratory in 1891 and moved to Washington, DC, where Congress authorized it to investigate "infectious and contagious diseases and matters pertaining to the public health." The Hygienic Laboratory became the National Institute of Health in 1930 and relocated to Bethesda, Maryland, in 1938. Parker's woodshed lab​ About the time the Hygienic Laboratory was created, other doctors far from the East Coast of the United States were struggling against a little understood disease. As the population expanded westward, many early settlers in the Montana foothills of the rugged Bitteroot Range of the Rocky Mountains were plagued with a disease known as "black measles," or "spotted fever," now known as Rocky Mountain spotted fever. In 1902, the U.S. Public Health Service sent out a research team to find the cause. Tents, cabins, and an old schoolhouse were used for housing the early Rocky Mountain Laboratory where researchers determined that the disease was transmitted by ticks, identified the cause as what is now called Rickettsia rickettsii, and formulated a vaccine against the agent. ​Developing a vaccine for Rocky Mountain spotted fever. The vaccine was created in 1924 at the Rocky Mountain Labs. In gratitude, the state of Montana built a new facility, which the Public Health Service purchased in 1931. The Rocky Mountain Laboratory in Hamilton, Montana, became part of the Division of Infectious Diseases at the National Institute of Health in 1937. In mid-1948, the National Institute of Health became the National Institutes of Health (NIH) with the creation of several individual institutes. Later that year, the Rocky Mountain Laboratory and the Biologics Control Laboratory joined the NIH Division of Infectious Diseases and Division of Tropical Diseases to form the National Microbiological Institute. Dr.Victor Haas was the Institute's first director. In 1955, Congress changed the name of the National Microbiological Institute to the National Institute of Allergy and Infectious Diseases (NIAID) to reflect the inclusion of allergy and immunologic research. As NIAID continues to pursue progress in understanding, treating, and preventing infectious and immunologic diseases, it recognizes that new challenges to public health continue to emerge. NIAID will continue its tradition of supporting innovative scientific approaches to address the causes of these diseases and find better ways to prevent, diagnose, and treat them. CONNECT WITH NIAID NIAID INFORMATION Home Temas de Salud Site Map Accessibility Privacy Policy Disclaimer Website Links & Policies FOIA Employee Emergency Information RELATED GOVERNMENT SITES

医学

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New Policy Makes Insurers Pay For Birth Control February 10, 20123:00 PM ET Julie Rovner The Obama administration revised its policy on providing cost-free birth control as part of the new health law on Friday. Institutions such as universities and hospitals that are run by religious groups will not be required to provide contraceptive coverage to employees. Rather, the insurance companies offering the plan will pay. AUDIE CORNISH, HOST: From NPR News, this is ALL THINGS CONSIDERED. I'm Audie Cornish. ROBERT SIEGEL, HOST: And I'm Robert Siegel. President Obama today sought to defuse the controversy over a rule requiring most employers to provide insurance coverage for contraception. What the administration is calling an accommodation preserves the ability of women to get birth control without paying a deductible or copayment. But as NPR's Julie Rovner reports, it's not clear how the new plan will work or whether it will satisfy all the critics. JULIE ROVNER, BYLINE: Speaking in the White House briefing room this morning, the president said the new policy would let religious employers who object to offering contraceptive coverage pass that responsibility back to their insurance company instead. PRESIDENT BARACK OBAMA: The insurance company - not the hospital, not the charity - will be required to reach out and offer the woman contraceptive care free of charge, without copays and without hassles. ROVNER: Women's health groups were pleased with the change. Nancy Keenan is president of NARAL Pro-Choice America. NANCY KEENAN: The announcement by the president is a reaffirmation of his commitment and the administration's commitment to ensuring contraceptive coverage. ROVNER: Even some key Catholic leaders who had protested the original requirement pronounced themselves satisfied. That included people like former Democratic National Committee Chairman Tim Kaine, now running for a swing Senate seat in Virginia, and Sister Carol Keehan, president of the Catholic Health Association. But some people, like insurance industry consultant Robert Laszewski, have their doubts. ROBERT LASZEWSKI: There is no free lunch, and there is no free contraception. ROVNER: He says it's basically a charade to suggest that insurance companies will pay for contraception without passing that cost right back to their customers, including the religious employers who say they don't want anything to do with it. LASZEWSKI: What's sort of hypocritical about this is all policies, whether you're a Catholic institution or not, is now going to have contraception without deductibles and copays, and they'll all pay for it. But we'll just pretend the Catholic institutions are not paying for it. ROVNER: And even those with a somewhat more charitable view of the proposal are still worried. HELEN DARLING: It isn't clear exactly how it's going to work. ROVNER: That's Helen Darling. She's president of the National Business Group on Health. She says she's glad the president found a policy that seems to satisfy many on both sides of the women's health-religious employer divide, but she's not convinced how workable this particular arrangement will be. DARLING: The logistics will be a little bit complicated. There's no question about that. And a lot of questions get raised about privacy and how one is identified as someone who's going to get this different product. ROVNER: Insurance companies weren't ready to speak for broadcast this afternoon. But in a statement, their industry group said they were concerned at the precedent the new policy could set. Meanwhile, getting lost in all the back and forth were the reasons why the policy was adopted in the first place. Alina Salganicoff is vice president for women's health at the Kaiser Family Foundation. She served on the Institute of Medicine panel that recommended no-cost contraception as part the preventive benefits package. She said it was partly because studies showed the U.S. has a higher-than-average rate of unintended pregnancy. She also said medical literature showed the benefit of contraception when used to space births. ALINA SALGANICOFF: Allowing a healthy interval of time is very important in promoting healthy moms and healthy babies. ROVNER: And many women use contraception for reasons wholly unrelated to preventing pregnancy. SALGANICOFF: There are many other health benefits to contraceptives for women, to manage other conditions, such as endometriosis and other health problems that could really benefit women. ROVNER: But while the new policy has brought back some doubters, it clearly hasn't ended the dispute. Senators who want the entire policy repealed may try to force a vote as early as next week. Julie Rovner, NPR News, Washington.

医学

2016-36/3165/en_head.json.gz/2198

Alzheimer's Drug May Slow Disease's Progression July 19, 20123:00 PM ET This week an international Alzheimer's conference is taking place in Vancouver, with researchers presenting findings on ways to detect the disease and slow its progression. Audie Cornish speaks with Bloomberg News science reporter Elizabeth Lopatto about some of the studies presented. AUDIE CORNISH, HOST: Now to more news about the brain, and how it works. This week, researchers gathered in Vancouver, British Columbia, for the Alzheimer's Association International Conference. While there's no cure for Alzheimer's, experts have been looking for ways to diagnose it earlier, and slow its progression. Among the studies presented this week was one that suggests that a drug may be able to stabilize Alzheimer's patients for up to three years. Bloomberg News science reporter Elizabeth Lopatto has been covering the conference all week, and she joins us now. Hi there, Elizabeth. ELIZABETH LOPATTO: Hello. CORNISH: So tell us a little bit more about this study, and this drug. I gather it was small, but it's generating a lot of buzz. LOPATTO: That's right. It's really unusual to see patients in this population stabilize. Usually, they decline. And although it's very small and early, there's going to be a follow-up study that should be complete next year; that will have more data on whether this is actually going to be a usable treatment. CORNISH: Why is it that even though it is a small study, it has created so much energy and talk? I mean, what's the mood in the research community about progress, when it comes to Alzheimer's? LOPATTO: Well, I think there's a real hunger for progress. There is, I think, a real desperation for any kind of treatment that could at least delay progression of the disease - although of course, the goal, eventually, would be to prevent it. CORNISH: We've talked about treatment, and I want to talk about the research related to detection. What research has been presented this week, that has been focused on trying to determine if somebody is developing Alzheimer's? LOPATTO: There have been two studies that were presented here, that I think are big for general practitioners; for knowing when somebody needs to go see a neurologist, and get a bigger workup. And the first is gait changes. So walking - we don't think of it as being very difficult, but it is pretty complex. And when you see changes in gait - when you see somebody slowing down or walking unevenly - if it's not due to something like arthritis, it could be a sign of cognitive decline. Similarly, there have been changes in sleeping patterns that have also been linked to cognitive decline. There were several studies that came out, suggesting that people who slept five hours or less, or nine hours a night or more, were more likely to experience cognitive declines; and that anybody who had changes in their sleep cycle might be experiencing changes that were related to Alzheimer's disease. And so those things are the sort of thing that a family doctor can ask about. CORNISH: We're talking about a disease that more than 5 million people in the U.S. now have, and that number is expected to triple by the year 2050. Now, do you sense that researchers are feeling - basically, pressure to come up with treatments and possibly, a cure? LOPATTO: Yeah, I think that there is a lot of pressure. It's a big drain not only on the person who is ill, but on their families and their communities. And so I think researchers are acutely aware of that. One of the metaphors that I've heard a lot here, is people talking about Alzheimer's disease the way they talk about heart disease. And what they're saying is, if you treat somebody who has mild dementia, what you're really doing is, you're trying to treat after a heart attack. And you can prevent somebody from getting worse after a heart attack, maybe. But, you know, what you want to do is actually prevent the heart attack. CORNISH: Elizabeth Lopatto, thank you for talking with us. LOPATTO: My pleasure. CORNISH: Elizabeth Lopatto is a science reporter with Bloomberg News. She joined us from Vancouver, where she's been covering the Alzheimer's Association International Conference. Discounts Aren't Enough to Halt Outrage At High EpiPen Prices

医学

2016-36/3165/en_head.json.gz/2199

Saving Lives And Surviving Paperwork Inside The LA County ER June 22, 20145:09 PM ET Dave Pomeranz, Ryan McGarry and William Mallon are some of the real-life ER doctors depicted in Code Black. Long Shot Release 2014 LA County Hospital sees some of the worst possible medical cases. Patients suffering from gunshots, car wrecks and other severe injuries frequently pass through the doors of the Level I trauma center. At the same time, since it's a public hospital, LA County ER doctors also often see patients who don't have life-threatening emergencies, but who otherwise lack access to health care. The new documentary Code Black goes behind the scenes at the hospital, depicting the intense efforts of doctors and nurses as they try to resuscitate patients on the brink of death and cope with the massive volume of people in need. The film's director, Ryan McGarry, is a physician specializing in emergency medicine. He trained at the hospital, which is officially called the Los Angeles County-USC Medical Center. The film goes beyond the medical drama to show the burdens paperwork can put on the doctor-patient relationship. McGarry tells NPR's Arun Rath that Code Black is both a testament to the people who work at the hospital and a critical look at the U.S. medical system. Interview Highlights On visiting LA County Hospital's ER for the first time I couldn't believe the volume and the amount of perceived chaos. And yet, underneath that chaos was a very well-functioning machine of resuscitation, both for critical illness as well as trauma. And I thought, "My gosh, I don't think Americans would believe that this is happening here in a major U.S. city ... this type of volume, this type of need. And it's seemingly working out." On LA County Hospital's legendary trauma bay, known as "C-Booth" LA County Hospital is one of the first places that emergency medicine was formed as a specialty. And it's important to recognize that emergency medicine — as is 911 — are actually fairly young. I mean, these are 1960s, 1970s developments in this country. When you look at all the specialties of medicine, emergency medicine is one of the youngest. And so this is where it's thought the specialty was born. C-Booth — it's been lost to history, but we think that means either "Critical Booth" or "Cardiac Booth" — is kind of where the sickest patients would come. And as a training physician, it's where you would oversee up to six or seven or even more of these critically ill patients. On the types of patients that go to the emergency room Even post-Obamacare, we're seeing, throughout the country, emergency room visits go up, and that might be counter-intuitive. But what we're finding is that, yes, more people have access, more people are getting insurance cards, but those cards aren't always premium. And we're already in a system where a lot of specialists won't take a sub-premium insurance card, because you're not seen as profitable enough. So many people end up coming to public hospital emergency departments, just to see an orthopedist, or an endocrinologist or someone who won't take their probably decent insurance, but it's not good enough. On what changed in 2008, when LA County Hospital relocated to a new facility They moved from an effectively historic landmark building to what's probably one of the most impressive, technology-laden medical facilities in the country. It was a $1 billion structure, and it's packed with absolutely incredible features. But what was lost along the way is not so much a reflection of the LA County's decision to move from one building to another, but really a perfect encapsulation of what modern healthcare has become. It's sort of become depersonalized as a result of a lot of well-intentioned features, whether that be safety regulations or privacy regulations or even a lot of technology. I mean, think about it. The last time you went to the physician, or even a nurse practitioner's office, a computer and a screen and a lot of charting was probably the mainstay of that experience. That didn't happen at the old place, because it was just so open and intimate. On coping with the burden of paperwork in modern medicine I think the major responsibility here is actually on the physicians. I think that we have to speak up. And probably most [doctors] have lost control over this ... You know, oftentimes we're the most invested in the patient care. I'm $300,000 in debt. I lost every weekend of my 20s to becoming a physician. And yet I'm the last one who decides what that patient-doctor experience is going to be like. That's now decided by everyone from politicians [to] insurance companies to people who got their MBAs online or something. I've invested so much into this idea of the patient-doctor experience, and yet I'm the last one to really get to say how that experience is going to go. So really, I think the answer is: Docs need to speak up. And I think partly that's what Code Black was for me, personally — a chance to say, "OK, this is the state of affairs. And I don't that we feel like it's acceptable." 'Southside With You': Meet The Actors Who Portray Barack And Michelle Obama Actor John Krasinski Takes Stock Of His 'Lottery-Ticket Life' Nate Parker's Past, His Present, And The Future of 'Birth Of A Nation': Episode 14

医学

2016-36/3165/en_head.json.gz/2232

More vets turn to prosthetics to help legless pets LOS ANGELES: A 9-month-old boxer pup named Duncan barreled down a beach in Oregon, running full tilt on soft sand into YouTube history and showing more than 4 million viewers that he can revel in a good romp despite lacking back legs. "It's a heartwarming, wonderful thing to see," said Dr. Bonnie Beaver, a professor at Texas A&M University's College of Veterinary Medicine and executive director of the American College of Veterinary Behaviorists. "These animals generally look to us as if they are very happy. We don't know that they are, but they are excited and jumping around and doing things that are wonderful to watch." Kittens accidentally shipped from Los Angeles to San Diego SAN DIEGO: A San Diego cable company employee expecting a shipment of fiberglass equipment got a shock when he discovered two newborn kittens clinging to life inside the box. KGTV reports (http://bit.ly/1gE7wGG ) Thursday that the kittens are recovering after being accidentally shipped by truck from the Los Angeles area to a Cox Communications office in San Diego.

医学

2016-36/3165/en_head.json.gz/2369

Medical Awards The National Foundation of Medical Research held a highly-attended conference each year in Washington, DC. The Foundation had a series of awards that could be presented during the conference to doctors and medical professionals who had made a significant contribution to furthering medical knowledge in a main area of study. However, the awards were not generally awarded every year as the candidates must have made an outstanding and recognizable contribution to the science of medicine, which probably helped explain why the Foundation�s awards were considered some of the most prestigious in the medical industry. This year, several of the awards were given out to candidates scattered across the nation. Determine the full name of each recipient (one had a last name of Foster), the area of medical research each recipient contributed to (one area was back injuries), and the city where each recipient lived. 1. The doctor who came from Chicago was given an award for his research into cancer. 2. Patricia was researching heart disease but she didn�t live in Miami. 3. Harry�s last name wasn�t Atkins. Amy didn�t live in Charlotte. 4. Ms. Ford�s award was for her work in DNA mapping. 5. Michelle Slater wasn�t researching mental diseases. 6. Chet lived in Dallas. The doctor whose last name was McQueen worked in Seattle. If you enjoyed this puzzle and want to play another one online, go

医学

2016-36/3165/en_head.json.gz/2388

Several Common Differentially Expressed Genes Between Kashin-Beck Disease And Keshan Disease Kashin-Beck disease (KBD) and Keshan disease (KD) are major endemic diseases in China. Postgraduate Xi Wang et al., under the guidance of Professor Xiong Guo from the Institute of Endemic Diseases of the Faculty of Public Health, Medicine College of Xi'an Jiaotong University, Key Laboratory of Environment and Gene Related Diseases in Ministry of Education, Key Laboratory of Trace Elements and Endemic Diseases of Health Ministry, set out to tackle these two endemic diseases. After several years of innovative research, they have made significant progress in determining the etiology and pathogenesis of these diseases at a molecular level; in particular, the identification of some common differentially expressed genes. Their work, titled "Comparing gene expression profiles of Kashin-Beck and Keshan diseases occurring within the same endemic areas of China", was published in SCIENCE CHINA Life Sciences. 2013 Vol.56(9). KBD and KD are distributed from the northeast to the southwest of China, where the selenium content is low in the soil. In China, there are 660000 KBD and 40000 KD patients, and approximately 30 million people are at risk. KBD is an endemic osteoarthropathy, the pathologic changes of KBD included significant alterations in chondrocyte phenotype, necrosis, and apoptosis, and abnormal terminal chondrocyte differentiation. The mainly pathologic changes of KD are multifocal myocardial necrosis and fibrosis that can result in cardiogenic shock and congestive heart failure. KD is an endemic myocardosis that happened in women and preschoolers. Since osteoarthritis and myocardium deformities, the most of KBD and KD patients will partially or completely lose their abilities to work even self-care, which seriously reduces their quality of life, and also bring heavy medical burden to society; the etiology and pathogenesis of KBD and KD remain unclear. However, both diseases happened in the same area of China. Moreover, the living conditions of KBD and KD patients are similar, for example, most patients live in remote rural areas and the areas of awful transportation, have a meager income, and a simply diet. There is little research conducted to compare KBD and KD gene expression profiles. Therefore, the two diseases may have a further relationship at the molecular biology level. In this study, the Agilent Human 1A Oligo microarray was used to compare gene expression profiles of peripheral blood mononuclear cells (PBMCs) between KBD or KD patients and healthy controls, and identified the common genes differentially expressed in both diseases groups. One hundred and thirty-six differentially expressed genes (53 up-regulated and 83 down-regulated) were identified between KBD and normal controls. Moreover, comparing KD and normal controls, 3310 differentially expressed genes (3154 up-regulated and 156 down-regulated) were identified. Comparing all identified differentially expressed genes, 16 genes showed differential expression in both diseases, including nine with synchronous and seven with asynchronous expression. These 16 genes were subdivided into 11 categories, namely metabolism, cytochrome enzymes, transcription-related, G-protein-related, receptor, cytokine factor, ion channel transport protein, signal transduction, hematopoietic related, interleukin, and immune-related. The distribution of KBD and KD is in the similar geographical regions, although the clinical presentations and target pathological focus are not same. The common differentially expressed genes identified in both KBD and KD could be helpful to identify the potential mechanisms of the different organ lesions, caused by similar environmental risk factors, selenium deficiency. These findings make a great contribution towards clarifying the etiology and pathogenesis of KBD and KD. The discovery of these common differentially expressed genes of KBD and KD was a collaborative effort involving many researchers from different institutes and universities. This research project was supported by a grant from the National Natural Science Foundation of China (30872192, 81273008) and a grant from Key Scientific and Technological Innovation Special Projects of Shaanxi "13115" of China (2009ZDKG-79). It is an important breakthrough in the field of endemic disease research. The researchers suggested that their work needs to be further validated and researched in different methods. These efforts will have significant impact on elucidating the etiology and pathogenesis of KBD and KD. Science China Press SCIENCE CHINA Life Sciences

医学

2016-36/3165/en_head.json.gz/2389

Adults Stop Anti-Rejection Drugs After Stem-Cell Transplant Reverses Sickle Cell Disease NIH/National Institute of Diabetes and Digestive and Kidney Diseases Adults stop anti-rejection drugs after stem-cell transplant reverses sickle cell disease NIH trial success suggests a new treatment option for older, sicker patients Half of patients in a trial have safely stopped immunosuppressant medication following a modified blood stem-cell transplant for severe sickle cell disease, according to a study in the July 1 issue of the Journal of the American Medical Association. The trial was conducted at the National Institutes of Health's Clinical Center in Bethesda, Maryland, by researchers from NIH's National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the National Heart, Lung, and Blood Institute. The transplant done in the study reversed sickle cell disease in nearly all the patients. Despite having both donor stem-cells and their own cells in their blood, the patients stopped the immunosuppressant medication without experiencing rejection or graft-versus-host disease, in which donor cells attack the recipient. Both are common, serious side effects of transplants. "Typically, stem-cell recipients must take immunosuppressants all their lives," said Matthew Hsieh, M.D., lead author on the paper and staff clinician at NIH. "That the patients who discontinued this medication were able to do so safely points to the stability of the partial transplant regimen." In sickle cell disease (SCD) sickle-shaped cells block blood flow. It can cause severe pain, organ damage and stroke. The only cure is a blood stem-cell, or bone marrow, transplant. The partial transplant performed in the study is much less toxic than the standard "full" transplant, which uses high doses of chemotherapy to kill all of the patient's marrow before replacing it with donor marrow. Several patients in the study had less than half of their marrow replaced. Immunosuppressant medication reduces immune system strength and can cause serious side effects such as infection and joint swelling. In this study, 15 of 30 adults stopped taking the medication under careful supervision one year after transplant and still had not experienced rejection or graft-versus-host disease at a median follow up of 3.4 years. "Side effects caused by immunosuppressants can endanger patients already weakened by years of organ damage from sickle cell disease," said John F. Tisdale, M.D., the paper's senior author and a senior investigator at NIH. "Not having to permanently rely on this medication, along with use of the relatively less-toxic partial stem-cell transplant, means that even older patients and those with severe sickle cell disease may be able to reverse their condition." "One of the most debilitating effects of sickle cell disease is the often relentless pain," added Dr. Hsieh. "Following the transplant, we saw a significant decrease in hospitalizations and narcotics to control that pain." The partial transplant used donor stem-cells from healthy siblings. It effectively reversed SCD in 26 of 30 patients and allowed them to achieve stable mixed donor chimerism, a condition in which a person has two genetically distinct cell types in the blood. The study includes patients from an NIH study reported in 2009, in which partial stem-cell transplants reversed SCD in 9 of 10 people. In the United States, more than 90,000 people have SCD, a genetic disorder found mainly in people of African ancestry. Worldwide, millions of people have the disease. "The devastating complications associated with sickle cell disease can deeply affect quality of life, ability to work and long-term well-being," said NIDDK Director Griffin P. Rodgers, M.D., a co-author on the paper. "This study represents an important advance in our efforts to make a potentially transformative treatment available to a wider range of people, especially those who could not tolerate a standard stem-cell transplant or long-term use of immunosuppressants."

医学

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our miraculous daughter 19connie63 6 years ago When I found myself pregnant at the age of 19 in an era when pregnancy without a partner was not acceptable and one was generally looked down upon for their wayward ways, and when abortion was not legal or a viable option, I decided that I would put the baby up for adoption. When my daughter was born at the old Letterman Hospital with Dr. Harry Beaver performing the delivery, I took one look at her and knew she was mine for the long haul. It turned out that I had passed on to my lovely daughter a genetic mutation that occurred spontaneously at conception and, to be discovered much later, it was so rare that there are only 17 other known cases in the world. Initially the doctors thought that the physical problems were due to rubella (german measles) that I had been exposed to while I worked as a corspeman in the hospital at Hamilton AFB. Due to this and the fact at that time the state was trying legalize therapeutic abortions, my daughter and I were interviewed by Walter Cronkite for his tv show. I was asked that if I had known that my daughter was going to have these anomalies, would I have elected to have an abortion. My daughter was, at that point, a beautiful little girl of about 18 months. And I loved her with all my heart. My daughter had to have open heart surgery early on (and by the infamous Dr. Norman Shumway at Stanford Hospital, a pioneer in cardiac surgery), she had cataracts and subsequently develped glaucoma, and multiple other problems. She was transferred to UCSF medical center initially and later followed by Dr. Tarnoff at Kaiser San Francisco. Throughout the years I discovered that althought my daughter had multiple physical problems, her brain was not affected. In fact, she is an extremely bright young woman. She managed, with limited vision, to graduate from Mercy High School with a gpa of 3.8, went on to Humboldt State University, worked in high school cleaning houses, working as a server in a food court, later in college worked in a home for very disabled people, found her way on buses, Bart, and has been generally independent throughout her life. She even at one point traveled to Europe on her own. She found herself on SSI early on in her 20's and hated it. She wanted desparately to be independent . She found that the State Department of Rehab would assist her with computer studies. She had majored in education as a student but found, at that time, it was difficult to get into this field with limited vision. After completing the computer couse that rehab offered she was able to find a job at Wells Fargo working at night in the credit card department. In the interim she met her husband and became pregnant with her first child. The morning that her daughter was born, we received a call from the hospital that her daughter had developed congestive heart failure. The feeling of dejavu was unreal for me! It was shortly after that we discovered that my daughter's physical problems were due to a spontaneous genetic defect. Her daughter had all the same anomalies that my daughter had but several that were more serious. However, the National Institute of Health invited us back to Bethesday, Maryland, several years ago to do more studies on both my daughter and grandaughter. It is still considered a very rare genetic disorder. After the birth of her daughter, my daughter's glaucoma became worse, a surgical procedure was attempted to assist the drainage of fluid in the eye. It did not work and subsequently my daughter had to have an enucliation, i.e. her right eye had to be removed! In the interim, my daughter has gone on to be promoted at Well Fargo into a vip position, after 19 years, she is currently working on her MBA, has successfully been a single parent (her husband and her separated several years ago and are still friendly) of two children ( her son was born 12 years ago, perfectly normal. The genetic mutation only affects the females conceived and about 50+% of the time. If a male is conceived he would die in utero). She is now almost completely blind but has a special computer program at Wells that allows her to do her job. She has been praised over and over by her supervisors at Wells, has received numerous awards, and is loved by her clients. She has gone though numerous surgeries due to her congenital problems and then six years ago found that she had breast cancer. She went through mastectomy, chemo therapy, radiation therapy, and lots of support groups, all this without a partner. She did have alot of family and peer support, thank God. After the breast cancer ordeal she suffered a brown recluse spider bite while playing with her children in their front yard. She was hospitalized and the infectious disease physician who cared for her said that she had never seen a recluse spider bite in real life, only in text books. Several years ago her daughter, who had also developed glaucoma at this point, was advised by her opthalmologist to have a drain put into her eye. Once again the procedure did not work and my grandaughter lost the vision completely in her right eye. She was ten years old. And until that time had vision enough that she probably could have driven a car at the age of 16. But that is no longer so. However, she is now 15 and is taking courses this summer to be a camp counselor and wants very much to work next year, if possible, at Enchanted Hills Camp in Napa. This is a camp started by Rose Resnick/Lighthouse for the Blind. My grandaughter has attended that camp every year for the past four years. My grandaughter also skis, she is going to Colorado this summer to rock climb, white water rafting on the Colorado river, horseback riding, and, of course, she will fly to Denver on her own. I decided to write this article because my daughter and grandaughter are miracles to me and my family. My husband, who adopted my daughter when she was three, and I are proud of all of our children, but we feel so incredibly blessed with these two miraculous people, especially our daugher. qeazetq pcksvmu by roberthkdonald edvjgbwu kbivor by roberthkdonald Hv Pdw YgjVyx Rwo VxqFb by LiekCrittib what an amazingly strong by xserenax

医学

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Stepping Up to HIV Stigma in the U.S. South An Interview With Monica Johnson -- Part of the Series This Positive Life By Olivia Ford 1 | 2 | 3 | Next > Monica Johnson is from the small town of Columbia, Louisiana, but you may recognize her from the gripping HIV-focused documentary deepsouth. Her organization, HEROES, like many other small and struggling rural agencies, serves people living with HIV who might otherwise not have anywhere else to go. After Monica became HIV positive through a blood transfusion in the early 1980s, she gave birth to an HIV-positive baby boy who passed away at a young age. Throughout his life and hers, she has faced the gamut of HIV stigma: Her son was asked not to attend school with other children, and Monica was asked to leave her town. She told them she wouldn't go. As Monica herself puts it: "My glass is always half full": Not only did she stay put in Louisiana, she advocates for other Louisianans who are living with HIV. Her organization operates on a shoestring budget, and she knows how to make the best of HIV care when there is no infectious disease specialist even within a few hours' drive. This interview was conducted in October 2012. Inspiring stories of people living with HIV. Can you talk a little bit about how you found out you were HIV positive, and what year it was? I received a blood transfusion in 1984. And in I want to say 1985, 1986, I received a letter from the blood center, saying the person whose blood I received had died from AIDS, and they asked me to be retested. I think it was '85. I was retested and the test was inconclusive. I was in school, doing my thing; so I didn't retest again. I was, like, "OK, cool. Not me." Inconclusive, meaning? They didn't give me a yes or no. And so in 1990, I was pregnant with my son. I told my doctor what happened with the first inconclusive test. She retested me, and the test came back positive. What did you think, and how did you feel, when you first heard the news? Well, at that point, I really didn't have a lot of time to think about me. It was, like, choices laid out about my baby: What should I do? Because it was early on -- there was no treatment, really -- it was like, "Do you want to abort? " She never said I had to. And my doctor was really supportive, so she never even recommended that I abort. But there were other people in her office, the counselors, who said, "You know, you really should think about abortion." I was thinking about what I needed to do for my baby at that point. What did you end up doing? I had my baby. He was born in April, Easter Sunday, 1990. So it was '89 when I found out I was pregnant. Because he was born in April of '90. Well, for the first six months of his life, he was very, very, very healthy. He stayed on the growth chart and, you know, the little curves; he was right on target. And right at about 6, 7 months, when he started developing his own immune system, he started getting sick. And they sent him to my pediatrician, who I love, still, today; sent him to New Orleans -- because at that time, New Orleans still had a leper colony; I mean, just for study purposes. So they took him down there; they drew blood; sent it there. And they told us maybe the week before Christmas that he would develop AIDS and probably wouldn't live to be 1 year old. How did you feel when you first heard that news? At that point, I was like; I cried for a little minute. And then I came up with a game plan. We took pictures every day. We did birthday parties. We were doing our lifetime worth of stuff in the next six months. Because Easter was going to be in April; this was December. We was trying to get everything out. What was your baby like? Oh. Oh, he always smiled. Always, always. He was very happy. Always, always, always, always smiling, even when he was in pain. I've thought about that, because I've never really been sick -- I have gone to the hospital one time, but I've never really been sick -- but I just think they've put a man on the moon; I don't think anything on me should hurt. So I need to tell my doctors, "You need to work it out. I don't think nothing on me should hurt." He never really verbally communicated, but a couple of times, he had kidney stones. My doctor said that was the extreme, extreme, extreme of pain. He would cry, but he still smiled through that. You know, he just always smiled. I'm like, that ain't the creed I'm cut from. I want something! So he was extremely happy. Was it at some point during his life that you started to come to terms with your own diagnosis and think about yourself? Or did that come later? "'Nos' really fuel me." No. Well, what happened was, when he was 2 -- in the state of Louisiana, if you have a physical challenge, or something wrong, you're supposed to be able to start school. I think at this point he was not thriving. He had fallen off the growth chart, and he had lost weight. You know, he looked, not sickly, but he was sick. And the doctor, his pediatrician, started trying to get him into the special-needs school, so he could start the educational process. And the school system where I live said "No." They did not want him to come to school. He could not come to school there, even when he turned 3. And "Nos" really fuel me. So at this point: "Why can't he come? I want him to have everything everybody else gets." And so then anger kicked in, and so I started advocating on his behalf then. And I advocated on his behalf until he died. And then, when he died, I had about maybe about a six-month grace period. And I started thinking. Well, no. What happened was, a friend of mine had a baby. And her baby was not infected. She was. And the school system was just not doing her right, because somebody had found out. And I started advocating. And I said, "I wonder how many times this happened to other people?" And they just don't want to say anything. So that's how it started. 1 | 2 | 3 | Next > Related Stories A Longtime HIV Survivor on Public Health, Private Health and Spiritual Wellness This Positive Life: An Interview With Patricia Nalls deepsouth, a New HIV/AIDS Documentary, Premieres This July Southern Women HIV/AIDS Leaders Speak Back to Their Communities More Personal Accounts of Women With HIV/AIDS The Dilemma of Dating Positive! IAS Journal Publishes Supplement on HIV Stigma, Discrimination This article was provided by TheBody.com. It is a part of the publication This Positive Life. Comment by: Audrey (Seattle) Sat., Mar. 29, 2014 at 2:48 am EDT This story is hard to follow. ..but ok. Comment by: Daddy.Bearby (Alabama) Thu., Feb. 6, 2014 at 10:44 pm EST You go girl don't fall down and lay there get back up and FIGHT with all your mite never accept the word NO as the final answer !

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Health Advisor Vancouver's safe injection site cuts overdose deaths André Picard - PUBLIC HEALTH REPORTER Vancouver — The Globe and Mail Sunday, Apr. 17, 2011 7:14PM EDT The number of drug-overdose deaths on Vancouver's notorious downtown Eastside fell sharply after the opening of a safe injection site, new research shows. The study, published online Monday in the medical journal The Lancet, shows that fatal overdoses dropped 35 per cent in the vicinity of Insite in the two years after it opened. By comparison, OD deaths dropped only 9 per cent in the rest of Vancouver in that same period. "No one has ever been able to demonstrate a substantial reduction in overdose deaths due to the presence of a safe injection site, but we have done so," Thomas Kerr of the Urban Health Research Initiative at St. Paul's Hospital in Vancouver said in an interview. Until now, research has shown that Insite reduces behaviours that lead to deadly infections like HIV and hepatitis C, and it reduces public disorder by getting intravenous drug use off the streets. But the federal government has argued that the evidence of benefit is unclear and tried to shut down Insite. This has lead to a protracted legal battle - one that has become an important jurisdictional struggle between the provincial and federal governments. Both the B.C. Liberals and New Democrats support Insite and the program has the strong backing of the provincial health officer. In January of 2010, the B.C. Court of Appeal decided 2-1 that the province has jurisdiction over the facility since it provides IV drug users with a health-care service, which is within provincial jurisdiction. Its ruling upheld a 2008 trial decision by the B.C. Supreme Court, which found that the application of the federal drug law would violate IV drug users' Charter rights to life, liberty and security of the person. The case will be heard in the Supreme Court of Canada on May 12. "The Conservatives can no longer go around saying the evidence is unclear because the evidence is clear - Insite saves lives," Dr. Kerr said. The new study, which examined coroners' reports, shows that between 2001 and 2005, there were 290 overdose deaths in Vancouver. Eighty-nine of those deaths occurred within a 500-metre radius of Insite, which is located in the heart of Vancouver's skid row. The safe-injection facility opened on Sept. 20, 2003, when the Liberal government was in power. Nurses can supervise IV drug users because the facility was specifically exempted from federal drug possession and trafficking laws. The Conservatives oppose this approach, saying it flies in the face of their anti-drug strategy. In the two years prior to the opening, there were 56 OD deaths in the neighbourhood; in the two years subsequent, there were 33. There have been more than 2,000 overdoses at the facility but not a single death. Insite provides booths, along with clean syringes, where intravenous users can inject. Nurses can also revive users who OD - which happens frequently because the purity of street drugs is unpredictable. The authors argue that having overdoses occur in a controlled setting is much more cost-effective because it takes pressure off the health system. "The nurse saved my life when I ODed," said Gary Kyle, who has been an IV drug user on-and-off since 1977. By contrast, he once overdosed on the street, which required the intervention of paramedics, a visit to emergency and hospitalization. "I've shot up in an alley, in the McDonald's bathroom, the library, you name it. When I do it in public, I'm rushed and careless. At Insite, it's safer," Mr. Kyle said. Conservative Senator Pierre Claude Nolin, a long-time supporter of Insite, said he was reluctant to speak during a federal election campaign, but the new evidence is clear. "Public health programs like this need to be evidence-based, not politically driven," he said. "And the new evidence proves that it works, that Insite reduces overdoses," he said. An earlier study, by the same group of researchers, found that there were more than 900 overdose deaths in British Columbia between 2001 and 2005, and that aboriginal people were disproportionately at risk. About 12 per cent of the OD deaths involved first nations people, who make up less than 4 per cent of the province's population. Follow André Picard on Twitter: @picardonhealth Dying for a change on safe-injection site Ottawa takes injection battle to top court One Big Idea: Supervised drug use on the Downtown Eastside

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Health System > Office of the Vice Chancellor and Dean > New targeted drug for treating fragile X syndrome, ... Office of theVice Chancellor Dean's Office Leadership Dean's Departments and Offices Degree and Certificate Programs Residency and Fellowship Programs Nursing Degree Programs Betty Irene Moore School of Nursing Leadership Communities & Physicians Together Program Community Benefit Report (PDF) Office for Equity, Diversity & Inclusion Office of Student and Resident Diversity Center for Reducing Health Disparities Advisers & Friends Newsroom & Publications Magazines and Reports UC Davis Medicine Magazine Synthesis Magazine Community Benefit Report, Annual Report, State of the Health System Address and Strategic Plan About UC Davis Health System Strategic Planning Initiative Giving to UC Davis Health System Phyllis BrownUC Davis MIND Institute John M. Pontarelli, Assistant Vice President, Public Relations Phone:312-942-5949Rush University Medical Center Kari Watson, Senior Vice President Phone:781-235-3060MacDougall Biomedical Communications NEWS | September 19, 2012 New targeted drug for treating fragile X syndrome, potentially autism, is effective Study finds drug treats social withdrawal and challenging behaviors in fragile X Editor's note:View this release en español or 中文 Chinese An investigational compound that targets the core symptoms of fragile X syndrome is effective for addressing the social withdrawal and challenging behaviors characteristic of the condition, making it the first such discovery for fragile X syndrome and, potentially, the first for autism spectrum disorder, a study by researchers at the UC Davis MIND Institute and Rush University Medical Center, Chicago, has found.The finding is the result of a clinical trial in adult and pediatric subjects with fragile X syndrome. It suggests, however, that the compound may have treatment implications for at least a portion of the growing population of individuals with autism spectrum disorder, as well as for those with other conditions defined by social deficits. The study is published online today in the journal Science Translational Medicine. A second article by the manufacturer of the compound is included in the same issue.The "first-in-patient" drug trial was led by internationally recognized fragile X researchers Elizabeth Berry-Kravis of Rush University Medical Center and Randi Hagerman of the UC Davis MIND Institute. It examined the effects of the compound STX 209, also known by the name arbaclofen. The study was conducted collaboratively with Seaside Therapeutics, a Cambridge, Mass., pharmaceutical company that is focused on translating bench research on fragile X and autism into therapeutic interventions. Seaside Therapeutics is developing the compound and supplied it for the clinical trial.Researcher Randi Hagerman with patient"This study shows that STX 209 could become an important part of the treatment for fragile X syndrome, because it appeared to improve symptoms in those with significant social deficits or autism as well as fragile X syndrome," said Hagerman, medical director of the MIND Institute. "Additional studies also are suggesting that STX 209 could be helpful for autism without fragile X syndrome. Until now, there have been no targeted treatments available for autism. This appears to be the first."Fragile X syndrome is the most common, known cause of inherited intellectual impairment, formerly referred to as mental retardation, and the leading known single-gene cause of autism. Social impairment is one of the core deficits in both fragile X and autism. The U.S. Centers for Disease Control and Prevention (CDC) estimates that about 1 in 4,000 males and 1 in 6,000 to 8,000 females have the disorder. An estimated 1 in 88 children born today will be diagnosed with autism, according to the CDC."There are no Food and Drug Administration-approved treatments for fragile X syndrome, and the available options help secondary symptoms but do not effectively address the core impairments in fragile X. This is the first large-scale study that is based on the molecular understanding of fragile X and suggests that the core symptoms may be amenable to pharmacologic treatment," said lead study author Elizabeth Berry-Kravis, professor of pediatrics, neurological sciences and biochemistry at Rush University Medical Center."This study will help to signal the beginning of a new era of targeted treatments for genetic disorders that have historically been regarded as beyond the reach of pharmacotherapy," Berry-Kravis said. "It will be a model for treatment of autism, intellectual disability and developmental brain disorders based on understanding of dysfunction in brain pathways, as opposed to empiric treatment of symptoms. We hope mechanistically based treatments like STX209 ultimately will be shown to improve cognitive functioning in longer-term trials."Studies in mice genetically engineered to exhibit features of fragile X, including social impairment, have suggested that the behavioral abnormalities in fragile X result from deficiencies in the neurotransmitter gamma-amino butyric acid (GABA). Decreased GABA has been observed in a mouse model of fragile X in many areas of the brain, including the hippocampus, and has been hypothesized to be a basis of the social anxiety and avoidance characteristic of fragile X sufferers, the study says.Arbaclofen is an agonist for gamma-amino butyric acid type B, or GABA-B, receptors. An agonist is a chemical that effectively combines with a receptor on a synapse to effect a physiologic reaction typical of a naturally occurring substance. Anxiety-driven repetitive behavior and social avoidance have been reduced in fragile X-engineered mice treated with arbaclofen. The current, first-of-its-kind study investigated whether arbaclofen would produce similar results in human subjects.The double-blind, placebo-controlled clinical trial initially recruited 63 male and female subjects at 12 sites across the United States for the research, conducted between December 2008 and March 2010. The participants ranged in age from 6 to 39 years. Of the initial participants, 56 completed the clinical trial. There were no withdrawals related to drug tolerability. The majority of the subjects were treated with what was assessed as the optimum tolerated dosage of the study drug, 10 milligrams twice a day in younger patients and three times a day in adults. Compliance was monitored by patient guardians, who filled out a dosing form on a daily basis.The study subjects returned for evaluations at two- and four-week intervals after beginning the six-week-long treatment. The drug then was tapered down over a one- to two-week period. After a week, the subjects entered a second treatment period.The effects of the medication were scored on variables of the Aberrant Behavior Checklist (ABC), a behavior-rating scale for the assessment of drug-treatment effects. The checklist includes variables for irritability, lethargy/withdrawal, stereotypic (repetitive) behavior and hyperactivity, among other factors.The study found improvement for the full study population on the social-avoidance subscale, an analysis validated by secondary ratings from parent observation of improvement in subjects' three most problematic behaviors. It found that the medication was the same as placebo, however, on the subscale for irritability.The study is one of several at the MIND Institute aiming to help improve behavior and cognition for individuals with fragile X syndrome and autism spectrum disorder. Hagerman currently is leading larger controlled trials of STX 209 at UC Davis that also are carried out at multiple centers and are enrolling individuals with fragile X syndrome from ages 5 to 50. Individuals interested in enrolling may contact Lindsey Partington at 916-703-0471 or via e-mail at [email protected]. Details of the study also can be found at ClinicalTrials.gov, an online resource for people interested in learning more about advanced clinical studies in a variety of different therapeutic areas."We are looking forward to further studies utilizing STX 209 in both autism and fragile X syndrome because the fragile X mouse studies demonstrate long-term strengthening of synaptic connections with continued use of this medication," Hagerman said.Other study authors include David R. Hessl, Yi Mu and Danh V. Nguyen of UC Davis; Barbara Rathmell, Peter Zarevics, Maryann Cherubini, Karen Walton-Bowen, Paul P. Wang and Randall L. Carpenter of Seaside Therapeutics; Joseph Gonzalez-Heydrich of Boston Children's Hospital; and Mark F. Bear of the Massachusetts Institute of Technology.The study was funded by Seaside Therapeutics.Rush is a not-for-profit academic medical center in Chicago comprising Rush University Medical Center, Rush University, Rush Oak Park Hospital and Rush Health. Rush University is a private, health sciences university offering more than 30 unique degree or certificate options in medicine, nursing, allied health and biomedical research. Rush University is comprised of Rush Medical College, the College of Nursing, the College of Health Sciences, and the Graduate College. At the UC Davis MIND Institute, world-renowned scientists engage in research to find improved treatments as well as the causes and cures for autism, attention-deficit/hyperactivity disorder, fragile X syndrome, Tourette syndrome and other neurodevelopmental disorders. Advances in neuroscience, molecular biology, genetics, pharmacology and behavioral sciences are making inroads into a better understanding of brain function. The UC Davis MIND Institute draws from these and other disciplines to conduct collaborative, multidisciplinary research. For more information, visit mindinstitute.ucdavis.edu. Office of theVice Chancellor | 4610 X Street | Sacramento, CA 95817 | 24-hour Sacramento campus operator: (916) 734-2011 | Davis campus operator: (916) 752-1011

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You are hereHome > UCSF News Center > New Brain Cancer Treatment May be More Effective, Less Toxic New Brain Cancer Treatment May be More Effective, Less Toxic Results of UCSF Clinical Trial May Change Standard of Care for Primary CNS Lymphoma, Researchers Say By Jason Bardi on April 08, 2013 A Phase 2 clinical trial testing a new protocol for treating a relatively rare form of brain cancer, primary CNS lymphoma, may change the standard of care for this disease, according to doctors at UC San Francisco who led the research. Described this week in the Journal of Clinical Oncology, the trial involved 44 patients who were given a combination of high-dose chemotherapy with immune therapy, rather than the standard combination of chemotherapy with a technique known as whole-brain radiotherapy. The figure shows the before (A) and after (B) brain scan of a primary CNS lymphoma patient treated with a combination of high-dose chemotherapy with immune therapy, avoiding the need for whole-brain radiotherapy. Image courtesy of James Rubenstein. The new treatment approach was significantly less toxic because it avoided whole-brain radiotherapy, which at high doses can kill brain cells and lead to a progressive deterioration of the function of the nervous system in patients. Many patients die from the toxicity of the radiation as opposed to the cancer itself. The new treatment also seemed to work better, with the majority of patients on the trial still alive with a follow-up of nearly five years, researchers found. The lymphoma-free survival of patients with this form of brain cancer was doubled compared to the lymphoma-free survival in previous multicenter U.S. cooperative-group-sponsored clinical trials involving brain radiotherapy, said UCSF oncologist James Rubenstein, MD, PhD, associate professor of medicine, who led the study. In addition, unlike previous treatments for primary CNS lymphoma, the new approach was equally effective in older patients – those over 60 – as it was in younger patients. This is particularly significant given that the incidence of this type of brain tumor appears to be increasing in patients 65 and older. Rubenstein is a member of the UCSF Helen Diller Family Comprehensive Cancer Center, which is one of the country’s leading research and clinical care centers, and is the only comprehensive cancer center in the San Francisco Bay Area. The work raises the possibility of taking a “personalized medicine” approach to guiding treatment for this form of cancer because the researchers identified a biomarker – a gene called BCL6 – which could predict the outcome of treatment depending on how much of the gene was present in the tumor. A randomized clinical trial, which will test the effectiveness of the new therapeutic approach in a larger patient population, is now enrolling at UCSF and at other medical centers in the United States. A Deadly, Debilitating Disease Primary CNS lymphoma is a deadly and debilitating form of non-Hodgkin’s lymphoma, which is the fifth leading cause of cancer in the United States. James Rubenstein, MD, PhD About 1,600 Americans are diagnosed with primary CNS lymphoma every year, and its diagnosis is made difficult because the disease is often mistaken for other forms of brain cancer or other neurological diseases such as Alzheimer’s or multiple sclerosis. One of the unmistakable features of the disease, however, is its poor outcomes and its often severe and debilitating neurological symptoms. Unlike other forms of brain cancer, in which surgery is a front-line treatment, surgery is performed only to establish the diagnosis for primary CNS lymphoma because the tumors tend to be widely disseminated within the brain. More than a decade ago, when Rubenstein arrived at UCSF, he was interested in changing this reality, and a dozen years ago he designed a new protocol with his colleagues in the UCSF Hematology and Bone Marrow Transplant Unit, led by Lloyd Damon, MD, based on combining chemotherapy with immunotherapy, which relies on biological drugs derived from immune system components. “We were interested in developing a new therapy for these patients, with greater efficacy and less toxicity compared to the standard of care regimen,” Rubenstein said. By 2005, the UCSF regimen was being tested in a multicenter study. The results of the Phase 2 multicenter clinical trial replicate the initial UCSF results with the regimen, which demonstrate that long-term survival is feasible in this disease. The article, “Intensive Chemotherapy and Immunotherapy in Patients With Newly Diagnosed Primary CNS Lymphoma: CALGB 50202 (Alliance 50202)” is authored by James L. Rubenstein, Eric D. Hsi, Jeffrey L. Johnson, Sin-Ho Jung, Megan O. Nakashima, Barbara Grant, Bruce D. Cheson, and Lawrence D. Kaplan. It appears in the April 8 issue of the Journal of Clinical Oncology. In addition to UCSF, authors on this study are affiliated with the Cleveland Clinic; Duke University Comprehensive Cancer Center in Durham, NC; the University of Vermont in Burlington, VT; and Georgetown University Hospital in Washington, D.C. This work was supported by the National Cancer Institute, one of the National Institutes of Health, via grant #RO1CA1398301, #CA60138, #CA21115, #CA33601, #CA77406, #CA77597, #CA31946, and #CA33601. Related Articles Research August 24, 2016 Some Breast Cancer Patients With Low Genetic Risk Could Skip Chemotherapy, Study Finds Research August 22, 2016 Frequency of Breast Cancer Screening is Best Guided by Both Risk, Breast Density, Says Study Research August 15, 2016 Immune-Cell Population Predicts Immunotherapy Response in Melanoma Subscribe to this topic » Explore Other UCSF News Research July 18, 2016 Researchers Map Zika’s Routes to the Developing Fetus Patient Care July 14, 2016 UCSF Develops Program to Help San Francisco Workers Deal with Stress on the Job Campus News June 21, 2016 UCSF Installs New Gender-Inclusive Restroom Signage Education May 6, 2016 UCSF Class of 2016 Reflects on Achievements, Challenges Search

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Home / Health News $100 million for U.S. autism research Sept. 5, 2012 at 1:00 AM Follow @upi Comments BETHESDA, Md., Sept. 5 (UPI) -- The National Institutes of Health awarded $100 million over five years for nine U.S. Autism Centers of Excellence, officials said. Alice Kau of the Eunice Kennedy Shriver National Institute of Child Health and Human Development says the National Institutes of Health created the Autism Centers of Excellence Program in 2007 to begin an intense and coordinated research program into the causes of autism and to find new treatments. "The Autism Centers of Excellence program allows NIH institutes to leverage their resources to support the large collaborative efforts needed to advance the broad research goals for autism spectrum disorders research," Kau says in a statement. "This year, the program has expanded to such areas as children and adults who have limited, or no speech; possible links between autism spectrum disorders and other genetic syndromes and potential treatments and the possible reasons why autism spectrum disorders are more common among boys than girls." The funded programs include: -- University of California, Los Angeles, which uses brain imaging technology to chart brain development among individuals having genes suspected of contributing to autism spectrum disorders. -- Emory University in Atlanta, which investigates risk and resilience in autism spectrum disorders, such as identifying factors associated with positive outcomes or social disability. -- Boston University, which uses brain imaging in an effort to understand why some with autism do not learn to speak. -- Yale University in New Haven, Conn., which investigates the poorly understood nature of autism spectrum disorders in females. $169M allocated for U.S. autism research Bush signs autism measure Online autism registry to push research Caring for all with autism: $35B per year

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Flu, measles alert continues; Vaccines available in the Valley Feb 15, 2013 at 11:16AM Flu season is hitting hard, but it's not too late to get immunized. King County Public Health clinics and community health clinics have vaccines available, and many other private locations are providing flu shots now, according to County Councilwoman Kathy Lambert's office. In the Snoqualmie Valley, flu vaccines are provided at Snoqualmie Ridge Medical Clinic at 35020 SE Kinsey St., Snoqualmie. No appointment is needed. Office hours are from 8 a.m. to 6 p.m. Monday through Friday and from 9 a.m. to 2 p.m. Saturdays. Vaccines are also available at the Snoqualmie Valley Hospital Primary Care Clinic during normal business hours. Unlike a regular cold, the flu comes on suddenly. Symptoms include fever, sore throat, dry cough, headache, dizziness and general body aches. Using good health habits can help prevent spreading the flu to others. Wash your hands frequently, cover your cough and stay home when you're sick. Measles alert Also of concern to public health this winter, health officials are tracking two reported cases of measles in King County in the past week. Exposures to this serious virus could have occurred January 18 at Sea-Tac Airport, or January 23-26 in Klahanie at the QFC and Starbucks. More information about dates and times of potential exposures is available here. Measles is a highly contagious disease. It is mainly spread through the air after a person with measles coughs or sneezes. Because most people in our area have immunity to the measles through vaccination, the risk to the general public is low. Drive-thru flu vaccinations available at Snoqualmie Valley Hospital Health officials announce public exposures to new Eastside measles case Bartell offers child vaccinations

医学

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Cigarettes kill — smokers know it, non-smokers know it. And the effects of inhaling second hand smoke are almost as detrimental as smoking itself. Studies show that a waitress who is working in a smoking environment involuntarily inhales an estimated two cigarettes every hour. And yet, there are little-to-no laws in Pulaski County protecting its citizens from the dangers of secondhand smoke and many local restaurants allow smoking in their establishments.But in 2013, Pulaski County Health Department (PDHD) is making strides to change this.PCHD recently announced that they received funds for the Healthy Futures Pulaski County (HFPC) initiative from the Missouri Foundation for Health, which focuses improving health through education of Environmental Tobacco Smoke (ETS).Israel Doba, HFPC tobacco control coordinator, said that Pulaski County has a higher smoking rate (at 23 percent) than the U.S. population (at 20 percent). He also said that Pulaski County's most prevalent disease is chronic obstructive pulmonary disease, which is caused by smoking.Even more alarming, he said that one in three Pulaski County youth between sixth and 12th grades have smoked a cigarette and that one in five youth are regular cigarette smokers."We are trying to educate and inform about environmental tobacco smoke to improve health in our county," he said.The initiative's objective is simple: to make Pulaski County become ETS-Free within the next three years. The health department is seeking members to form a coalition as a part of the first step to reaching this goal.The coalition will also formulate a policy that they feel will help our community decrease ETS, and in the greater view decrease unwanted health complications caused by tobacco smoke."The impact of secondhand smoke is way more detrimental than what people think it is," he said.According to PCHD, after three hours of being in the proximity of a smoker, a person has unknowingly and unwillingly smoked one whole cigarette.Doba said that protecting Pulaski County children against secondhand smoke is very important."Children don't have an option if their parents pull them into a smoking establishment, they can't tell their parents they don't want to go there," he said. "It's not their choice. But in the long run it inflicts many ailments on children including asthma, allergies, multiple types of cancer, and a wide range of respiratory ailments."HFPC also distributes information to the public concerning ETS, and in the near future will distribute brochures and pamphlets on the many smoke-free business establishments around the county. In addition, HFPC will also work with the schools to educate children on the harms of tobacco.

医学

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By Charlotte Boyd Norton and University of Louisville yet to reach agreement The bitter dispute between the University of Louisville and Norton Healthcare over the future of Kosair Children's Hospital continued yesterday. Louisville City FC beats Bethlehem... The University of Louisville says Norton rejected an offer to meet face to face with Gov. Steve Beshear and Attorney General Jack Conway to reach an agreement. In September, Norton filed a lawsuit claiming that U of L had no legal right to evict Norton from Kosair so it can take the building for its own use.Since then, the organizations have tried to reach an agreement. U of L says it was under the impression they were getting close to a deal and was surprised by Norton walking away.In a statement, Norton said it's unfortunate an agreement was not reached this week but that it is committed to continuing a relationship with the university. Tweet Copyright 2014 by WLKY.com. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. Kosair Children's Hospital

医学

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Black Lung Makes A Deadly Resurgence ShareTwitter Facebook Google+ Email Listen Listening... Originally published on July 16, 2012 4:54 pm Transcript SCOTT SIMON, HOST: Earlier this week, NPR and the Center for Public Integrity reported astonishing news: the coal miners' disease called black lung is a growing problem again. The investigative report also showed that weak regulation and industry deception has thwarted the effort to protect miners from the coal mine dust that causes black lung. NPR's Howard Berkes joins us. Howard, thanks for being with us. first, HOWARD BERKES, BYLINE: It's good to be with you, Scott. SIMON: And, Howard, I think in this day and age, it might be good to begin with a refresher. What is black lung? BERKES: Well, the formal name is actually coal workers' pneumoconiosis and it's triggered by the inhalation of coal dust. And over time, if there are enough of these particles and exposure continues, the affected lungs shrivel, they harden, they turn black. To me, they look like a scorched paper bag. And what NPR and the Center for Public Integrity found is that coal mining in portions of Virginia, West Virginia and Kentucky in particular, now involves more cutting of quartz rock that surrounds and courses through the coal seams and that adds silica to the coal dust. And the combination of silica and coal dust is especially toxic. We now have younger miners that are afflicted with black lung, and there's more rapid progression of the disease to more serious stages. SIMON: And I know you've spent some time with miners who are suffering from this disease. What stands up for you about your visits with them? BERKES: You know, that it wasn't supposed to be this way. That's 40 years ago, Congress and federal regulators promised an end to at least the worst stages of black lung. They imposed these strict limits on exposure to coal dust. They imposed an enforcement system that was supposed to hold mining companies to those limits and hold them accountable. Well, what we found is that mining companies gamed the system from the very beginning, so that there hasn't been reliable and accurate reporting of exposure to coal mine dust. And federal regulators have cracked down from time to time, but NPR and the Center for Public Integrity obtained federal records and they show that in the last decade alone, there were 53,000 valid dust samples that were excessive, but only 2,400 violations were issued. So coal miners like one we met, a guy named Mark McCowan. He's 47. He should have at least 10 more years of work ahead of him, maybe 40 more years of life, and he and the others are left with ruined lives. SIMON: Now, in your stories, we heard Mark McCowan's labored breathing when he talked about his work as a coalminer in Virginia and he lives with black lung. He told you it was even tough to hold his 2-year-old grandson. BERKES: Yeah, and at one point in our interview, I pointed to the photograph on the wall behind him of his grandson. He has this big, broad smile on his face. And this is what McCowan told us. MARK MCCOWAN: And my biggest fear is I won't live long enough for him to remember me. 'Cause I know my grandfather died when I was 2 and I don't have any memory of him. So, on the one hand you know you're leaving and on the other hand, you know you better make the most of what you've got. SIMON: Howard, I think almost anyone listening to this will wonder, what's being done? Are there congressional hearings? Are there protests? Are there reform movements? BERKES: You know, the last time the nation was energized about black lung was back in 1969. That's when 40,000 West Virginia coalminers staged a wildcat strike. And within a few months, just a few months, Congress acted. But I can't resist playing for you a bit of a speech from that era by West Virginia congressman Ken Hechler. This is from a black lung rally. (SOUNDBITE OF ARCHIVED SPEECH) REPRESENTATIVE KEN HECHLER: The greatest heroes are you the coalminers. UNIDENTIFIED WOMAN: That's right. HECHLER: You've taken the future, your future, in your hands. And you've proclaimed no longer are we going to live and work and die like animals. We're free men. (APPLAUSE) SIMON: It does sound like it's from a time capsule. BERKES: Well, you know, you don't hear members of Congress making speeches like that anymore, especially about black lung. And we're not hearing now anything like, you know, the passion, the urgent calls for action that we heard back then. The Mine Safety and Health Administration is vowing to tackle black lung and they have a program called Dust Busters, where they've targeted specific mines. The agency has proposed some major reforms, but they've been blocked by congressional Republicans who've asked the Government Accountability Office to investigate the research that shows black lung is back. And there are concerns that the Obama administration won't move ahead with any reforms in an election year. In the last 40 years, Scott, black lung killed or helped kill 70,000 coalminers. Together, the industry and the federal government have paid out $45 billion in compensation. These are undeniable facts, and you'd think that might trigger outrage and action in Washington. SIMON: We have all of our stories about black lung on our website at npr.org. Howard Berkes, thanks for joining us. BERKES: You're welcome, Scott. SIMON: NPR's Howard Berkes worked with the Center for Public Integrity on an investigation of the resurgence of the coal miners' disease black lung. (SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.Related Program: Weekend Edition © 2016 WYSO

医学

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Saving Newborns: 'Kangaroo Care' Could Go A Long Way By Jason Beaubien May 7, 2013 ShareTwitter Facebook Google+ Email View Slideshow A health worker weighs a Somali baby on scales at a medical clinic in Mogadishu. Babies in Somalia have the highest risk of dying within the first 24 hours after birth. Carl de Souza Simply teaching women to breast-feed their infants could prevent many newborn deaths, says Dr. Gulchehra Boboeva, from Save the Children in Dushanbe, Tajikistan. Originally published on May 8, 2013 9:46 am In the developing world, a baby's first day of life is often the most perilous. Roughly 3 million newborns die each year, the nonprofit Save the Children reported Tuesday. Most of these deaths occur in the first week of life, and more than 1 million babies pass away within 24 hours of being born. Although the report calls for some big changes in health care systems to prevent newborn deaths, it also says that some simple, inexpensive things could save many lives. For instance, teaching mothers to hold their newborns against their skin — a technique called kangaroo care — could help many babies survive. Washing umbilical cords with an antiseptic could reduce infections among newborns. And a little training for midwives could prevent thousands of babies from being strangled by umbilical cords during delivery. There are also easy ways to revive many infants that aren't breathing. For the first time, Save the Children ranked 176 countries in terms of the risk of a baby dying within 24 hours after delivery. Not surprisingly, the worst place in the world to be a newborn is sub-Saharan Africa. The last 10 slots in the ranking were all in Africa, with Somalia and the Democratic Republic of Congo at the very bottom. Countries in South Asia were ranked higher in the index, but the region as a whole did poorly. The sheer number of babies dying in South Asia is higher than anywhere else in the world, the report finds. Each year more than 400,000 newborns die on day one in India, Pakistan and Bangladesh alone. The worst country in Eastern Europe and Central Asia is Tajikistan. Infant mortality is high all across Tajikistan, but it's particularly bad in remote, mountainous parts of the country, says Dr. Gulchehra Boboeva, from Save the Children in Dushanbe, Tajikistan. "In these areas, up to 80 percent of the births take place in the home — most without a skilled birth attendant," she says. The landlocked former Soviet republic is one of the poorest countries in the world. Many African nations actually ranked higher than Tajikistan on Save the Children's list. Boboeva says many Tajiks don't have health care for two reasons. They can't afford to pay for it, and there simply aren't clinics or nurses, never mind doctors, in many parts of the country. After the communist social safety net collapsed along with the Soviet Union, Tajikistan has struggled to re-establish a public health care system. "In Tajikistan, in the very remote areas, some of the villages have no health facilities and no health workers," Boboeva says. "One health worker provides medical services to three or four villages. And they do not have enough time to sit with the families, mothers and conduct some education sessions." That health worker may not even be a trained nurse, and he or she probably makes rounds on foot over long distances. Boboeva says simple training of expectant mothers and birth attendants could dramatically reduce the thousands of newborn deaths that occur each year in Tajikistan. For instance, she says, after a baby is born, other women traditionally take the infant away and bathe it. "They think that after the birth they have to wash the baby first before putting it to the breast-feeding," she says. "This will be problem." The babies are often taken away for long periods of time to let the mother rest, but Boboeva says the child is at risk of getting chilled at a time when it's extremely vulnerable to infections. She and Save the Children advocate kangaroo care and immediate breast-feeding. There's evidence that a mother's initial milk, the colostrum, contains antibodies that help protect the baby. But Boboeva says some women think they need to get past the colostrum. "Our women, they think that the colostrum is not clean. They will remove it and then put the baby to the breast," she says. There's an opportunity to save many babies in Tajikistan and around the world, Boboeva says, by focusing more on these small details during the first few hours of life.Copyright 2013 NPR. To see more, visit http://www.npr.org/. © 2016 WYSO

医学

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Operation Rescue staff NewsAbortionMon Jul 9, 2012 - 4:43 pm EST State cites safety concerns in defending Mississippi law that could close its last abortion clinic , jackson women's health organization , mississippi , operation rescue Jackson, Mississippi, July 9, 2012 (OperationRescue.org) – Documents filed in Federal Court Friday by the State of Mississippi show that serious health and safety concerns were primary motivating factors in passing a law that threatens to close that state’s last abortion clinic. That law, which requires that abortionists be board certified or eligible as Ob/Gyns and that they maintain local hospital privileges, was challenged by Jackson Women’s Health Organization in Federal Court to block its implementation after admitting that it could not comply with the law. The brief, submitted by Special Assistant Attorney General Benjamin Bryant, cited the recent closure of Alabama’s New Woman All Women after the Alabama Department of Public Health discovered 76 pages of violations, including “evidence that clinic staff failed to respond to complaints of post-surgical complications.” New Woman All Women was owned by Diane Derzis, who also owns the Jackson Women’s Health Organization. Instead of remedying the violations, Derzis agreed to close the abortion clinic and disaffiliate from any one that might attempt to relicense the facility. The State’s brief also cited a lawsuit filed in 2011 by abortionist Joseph Booker, a former employee of the Jackson Women’s Health Organization (JWHO), who sued the clinic “alleging that Derzis had instituted numerous practices that jeopardized the health and safety of patients, including: • Permitting untrained staff to perform and interpret ultrasounds, despite the fact that accurate ultrasound are vital to the medical safety of patients. • Pressure from the JWHO administrator to administer RU486 abortion pills in a manner that is “dangerous” and not approved by the Federal Food and Drug Administration (FDA). • Belief that JWHO does not carry malpractice insurance. • JWHO is jeopardizing patient safety by not using a “local doctor who has hospital admitting privileges” when administering RU486 because of the “real risk of severe hemorrhage” and “the risk of ectopic pregnancy” associated with the drug. The State noted that as the Supreme Court abortion rulings currently stand, “the right to abortion services belongs to the women who access those services – not to the physicians who provide them.” Parker has claimed that his right to perform abortions is jeopardized by the new law, when no such Constitutional right exists. The State’s Exhibits appear to be devastating to the abortion clinic’s arguments that abortion is so safe that hospital privileges are unnecessary. A declaration submitted by John Thorp, Jr., M.D. notes that hospital privileges make it more likely that abortionists can effectively care for patients. He stated that 73% of hospitals report inadequate on-call coverage by specialists, especially Ob/Gyns. Dr. Thorp also concluded that hospital privileges prevents patient abandonment by itinerate physicians. A declaration by James C. Anderson, M.D. states that the new law “will most likely improve the quality of care…and enhance patient follow-up care after an abortion.” Anderson continued, “As stated earlier, I have worked in local Emergency Rooms across Virginia for over thirty years. When women have come to the Emergency Room with complications related to an abortion, never once have I received a phone call initiated by the provider conveying information about the abortion, the young woman’s condition or potential complications. I have always had to evaluate the situation, come to my own conclusions, and initiate what I thought was appropriate treatment. This definitely created some time delays that were not in the patient’s best interest. I have called many abortion clinic physicians but never once has the provider come to the Emergency Room to assume care. I have always had to call a staff physician. This then creates another delay since the staff physician is taking care of his/her own patients, but now must change his/her schedule to assume the care of someone else’s patient. These delays can have life-threatening implications when dealing with hemorrhage or infection.” Dr. Anderson cites the cases of 35 abortion clinics and providers from recent news stories as “illustrative of the need for state regulation of abortion practice and conformity to standards of care in medicine.” Those cases include that of Ann Kristin Neuhaus in Kansas, Feliciano Rios and Andrew Rutland in California, Rapin Osathanondh in Massachusetts, Alberto Hodari in Michigan, and ten abortionists in Texas who were discovered to have committed violations during an undercover investigation conducted in 2010 by Operation Rescue and The Survivors, and other cases. Judge U.S. District Judge Daniel P. Jordan III, who is an appointee of President George W. Bush, will hear oral arguments at a hearing scheduled for Wednesday, July 11, 2012. “We are guardedly optimistic that the judge will uphold this much needed safety rule on Wednesday, and are very confident that the law will eventually be cleared by the courts for enforcement since similar laws in other states have been upheld as Constitutional,” said Troy Newman, President of Operation Rescue and Pro-Life Nation, who has been involved in supporting the pro-life law since its inception. “The states have a right to protect women, and that is what Mississippi is trying to do. It is ridiculous to argue, as Jackson Women’s Health Organization has, that it is in the best interest of women to keep an abortion facility open that cannot ensure that patients receive safe and timely emergency care. If they can’t comply with even this minimum safety law, then they should not be allowed to continue to endanger the health and safety of women.” State cites safety concerns in defending Mississippi law that could… By Operation Rescue staff The first step needed to get the Church out of the current crisis

医学

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Cold viruses point the way to new cancer therapies Salk Institute for Biological Studies Cold viruses generally get a bad rap -- which they've certainly earned -- but new findings by a team of scientists suggest that these viruses might also be a valuable ally in the fight against cancer. Salk researchers discovered that a small protein produced by cold viruses disables large cellular machines involved in growth, replication and cancer. These proteins accomplish this by forming a three-dimensional web inside a cell's nucleus (yellow) that traps these components. The findings point the way to new ways to target and destroy tumors. Credit: Courtesy of the Salk Institute for Biological Studies Cold viruses generally get a bad rap -- which they've certainly earned -- but new findings by a team of scientists at the Salk Institute for Biological Studies suggest that these viruses might also be a valuable ally in the fight against cancer. Adenovirus, a type of cold virus, has developed molecular tools -- proteins -- that allow it to hijack a cell's molecular machinery, including large cellular machines involved in growth, replication and cancer suppression. The Salk scientists identified the construction of these molecular weapons and found that they bind together into long chains (polymers) to form a three-dimensional web inside cells that traps and overpowers cellular sentries involved in growth and cancer suppression. The findings, published Oct. 11 in Cell, suggest a new avenue for developing cancer therapies by mimicking the strategies employed by the viruses. "Cancer was once a black box," says Clodagh O'Shea, an assistant professor in Salk's Molecular and Cell Biology Laboratory, who led the study. "The key that opened that box was revealing the interactions between small DNA tumor virus proteins and cellular tumor suppressor complexes. But without knowing the structure of the proteins they use to attack cells, we were at a loss for how these tiny weapons win out over much larger tumor suppressors." O'Shea's team studied E4-ORF3, a cancer-causing protein encoded by adenovirus, which prevents the p53 tumor suppressor protein from binding to its target genes. Known as the "guardian of the genome," p53 normally suppresses tumors by causing cells with DNA damage -- a hallmark of cancer -- to self-destruct. The p53 tumor suppressor pathway is inactivated in almost every human cancer, allowing cancer cells to escape normal growth controls. Similarly, by inactivating p53, the E4-ORF3 protein enables adenovirus replication in infected human cells to go unchecked. Two years ago, O'Shea discovered that E4-ORF3 clears the way for adenovirus to proliferate by deactivating genes that help the cell defend itself against the virus. "It literally creates zip files of p53 target genes by compressing them until they can no longer be read," she explains. E4-ORF3 self-assembles inside cells into a disordered, web-like structure that captures and inactivates different tumor suppressor protein complexes. Horng Ou, a postdoctoral researcher in O'Shea's laboratory, says E4-ORF3 is unusual. "It doesn't resemble any known proteins that assemble polymers or that function in cellular tumor suppressor pathways," he says. "Most cellular polymers and filaments form uniform, rigid chains. But E4-ORF3 is the virus's Swiss army knife -- it assembles into something that is highly versatile. It has the ability to build itself into all sorts of different shapes and sizes that can capture and deactivate the many defenses of a host cell." In collaboration with scientists from the National Center for Microscopy and Imaging Research at University of California, San Diego, led by Mark Ellisman, the center's director, O'Shea's team used new techniques to reveal the ultrastructure of the remarkable polymer that E4-ORF3 assembles in the nucleus -- something that previously had proven difficult since the polymer is effectively invisible using conventional electron microscopy. "What you see is the E4-ORF3 polymer bending and weaving and twisting its way through the nucleus," she says. "It does appear to have a single repeating pattern and creates a matrix that captures several different tumor suppressors and silences p53 target genes." Initially, E4-ORF3 forms a dimer, made up of only two subunits. In this form, E4-ORF3 largely ignores its cellular targets. The researchers theorized that when E4-ORF3 assembles into a polymer, however, it binds to tumor suppressor targets far more aggressively. To test this theory, they genetically fused E4-ORF3 polymer mutants to lamin, a cellular protein that assembles intermediate filaments that provide stability and strength to cells. They showed that the lamin-E4-ORF3 fusion protein assembled into cylinder-like superstructures in the nucleus that bind and disrupt PML, a protein complex that suppresses tumors. The Salk findings may help scientists develop small molecules -- the basis for the vast majority of current drugs -- capable of destroying tumors by binding and disrupting large and complex cellular components that allow cancer cells to grow and spread. Understanding how viruses overcome healthy cells may also help scientists engineer tumor-busting viruses, which offer a new and potentially self-perpetuating cancer therapy. Such modified viruses would destroy only cancer cells, because they could only replicate in cells in which the p53 tumor suppressor has been deactivated. When a cancer cell is destroyed it would release additional copies of the engineered viruses, which would seek out and kill remaining cancer cells that have spread throughout the body. Engineering these viruses requires disabling the ability of the E4-ORF3 protein to inactivate p53 in healthy cells -- otherwise, the virus could destroy healthy cells as well as cancer cells. At the same time, E4-ORF3 has certain important functions in allowing the virus to replicate in the first place, so it can't be completely removed from the virus's arsenal. Thus, the Salk researcher's work on understanding the protein's precise structure, functions and interactions is crucial to engineering viruses in which E4-ORF3's abilities have been precisely modified. Other researchers on the study were Witek Kwiatkowski, Katherine Blain, Hannah Land, Conrado Soria, Colin Powers, James Fitzpatrick, Jeff Long and Senyon Choe from the Salk Institute; Thomas Deerinck, Andrew Noske, Xiaokun Shu and Roger Tsien of the University of California, San Diego; and Andrew May of Fluidigm. The work was supported by the National Institutes of Health, American Cancer Society, Sontag Foundation, the Arnold and Mabel Beckman Foundation, and Anna Fuller Foundation. The above post is reprinted from materials provided by Salk Institute for Biological Studies. Note: Content may be edited for style and length. Horng D. Ou, Witek Kwiatkowski, Thomas J. Deerinck, Andrew Noske, Katie Y. Blain, Hannah S. Land, Conrado Soria, Colin J. Powers, Andrew P. May, Xiaokun Shu, Roger Y. Tsien, James A.J. Fitzpatrick, Jeff A. Long, Mark H. Ellisman, Senyon Choe, Clodagh C. O'Shea. A Structural Basis for the Assembly and Functions of a Viral Polymer that Inactivates Multiple Tumor Suppressors. Cell, 2012; 151 (2): 304 DOI: 10.1016/j.cell.2012.08.035 Salk Institute for Biological Studies. "Cold viruses point the way to new cancer therapies." ScienceDaily. ScienceDaily, 16 October 2012. <www.sciencedaily.com/releases/2012/10/121016162830.htm>. Salk Institute for Biological Studies. (2012, October 16). Cold viruses point the way to new cancer therapies. ScienceDaily. Retrieved August 28, 2016 from www.sciencedaily.com/releases/2012/10/121016162830.htm Salk Institute for Biological Studies. "Cold viruses point the way to new cancer therapies." ScienceDaily. www.sciencedaily.com/releases/2012/10/121016162830.htm (accessed August 28, 2016). Human parainfluenza viruses Aug. 18, 2016 — There are four globally endemic human coronaviruses which, together with the better known rhinoviruses, are responsible for causing common colds. Usually, infections with these viruses are harmless ... read more Mutations of Immune System Found in Breast Cancers Nov. 18, 2013 — Mutations in the genes that defend the body against cancer-related viruses and other infections may play a larger role in breast cancer than previously thought, according to a ... read more Percentage of Cancers Linked to Viruses Potentially Overestimated Aug. 5, 2013 — The results of a large-scale analysis of the association between DNA viruses and human malignancies suggest that many of the most common cancers are not associated with DNA viruses. The findings ... read more 'Molecular Wipe': Potential Treatment for 'Pink Eye' Epidemic Sep. 28, 2011 — Scientists are reporting discovery of a potential new drug for epidemic keratoconjunctivitis (EKC) -- sometimes called "pink eye" -- a highly infectious eye disease that may occur in 15 ... read more Strange & Offbeat

医学

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Home birth: 'What the hell was I thinking?' There's the blood, the pain, the second thoughts. Are home births an unnecessary trial – or the most rewarding way to have a baby? Amelia Hill joins one woman in labour to find out Karen King: ‘I’m pregnant, not sick, so why should I go into hospital?’ Photograph: Lydia Goldblatt Amelia Hill @byameliahill "It hurts!" wails Karen King, gripping the rim of the birthing pool, her face contorted in agony. The midwife looks up from her file of notes. "I know," she says calmly. "It means you're getting there." From somewhere deep inside, Karen expels a shattering howl. It ricochets around the living room, where the paraphernalia of everyday life has been piled into corners to make space for the business of childbirth: latex gloves draped over a fruit bowl; a gas canister slung on top of a pile of unsent cards. Water slops from the pool on to the parquet where, in a few days, a baby will hopefully be sleeping in a moses basket. Kevin, Karen's husband, strokes her hair from her eyes. "If I could, I'd swap places with you and take the pain myself," he whispers. Karen moans. "What the hell was I thinking? I just want an epidural. Or a caesarean." Kevin and the midwives share a glance, unsure whether Karen is serious – which would mean an emergency transfer to hospital. Between the waves of pain, though, Karen is clearly relieved to be at home and in control, instructing Kevin to get towels from upstairs, cushions from next door and pills from her bag. In the kitchen, champagne and pâté are chilling in the fridge. Upstairs, scented candles surround the bed, ready for when the new family curl up together for the first time. A week earlier, Karen had been very clear on the reasoning behind their choice: "We're not hippies," she said, "but I'm pregnant, not sick, so why should I go into a hospital? Why go into an unfamiliar, clinical setting where you don't get continuity of care and are at risk of all sorts of other things like MRSA and swine flu? "The best thing is that, after a home birth, I can shower in my own bathroom, then get into my own bed with my new baby," she added. Yet there are medical experts who maintain that home births are dangerous and irresponsible. Some believe the practice is so reckless, it amounts to child abuse. So powerful is this anti-home birth lobby that not even Karen's hippies are choosing the option in great numbers any longer. Until the advent of modern medicine, home birth was the de facto method of delivery. Long acknowledged to be safe for low-risk mothers, it is, when compared with hospital delivery, associated with fewer maternal interventions and a shorter recovery time. Women are less likely to haemorrhage, or to experience lacerations or infections. Despite this, the practice has suffered a precipitous decline. In 1959, 34% of women gave birth at home in the UK. Last year, just 2.7% made the same decision. In Scotland, 1.2% of births take place at home. In Northern Ireland, this drops to fewer than 0.4%, while in the Republic of Ireland, the nursing and midwifery bill currently going through the Dáil will criminalise any midwife who doesn't take a woman to hospital 24 hours after her waters have broken, even though this can happen up to 12 hours before contractions begin and the labour might be proceeding well, requiring no medical intervention. Even in Wales, which in 2002 became the only country in the world to set a target for home births – 10% by 2007 – local authorities report rates varying between 1% and 3.8%. Yet, low as they are, rates in the UK are still higher than across most of the developed world. In some US states, rates are down to 0.1%, while in the Netherlands – the country to which home birth campaigners have long looked for support and inspiration – numbers have plummeted from two-thirds in 1965 to less than a quarter today. Supporters of the practice say there is a very real possibility that legal home births will be eradicated in some countries in the very near future. The overall picture is so bad, says Annie Francis, from Independent Midwives UK, she is tempted to believe there is a "global conspiracy against home birth". "That's probably not the case," she concedes, "but people get so vitriolic and polarised about home births that it's hard to have a sensible conversation. We need to ask the questions: how has medicalised childbirth become the default position? Where has this great fear of childbirth come from in the west?" Back in Hertfordshire, Karen lies on the sofa, one leg slung over the back cushions, the other foot resting on the floor. "You couldn't, with any degree of honesty, say I'm unstressed or relaxed at the moment," she says, between waves of pain. "But in a hospital there would be beeping machines and strangers. I'm not saying this is great – but that would make it so much worse." Philip Steer, emeritus professor in obstetrics and gynaecology at Imperial College London, has assisted at around 8,000 births and was an adviser to Nicholas Winterton's committee on health when it undertook an in-depth inquiry into maternity services in 1992. He insists he is not "anti home birth", but admits he "feels slightly frustrated when women's groups say most women should have a natural labour". Human birth is not as straightforward as many claim, he argues. "Over the last half a million years, the pelvis has become much smaller, to adapt to our upright posture. And because being brainy is such an advantage, our baby's heads have become much bigger. In some parts of Africa, this causes the death of one in six women from obstructed labour. In Nigeria alone, more than one million women are waiting for surgery to have their bladder repaired because of damage done by pressure of a prolonged labour during childbirth." Problems in labour arise far more commonly than many people appreciate, Steer says. Around half of pregnant women in the UK will have or develop a complicating factor – from high blood pressure to diabetes – that makes a hospital birth advisable. Of the remaining half, he says, about 50% develop a problem during labour that may require an emergency transfer to hospital. "That can be very traumatic, even if things end up well." For a moment last summer, it looked as though a new report would sound the death knell for home birth. The well-respected American Journal of Obstetrics & Gynaecology carried a meta-analysis of studies from several industrialised nations that concluded planned home births carried two to three times more risk of neonatal death than a planned hospital delivery. The findings reverberated across the world. In the UK, an editorial in The Lancet said the study "provides the strongest evidence so far that home birth can, after all, be harmful to newborn babies". The editorial went on to claim the findings were so unequivocal that women should no longer have the right to choose a home birth: "Women have the right to choose how and where to give birth, but they do not have the right to put their baby at risk." The reaction of the midwifery community was excoriating. Cathy Warwick, general secretary of the Royal College of Midwives, denounced the research as "flawed". Picking apart the study's methodology and findings, she concluded it was "a deliberate attempt to undermine home births". The AJOG is now backpedalling. "Due to an enormous amount of correspondence we have received raising concerns over this article, it is undergoing a careful review," says Thomas Garite, the journal's editor-in-chief. "We would prefer not to comment until that review is completed." The debate is muddied by the fact that evidence for outcomes of newborn babies delivered at home is contradictory: data comes from small, observational studies, and frequently includes misclassified cases – such as the actual rather than the planned delivery location. Even vital facts, such as perinatal mortality or caesarean rates, cannot be compared because of variations in how the data is collated and defined. In the face of such confusing messages from the medical community, women such as Karen, who choose to have their first child at home, are increasingly rare. Marie Martin's first child, Alexandra, was born in hospital in 2007. "I had wanted the security of a hospital birth, but it turned out to be anything but reassuring," she says. "Instead, I found it very distressing and disempowering. There were lots of drugs involved, and an overwhelming feeling that I was not in control, a feeling that I am certain contributed to the postnatal depression that dogged me for the first year of motherhood." When it came to giving birth to Alex's brother, Philip, in October, she decided to deliver at home. "I have to admit that the home birth was not the experience I thought it would be, either," she says. "It was really painful and hard work. I didn't feel particularly empowered. But it was miles better than being in hospital – and when we were left alone, minutes after Philip arrived, in our own home, the family bonding was unbelievably intense and wonderful. I have never experienced such unadulterated joy. We were all literally weeping with happiness." The experience is not always so blissful, however. When Kim Mussell gave birth to Daisy, her second daughter, at home in south London five years ago, she ended up with an infection so serious she nearly died: "The midwife made me give birth in a position I wasn't comfortable in, which meant I tore really badly. She stitched me up, but there was internal damage she missed. I ended up in hospital on a drip for a week and having to undergo reconstructive surgery." ‘I’d rather have the drugs right now than be at home.’ Photograph: Lydia Goldblatt Karen's home birth doesn't go to plan, either. By the time the midwives have been with her for three hours, she is ready to give up. "I can't take this pain. I'm sorry, everyone, but I don't think I'm going to make it. I would rather have the drugs right now than be at home." Depending on one's interpretation, the midwife is either calming – or reluctant to admit defeat. "Do you really, really want that?" she asks. "Why don't you listen to some music instead?" Karen doesn't have the strength to argue. They agree to compromise: the baby has two more hours to show up. After that, Karen will go to hospital and take every drug she can lay her hands on. The decline in UK home births began after the Peel Report of 1970, which said every woman should have the right to give birth in hospital. As Professor Steer says, "I'm old enough to remember the 60s, when women marched in the streets, demanding more places be made available for hospital births." But it took less than a generation for women to realise what they had lost: by 1992, a survey by the expert maternity committee found that 72% of women said they wanted an alternative to a hospital delivery. Of those, 44% were interested in home birth. The government, the Royal College of Obstetricians and Gynaecologists, and the Royal College of Midwives came out in support of greater choice for women, including access to home births. Britain's maternity services were duly transformed. The conundrum today is why, despite 50% of women regularly polling as being in support of the practice, the take-up is still so low. "You need three things in order for women to be free to choose home births," says Dr Leonie Penna, a consultant in foetal medicine and obstetrics at King's College hospital. "You need women who want a home birth, you need a supportive infrastructure and you need midwives who are happy to deliver it. Unfortunately, we obstetricians undermine the first two – and sometimes even all three. By our nature, we are very risk averse. Many of us blow out of proportion the risk inherent in home births, counselling women against it in a very paternalistic way. The fewer women chose it, the more the infrastructure is weakened. Then midwives begin to lose confidence, and suddenly the entire structure becomes shaky." The risks are not just health-related. Disputes involving obstetricians now account for almost two-thirds of the annual £800m NHS medical litigation bill. That means that about 15% of the current maternity budget is going to lawyers and clients: an almost tenfold increase in 11 years. "Cerebral palsy victims – one case in six of which are associated with mistakes during labour – can each get £6m or more, and I know of private sector obstetricians faced with insurance premiums of £100,000 or more a year," Steer says. "It is inevitable that everyone wants to play safe." Perhaps most crucially in the UK, there simply aren't enough midwives: the small increase in numbers over the past few years has nowhere near kept pace with our historically high birthrate, itself complicated by increasing numbers of obese and older women, who are likely to need more medical attention. Against this backdrop – and despite the onus on trusts to provide home births for any low-risk woman who wants one – women are finding they now have only very limited access to them in parts of Britain, with midwifery services often withdrawn at short notice. Karen is one of the lucky ones. For her entire labour, she has the dedicated attention of two NHS midwives. Armed with just gas and air and a Tens machine, they respond to Karen's pleas for drugs with the suggestion that she tries a birthing ball – "Or perhaps we could all sing a song?" Karen growls at this suggestion, while Kevin ducks his head to hide a smile. But this well-staffed, relatively laid-back home birth is not available to every mother. And, according to Mary Newburn, head of research and information at the parenting charity the National Childbirth Trust, unless at least 5% of women choose a home birth, the practice will never gain the momentum required to steamroller the necessary infrastructure into existence. In the Netherlands, however, where the infrastructure does exist, home birth rates have nonetheless "dropped like a stone", according to Professor Simone Buitendijk, head of the child health programme at the Netherlands Organisation for Applied Scientific Research. Confidence faltered after the death rate among newborn babies failed to decline as fast as in some other European countries. A series of media reports raised questions about the safety of home births, culminating in a leading national newspaper running a front-page splash entitled: "Don't Try This At Home." "Soon, there will not be enough demand to justify the infrastructure," Buitendijk says. "Then the system will collapse – and let there be no misunderstanding: we won't be able to rebuild it." In other countries, midwives face prosecution for delivering babies at home. Just last month, Hungarian midwife and home birth expert Dr Agnes Gereb was sentenced to two years in prison for malpractice, after a mother went into early labour in her birthing centre. The judge also found Gereb guilty of medical negligence in two other home births, including one in which the baby died. The sentencing came just weeks after the Hungarian government finally decided to regulate home births. Until last month, women in Hungary have had the right to give birth at home – but medical professionals were banned from assisting at planned home births. Home births will now be allowed from 1 May, but only under strict safety conditions. Whether, after Gereb's sentencing, there will be any midwives prepared to take the risk is another question. For a brief period last May, it even became illegal to have a home birth in New York City. Under a "written practice agreement" system introduced in 1992, midwives in New York state are obliged to be approved by a hospital or obstetrician. Only one hospital – St Vincent's in Manhattan – was prepared to do that. When it went bankrupt on 30 April 2010, the city's midwives were unable to find another institution willing to underwrite them. Overnight, the city – which already had a home birth rate of just 0.48% – was left without a single midwife legally able to help a woman give birth in her own home. A mass public protest led to the passing of the Midwifery Modernisation Act, which allows midwives to work free from the control of obstetricians. But the American College of Obstetricians and Gynaecologists continues to denounce home births. Choosing to have a baby at home, it says, is to show preference for the process of giving birth over the goal of having a healthy baby. In a statement, it said: "We do not support programmes that advocate for, or individuals who provide, home births. Childbirth decisions should not be dictated or influenced by what's fashionable, trendy, or the latest cause célèbre." Back in the King house, Karen has managed without drugs – although it has been a close call on a number of occasions. At 2.40pm, almost exactly four hours after Kevin called the midwives, Karen rises from the sofa like Gaia. Throwing her legs apart, she squats with her hands on her hips and turns her face upwards. There is a sudden silence in the room. All attention is focused on Karen but she is elsewhere, straining against the pain of the contractions. At 3.12pm, the baby's head appears. Beside himself, Kevin rubs Karen's thigh, her shoulder, her forehead: "Hey, baby! Hello. Hello, gorgeous!" he weeps. Together on the sofa, the new parents look like children themselves: gleeful, astonished and amazed. "Oh dear God," breathes Karen. "I didn't think I was going to make it. Hello, baby. Hello, Agatha Florence Fenella King. It's OK: Mummy's here. Daddy's here." But that is not the end of the story: an hour after giving birth, Karen has still not delivered the placenta. An injection of syntometrine proves useless. The placenta refuses to appear. Agatha suckles and is weighed – 6lb 9.5oz. She is measured and her temperature taken. But the atmosphere in the room has changed. It is no longer celebratory. At last, an hour later, the midwife gives up hope. The ambulance and paramedics are called. Karen struggles to take a balanced view. "It seems so unfair that I have to have an epidural now, when I didn't have it when the pain was so indescribably awful," she says weakly. Seventeen minutes later, an ambulance pulls into the driveway. The front door bangs open and a blast of cold air accompanies the bustling paramedics into the room. They immediately take control. Still bloodied and dazed, Karen must hand over her baby and be led outside. As she lies alone in the back of the ambulance – parents are not allowed to make emergency transfers with their babies – there is a second flurry of panic in the house. Unbeknownst to Karen, Agatha has stopped breathing. In the living room, Kevin stares mute and helpless as his child turns blue on the sofa in front of him. The midwife swiftly resuscitates the baby and, as colour floods back to her face, a second ambulance is called. Agatha is out of danger, but will be checked over at the hospital, just in case. A paramedic goes outside to tell Karen what has happened, speaking so skilfully she barely has time to register that her daughter was in danger before understanding that she is now safe. Her ambulance speeds away into the night, leaving an ashen-faced Kevin tightly clutching his daughter – a tiny bundle, swaddled in thick, red blankets. While the paramedics and midwives exchange notes back in the house and quickly clear up their equipment, Kevin is left alone to climb into the back of another ambulance. There he waits, until the doors are closed and he, too, speeds away. Distressing as it might be, this is not an unusual outcome for home births: around 40% of first-time mothers who plan to deliver their child at home end up being transferred to hospital. It is for this reason that some experts, including Professor Steer, believe home births are suitable only for those who have previously had an uncomplicated pregnancy and a healthy baby: about a quarter of pregnant women. There is, however, no evidence that emergency transfers put the mother or baby at any risk. The Confidential Enquiry by the National Birthday Trust into every UK home birth in 1994 found that, though the 769 mothers and babies who were transferred included two stillbirths and two neonatal deaths, "the outcome was satisfactory for the baby in the vast majority of cases". Back at home, the day after the birth, the Kings are exhausted and dazed, but don't regret their decision. "At least we had a chance of experiencing what would have been, for us, the perfect birth," Karen says. "We lost nothing by trying: we ended up in hospital, which is where we would have been had we opted for that in the first place." In fact, the few hours Karen spent in hospital merely confirmed her suspicions. "I was right: hospitals stress me out. Despite everything, I'd try for a home birth again next time." Agatha shifts in her cot and lets out a contented sigh. Her parents look over at the sleeping child, almost in surprise. "I keep forgetting that she's actually here: that we've really got this wonderful, beautiful baby," says Karen. "We've finally got our family." Parents and parenting Being pregnant felt like being in drag Kira Cochrane: As a butch lesbian, AK Summers had to cope with the challenge of living in her pregnant – suddenly feminised – body Babies born in private hospitals ‘more likely’ to have health problems Guardian Australia: Study, which looked at 700,000 ‘low-risk’ births in NSW, suggests higher rates of medical intervention could be the cause Hospital births have never been safest – Nice is right to reverse this myth Since the 1960s, UK births have increasingly taken place in the stressful environment of hospitals, but as this week’s guidelines highlight, there was never any proof that this was the safer option Published: 2 Dec 2014 Tales of pregnancy and childbirth: the world wide womb Global traditions have much to teach us on pregnancy and childbirth. In the run-up to Mother's Day, a new book reveals what we can learn from Japan's sumo wrestlers, the generous Finns and Moldova's fear of fish, writes Amy Fleming Published: 24 Mar 2014 Freebirthing: is giving birth without medical support safe? Gay parenting: it's complicated Home or hospital? A Guardian roundtable debate on where to give birth Experience: I was a sperm donor for my friends

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Science Stem cell researchers awarded $500K prize in NY ALBANY, N.Y.—Three stem cell researchers have been awarded the annual Albany Medical Center Prize in Medicine and Biomedical Research for their pioneering work in human stem cells.The winners announced Wednesday are Elaine Fuchs of Rockefeller University in New York City; James A. Thomson of the private, nonprofit Morgridge Institute for Research and the University of Wisconsin-Madison School of Medicine and Public Health; and Shinya Yamanaka of Kyoto University in Japan and Gladstone Institute of Cardiovascular Disease in San Francisco.They will share $500,000, the largest award in medicine and science in the United States. The prize was established in 2000 by the late Morris "Marty" Silverman.James Barba, president and CEO of the medical center, said their discoveries move medical researchers closer to new treatments for diseases such as diabetes, Parkinson's, spinal cord injury and cancer."The solutions to these debilitating diseases and many, many others that plague humans might very well be found through the science of stem cells," Barba said in a statement.Stem cells are prized for their versatility. They can turn into any cell in the body.Yamanaka and Thomson are credited with discovering in their separate labs how to genetically reprogram adult human cells back to an embryonic state. This discovery was reported as a major scientific breakthrough in 2007. The cell lines, now used in laboratories worldwide, promise to speed up stem cell research by offering an alternative to actual embryonic stem cells.Fuchs' work has focused on the biology of stem cells. Her discoveries in understanding how stem cells make skin and hair and how they repair wounds have led her laboratory to the genetic bases of human skin disorders, including cancers.------Online:http://www.amc.edu/Academic/AlbanyPrize More articles in Science

医学

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Our blog Join Now Our blogHow Music Heals Us: An Interview With Dr. Stephan Quentzel April 6, 2012In honor of “Music Is Good For You” month, we sat down to chat with Dr. Stephan Quentzel about some of the amazing ways he and his colleagues are channeling music’s unique power into healthcare. Dr. Quentzel is triple board-certified in psychiatry, family medicine, and holistic medicine. Not only is he a private practitioner in New York City, he also serves as the Medical Director of The Louis Armstrong Center for Music & Medicine in Manhattan’s Beth Israel Hospital, where the healing power of music plays a dynamic role in a variety of treatments. Hi Dr. Quentzel! Thank you so much for taking the time to chat with us. What is it like at the Louis Armstrong Center For Music? What kinds of patients come to the center, and what kind of treatment do they receive? Well, musical therapy is useful in relaxing people – whether it’s going into surgery or dealing with pain. There’s a lot of data on the psychological and brain physiology changes that come with music. They help one to relax, to feel less pain, to feel less tension or anxiety, and that’s a big benefit when you’re going into surgery or dealing with medical or psychiatric issues. There are also a lot of uses for music therapy in pediatric cases. Kids tend to be particularly responsive to music in two important ways. One is the physiology of the relaxation response, the opposite of the stress response. The other is that kids tend to be a little more open than adults, and music can serve a useful role as an avenue of expression. Even though they’re not musicians per se, they can use music as an avenue of expression to deal with their fears, their guilt, their anxiety about the medical situation they find themselves in. Even in the NICU, dealing with newborns who are undergoing medical problems, and their attentive parents who are stressed by the situation, music therapy helps. You can literally see the difference when you look at the monitor and watch the breathing rate or the heart rate of these newborns. It runs the gamut of physiological and psychological benefits, from cradle to grave. And music therapy is applied throughout Beth Israel Medical Center for a variety of these benefits. Is there a special place in medicine for music that is familiar to us? For instance, when treating a person with Alzheimer’s, would a music therapist use pop music from the patient’s youth? Without a doubt, that is the case. For example, we’ve all had this experience where you hear just two or three notes of a song you knew as a child and it all rushes back. The memory trigger of music, with its own unique pathways in the brain, can very much generate long term memories and bring back some of that material. It can be particularly comforting for people wrestling with a variety of things late in life, Alzheimer’s being one of them. There are also a variety of debilitating illnesses where the calming effect of tapping into those joyful childhood memories through music has a real, significant impact on quality of life in the moment. Even at a physiological level. For example? For example, someone who has had a stroke and can no longer speak. The hard wiring, the nerve networks of the brain for speech are different than for singing. So someone who has had a stroke and can’t speak can still sing! You can teach them to sing their expression, their needs, rather than speak them. In essence, you can get them singing and slowly remove the melody and just leave the lyrics. So if they can sing to you what they need to express, rather than speak it, it offers up a nerve path around the damage of the stroke and still allows them to communicate, when they apparently couldn’t through just speech. You serve autistic children at the clinic. What advice would you give to parents who are helping their kids deal with autism? Are there special ways for them to incorporate music into their daily lives? Absolutely. The use of music therapy in autism is a very rich therapeutic modality. It’s used intensely to help folks suffering from autism. Music seems to provide, at a physiological level as well as an interpersonal level, a language or an avenue for connection where autistic kids respond when they aren’t through other ways of connecting. The music can vary for what resonates with a particular autistic child. Some respond to rhythm, some respond to melodies, different types of music. A good music therapist can find the type of music that connects best with the individual kid. But a parent can do the same, and go through a series of instruments, a series of styles, singing or no singing, percussion and rhythm emphasis, melodic emphasis, the pace, to find things that resonate most intensely with the unique autistic child that they have in their family, and to help draw connection with the child and the rest of the world. A music therapist can certainly help to expedite that process and refine it, but a parent on his or her own can experiment with different instruments, different approaches to music, and find what really connects with the child. You also manage a program that’s specifically tailored to the healthcare needs of musicians. What do you provide for artists and performers that they may not be able to get at a regular hospital? Well, we’re geared toward comprehensive care, so we provide medical care, psychiatric care, holistic care, music therapy, and music psychotherapy for musicians and performing artists, in a context where the realities of being a performer are understood. So it’s sort of a friendly home for musicians. In addition, we provide psychiatric care and music psychotherapy for musicians, which is an interesting perspective, because there are some psychiatric conditions that tend to be present in musicians more often than the general public. Things like insomnia, anxiety, depression, bi-polar disorder, substance abuse, and then a variety of life stressors. Because every gig is your last, you’re never assured that you have work in the future unless you’re in the upper, tiny echelon of performers. So we take them, as we say, “from Broadway to subway”. Music psychotherapy for musicians is a fascinating process, in that we use music as one of the languages to reach the psycho-dynamic material, or the unconscious material of musicians, since it’s the language that can be useful for them as an expressive outlet. There are psychological issues that are over-represented in the musician population that we are particularly sensitive to treating. Things as run-of -the-mill as stage fright, but also more complex things. What sort of special psychological pressures do musicians face? We all have a “true self” internally and an external or “false self” that we present to the world. Everybody has that. But it tends to be magnified in performers, where they have a stage persona and an internal persona. That large difference can generate a great deal of conflict, where the internal self and the external self are not meshing. It can generate a lot of psychological disturbance. Once your sense of valuation is no longer internal, no longer judged by yourself but by the audience, you’re in a lot of trouble because ultimately you can never get enough applause to have a sense of self-worth. You can start playing in a small bar and graduate up to playing in a football stadium, but you can never get enough applause if you’re looking for external validation. So those are a few facets of what makes us unique in trying to help musicians and performing artists with the things that they wrestle with. But of course, a lot of it is overlap with what the general public has. These aren’t unique issues, they just may be magnified when it comes to musicians and performing artists. Do you think struggling with psychological issues or depression as an adolescent can play a part in people initially immersing themselves in music? That’s an interesting question. You start to talk a little bit about left brain/right brain and the folks who were born with the more creative right brain emphasis. They have to meet the same day-in and day-out pressures from the rational world, which as an adolescent might be school. But an adult has to put food on the table and pay the rent. These kinds of skills are often more in the logical brain. You know, like an accountant. An accountant may not be creative, but he can pay the bills. He has a brain that allows him to meet the demands of typical American life, that makes him employable, able to pay the rent, put food on the table, even if he does not have a particularly creative existence. So at least he doesn’t starve to death. He may suffer from the lack of creativity, but not suffer to the point where it jeopardizes his existence. On the other hand, the performing artist or musician may very well be endowed with these creative abilities which are wonderful, and do a great deal of service to society as a whole – but can make it rather difficult in our society to pay the bills, to put food on the table and pay the rent. So they may not be suffering from a loss of creativity and what that brings to light, but if they can’t pay the rent, a lot of good their creativity does them! So in that respect, you think our society puts special pressures on musicians? Sure. Even when you look back to adolescence, we don’t have a particularly supportive system for the artist. We don’t have a social safety net that says: the arts are so important to us collectively that we should be pooling our resources (let’s say through a government program) to make sure that the artist doesn’t have to worry about housing, food, and supporting the family. We should, because what the artist brings is valuable to the rest of us. But in our culture, the artist still has to find a way to pay the bills. So, there are a unique set of pressures that the artist faces – not because he’s an artist, but because he has the brain of an artist. That may not satisfy some of the “pull yourself up by your bootstraps” demands of our culture, even though it blesses him with the creativity that many of us wish we had. So it is fair to talk about some of the unique pressures or difficulties in meeting some of the normative demands which are so narrowly defined in our culture, when one is sort of born an artist. It’s a fair conversation to have. Do you have any favorite artists that you find yourself returning to for their success in a healing context? When I’m looking for emotional stuff I tend to end up with “gut music,” simple folk stuff which resonates in the gut. Or some of the more transcendental jam music, psychedelic kind of stuff. But also from the jazz world, somebody like Louis Armstrong is such a pioneer, he’ll be known 300 years from now the way we look back and know Bach or Mozart. There are hundreds and hundreds of composers that we don’t know now, or only musical historians know. The biggest pop bands of today will be a blip on the historical record. They will not matter 300 years from now. But Louis Armstrong will. Muddy Waters will. Bob Dylan will, as real unique genres of music that have long term lives. So for me, some of those real pioneers have ways of touching the soul in powerful ways. Thank you so much, Dr. Quentzel! Head on over to our Facebook page for more musical goodness! Popcorn: Healthier Than You ThinkWe're Here To Help (In Any Language) Zocdoc News Connect With ZocDoc Need help booking? Call Zocdoc at (855) 962-3621 or email [email protected] Rural Estates South Naples Gynecologists Zocdoc for Business Copyright ©2016 Zocdoc, Inc. Zocdoc is a registered trademark of Zocdoc, Inc. 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医学

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Radiation Therapy for Prostate Cancer Both external and internal may be used to treat prostate cancer. External Beam Radiation Therapy External beam radiation therapy uses radiation produced by a machine called a linear accelerator. Short bursts of x-rays are fired from the machine at the tumor. The x-rays come out in square shapes; the radiation oncologist designs special blocks or special collimators within the machine to shape the radiation beam so that it treats the cancer and as little normal tissue as possible. There are several newer techniques that may be used in treating your prostate cancer, including conformal treatment planning and intensity modulated therapy (IMRT). These techniques allow a more precise delivery of radiation to the tumor area and may be used alone or in combination with surgery, hormonal therapy, or brachytherapy (implantation). Radiation of a Tumor The side effects of radiation result from injury to the normal tissues. There are many new ways that a radiation oncologist can customize your treatment to try to kill as much cancer while sparing as much normal tissue as possible. The radiation oncologist will determine how many treatments you will receive. Treatment generally only takes a few minutes, and the total treatment time can range from 5-8 weeks depending on the total dose required. Radiation therapy can be given to treat cancer at its initial site or once it has spread. In some cases, once cancer has spread, radiation is no longer curative. However, the treatments can help resolve problems that the cancer may be causing, including pain and weakness. Can you continue to receive radiation to an area that has already undergone radiation treatment? While it is true that each tissue in the body can only safely tolerate a certain dose of radiation, radiation therapy is very focused. Therefore, it is possible to receive additional treatments to an already treated area. Your radiation oncologist is the best source of information as to what dose you can safely receive. Internal Radiation Therapy Internal radiation therapy, also called brachytherapy, places the radiation source as close as possible to the cancer cells. To treat prostate cancer, a capsule containing radioactive materials is placed directly into the prostate. Some implants are left in place permanently, while others are left in place for only 1-3 days. Depending on which type of implant you receive, you may stay in the hospital while the implants are in place. Sometimes implant/internal radiation is combined with external beam radiation therapy. Brachytherapy requires a short hospital stay and, because of the radioactivity emitted by the capsule, may require some modifications in lifestyle for a period of time after the procedure. Research continues to show that brachytherapy is equivalent to external beam radiation therapy or in the treatment and cure of prostate cancer. However, the practice of brachytherapy, like surgery, is dependent on who is doing the procedure. Some doctors who perform brachytherapy procedures participate in quality control programs that monitor their practices and help improve their results. Radiation therapy for prostate cancer may cause erectile dysfunction (ED), and urinary and bowel problems. Most studies show that ED rates are less for radiation therapy than for standard prostatectomy and slightly less than that for nerve-sparing procedures. Rates of following radiation therapy are also less than following prostatectomy. But, there is an increased risk of due to radiation. Treatments are available to help manage these side effects. Sometimes adjustments to treatment doses may also be possible. The earlier side effects are addressed, the more likely they will be controlled with a minimum of discomfort. Revision Information Prostate cancer. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 2, 2015. Accessed October 2, 2015. Prostate cancer. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/genitourinary-disorders/genitourinary-cancer/prostate-cancer. Updated November 2013. Accessed October 2, 2015. http://www.ebscohost.com/dynamed. Smith DP, King MT, Egger S, et al. Quality of life three years after diagnosis of localised prostate cancer: population based cohort study. 2009;339:b4817.

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Old wives' tales that are true Some old wives' tales are myths, and some even dangerous -- but others are real, and backed by medical science. Check out this collection of old wives' tales that are true. An apple a day keeps the doctor away: Research at the University of Ulster found that apple phenols protect against colon cancer. Researchers at Cornell University also found that up to six apples a day can prevent breast cancer in primates, and believe this may also apply to humans Hot tubs may decrease chances of pregnancy: A three-year study at the University of San Francisco found men who switched to showers instead of their normal hour-long hot baths had sperm counts that rose nearly 500 percent. Long labor, must be a boy: Researchers at Dublin's National Maternity Hospital studied 8,000 births and found that mothers of boys were significantly more likely to have longer labor and more complications. Don’t swim right after eating: The Winnipeg Regional Health Authority says after a meal, blood is diverted to the digestive tract to help assist with the digestive process. Exercise diverts blood to muscles, so it is possible that vigorous exercise after a meal could lead to cramps. Wear a hat to hold onto your body heat: U.S. military research in the Arctic in the 1950s found up to 80 percent of body heat was loss through the uncovered heads of volunteers. Subsequent research conducted in Army labs qualified the claim, finding that a body at rest loses 7 to 10 percent of heat through the head, and during exercise, up to 50 percent, according to TLC: How Things Work. Eat your carrots: Researchers at the Erasmus Medical Centre in Rotterdam found that eating high levels of beta carotene - the compound that gives carrots their coloring - as well as vitamins C, E and zinc, lowers the chance of age-related macular degeneration by up to 35 percent. Other sources of beta carotene include pumpkins, sweet potatoes, pink grapefruit and spinach. Gain a child, lose a tooth: New York University College of Dentistry did a study of more than 2,500 women and found that as the number of children increases, so does the mother's risk of losing teeth. More children also led to a greater risk of developing periodontal disease. Drink cranberry juice for a bladder infection: A study done at Harvard Medical School showed that properties in cranberries destroy bacteria clinging to the wall of the bladder. Blackberry juice has a similar effect. Chicken soup fights a cold: Allabouthhealth.org/UK says that in the 1980s, researchers from the University of Nebraska Medical Center found chicken soup has anti-inflammatory properties that help soothe a cold. Other researchers have found that the amino acid, cysteine, is a byproduct of chicken soup, seems to reduce the inflammatory response that comes from colds and other upper-respiratory infections. Willow bark tea can cure a fever: The University of Maryland Medical Center says the use of willow bark dates back to the time of Hippocrates (400 BC) when patients were advised to chew on the bark to reduce fever and inflammation. The bark of white willow contains salicin, a chemical similar to aspirin (acetylsalicylic acid). In the 1800s, salicin was used to develop aspirin. White willow appears to bring pain relief more slowly than aspirin, but its effects may last longer. Swallowing gum can plug up your intestines: Swallowing a huge wad of gum or swallowing many small pieces of gum in a short time can cause a blockage within the digestive system called a bezoar, most often in children who have a smaller-diameter digestive tract than adults, according to Scientific America. But the condition is extremely rare. Fish is brain food: Fish oil is high in the essential fatty omega-3 and omega-6, which are good for brain health and function. According to Dr. Jennifer Thieman, a recent study showed that, among people over age 65, those with high fish intake showed a lower rate of cognitive decline. Another study, done at Oxford University, found that children with coordination problems who were given omega-3 and omega-6 EFAs over three months showed significant improvements in school performance. Thumb sucking gives children buck teeth: Unless a thumb sucking child stops before age 4, gums, jaw and permanent teeth can be affected, causing the condition known as buck teeth, according to Kids Health from Nemours. You’ll snore more if you sleep on your back: Sleeping on your back allows gravity to make your tongue fall back into your throat, partially blocking the airway, causing your tongue to vibrate as air passes, increasing snoring, according to the British Snoring and Sleep Apnea Association. Chewing parsley cures bad breath: Parsley has long been known to counteract garlic breath. Herbalist Dee Atkins says that the high sulphur content of garlic that causes the unpleasant odor it counteracted by compounds in parsley. But putting parsley in food to cure bad breath doesn’t work. It takes chewing a sprig of fresh parsley. Loud music will ruin your hearing: Over time, repeated exposure to loud music or noise can cause hearing loss, according to U.S. National Library of Medicine. Sounds above 80 decibels may cause vibration intense enough to permanently damage the inner ear, especially if the sound continues for a long time. Spider webs stop bleeding, heal wounds: In traditional European medicine, spider webs are used on wounds and cuts to help healing and reduce bleeding. Spider webs are rich in vitamin K, which can be effective in clotting blood. arachnologist Rainer Foelix says a coating on webs may protect old and abandoned webs from fungal and bacterial attack, giving spider webs an antiseptic quality. Full moon causes seizures: Researchers at the University of Patras Medical School in Greece found "significant clustering of seizures" around the full moon in a study involving hundreds of patients. "I can feel it in my bones:" Researchers at Instituto Poal de Reumatologia in Barcelona found that arthritic patients had increased joint pain when there was a drop in atmospheric pressure. Heartburn during pregnancy means a hairy baby: Pregnant women who reported moderate heartburn had hairy newborns 82 percent of the time while the majority of heartburn-free women gave birth to bald babies, according to a study done by researchers at Johns Hopkins Hospital in Baltimore. Researchers surmise that the pregnancy hormones that stimulate fetal hair growth, also relax the esophageal sphincter, allowing stomach acid to back up into the esophagus and causing heartburn. Breakfast is my most important meal of the day: Skipping breakfast can lead to low blood sugar. Once food is eaten later, insulin levels shoot up, leading to hunger later in the day and disposition of fat in the abdomen, according to Dr. Judith Reichman, NBC Today Health. Non-breakfasting individuals are more likely to become obese, and to develop heart disease and have higher and earlier rates of mortality, she says. Trout jump high when rain is nigh: When rain is impending, low pressure systems generally occur, according to Accuweather.com. The lowering of pressure can cause plant particles that were trapped at the bottom of a lake to rise, providing food for small fish. The small fish, in turn, become food for larger fish. The saying may be referring to this increased activity, and not necessarily jumping trout in particular. Vitamin C Cures Colds: The belief that vitamin C cures colds goes back to disputed claims made by Nobel Prize winner Linus Pauling in 1970. TLC, How Stuff Works, reported that in 2007, a sweeping review of 60 years of studies found that taking 200 milligrams of vitamin C every day shortened the duration of colds by a day, and it also seemed to cut the incidence of colds in people who were under extreme stress by 50 percent. Researchers say the antioxidant effect of vitamin C also helps rebuild molecules that are damaged during everyday activities. Bees never get caught in a rain: Bees stick close to their hives just prior to rain. According to experts, bees use light from the sky to orient themselves. Before it rains, there are ice crystals in the clouds which foul bees’ ability to “see,” so they move inside before it rains, according to Examiner.com. Red sky at night, sailors’ delight: When we see a red sky at night, this means that the setting sun is sending its light through a high concentration of dust particles, according to the Library of Congress, Everyday Mysteries. This usually indicates high pressure and stable air coming in from the west. Typically, good weather will follow. Red sky in morning, sailors take warning: A red sunrise reflects the dust particles of a system that has just passed from the west, according to the Library of Congress, Everyday Mysteries. This indicates that a storm system may be moving to the east. If the morning sky is a deep fiery red, it means a high water content in the atmosphere. So, rain is on its way.

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Search Untangling the HIE Mess Shelley Slade Boosting a Drug’s Market Share Can Cross a Dangerous Line Finally, Attention Switches To Progressive Multiple Sclerosis Home MANAGED CARE February 2008News and CommentaryHeadlines on Deadline... Linkedin Share ButtonTweet WidgetShare on Facebook Sounds like capitation to me. Blue Cross & Blue Shield of Massachusetts is proposing to overhaul the way it pays doctors and hospitals. The plan wants to stop paying doctors and hospitals for each patient visit or treatment, and instead wants to pay a flat sum per patient each year. The fee would be adjusted for age and sickness, and would include a bonus if the providers improve care. . . . Updated rates of uninsured women categorized by state have just been issued by the Kaiser Family Foundation. The rates range from a high of 28 percent of women 18–64 (Texas) to a low of 9 percent (Minnesota). Among low-income women, in the same age group, the uninsured rate ranges from 51 percent (Texas) to 20 percent (Maine and Vermont). . . . The slowdown in health spending growth is not likely to last, according to a report issued by the Center for Studying Health System Change. Government economists report that personal health care spending — the portion of national health care spending that accounts for health care goods and services, grew 6.6 percent in 2006, just a hair below 2005’s 6.8 percent growth.

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DEALBOOK; A Health Deal As Japanese Look Abroad For Growth By MARK SCOTT and MICHAEL J. DE LA MERCED 5:40 p.m. | Updated The Asahi Kasei Corporation of Japan agreed on Monday to buy Zoll Medical, a health care equipment maker in the United States, for $2.2 billion, becoming the latest Japanese company to expand abroad. Under the terms of the deal, Asahi will pay $93 a share, a 24 percent premium to Zoll's Friday closing price. While mergers activity over all has slowed down in the last year, deal makers point to a few pockets of sustained interest. One of them is Japanese companies pursuing markets overseas even as their home markets stagnate. About $82.8 billion worth of cross-border deals involving Japanese buyers have been announced in the last 12 months, nearly quadrupling the previous year's volume, according to data from Capital IQ, a research firm. The health care sector has usually been among the busiest industries for deals, as companies seek to bolster their offerings with higher-growth areas like devices. ''In the medical devices business, the U.S. market leads the world, not only in size and scope, but also in technological innovation, so establishing a strong infrastructure in the U.S. is an important step for Asahi Kasei,'' Taketsugu Fujiwara, the Japanese company's president, said in a statement. He added: ''This transaction will allow us to build on Zoll's strong U.S. business position and its technology leadership, with Zoll forming the cornerstone of our critical care business.'' Asahi Kasei, based in Tokyo, said the acquisition would help the company increase its presence in the health care market. The company generates less than 8 percent of its annual revenue from its health care division. The majority of its sales come from its chemical and fibers businesses. Zoll, based in Chelmsford, Mass., said this year that revenue for the three months through Jan. 1 rose 18 percent, to $133.7 million, compared with the period a year earlier. Net income rose 70 percent, to $6.6 million, over the same period. The two companies already have done business together. Last July, Asahi Kasei reached a deal to market Zoll's AED Plus defibrillator device in Japan. Zoll's management team will remain intact after the deal's closing, which is expected by the end of the second quarter. The deal is notable in one other aspect: Zoll received financial advice from Brown Brothers Harriman & Company, an old-line Wall Street firm not usually associated with multibillion-dollar deals. The transaction on Monday was the biggest advisory assignment for Brown Brothers on record, according to data from Reuters. Zoll also received legal advice from Goodwin Procter. Asahi Kasei was advised by UBS and the law firm Cleary Gottlieb Steen & Hamilton. This is a more complete version of the story than the one that appeared in print. Inside NYTimes.com Health » Too Hot to Handle

医学

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Registered Nurses' Association of Ontariol’Association des infirmières et infirmiers autorisés de l’Ontario Speaking out for nursing. Speaking out for health. MyRNAO eHealth & Technology Best Practice Guidelines Policy & Political Action Home » Newsroom » Media Releases RNs lay out expectations for political parties in advance of Ontario election 2007-05-10 Marion Zych TORONTO, May 10, 2007 – Ontario’s RNs are marking Nursing Week with a challenge to all political parties to adopt policies and programs that will advance a better health-care system and a healthier society for all Ontarians. The nurses’ platform, Creating a Healthier Society, released this morning at Queen’s Park by the Registered Nurses’ Association of Ontario (RNAO), outlines recommendations in five key areas: social determinants of health, the environment, Medicare, the nursing workforce, and taxes. RNAO says the evidence on the social determinants of health is irrefutable and the time for action is now. “We offer a clear vision and pragmatic solutions about the support systems that are needed to help people maintain or regain their health,” says RNAO President Mary Ferguson-Paré. “We live in an affluent province and can no longer ignore the increasing number of men, women and children who are left behind due to poverty. A $10 minimum wage; protection for vulnerable workers; higher social assistance rates; a community-based housing strategy; concrete steps to raise children above poverty – these are the actions that will help vulnerable people fight poverty,” says Ferguson-Paré. The nurses’ platform also outlines what steps need to be taken to ensure a healthier environment and reduce exposures to pollution, toxins, and harmful chemicals, and to change our energy policies to emphasize conservation and to avoid further disruption to our planet and to our health. “These are the factors that keep people healthy and make people sick. We work with patients every day – in hospitals, nursing homes, and in the community at large. We know what makes a difference in the quality of our patients’ lives,” says RNAO’s President.RNAO’s platform also addresses the investments needed to build Ontario’s publicly funded and not-for profit health-care system and keep it sustainable for decades to come. “We need political leaders who have the courage to say no to those who want to benefit from privatization and the destruction of Medicare,” says RNAO Executive Director Doris Grinspun. “We have one of the best acute care systems in the world, and as we continue improving it, we must do much more to promote health, prevent illness and help people with chronic conditions manage their diseases. This can only be achieved by ensuring adequate numbers of nurses working to their full potential in all health sectors and substantial investments in primary care and home care,” she says. “We also need another 9,000 RNs employed in Ontario by 2010 and 70 per cent of them working full-time to provide the public with the nursing care they need and deserve,” says Grinspun.“These strategies, accompanied by a continued commitment to full-time guaranteed employment for graduating nurses and the adoption of the 80/20 strategy for nurses 55 and over (80 per cent of nurses’ time spent in direct patient care and 20 per cent spent mentoring new graduates), will ensure a healthier nursing workforce and improve retention and recruitment to the profession. This will also benefit the public,” she adds. “Our proposals set the stage for a critical dialogue over the coming weeks and months, and we urge Ontario’s political parties to adopt our recommendations in their own platforms,” says Ferguson-Paré. “We also want people to know where nurses stand on these important issues because they will define the campaign and help voters decide what kind of province they want to live in.” She concludes that “nurses say no to tax cuts and yes to social, environmental and health services that will create a healthier society.” The association’s full report can be found at RNAO’s website at www.rnao.ca.The Registered Nurses’ Association of Ontario (RNAO) is the professional association for registered nurses in Ontario. Since 1925, RNAO has lobbied for healthy public policy, promoted excellence in nursing practice, increased nurses’ contribution to shaping the health-care system, and influenced decisions that affect nurses and the public they serve. -30- Marion Zych, Director of Communications, RNAO Toll free: 1-800-268-7199 ext.209 [email protected] Media Spokespersons Media Advisories/Releases Contact a Communications Professional Nursing Workforce Backgrounder Media Awards RNAO in the News

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