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Plea for £20m hospital shortfall is turned down By Gillian Ellison Last updated at 11:21, Thursday, 13 December 2012 A PLEA for £20million from the Government to plug a shortfall in the cost of redeveloping West Cumberland Hospital has been turned down. shortfall: The West Cumberland Hospital Copeland MP Jamie Reed made the request to Health Secretary Jeremy Hunt after saying there was not enough money for the major project. But he has been told that hospital bosses have to find any money needed themselves. The original budget for the new West Cumberland Hospital was £100million, before the abolishment of the North West Development Agency which resulted in the loss of its promised £10million. And there is a question mark over how much of the original £10million commitment from North Cumbria University Hospitals Trust will be available as a result of its financial situation. Its takeover by Northumbria Foundation Trust has now been delayed beyond April 1 next year partly due to a “significant deterioration” in North Cumbria’s finances. Northumbria says money is needed for new equipment and furniture which the original development planned by the current trust did not provide. The £70million bulk of the funding has still not been released by the Treasury because contractual agreement has still not been reached. Mr Reed told The Whitehaven News this week: “Construction has begun on the new West Cumberland Hospital, foundations are going in, yet we face a significant shortfall in funding from government – this is a deliberate policy seen across the country. “I am prepared to be flexible about funding cuts from the government if the hospital delivers what we expect and what we have been promised in terms of beds and services, but right now it’s very hard to see how this is possible when government has taken one fifth of the funding from the project. “I will be asking Northumbria University Hospital Trust to help me to lobby government to ensure that the funding gap is filled. The hospital we have been promised, and the services within it, must not be compromised – irrespective of NHS funding being cut and the secretary of State for Health returning ‘NHS underspend’ to the Treasury.” The MP said resources were not being put into the community to provide sufficient out-of-hospital care, and the hospital project is “having its funding pilfered”. “This is fast becoming a crisis,” he said. “Unless something significant changes soon, then the government will have killed ‘Closer to Home’, we’ll have wasted a fortune and we’ll be back to the drawing board. I want the government to help local partners to stop this from happening: we face a harsh winter and our health services are going to be stretched like never before. We owe a huge debt to those medical staff who work in such conditions to keep our local NHS operational.” First published at 10:55, Thursday, 13 December 2012 Interesting that NCUH is in financial trouble and the redevelopment has stalled yet Mr Mulvey is now interim Finance Director at Arrowe Park Hospital where the previous project director also is now a director. Posted by Observer on 18 December 2012 at 16:18 I can hear the trumpet now - don't worry the white knight from down the road will be along soon ( at least before decision day 30 Jan ). Remember 'community benefits'!!What shall we call it ? The Sellafield wing or the Energy coast medical centre !! Sugestions on a postcard to your local MP. Posted by John on

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Severe complications of hand, foot and mouth disease (HFMD) caused by EV-71 in Cambodia – conclusion of the joint investigation 13 July 2012 - The investigation into the illnesses and deaths in Cambodia, which mainly affected very young children, concluded that a severe form of hand, foot and mouth disease (HFMD) was the cause in the majority of cases reported to the Ministry of Health. Samples from a total of 31 patients were obtained and tested for a number of pathogens by Institut Pasteur du Cambodge. Most of these samples tested positive for enterovirus 71 (EV-71) which causes HFMD. A small proportion of samples also tested positive for other pathogens including Haemophilus Influenzae type B and Streptococcus suis. It was not possible to test all the patients as some of them died before appropriate samples could be taken. The investigation included: a thorough review of the hospital records of the patients from Kantha Bhopa hospital as well as from other hospitals; laboratory tests; active follow-up with the affected families by the local Rapid Response Teams (RRT); and evaluation of the data from the national surveillance system. A total of 78 cases were identified. These included the initial 62 cases reported by Kantha Bopha hospital, and cases reported from other hospitals. Of these, the investigation focused on 61 cases that fitted a specific criteria (the case definition), and of which 54 had died. The investigation revealed that most of the cases were under 3 years of age, from 14 different provinces, with some suffering from chronic conditions. A significant number of cases had been treated with steroids at some point during their illness. Steroid use has been shown to worsen the condition of patients with EV-71. The Ministry of Health, with support from WHO and partners, which included Institut Pasteur du Cambodge and the US Centers for Disease Control and Prevention, conducted the investigation following reports from Kantha Bopha Children’s hospital of unusual numbers of illness and deaths among children hospitalised since April 2012. In response to this event, health centers have been instructed by the Ministry of Health to report all patients with HFMD. In addition, the Ministry of Health, assisted by WHO, has begun enhanced surveillance for neuro-respiratory syndrome, a key syndrome observed among patients with severe HFMD caused by EV-71. It is expected that the enhanced surveillance will identify occasional new cases of the severe form of the disease in the coming months. In addition, the Ministry of Health is developing guidelines and training courses for staff to manage patients with mild and severe forms of HFMD. A campaign to raise awareness on the prevention, identification and care of children with HFMD is underway. Related links A Guide to clinical management and public health response for hand, foot and mouth disease (HFMD) Hand, foot and mouth disease information sheet You are here:

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Home > News & Media > English UC Berkeley School of Public Health awarded $2.75 million grant to launch Best Babies Zones in four U.S. cities The W.K. Kellogg Foundation has awarded a $2.75 million grant to the University of California, Berkeley School of Public Health to implement a three-year pilot initiative, Best Babies Zone (BBZ), aimed at improving birth outcomes for infants and addressing health disparities in four major U.S. cities – Cincinnati, Milwaukee, New Orleans and Oakland, Calif. “Infant mortality is a powerful measure of the social inequities that exists in our nation,” says Dr. Cheri Pies, clinical professor at the UC Berkeley School of Public Health and principal investigator of the BBZ. “The goal of the Best Babies Zone Initiative is to close the infant mortality gap by helping communities build capacities so that babies are born into communities that enable them to thrive and reach their full potential.” As BBZ works towards their goals of improving infant mortality rates, the organization employs three primary strategies: identifying a small zone where change is greatly needed and resources are aligned to produce and measure impact; forming a broad collaborative to work across health, economics, education and community to achieve collective impact; and cultivating a social movement within the city to do whatever it takes to improve birth outcomes in the zone. Similar to the successful Harlem Children’s Zone, the BBZ Initiative takes a holistic approach. BBZ works to improve health systems by increasing access to quality prenatal and intrapartum care; provide pipelines to educational success beginning with “baby college” and quality early learning opportunities; and strengthen economic systems through microfinance, job readiness and financial management programs. The BBZ pilots in the four cities will serve as a blueprint for site development and implementation in other cities across the country. “The Kellogg Foundation believes in healing the profound gaps and disparities that exist in our country,” says Dr. Gail C. Christopher, vice president – program strategy for the W.K. Kellogg Foundation. “By concentrating on improving birth outcomes and taking a holistic approach, the Best Babies Zone Initiative will be giving our most vulnerable children the best chance to succeed against inequities they face.” The UC Berkeley School of Public Health will serve as the lead agency for the BBZ Initiative. Major collaborators on this project will include a consortium of national organizations including the Association of Maternal and Child Health Programs (AMCHP), CityMatCH and National Healthy Start Association. For more information, visit sph.berkeley.edu. Healthy Kids, News Chicago's communities turning schoolyards into vibrant outdoor spaces Space to Grow has secured $51 million in funding and plans to rebuild 30 schoolyards across Chicago in the next five years. Healthy Kids Oct. 15, 2014 Related Mississippi governor celebrates young men of color Mississippi Oct. 14, 2014 Detroit health care advocates and residents call for solutions on the city’s infant mortality crisis Healthy Kids Oct. 13, 2014 Northern Initiatives invests in small businesses to drive economic growth in northern Michigan communities Mission Driven Investments Sep. 17, 2014 Best Babies Zone: A holistic, neighborhood-based approach to improving birth outcomes Healthy Kids Aug. 13, 2014 Putting Children First

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Thoracic Oncology Home Thoracic OncologyThe Yale Cancer Center Thoracic Oncology Program (TOP) is a multidisciplinary program dedicated to providing cutting-edge evaluation and treatment to patients with thoracic malignancies in an efficient and coordinated manner.Through TOP, patients have access to nationally recognized expert clinicians, who provide an organized, collaborative approach to cancer care, and access to the latest technologies and treatments. Patients also benefit from newly available cancer therapies resulting from scientific insights gained in Yale laboratories and those of other comprehensive cancer centers in the United States.The program coordinates and integrates the diagnosis, evaluation, and treatment of patients with a thoracic malignancy, including lung cancer, esophageal cancer, thymoma, or chest wall tumors. The program involves a collaboration of specialty physicians, many of whom are listed among the country's best cancer physicians, and are nationally and internationally recognized for their expertise in these types of cancer. Specialties involved include medical oncology, radiation oncology, thoracic surgery, pulmonary medicine, digestive diseases, pathology, diagnostic imaging, and nursing.Any patient cared for by one of the TOP physicians benefits from the collective expertise of the entire program's physicians because of the team approach that is integral to the program. Patients also benefit from a comprehensive program to help with the physical, emotional, and psychological issues that are part of effectively confronting cancer. Finally, because cutting edge care is at times complex, patients also benefit greatly from the involvement of the team's care coordinators, who make management of even the most detailed multidisciplinary treatment plan less complicated.Cutting-edge TreatmentThe goal of the Thoracic Oncology Program is to treat most patients on a clinical trial or through an approach that represents the forefront of clinical care. TOP focuses the majority of their clinical research on areas of thoracic oncology where the standard treatment is poor and where the optimal treatment approach remains unclear. In these areas, the majority of patients are enrolled in a clinical trial providing them with access to innovative therapy options for their advanced disease. In diagnoses where standard treatment is a well-accepted approach, patients are provided access to cutting-edge approaches to deliver the treatment, including minimally invasive surgery and highly technically advanced radiation therapy treatment planning. Clinical Program Leader:Frank C Detterbeck, MDClinical Research Program Leader:Roy S. Herbst, MD, PhD Survivor Highlight Victor: Lung Cancer SurvivorWhen I found out that I was sick I didn’t know a lot about cancer or treatment options. I went to see my doctor because I noticed I had been losing weight, and was told I may have emphysema.Read More...Quick LinksMake an AppointmentClinical TrialsNews Make a GiftSurvivorship ClinicRelated LinksVisit the Yale Lung SCAN webpageStaging Lung CancerProclamation of Lung Cancer Awareness Day © Yale School of Medicine Yale School of Medicine

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Governor Quinn Tours Health Care Facilities in Southern Illinois Highlights New Law Benefiting Rural Hospitals; Celebrates Nursing Home Reforms BENTON – August 28, 2010. Governor Pat Quinn today toured several health care facilities in southern Illinois to highlight a new law that will benefit critical access hospitals, especially in rural parts of the state, and nursing home reforms. “It is critical that all Illinoisans have access to the medical care they need to live healthy lives. It is also very important that our most vulnerable citizens are kept safe when receiving care at a hospital or nursing home,” said Governor Quinn. “We must continue to do everything we can, including enacting good legislation, to improve our health care system.” The Governor’s first stop was Franklin Hospital, a critical access hospital in Benton, where he met with hospital administrators and local legislators to tour the facility. During his visit, Governor Quinn stressed the importance of newly signed legislation that will make sure citizens in rural parts of the state have access to medical care. Governor Quinn recently signed House Bill 5765, sponsored by Sen. Gary Forby (D-Benton) and Rep. John Bradley (D-Marion), which will go into effect on Jan. 11, 2011. The new law particularly benefits smaller rural hospitals, including those that are located throughout southern Illinois where many critical access hospitals are often several miles away from the nearest medical facility and serve large areas of the state. The new law requires critical access hospitals to be reimbursed for outpatient Medicaid services based on cost. Governor Quinn also today toured the McLeansboro Rehabilitation and Health Care Center, a 43-bed skilled nursing home facility in McLeansboro. During his visit, the Governor highlighted a landmark new law signed in July that transforms Illinois’ system of long-term care for frail older adults and persons with disabilities. The new law remakes the system of admission to nursing homes, ensuring that only those in need of 24-hour skilled care are admitted. The law also strengthens the screening process to prevent residents with violent criminal histories from being placed with vulnerable, older adults. Senate Bill 326, sponsored by Sen. Heather Steans (D-Chicago) and Rep. Barbara Flynn Currie (D-Chicago), resulted from strong collaboration between state agencies, members of the Illinois General Assembly, advocates, home and community based service providers, residents and the nursing home profession, led by Governor Quinn’s Nursing Home Safety Task Force. As part of his weekend tour of health care facilities in southern Illinois, Governor Quinn will also visit the Phoenix Foundation of Southern Illinois in Carmi later today to make an announcement that will improve access to medical care for residents living in or around White County.

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environment genomics The Spread of Dengue Fever Duane J. Gubler This Viewpoint discusses one innovative way to reduce the spread of dengue fever. interviewhighlights Dengue fever is a serious disease, which is transmitted from a certain type of mosquito. Dengue fever has reached pandemic status in most of the tropical countries. Urbanization, lack of mosquito control, and modern transportation accelerate the spread of the virus. Stored-water systems versus piped-water systems encourage mosquito breeding. More air travel to tropical areas increases the potential for the spread of the disease. read interviewlearn moreget involvededucator resources What is dengue fever? Dengue fever is a virus caused by mosquitoes. Gubler: Dengue [pronounced DEN-ghee] fever is a flu-like illness without the upper respiratory symptoms. It is caused by a virus that is transmitted by common mosquitoes. Mosquitoes are all over the world but several things are needed to contract the disease: susceptible human beings, competent mosquito vectors (carriers), and a particular virus transmitted by the mosquito. The Aedes aegypti mosquito can spread the dengue fever. Source: CDC, James Gathany. Dengue fever is caused by four distinct viruses; but, they are very closely related to each other. The illness is the same; the mosquito vector is the same; and the host is the same. A person living in a tropical area where there are disease-carrying mosquitoes can have four separate types of infections in his or her lifetime. We usually hear about the disease in the tropics because that is where it thrives. But dengue arrived in the United States some 300 years ago. Fortunately, we eliminated dengue along with malaria and yellow fever more than 50 years ago. We eliminated it, not by eliminating the mosquitoes, they’re still here, but by improving our living standards, with better housing, hot water systems, medical care, mosquito control—essentially good public health. In recent years, we have seen a dramatic increase in dengue fever worldwide. America is vulnerable since the more dengue occurs in tropical, tourist, and business destinations, the more likely it will be imported into the USA. We have two mosquitoes in the USA that can transmit dengue. The mosquito that is a very efficient epidemic vector, Aedes aegypti, is mostly localized in south Texas, south Florida and some areas in Arizona. Interestingly in the desert, by turning places like Tucson into tropical oases, we made a good home for the mosquitoes. Is Dengue fever a serious health concern? It has medical and economic consequences. Gubler: In terms of health, it is serious because it causes an acute prostration febrile illness, in other words, a fever illness that causes people to be laid up for probably a good week to six weeks, depending on the individual and the particular infection. There are no permanent, lasting effects associated with it. A small percentage of patients develop a severe form of the disease. Some patients will have a viral encephalitis-like illness (affecting the brain) or internal bleeding. The severe form spans a spectrum of conditions. Dengue fever can have a tremendous economic impact on populations when it causes a major epidemic affecting thousands of cases. When that happens, essentially the community and the medical system shut down. It puts a big overload on the hospitals and clinics. All in all, dengue fever is a very important disease. From the economic impact standpoint, its impact can be measured by what we call “disability adjusted life years.” The impact is of the same order of magnitude as many of the important infectious diseases we hear about on a daily basis. What are the major drivers for this disease? Urbanization is a factor in the spread of dengue. Gubler: The major driver is urbanization. As the cities of the tropical developing world have grown, the mosquito vector that has been there for many years has expanded. All of a sudden, you have large human populations living in intimate contact with the mosquito populations. If the virus is not already there, it could be introduced. But, the disease is there in most of these cities so you have constant transmission, which increases the possibility of genetic change in the virus, which then increases the probability of an epidemic strain emerging. If the major driver is urbanization, it becomes more acute when there is a lack of effective mosquito control. Combine that with modern transportation and you have a formula for potential disaster. Up until the 1960s most of travel was by boat. It took us weeks to get across the ocean. Beginning in the 1960s, but accelerating in the 1970s and 1980s, people began to travel mostly by airplane. In the 1980s and 1990s, we began to move most of our commodities by plane. Modern transportation has become a new major driver that helps spread the virus to urban centers around the world. Is dengue fever confined to the tropical regions? Dengue thrives in tropical regions. Gubler: Yes, it is mostly confined to tropical regions. Sub-tropical regions, like Texas and Florida, can be susceptible. Here in the United States, we are lucky, for several reasons. First, we eliminated the diseases in the 1950s and 1960s through improved living standards—by better public health. Furthermore, our population density is not that great in those areas of the USA where there are mosquitoes. So you have the combination of better public health, lower mosquito populations, and lower human populations, which results lesser risk of human-mosquito contact. Even though we have many viruses imported into the USA from tropical areas, the amount of local transmission is very limited and sporadic. Does the virus mutate quickly or has it remained the same over time? Dengue mutates but not as quickly as flu. Gubler: Luckily, dengue does not mutate as fast as the avian influenza, but it does mutate. As we have learned more about the viruses in the last 10-15 years, we’ve been able to use new technologies to study the genetic changes that occur in the viruses. We are finding genetic changes, or mutations, as you call them, which influence the epidemic potential of these viruses. So, it does not change as fast as flu, but it does change. It is not a static or monolithic organism, and we do see that there is genetic change that influences epidemic transmission. As tropical cities grow and human populations get larger, and we have all four serotypes (groups) co-circulating in those cities, transmission increases. This increases the possibility of genetic change in the virus, which then increases the probability of a new strain being selected that has greater fitness and greater epidemic potential. Does dengue fever have the potential to adapt to colder climates? We have dengue fever cases in the USA. Gubler: Probably not. We have had major epidemics of yellow fever and dengue in the USA, as far north as Philadelphia and Boston. The reason this happened is that during the summer months it was warm enough to transmit tropical diseases. If you have diseases introduced into an area where the mosquito occurs, you can have transmission. In the old days, the mosquito was found in the Gulf Coast states, but every summer it would migrate up the rivers or the coast in boats and re-infest port cities on the rivers or the ocean. Every summer, there would be populations of mosquitoes breeding in these cities. That could happen today, but our northern cities now do not have the conditions that allow mosquitoes to breed. Mosquitoes breed primarily in stored water containers. In the old days, we did not have piped-water systems. We stored water, which was ideal for the mosquitoes. Today, not only do we have piped-water systems, we also have good sewer systems. There are very few places for the mosquito to breed. Even if they are introduced to new places, they do not become established. Have there been pandemics of dengue fever? We are in the midst of a major outbreak. Gubler: Well, a pandemic is defined as a global epidemic. We are in the middle of one right now. It began in the 1950s, and it has been getting progressively worse for 50 years. I do not know how much worse it is going to get, but I think most of the whole tropical world has been infected. Most of the four serotypes occur in all the urban tropical cities. I do not expect to see epidemics in the USA because the one vector that we have here that has widespread distribution is a very inefficient epidemic vector. It can transmit but sporadically. The current pandemic is pretty bad because it is all over the tropical world. There have been pandemics of this disease in the past, as well. In the 1800s, these diseases would move from region to region in sailing boats; they would actually breed in the stored water on the boats, and that is how the mosquito was introduced into new areas. The mosquitoes they were transporting were being transmitted among the ship’s crew and when they went on shore, they introduced the virus to the mosquito population that lived there. Those pandemics were not nearly as bad as the current one, and the reason is that the cities today are much larger. We have a much larger population. We have jet airplanes as opposed to boats. So, the pandemics we experience now are far worse than anything we have experienced in the past. These same factors will influence pandemic influenza if it occurs in the future. You have something like two billion people a year getting on airplanes and flying somewhere, so you have the mechanisms not only for dengue, but also for other diseases like influenza to spread rapidly. Is there a vaccine or other preventative measures for dengue? We are close to developing cures for dengue. Gubler: There is no vaccine. There is no drug. There is a lot of progress in both areas, and I am going to come back to that. There are very effective methods of controlling and preventing the disease, and that is simply by controlling the mosquito. The mosquito is a highly domesticated insect that lives in intimate association with humans. It prefers to live in a house; it prefers to breed in a house; it prefers to rest in the house. So, if you eliminate stored-water containers in the environment, you can greatly reduce the population of mosquitoes, and therefore greatly reduce the probability of transmission. That is what we have not done adequately in most parts of the tropical world. Many places do not do good mosquito control, mainly because it is too hard. The Gates Foundation has funded a program called The Pediatric Dengue Vaccine Initiative, which focuses on helping companies that are developing a dengue vaccine and eventually distributing it to at-risk populations. That program has great potential. We have a whole generation of people in the world today that have been raised since the 1960s to believe that basically, they do not have a major role to play in their health destinies. There are drugs; there are vaccines. We do not even teach hygiene in our schools anymore. One of the most effective ways of preventing diseases like influenza is washing your hands. It is too easy now. You get sick, you go to the doctor; you get a drug; you get an antibiotic. In the tropics, you get an injection. You get better, so there is no responsibility by people. We live in a crisis-oriented society—we do not do anything until there is a crisis. We wait for the epidemic to occur, and then we try to respond to it. People could very easily help public health officials with this disease if they would control disease in their own domestic environment. But, many will not do it; they believe it is the government’s responsibility to do that. Researchers started working on a vaccine 30 years ago, in the late 1970s. It is a very complex problem because there are four viruses. You have to immunize against all four simultaneously, and that is what makes it so difficult. They have made very good progress, though. We have probably at least five good vaccine candidates in the pipeline. In the next couple of years, there will probably be several of them that will undergo efficacy trials in the human population. And, the best guess is that probably in five to seven years, we may have a vaccine. But, we have been saying that for 30 years, so … The other area where there is a lot of progress is an antiviral drug that will inhibit virus replication in the human body. The Novartis Institute of Tropical Diseases has focused exclusively on dengue and tuberculosis in developing an antiviral drug. They have a good candidate that is probably going into clinical trials next year and it looks very promising. © 2008, American Institute of Biological Sciences. Educators have permission to reprint articles for classroom use; other users, please contact editor@actionbioscience.org for reprint permission. See reprint policy. Dr. Duane J. Gubler is professor and chair, Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawai’i. He also serves as director, Asia-Pacific Institute of Tropical Medicine and Infectious Diseases, director of the Pacific Regional Biocontainment Laboratory at the University of Hawai’i, and as director of the Signature Research Program of Emerging Infectious Diseases, Duke University/National University of Singapore. Gubler has an M.S. in parasitology from the University of Hawai’i and a Sci.D. in Pathobiology from the Johns Hopkins University lf Hygiene and Public Health. He has spent 40 years working on tropical parasitic and infectious diseases, with extensive field experience in Asia, the Pacific, tropical America, and Africa. He served as Director of the Division of Vector-Borne Infectious Diseases, National Center for Infectious Diseases, Center for Disease Control and Prevention for 15 years. Dr. Gubler has worked closely with WHO as a consultant and temporary advisor since 1972. Gubler was interviewed at the 2008 annual meeting of the American Institute of Biological Sciences. http://jabsom.hawaii.edu/JABSOM/faculty/bio.php?facultyid=128 This Viewpoint discusses one innovative way to reduce the spread of dengue fever. learnmore linksget involved references educator resourcestop Media presentation by Duane Gubler View or listen to Gubler’s talk “The 20th Century Emergence and Spread of Epidemic Dengue/Dengue Hemorrhagic Fever: Is Climate or Environmental Change Responsible?” presented at the AIBS 2008 annual meeting. Scroll down the page for the menu of 2008 presentations. http://www.aibs.org/media-library/ Mosquito-borne diseases » http://hubpages.com/hub/Mosquito-Diseases » http://www.cdc.gov/ncidod/diseases/list_mosquitoborne.htm » http://www.weather.com/activities/homeandgarden/home/mosquito/articles/related_diseases.html How mosquitoes work Information, illustrations, and video about the pesky insect. http://www.howstuffworks.com/mosquito.htm Combating dengue fever » The Pediatric Dengue Vaccine Initiative: http://www.pdvi.org » The Novartis Institute of Tropical Diseases: http://www.nitd.novartis.com/ » World Health Organization: http://www.who.int/tdr/diseases/dengue/ » Dengue Fever Information: http://denguefeverinformation.com/page/2/ Current outbreaks of dengue fever The Center for Disease Control’s informational page: http://www.cdc.gov/ncidod/dvbid/dengue/ getinvolved linkslearn more references educator resourcestop PreventInfection.org The site is an objective, non-commercial resource for infection prevention information for patients and consumers. http://www.preventinfection.org/ How to prevent getting dengue fever Short, precise information about how to avoid getting the disease. http://www.wikihow.com/Prevent-Getting-Dengue-Fever Clean Hands Campaign The American Society for Microbiology asks you to spread the importance of handwashing. http://www.rch.org.au/washup/index.cfm?doc_id=4770 Virology meetings worldwide A compendium of current events in virology, with information on meetings and registration. Of interest to professionals and students. http://www.virology.net/ Directors of Health Promotion and Education Their mission is “to strengthen, promote, and enhance the professional practice of health promotion and public health education nationally and within State health departments.” http://www.dhpe.org/ Educator resources for grades 9-12 The National Institutes of Health offer free high-school curriculum supplement on emerging and re-emerging infectious diseases (web version, downloadable CD-ROM version, or postal mail delivery). http://science-education.nih.gov/Customers.nsf/HSDiseases?OpenForm educatorresourceslearn more get involved article referencestop articlereferenceslearn more get involved educator resourcestop Advertisement Navigate actionbioscience topic directory partners & collaborators jobs and classifieds actionbioscience en español © 2000-2014 American Institute of Biological Sciences. All rights reserved.

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‣ Final Public Input Meeting To Be Held On Proposed Mental Health Facility Media Advisory Final Public Input Meeting To Be Held On Proposed Mental Health Facility Archived. This is an older press release from 2010 and may not contain the latest information. Please view our current press releases for 2014 items. Community members are urged to participate in a final opportunity to give input on the use of purchased property at 20 Allen Street in Martinez. The Mental Health Division of Contra Costa Health Services is hosting a community meeting August 31 to discuss two uses of the property to offer more flexible, cost-efficient and accessible mental health services outside of a hospital setting. The first proposed use is a voluntary assessment and recovery urgent care clinic that would serve all age groups. The second proposed use is a voluntary crisis residential facility for adults. Contra Costa Mental Health urges all comments pertaining to the proposed services, building and location. Funding for the selected proposal will come from several sources, including the Mental Health Services Act, otherwise known as Proposition 63. The meeting is 5 to 7 p.m. Tuesday, August 31 at the Pleasant Hill Community Center - Parkside Room, 320 Civic Drive (off Taylor Blvd), Pleasant Hill. County shuttle vans will depart from the Pleasant Hill BART station at 4:30 and 4:40 p.m. and the Concord BART station at 4:17 and 4:27 p.m. Call Mental Health Consumer Concerns at 925-521-1230 or Putnam Clubhouses at 925-691-4276 to arrange shuttle transportation from East or West County. How: The plan is available online at www.cchealth.org/services/mental_health/ or by request at the Mental Health Administration Offices, 1340 Arnold Drive, Suite 200, Martinez. Why: The Mental Health Services Act, passed by voters in 2004, includes a Capital Facilities component in which local counties can receive state funding to build facilities where people can get mental health services. The primary goal of the Capital Facilities Needs funds is to expand opportunities for accessible community-based services for clients and their families. The objective is to reduce disparities in mental health services provided to underserved groups. Donna Wigand

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Home | Login | Contact Us About UsWhat's EpilepsyProgramsFor...YouNews & EventsLearning CenterWays to GiveOscar Project Donate Now!Sign up for Email Updates MissionStaffNewsPresident and CEO’s MessageNewslettersDirectors About the EFWCP The Epilepsy Foundation Western/Central Pennsylvania (EFWCP) is a private, non-profit service organization providing public education and supportive services to individuals and families affected by epilepsy/seizure disorders. Our mission is to lead the fight to stop seizures, find a cure and overcome challenges created by epilepsy. With offices and staff in Pittsburgh, Harrisburg and Johnstown, the EFWCP now offers its nationally recognized programs and services to residents in 49 counties throughout western and central Pennsylvania. The work of the EFWCP is supported through private donations, a variety of grants and a contract with the Pennsylvania Department of Health, as well as special fundraising events. With support from a volunteer Board of Directors and Professional Advisory Board that provides medical expertise, the EFWCP works to ensure an improved quality of life for those who face the challenges presented by epilepsy or seizure disorders. The EFWCP was founded in 1972 and in 2012 celebrated 40 years of growth and success. We are an independently incorporated affiliate of the Epilepsy Foundation National. Click here for a historical view of the EFWCP’s first 40 years. Copyright © 2012 Epilepsy Foundation Western/Central Pennsylvania. An Independently Incorporated Affiliate of the Epilepsy Foundation of America. • Privacy

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DesOrmeaux, Anna Louise adesor2@lsu.edu The Black Death and Its Effect on Fourteenth- and Fifteenth-Century Art Justin Walsh Marchita Mauck Mark Zucker In early October of 1347, ships from Caffa docked at the port of Messina in Sicily. The traders brought with them a fierce plague that swept through Europe from 1348 to 1352. This pandemic, which killed approximately half of Europe's population, came to be known as the Black Death. The fear propagated by the spread of the plague and its cyclical recurrence greatly affected the art created in Europe over the next 150 years. Accounts of victims of the plague and other contemporary documents, such as medical treatises, give modern readers a glimpse into the psyche of medieval people. These insights aid in understanding the symbols and subject matter of art that was created in the wake of outbreaks of the plague. Images of the physical manifestations of disease and images of death, such as the jolly skeletons in scenes of the dance of death, preserve medieval peoples' preoccupation with and fear of death. Psychosocial responses are recorded in images of hysterical actions, such as the burning of Jewish people. The succor that was sought through adoration of religious images, such as saints and the Madonna, confirms that medieval people retained hope despite their fear. Both the resilient nature of humans and the fear initiated by widespread, sudden, gruesome death have been preserved in these images. Through this art, we discover that medieval people were not entirely unlike ourselves. Files Filename Size Approximate Download Time (Hours:Minutes:Seconds) 28.8 Modem 56K Modem ISDN (64 Kb) ISDN (128 Kb) Higher-speed Access DesOrmeaux_thesis.pdf

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Mayo and March of Dimes Stress 40 Week Pregnancy By: Brianna Long Forty weeks; that's how long a full-term pregnancy lasts. But many women actually choose to be induced early. And now, Mayo Clinic doctors are saying that needs to stop. "I have a soon-to-be seven-year-old. Her name is Ariana and then a 17-month-old named Claira," said Sarah Suhr. Having already given birth twice, Sarah knows the joys of pregnancy, and also the frustrations that can come with it; especially towards the end. "The first one, she was born in January. And it was cold, my feet were swollen. I couldn't wear shoes. I had to wear flip-flops in the snow. That wasn't so fun so I was like get this baby out of here," said Sarah. Since she had her daughters, who were both born pretty close to their due dates, Sarah began working at March of Dimes, helping educate people on premature births. "Respiratory difficulties, feeding difficulties, and increased risk of having problems potentially like Cerabral Palsy," said Dr. Jani Jensen, with Mayo Clinic. Mayo Clinic is also stressing the importance of keeping the baby inside the womb for at least 39 weeks. "Even though the overall risks are very low, they're higher compared to babies that are born at 39 weeks or later. There's also an increased risk of mortality overall for infants that are born in the early term versus the late term gestation," said Dr. Jensen. One research study put on by Mayo included 650 women who recently delivered a baby. Half of them believed a full term pregnancy was 37-38 weeks. Twenty five percent of them thought it was safe to deliver at 34 to 36 weeks. "I think there's a huge need to have patient awareness and increased public perception of actually what is a term pregnancy," said Dr. Jensen. And for Sarah, who is actually now expecting her third baby, that 39 week mark makes perfect sense. "Even though you might be miserable, the baby's not miserable and you need to know that you need to do the right thing for your baby, not what's convenient for you," said Sarah. Mayo has actually looked into a new policy called a "hard stop policy" which would prohibit physicians from scheduling an elective induction before 39 weeks.

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Arizona Man Has New Lease on Life Thanks to SynCardia Total Artificial Heart Jess Gomez Andrew Weaver and his wife, Heather, feared he wouldn’t see their daughter, Haley, grow up because he was dying of heart failure. Instead, Andrew gets to cherish family moments that he would have missed, thanks to the SynCardia temporary Total Artificial Heart that bridged him to a heart transplant and his great medical team at the Intermountain Medical Center Heart Institute in Murray. The Ice Bucket Challenge and ALS: What's It All About? Your social feeds have been crammed with the Ice Bucket Challenge lately, and you've been properly inundated with hilarious videos of celebs, personalities, and everyone in between pouring buckets of frigid water over their heads in the name of ALS. The campaign has raised over $22.9 million for the ALS Association, an astonishing feat and true testament to the power of social media. Help Improve How Brain Injuries Are Treated Hyperbaric Medicine is looking for healthy people who’ve never had a brain injury to participate in a study that will improve how brain injuries are treated Parents: How to Avoid the Back-to-School Plague According to the Centers for Disease Control and Prevention (CDC), elementary school children get eight to 12 colds or cases of the flue each school year. With year-round school underway in Utah and other schools about to start, here are a few tips to help your kids avoid the Back to School Plague. Read More

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> Researcher working to end keiki kidney disease wins March of Dimes award Researcher working to end keiki kidney disease wins March of Dimes awardUniversity of Hawaiʻi at MānoaContact:Tina Shelton, (808) 692-0897Director of Communications, Office of Dean of MedicinePosted: May 5, 2014Dr. Benjamin Fogelgren in his Kaka`ako lab.Medical research at UH Mānoa aimed at preventing kidney disease in children is being recognized with a prestigious grant by the March of Dimes. The Basil O’Connor Starter Scholarship Research Award, presented to John A. Burns School of Medicine (JABSOM) researcher Ben Fogelgren, is worth $150,000 over the next two years.This is the first time a Hawai`i investigator has won the award.“I have always loved science, but am thrilled to be able to focus on research that can be translated into new therapies and diagnostics for patients,” said the Assistant Professor of Anatomy, Biochemistry and Physiology at JABSOM.Hawaiʻi’s population has a 30% higher chance of suffering from kidney failure than the national average, according to the National Kidney Foundation of Hawai`i. Starter scholar awards are designed for young scientists at the beginning of their independent careers and help support basic research. Dr. Fogelgren’s research is dedicated to prevent kidney diseases in children by seeking ways to improve the ability to diagnose and predict disease progression as well as to expand available treatment options.The devoted father of a 6-year-old son hopes his work can help children all over the world. “Throughout my career I have been particularly driven to fight diseases affecting children, so I am overjoyed to receive this award from the March of Dimes. They have been at the forefront in the fight against child suffering for 70 years,” said the Kaneohe resident.The leading causes of kidney disease in children and infants are urinary tract obstructions that are developed while the unborn baby is still in the womb. These blockages lead to hydronephrosis, swelling of the kidneys, which is also the most common prenatal abnormality detected by ultrasound. It can cause highly inconsistent and unpredictable damage to the kidneys so it is difficult to decide when surgery is needed.The causes of these birth defects are largely unknown and for the longest time, there have been no scientific tools to study this disease. In the last two years, Dr. Fogelgren and his outstanding research team of several UHM students and a postdoctoral trainee have created a unique mouse model that consistently forms a blockage between the kidney and bladder, within a womb, and leads to severe swelling and kidney damage.They are hopeful that this study will advance to a better understanding of human urinary obstructions and to the discovery of new treatments and diagnostic tools for this pediatric disease. Chronic kidney disease is also caused by other conditions including diabetes and high blood pressure. Unfortunately there are few treatment options for most types of kidney diseases other than dialysis and transplant.The March of Dimes was initially established in 1938 by President Franklin D. Roosevelt, to fight polio. Today, the foundation focuses on the prevention of health problems in babies, especially premature birth, birth defects and low birthweight. A number of researchers funded by the foundation have gone on to win Nobel prizes, including three recipients of Basil O'Connor awards.In addition to funding from the March of Dimes, Dr. Fogelgren's research at JABSOM is supported by the The National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK) of the National Institutes of Health and the Hawai`i Community Foundation, and support from the Research Centers in Minority Institutions Program.For more information, visit: http://jabsom.hawaii.edu

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New study finds maternal diet important predictor of severity for infant RSV March 4th, 2013 in Diseases, Conditions, Syndromes / An important predictor of the severity of respiratory syncytial virus (RSV) in infants may be what their mothers ate during pregnancy, according to a Vanderbilt study published in the American Journal of Respiratory and Critical Care Medicine. RSV is the most common cause of severe lower respiratory tract disease among infants and young children worldwide. Currently there is no effective vaccine against RSV. Outbreaks occur in communities each year, usually lasting 4-5 months during the fall, winter and/or spring months. Lead author Fernando Polack, M.D., Cesar Milstein Professor of Pediatrics, said his study found that the most serious cases of RSV correlate with mothers who ate a diet high in carbohydrates during pregnancy. "These cases were not just severe, but the sickest of sick," Polack said. "What we found was the presumptive impact of a carbohydrate-rich diet was clearly dose dependent." More than 1,200 infants younger than 2 years old were hospitalized in 12 institutions in Buenos Aires, Argentina, during the 2011 RSV season. Of those patients, nearly 800 were found to have RSV infection, and 106 of those babies were considered to have a life-threatening form of the disease, with oxygen saturation rates below 87 percent: Twenty-two infants died in the hospital, and an additional 26 infants died at home with evidence suggesting they died from RSV. Polack and his collaborators had the mothers fill out a nutrition survey during their final trimester of pregnancy in order to examine the impact of maternal diets heavy in fruits and vegetables versus protein, fats or carbohydrate-rich diets. Overall, the frequency of life-threatening or fatal RSV in infants was about 12.7 percent among participants, but that rate jumped to 55.6 percent for babies whose mothers ate the greatest proportion of carbohydrates. "Our study suggests that, where RSV and other respiratory viruses are concerned, the more sugars a mother eats the worse the situation may get for the baby in the first part of life," said Polack, adding that the next step will be to confirm the association in future studies.Provided by Vanderbilt University Medical Center "New study finds maternal diet important predictor of severity for infant RSV." March 4th, 2013. http://medicalxpress.com/news/2013-03-maternal-diet-important-predictor-severity.html

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amyloid plaque News tagged with amyloid plaque all Alzheimer's disease & dementia Novel culture system replicates course of Alzheimer's disease, confirms amyloid hypothesis An innovative laboratory culture system has succeeded, for the first time, in reproducing the full course of events underlying the development of Alzheimer's disease. Using the system they developed, investigators ... Lilly, AstraZeneca team up on Alzheimer's drug Eli Lilly and Co. plans to pay up to $500 million to fellow drugmaker AstraZeneca as part of a collaboration to develop and sell a potential Alzheimer's disease treatment that is in the early stages of clinical testing. Can amyloid plaque in Alzheimer's disease affect remote regions of the brain? In Alzheimer's disease, accumulation of amyloid plaque in the brain is believed to play an important role in many characteristic disease symptoms, including memory loss and other mental state changes. But ... Could a simple smell test help spot Alzheimer's early? New research suggests that a faltering sense of smell might signal the early stages of Alzheimer's disease, and that an inexpensive, low-tech smell test could spot who needs more extensive screening for dementia. New technology reveals insights into mechanisms underlying amyloid diseases Amyloid diseases, such as Alzheimer's disease, type 2 diabetes, cataracts, and the spongiform encephalopathies, all share the common trait that proteins aggregate into long fibers which then form plaques. ... Researchers find clue to stopping Alzheimer's-like diseases (Medical Xpress)—Tiny differences in mice that make them peculiarly resistant to a family of conditions that includes Alzheimer's, Parkinson's and Creutzfeldt-Jakob Disease may provide clues for treatments ... Trial to test new drug that may slow Alzheimer's memory loss (Medical Xpress)—A new research study at Northwestern Medicine and Rush University Medical Center is testing whether a new investigational treatment can slow the memory loss caused by Alzheimer's disease. Rescue of Alzheimer's memory deficit achieved by reducing 'excessive inhibition' A new drug target to fight Alzheimer's disease has been discovered by a research team led by Gong Chen, a Professor of Biology and the Verne M. Willaman Chair in Life Sciences at Penn State University. The ... Launching a new Alzheimer's prevention study New diagnostic techniques are giving doctors the ability to recognize clinical signs suggestive of Alzheimer's disease as much as 15 years before symptoms appear. A new drug trial is testing whether the onset of disease ... Early detection of Alzheimer's disease made possible by analyzing spinal fluid Researchers have shown that they can detect tiny, misfolded protein fragments in cerebrospinal fluid taken from patients. Such fragments have been suggested to be the main culprit in Alzheimer's disease. The findings reported ... Chronic sleep disturbance could trigger onset of Alzheimer's People who experience chronic sleep disturbance—either through their work, insomnia or other reasons—could face an earlier onset of dementia and Alzheimer's, according to a new pre-clinical study by researchers at Temple ... New risk gene illuminates Alzheimer's disease A team of international scientists, including a researcher from Simon Fraser University, has isolated a gene thought to play a causal role in the development of Alzheimer's disease. The Proceedings of the National Academy of ... Natural plant compound prevents Alzheimer's disease in mice (Medical Xpress)—A chemical that's found in fruits and vegetables from strawberries to cucumbers appears to stop memory loss that accompanies Alzheimer's disease in mice, scientists at the Salk Institute ... | Alzheimer's disease & dementia Team finds regulator of amyloid plaque buildup in Alzheimer's disease Scientists from the Florida campus of The Scripps Research Institute have identified a critical regulator of a molecule deeply involved in the progression of Alzheimer's disease. Alzheimer's drugs fail, but lessons are learned Dr. Stephen Salloway pulls no punches in describing the results of two clinical trials of the Alzheimer's drug bapineuzumab that he helped to lead. The antibody failed to produce cognitive improvement for ...

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Nurse Steps Into New Role as an Executive July 20, 2011 by Linda Friedel | Reprinted courtesy of KC Nursing News Linda Rittermeyer, RN, is taking her management skills to a new level. Rittermeyer, former director of perioperative services at Lee's Summit Medical Center, has spent the past month as associate chief nursing officer in Menorah Medical Center's HCA executive development program. Rittermeyer will shadow the hospital's chief nursing officer, Kathy Sankovich, for about a year before applying for a CNO position within the organization. "You went from knowing to not knowing," she said. "Now I'm right back at the beginning. It's like being in school again." Rittermeyer said her years of leadership date to her role as a charge nurse 20 years ago. Rittermeyer, who has an MBA in health care management, has enjoyed a variety of leadership positions through the years, she said, but wanted to make an impact in a new way. "I thought I had a good finger on the pulse of nursing," she said. "Nursing could use leaders that remember what it is like at the bedside. That's what keeps me focused." In the past month, Rittermeyer said she has learned everything from finding her way around the hospital, to advanced multi-tasking to discovering global aspects of the organization. "That's been a learning curve for me," she said. "It's a nice transition." Rittermeyer said as she grasps the hospital's broader scopes such as meeting with medical executives, physicians and boards, she is learning to let go of details that as a nurse she is accustomed to handling. She will also better be able to impact the nurses and technicians she oversees, helping them to maintain balance in their lives professionally and with their families, she said. Rittermeyer sees her role as a support to nurses, someone who encourages them to enjoy their work and their family time in order to live a more rounded, fulfilled life. "We are the ultimate caregivers of our families and our patients at work," she said. "They have a life. I believe family is important." Rittermeyer said she remains dedicated to shepherding nurses, helping them achieve their goals. "I love to see people grow," she said. "I love to mentor. I like to develop them." She defines nursing as a personal mission. "Nursing is the core inner peace of your heart to help people no matter what they're going through," Rittermeyer said. Sankovich said the selection process for the executive shadowing program at HCA is very strenuous and it is a huge honor to be selected. She said Rittermeyer demonstrated low staff turnover, works extremely well with physicians and has already formed relationships with key stakeholders. "Her leadership capabilities are amazing," Sankovich said. "She is very effective in being able to accomplish a lot of things. I'm very honored to be her mentor." For inquiries, you can contact our Media Liaisons: Leslie Helmer (913) 498-6861Leslie.Helmer@hcahealthcare.com Stann Tate (913) 498-7407Stann.Tate@hcahealthcare.com Social Media http://t.co/G8FiQqj8g0 Uploaded on Mon, May 6 2013 80th Anniversary - Menorah Medical Center Uploaded on Mon, June 10 2013

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You are here: Home / Health / Science Debunks Morning-After Pill’s Abortion Myth Science Debunks Morning-After Pill’s Abortion Myth June 7, 2012 by Kristina Chew | 1 Comment A New York Times analysis has found that the morning-after pill—drugs including Plan B One-Step and Ella, which are taken to prevent pregnancy after sex—do so not by keeping fertilized eggs from implanting in the womb, but by delaying ovulation. Some pills also thicken cervical mucus so that sperm have difficulty swimming. However, labels on the inside of boxes for the pills say they may work by blocking fertilized eggs from implanting in a woman’s uterus—descriptions that have led to some religious groups, conservative politicians and others to claim that the pills cause abortion. Dr. Donna Harrison, director of research for the American Association of Pro-life Obstetricians and Gynecologists, told the Times that using the pills is the “moral equivalent of homicide.” Mitt Romney has been more straightforward, dubbing morning-after pills as “abortive pills.” Although the websites of medical authorities, including the National Institutes of Health and the Mayo Clinic, have said that emergency contraceptives may prevent implantation of a fertilized egg, the New York Times has discovered that such a result is not borne out in scientific studies: It turns out that the politically charged debate over morning-after pills and abortion, a divisive issue in this election year, is probably rooted in outdated or incorrect scientific guesses about how the pills work.” [my emphasis] These findings about how emergency contraceptives work would mean that drugs like Plan B One-Step and Ella “would not meet abortion opponents’ definition of abortion-inducing drugs.” In contrast, RU-486 can be called an abortion pill “because it destroys implanted embryos, terminating pregnancies.” Despite the lack of scientific evidence, the Food and Drug Administration included information about the “implantation idea” on labels for emergency contraceptives. During the approval process for the drugs in 1999 the manufacturer of Plan B—Barr Pharmaceuticals, which has since been acquired by Teva Pharmaceuticals—had asked the FDA not to include the implantation idea on it. But the FDA decided to because of hypotheses about how the pills worked: Experts say implantation was likely placed on the label partly because daily birth control pills, some of which contain Plan B’s active ingredient, appear to alter the endometrium, the lining of the uterus into which fertilized eggs implant. Altering the endometrium has not been proven to interfere with implantation. But in any case, scientists say that unlike the accumulating doses of daily birth control pills, the one-shot dose in morning-after pills does not have time to affect the uterine lining. “It takes time for an endometrium to change, for its cells to divide,” said Susan Wood, a biochemist who, shortly after Plan B’s approval became the F.D.A.’s top women’s health official and later resigned, frustrated with the delay in making the pill available without prescription. “Wishful thinking” on the part of scientists also played a role, as some of them “thought that if it could also block implantation, it would be even better at preventing pregnancy.” But starting in 2002, studies offered evidence that morning-after pills do not block implantation. Indeed, some organizations, when confronted with the New York Times‘ findings, changed their information to reflect these: After the Times asked about this issue, A.D.A.M., the firm that writes medical entries for the National Institutes of Health website, deleted passages suggesting emergency contraceptives could disrupt implantation. The New York Times, which uses A.D.A.M.’s content on its health webpage, updated its site. At the Mayo Clinic, Dr. Roger W. Harms, the website’s medical editor in chief, said “we are chomping at the bit” to revise the entry if the Food and Drug Administration changes labels or other agencies make official pronouncements. Despite more and more scientific studies in the past decade, abortion opponents have continued to resist changing the labels. For instance, Dr. Harrison told the New York Times that while the Plan B studies were “led by ‘a good researcher,’ … she would prefer a study with more women and more documentation of when in their cycles they took Plan B.” As the New York Times underscores, the stakes about the information on the morning-after pill’s label—on whether or not the “implantation idea” is specifically noted—are high. Controversies about contraceptions and about emergency contraception have become a factor in the debate about President Obama’s health care law and, indeed, about the presidential race. A number of religious groups and abortion opponents are fighting the law on the grounds that it would require third-party insurers to cover contraceptives for employees of Roman Catholic schools, hospitals and organizations, as well as other institutions that are officially—and religiously—opposed to birth control. Supporters of “personhood” initiatives who define fertilized eggs as people say that their proposals will ban the emergency contraceptives if they do prevent implantation. The FDA and government agencies need to act quickly and efficiently to revise the labels of the morning-after pill to reflect the latest scientific evidence about the drugs not preventing implantation. Abortion foes are already criticizing scientists and government agencies for letting ideology seep into their decisions. The FDA and scientists need to take control of the conversation and make it clear to the public that emergency contraceptives delay ovulation and do not prevent implantation, not only for the sake of women’s health, but for the sake of science and scientific accuracy. Reprinted with permission from Care2. Photo courtesy of Flickr user jojo_1785 under Creative Commons 3.0. Comments Charlotte Miller says: June 20, 2012 at 2:56 pm Remember Ann Keenan on Tuesday, November 6, 2012: http://www.salon.com/2011/08/08/mitt_romney_abortion_ann_keenan

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Targeting evolution: Could this be the next strategy to stop superbugs? November 6th, 2013 in Biology / Cell & Microbiology A Penn Medicine researcher is among the winners of a GlaxoSmithKline (GSK) "academic drug hunter" competition that will help fast track his lab's work to stop drug-resistant bacteria. "Superbugs" are evolving faster than antibiotics can keep up with, and as a result more than 2 million people in the United States get infected every year, and at least 23,000 people die as a direct result. With this new partnership, Rahul Kohli, MD, PhD, an assistant professor in the division of Infectious Diseases and department of Biochemistry and Biophysics at the Perelman School of Medicine at the University of Pennsylvania, and his lab can ramp up their efforts to discover drugs that stop the evolution in its tracks. Rather than taking the conventional approach of modifying existing antibiotics to overcome resistance, Kohli's lab aims to target the very pathways by which bacteria adapt to antibiotics and evolve resistance. Kohli's team, spearheaded by Charlie Mo, a graduate student in Biochemistry and Molecular Biophysics, will now have access to 1.8 million compounds kept in GSK's chemical library and their other drug discovery technologies. "The search is on to find a molecule that can disrupt the pathway that allows bacteria to acquire drug resistance," Kohli said. "The hope is that such a molecule can make bacteria more sensitive to existing antibiotics or slow the acquisition to the resistance, both of which would be valuable in the clinic." This is GSK's first Discovery Fast Track competition in North America, which is designed to translate academic research into starting points for new potential medicines. There were eight winners in total across the country, selected from an initial pool of over 140 applications across 17 therapeutic areas and from 70 different institutions. The competition was sponsored by GSK's Discovery Partnership with Academia program, a new approach to drug discovery where academic partners become core members of drug-hunting teams. GSK and the academic partner share the risk and reward of innovation: GSK funds activities in the partner laboratories and provides in-kind resources to progress a program from an idea to a candidate medicine. "We were extremely pleased to be recognized," Kohli said. "Now we can take an idea that has good potential and efficiently move it from a theoretical academic pursuit into the practical realm, where it can hopefully ultimately benefit patients." Work on the winning Discovery Fast Track projects will begin immediately and the first screens are expected to be completed in mid-2014. Kohli expects results from his investigation shortly thereafter.Provided by University of Pennsylvania School of Medicine "Targeting evolution: Could this be the next strategy to stop superbugs?." November 6th, 2013. http://phys.org/news/2013-11-evolution-strategy-superbugs.html

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NIH completes Nanomedicine Network NIH Completes Formation of National Network of Nanomedicine Centers What: The National Institutes of Health (NIH) has completed its national network of eight Nanomedicine Development Centers (NDCs). Why: To announce to the scientific community the completion of the national network of NDCs. When: The final four NDCs were funded this year. NIH funded four NDCs last year. Where: The final four NDCs are located at: Georgia Institute of Technology in Atlanta Purdue University in Lafayette, Indiana University of California at Los Angeles University of California Lawrence Berkeley National Laboratory The four NDCs funded last year are located at: Baylor College of Medicine in Houston University of Illinois Urbana-Champaign University of California at San Francisco Columbia University, New York Morningside More Information: NDCs are staffed by multidisciplinary scientific teams, including biologists, physicians, chemists, physicists, mathematicians, engineers, and computer scientists. In addition to conducting research into the physical properties of structures inside cells to determine how biology's molecular machines are built, these teams will begin training the next generation of students in this emerging field of medical science. The Nanomedicine Initiative applies an engineering approach to the study of cellular and subcellular systems in an effort not only to understand, but to precisely control molecular complexes that operate at the nanoscale. This will allow for development of new technologies to prevent or cure disease and to repair damaged tissue. The Nanomedicine Initiative, part of NIH's Roadmap for Medical Research, is led by Paul A. Sieving, M.D., Ph.D., director of the National Eye Institute (NEI), Jeffery Schloss, Ph.D., program director, Technology Development, National Human Genome Research Institute, and Richard S. Fisher, Ph.D., program director, Corneal Diseases at NEI, in collaboration with a program team representing institutes and centers across the NIH. "Future progress in medicine will depend on our understanding and modulating the complexity of biological systems," said Dr. Sieving. "The NIH Roadmap, including the Nanomedicine Initiative, will advance our knowledge of biological systems. This will provide the scientific foundation for new strategies for diagnosing, treating, and preventing disease." NIH News Advisory For Immediate Release neinews@nei.nih.gov For further information on this program, visit: http://nihroadmap.nih.gov/nanomedicine/index.asp. The NIH Roadmap for Medical Research is a series of far-reaching initiatives designed to transform the Nation's medical research capabilities and speed the movement of scientific discoveries from the bench to the bedside. It provides a framework of the priorities the NIH must address in order to optimize its entire research portfolio and lays out a vision for a more efficient and productive system of medical research. Additional information about the NIH Roadmap can be found at http://nihroadmap.nih.gov. The National Eye Institute (NEI) is part of the National Institutes of Health (NIH) and is the Federal government's lead agency for vision research that leads to sight-saving treatments and plays a key role in reducing visual impairment and blindness. For more information, visit the NEI Website at http://www.nei.nih.gov/. The National Institutes of Health (NIH) -- The Nation's Medical Research Agency -- includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov/. Last reviewed: Men will always be mad, and those that think they can cure them are the maddest of them all. -- Voltaire

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Barry Kieselstein-Cord and Bergdorf Goodman Team Up to Fight Cancer Internationally renowned New York City artist, designer, and entrepreneur, Barry Kieselstein-Cord and Bergdorf Goodman has planned a tribute and exclusive preview and sale where a portion of the proceeds will benefit the University of Miami Sylvester Comprehensive Cancer Center in Miami, FL. Kieselstein-Cord will reveal a new ‘Collection’ at a cocktail reception on October 24 from 8:00 to 9:30 p.m. at Bergdorf Goodman, a luxury department store located in midtown Manhattan. Kieselstein-Cord has been committed to UM/Sylvester since the cancer center opened in 1992 and has spent the last fifteen years combining his talents as a jewelry designer with his passion to support research at UM/Sylvester. The first of many exclusive pieces designed by Kieselstein-Cord for the cancer center was the Tree of Life pin awarded to all UM/Sylvester donor society members. With each exquisite creation Kieselstein-Cord crafts for UM/Sylvester, he furthers the ambition of late founder Harcourt Sylvester Jr. to provide a world-class cancer research and treatment facility. “Over the last decade and a half, I’ve watched UM/Sylvester become a major, major player in the world of cancer research and clinical care,” said Kieselstein-Cord, whose mother is a Florida native. “UM/Sylvester’s mission is one that I’m very happy to support.” His dedication to South Florida’s only university-based cancer center has helped to attract donors to UM/Sylvester. International honorary chair of UM/Sylvester’s biannual gala, Kieselstein-Cord, has designed, produced, and donated a unique and important piece of jewelry which has been raffled at every gala. The relationship between Kieselstein-Cord and UM/Sylvester came about 15 years ago when Lynn Hover (at the time Vice President and General Manager of Neiman Marcus in Bal Harbour, FL) along with UM/Sylvester Founders Fredi Consolo and Gail Gidney, asked him to join their leadership team as they established community support for the cancer center. A research laboratory at UM/Sylvester is named in Kieselstein-Cord’s honor in recognition of his long standing commitment and faithful dedication. Kieselstein-Cord’s work is actively collected by celebrities from Steven Spielberg to Oprah Winfrey, from Giorgio Armani to Tom Hanks. His pieces, every one of which is signed, dated, and copyrighted, are widely sought and become instant classics, claiming high prices at auctions, making them an increasingly wise investment. UM/Sylvester opened in 1992 to provide comprehensive cancer services and today serves as the hub for cancer-related research, diagnosis, and treatment at the University of Miami Leonard M. Miller School of Medicine. UM/Sylvester handles nearly 1,600 inpatient admissions annually, performs 2,600 surgical procedures, and treats 3,400 new cancer patients. All UM/Sylvester physicians are on the faculty of the Miller School of Medicine, South Florida’s only academic medical center. In addition, UM/Sylvester physicians and scientists are engaged in more than 250 clinical trials and receive more than $30 million annually in research grants. UM/Sylvester at Deerfield Beach opened in 2003 to better meet the needs of residents of Broward and Palm Beach counties. A major expansion is currently underway, which will double the size of this facility by adding diagnostic imaging services, additional chemotherapy chairs, and expanded exam rooms. Deerfield Beach offers appointments with physicians from 12 of UM/Sylvester’s 15 Site Disease Groups, complementary therapies from the Courtelis Center, and education and outreach events.

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Groups/Classes Video feed Audio feed Print feed Publications Press release details Italy looks to New Britain General Hospital for Expertise on Endometriosis New Britain [January 10 2006] - Three members of the Italian Senate arrived at New Britain General Hospital Tuesday on a fact-finding mission to learn about a disease that can greatly impact women’s fertility and day-to-day lives. The senators (see below for names) came to learn about endometriosis, an often painful condition in which the uterus repeatedly produces excess lining, which can also hinder a woman’s ability to become pregnant. The senators met with Anthony Luciano, M.D., head of the Center for Fertility and Women’s Health at the hospital, and an international authority on endometriosis. In addition, Congresswoman Nancy Johnson was on hand to meet the visiting dignitaries and discussed differences between the healthcare systems of the United States and Italy. “Endometriosis is a chronic, non-curable disease that can impact a woman’s quality of life in many ways,” Luciano explained. “Because it can be so painful, it can affect their roles as spouses, employees, and their overall ability to function in society.” Often the disease begins when a young woman begins menstruating, and continues until she reaches menopause. While there is no cure for endometriosis, there are several effective treatments, and Dr. Luciano has been actively involved in international research centered on treating the disease. The Italian government is particularly interested in endometriosis because of the system of socialized medicine in that country. Two years ago, the European Congress voted to designate endometriosis as a “disease of society,” which gives it priority in their echelon of medical care, Luciano explained. If Italy decides to do so as well, women in that country will get treated more quickly and may receive additional social support. In addition, physicians who treat the disease will receive a better reimbursement. Editor’s note: The senators are Laura Bianconi, Monica Beltoni, and Rossana Lidia Boldi. Contact: Helayne Lightstone, 860-224-5470 or 860-224-5695 HCC Corporate Communications (860) 224-5695 • Fax (860) 224-5779 Share

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Email to a friend The Social Death Penalty: Why Being Ostracized Hurts Even More Than Bullying Thursday, 05 June 2014 09:57 By Lynn Stuart Parramore, AlterNet | News Analysis font size (Photo via Shutterstock)In recent years, bullying and harassment at work and in school have been grabbing headlines, creating greater awareness. But there’s a dehumanizing experience that is just as common, perhaps even more damaging to targets, and far less well-understood. We’re talking about ostracism, a form of social rejection that goes by many names and comes in many flavors. Some call it the “social death penalty.” It’s the feeling of being a pariah, of being shunned, ignored by the group, or given the silent treatment. It can mean anything from physical exile to subtle forms of psychological isolation. Whatever you call it, ostracism is a ghastly form of hurt. You might think bullying is worse than ostracism, but recent research suggests that being frozen out is actually more painful. From social exclusion on the playground to being ignored in the workplace, ostracism is among the most devastating experiences we can endure, deeply connected to our most fundamental human need to be recognized and accepted. Ostracism can reshape the human brain, and in extreme cases, even make a person want to go on a killing spree. Isn’t it time we knew more about it? The Ancient Roots of Ostracism The modern word “ostracism” comes from an ancient Athenian political practice in which a person could be removed for 10 years if enough citizens expressed this desire through a vote cast on a pottery shard (ostrakon). Interestingly, ostracism was often used preemptively as a way neutralizing someone who might be a threat to the state. There was no trial, no jury and no defense. You simply had to pack your bags and get out of town. Political theorists have suggested that ostracism served to solidify group identity — clarifying what “we” are and what “we” are not. In the Athenian democracy, the rejection was often centered on a person, frequently powerful, with a tendency toward tyranny. Throughout human history, ostracism has served this identity purpose and many others in communities and institutions, including the enforcement of conformity, punishment and control. In religious systems, those who are rejected are often excommunicated, an exclusion so profound it is sometimes considered eternal. Imprisonment, of course, is a form of ostracism, with solitary confinement being the most extreme example. Ostracism often expresses group fear, either physical or spiritual. A person can be ostracized due to illness, physical difference, or even normal bodily functions considered threatening. Menstruating women have been considered threats and temporarily ostracized in many cultures. Ostracism has been a common strategy in dealing with those considered deviants or low-status by the group, and is inextricably linked to all forms of bigotry and prejudice. It manifests in activities as large-scale as apartheid and as understated as averting the gaze. Why Ostracism Hurts Human beings are social animals; the ability to interact with others is among our most basic requirements. For all mammals, social distance from the group is every bit as dangerous as hunger, thirst, or physical injury. In human societies, ostracism can mean death if the target is deemed outside the protection of the law or cut off from group support, including access to food. Because ostracism can be so deadly, researchers think we have developed acute sensitivity to it. It can freak us out even more than being hit, ridiculed or yelled at, causing our bodies and minds to suffer exquisitely. Our need to belong is so strong that we experience psychological and physical effects right away. Neuroscientists have found that social rejection is experienced much like physical pain — connected to the same neural circuitry. In the short-term, ostracism can create a bad mood or other forms of physiological arousal. If it goes on, it can cause low self-esteem, profound feelings of helplessness, self-imposed isolation, and suicidal thoughts. Research collected in The Social Outcast: Ostracism, Social Exclusion, Rejection, and Bullying shows the myriad ways ostracism can harm both the target and the community. The work of Lowell Gaernter and Jonathan Iuzzini suggests that people who perceive that they have been rejected or excluded by a group are more likely to harm multiple persons if they become violent. Why is the pain so acute? When you are the object of a heated argument, you may feel angry, but at least you are interacting with someone. When you get the silent treatment, a common form of ostracism, you feel as if you don’t even exist. There’s no playing field on which to influence the relationship or situation — you may not even know the nature of the offense. The imposition of silence is a power play that expresses the ultimate contempt for the target: as George Bernard Shaw put it, “Silence is the most perfect expression of scorn.” The one giving the silent treatment — whether it’s not answering email, turning away in the middle of a conversation, or pretending not to hear a question — gets to feel control. In not explaining the cause, the perpetrator delivers particular pain. The message is loud and clear: “You do not matter.” Another reason ostracism hurts so badly is that the hurt is not confined to the period when it happens. Researchers find that all you have to do is relive a past ostracism episode, or even imagine a future event, and you will feel psychological agony. So intense is the pain of ostracism that even being rejected from a despised group makes people upset. Observing ostracism distresses even bystanders. The Young Brain in Pain Children know all about ostracism. They know it so deeply that some of their most common games, like musical chairs, play out social exclusion. On the playground, the child considered the slowest, weakest, or different in some respect is marked for ostracism. Research suggests that children and adolescents may be impacted more negatively by ostracism than adults, with more extreme reactions. The brains of adolescents who experience chronic ostracism may undergo telltale long-term changes, with normal development short-circuited. Through an online game called Cyberball, scientists have studied over 20,000 children to see how they are impacted by ostracism. Among the findings: ostracism adversely affects a young person’s cognitive ability. It can influence everything from food intake to hormonal systems, and it can induce symptoms ranging from paranoia to substance abuse. Not only can ostracism damage the brain; it is also more commonly directed at those who have cognitive and psychiatric challenges. One study found that children with attention deficit/hyperactivity disorder and autism spectrum disorders were more likely to be ostracized when compared to children with other special needs or those without a diagnosis. Chronic ostracism in young people can be dangerous: One well-known analysis of 15 U.S. school shootings from 1993-2001 suggests that ongoing exclusion was a major contributing factor in 87 percent of events. More recent tragedies show patterns linked to ostracism response, like that of alleged Isla Vista shooter Elliott Rodger. A common reaction to the perception of social rejection is trying desperately to forge new group identities, such as those available online. Rodger, who felt ignored and rejected particularly by female peers, sought to forge a new group identity through online “Men’s Rights” communities. When he finally snapped, Rodger followed the predicted pattern of violence in the ostracized in not wanting merely to harm himself or random people, but members of the group from which he felt excluded. Ostracism in the Workplace Adults experience plenty of ostracism, too, in romantic relationships, family life and on the job. Researchers have found that in the workplace, ostracism is more likely to make someone feel horrible and want to quit than more overt forms of abuse. Sandra Robinson of University of British Columbia's Sauder School of Business, who co-authored a recent paper on the subject, explained that adults may feel that ostracism is a more acceptable form of social control: “We've been taught that ignoring someone is socially preferable—if you don't have something nice to say, don't say anything at all…But ostracism actually leads people to feel more helpless, like they’re not worthy of any attention at all.” One of the things about ostracism in the workplace that makes it so hard to deal with is that it can be very subtle. Getting ignored in a meeting is hard to prove and respond to, but it can be psychologically devastating. In the hands of a petty and malicious boss, ostracism becomes a finely tuned instrument of torture, and one that can be implemented with little fear. There is an ambiguity to it: the targeted person wonders if it’s really happening, and since no one tells the target what may be wrong, the person can’t address the problem. The target feels humiliated and without recourse. In the corporation, ostracism is often used to deal with the threat of whistleblowers. Unlike other forms of retaliation, like termination, demotion or a poor performance review, ostracism is difficult to document and probably won’t qualify for legal intervention. It is extremely effective because it prevents the target from being able to do his or her work properly, which can create grounds for retaliation that appear to be legitimate. A Building Crisis? Social psychologists and others who investigate the malicious ways people treat each other are finding that in fragmented modern societies, where superficial relationships prevail, victims of ostracism are particularly vulnerable. Kipling Williams, a psychologist who researches ostracism, warns that people may not realize the emotional or physical harm that is being done when they ostracize others. He notes “in the past, people who were ostracized at work or by a friend could seek support and control through another significant relationship. But because people report growing more distant from extended family and relying on fewer close friendships, they might lack the support to deal with ostracism." Certainly, the evidence shows that ostracism should be considered a major concern for psychologists, educators, parents, and legal professionals. This piece was reprinted by Truthout with permission or license. It may not be reproduced in any form without permission or license from the source. Lynn Stuart Parramore Lynn Stuart Parramore is an AlterNet contributing editor. Related StoriesBully Politics By Michael I Niman, Art Voice | Op-EdBullying and the Power of PityBy Max Eternity, The Eternity Group | OpinionBully NationBy Yale Magrass and Charles Derber, Truthout | Op-Ed Show Comments By Amy Goodman and Aaron Mate, Democracy Now! | Video Interview The Social Death Penalty: Why Being Ostracized Hurts Even More Than Bullying

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By Allison Perry UK Markey Cancer Center Welcomes Four New Faculty That Comprise Innovative Metabolic Cancer Research Team Published: Sep 2, 2013 SHARE: LEXINGTON, Ky. (Sept. 2, 2013) -- The University of Kentucky Markey Cancer Center announces the addition of four new faculty members who study the role that metabolism plays in cancer. Teresa Fan, Andrew Lane, Richard Higashi and Hunter Moseley will bring more than $17 million over five years in current federal funding and will develop a research center at UK. The researchers will establish a UK Center for Regulatory and Environmental Analytical Metabolomics (UK-CREAM), in partnership with Markey over the next few months with their laboratories being located on the fifth floor of UK's BioPharm Complex, which is already home to other innovative cancer researchers. Fan, Lane, Higashi, and Moseley utilize state-of-the-art instrumentation to understand – by tracking atoms – how various conditions or environmental exposures disrupt normal metabolism and how abnormal metabolism contributes to the development and/or spread of cancer. "The addition of this team of highly accomplished researchers is a major catalyst in the efforts of the Markey Cancer Center to both grow its cancer-related research funding and enhance its ability to submit a competitive renewal application of its National Cancer Institute (NCI) Cancer Center Support Grant in the next cycle,” said Dr. Mark Evers, director of the UK Markey Cancer Center. Teresa Fan serves as director of UK-CREAM, currently located at the University of Louisville. She has been continuously funded in federal grants since 1996. She was trained as a plant biochemist at the University of California, Davis, followed by postdoctoral training on in vivo nuclear magnetic resonance (NMR) and metabolite profiling applications to stress metabolism at Stanford University. Together with Lane and Higashi, she pioneered the combined use of NMR and mass spectrometry (MS) for investigating environmental stress-induced metabolic changes in a variety of indigenous and model organisms. She has published 100 peer-reviewed papers and holds two patents. She has trained 11 postdoctoral scholars, one surgical resident, six medical students, and 8 graduate students. Andrew Lane is associate director of NMR Development at UK-CREAM. He was trained in biochemistry and enzymology at University College London and then received further training in biophysics (Biozentrum, Basel) and NMR (Stanford University) before becoming a tenured staff scientist at the National Institute for Medical Research in London. In his most recent post, he was the program leader in structural biology and director of the NMR facility. Lane has published 189 articles, 160 abstracts and presentations, holds two patents and has been awarded 25 grants as PI or co-I from both federal and nonfederal sources. Richard Higashi is UK-CREAM associate director of mass spectrometry development. He is a bioanalytical chemist with a highly diverse background spanning three decades, ranging from pesticide chemistry, aquatic toxicology, plant biochemistry, bioremediation, air pollution, to biochemical imaging, and most recently cancer metabolism. He has served in co-directorship of various research centers across all of these fields for more than 15 years. Higashi has more than 84 peer-reviewed publications and currently is involved in more than $9 million in extramural funding, mostly from NIH but also from entities such as the Bill and Melinda Gates Foundation. He was one of the founding members of the International Metabolomics Society. Hunter Moseley is UK-CREAM associate director of informatics. He has degrees spanning computer science, mathematics, chemistry, and biochemistry and more than 20 years of experience in bioinformatics research, particularly in the development of automated analyses of NMR and mass spectrometry data. He holds a patent in computational methods for NMR data analysis and has published 27 peer- reviewed papers. He recently received the Kentuckiana Metroversity Award for Instructional Development, the Kentucky Academy of Science Outstanding Early Career Award, and an NSF Career Award. The investigators' projects include a newly funded program project grant (P01) from NCI titled, “Systems Biochemistry in Lung Cancer: Toward a Mechanistic Understanding of NSCLC,” and a large multi-PI R01 platform grant titled, “Integrated Chemoselective and Informatics Platform for Large-Scale Metabolomics” funded in September 2012. MEDIA CONTACT: Allison Perry, (859) 323-2399 or allison.perry@uky.edu Tags: Two-Time Breast Cancer Survivor Shares Her Experiences to Help Others | 'Wake-Up Call' at 36 Prompts Life Transformation | UK HealthCare Pediatric Team Brings Guatemalan Child Closer to a Normal Life | Migraine Sufferer Finds Relief at the Kentucky Neuroscience Institute's Headache Clinic | UK Study Identifies Molecule That Induces Cancer-killing Protein search

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Mice Holding Back Muscular Dystrophy Research? Animal Rights Articles Visit our Home Page Write us with your comments From ScienceDaily.com Humans and mice have previously unknown and potentially critical differences in one of the genes responsible for Duchenne muscular dystrophy (DMD). Researchers writing in the open access journal BMC Biology have found that two major features of a key DMD gene are present in most mammals, including humans, but are specifically absent in mice and rats, calling into question the use of the mouse as the principal model animal for studying DMD. Roland Roberts led a team of researchers from King's College London, UK, and was funded by the Muscular Dystrophy Campaign. The team made the discovery while studying α-dystrobrevin, a component of the dystrophin protein complex that is disordered in DMD. Roberts said, "Two previously unrecognized features (a gene switch or promoter and a novel binding site for the adaptor protein syntrophin) are encoded by the α-dystrobrevin gene of almost all four-legged animals except mice. We assume that this tardy recognition of key features of a gene that has been intensively studied since its discovery 13 years ago is due to the predominance of the mouse as the model organism for studying DMD and the specific destruction of these parts of the gene in the mouse." A major consequence of these findings is that mice (and their rat and hamster relatives)

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Senate bill could hurt insurers at least initially By TOM MURPHY AP Business Writer President Barack Obama, accompanied by Vice President Joe Biden, speaks in the State Dining Room of the White House in Washington, Thursday, Dec. 24, 2009, after the Senate passed the health care reform bill. (AP Photo/Evan Vucci) INDIANAPOLIS (AP) - Health insurers get some big presents in the Senate's health overhaul bill - about 20 million new customers and no competition from a new government plan.Taking advantage of those boons might take some time, though.The bill imposes hefty new taxes and coverage rules that will pinch insurers by forcing them to cover more sick people without gaining enough healthy, lower-cost customers, industry insiders say. The industry is also worried the bill doesn't do enough to control health care costs.It's a matter of figuring out how to make those new customers profitable, analysts say."There's opportunity," Miller Tabak analyst Les Funtleyder said. "Where the rubber meets the road is can you access that opportunity? At least some of them will figure out how to do it."The Senate bill is much more favorable to insurers than a similar bill passed in the House that contains a government-run option for consumers seeking individual insurance, something insurers have fought hard. They worry that a government-run plan that sets rates below market prices would pose unfair competition.Though the Senate bill still has to be reconciled with the House bill, most observers believe the government-run plan, often called a "public option," will disappear because it lacks Senate support.Both bills call for the creation of insurance exchanges that help people buy coverage. Insurers likely will lose money on business from those exchanges, said Robert Laszewski, a former insurance executive and president of Health Policy and Strategy Associates, a Virginia-based health care consultant.It's a tradeoff: People without insurance would be required to buy it - in some cases, subsidies will help them pay for it - or face fines if they don't. Insurers, in turn, would no longer be able to deny coverage based on pre-existing conditions such as diabetes or cancer.But the proposed fines are too weak and the subsidies too meager to truly motivate people to buy insurance, Laszewski said. This means the people most motivated to buy coverage through these exchanges will be those who already have health problems - who are money losers for insurers.Insurers need a mix of healthy people enrolled in their coverage to help balance out claims they pay for patients who use more insurance.The Senate bill calls for fines for people who do not purchase coverage and are not exempt from a mandate to buy it. They start at $95 in 2014 and rise to $750 by 2016.That's a lot more affordable than what some people would pay for insurance. A sliding scale of subsidies will help people or families with incomes up to 400 percent of the federal poverty level, or $88,200 for a family of four this year. But a family of four with income of $65,000 would still have to pay nearly 10 percent of that income, or $6,500, toward coverage."There aren't a lot of families with an extra $6,500 in their checking account," Laszewski said. "The problem with this bill is the subsidies are really quite modest, and there really aren't any penalties."An ideal bill for insurers, he said, would pair better subsidies for the uninsured with higher penalties that motivate people to buy coverage and get more healthy people into the risk pools.The Senate bill hurts managed care companies in other ways. Insurers use a person's age and other variables to figure out the price of an individual insurance policy. Older people often have to pay more because they tend to generate more claims. But the Senate bill limits how much more insurers can charge for older customers.That means people under age 30 likely will see a "substantial increase" in the cost of a policy - making them less inclined to buy insurance - while older people will see a smaller decrease, said Brad Fluegel, chief strategy and external affairs officer for WellPoint Inc., the nation's largest health insurer based on membership.The Senate bill also calls for the industry to pay annual fees for the plan that start at $2 billion in 2011 and increase to $10 billion by 2017. Analysts say costs like these will be passed to consumers because insurers want to protect profit margins, which are generally thinner than other health care companies like drugmakers."I think we're going to be discussing health care reform continuously for the next several years as we try to fix all the things that are broken with this existing bill," Fluegel said.Added up, insurers say the bill would mean higher premiums for consumers and likely for employers who buy coverage. And that's on top of hikes spurred by rising medical care.The stock market no longer seems worried. Shares of the five largest managed care companies have risen more than 120 percent, on average, since they bottomed out in early March. In contrast, the Standard & Poor's 500 index has increased about 63 percent over the same span.Investors had big worries when the debate picked up steam last spring, but stocks started climbing as they realized "doomsday scenarios" such as a government takeover would not happen, Funtleyder said.He thinks insurers will learn to live with the overhaul and eventually benefit from it. They should be able to adjust their prices to accommodate taxes, fees and the new regulations once they understand the claims their exchange customers will generate."It's kind of tricky, at least in the beginning."

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Reference > Anatomy of the Human Body > II. Osteology > 6c. 5. The Tibia 6c. 5. The Tibia (Shin Bone)The tibia (Figs. 258, 259) is situated at the medial side of the leg, and, excepting the femur, is the longest bone of the skeleton. It is prismoid in form, expanded above, where it enters into the knee-joint, contracted in the lower third, and again enlarged but to a lesser extent below. In the male, its direction is vertical, and parallel with the bone of the opposite side; but in the female it has a slightly oblique direction downward and lateralward, to compensate for the greater obliquity of the femur. It has a body and two extremities. 1 the Semimembranosus. Its medial surface is convex, rough, and prominent; it gives attachment to the tibial collateral ligament. The lateral condyle presents posteriorly a flat articular facet, nearly circular in form, directed downward, backward, and lateralward, for articulation with the head of the fibula. Its lateral surface is convex, rough, and prominent in front: on it is an eminence, situated on a level with the upper border of the tuberosity and at the junction of its anterior and lateral surfaces, for the attachment of the iliotibial band. Just below this a part of the Extensor digitorum longus takes origin and a slip from the tendon of the Biceps femoris is inserted. 2 The Body or Shaft (corpus tibiæ).—The body has three borders and three surfaces. 3 Borders.—The anterior crest or border, the most prominent of the three, commences above at the tuberosity, and ends below at the anterior margin of the medial malleolus. It is sinuous and prominent in the upper two-thirds of its extent, but smooth and rounded below; it gives attachment to the deep fascia of the leg. 4 The medial border is smooth and rounded above and below, but more prominent in the center; it begins at the back part of the medial condyle, and ends at the posterior border of the medial malleolus; its upper part gives attachment to the tibial collateral ligament of the knee-joint to the extent of about 5 cm., and insertion to some fibers of the Popliteus; from its middle third some fibers of the Soleus and Flexor digitorum longus take origin. 5 The interosseous crest or lateral border is thin and prominent, especially its central part, and gives attachment to the interosseous membrane; it commences above in front of the fibular articular facet, and bifurcates below, to form the boundaries of a triangular rough surface, for the attachment of the interosseous ligament connecting the tibia and fibula. 6 remaining part of the posterior surface is smooth and covered by the Tibialis posterior, Flexor digitorum longus, and Flexor hallucis longus. Immediately below the popliteal line is the nutrient foramen, which is large and directed obliquely downward. 9 The Lower Extremity (distal extremity).—The lower extremity, much smaller than the upper, presents five surfaces; it is prolonged downward on its medial side as a strong process, the medial malleolus. 10 Surfaces.—The inferior articular surface is quadrilateral, and smooth for articulation with the talus. It is concave from before backward, broader in front than behind, and traversed from before backward by a slight elevation, separating two depressions. It is continuous with that on the medial malleolus. 11 the attachment of the anterior fibers of the deltoid ligament of the ankle-joint; its posterior border presents a broad groove, the malleolar sulcus, directed obliquely downward and medialward, and occasionally double; this sulcus lodges the tendons of the Tibialis posterior and Flexor digitorum longus. The summit of the medial malleolus is marked by a rough depression behind, for the attachment of the deltoid ligament. 15 Structure.—The structure of the tibia is like that of the other long bones. The compact wall of the body is thickest at the junction of the middle and lower thirds of the bone. 16 Ossification.—The tibia is ossified from three centers (Figs. 260, 261): one for the body and one for either extremity. Ossification begins in the center of the body, about the seventh week of fetal life, and gradually extends toward the extremities. The center for the upper epiphysis appears before or shortly after birth; it is flattened in form, and has a thin tongue-shaped process in front, which forms the tuberosity (Fig. 260); that for the lower epiphysis appears in the second year. The lower epiphysis joins the body at about the eighteenth, and the upper one joins about the twentieth year. Two additional centers occasionally exist, one for the tongue-shaped process of the upper epiphysis, which forms the tuberosity, and one for the medial malleolus. 17

医学

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Flamel Technologies (FLML) Announces Positive Results Of A First-in-Man Clinical Trial With Micropump Sodium Oxybate 4/7/2014 11:03:42 AM LYON, FRANCE--(Marketwired - April 07, 2014) - Flamel Technologies (NASDAQ: FLML) today announced that its First-in-Man (FIM) clinical study in healthy volunteers using its proprietary Micropump® technology applied to sodium oxybate has identified formulations that demonstrate the potential to eliminate the second nighttime dose for patients suffering from narcolepsy. The current dosing regimen for the standard of care, Xyrem® (sodium oxybate), in the United States is two equal, divided doses: the first dose at bedtime and the second dose 2.5 to 4 hours later. The elimination of the second dose for narcolepsy patients would not only provide more convenience, but may improve the benefit sodium oxybate provides as there will be no disruption to nighttime sleep. The potential for additional benefits, including improved safety, will be studied. The trial was designed as a 16 subject four-way crossover evaluating three different formulations of Micropump sodium oxybate and Xyrem at a nightly dose of 4.5g (two doses of 2.25g for Xyrem) with an extension phase at 6g for successful Micropump formulations. Each subject consumed a standard meal two hours prior to dosing. Subjects were instructed to maintain a consistent meal time and dosing schedule throughout the study. When a subject took Xyrem they were instructed to take the second dose 4 hours after the first dose. Two subjects dropped out of the study prior to the completion of the 4.5g dosing portion for reasons unrelated to drug. The key data for the 14 evaluable subjects at 4.5g are: Onset of action similar to Xyrem Cmax lower than Xyrem Mean blood concentration (ug/ml) at hours 7 and 8 similar to Xyrem For the extension phase of the study, two formulations were moved forward for dosing at 6g. Thirteen subjects were evaluable as one subject dropped out for a reason unrelated to drug. The profiles for both formulations were consistent with expectations. The current study will continue to treat subjects at higher doses. Given these results, Flamel plans to begin a new clinical study before the end of 2014 in a larger number of subjects further evaluating its formulations as well as certain pharmacodynamic endpoints. This study is not expected to be a registration study. Flamel plans to meet with regulatory authorities prior to embarking upon registration studies which are expected to begin prior to the end of 2015. Flamel's Micropump technology is protected by intellectual property through at least 2025 in the United States. Micropump is a proven drug delivery platform for the oral delivery of small molecules. Narcolepsy is a sleep disorder involving irregular patterns in Rapid Eye Movement (REM) sleep and significant disruptions of the normal sleep/wake cycle. People with narcolepsy experience excessive daytime sleepiness, sleep attacks, cataplexy, sleep paralysis, hallucinations and disrupted nighttime sleep. Xyrem® is sold in the United States by Jazz Pharmaceuticals plc, in Canada by Valeant Canada Limited (via license from Jazz) and in twenty-two EU countries and Mexico by UCB Pharma Limited (via license from Jazz). A conference call to discuss these results and other updates is scheduled for 8:45 AM Eastern Daylight Time on April 7, 2014. A question and answer period will follow management's prepared remarks. To participate in the conference call, investors are invited to dial 888-857-6930 (U.S.) or 719-457-2615 (international). The conference ID number is 9695267. The conference call webcast may be accessed at www.flamel.com. A replay of the webcast will be archived on Flamel's website for 90 days following the call. About Flamel Technologies. Flamel Technologies SA's (NASDAQ: FLML) business model is to blend high-value internally developed products with its leading drug delivery capabilities. The Company has a proprietary pipeline of niche specialty pharmaceutical products, while its drug delivery platforms are focused on the goal of developing safer, more efficacious formulations of drugs to address unmet medical needs. Its partnered pipeline includes biological and chemical drugs formulated with its Medusa™ and Micropump® (and its applications to the development of liquid formulations, i.e. LiquiTime® and of abuse-deterrent formulations Trigger Lock™) proprietary drug delivery platforms. Several Medusa-based products have been successfully tested in clinical trials. The Company has developed products and manufactures Micropump-based microparticles under FDA-audited GMP guidelines. Flamel Technologies has collaborations with a number of leading pharmaceutical and biotechnology companies, including GlaxoSmithKline (Coreg CR®, carvedilol phosphate). The Company is headquartered in Lyon, France and has operations in St. Louis, Missouri, USA, and manufacturing facilities in Pessac, France. Additional information may be found at www.flamel.com. This release contains "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995, including certain plans, expectations, goals and projections regarding financial results, product developments and technology platforms. All statements that are not clearly historical in nature are forward-looking, and the words "anticipate," "assume," "believe," "expect," "estimate," "plan," "will," "may," and similar expressions are generally intended to identify forward-looking statements. All forward-looking statements involve risks, uncertainties and contingencies, many of which are beyond our control that could cause actual results to differ materially from those contemplated in such forward-looking statements. These risks include risks that the launch of Bloxiverz will not be as successful as anticipated; our ability to bring other R&D projects of the former Éclat Pharmaceuticals to market may be unsuccessful; FDA may not take action on the status of unapproved versions of neostigmine still on the market; clinical trial results may not be positive or our partners may decide not to move forward; products in the development stage may not achieve scientific objectives or milestones or meet stringent regulatory requirements; products in development may not achieve market acceptance; competitive products and pricing may hinder our commercial opportunities; we may not be successful in identifying and pursuing opportunities to develop our own product portfolio using Flamel's technology; and the risks associated with our reliance on outside parties and key strategic alliances. These and other risks are described more fully in Flamel's Annual Report on Form 20-F for the year ended December 31, 2012 that has been filed with the Securities and Exchange Commission (SEC). All forward-looking statements included in this release are based on information available at the time of the release. We undertake no obligation to update or alter our forward-looking statements as a result of new information, future events or otherwise. Flamel Technologies (FLML) Announces Fourth Quarter And Full Year 2013 Results Men Who Started Smoking Before Age 11 Had Fatter Sons, University of Bristol Study Flamel Technologies (FLML) Announces Pricing Of Public Offering Of American Depositary Shares Stroke Risk Higher After Shingles, But Antiviral Drugs May Provide Protection, London School Of Hygiene & Tropical Medicine Study Flamel Technologies (FLML) Announces Proposed Underwritten Public Offering Of American Depositary Shares Low-Dose Aspirin Won't Prevent Pregnancy Loss, University at Buffalo Study Flamel Technologies (FLML) To Report Fourth Quarter And Fiscal Year 2013 Results And Conference Call Obesity Primes The Colon For Cancer, National Institutes of Health (NIH) Study Flamel Technologies (FLML) Announces $15 Million Line Of Credit Circumcision Could Prevent Prostate Cancer… If It’s Performed After The Age Of 35, University Of Montreal Study Please enable JavaScript to view the comments powered by Disqus. Flamel Technologies S.A.

医学

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Insights Into Cancer: Cancer-Related Employment and Insurance Issues—What all Patients and Caregivers Need to Know Cost: Free and open to the public Location: Ronald Reagan UCLA Medical Center Auditorium, B Level Room B130757 Westwood PlazaLos Angeles, California 90095 Once a month, the Simms/Mann–UCLA Center for Integrative Oncology presents Insights Into Cancer, a free public lecture series for cancer patients, their families and the community. Each lecture features a leading professional who provides up-to-date information, practical advice and answers to cancer-related questions. December 4, 2012Cancer-Related Employment and Insurance Issues: What all Patients and Caregivers Need to Know A cancer diagnosis can bring with it a myriad of legal, financials, and insurance issues. Navigating these issues can be complicated, overwhelming, and stressful. But it doesn't have to be. This presentation identifies the most common cancer-related legal issues that arise for survivors and caregivers, including: health insurance and health care options; employment rights and taking time off work; and access to disability insurance and paid family leave benefits. Ms. Morales explains the laws that protect people and provide access to benefits to help people navigate these cancer-related legal issues. She also covers the ways that the Affordable Care Act (health care reform) applies to people coping with cancer. *** Insights Into Cancer lectures are held in the Ronald Reagan UCLA Medical Center Auditorium, B Level, Room B130, 757 Westwood Plaza, Los Angeles, CA 90095. UCLA parking is $11 and is wheelchair accessible. Attendees can park in the medical plaza, or take advantage of the valet parking at the front of Ronald Reagan UCLA Medical Center.

医学

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Multistate Outbreak of Fungal Infection Associated with Injection of Methylprednisolone Acetate Solution from a Single Compounding Pharmacy — United States, 2012 MMWR On September 18, 2012, the Tennessee Department of Health was alerted by a clinician regarding a patient with culture-confirmed Aspergillus fumigatus meningitis diagnosed 46 days after epidural steroid injection at a Tennessee ambulatory surgical center. By September 27, the initial investigation, carried out by the Tennessee Department of Health in collaboration with CDC and the North Carolina Department of Health and Human Services, had identified an additional eight patients with clinically diagnosed, culture-negative meningitis: seven in Tennessee and one in North Carolina. All nine patients had received epidural steroid injection with preservative-free methylprednisolone acetate solution (MPA), compounded at New England Compounding Center (NECC) in Framingham, Massachusetts. All nine patients had received one or more injections from three lots of MPA (lot numbers 05212012@68; 06292012@26; and 08102012@51). As of October 10, a multistate investigation led by CDC in collaboration with state and local health departments and the Food and Drug Administration (FDA) had identified 137 cases and 12 deaths associated with this outbreak in 10 states. Active case-finding efforts and extensive investigation into medications and medication lot numbers received by patients have confirmed that, as of October 10, no cases were associated with other lots of MPA, nor were any associated with other NECC products. This report describes the ongoing investigation by CDC and state and local health departments, and includes important recommendations for physicians and patients. NECC was informed of the ongoing investigation on September 25 and provided invoice information indicating that approximately 17,500 vials of MPA (80 mg/ml) from these lots were packaged in 1ml, 2ml, and 5ml vials and distributed to 75 facilities in 23 states. These lots of MPA were used to treat both peripheral joint and back pain. On September 26, NECC voluntarily recalled the three lots of MPA, followed by an expanded voluntary recall of all lots of MPA and all lots of sterile products intended for intrathecal injection on October 3. This was followed by a voluntary recall of all remaining products on October 6. Some patients received multiple injections with the three lots of MPA, and some vials were unused. As of October 10, state and local health departments had identified almost 14,000 per

医学

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COMMON INJURY/POISON What is Lyme disease? Lyme disease (LD) is a multi-stage, multi-system bacterial infection caused by the spirochete Borrelia burgdorferi, a spiral shaped bacterium that is most commonly transmitted by a tick bite. The disease takes its name from Lyme, Connecticut, where the illness was first identified in the United States in 1975. According to the Centers for Disease Control and Prevention (CDC), Lyme disease continues to be a rapidly emerging infectious disease, and is the leading cause of all insect-borne illness in the US. The number of annually reported cases has increased 25-fold since national surveillance began in 1982. Fewer than 20,000 people are infected each year in the US. The majority (95 percent) of cases are reported in Connecticut, Rhode Island, New York, Pennsylvania, Delaware, New Jersey, Maryland, Massachusetts, Maine, Minnesota, New Hampshire, and Wisconsin. Depending on the location, anywhere from less than 1 percent to more than 50 percent of the ticks are infected with spirochetes (bacteria that are usually carried by the tick). Lyme disease is a year-round problem, although April through October is considered tick season. Cases of LD have been reported in 45 states in this country, with most cases occurring in: the coastal northeast the mid-Atlantic states Wisconsin and Minnesota Many cases have also been identified in large areas of Asia and Europe. What are the symptoms of Lyme disease? The list of possible symptoms for Lyme disease is non-specific, and symptoms can affect every part of the body. Symptoms usually appear within two to 21 days. The following are the most common symptoms of LD. However, each child may experience symptoms differently. One of the primary symptoms is often a rash that can be pink in the center and a deeper red on the surrounding skin, but can vary in appearance. The rash: can appear several days after infection, or not at all. can last a few hours or up to several weeks. can be very small or very large (up to 12 inches across). can mimic such skin problems as hives, eczema, sunburn, poison ivy, and flea bites. can itch or feel hot, or may not be felt at all. can disappear and return several weeks later. Several days or weeks after a bite from an infected tick, flu-like symptoms can appear, including the following: stiff neck aches and pains in muscles and joints low-grade fever and chills After several months, painful and swollen joints may occur. Other possible symptoms may include the following: problems with coordination Symptoms of LD may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis. How is Lyme disease diagnosed? LD may be difficult to diagnose because the symptoms may resemble other conditions. The primary symptom is a rash, but it may not be present in up to 10 to 15 percent of cases. Diagnosis is usually based on symptoms and a history of a tick bite. Diagnosis of Lyme disease must be made by an experienced physician. Blood and laboratory tests may be performed to rule out other conditions. Research is underway to develop and improve methods for diagnosing LD. Treatment for Lyme disease: Your child's physician will determine the best treatment plan based on your child's individual situation. Lyme disease is usually treated with antibiotics. Treatment will be considered based on these and other factors: If you are bitten by a tick that tests positive for spirochetes. If you are bitten by a tick and have any of the symptoms. If you are bitten by a tick and are pregnant. If you are bitten by a tick and live in an area where the ticks are known to be infected. How can Lyme disease be prevented? Humans do not develop an immunity to LD and reinfection is possible. In 1998, the US Food and Drug Administration (FDA) had approved a new vaccine against Lyme disease called LYMErix. The vaccine was not 100 percent effective, however, and the FDA still recommended using other preventive measures. In 2002, the manufacturer of LYMErix announced that the vaccine would no longer be available commercially. Some general guidelines for preventing LD include the following: Ticks cannot bite through clothing; dress your child and family in: light-colored clothing. long-sleeved shirts tucked into pants. socks and closed-toe shoes. long pants with legs tucked into socks. Check your family often for ticks, including: all parts of the body that bend: behind the knees, between fingers and toes, underarms, and groin. other areas where ticks are commonly found: belly button, in and behind the ears, neck, hairline, and top of the head. areas of pressure points, including: where underwear elastic waist band touches the skin. where bands from pants or skirts touch the skin. anywhere else where clothing presses on the skin. Visually check all other areas of the body and hair, and run fingers gently over skin. Run a fine-toothed comb through your child's hair to check for ticks. Other helpful measures include the following: Walk on cleared paths and pavement through wooded areas and fields when possible. Shower after all outdoor activities are over for the day. It may take up to four to six hours for ticks to attach firmly to skin. Showering will help remove unattached ticks. Use insect repellents safely: Products that contain DEET are tick repellents, but do not kill the tick and are not 100 percent effective. Use a children's insect repellent and check with your child's physician if your child is younger than 1 year of age before using. Treat clothing with a product that contains permethrin, which is known to kill ticks on contact. Do not use permethrin on the skin. Check pets for ticks and treat as needed. Online Resources of Common Childhood Injuries & Poisonings GR_ATP COMMON INJURY/POISON HOME

医学

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Our ServicesBone & Joint HealthCancer CareHeart & Vascular HealthHome Health CarePrimary CareResearchWomen's HealthX-ray, MRI, CT... (Imaging)View all servicesPatient & Visitor GuideHospitals & FacilitiesYour Hospital StayMyHealth Patient PortalsPhone DirectoryVisiting a PatientBillingHelp with Health InsuranceFinancial AssistanceYour PrivacyHealth & WellnessEvents & ClassesWellness BlogCommunity Health LibrariesHealth LinksHealthy Living GuidesHealth ToolsWatch Surgery VideosAbout UsWho We AreChristiana Care NewsQuality & Patient SafetyCommunity BenefitRequest a SpeakerFor Health ProfessionalsResidency ProgramsFellowshipsDepartments & SectionsEducationFor PhysiciansResearchQuality PartnersLearning InstituteValue Institute Physicians & Staff The Christiana Care Way Gregory A. Masters, M.D. Director, Med. Onc. Fellowship Lung cancer specialist Gregory A. Masters, M.D., joined Christiana Care's Helen F. Graham Cancer Center as an attending physician in 2003. In addition to caring for patients at the Helen F. Graham Cancer Center, this former high school chemistry teacher currently serves as an associate professor at Thomas Jefferson University Medical School in Philadelphia. He is a diplomate of the American Board of Internal Medicine in both internal medicine and medical oncology, and is a licensed physician and surgeon in both Delaware and Illinois. Past-president of the Delaware Society of Clinical Oncology, Dr. Masters currently serves on the American Society of Clinical Oncology Clinical Practice Committee, on the Editorial Board of the Journal of Clinical Oncology, and as a member of the Professional Advisory Board for The Wellness Community in Delaware. Dr. Masters is a highly published expert who travels the country speaking to medical audiences on lung cancer. He also serves as a reviewer for many of the leading oncology clinical publications, including Lancet, Journal of Clinical Oncology, Lung Cancer, Cancer, British Journal of Cancer, and the American Journal of Cancer. He has received numerous professional honors, most notably a physician ambassador award bestowed by the Christiana Care Nursing staff, and the Meredith Benjamin Award from Northwestern University Medical School as the medical student best representing the personal qualities of a medical doctor. A graduate of Northwestern University Medical School in Chicago, Dr. Masters completed his residency in internal medicine at the Hospital of the University of Pennsylvania and earned a fellowship in hematology/oncology at the University of Chicago Hospital. He came to Christiana Care from Northwestern University Medical School, where he served as assistant professor in the Department of Medicine and as attending physician at Evanston, Northwestern Healthcare. He also instructed in the Department of Medicine at the University of Chicago. He is a member of the American College of Physicians, the American Society of Clinical Oncology, the International Association for the Study of Lung Cancer, the Eastern Cooperative Oncology Group, Cancer and Leukemia Group B, the Radiation Therapy Oncology Group, the American College of Chest Physicians and the Medical Society of Delaware. Specialties: Medical Oncology Hematology Consultants Contact: Med. Onc. Hem.Consultants, PA 4701 Ogletown-Stanton Rd.,S-3400 Newark, DE 19713302-366-1200 Education: Christiana Care Websites Christiana Care Careers ChristianaCare.org en Español Christiana Care News Christiana Care Login Christiana Care is a private not-for-profit regional health care system and relies in part on the generosity of individuals, foundations and corporations to fulfill its mission. To learn more about how you can support our mission, please visit christianacare.org/donors. Christiana Care Health System PO Box 1668, Wilmington, DE 19899 800-693-CARE

医学

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Covering the $1,000 pill Five questions reporters still need to ask about very expensive new drugs like sofosbuvir—-and the cost of healthcare overall By Trudy Lieberman Are the costs of super expensive drugs—to cure whatever ails Americans—justifiable? The drug sofosbuvir, used to treat hepatitis C, has emerged as the poster child for this nagging question. Slowly, the press—which has often acted as a cheerleader for new drugs—is taking a more skeptical look at sofosbuvir, and exploring whether the drug justifies the outlay from the public purse, or from the wallets of insurance companies for that matter. The drug costs $1,000 a pill or around $84,000 for a 12-week course of treatment. When it first debuted in late November—under the brand name Sovaldi, sold by Gilead Sciences—early press coverage was typical of announcements for new drugs; that is, it was laudatory, gave short shrift to the evidence for the drug’s efficacy, lots of ink to the potential for profitability and market share as well as the drug maker’s rationale for its high price. As I noted then, “The story of the new hepatitis C drug opens the door for a renewed examination of the high cost of medicines and their contributions to the high cost of medical care in the US.” In early January, NPR’s Richard Knox reported on Sovalidi’s pricing by going beyond the drug makers’ standard spiel and interviewing outside experts. One researcher at the University of Liverpool estimated that the cost to produce “a course of these treatments would be on the order of $150 to $250 per person” based on the cost of similar antivirals to treat patients with HIV. A doctor at Beth Israel Deaconess Medical Center in Boston questioned whether the price was justified once the company recovered its initial investment—after which, she told Knox, “I don’t want to say [the price is] unfair, but it does start feeling more exploitative.” Saturday, The Washington Post’s Sandhya Somashekhar advanced the story by interviewing those who pay for the drug and, what do you know, she discovered some pushback. (Kaiser Health News had a similar report on Monday). Somashekhar reported Molina Healthcare, a company that operates Medicaid managed-care plans in 11 states, has told state officials it cannot bear the cost of covering the drug, and is asking states to pay separately for the drug instead of bundling it into a flat fee. It also is deciding whether to cover it at all. Express Scripts, the country’s largest pharmacy benefit manager, is asking doctors in its networks to delay prescribing the drug if patients can safely wait. This is the first time Express Scripts—whose job is to contain the costs of prescription drugs for employers—has asked doctors to avoid a drug because of its costs. State Medicaid directors say taxpayers will have to pick up most of the cost of the drug because many people who have hepatitis C get their healthcare through Medicare, Medicaid, or the prison system—and Medicaid officials aren’t happy about it . “Advocates say Gilead has taken corporate greed to new levels,” Somashekhar wrote. (While Gilead touted to the Post its “generous assistance program to help low-income people get the drug at a low cost,” giving some people with low incomes help with the bill doesn’t make the bill lower for the rest of the population, and that bill still gets figured into the insurance premiums everyone pays.) Dr. Arthur Kellermann, dean of the US Medical School, reinforced that point in a tweet on Sunday: “If you have a great new drug, and no sense of shame, this is what you can do. Can our nation afford it?” That’s a question the press needs to continue asking. A week ago, New York Times reporter Elisabeth Rosenthal told us she hopes her series on the high price of American healthcare will spark a very loud conversation that politicians can’t ignore. How can reporters advance this story and contribute to that conversation? When it comes to reporting fully and carefully on sofosbuvir, here are some questions journalists should be asking: Where does this drug live on the cost (and efficacy) spectrum compared to other drugs that can fight hep C? In other words, put Solvaldi’s $84,000 price tag in context for readers. The Post describes Sovaldi as costing “more than what many cancer treatments cost in a year,” for example, but the only mention of how it compares to the price of existing hep C treatments is from Gilead itself, which told the Post “the price is fair because it is a signifcant improvement from previous treatments and it is not more expensive than the old treatment.” Kaiser reports that “older drugs cost about $25,000 per treatment, while some newer products approved in 2011 have prices closer to Sovaldi, but have more side effects or are more complex to administer.” Clearly, further reporting is needed here. How much does the drug cost in other countries? When the drug first appeared, Gilead hinted it might be cheaper in places like India, China, and Egypt. What about other countries that contain costs better than we do—like Canada, Germany, or the UK? And speaking of the UK, has NICE, the National Institute for Health and Clinical Excellence, passed judgment on the drug and how it should be used? Is there enough clinical evidence for its use? Will the price of sofosbuvir drop when competitors show up? This is one to watch. As Stephen Hall reported in his New York magazine piece last fall, “what predicts the price of the next cancer drug is the price of the last cancer drug.” Will the same be true of Sovaldi and its competitors? Are Medicaid directors in the 25 states that have so far not expanded their Medicaid programs rushing to pay for the new drug? Those states say they aren’t expanding because of the cost of insuring more people. If they are paying for the drug, what figures into the decisions to pay for an expensive drug to help a few while leaving thousands of low income residents without access to health insurance? What’s the cost benefit analysis? NPR’s first story in early December reported health officials were recommending that some 79 million baby boomers born between 1945 and 1965 should get tested for hepatitis C. Did that mean even the millions who are at zero risk for the disease—those who had no blood transfusions or exchanged needles? In his November piece about the drug, New York Times reporter Andrew Pollock wrote, “For patients who can afford them, the temptation to take the new drugs before trouble arises will be powerful.” Reportters need to ask some questions of the CDC and other experts about the costs and benefits of such measures. Follow @USProjectCJR for more posts from this author and the rest of the United States Project team. The new hepatitis C drug costs how much?! America’s healthcare prices are absurd…so now what? Oregon doctors say no to drug companies More in The Second Opinion The casualties of healthcare competition Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman. I am always reminded of Dr. Jonas Salk who gave the world the polio vaccine for free and compare his actions to the corporate world of pharmaceuticals today. The overweening greed is evident. The profit motive has gotten out of hand when people are willing to exploit the health of people just to amass far more money than is necessary. the desire for a yacht should never be allowed to prevent distribution of a drug the help the ailing. Charge enough to pay wages and have a comfortable life ok, but the greed is out of this world. #1 Posted by Max Berry, CJR on Wed 5 Mar 2014 at 10:19 AM One needs to think about HCV infection in the same way as prostate cancer; both are relatively slow progressing diseases and often watchful waiting or monitoring progression of the disease is the best care. Not all people need to be treated, at least not right away. The difference between the two diseases is that for prostate cancer, the alternative treatments leave something to be desired, while for HCV, one can achieve a very high cure rate in a fairly short period of time, with very low side effects. And $84,000 is a LOT cheaper than a liver transplant and the associated costs of immunosuppressant drugs and doctor visits for the rest of the patient's life. As for cost effectiveness of the treatment, when I asked the question at a CROI news conference this week, the experts on the panel said that given the costs of older drugs, their duration, rates of failure, the need for a second round of treatment in nearly half of those treated – for a longer duration – and management of side effects related to use of ribavirin and interferon (including expensive EPO), then the net cost of Solvaldi is about comparable. The drug is only approved in the US and Canada, Europe is expected to approve it later this year, so NICE etc. have not yet weighed in on it. #2 Posted by Bob Roehr, CJR on Fri 7 Mar 2014 at 08:33 PM Can't wait for Brazil and India to reverse engineer these treatments and watch the discussion about protecting intellectual property and patents. it is a crime to charge these prices. in a three drug combo the treatment will exceed $100,000.00 for 12 weeks . #3 Posted by Robert , CJR on Sun 9 Mar 2014 at 05:56 PM Follow @Trudy_Lieberman ALSO BY TRUDY LIEBERMAN What hospital data can tell us about how communities care for the elderly Can I keep my doctor with Obamacare? There's a database for that, thanks to the LA Times How one Massachusetts reporter provides a clear view on the healthcare market The casualties of healthcare competition – The Record and Pittsburgh Tribune-Review report on the dark side of the medical marketplace Cut to: Medicare 'cuts' – Reporters get another chance to put a recurring talking point in context and honestly explain to seniors what's at stake Most Popular

医学

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Effectiveness of a Web-based Prevention Program for Postpartum Depression University of California, San Francisco Collaborator: Alinne Barrera, University of California, San Francisco The original trial will evaluate the effectiveness of a Web-based program in preventing postpartum depression. The site has been modified to provide materials from both conditions. Behavioral: Mothers and babies Internet course and PPD informational brochure Allocation: Non-RandomizedEndpoint Classification: Efficacy StudyIntervention Model: Single Group AssignmentMasking: Open LabelPrimary Purpose: Prevention Using the Internet for English/Spanish Randomized Trials for Postpartum Depression Edinburgh Postnatal Depression Scale (EPDS) [ Time Frame: Measured monthly for 6 months postpartum ] [ Designated as safety issue: Yes ] Center for Epidemiologic Studies-Depression (CES-D) Scale [ Time Frame: Measured monthly for 6 months postpartum ] [ Designated as safety issue: Yes ] Experimental: Self-help course and information An eight-lesson, self-help, Web-based program for the prevention of postpartum depression based on cognitive behavioral therapy, social-learning, and attachment theory. The PPD informational brochure is a four-page pamphlet that contains information about postpartum depression. Depression is a mental health condition in which symptoms such as sadness, inability to feel pleasure, and loss of energy interfere with a person's normal life. Postpartum depression is a type of depression experienced by women after giving birth to a child. In this study an intervention for preventing postpartum depression that has been adapted for use over the Internet will be tested. Administering a depression-prevention program over the Internet has several advantages: after the initial investment is made to develop the program, costs are lower for treating each patient; online treatment is more accessible to a greater number of people than any given clinic; and participants who may be worried about a stigma associated with mental health problems often feel more comfortable seeking information through the Internet. Previous research has shown that symptoms of depression can be reduced through Internet-based interventions, but no research has examined such interventions specifically for postpartum depression. The program tested in this study is not aimed at replacing in-person mental health care—in fact, people who have signs of serious depression will be directed to in-person mental health care. Instead, the program is aimed at providing an additional mental health service among the range of available options. The original trial was a two-arm pilot prevention of postpartum depression trial comparing the Internet-based course called "Mothers and Babies/Mamás y Bebés" (M&B) to informational materials on postpartum depression. In the original trial, 1088 pregnant women were recruited and randomized (as anticipated) to either condition. The study Website has therefore been modified such that all participants who consent to participate will now receive materials from both conditions. We have eliminated the randomization procedure. As in the original study, participants be allowed to enroll at any time during their pregnancies and will be followed for 6 months after the birth of their children, so the length of participation will vary between 6 and 15 months. After undergoing a screening process, participants will now have access to both the Internet-based course called "Mothers and Babies/Mamás y Bebés" (M&B) and the informational materials. The informational materials will include information about postpartum depression and depression that may occur before childbirth. All participants will be invited via email to complete monthly assessments for the duration of the study. These assessments will measure mood, depression, and satisfaction with the assigned intervention. Fluent in English or Spanish San Francisco, California, United States, 94110 Sponsors and Collaborators Alinne Z. Barrera, PhD English-speaking participants click here for more information on this study. Spanish-speaking participants click here for more information on this study. No publications provided by University of California, San Francisco Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number): Barrera AZ, Kelman AR, Muñoz RF. Keywords to recruit Spanish- and English-speaking participants: evidence from an online postpartum depression randomized controlled trial. J Med Internet Res. 2014 Jan 9;16(1):e6. doi: 10.2196/jmir.2999. Alinne Barrera, Staff Psychologist, University of California, San Francisco F32 MH077371, F32MH077371, 5A, DATR AK-TAIF Depression, Postpartum

医学

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Highs and lows of using marijuana updated 10:33 AM EST, Mon November 12, 2012 In the last 3 years, more than 6,000 studies have been published about cannabis Medicinal marijuana prescribed to combat nausea, stimulate appetite, fight chronic pain Adolescents may be at a higher risk for brain damage after marijuana use (CNN) -- On Tuesday, Colorado and Washington became the first two states to legalize recreational use of marijuana. The referendums come at a time when more than a third of states have approved the cannabis plant for medicinal purposes. Proponents for legalizing marijuana tout its pain-relieving benefits and use by cancer patients undergoing chemotherapy or radiation treatments; opponents stress that science has yet to prove the drug is safe. It's a bit like the fairytale, "Jack and the Beanstalk." This "magic" plant that could help with everything from glaucoma to Lou Gehrig's disease could also contain unknown dangers to our heart, lungs and brain. The real question is, if we legalize marijuana, will we all live happily ever after? The Drug Enforcement Administration lists (PDF) marijuana under the Schedule I category of controlled substances, meaning it has a high potential for abuse, has no currently accepted medical purpose in the United States and is not deemed safe for use. Buzzkill to your IQ score Legalized marijuana: A good idea? Doped-up dogs on the rise 87-year-old busted dealing pot The DEA's stance has made it difficult for scientists to push forward national clinical trials on the drug. In 2009, the American Medical Association urged the government to review marijuana's classification with "the goal of facilitating the conduct of clinical research and development of cannabinoid-based medicines" to no avail. Still, in the last three years, more than 6,000 studies have been published in scientific journals about the cannabis plant, according to NORML, an organization that works to legalize marijuana. Much of the research has focused on the plant's effects on the body's endocannabinoid system. The endocannabinoid system acts like a bridge between mind and body, helping different types of cells communicate with each other. Our bodies make natural cannabinoids, or active chemicals that cause drug-like effects through the body, according to the National Cancer Institute. The main psychoactive ingredient in marijuana -- delta-9-tetrahydrocannabinol, or THC -- works in the same way as these natural chemicals. Dr. Julie Holland, editor of "The Pot Book," says medicinal cannabis is most often prescribed to combat nausea and stimulate appetite. It is also prescribed to manage chronic pain. The Food and Drug Administration has approved two synthetic cannabinoid drugs for use in patients with extreme nausea: dronabinol and nabilone. Another, Sativex, is undergoing phase III clinical trials in the United States for the treatment of cancer pain. A series of trials published by the University of California Center for Medicinal Cannabis Research in May showed cannabis can help patients suffering from neuropathic pain, commonly caused by degenerative diseases like multiple sclerosis or fibromyalgia. Neuropathic pain is also a common side effect of chemotherapy and radiation. Study participants on cannabis reported a 34 to 40% decrease in pain compared to the 17 to 20% decrease seen from patients on a placebo drug. Another study, published in the British Medical Journal in February, found a lower prevalence of Type II diabetes in marijuana users. The researchers hypothesized that cannabis lowers the risk for diabetes due to its immunomodulatory and anti-inflammatory properties. Even with all its potential benefits, cannabis should not be viewed as a harmless substance, NORML says. The drug's active constituents "may produce a variety of physiological and euphoric effects," the organization's website states. "As a result, there may be some populations that are susceptible to increased risks." The National Institute on Drug Abuse says that marijuana causes an increase in heart rate, which could put users at risk for a heart attack or stroke. Marijuana smoke also contains carcinogens similar to tobacco smoke. A 2011 study published in the journal Addiction found marijuana has little long-term effect on learning and memory, according to TIME.com. The study authors followed nearly 2,000 Australian adults, aged 20 to 24, for eight years. They concluded that the adverse impacts of cannabis use (shown in earlier studies) were either related to pre-existing factors or were reversible after even extended periods of use. Yet a similar study out of New Zealand earlier this year showed the opposite may be true for adolescent marijuana users. The New Zealand researchers found that teens who smoked pot heavily (at least four days a week) lost an average of eight IQ points between the ages of 13 and 38. Adults who had smoked as teens tended to show more pronounced deficits in memory, concentration, and overall brainpower in relation to their peers. Kids and teens' brains are still developing, Holland says, which is why they may be more vulnerable to the drug's effects. People with a family history of mental illness are also at a greater risk for seeing the drug's mind-altering effects. A number of studies have linked chronic marijuana use to increased rates of anxiety, depression and schizophrenia, according to DrugAbuse.gov. And a more recent study published in The American Journal of Addictions showed an association between adolescent pot smoking and an increase risk of exhibiting anti-social behavior as an adult. The good news is that marijuana has a low rate of addiction; estimates place it at about 9% of users. And as NORML points out, "the consumption of marijuana -- regardless of quantity or potency -- cannot induce a fatal overdose." Experts say more research is needed to determine the true benefits and long-term side effects of marijuana. Opinion: End the war on marijuana Part of complete coverage on Election 2012 Full coverage: CNN's Election Center Get all the latest news at CNN's Election Center. There are race updates, a delegate counter and much more. Obama makes history, again A black man is returning to the White House. Four years ago, it was a first, the breaking of a racial barrier. Tuesday night, it was history redux. And more. Five things we learned The 2012 presidential election shattered spending records, further polarized a divided country and launched a thousand hashtags. Fiscal cliff looming: Compromise or confrontation? updated 1:41 PM EST, Thu November 8, 2012 Democratic and Republican congressional leaders continue to sharply disagree over the key issue of whether top tax rates should be raised to help resolve the looming crisis. Voters approve same-sex marriage In a historic turnaround, the ballot box is showing America's shifting attitudes about same-sex marriage. Demanding more from second term Even though voters indicated to pollsters that their financial situation is the same or worse than it was four years ago, they put their trust in the president. Victorious Obama faces challenges The president faces a long and familiar set of challenges after riding a wave of support from moderates, women and minorities to victory. GOP retains grip on House updated 9:27 AM EST, Wed November 7, 2012 Republicans kept a lock on the U.S. House of Representatives, a crucial victory after the party failed to wrest away the presidency from Barack Obama and the Senate from the Democrats. Democrats keep control of Senate Democrats will retain their control of the Senate after winning several closely contested races on Tuesday. Health Resources from HealthGrades Facing the stigma of diabetes Exercising after an Angioplasty 8 home set-up tips for people with RA Frequent urination: What's normal? 10 assistive devices for MS Home | Video | U.S. | World | Politics | Justice | Entertainment | Tech | Health | Living | Travel | Opinion | iReport | Money | Sports

医学

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Category: Cardiology | Neurology | Nursing | Pulmonology | News Back to Health News Sleep Apnea ‘Mask’ Might Also Help the Heart Last Updated: May 22, 2012. CPAP treatment was tied to lowered odds for high blood pressure, study found CPAP treatment was tied to lowered odds for high blood pressure, study found.By Carina StorrsHealthDay Reporter TUESDAY, May 22 (HealthDay News) -- New research suggests that treating obstructive sleep apnea, a common cause of snoring and daytime sleepiness, might also cut down on a serious health hazard associated with the condition -- the risk of developing high blood pressure. Researchers in Spain examined the number of new cases of high blood pressure in two groups with sleep apnea who used continuous positive airway pressure therapy, or CPAP, for either about four or 11 years. CPAP involves the use of a mask to help push air into the lungs while asleep. The results were published in a pair of studies in the May 23/30 issue of the Journal of the American Medical Association. Both studies found that people who used CPAP, the most common treatment for sleep apnea, for at least four hours a night had lower rates of developing high blood pressure compared with those who were not prescribed CPAP or who used it less regularly. "CPAP seems to have a protective effect in patients who use the machine properly," said Dr. José Marin, director of the Sleep Respiratory Unit at Miguel Servet University Hospital in Zaragoza, an author of both studies. However, about 10 percent of people used the machine for fewer than four hours nightly, which is considered the minimum amount to see benefits, Marin said. Many patients are uncomfortable with CPAP because it is inconvenient and the mask covers their nose while they sleep, or the person they sleep with does not like the noise the machine makes, Marin said. But alternative treatments, such as surgery or mouth devices, generally don't work as well as CPAP, and there are less data suggesting they reduce the risk of high blood pressure, said Dr. Aneesa Das, assistant director of the sleep disorders program at the Ohio State University Wexner Medical Center. A reduction in high blood pressure risk could also reduce the risk of other diseases, such as heart failure, which are more common in people with sleep apnea. "The idea is that there are probably multiple factors that are causing cardiovascular events and stroke [in sleep apnea patients], including [high blood pressure]," said Das. It is estimated that 17 percent of U.S. adults have obstructive sleep apnea, which occurs when the airway closes during sleep and restricts breathing. It can cause people to wake up repeatedly and can lead to low levels of oxygen in the blood. One of the studies included about 1,900 patients at Marin's sleep clinic who did not have high blood pressure. Their average age was 50. The researchers assigned participants to CPAP treatment if they had severe obstructive sleep apnea or a less severe form along with daytime sleepiness. Then they measured their blood pressure each year for an average of 11 years. The investigators found that patients with sleep apnea who used CPAP therapy were 29 percent less likely to develop high blood pressure during the study than the "control" group, which did not have sleep apnea and did not receive CPAP. However, as Marin pointed out, the people in the control group were "snorers, and they have been reported to have cardiovascular problems." The researchers also found that patients with sleep apnea who did not use CPAP had higher rates of high blood pressure compared with the control group. For example, the 10 percent of 922 participants who did not use CPAP at least four hours a night had a 78 percent higher risk of developing high blood pressure than the control group. The researchers found that the lower risk of high blood pressure in the CPAP group could not be explained by differences in factors such as patients' body mass index (a measurement that takes into account height and weight), alcohol use or blood pressure at the beginning of the study. However, there could still be differences between the CPAP-treated and untreated groups that could make the CPAP group less likely to develop high blood pressure, Marin said. Marin and his colleagues conducted a second study in which they randomly assigned 725 patients who had obstructive sleep apnea but not daytime sleepiness to use CPAP or not to use CPAP. Then they tracked participants' blood pressure and heart disease for an average of four years. At first the researchers did not see a statistically significant difference between the groups. However, 36 percent of the CPAP group was using the machine less than four hours a night. In a follow-up analysis, which the authors pointed out may be open to bias, the researchers found that patients using CPAP for at least four hours a night were 28 percent less likely than the control group to develop high blood pressure. Dr. Stuart Quan, professor of sleep medicine at Harvard Medical School in Boston, wasn't surprised by the findings. "I already believe that sleep apnea impacts [high blood pressure] and treating with CPAP reduces the risk, so these studies do not affect my way of thinking about this," he said. Quan added that he prescribes CPAP to patients with at least moderate obstructive sleep apnea or those with sleep apnea and symptoms such as daytime sleepiness or mood problems. Medicare requires patients to use CPAP at least four hours a night for 70 percent of nights to cover the treatment. The insurance deductible for CPAP is usually between $100 and $500, Quan said. While the study uncovered an association between CPAP use and reduced risk of developing high blood pressure, it did not prove a cause-and-effect relationship. To learn more about sleep apnea, visit the U.S. National Heart, Lung, and Blood Institute. SOURCES: José Marin, M.D., director, Sleep Respiratory Unit, Miguel Servet University Hospital, and professor, University of Zaragoza, Zaragoza, Spain; Aneesa Das, M.D., assistant director, Ohio State sleep disorders program, and assistant professor, pulmonology, allergy, critical care, sleep, Wexner Medical Center at Ohio State University, Columbus, Ohio; Stuart F. Quan, M.D., professor, sleep medicine, Harvard Medical School, Boston; May 23/30, 2012, Journal of the American Medical Association Previous: Studies See Advances in Detecting, Treating Pancreatic Cancer Next: U.S. Sees Drop in Deaths Linked to Diabetes

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Dear Lord, give me strength and courage to develop the best possible understanding of every task and responsibility for which I am entrusted. Help me to become excellent. Even though I may achieve a superior understanding, I surrender the outcome to my trust in You. Dr. Stutsman Raised in the East Texas town of Texarkana, Dr. Stutsman attended Stephen F. Austin State University after graduation from High School. Graduating with a Bachelor of Science degree in Biology, he afterwards worked for The Dow Chemical Company for two years. In 1976, he applied for and was accepted into the Graduate Program at Baylor University in Waco where he received his Masters of Science degree in microbiology. Later, he received his Doctor of Dental Surgery (DDS) degree from Baylor College of Dentistry in Dallas, Texas. His wife Karen and he have two daughters. The oldest is married and lives in Dallas to the delight of her parents. The youngest daughter will graduate from Texas A&M University, as did her sister. Ideally she will come back to Dallas to live, but we are comfortable in leaving that in God’s hands! An interesting side note of Dr. Stutsman is his past hobby performing standup comedy. The Colgate Company sponsored a nationwide search for “America’s Funniest Dentist”. He competed in Los Angeles and New York and won this award in 1992. He was active in the after dinner speaking scene until recently when this hobby was replaced with a cruiser motorcycle. He takes long and short trips around town and into surrounding states and absolutely enjoys riding, EXCEPT in the dog days of our Dallas summers. Our professional but friendly staff has over 100 years of combined experience in dental service. We are proud of our long-term patient relationships and welcome you to visit our downtown Dallas office.� Karen Stutsman, RDH Years with downtown practice - 25 Maggie Cole Jackie Stockwell Laurie Hanley, RDH Margaret Rice, RDH Dart Schedule New Patient Forms Copyright © - website by danadesigns

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ABC News spotlights pediatric dental sedation risks July 13, 2012 -- An ABC News story that aired July 12 took a hard-hitting look at the potential risks of pediatric dental sedation, alleging that, in some cases, undertrained dentists motivated primarily by profits are unnecessarily sedating young patients for routine procedures. Even well-trained dentists have been "unable" or "ill-equipped" to deal with such scenarios involving pediatric patients, according to the report, which characterized the matter as a growing problem. The story appeared on "Nightline" and "World News With Diane Sawyer." The segment highlighted weekend training courses that pitch dental anesthesia as a way to increase dentists' bottom line. The courses were cited as the source of "explosive growth" in the number of dentists using anesthesia while treating patients, claiming that some 18,000 U.S. dentists have signed up for these courses in the last five years. "This is something that is being presented to the practitioners, the dental community, as a very easy thing to do, and nothing could be further from the truth," Norbert Kaminski, DDS, told ABC News. Dr. Kaminski is a dental anesthesiologist in Detroit and an advocate for tougher standards for dentists who work with sedation. Brochures for one program pitched, "Give us three days, and we'll teach you both adult and pediatric protocols -- serving patients from ages 5 to 95 -- that you can take home and implement immediately," ABC News reported. While the training program encourages an additional "pediatric advanced life support" course, Indru Punwani, DDS, an American Academy of Pediatric Dentistry (AAPD) spokesman, told ABC News that a weekend course is inadequate if it is the only training the dentist has received. “To perform sedation does require significant training, either in a pediatric residency program or through a lengthy series of courses. ...” — Joel Berg, DDS, president of the American Academy of Pediatric Sedation is extremely safe when proper procedures are followed, Joel Berg, DDS, president of the AAPD and a professor of pediatric dentistry at the University of Washington School of Dentistry, emphasized in an interview with DrBicuspid.com. This includes adequate training on proper case selection, delivery of medication, appropriate use/dosing, and proper monitoring of the patient during and after the procedure. (Click here to read the AAPD's guidelines on sedation, developed in conjunction with the American Academy of Pediatrics.) "To perform sedation does require significant training, either in a pediatric residency program or through a lengthy series of courses where there is mentoring and calibration," he said. "It is hard to imagine that in a matter of a few days without any previous training or experience that it would provide enough training." The ABC story also neglected to point out that sedation is a necessary part of treatment for some children, Dr. Berg added. "Often, children of a very young age have many cavities and are 'precooperative,' so the only way you can treat them is with sedation or general anesthesia," he said. "In these cases, these are medically necessary procedures that have to be done safely and effectively, with proper training." Emergency preparedness critical The ABC story also showcased the work of the Raven Maria Blanco Foundation (RMBF) and its ongoing mission to bring medical emergency awareness to the dental community. The foundation -- founded in 2007 in honor of 8-year-old Raven Maria Blanco, who died after receiving 1300 mg of chloral hydrate and 30 mg of hydroxyzine prior to having her teeth cleaned and calcium deposits removed -- maintains a list of children who have died while undergoing sedation for dental work. In a statement issued following the ABC News broadcast, RMBF emphasized the need for dental practices to be better-prepared for catastrophic events, and took the ADA to task for not having established guidelines, policies, or a position statement regarding emergency preparedness. "Instead, the ADA offers an assortment of journal articles on medical emergencies and urges its members to review them and then choose, on an ala carte basis, those concepts they believe would benefit their office," the RMBF statement said. "This approach is haphazard, at best." While RMBF is committed to working with the ADA, change is most likely to occur through pressure from the public, the foundation added. "I've been trying to work with the ADA for quite some time to establish standards in all dental offices, but they say it’s not their responsibility to set standards,” Nicole Cunha, RMBF executive director, said in an interview with DrBicuspid.com. "It's been frustrating but we're trying to stay positive. I hope this pushes them to step it up in that area because it is lacking." RMBF also addressed weekend training courses in anesthesia, saying that "the story raised a legitimate question concerning the applicability of teaching pediatric oral sedation in such a limited time period without actual clinical practice." It also defended the practitioners who attended the courses and said that ABC News was "unfair to impugn the motives of the individual attendees." Cunha said that, overall, she was disappointed in the way the story focused primarily on greed. "I had hoped it would focus on preparedness," she said. RMBF encourages dentistry to adopt its Six Links of Survival checklist: Adequate training of the dentist Training of the entire staff Periodically holding mock emergency drills Having a written emergency plan Stocking appropriate medications Maintaining necessary emergency equipment Three dental schools and numerous local dental associations have already adopted these guiding principles, according to Cunha. "We're trying to take the high road at RMBF -- we're not pointing the finger at doctors," she said. "We want practices to know what tools they need to be properly prepared. And our goal is to help parents recognize a prepared practice."

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2012 off to 'soft start' as patent cliff continues Speech by Doug Long caps off NACDS Pharmacy and Technology Conference August 28, 2012 | By Alaric DeArment DENVER — While the growth in healthcare costs remains a threat in the United States, the growth in drug expenditures is moderating, but numerous opportunities exist for retail, according to a speech delivered Tuesday morning at the National Association of Chain Drug Stores' 2012 Pharmacy and Technology Conference in Denver by Doug Long, VP industry relations of healthcare industry research firm IMS Health. The moderation is due to a number of factors, such as the economic downturn, more introductions of new generic drugs, an innovation drought in the drug industry, concerns over the safety of certain drugs, over-the-counter switches and increased cost sharing. Real per capita spending growth in 2011 was 0.5%, Long said, saying that 2012 was off to a “soft start.” In particular, usage of generics has skyrocketed, and they currently account for about 80% of dispensed prescriptions, according to IMS data, while a recent report by the company and the Generic Pharmaceutical Association found that usage of generics has saved the country more than $1 trillion over the last 10 years. Spending on branded drugs increased in 2011 by 2.1%, to $235 billion, while branded generics saw a 2.8% increase and generics experienced a 13.8% increase. Obviously, generics are doing better than brands and better than branded generics,” Long said. “I think this is a symptom of what I call the commoditization of oral solids.” Oral solids, meaning capsules and tablets, especially primary care drugs, have seen tremendous erosion in sales due to loss of patent protection, with many classes, such as lipid regulators, set to lose their places among the top-selling drug classes because so many are going generic. Meanwhile, biologics have seen higher spending growth than small-molecule drugs, having increased by 6% to $69 billion, while small molecules have increased by 2.9% to $250 billion and spending on traditional drugs increased by 2%, while spending on specialty drugs increased by 8.8%. Overall, $319.4 billion was spent on medicines in 2011, according to IMS. Of that, 3.6% of spending went through retail channels, while institutional channels accounted for 3.7%. While generic drug makers have benefited tremendously from patent expiries on blockbuster drugs, the period when that pool of expiring patents begins to dry up, commonly known as the patent cliff, has continued. 2012 has been a peak year for patent expiries, with $35 billion worth of drugs coming off patent, and 2014 will be an important year as well. But the party only lasts for the 180 days during which the first generic drug maker to successfully file for Food and Drug Administration approval has the exclusive right to compete against the branded drug, after which the drug becomes commoditized. Pfizer's cholesterol drug Lipitor (atorvastatin) is a prime example: The drug lost patent protection in November 2011, and Ranbaxy launched its generic version; after Ranbaxy lost its own exclusivity period in May 2012, atorvastatin became fair game for any generic drug company that can win FDA approval. “We're in the teeth of the patent cliff,” Long said, speaking of what he called the “cone of commoditization.” This includes such drug classes as cholesterol medicines, antidepressants and others that have become essentially dominated by generics, compared with classes outside the “cone” that remain relatively safe from generic competition, such as drugs for HIV, hepatitis C and diabetes. The result is that new small molecules ripe for generic competition will gradually dry up. “If they weren't invented in the first place, then there's nothing to be genericized,” Long said. Many drug makers have sought to protect themselves by moving up the value chain, Long said. For generic companies, this has often meant branching out from oral solids and into more complex methods of delivery, such as transdermal patches, injectables and follow-on biologics. While the Patient Protection and Affordable Care Act created an abbreviated approval pathway for follow-on biologics, the regulations are still not in place, prompting some companies looking to make them, such as Teva Pharmaceutical Industries, to seek FDA approval through the same means used by makers of branded biologics. For branded companies, resisting commoditization means innovation. Long said much of the innovation occurring today is happening in treatments for cancers, autoimmune disorders, orphan diseases and chronic viral infections. “Innovation has picked up in specialty, [but it's] not quite there in primary care,” Long said. The growth of specialty drugs and biosimilars opens some opportunities for pharmacy retailers too. According to IMS, retailers command only 8.6% of the market for many cancer drugs. But in such areas as HIV and other antivirals, they largely dominate, and Long said there is potential in autoimmune disorders as well. Indeed, many pharmacy retailers, ranging from national chains, inclduing Costco Wholesale, Walgreens and CVS/pharmacy, to regional chains like Hy-Vee, already have branched into specialty pharmacy. “Maybe the focus shouldn't be on cancer and EPOs and ECGFs — it should be on other classes, Long said.” Pharmacy retailers also have a role to play in offering primary care services, Long said. “You can play a big role in this as retailers, with your retail clinics and preventive efforts,” Long said, noting opportunities to increase adherence and compliance(especially among elderly patients) and citing a recent medication synchronization study conducted by Thrifty White Pharmacy and Virginia Commonwealth University that tested such efforts as advertising and packaging designed to boost adherence, such as the digital Rx Timer Cap. But despite 2012's soft start, a number of notable things have happened already this year, Long said. These included the completion of the merger between Express Scripts and Medco Health Solutions and the merger between pharmacy benefit managers SXC and Catalyst; the announced merger between Walgreens and USA Drug; the Supreme Court's affirmation of the healthcare-reform law; free oral contraceptives; generic drugs reaching 80% market share and generic drug company mergers, such as Watson's acquisition of Actavis and Sandoz's acquisition of Fougera; the Generic Drug User Fee Amendments to the Prescription Drug User Fee Act reauthorization; drug shortages; the Drug Enforcement Administration's stepped up enforcement of laws; Walgreens' acquisition of Alliance Boots and the resolution of its dispute with Express Scripts, among other events. Long originally had been scheduled to speak on Monday morning, but switched places with former Centers for Medicare and Medicaid Services and FDA chief Mark McClellan. Long's speech followed the presentation of an award presented by Boehringer Ingelheim Pharmaceuticals national accounts director Colin Carr-Hall to Costco Wholesale SVP pharmacy Vic Curtis. Curtis' award consisted of a plaque and a $10,000 contribution in his name to the NACDS Foundation. Additionally, Matthew Machado, a professor of pharmacy at the Massachusetts College of Pharmacy and manager of patient care services for Walgreens in the Boston area, was awarded the Apotex Preceptor of the Year Award by Apotex director of trade sales and pharmacy relations Sam Boulton.

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'Doctor-Shopping' for Painkillers Common After Broken-Bone Surgery, Study FindsBy Randy DotingaHealthDay ReporterFRIDAY, Aug. 29, 2014 (HealthDay News) -- About one in five patients operated on for broken bones or other orthopedic trauma shops around for additional painkillers after surgery, a new study finds. Less-educated patients and patients who had used narcotic painkillers previously were several times more likely to be "doctor shoppers," said study lead author Dr. Brent Morris, a shoulder and neck surgeon in Lexington, Ky. Overall, he said, the study suggests that doctors aren't talking to one another about the painkiller needs of their patients. "There needs to be coordination if additional pain medications are needed," he said. "Patients should not be receiving multiple narcotic pain medication prescriptions from multiple providers without coordinating with their treating surgeon." Use of narcotic painkillers for nonmedical purposes is a serious concern in the United States. Unintentional overdose deaths increased 124 percent from 1999 to 2007 largely because of prescription narcotics, according to background information in the study. Doctor shoppers go to multiple physicians in search of prescription medications, often narcotic painkillers, anti-anxiety drugs such as Xanax, or medications to treat attention deficit hyperactivity disorder (ADHD), said Julie Worley, an assistant professor of nursing at Rush University in Chicago, who has studied the trend. Patients who doctor-shop are often addicted to painkillers or looking to get drugs they can sell, Worley said. Most states track prescriptions of narcotic painkillers to prevent abuse, but the systems "have many issues and aren't foolproof," she said. In addition, she said, physicians are often wary of confronting their patients. In the new study, published in the August issue of the Journal of Bone & Joint Surgery, researchers examined the medical and pharmacy records of 130 patients ages 18 to 64 who sought treatment at Nashville's Vanderbilt University Medical Center in 2011. They looked at painkiller prescriptions for three months before admission and six months after discharge. All of the patients suffered from single orthopedic injuries such as broken legs, ankles and arms. "The surgeon that performed the operation is typically responsible for pain control immediately after surgery," Morris said. "Pain control after this type of surgery often requires narcotic pain medications for the first several weeks." Overall, 21 percent of the patients tried to get narcotic painkillers from more than just the surgeon who treated them. Patients who weren't college-educated were 3.2 times more likely to try to get the drugs from more than one doctor, and those who had used narcotic painkillers before were 4.5 times more likely. The doctor shoppers -- who were mostly white males -- used narcotics for about 3.5 months after surgery whereas single-provider painkiller users took them for four weeks on average, the study found. Many obtained seven or more narcotic prescriptions compared to two prescriptions for single-provider patients. Whether the doctor shoppers had legitimate pain needs isn't clear from the study. "The ER is definitely an area where people doctor-shop. But I don't know that they're going to be having an orthopedic trauma to get drugs," said Worley. It's possible, she said, that some of the patients went to other doctors, perhaps their own physicians, in search of painkillers. Whatever the reasons, Morris and Worley called for more reliable systems to prevent patients from abusing narcotic painkillers. Worley said physicians should be wary of patients who pay with cash since doctor-shoppers with insurance are more easily detected. It's also helpful to check patients for needle marks and to use more extensive drug test procedures to make sure patients aren't sneaking in someone else's urine, she said. Morris added that one important way to help identify patients who are doctor-shopping is by using a prescription drug-monitoring program. Nearly all states have an active prescription drug-monitoring program, "but only seven states actually mandate use of these programs," he said. "Physicians and patients have to work together," he added, "to establish reasonable expectations for pain control and to identify at-risk patients early on to allow appropriate interventions." For more about painkiller abuse, see the U.S. National Institute on Drug Abuse.

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Spring 2007 Front PageAnnouncementsCardiologyEventsFocus on FoodGet MovingGet Up & GoHealthy GivingIn MemoriamMessagePersonal StoriesPhysician ProfileRoundtableServicesSpotlightWell-BeingWhat's New Table of Contents Get Well. Be Well. Stay Well. WHEN GREG AND STACEY RENKER SURVIVED NEARLY FATAL ILLNESSES, IT CHANGED THEIR PERSPECTIVES ON LIFE. THEY FEEL BLESSED AND GRATEFUL FOR THEIR EXCELLENT DOCTORS AT EISENHOWER MEDICAL CENTER. In their early 40s, dynamic, active and healthy, Greg and Stacey Renker never dreamed that disaster would strike them both when they were so young. But unexpected illnesses gave them an unexpected gift — the gift of gratitude. “If it wasn’t for the world-class expertise and dedication of the doctors and staff at Eisenhower Medical Center, neither one of us would be here today,” shares Greg Renker. “We consider Eisenhower a part of our extended family. They took care of us and saved our lives, and that’s why we’ve made a lifelong commitment to do the same for the Eisenhower Medical Center.” Greg, a founding principal of the Guthy-Renker® Corporation, the world’s largest direct response television company, always took care of his health.He had regular check ups and health screenings, ate well, controlled his cholesterol, and exercised daily. In fact, Greg and his wife Stacey had it all — a happy marriage, three beautiful children, a successful business, and an active lifestyle. However, in 1998, at the age of 41, Greg began experiencing shortness of breath while exercising. He mentioned it to close friend Michael Landes, Eisenhower Medical Center Foundation President, who insisted that he contact Ron Sneider, MD, Board Certified Pulmonologist at Eisenhower, for an immediate consultation. Dr. Sneider recommended that Greg schedule a treadmill stress test for the very next day with Barry Hackshaw, MD, an Eisenhower Board Certified Cardiologist. Less than ten minutes into the test, Dr. Hackshaw recognized irregular rhythms and other cardiac changes that suggested an inadequate blood supply to the heart. While the electrocardiogram (EKG) confirmed that Greg had not had a heart attack, it did indicate that he was at very high risk. Further test results revealed one coronary artery was completely blocked and two more were nearly blocked. “I thought Stacey and I would be flying to Las Vegas that evening, and all of a sudden, not just my schedule but my entire life was put on hold,” recalls Greg. “Heart disease is not part of my family history, so I was shocked when Dr. Hackshaw told me that I could have a heart attack at any moment.” Greg agreed to an emergency angioplasty and stent procedure to quickly restore the blood flow to his heart. During this sensitive surgery, the first two arteries were successfully opened when an uncommon complication arose. The catheter that guides the position of the stent perforated Greg’s blocked right coronary artery. The membrane that surrounds the heart, or pericardium, began filling with blood, causing Greg’s heart to come to a complete stop. A “Code Blue” was called, his blood pressure dropped to zero, and cardiopulmonary resuscitation (CPR) was started immediately. Dr. Hackshaw worked swiftly to save Greg’s life. Stacey Renker heard the “Code Blue” alarm from the waiting room, and she was immediately informed that the code had been called for Greg. Joseph Wilson, MD, a Board Certified Cardiothoracic Surgeon, responded to the Code Blue and performed emergency open-heart surgery, quickly stitching the perforation closed and performing beating heart coronary bypass surgery on the blocked artery (see Feature, "Coronary Artery Bypass Graft Surgery"). The quick action from both doctors saved Greg’s life. “I felt helpless in that moment,” says Stacey, “which is why I’ll always be grateful for the surgeons who not only detected the blockage but saved his life. Thoughts raced through my mind…we were so young, but there I was, so close to losing him!” Fortunately, Greg made a full and complete recovery. As a direct result of this life-changing experience, Greg and Stacey made a decision to found the Renker Wellness Center for the treatment of cardiac and pulmonary patients. Opening on March 3, 2004, the Renker Wellness Center offers state-of-the-art cardiac and pulmonary rehabilitation programs, in concert with a high-tech exercise facility with the best aerobic and cardiac monitoring equipment available. “Several weeks before my bypass surgery,” Greg reflects, “I was sitting in a conference room at Guthy-Renker headquarters. I experienced a fleeting moment where I sensed that something wasn’t quite right, but I couldn’t pinpoint it…other than a vague sense of discord…. Other than that, I had no indication that I was so close to having a major heart attack,” explains Greg. “Had it not been for the miraculous sequence of events — and the fast thinking of Drs. Sneider, Hackshaw and Wilson, I wouldn’t be here today.” “Greg’s taken charge of his life. He eats right, exercises, and practices effective stress management techniques,” says Dr. Hackshaw. “Through diet, exercise, and medication, his prognosis is great. Since we were able to prevent a heart attack, Greg’s heart muscle suffered no damage. Greg’s an excellent example of how well a post-bypass patient can do — no one could ask for a better outcome!” “We now try to live life to its fullest — whether it’s through our commitment to the Eisenhower Medical Center, or our appreciation of our family, friends, art, music, and travel.” It was a short five years later that the Renkers would experience another lifethreatening health crisis. This time, however, it was Stacey Renker whose life was in jeopardy. In February 2003, Stacey was preparing for her son Ryan’s 11th birthday party. She had been fighting a cold, and suddenly, she began feeling worse. For several days, Stacey had endured a fever, sore throat and cough. All at once, she became exhausted and had difficulty breathing. Stacey called her sister, a nurse, who insisted that Stacey go to the Emergency Department at Eisenhower Medical Center where Ken Jesser, MD, Board Certified in Emergency Medicine, admitted Stacey immediately. Her sickness escalated rapidly, and she began coughing up blood. “I learned through Greg’s health event that when you have a life-threatening illness, nothing else really matters,” says Stacey. By the next morning, Stacey had been moved to the Intensive Care Unit and was experiencing multiple organ failure, but the root cause of her illness was still a mystery. Richard Stone, MD, ordered hemodialysis to help remove the toxins from her system. Concurrently, Lawrence A. Cone, MD, a Board Certified specialist in Infectious Disease, acting on a “hunch,” administered gamma globulin (antibodies that boost the immune system), Xigris®, which is a synthetic activated Protein C (an enzyme that is an anticoagulant, as well as an anti-inflammatory), and an antibiotic. “Even though the results of Stacey’s blood work were not yet back from the lab, there was no time to waste,” recalls Dr. Cone. “I had discovered the first two cases of a Group A Streptococcus pyogenes Toxic Shock at Eisenhower Medical Center, back in 1987, which were published in The New England Journal of Medicine, and had a hunch that this was the infection that we were dealing with,” Cone explains. “If I was right, we had less than 24 hours to successfully treat it…or Stacey’s chances of survival were slim.” Severe invasive Group A Streptococcus pyogenes infections associated with shock and organ failure have been termed “streptococcal toxic shock syndrome” (TSS). People of all ages can be affected, and most do not have an underlying predisposing disease. Despite aggressive treatment, 30 to 70 percent of patients with TSS do not survive. Fortunately, Dr. Cone’s hunch was exactly right. The lab tests confirmed that Stacey indeed had a Streptococcus pyogenes infection in her bloodstream. Her body was utilizing the anticoagulant activated Protein C faster than it could manufacture more, causing her blood to clot, and thus, causing the multiple organ failure. Dr. Cone immediately began an aggressive treatment protocol to kill the bacteria. Within the next 24 hours, Stacey’s condition improved dramatically. She spent another 10 days in the hospital before returning home. “I could not believe that my life had been on the line. The care that we received from the doctors and staff at Eisenhower Medical Center was second to none,” says Stacey. “It was clear, from the very moment we arrived at the hospital, that the doctors and the nursing staff were completely focused on my condition. That gave me hope and confidence when I needed it most.” “Stacey has recovered fully and has had no lasting effects from her condition,” says Dr. Cone. “In fact, Stacey Renker’s case was so unique, and she responded so well to the activated Protein C treatment, that I wrote an article along with Stacey which was published recently in the Scandinavian Journal of Infectious Diseases.” “To say the least, we’ve become very familiar with the staff at Eisenhower Medical Center over the years,” shares Stacey. “At one point, we even had three family members in the hospital at the same time!” The Renkers are filled with gratitude and optimism. “This entire experience was a blessing for us. We no longer take life for granted,” explains Stacey. “We now try to live life to its fullest — whether it’s through our commitment to the Eisenhower Medical Center, or our appreciation of our family, friends, art, music, and travel.” Greg and Stacey’s advice is to “Be aware of intuitive messages, and act on them. Don’t wait — go to the doctor to have it checked out,” shares Greg Renker.“…And when you’re given a second chance, make sure those around you know how much you appreciate them!” Healthy Living Magazine is a publication of Eisenhower Medical Center · © Copyright 2014 All Rights Reserved · Email the Webmaster

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Issue 154: Fired Up! It’s that time of year when many of us get fired up for the big game. Unfortunately, many of us also have another form of being fired up—unhealthy inflammation. Inflammation is a natural response of the immune system, which occurs when the body’s white blood cells and their chemicals move in to protect the body from infection and foreign invaders like bacteria and viruses. This natural and healthy form of inflammation is necessary and can actually save us from further infection or injury. In short, good inflammation is one of our body’s first lines of defense and takes its cues from our immune system, the body’s commander-in-chief against invaders. It’s when the body’s inflammation responses go overboard that trouble can begin. Sometimes, this usually protective and innocuous immune system/inflammation response—good inflammation—can go into overdrive and become persistent, pervasive and potentially devastating. In fact, the raging fires of prolonged burning, systemic inflammation can cause all sorts of bodily damage and adversely affect bones, joints, tissues, blood vessels, blood sugar, cells and bodily organs such as the heart, lungs, kidneys and intestines—to name a few. This kind of damaging inflammation can go undetected, too, as many organs don’t have pain-sensitive nerves, and there are virtually no outward signs of the fires within. Unrelenting chronic inflammation can even create atherosclerosis—a process by which fatty deposits develop in the artery linings—and can weaken artery walls, cause plaque rupture, prompt thrombus formation and embolize the heart’s blood vessels. All of these developments can increase the risk for an unhealthy heart and overall unhealth. What might add fuel to the fire, so to speak, is that most people aren’t even aware that they’re walking around with unhealthy levels of inflammation—and it’s difficult to effectively deal with something if you don’t know it’s there. Since there are limited outward signs of this kind of inflammation, a blood test is usually necessary to measure the extent of inflammation indicators like C-reactive protein, or CRP, which is produced by the liver during those excessively fiery times. The good news, however, is that there are some steps you can take to help tame the fires of inflammation. One of those steps includes eating healthy fats such as extra virgin olive oil and fatty acids which are found abundantly in fatty fish like wild salmon or sardines. Researchers say that a healthy balance of fats can reduce the production of a hormone-like substance that fans the flames of inflammation. But fats aren’t the only firefighters in food form. Eating a diet with plenty of vegetables and fruits also appears to support healthy inflammation levels. Antioxidant vitamins like vitamin C in these kinds of foods are believed to interact with a broad range of protective plant compounds to add to these health benefits that can douse the fires within. The truth is that the foods we eat influence inflammation through chemicals called prostaglandins from the foods’ nutrients. Foods like wild fish, cruciferous vegetables, green, leafy vegetables and some spices like ginger and garlic may be especially healthy for supporting normal inflammation. And note this: even many “good inflammation” foods like salmon depend on whether they are farm raised or wild. For example, three ounces of farm-raised Atlantic salmon has an unhealthy inflammation score at -180, while three ounces of wild Atlantic salmon comes in at a +493. Other foods that rank positively in supporting healthy inflammation levels include: extra virgin olive oil, broccoli, cauliflower, spinach, kale, almonds, chia seeds, walnuts, pecans, blueberries, blackberries and strawberries. Managing one’s weight is important, too, when it comes to cooling those internal flames. When people are overweight, their fats cells increase in size and inflammation-promoting protein production is increased. The bottom line is this: you can get fired up as much as you want about the game and other interests, but be sure you manage the unseen fires of unhealthy inflammation.

医学

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Read Online/TOC Advances in Wound Care Editor-in-Chief: Chandan K. Sen, PhD ISSN: 2162-1918 • Published Monthly • Online ISSN: 2162-1934Current Volume: 3 "Advances in Wound Care provides the most rapid and efficient way to stay up-to-date on advances in wound care research and practice." Sean M. O'Connell, PhD Assistant Professor of Surgery Mt. Sinai School of Medicine"Advances in Wound Care crosses research to translational boundaries, impacting new discoveries the field." Ronald G. Scott, MD Medical Director The Wound Care Center at the Medical Center of Plano Plano, Texas"Advances in Wound Care is a pioneer journal in this field." Ahmad Mehdipour I.R. Iran "Over the past three years, more than 320,000 manuscripts have been published in the field of wound healing! There is no way that researchers, clinicians, government agencies and industry can stay on top of this mountainous wave of publications. Thankfully, Advances in Wound Care, an Official Publication of Wound Healing Society, has done the work for us by carefully selecting and reviewing the most critical developments in the wound healing field." Robert F. Diegelmann, PhD Professor of Biochemistry & Molecular Biology Anatomy & Emergency Medicine President Elect of the Wound Healing Society"It remains critical to link researchers who produce new knowledge and information to clinicians who apply that knowledge to patient care. Advances in Wound Care provides a important resource for researchers and clinicians to have access to cutting edge information in wound healing, regeneration and wound care, whether to assure your research work or your patient care is up to date. Advances in Wound Care is a 'must read'." Robert S. Kirsner, MD, PhD Professor, Vice Chairman & Stiefel Laboratories Chair Department of Dermatology & Cutaneous Surgery Chief of Dermatology University of Miami Hospital University of Miami Miller School of Medicine You may be interested in the following publications: Advances in Wound Care, Volume 1 Advances in Wound Care, Volume 1 A comprehensive reference for wound care professionals synthesizing current clinical and research developments. Seminal basic science discoveries are highlighted with the intent to explore future potentials in wound care. Surgical Infections Surgical Infections Comprehensive, authoritative information and original articles on the biology, prevention, and management of post-operative infections. Antioxidants & Redox Signaling Antioxidants & Redox Signaling The leading resource for the latest research and information on antioxidants and redox biology. The Journal explores key aspects of the important and expanding world of redox-based therapeutics. Browse All Publications

医学

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Healthy LifestyleAdult health Denial is a coping mechanism that gives you time to adjust to distressing situations — but staying in denial can interfere with treatment or your ability to tackle challenges.By Mayo Clinic Staff If you're in denial, you're trying to protect yourself by refusing to accept the truth about something that's happening in your life. In some cases, initial short-term denial can be a good thing, giving you time to adjust to a painful or stressful issue. It might also be a precursor to making some sort of change in your life. But denial has a dark side. Being in denial for too long can prevent you from dealing with issues that require action, such as a health crisis or a financial situation. Find out when denial can help — and when it can be a roadblock.Refusing to acknowledge that something is wrong is a way of coping with emotional conflict, stress, painful thoughts, threatening information and anxiety. You can be in denial about anything that makes you feel vulnerable or threatens your sense of control, such as an illness, addiction, financial problems or relationship conflicts. You can be in denial about something happening to you or to someone else. When you're in denial, you: Refuse to acknowledge a stressful problem or situation Avoid facing the facts of the situation Minimize the consequences of the situation Refusing to face facts might seem unhealthy. Sometimes, though, a short period of denial can be helpful. Being in denial gives your mind the opportunity to unconsciously absorb shocking or distressing information at a pace that won't send you into a psychological tailspin. For example, after a traumatic event, you might need several days or weeks to process what's happened and come to grips with the challenges ahead. Imagine what might happen if you find a lump in your throat. You might feel a rush of fear and adrenaline as you imagine it's cancer. So you ignore the lump, hoping it'll go away on its own. But when the lump is still there a week later, you consult your doctor. This type of denial is a helpful response to stressful information. You initially denied the distressing problem. As your mind absorbed it, however, you came to approach it more rationally and took action by seeking help. But what if you had continued to be in denial about the lump? What if you never sought help? If denial persists and prevents you from taking appropriate action, such as consulting your doctor, it's a harmful response. Consider these examples of unhealthy denial: A college student witnesses a violent shooting but claims not to be affected by it. The partner of an older man in the end stage of life refuses to discuss health care directives and wills, insisting that he's getting better. An administrator periodically misses a morning meeting after drinking excessively the night before, but insists there's no problem because the work is still getting done. A couple are ringing up so much credit card debt that they toss the bills aside because they can't bear to open them. The parents of a young daughter with drug addiction keep giving her "clothing" money. In situations such as these, denial might prevent you or your loved one from getting help, such as treatment or counseling, or dealing with problems that can spiral out of control — all with potentially devastating long-term consequences.When faced with an overwhelming turn of events, it's OK to say, "I just can't think about all of this right now." You might need time to work through what's happened and adapt to new circumstances. But it's important to realize that denial should only be a temporary measure — it won't change the reality of the situation. It isn't always easy to tell if denial is holding you back. If you feel stuck or if someone you trust suggests that you're in denial, however, you might try these strategies: Honestly examine what you fear. Think about the potential negative consequences of not taking action. Allow yourself to express your fears and emotions. Try to identify irrational beliefs about your situation. Journal about your experience. Open up to a trusted friend or loved one. Participate in a support group. If you can't make progress dealing with a stressful situation on your own — you're stuck in the denial phase — consider talking to a mental health provider. He or she can help you find healthy ways to cope with the situation rather than trying to pretend it doesn't exist.You might find it frustrating when someone you love is in denial about an important issue. But before demanding that your loved one face the facts, take a step back. Try to determine if he or she just needs a little time to work through the issue. At the same time, let the person know that you're open to talking about the subject, even if it makes both of you uncomfortable. Ultimately, this might give your loved one the security he or she needs to move forward. If your loved one is in denial about a serious health issue, such as depression, cancer or an addiction, broaching the issue might be especially difficult. Listen and offer your support. Don't try to force someone to seek treatment, which could lead to angry confrontations. Offer to meet together with a doctor or mental health provider. Seaward BL. Managing Stress: Principles and Strategies for Health and Well-Being. 6th ed. Sudbury, Mass.: Jones and Bartlett Publishers; 2009:88. Seward BL. Essentials of Managing Stress. 3rd ed. Sudbury, Mass.: Jones and Bartlett Publishers; 2014:70. Coping with a diagnosis of a chronic illness. American Psychological Association. http://www.apa.org/helpcenter/chronic-illness.aspx. Accessed Feb. 6, 2014. Rabinowitz T, et al. Nothing is wrong, doctor: Understanding and managing denial in patients with cancer. Cancer Investigation. 2006;24:68. Telford K, et al. Acceptance and denial: Implications for people adapting to chronic illness: Literature review. Journal of Advanced Nursing. 2006;55:457. Adjusting to life after being held hostage or kidnapped. American Psychological Association. http://www.apa.org/helpcenter/hostage-kidnap.aspx. Accessed Feb. 6, 2014. Travis AC, et al. Denial: What is it, how do we recognize it and what can we do about it? American Journal of Gastroenterology. 2011;106:1028. Sjolander C, et al. Striving to be prepared for the painful: Management strategies following a family member's diagnosis of advanced cancer. BMC Nursing. 2011;10:18. Creagan ET (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 10, 2014. May 20, 2014Original article: http://www.mayoclinic.org/healthy-living/adult-health/in-depth/denial/art-20047926

医学

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News Releases As Outdoor Activity Increases, So Do Accidents And Injuries, Tips For Safe Summer Fun Expert from The Children’s Hospital at Montefiore Shares Sun, Water and Outdoor Activity Advice New York (June 21, 2013) – Today is officially the first day of summer and it’s important for Americans to take safety seriously as they head to the beach and into the sun. Every day 10 people die from drowning and more than 600 people die each year from exposure to excessive heat. In order to keep kids active, healthy and out of the Emergency Room this season, Laura Holihan, R.N., Administrative Nurse Manager, Pediatric Emergency Department, The Children’s Hospital at Montefiore (CHAM) shares the following essential summer safety tips. “As kids get off school and spend more time outdoors, we see an uptick in Emergency Department visits,” Ms. Holihan said. To be sure the season is fun for everyone, she recommends caregivers and kids keep these tips in mind: Sun safety – On average, 618 people per year die due to exposure to excessive natural heat. Protective clothing, a hat with a broad brim and sunglasses will help people keep cool and protect skin from dangerous UV rays, especially during the peak hours of 10 a.m. to 4 p.m. To avoid sunburn, the equivalent of a shot glass full of sunscreen should be applied to the body and reapplied about every two hours, especially after swimming or playing outdoors. Choose a sunscreen with broad-spectrum protection that blocks both UVA and UVB radiation with an SPF of 30 or higher. Water safety – Never assume a child is safe with a swimming aide such as a water noodle or arm floaties. An adult should monitor children at all times to reduce the risk of drowning and ensure water play is safe. It’s important to know that small children can drown in as little as one inch of water. Hydration is key – Staying hydrated should be on everyone’s mind all year round, but as the summer sun beats down and the temperature rises, it’s more important than ever. Caregivers should send children to any sporting activity with a water bottle and make sure that they keep it filled while participating in activities. And it’s not just while playing that water matters, hydration should occur before, during and after the activity. Stretching makes a difference – Each year, more than 2.6 million children receive medical treatment for sporting and recreational injuries. Making sure kids properly warm up and stretch before outdoor sports and activities can make all the difference. Stretching helps release muscle tension and can help prevent muscle tears or sprains. Something often forgotten, especially as kids move from one activity to the next, is the importance of stretching after the activity, which can reduce the risk of injuries over time. Bug bites – When a child is stung by a bee, wasp or hornet, wash the site with soap and water and try to remove the stinger. When playing where stinging insects may be present, kids should avoid looking or smelling like a flower and wearing brightly colored clothing or flowery prints. If possible, they should wear pants, long-sleeved shirts, close-toed shoes and socks when playing outdoors. Adults should check food and drinks consumed outdoors, particularly open cans of soda, since yellow-jackets and other stinging insects are attracted to sugar. Other things that caregivers should look out for are Lyme disease and West Nile virus. Lyme disease is caused by bites from very small blacklegged ticks that are infected with the bacterium Borrelia burgdorferi. Children between the ages of 5 and 9 are most affected and symptoms include fever, headache, fatigue and a telltale bulls-eye skin rash. West Nile Virus is spread by infected mosquitos. Most people do not show symptoms and improve without treatment. Those that do show symptoms may experience fever, headache and body aches, nausea, vomiting and sometimes swollen lymph glands or a skin rash on the chest, stomach and back. Kids who have had severe allergic reactions to insect bites or stings should consider carrying an epinephrine auto injector (EpiPen). Some people who are allergic can receive a series of allergy desensitization injections to prevent severe reactions in advance of any sting. The Pediatric Emergency Department at The Children’s Hospital at Montefiore receives almost 60,000 emergency care visits per year and is one of the busiest Pediatric Emergency Departments in the tri-state area. CHAM is consistently ranked among the nation’s leading children’s hospitals by U.S. News & World Report. Its physicians and staff are making extraordinary contributions in the field of children’s health, working to curb prevalent problems including obesity, diabetes and asthma. As part of a premier academic medical center, and the pediatric hospital for Albert Einstein College of Medicine, CHAM is dedicated to training the next generation of pediatric healthcare professionals and transforming the future of children’s health. Patients & Visitors

医学

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How You Can Survive the 2013 Flu EpidemicIt's the worst flu season in years, but people over 50 can still take action to protect themselvesby Andrea King Collier • Next Avenue Photograph: Shutterstock.com It's official: The United States is experiencing a flu epidemic, the worst in several years. According to the federal Centers for Disease Control and Prevention, at least 20 children have died of flu so far this winter — and that is likely a conservative count. The agency does not announce the number of adult flu-related deaths until the end of the season, but it is presumably higher than usual: 47 states have reported significant public-health impact from the first wave of flu. (The CDC defines flu-related deaths as those in which the flu infection was a contributing factor, if not the primary cause.) In states like New York and cities like Boston, officials have taken steps to declare public-health emergencies, freeing up reserves of vaccines and loosening rules to allow pharmacists to administer shots to children, who, along with the elderly, are at highest risk. (Learn more about the latest outbreak from Google's interactive Flu Trends map.) (MORE: Yes, You Really Do Need a Flu Shot) For most people who come down with the flu, it may make you extremely sick over the course of a week or more and then subside. But for young children and people over 50, especially those with other health conditions, the flu can be far more serious, even life-threatening. As we age, our immune systems weaken, making us more vulnerable to airborne illnesses, like the flu. According to the CDC, 90 percent of flu-related hospitalizations and 50 percent of flu-related deaths occur among people who are 65 or older. Of course, the surest thing you can do to keep the virus at bay is to get the vaccine through your health-care provider or at your workplace or local pharmacy. "Getting the influenza vaccine once a year is the best defense, especially for people over 50," says Dr. Carolyn Bridges, associate director of adult immunizations at the CDC. Health officials had recommended that people get the flu shot or nasal spray by late October or November, before sick season kicked into high gear, because it normally takes around two weeks for the vaccine to become effective. But it's not too late to get a flu shot even now, although you might have to search a bit for providers that still have shots available. "It may take two or three calls, but it is well worth it," Bridges says. You can check for availability online by using the HealthMap Vaccine Finder. Most insurance plans cover the flu shot without copay; Medicare Part B fully covers the vaccination. The flu shot may be the most effective defense, but it's not foolproof. In a preliminary CDC study, experts rate this season's edition as 62 percent effective in combating current strains, which is within the typical annual range of 50 to 70 percent effectiveness. Bridges also advises everyone to make sure they're current on other shots, including the vaccine that prevents pneumonia. This applies especially to people who have compromised immune systems, asthma or chronic obstructive pulmonary disease. You cannot get the flu from the flu vaccine, but some people do experience short-term side effects, such as soreness, redness or swelling at the spot of the injection; low-grade fever; or aches, none of which should persist beyond one or two days. On rare occasions, people can experience a severe allergic reaction to the flu shot. People who have ever had such a reaction or who have a severe allergy to chicken eggs should talk to a doctor before getting the shot, and anyone who has ever had Guillain–Barré Syndrome should not get the shot without consulting a doctor. If you have a cold or fever, don't get the flu shot until you've fully recovered. (MORE: Why We Don't Do What's Good for Us) As with all vaccines, the flu shot is more effective the more widely it's administered. So to better protect yourself and others, urge family, friends and co-workers to get vaccinated too. "It is especially important for caregivers," Bridges says, "and for grandparents who could expose newborns and infants under six months, who are too young to get the vaccine." Typically, about 37 percent of all Americans get a flu shot each year; given the severity of this season's outbreak, the CDC hopes that closer to 50 percent of the population will eventually be vaccinated. The agency has encouraged officials to actively promote the shot nationwide. Is It the Flu or Just a Cold? Worried that you may have the flu? It isn't always easy to know, Bridges says. Like a cold, the flu can come with a cough or sore throat and a stuffy or runny nose. But unlike colds, the flu is also typically characterized by inflammation, headaches and achy muscles, along with a fever of 100 degrees Fahrenheit or higher. Nausea and diarrhea are other common symptoms. When Should I See a Doctor? If you do have the flu, prescription antiviral medications like Tamiflu or Relenza can lessen the symptoms, which can also include: Difficulty breathing. Pain in the abdomen or chest. A fever that spikes at 100 or above. A seizure. Click here for tips for preventing the flu on Next Avenue Don’t miss out on MORE great articles like this one. Click here to sign up for our weekly newsletter! Photo courtesy of john a. shaw/Shutterstock.com First Published Wed, 2013-01-23 18:34 Find this story at:http://www.more.com/health/wellness/how-you-can-survive-2013-flu-epidemic

医学

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Back Tenofovir Access Program in 68 Developing Countries Press Release GILEAD LAUNCHES ACCESS PROGRAM TO PROVIDE ANTI-HIV THERAPY VIREAD� IN 68 DEVELOPING COUNTRIES AT NO PROFIT Foster City, CA, April 4, 2003 - Gilead Sciences (Nasdaq: GILD) today announced details of the Gilead Access Program, which will provide access to Viread� (tenofovir disoproxil fumarate), the company's once-a-day antiretroviral medication for HIV, at no profit in every country in Africa and in 15 additional countries in other parts of the world classified as "least developed" by the United Nations (UN). The Gilead Access Program is now open to receive requests for the drug from the 68 eligible nations. The program has been designed to expeditiously review requests for Viread and to ship drug directly to treatment programs in the eligible countries. "The Gilead Access Program was created in consultation with experts and advocates, with the objective of making Viread available where the need is greatest and in a way that best addresses the treatment landscape in the developing world," said John C. Martin, PhD, President and CEO, Gilead Sciences. "Based on its efficacy, positive resistance and side effect profile, and once-daily dosing, we believe that Viread will be a particularly important treatment option for physicians and patients in these regions." Gilead will make Viread available to any private or public program treating people with HIV/AIDS in the 68 nations for US$39 for a 30-day supply, or $1.30 per day. The price for supplying Viread represents Gilead's cost of manufacturing the drug and administering the program. "Price is just one component of the access equation, but it is an important piece, and we have worked diligently to reduce the cost of providing Viread in the countries where it is needed most," said Dr. Martin. "In creating this program, we also have included other elements designed to meet the needs of treaters in resource-challenged settings, such as a streamlined and rapid review of requests, and shipment of drug direct to treatment programs, without expensive or time-consuming intermediaries." Key Features of the Program The Gilead Access Program is comprised of four main elements designed to improve access to Viread on a sustainable basis: Sale of the drug at no profit in the 53 nations of Africa and in 15 other UN-designated "least-developed" countries. Simplified purchasing in which Gilead will provide Viread directly to treatment programs, avoiding the cost and delay frequently caused by third-party suppliers. Information and guidance to programs seeking access to Viread, including technical assistance in the preparation of requests for reduced-price access to the drug. Research to optimize HIV treatment strategies through clinical trials that help to define the best method for delivering anti-HIV therapy in resource-challenged settings. Gilead is participating in the "Development of Antiretroviral Therapies" (DART) study, a 3,000-patient clinical trial sponsored by the United Kingdom's Medical Research Council that began earlier this year in Uganda and Zimbabwe. The DART study is designed to evaluate antiretroviral management strategies adapted for use in parts of the world where resources are limited. Gilead also is participating with Family Health International, with the support of the Bill and Melinda Gates Foundation, in a multinational study to evaluate the potential use of Viread as a method of preventing transmission of HIV. Program Details Request forms can be submitted via the Internet or by email, mail or fax. The company will be prepared to ship Viread to qualifying programs as soon as requests forms are reviewed and approved. Requests will be reviewed by independent experts, and programs requesting drug will be evaluated based on their ability to provide quality and sustainable patient care. Gilead will take appropriate steps to ensure that Viread shipments reach their intended destination and, to the extent possible, will monitor the recipient programs to ensure that quality care is being provided. Complete program information and requests forms are available at www.gileadaccess.org. Programs without Internet access can call the Gilead Access Program in the United States at 1-800-GILEAD-5 (1-800-445-3235) or 1-650-574-3000 or in Uganda at +256-41-340-806. Gilead also announced that the company is completing plans for reduced price access to Viread in middle-income developing countries in Eastern Europe, Asia and Latin America. About Viread Viread is the first nucleotide analogue reverse transcriptase inhibitor (NtRTI) approved for the treatment of HIV in the United States and Europe. Since approval, more than 100,000 patients have been prescribed Viread as part of combination therapy. The U.S. Food and Drug Administration approved Viread for marketing in October 2001 and the European Commission granted approval in February 2002. In clinical trials and expanded access programs, approximately 10,000 patients have been treated with Viread in combination with other antiretroviral products for periods up to four years. The drug works by blocking reverse transcriptase, an enzyme involved in the replication of HIV. The approved dose of Viread for the treatment of HIV infection is 300 mg once daily taken orally with a meal, in combination with other anti-HIV medications. In the United States, Viread is indicated for use in combination with other antiretroviral agents for the treatment of HIV-1 infection. This indication is based on analyses of plasma HIV-1 RNA levels and CD4 cell counts in a controlled study of Viread of 24 weeks duration and in a controlled, dose-ranging study of Viread of 48 weeks duration. Both studies were conducted in treatment-experienced adults with evidence of HIV-1 viral replication despite ongoing antiretroviral therapy. Studies in antiretroviral-na�ve patients are ongoing; consequently, the risk-benefit ratio for this population has yet to be determined. Assessment of adverse reactions is based on two studies (902 and 907) in which 653 treatment-experienced patients received treatment with Viread 300 mg (n=443) or placebo (n=210) for 24 weeks followed by extended treatment with the drug. Adverse event rates in the Viread group were similar to those in the placebo-treated patients. The most common adverse events in patients receiving Viread were mild to moderate gastrointestinal events such as nausea, diarrhea, vomiting and flatulence. Laboratory abnormalities observed in clinical studies occurred with similar frequency in the Viread and placebo-treated groups. In clinical practice, a number of adverse events, including renal impairment, nausea, rash and asthenia (weakness) have been reported. Renal impairment occurred most often in patients with underlying systemic or renal disease, or in patients taking concomitant nephrotoxic agents. Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of nucleoside analogues alone or in combination with other antiretrovirals. About Gilead Gilead Sciences is a biopharmaceutical company that discovers, develops and commercializes therapeutics to advance the care of patients suffering from life-threatening diseases worldwide. The company has six marketed products and focuses its research and clinical programs on anti-infectives. Headquartered in Foster City, CA, Gilead has operations in the United States, Europe and Australia. For information about the Intl program contact: Susan Hubbard, Investors (650) 522-5715; Amy Flood, Media (650) 522-5643 Viread is a registered trademark of Gilead Sciences, Inc. For full U.S. prescribing information on Viread, please call the Gilead Public Affairs Department at 1-800-GILEAD-5 (1-800-445-3235) or visit www.viread.com.

医学

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College Efforts Put Physicians in Rural Communities Grant Sloan BRANSON, Mo. -- State leaders are hoping a new law for doctors will help fill the current void in rural areas. BRANSON, Mo. -- State leaders are hoping a new law for doctors will help fill the current void in rural areas. Currently 37 percent of Missourians live in rural areas, but only 18 percent of Missouri doctors choose to practice there. While opinions on the new law are vary, University of Missouri has spent the last 20 years working to fix the problem with it's Rural Summer Community Program. "I knew I would go into rural medicine," says MU Medical Student Kayla Matzek, "I chose [Cox Medical Center] Branson because I'm from around here, so it's just a perfect fit." Matzek is one of some 300 students who have, or are currently participating, in Mizzou's Rural Doctor Program. Cox Medical Center Branson Family Doctor Holly Wherry is a former participant of the program. "When you're on a rural rotation, that's that one-on-one time in the real world," says Dr. Wherry. "With an attending physician teaching one-on-one, that experience in invaluable." Dr. Wherry says nearly all the counties in Missouri are considered under-served, especially in rural areas. So far though the program at MU, nearly 50 percent of participants have returned to practice in rural areas, nearly 40 percent above the national average. "Sometimes you have to be more than just their Primary Care Physician," says Matzek, referring to what's she learned though the program. "You don't always have all the resources that you need to refer patients to the right place." University of Missouri Associate Dean Kathleen Quinn says with the help of technology, that's also changing. "They do have access to specialist, if not in that town, they have access to 'Telehealth' and 'Telmedicine' and technology," says Quinn. "I think the rural doctors like seeing their patients, treating their entire family, and giving back to the community that raised them." Missouri Legislators are also working to push future doctors to rural areas. Now, assistant physicians who have completed their licensing exams can practice in rural areas after spending 30 days under the supervision of a doctor. "Those years in residency teach you a lot," says Matzek. "You have a lot to learn." "Those extra three or four years after medical school, when you learning how to be a doctor," says Dr. Wherry. "That can't be understated." Many lawmakers says this option will allow the assistant physicians to provide immediate care, rather than waiting on residency spots that can quickly fill up. Opponents are concerned about over-all health care with assistant physicians, and say a better, but more expensive option, would be to fund rural programs, or help provide more residency spots at teaching hospitals. Page:

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Home > NIH Needs Substantial Funding Increase to Remain Competitive, says PAN CEO NIH Needs Substantial Funding Increase to Remain Competitive, says PAN CEO Underinvestment in Biomedical Research Puts America’s Health At Risk June 14, 2012 The following is a statement from Parkinson’s Action Network CEO Amy Comstock Rick: “Today, the U.S. Senate Appropriations Committee, which oversees funding for the National Institutes of Health (NIH), recommended only a modest budget increase instead of funding the NIH at a level which would allow it to keep pace with inflation, encourage innovation, and strengthen local economies in the cities and towns across America where NIH-funded research happens. The biomedical research and patient advocacy communities came together to recommend Congress and the president fund the NIH at a minimum of $32 billion for Fiscal Year 2013. While we appreciate the modest increase the Senate committee provided, it is not enough. “A Fiscal Year (FY) 2013 funding level of $30.723 billion--an increase of $100 million above FY 2012--will not allow the NIH to remain a global leader in research and development. NIH funding over the past nine years has not come close to meeting the rate of inflation, putting at risk biomedical research innovation and taxpayers’ health and well-being. Federal investment in biomedical research not only helps encourage private sector growth and investment, it also strengthens our nation’s long-term health. As our population ages, more people will be diagnosed with diseases like Parkinson’s, and without strong federal investment in the fight for better treatments and cures, the burden only worsens. “On behalf of the Parkinson’s community, we call on Congress to take a good hard look at how investments in NIH can have a broader impact across the country and around the world, and fund the NIH at the highest level.” : http://www.parkinsonsaction.org/news/nih-needs-substantial-funding-increase-remain-competitive-says-pan-ceo

医学

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Bismarck Pesthouse During the winter of 1920-21, about fifty cases of smallpox were reported and treated in the city of Bismarck. Most of them were mild, and many patients came from outside of the city, according to a report in the Bismarck Tribune. In fact, it was reported that Dr. C. E. Stackhouse, the city health officer, felt that smallpox had “about run its course” for the winter. Certainly, residents of the city were pleased to hear this–and not just because they didn’t want to get sick! On this date in 1921, eight men and women who had been sick with smallpox came forward to complain about the conditions of the city’s detention hospital, otherwise known as the city pesthouse. The pesthouse was located on Thompson, near what was then the northern city limits, and its purpose was to house those infected with diseases that could spread easily. The former patients had been sick between mid-February and the beginning of March, and in that short time had a number of troubling complaints. The first complaint was particularly damning for a hospital setting – labeling the facility as “absolutely unsanitary and not fit for human habitation.” There was no water in the house, and the walls were dirty. The place was heated by a hot air furnace, which, the ex-patients stated, only carried disease around the building. The rooms were too small and were overpacked, and although the patients were confined to their room, they also had no privacy. Moreover, no one knew for sure where their money was going. They claimed they heard “many contradictory statements” from people connected with the place concerning their money and their care. Some were held for several days past the point of contagion while others were not, and some claimed they were charged $5 just for entering, while others were not. This critique of the system was presented to the city commission and published in the Bismarck Tribune. At the end of their comments, the ex-patients stated, “Those of us who are residents of Bismarck are vitally interested in this case, and we certainly expect to see some action taken in the matter so that our citizens may be protected and the Detention Hospital will not be a menace to our city. The rest of us feel that for common decency and common humanity, this deplorable condition should be corrected.” Dakota Datebook written by Sarah Walker The Bismarck Tribune, March 11, 1921 Keiter’s Bismarck City Directory, p.128 of 1916-7; p.18 of 1919-20

医学

2014-42/1180/en_head.json.gz/11242

Training Curriculum Professor's Rounds The Balanced Mind Foundation Contact Clinical Programs Pediatric Mood Disorders ClinicPediatric Brain Research And Intervention Center NeuroscienceResearch Programs Reward Mechanisms Cognitive Remediation Mindfulness Study PsychosocialResearch Programs Cognitive Behavioral Therapy (Rainbow) People: Faculty Jeffery R. Bishop, PharmD Director, Psychiatric Pharmacogenomics Assistant Professor of Pharmacy Practice and Psychiatry Dr. Bishop is an investigator in the UIC College of Pharmacy Pharmacogenetics Laboratory. His area of expertise is investigating pharmacogenetic candidate genes as predictors of response and adverse events in persons treated with psychiatric medications. He is currently involved with studies of the pharmacogenetics of risperidone in first episode schizophrenia patients, the pharmacogenetics of agents used in pediatric bipolar disorder, and the pharmacogenetics of adverse effects of SSRIs in person with depression. Julie A. Carbray, PhD, APN, PMHCNS-BC Administrative Director, Pediatric Mood Disorders Program Dr. Carbray holds her PhD (93) and Master of Science (88) degrees from Rush University, Chicago and her Bachelors of Science (87) degree from Purdue University in West Lafayette, Indiana. A Clinical Professor of Psychiatry and Nursing at the University of Illinois at Chicago, she has been on faculty at UIC since 1993. As faculty in Nursing and Psychiatry, Dr. Carbray teaches course content in psychopharmacology, mood disorders, and development and therapeutic interventions with children and adolescents for students from various multidisciplinary programs within the UIC community. Dr. Carbray has also been a liaison with the Chicago Police Department’s Crisis Intervention Team, which trains officers about interacting with children with mental illness. As the Administrative Director of the Pediatric Mood Disorder Clinic, Dr. Carbray manages the clinical programs and multidisciplinary training for the clinic, and is a clinical expert in the area of children and adolescents with mood disorders. As a clinician, Dr. Carbray has a national reputation of excellence in serving families of children with mood disorders, and was recognized by the UIC community in 2008 by receiving the Karen Gousman Excellence in Nursing Award and the American Psychiatric Nurses Association’s (APNA) Best Practices in Outpatient Mental Health Nursing Award. With a particular focus on helping families to manage their children with mood disorders, Dr. Carbray supervises the parent component of the RAINBOW group therapy program for children with Bipolar Disorder. Dr. Carbray currently is engaged in programs of research that are investigating the psychopharmacology of mood disorders, neurobiology of mood disorders, detecting depressive symptoms in minority youth, and family response to childhood mood disorders. Dr. Carbray is an internationally recognized speaker and clinical expert on therapeutic work with children and adolescents with mood disorders. In particular, Dr. Carbray has expertise with psychopharmacologic interventions and developmentally based work with children and adolescents. Dr. Carbray is currently involved in research that is testing models of care for children and adolescents with Mood Disorders, psychopharmacologic interventions in mood disorders, and has co-authored scientific papers in this area of expertise. Dr. Carbray is a leader in the field of advanced practice psychiatric nursing, and chairs the APNA Clinical Psychopharmacology Institute and serves on the National Child and Adolescent Practice Council and Illinois APNA Board of Directors. AFFILIATIONS/MEMBERSHIPS American Psychiatric Nurses Association (APNA) Illinois Advanced Practice Nurses Association Child and Adolescent Bipolar Foundation Professional Member Sigma Theta Tau Member Collaborative Lithium Trials (COLT) Psychosocial Treatment in Pediatric Bipolar Disorder Affective Neuroscience of Pediatric Bipolar Disorder Developing Brain Function in Adolescent Bipolar Disorder Rachel Jacobs, PhD Research Assistant Professor of Psychiatry Dr. Jacobs has a background in treatment outcomes for pediatric mood disorders and is interested in studying mechanisms of effective treatment. Recently, Dr. Jacobs has focused on the problem of relapse in adolescent depression and whether mindfulness may protect against the return of depressive symptoms. Dr. Jacobs attended the University of Michigan where she worked with Susan Nolen-Hoeksema, Ph.D. studying rumination. She obtained her Ph.D. from Northwestern University working with Mark Reinecke, Ph.D. on the Treatment for Adolescents with Depression Study (TADS) and completed postdoctoral work with Bradley Peterson, M.D., Myrna Weissman, Ph.D., and Anne Marie Albano, Ph.D. at Columbia University where her primary focus was learning the methodology of fMRI. Lisa H. Lu, PhD Dr. Lisa Lu is interested in normal and abnormal development of language and motor systems, especially as relates to autism spectrum disorders and learning disabilities. Other research interests include using neuroimaging techniques (e.g., fMRI, DTI) to correlate neural systems with behavior, affect regulation in autism, the interface between cognitive processes and affective regulation, Bipolar Disorder, and ADHD. “If something is worth doing, it’s worth doing well.” Sonali Nanayakkara, MD Medical Director, Pediatric Mood Disorders Program Assistant Professor of Clinical Psychiatry Dr. Nanayakkara is a child psychiatrist with expertise in treating children and adolescents with mood disorders. As Medical Director of Pediatric Mood Disorders Clinic, Dr. Nanayakkara directly supervises training of child psychiatry fellows and medical students in the clinic. She also helps to manage treatment in a multidisciplinary setting to address needs of the surrounding underserved population. In addition, she is currently involved with research studies that are investigating the psychopharmacology and neurobiology of mood disorders. “Be the change that you want to see in the world.” - Mahatma Gandhi Alessandra M. Passarotti, PhD Assistant Professor in Psychiatry Dr. Passarotti is an Assistant Professor at the UIC Department of Psychiatry, and the Director of the Cognitive Neuroscience lab within the Pediatric BRAIN Center. She uses cognitive paradigms, conventional fMRI and functional connectivity methods to examine the bases of behavior control, and the differential neural mechanisms of affective and cognitive impulsivity in pediatric population such as PBD and ADHD, in order to better person_textrm diagnosis and more targeted intervention. She has received the NARSAD Young Investigator Award, to examine the behavioral and neural bases of reward-related mechanisms as they interact with cognitive and affective systems in pediatric bipolar disorder (PBD) and ADHD, and The Depressive and Bipolar Disorder Alternative Treatment Foundation Award to develop cognitive intervention for affective impulsivity in PBD. Based on these studies, she is currently developing a cognitive intervention program for children with attention and working memory problems. Dr. Passarotti obtained her Ph.D. in Biological Psychology at the University of Illinois at Urbana-Champaign, where she also completed a practicum in developmental clinical neuropsychology. She then specialized in developmental fMRI at the University of California, San Diego. “The noblest pleasure is the joy of understanding.” – Leonardo da Vinci Sally M. Weinstein, PhD Visiting Research Assistant Professor Licensed Clinical Psychologist Dr. Weinstein received a Bachelor of Science from Duke University (2001) and obtained her Ph.D. in Clinical Psychology from the University of Illinois at Chicago (2009). Dr. Weinstein completed her Internship in Child Clinical and Pediatric Psychology at La Rabida Children’s Hospital in Chicago, Illinois (2009), and completed a two-year Postdoctoral Fellowship, funded by the National Institutes of Health, within the Pediatric Mood Disorders Program/Pediatric Brain Research and Intervention Center at the University of Illinois at Chicago (2011). She is currently funded by the American Foundation for Suicide Prevention to examine risk factors and treatment for suicidality among children and adolescents with bipolar disorder. Dr. Weinstein is currently engaged in programs of research investigating the psychosocial treatment of children with bipolar disorder, and the assessment and treatment of suicidality within pediatric bipolar disorder. Dr. Weinstein also provides clinical evaluations and treatment for children and adolescents with mood disorders, facilitates the RAINBOW Cognitive Behavioral Group Therapy Program for children with bipolar spectrum disorders, and facilitates a cognitive-behavioral group treatment program for adolescent girls with depressive disorders. In addition, she supervises the clinical development of clinical psychology graduate students and interns involved in the Pediatric Mood Disorders Program. INTERESTSChild and adolescent mental health; pediatric mood disorders, particularly pediatric bipolar disorder and youth suicidality; cognitive behavioral treatment (CBT) for child and adolescent psychopathology; psychosocial intervention research; developmental psychopathology; risk for development of youth smoking and risky behaviors. Identifying Risk Factors and Intervention Methods to Prevent Suicide in Pediatric Bipolar Disorder (PI: Weinstein) Psychosocial Treatment for Pediatric Bipolar Disorder (PI: West) West, A.E., Weinstein, S.M., Celio, C., Henry, D., & Pavuluri, M.N. (2011). Comorbid Disruptive Behavior Disorder and Aggression Predict Functional Outcomes and Differential Response to Risperidone versus Divalproex in Pharmacotherapy for Pediatric Bipolar Disorder. Journal of Child and Adolescent Psychopharmacology, West, A.E., & Weinstein, S.M. (in press). Pediatric Bipolar Disorder. In R.B. Mennuti, R.W. Christner, & A. Freeman (Eds.) Cognitive-Behavioral Interventions in Educational Settings: A Handbook for Practice (Second Edition). New York: Routledge Publishing. Weinstein, S.M. & West, A.E. (2009). Cognitive Behavioral Therapy for Pediatric Bipolar Disorder. In: Evidence-Based Mental Health Treatment for Children and Adolescents, http://www.effectivechildtherapy.com/. Weinstein, S.M., Mermelstein, R., Shiffman, S., and Flay, B. (2008). Mood variability and cigarette smoking escalation among adolescents. Psychology of Addictive Behaviors, 22, 504 – 513. Weinstein, S.M., & Mermelstein, R.J. (2007). Relations between daily activities and adolescent mood: The role of autonomy. Journal of Clinical Child and Adolescent Psychology, 36, 1 – 13. Weinstein, S.M., Mermelstein, R.J., Hankin, B.L., Hedeker, D., and Flay, B. (2007). Longitudinal patterns of daily affect and global mood during adolescence. Journal of Research on Adolescence, 17, 587-600. Weinstein, S.M., Mermelstein, R.J., Hedeker, D., Hankin, B.L., and Flay, B. (2006). The time-varying influences of peer and family support on adolescent daily positive and negative affect. Journal of Clinical Child and Adolescent Psychology, 35, 420 – 430. Kassel, J.D., Weinstein, S., Skitch, S., Veilleux, J., and Mermelstein, R. (2005). The development of substance abuse in adolescence: Correlates, causes, and consequences. In B.L. Hankin and J.R.Z. Abela (Eds.), Developmental Psychopathology: A vulnerability-stress perspective. Thousand Oaks, CA: Sage Publications. Amy West, PhD Director, Pediatric Intervention Research in Affect Regulation and Mood Disorders (PIRAMD) Assistant Professor in Clinical Psychology Dr. West is an Assistant Professor in the Department of Psychiatry and also holds an appointment in the Department of Psychology at the University of Illinois at Chicago. Her research broadly focuses on the use of psychosocial interventions in the treatment of pediatric mood disorders. She is currently funded by the National Institutes of Mental Health to study a family-based cognitive-behavioral intervention (child and family-focused cognitive-behavioral therapy, CFF-CBT or the RAINBOW program) for children 7-13 with bipolar disorder. Dr. West also has research interests in the developmental psychopathology of mood disorders in children, treatment mechanisms in psychosocial interventions, suicidal behavior in pediatric bipolar disorder, and developing psychosocial treatments that are culturally-relevant to unique populations. Dr. West received a B.A. in Psychology from Stanford University, her Ph.D. in Clinical Psychology from the University of Virginia, and completed her pre-doctoral internship and post-doctoral fellowship at Harvard Medical School/Children's Hospital Boston. Minjie Wu, PhD Director, Neuroimaging Methods Research Assistant Professor in Psychiatry Dr. Wu is a Research Assistant Professor in the Department of Psychiatry of UIC and the Director of Neuroimaging Methods at the UIC Pediatric BRAIN Center. At the BRAIN Center, Dr. Wu is developing advanced functional and structural MR imaging techniques (including T1w, DTI, resting-state and task-evoked fMRI) and applying these techniques to characterize the developmental trajectories of normal brain maturation as well as the developmental perturbations or deviations in neuropsychiatric disorders. These include: map the abnormally engaged resting state affective, executive, and sensorimotor networks in psychotropic naïve patients with pediatric mania using resting state fMRI; probe the affective and cognitive abnormalities in pediatric psychiatric disorders using GLM-based and ICA-based functional connectivity methods on task-evoked fMRI; identify structural abnormalities in major white matter bundles and cortical gray matter in pediatric bipolar disorder. During her Ph.D. training in Bioengineering at the University of Pittsburgh, Dr. Wu worked at the Geriatric Psychiatry Neuroimaging Lab of the Western Psychiatric Institute and Clinic (WPIC), during which she developed MR imaging algorithms including Automated Labeling Pathway (ALP) for brain image segmentation, automated white matter hyperintensity (WMH) segmentation and localization algorithms, and Optimum MRI Template Selection method for more accurate brain image segmentation/normalization. Using resting-state fMRI, Dr. Wu found altered default-mode network in late-life depression compared to controls. During her curricular practical training in the Section on Tissue Biophysics & Biomimetics (STBB), National Institute of Child Health & Human Development (NICHD)/National Institutes of Health (NIH), Dr. Wu developed the image-registration based EPI distortion correction algorithm for DTI data processing, which is included in the NIH diffusion MRI data processing software package: TORTOISE. During her post-doctoral training at the Department of Neurology, Northwestern University, Dr. Wu used high resolution DTI and resting state connectivity analysis method to study Parkinson's disease. INTERESTS:Resting state fMRI, diffusion tensor imaging, task-based fMRI, multi-modality imaging fusion, graph theory, machine learning, normal brain development, pediatric bipolar disorder, late-life depression. AFFILIATIONS/MEMBERSHIPSInternational Society for Magnetic Resonance in MedicineOrganization for Human Brain Mapping The Brain Center and the clinic is a part of the Pediatric Mood Disorders Program, The Colbeth Child and Adolescent Psychiatry Clinic, the Institute for Juvenile Research, and the Department of Psychiatry at the University of Illinois at Chicago. 1747 West Roosevelt RoadSuite 155, M/C 747Chicago, IL 60608Phone: (312) 996-7723Fax: (312) 413-0063 Click here to learn more about how your contribution can support and improve the lives of children and adolescents with mental health issues (312) 996-7723 | 1747 West Roosevelt Road | Chicago, IL 60608

医学

2014-42/1180/en_head.json.gz/11256

Site Search: Basic Guide to Pesticides: Their Characteristics and Hazards The pesticide chemical in pure form (95-100% concentration) as it is manufactured by a chemical company prior to being formulated into wettable powders, dusts, emulsifiable concentrates, granules, etc. Adipsia Absence of thirst, or abnormal avoidance of drinking. Absence of the hair from skin areas where it normally is present. Anaphylactic An unusual or exaggerated reaction of the organism to foreign protein or other substances; decreasing immunity instead of increasing it. Anticholinesterase A compound that causes excessive nerve transmission at (cholinergic) synapses by blocking ability of cholinesterase to break down acetylcholine into acetic acid and choline. Chemicals with this activity include poisons of the nerve gas type as well as pesticides of the organophosphate or carbamate class. Neuralgia or pain in a joint. Ataxia Failure of muscular coordination; irregularity of muscular action. Atrial Fibrillation (auricular): A condition characterized by irregular convulsive movements of the aria of the heart, the number of impulses being great, and individual fibers acting independently (ventricular): A condition characterized by fibrillary twitching of the ventricular muscle, with the impulses traversing the ventricles so rapidly that coordinated contractions cannot occur. Bradycardia Abnormal slowness of the heartbeat, as evidenced by slowing of the pulse rate to 60 or less. The Bt (Bacillus thuringiensis) bacteria produce a toxic protein lethal to caterpillars due to a unique condition in the caterpillar intestinal tract. The gene for the Bt protein has been transplanted into a corn plant producing transgenic Bt corn. This is a patented life form. A chemical class that includes insecticides. They may or may not act as anticholinesterases (or cholinesterase inhibitors). Includes the insecticides: methomyl, carbaryl, propoxur (which are cholinesterase inhibitors) and fenoxycarb (which is not a cholinesterase inhibitor). Those acting as cholinesterase inhibitors are neurotoxic agents that can have additive effects with organophosphates (OPs). They can be very acutely toxic, but do not bind as tightly to the sites of action as do the OPs. carcinogen a substance that can cause cancer. Any substance capable of producing cancer. CAS Chemical Abstract Service http://www.cas.org/ which assigns numbers for chemicals used in commerce. - A cleansing or purgation, especially for the digestive system. ChE inhibitor cholinesterase inhibitor Coagulopathy A disease or condition associated with the process of clot formation. Conjunctivitis Inflammation of the conjunctiva, the delicate membrane that lines the eyelids and covers the exposed surface of the eyeball. Cranial Nerve Deficits A lack or defect regarding any of the twelve pairs of nerves that are connected with the brain. (in dogs)- A syndrome which may be accompanied by signs of polydipsia [excessive, extended thirst], polyuria [passing a large volume of urine in a given period], abdominal distension, lethargy, muscular weakness, and testicular shrinkage. Delayed Neurotoxicity Effect associated with certain organophosphates which starts several weeks following recovery from acute toxicity. Signs usually start at the extremities, arms and legs. Can be permanent or temporary and may be accompanied by nervous tissue degeneration. delayed toxicity effects may become evident some time after exposure which may delay treatment Dermal Excoriation Any superficial loss of the skin, such as that produced by scratching. Dermatitis Inflammation of the skin. Diaphoretic Characterized by or promoting excessive perspiration. Dyspnea Difficult or labored breathing. Ecological Effect Brings about a change in the ecosystem. Since we do not understand completely the function and structure of most ecosystems, we generally are not aware of all the ecological effects of our actions. Ecological effects which could result from use of chemical insecticide products outdoors include harm to birds and beneficial insects as well as poisoning of fish, and aquatic invertebrates. Ecosystem An interacting system of all living organisms in an area and their non-living environment. The presence of abnormally large amounts of fluid in the intercellular tissue spaces of the body; usually applied to demonstrable accumulation of excessive fluid in the subcutaneous tissues. Effusion the escape of fluid into a part or tissue. Endocrine Disruptor An exogenous agent that interferes with the synthesis, secretion, transport, binding action or elimination of natural hormones in the body that are responsible for the maintenance of homeostasis, reproduction, development, and behavior. Epidemiology The field of science relating to the various factors that determine the frequencies and distributions of a disease or condition in a human or animal community. Erythema - A name applied to redness of the skin produced by congestion of the capillaries. Exogenous Developed or originating outside the organism. Fasciculation A small local contraction of muscles, visible through the skin, representing a spontaneous discharge of a number of fibers innervated by a single motor nerve filament. fetotoxin a substance that can poison the fetus (child developing in the womb) Fetotoxin Any substance capable of causing toxic effects on the fetus. Fibromyalgia Pain of the muscle fibers. Formication A sensation as if small insects were crawling over the skin. Formulated Product The physical form in which insecticide products are marketed, generally a combination of the active ingredients with inert substances, other carriers, solvents, etc. The inert ingredients are not intended to act on the pest for which the product is labeled, although they may prove toxic to other pests or to non-target plants or animals. The resulting insecticide products may have the form of sprays, dusts, granules, pour-ons, aerosols, collars or wipes. GABA is the acronym for Gamma Amino Butyric Acid, a neurotransmitter. GABA acts to stop transmission of impulses in vertebrates and invertebrates. It operates at sites in the choloride channel of the nerves in the central nervous system of mammals and throughout the nervous system of insects. Fipronil, type II pyrethroids and some organophosphates can act on various aspects of the GABA receptor. genetically engineered Genetic Engineering is based on the technology which makes possible the ability to move genetic material (DNA) from one organism (a virus, fungus or animal) to another organism (a plant, animal or bacteria). Totally new life forms can be created by this technology. Thus these novel life forms can be patented. Hemoptysis Expelling blood from the respiratory tract. Hemorrhaging Pertaining to the liver. Hyperesthesia Abnormally increased sensitiveness of the skin. Hyperpnea Abnormal increase in the depth and rate of the respiratory movements. Hyperthermia An abnormally high body temperature; fever. Ileus Obstruction of the intestines. immunotoxin a substance that damages the immune system Insecticide Registration The Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) defines the standards by which insecticide products must be registered. FIFRA requires that the technical chemicals in a product only be tested on birds, fish, and small mammals, not on trees or other plant life. In addition, the USEPA may waive the requirement for proof of efficacy. Once the technical chemical has fulfilled all requirements, the formulated products which contain that chemical undergo limited acute toxicity testing on laboratory animals as a minimum requirement. A lethal dose for 50% of the test organisms. The dose of toxicant producing 50% mortality in a population. A value used in presenting mammalian toxicity, usually oral toxicity, expressed as milligrams of toxicant per kilogram of body weight (mg/kg). Leukocytosis An increase in the number of white cells in the blood. Lipophilic Having an affinity for fat The mass of tissues and organs separating the two lungs, between the sternum in the front and the vertebral column behind, and from the thoracic inlet above to the diaphragm below. It contains the heart and its large vessels, the trachea, esophagus, thymus, lymph nodes, and other structures and tissues, and is divided into anterior, middle and posterior and superior regions. Miosis Excessive contraction of the pupil. Muscarinic Receptors Types of acetylcholine receptors which can affect the GI tract, respiratory system, urinary tract, and the eyes. Muscarinic Receptors mutagen a substance that causes mutation in cells Pain in a muscle or muscles. Mydriasis Extreme or morbid dilation of the pupil. Necrosis Death of tissue, usually as individual cells, groups of cells, or in small localized areas. Nerve Gas A type of chemical weapon with anticholinesterase activity. This is also the mode of action of the organophosphate and carbamate pesticides. For both, the nerve gas and the pesticide, atropine is the antidote. The means by which the body coordinates activity. It is composed of the brain, spinal cord and peripheral nerves. Pain of the nerves. Functional disturbance and/or pathological changes in the peripheral nervous system. Neurotoxic Harmful to the nervous system. neurotoxin a substance that damages nerves or the nervous system Organophosphate Insecticides (also one or two herbicides and fungicides) derived from phosphoric acid esters Inflammation of bone usually caused by an infectious organism. Pancreatitis Inflammation of the pancreas, a part of the digestive system, with pain and tenderness of the abdomen and vomiting. Pancytopenia Deficiency of all the cell elements of the blood; aplastic anemia. Paresthesia Morbid or perverted sensation; an abnormal sensation, as burning, prickling, formication, etc. Photophobia Abnormal intolerance of light Polydipsia Excessive thirst persisting for long periods of time. Polyuria The passage of a large volume of urine in a given period. Prostration Extreme exhaustion or powerlessness. Pruritis An effusion of serous fluid into the air vesicles and interstitial tissue of the lungs. Pyrethroid Synthetic insecticides and nerve toxins belonging to the pyrethroid class must be distinguished from the naturally occurring pyrethrin/pyrethrums isolated from chrysanthemums. Pyrethroids are much more potent, toxic, and significantly more persistent in the environment than are the plant-derived compounds (see Section 2, Overview, Part I-1 Pyrethroids for details). Occasionally, chemical company representatives try to blur this distinction by stating that pyrethroids are derived from the natural pyrethrums, but this is misleading. Pyrethroids are synthesized products designed to be more powerful and longer lasting insecticides than are the pyrethrums, partly because the latter are too easily destroyed by ultraviolet light. A fever, or a febrile condition; abnormal elevation of the body temperature. Rale Any abnormal respiratory sound heard while listening with a stethoscope and indicating some pathologic condition. Registration Number A number assigned to a pesticide product by the EPA when the product is registered by the manufacturer or his designated agent. The number must appear on all labels for a particular product Inflammation of the mucous membrane of the nose. Serous Fluid The clear portion of any animal liquid separated from its more solid elements especially the clear liquid portion of the blood (without the blood cells) that can diffuse into body cavities. Stomatitis Inflammation of the mucous membranes of the mouth. Synergist A chemical which interacts with another chemical to dramatically increase the potency of one or both of the chemicals. Synovitis Inflammation of a synovial [joint-lining] membrane. It is usually painful, particularly on motion, and is characterized by a fluctuating swelling, due to effusion within a synovial sac. Affecting the body generally; distributed throughout the body. [It can pertain to plants as well as to animals.] Tachycardia Excessive rapidity in the action of the heart. Tachypnea Excessive rapidity of respiration; a respiratory neurosis marked by quick, shallow breathing. Technical Chemical The pesticide chemical in pure form (95-100% concentration) as it is manufactured by a chemical company prior to being formulated into wettable powders, dusts, emulsifiable concentrates, granules, etc Technical Chemical The pesticide chemical in pure form (95-100% concentration) as it is manufactured by a chemical company prior to being formulated into wettable powders, dusts, emulsifiable concentrates, granules, etc. teratogen a substance that can cause birth defects Teratogen Any substance capable of producing structural abnormalities of prenatal origin, present at birth or manifested shortly thereafter pertaining to the chest Decrease in the number of blood platelets. Tissue A group of specialized cells that are connected and perform a given function, such as lung tissue, skin tissue, etc. Topical Application Treatment applied to the body’s surface, such as an animal’s skin or coat. Toxicosis Any disease condition due to poisoning. transgenic A transgenic plant is one in which a genetically engineered method has been used to insert foreign genetic material (DNA). In the case of the Bt transgenic corn (for example) the genetic material comes from bacteria. United States Environmental Protection Agency (USEPA)- Formed in 1970, responsible for enforcement of the Federal Insecticide, Fungicide and Rodenticide Act, (FIFRA). Registers pesticide products if it is determined that they do not pose an “unreasonable” risk to human health and the environment when used as directed by product labeling. A vascular reaction of the skin marked by the transient appearance of smooth, slightly cleaved elevated patches (eruptions), which are redder or paler than the surrounding skin and often attended by severe itching. The eruption rarely lasts longer than two days, but may exist in a chronic form. USEPA Formed in 1970, responsible for enforcement of the Federal Insecticide, Fungicide and Rodenticide Act, (FIFRA). Registers pesticide products if it is determined that they do not pose an “unreasonable” risk to human health and the environment when used as directed by product labeling. A hallucination of movement; a sensation as if the external world were revolving around the patient or as if he himself were revolving in space. The term is sometimes erroneously used as a synonym for dizziness. viral enhancer increases the toxicity of viruses that an exposed person or animal encounters RACHEL CARSON COUNCIL, INC. • 8600 Irvington Avenue, Bethesda, MD 20817 • Phone: 301-214-2400

医学

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ADVERTISEMENT File photo: Medical care. Kathleen Galligan, Associated Press Profit-driven medicine means better care Article by: David Goldhill The fundamental problem with the U.S. health-care system, many people argue, is that medicine can't operate well on the profit motive. It is a social good, and profit-driven behaviors undermine efforts to provide high- quality care. It's true that our private health-care system provides care that is extraordinarily expensive, excessive, wasteful, patient- unfriendly and often dangerously sloppy. But the problem with this argument is that for-profit and nonprofit providers alike produce the same bad result. The profit motive itself doesn't seem to be the differentiator. Federal tax data show that for-profit hospitals actually provide more charitable care than nonprofits do. Nonprofits performed no better - in some cases much worse - than comparable for-profits on safety scores recently assigned by the Leapfrog Group, a health-care research organization. For patients, it's almost impossible tell the difference between nonprofit and for-profit hospitals. Nevertheless, it is true that the profit motive - and for that matter the nonprofit motive - is failing us in health care. Why does no one in this industry compete to be the low- priced leader? To be the provider with the best outcomes for specific illnesses? To be the service and efficiency king? To be the safest hospital in your town? Because none of these social benefits drives profits in the health-care business. Successful business models depend on completely different factors - the amount of excess care for which you can win reimbursement, your ability to prove your costs are high, your savings from avoiding investments in service and safety, mind-bending complexity that makes straightforward accountability impossible. These are the incentives in our system and, unfortunately, our providers respond to them perfectly. But perverse incentives are no more inevitable in health care than in any other industry. They're a direct consequence of government intervention in the market. Medicare is an entitlement - it will pay for all needed care for people who qualify - so the industry responds by endlessly expanding the definition of need. We invest almost nothing in oversight (Medicare's low spending on this is often cited as one of its advantages - as if banks without security guards would be more efficient), allowing a flood of excess treatment and haphazard care that represents a true assault on beneficiaries. Medicaid reimburses providers at extremely low levels for almost all services - far below the private market - so its beneficiaries get very little time-intensive primary care and lots of the tests and procedures that produce profits at high volumes. Even presumably private markets are dominated by perverse incentives driven by government policy. Our tax code favors employer-provided private insurance to the detriment of any other way of paying for medical treatment. To preserve this competitive advantage - and reduce their accountability to employer-purchasers - insurers have implemented an impossibly opaque payment system that bars any competing form of finance. I recently asked the cash price for my son's surgery; the ensuing disbelief and confusion could not have been greater if I had told them I was wearing an explosive vest and demanding free care. Finally, there's us, the patients. Government policy - culminating in the 2010 Affordable Care Act - has been to shift our own financial contributions from direct payment for care to insurance premiums and taxes. As a result, our out-of-pocket payments now represent only 11 percent of our spending on health care - one of the lowest shares in the world. That's not a misprint. Even as our nation's medical bill rises inexorably, we the patients are further shielded from the financial consequences of our decisions. In theory this is for our own benefit, but in reality it means we never act on our natural skepticism about the need for, or safety of, suggested treatments and tests. In talking about health care, we seem to forget what profits are: the return on capital employed in an activity. In the nonprofit world, this return may be called surplus, but there's no escaping the need to service the capital employed in buildings, equipment, training and even labor. So nonprofits' performance is, roughly, the same as that of for-profit providers. Yes, we could have the government take over private functions in health care and benefit from a lower cost of capital (especially since government is so good at disguising that it has an actual cost of capital, as the bank bailouts illustrated). But regardless of who provides the care, most of the costs involved - time spent by doctors, nurses, and orderlies; building construction; equipment and supplies - are still going to be set by private parties. The 15 million people who work in the health-care industry, and all of its outside vendors, will continue to be motivated by economic considerations. Which is why abandoning the profit motive in health care would be such a waste. We rely on it to make almost all of life's other essentials cheaper and better. Yes, private actors require a little more return on capital than governments do; but their competition with one another produces better results and more innovative services that usually overwhelm this small government advantage. Our health- care mess actually proves that the profit motive is working in health care, even if it is in response to perverse incentives. Let's restructure those profit incentives to better match our social needs - so that providers of more appropriate care with better prices, safety and customer service earn more, rather than less. We'll get much better results. David Goldhill, the president and chief executive officer of the cable TV network GSN, is the author of "Catastrophic Care: How American Health Care Killed My Father - and How We Can Fix It."

医学

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Texans Sound Off on Health Care Reform by Reeve Hamilton and Emily Ramshaw Texas Medical Association, David Dewhurst, Garnet Coleman, Greg Abbott, Henry Cuellar, Lloyd Doggett, Michael Williams, Pete Sessions, Wayne Christian, Health care and Texas, Texas Health and Human Services, Texas Medicaid House lawmakers passed the Senate version of long-awaited health care reform on Sunday night. And Texas leaders were quick to fire off on it. — On Facebook, Attorney General Greg Abbott was already declaring war on the health care bill. He said he had just left a conference call with officials from more than a dozen states: "Just got off the AG conference call," he wrote. "We agreed that a multi-state lawsuit would send the strongest signal." Later, he released a statement: "To protect all Texans' constitutional rights, preserve the constitutional framework intended by our nation's founders, and defend our ... March 21, 2010 @ 10:19 p.m. I applaud the AG for wasting no time in attempting to resolve this matter. ObamaCare will do nothing but cost...National Debt...Premiums...Health Care Costs...Patient Lives...Jobs. We need a free market system to fix health care, anything less is just a move for power.The Dems said that health care is a right of every American, but they forget that a right is an option each American can take or leave...at the very heart of this bill, and to the disappointment of the IRS themselves, is the inability to choose no health care.Maybe now the people who blindly voted for Obama and Pelosi will wake up and make smarter choices, or at the very least informed choices, next time they're at the voting booth. March 22, 2010 @ 2:23 a.m. TEXASdaughter November cannot come soon enough! Then WE get to vote! Gary Stone I can only hope, wish, pray, hold ceremonious ritual gatherings, etc. that there are another 200 million voters out there who think Just. Like. You.Every email I sent to Congressmen and women regarding this bill ended the same way and I'd like to share it here..."Bless you for taking a stand against tyranny, and may God be with those who forget who holds the power in the United States of America, because the People won't be."Indeed, November can not come soon enough! hear, hear! March 22, 2010 @ 11:30 a.m. EHascal It's interesting that those who are fighting to keep people from getting health care actually get state funded health care. There are 32 million Americans who will now get access to life saving/life improving health care.How is it possible that hard working people cannot provide health care for their family in this great country?Shame on all of you for trying to deny people the right to be healthy. March 22, 2010 @ 3:41 p.m. EHascal ~ That is a bold statement! But there's just one problem, I don't receive state funded health care and never have. Even at a time in my life when I could have used it, I chose to go without to avoid being yet another unconcerned citizen on the public dole. Sure, I got a cold for about a month, but I think I lived...Secondly, and far more importantly, what good is it to ensure another 30 million American's when the care they get will be scarcely elected by bureaucrats in Washington based on stats and expense and mortality rates? The last I checked even the dying need adequate care.No more experimental treatments for terminal illnesses such as cancer, and likely a drop in treatment for H.I.V. patients because let's face it, they'll just need more medicine. What about diabetics? They're in the same boat, expensive treatment regiments that last for years. And don't even give me the argument that the latter two caused their health issues, because it's crap!Rationing is a stated part of ObamaCare, why do you think it won't turn 30 million uninsured American's into 60 million uncovered American's? The only difference is that the government will making an informed choice to decide who those 60 million American's are.What about the insurance companies themselves? Do you think they're just going to take having to accept preexisting conditions lying down? No! They're going to start raising premiums and cutting coverage to make up for the possible billions in extra expense they'll have.I'm all for universal health care, but it's not going to happen with ObamaCare. Instead we should implement free market health care reform that allows American's to decide what happens to insurance through buying trends and consumer satisfaction.Members of Congress do not qualify! They have a special insurance program that will cover them for the rest of their lives, and now with ObamaCare passed, their care, as our representatives no less, is and always will be completely sufficient for even the most elective of procedures.Then, for those who still won't be covered because they can't afford insurance even after the free market system drops premiums to phenomenal lows by way of competition, the government can increase state funded health care programs. That entire measure still won't cost as much as the 860 + billion that ObamaCare will cost us, American taxpayers, in just the first decade.Not to mention the whole aspect that ObamaCare will outwardly fine us for not having health care, the thing they say while supporting this bill is an American right. Again, last I checked, a right cannot be fined. You don't see people being fined for NOT owning a gun do you? How about for NOT demonstrating their right to free speech? A right is ours, and we are FREE to choose if and when we WANT to enforce that right. ObamaCare says we cannot choose a right anymore. Does that really sound right to you? My body is my right, my property, and I always will be the only person who decides what is and is not done to it. What about you? Are you willing to hand your body over to the government? sgre144 Let's hope and pray as, after the UT football or basketball teams couldn't remain No. 1, AG Abbot suit to nullify providing many w/ health insurance is successful and Texas can remain No. 1 in percentage of the population w/out health insurance. I urge the AG to file immediately a writ of mandamus. I assume that our Republican house members can now campaign that they don't have either an altruistic or christian bone in their body, but that they are all Christians. Nicely said, iLiberty. I'm with ya.I am amazed how people do not get that our rights and freedoms are being chipped away..little by little and now, chunk by chunk. This bill isn't the only policy responsible for that...but this bill fundamentally changed the ideology on which our nation was built. THAT is what this is about.I am not keeping anyone from buying insurance. ..and it has absolutely nothing to do with Christian charity. It has everything to do with people consistently expecting others to pay their way. If ya want to buy insurance, go to school, get a job and PAY for your insurance...but don't expect me to go to school, get a job and pay for YOUR insurance. Personal freedom comes with personal responsibility. Right, I keep hearing an argument that health insurance is like car insurance, it makes sense to make health insurance required for it is for a car. And nobody seems to get the point.You can choose not to own a car! You can't not own your body anymore, not living at least. Maybe that's what EHascal and sgre144 want, genocide...But what's worse is that Obama has made it clear that he wants to share the wealth in the nation. To play Robinhood and take from the rich and give it to the poor. The thing that this bill does, though, is it takes from everyone, rich or poor, and gives it to anyone, rich or poor.We seem to agree that this bill is fundamentally jacked, but stealing from the poor to give to the rich is just insane. No matter how unlikely or rare the occurrence may ultimately be.

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December 1 2005 - NEW HEART SCANNER NOW AVAILABLE AT CENTER FOR ADVANCED SURGERY AND TECHNOLOGY AT M Press Release - December 1, 2005 NEW HEART SCANNER NOW AVAILABLE AT CENTER FOR ADVANCED SURGERY AND TECHNOLOGY AT MOTHER FRANCES HOSPITAL For Release John MooreMedia Relations(903) 531-4542 NEW 3-D HEART SCANNING TECHNOLOGY NOW AVAILABLEAT MOTHER FRANCES HOSPITAL IN TYLER TYLER, TX – Physicians at Mother Frances Hospital can now see 3-D images of all sides of the heart with more clarity than ever before through new technology that scans a patient’s body within minutes. The Center For Advanced Surgery and Technology (CASAT) at Mother Frances Hospital has added two SOMATOM Sensation 64 Multi-Slice CT scanners from Siemens Medical Systems, Inc. to their radiology department, one dedicated for cardiac imaging. The new CT scanners improve the diagnosis and treatment of patients by working in tandem with 3-D reconstruction computer software that provides radiologists greater clarity of a patient’s cardiovascular system than any other technology previously available. The new SOMATOM Sensation 64 CT provides the finest image quality and advanced clinical applications due to the Multi-Slice CT design. “The 3-D technology has been in use for a number of years, but CASAT is the only medical facility in this part of east Texas that combines the 64-slice CT scanner with the 3-D reconstruction images for diagnosing heart problems. The CT scanner takes 200 photos per second,” said Terry Byrd, RN, director of CASAT. “This technology was recently featured on NBC’s The Today Show. It truly is a great advancement in heart care and we are proud to offer it.” The technology is so new, all insurance companies do not cover it at this time. During the scan, a patient receives an intravenous contrast solution that illuminates the organs of the body. The prep time can take up to two hours, but the scan normally takes less than 20 minutes. “This would be a great holiday gift for someone,” added Ms. Byrd. “If you have someone who is hesitant to see a physician for regular check-ups, this minimally-invasive procedure can detect cardiac problems within a few minutes.” To schedule a heart scan at Mother Frances Hospital, call TeleCare Plus at 903-531-5678. For more information on all services available through Trinity Mother Frances Health System’s Center For Advanced Surgery and Technology, visit www.casattexas.org.

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AIDS: everybody’s business 12 September 2007Ces informations ne sont pas disponibles en français. Finding innovative solutions to key health challenges to ensure the long-term economic development of nations worldwide was the focus for business leaders attending the three-day meeting of New Champions. The meeting took place in Dalian in the People’s Republic of China from 6 to 8 September 2007. The issue of AIDS took a particularly prominent position with a symposium dedicated to how business could contribute to responding to the epidemic. The symposium gathered high-level representatives from government, business, NGOs and international organizations—including UNAIDS Executive Director Peter Piot—to discuss the issue of AIDS in the workplace. Christine Ockrent, author and Editor-in-Chief of the French television channel France 3,introduced the discussion noting how big business had been slow to realize the staggering impactl of the AIDS pandemic. “AIDS, she said, has become the fourth cause of death in the world and may soon be the third. Eight thousand people die each day from AIDS,” she added. What role can new business champions play? As part of his intervention, the UNAIDS Executive Director presented three comparative advantages of the business sector in addressing the epidemic. First of all, he underlined, business has expertise in long-term strategic planning, risk assessment, research, development and marketing. Private companies can also, reach out to millions of people, who would otherwise be out of reach, through HIV in the workplace programmes and workplace programmes also allow proper follow of the beneficiaries. Additionally, he stressed, the business sector has an outreach potential far beyond its own sector and plays a real leadership role in today’s world. Other speakers at the symposium included Bo Shao, Chairman, Novamed Pharmaceuticals in the People's Republic of China; Raenette Taljaard, Executive Director of Helen Suzman Foundation in South Africa; Sir Martin Sorrell, Group Chief Executive of WPP Plc in the United Kingdom; and Rajat Gupta, Senior Partner of McKinsey & Co. and Chairman of the Board of The Global Fund to Fight AIDS, Tuberculosis and Malaria. Mr Gupta noted that the case for business was grounded in completely enlightened self-interest. "We need a healthy workforce,” he said. WPP’s Sir Martin Sorrell added that HIV must be recognized as one of the world’s two global priorities, along with climate change. He cited ignorance and discrimination as major obstacles in the response to AIDS. “Obstacles, he noted, that can be overcome through better education and where New Champions can contribute by using existing services and by inventing new service delivery tools. ”While the business sector offers some examples of innovative partnerships in response to AIDS, most of them are to be found in large multinational companies. Adidas for example has partnered with Marie Stopes International to provide reproductive health and AIDS prevention education to the young, female migrant workers in their supplier factories. But many more such initiatives are needed across the sector. “Business has a vital role to play in the response to AIDS. The multi-sectoral nature of AIDS presents enormous opportunities for further contributions from business, in its resources, expertise and long-term planning,” said Regina Castillo, UNAIDS' Team Leader of Corporate and Private Sector Partnerships. Links: Read WEF press release Visit the World Economic Forum's web site for more information on the Dalian meeting Reportages connexes

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Big Cities and Small Towns Bear Similar Risks of Gun Death, says Penn Public Health Study Suicide Risk by Firearms Greater in Rural Areas (Philadelphia, PA) - Americans in small towns are statistically as likely to die from gunfire as people in major cities, according to a new study from the University of Pennsylvania School of Medicine - with one key distinction. “The difference is who does the shooting,” says lead author Charles C. Branas, PhD, Assistant Professor of Epidemiology. Branas and colleagues found that when looking at all deaths by firearms, the risk of being murdered with a gun in large cities and the risk of committing suicide with a gun in rural areas were almost identical. In fact, the risk of gun suicide in rural areas was slightly higher than the risk of gun homicide in major cities. After adjusting for income, education, employment rates, and other factors, the most rural counties had over 1.5 times the rate of gun suicides compared to the most urban counties. At the same time, urban areas experienced almost twice the gun homicide rate of the most rural counties. Similar trends were not found for other, non-gun forms of suicide or homicide. The investigators analyzed urban-rural differences in intentional firearm deaths-homicides and suicides-using over 580,000 death certificates from 1989 to 1999 in all counties in the United States. Their findings are reported in the October issue of the American Journal of Public Health. Over the last decade, gun suicides have outpaced gun homicides, accounting for over half of all firearm deaths in the United States. Even with that in mind Branas says that “gun suicide has become the forgotten side of all of this, and to reduce gun death in general we have to start making gun suicide a priority.” In the 1990s, a great deal of legislation was aimed at reducing gun homicide, which decreased in the United States by about 5 percent per year. Much of this decrease was in big cities. But almost no attention has been paid to gun suicide, which increased by about 1 to 2 percent per year, most starkly in rural areas, over the same period. “Ultimately we need to bring gun suicides out of the closet and raise public awareness about these tragic events,” says Branas. “We have to think more broadly about preventing gun suicide, especially in rural communities, through such efforts as better detection of mental-health problems and reduced access to guns for people who are known to be at risk for suicide.” Gun death should be broadly thought of as a public health issue, adds Branas, since it includes gun suicide, which often falls outside the bounds of the criminal justice and medical-care systems. “Killing yourself with a gun is not a crime and the results are so immediate that a hospital is very often bypassed for the morgue,” he says. The study also found that the same trend for gun death did not hold true for urban- versus-rural differences in non-gun methods of suicide or homicide. Thus, guns clearly functioned differently from other methods. But why the urban-rural difference? “We didn’t directly account for differences in availability of guns by location, but we can speculate how that might have affected our results,” says Branas, referring to the larger percentage of gun owners in rural areas versus cities. “A major take-home message from these findings is that although prevention efforts must be continued in big cities, dispelling the urban myth that gun death does not touch areas outside of big cities should be a high priority.” This work was funded by grants from the National Institute on Aging and the Chicago-based Joyce Foundation. Other Penn researchers contributing to the study are Drs. Michael L. Nance, Michael R. Elliott, Therese S. Richmond, and C. William Schwab. ### PENN Medicine is a $2.7 billion enterprise dedicated to the related missions of medical education, biomedical research, and high-quality patient care. PENN Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation’s first medical school) and the University of Pennsylvania Health System (created in 1993 as the nation’s first integrated academic health system). This release is available online at http://www.uphs.upenn.edu/news/News_Releases/sep04/firearmdeaths.htm

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Warwick awarded �1 million by Wolfson for new Clinical Trials Unit WEBWIRE – Wednesday, August 01, 2007 The University of Warwick has been awarded �1 million by the Wolfson Foundation towards the cost of building a new Clinical Trials Building for Warwick Medical School. The new facility will be a custom-built home for the Clinical Trials Unit and it is expected to be completed in late 2008. The Unit has grown dramatically since it was established in 2005 at the Warwick Medical School campus on Gibbet Hill. A number of international professorial research leaders have been appointed and the Unit has been awarded more than �5 million in grants for clinical trials in cancer, musculo-skeletal and emergency care. The Unit is co-ordinating the �PERSEPHONE� herceptin duration trial, comparing the effectiveness of the drug over 12 months compared to 6 months in early breast cancer, and investigating new scanning methods in the treatment of head and neck cancer. In addition, new trials have been funded to examine the use of treatments in intensive care, and in exercise to prevent depression in nursing home residents. Trials that have been completed include studies of back pain, severe ankle injuries and whiplash. Professor Yvonne Carter, Dean of Warwick Medical School, said the Wolfson grant was a real achievement for the School. She said: �We are delighted at receiving a �1 million Wolfson grant, we believe that this generous donation from the Wolfson Foundation recognises the huge potential to build on our success to date. The Clinical Trials Unit has successfully established itself as a leading research team in the School. Additional space is needed to help realise our vision for a large, specialist trials centre which co-ordinates trials from conception through to completion.� In addition The Wolfson Foundation has also awarded �250,000 to the University of Warwick�s main campus library. The money will be used to create a Research Exchange, which will be a flexible and technology-rich study and collaborative space for postgraduate research students and researchers. Related Links WebWireID44029

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What is Gerstmann-Straussler-Scheinker Disease? Patients with Gerstmann-Straussler-Scheinker disease eventually succomb to dementia. Watch the Did-You-Know slideshow Gerstmann-Straussler-Scheinker disease is an extremely rare inherited neurodegenerative disease which is currently not curable. It is part of a family of diseases known as Transmissible Spongiform Encephalopathies (TSEs), which appear to be caused by rogue proteins known as prions. These prions attack the brain and central nervous system, causing an assortment of symptoms which always eventually lead to death. Incidence of this disease is quite low around the world, and your chances of having it are extremely slim. Only a few families have a documented history of Gerstmann-Straussler-Scheinker, and it does not always emerge in people who are related to each other. Because incidence of the disease is rare, scientists have not invested heavily in trying to find a cure, although a cure may someday be realized through gene therapy which addresses the genetic component of the disease, stopping it before it even begins. Such therapy could also potentially be used to treat victims of other TSEs. Symptoms of Gerstmann-Straussler-Scheinker generally start when the patient is between 35-55 years of age, and the onset is typically slow. Progression may take two to 20 years; in some cases, patients may live a relatively normal life for some time, while in other instances the progress of the disease is rapid, barely giving the patient time to get his or her affairs in order. The first signs typically take the form of clumsiness and difficulty balancing or performing fine motor tasks, a combination of symptoms which is collectively known as ataxia. Ad In addition to ataxia, some patients also experience problems with their eyes which can lead to blindness, along with slurred speech and muscle spasms. Ultimately, the disease progresses into full-blown dementia, and the patient typically sinks into a coma. The most common cause of death for a patient with Gerstmann-Straussler-Scheinker is a secondary infection which is caused by the body's inability to cope with infections, with some families choosing to remove comatose patients from life support, since there is no expectation of recovery. Like other TSEs, Gerstmann-Straussler-Scheinker can be difficult to identify while the patient is alive, as an autopsy and examination of the brain tissue is needed to confirm diagnosis. Patients are typically diagnosed with Gerstmann-Straussler-Scheinker when they have a family history of the disease and they exhibit the required symptoms without recovering from treatments which could address other causes of these symptoms. Treatment for Gerstmann-Straussler-Scheinker is primarily aimed at keeping the patient comfortable, since there is no cure. Ad What Is Friedreich's Ataxia? What Is Pick's Disease? What Is Osteochondromatosis? What Is Cerebellar Ataxia? What Is a Slow Virus? What is Alexander Disease? What are Transmissible Spongiform Encephalopathies (TSEs)? indemnifyme @JessicaLynn - I think it's completely possible scientists could find a cure for this and other forms of prion disease while doing other research. I know a lot of research is being done right now about gene therapy, which could potentially treat or cure a lot of different diseases. Gerstmann-Straussler-Scheinker disease sounds pretty similar to Alzheimer's disease too. The clumsiness, muscles spasms, and eventual dementia are also Alzheimer's symptoms. It must be hard for doctors to differentiate. I wonder if some people are treated for Alzheimer's when they really have Gerstmann-Straussler-Scheinker disease instead? view entire post Incurable diseases are so depressing. I remember learning about this and other diseases like it (mad cow disease BSE is pretty similar, I believe that also had some effect on prions) in biology. Neurological diseases that are incurable are especially upsetting, because usually they cause dementia before the person dies.Anyway, I can only hope that they find a cure for this disease while doing other research. The fact that Gerstmann-Straussler-Scheinker disease isn't that common is probably no comfort to people who suffer from it. view entire post

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Nurse Attacked at ECMC For the second time in the last five weeks a nurse is attacked by a patient at the Erie County Medical Center in Buffalo.The latest attack happened Sunday afternoon although hospital administrators are not releasing many details. "I'm not sure it'd be fair to any of the parties involved to start talking about it until we're real clear about what happened," says Robert McCartney, V.P. of Behavioral Health for ECMC. ECMC is still investigating the incident and sources tell Eyewitness News the attack happened on the 11th floor in the psychiatric unit with the nurse suffering minor injuries. This follows another attack about a month ago at the hospital. In that case a patient allegedly punched a nurse in the head, choked her, and hit her with a telephone causing serious injuries. After that attack ECMC made some changes. "In the last month we've added more staff and we've also added 24 hours security on the floors and in addition to that we are continuing to move forward on the development of our more intensive care program for patients who are more agitated, more aggressive," says McCartney. Within the next two weeks ECMC also plans to implement an enhanced "panic alarm" system. "Those involved with drug patient care on the unit will carry a panic alarm button with them and when they push the button the alarm will sound at the nurses station and then immediately in our police station here at ECMC," explains McCartney. Hospital administrators say the need for increased security measures is not unique to ECMC or even hospitals in general."If you look throughout the whole country, you look in our schools, you look in workplace, you are seeing an increase in violence everywhere," says McCartney. McCartney says the hospital is working closely with the nurses unions on improving safety. Eyewitness News reached out to the nurses unions for comment for this story but we had not heard back from them as of Tuesday evening.

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HEALTHDAY - ALLERGY RESPIRATORY Oct 21, 2013 9:00 AM by Mary Elizabeth Dallas Fewer Infants Hospitalized for Whooping Cough, Study Finds MONDAY, Oct. 21 (HealthDay News) -- Widespread vaccination of teens against whooping cough has resulted in fewer U.S. infants being hospitalized for the respiratory infection, also known as pertussis, according to a new study. The researchers said their findings highlight the importance of raising vaccination rates among teens and adults to end the ongoing whooping cough epidemic among infants. Waning immunity and failure to vaccinate have been associated with the epidemic. In 2006, the U.S. Centers for Disease Control and Prevention recommended that all teens be vaccinated against whooping cough. At that time, the researchers began examining hospitalization rates for infants with the infection. Using hospitalization data collected between 2000 and 2005, they also estimated what hospitalization rates for infants would have been if the teen whooping cough vaccination program had not been implemented. "We know infants get pertussis from family members, including older siblings," study lead author Dr. Katherine Auger, a pediatrician in the division of hospital medicine at Cincinnati Children's Hospital Medical Center, said in a medical center news release. The new study, published Oct. 21 in the journal Pediatrics, revealed lower hospitalization rates than would have been expected for three of the four years reviewed after the teen vaccination recommendation was made. From 2008 to 2011, there were about 3.3 hospitalizations per 10,000 infants. If the teen vaccination recommendation had not been made, the researchers estimated there would have been 12 hospitalizations per 10,000 infants. "While it is encouraging to find a modest reduction in infant hospitalizations after the vaccination of adolescents began, there were still more than 1,000 infants hospitalized for pertussis in 2011," Augur said. "Expecting parents should discuss with their doctors the need for vaccination of all caregivers before the birth of a baby." In 2012, the CDC recommended that pregnant women also receive the whooping cough vaccine. The researchers said future research is needed to determine how this change will further affect whooping cough hospitalization rates among infants. More information The American Academy of Pediatrics provides more information on whooping cough. »Comments Top Videos

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Medical Record Snooping on the Rise Apparently, snooping around in medical records as opposed to stealing them is also on the rise as 14 more people affiliated with UCLA Medical Center are discovered trying to find out about their favorite celebrity, both inside and out. According to information contained in a recent report by the California Department of Public Health, which was cited in a recent article in the Los Angeles Times, the number of current and former UCLA Medical Center workers implicated in the snooping has risen to 68. One of the biggest offenders of the criminally curious not only looked at the records of friends and peers, but also celebrities such as Britney Spears and Farrah Fawcett. More than 13 others at UCLA peeked at Spears' medical records between July 2006 and May 2007 according to state inspectors. The longtime UCLA administrative specialist who tops the list in snooping was found to have a history of improperly accessing records and ultimately resigned after the latest incidents, which were brought to light by a complaint from Fawcett. The administrative specialist, who says she was just being nosy, was recently indicted by a federal grand jury for allegedly selling information to the news media. UCLA officials have appointed a committee to review privacy policies, institute staff retraining and improve computer systems to increase security. Copyright 2008 Nelson Publishing, 2500 Tamiami Trail North, Nokomis, FL 34275

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Report ProfileReport ThisAsk A Question American Autoimmune Related Diseases Association 20 Answers58 Followers754 Helpful Answer Votes FollowFollowingUnfollow Telephone:Address: 586-776-390022100 Gratiot Ave East Detroit, MI 48021 Organization website: www.aarda.org The American Autoimmune Related Diseases Association is dedicated to the eradication of autoimmune diseases and the alleviation of suffering and the socioeconomic impact of autoimmunity through fostering and facilitating collaboration in the areas of education, public awareness, research, and patient services in an effective, ethical and efficient manner. AARDA is the only national nonprofit health agency dedicated to bringing a national focus to autoimmunity, the major cause of serious chronic diseases. Approximately 50 million Americans, 20 percent of the population or one in five people, suffer from autoimmune diseases. Women are more likely than men to be affected; some estimates say that 75 percent of those affected--some 30 million people--are women. Still, with these statistics, autoimmunity is rarely discussed as a women's health issue. Facebook What does “immune system” mean? Your immune system is a group of cells and organs which is designed to protect your body from outside invaders.Your immune system includes your... How does your immune system work? When your immune system works the way it should, it can tell the difference between “good” cells that keep you healthy and “bad” cells that make you... What is autoimmunity? Sometimes the immune system can mistake your body's own cells as germs and will attack them. This attack can affect almost any part of the body... What causes autoimmune disease? Autoimmune diseases usually do not usually have a simple, single cause. There are usually two major factors that are involved in causing them:... Does autoimmune disease run in families? Autoimmune diseases are not typical “genetic” diseases like, for instance, sickle cell anemia, where there is a specific gene mutation. With... Who is affected by autoimmune disease? Over 75% of those affected are women. Different ethnic groups are more susceptible to certain autoimmune diseases. In lupus, for example, African... Do men get autoimmune disease? Millions of men suffer from these diseases, too. Sometimes, autoimmune diseases that develop in men tend to be more severe. There are a few... Can you have more than one autoimmune disease? Yes, overlapping genetic traits increase susceptibility to many of the diseases, so that someone can suffer from more than one autoimmune disease. What types of autoimmune diseases are there? Autoimmune diseases can affect the entire body (called systemic) or they can affect one part of the body (localized).Systemic autoimmune diseases... What is rheumatic autoimmune disease? A rheumatic autoimmune disease is defined as a disease characterized by inflammation, soreness and stiffness of muscles, and pain in the joints which... What type of doctor treats rheumatic autoimmune disease? An internist or primary care physician is often able to treat uncomplicated autoimmune disease. But with the advent of new therapies, specifically... Lupus is a chronic autoimmune disease in which the body immune system, instead of serving its normal protective function, forms antibodies that... Scleroderma is a chronic autoimmune disease that involves the skin and connective tissue. There are two types, localized and systemic. In the... What is Chronic Fatigue Syndrome? Chronic fatigue syndrome (CFS) is NOT an autoimmune disease. It is included here because the symptoms of fatigue, muscle pain, and depression are... What is vitiligo? Vitiligo is an autoimmune skin disease in which the absence of melanocytes (pigment-producing cells) causes a decreased pigmentation in the skin... 1-15 of 20 Answers Explore More Organizations on WebMD Answers

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Underage Drinking Discussed at Meeting Written by Karen Gellender Friday, 09 April 2010 00:00 Calling underage drinking a serious issue would be a gross understatement; in addition to serving as a causal factor for a host of debilitating and potentially deadly conditions, underage drinking costs residents of New York state billions of dollars in medical costs and lost work hours. Central Nassau Guidance and Counseling Services Inc. recently presented a special program entitled “Underage Drinking in Our Community,” to educate more people about the true risks that underage drinking presents. While parents and teachers do make some effort to discourage teens from drinking, from the information provided at the meeting, not nearly enough is being done.One factor that may lead to complacency on the part of parents and other authority figures is the cultural perception of alcoholics; people may not consider teens to be at risk unless they start to receive poor grades, or spend a lot of time outside of the home without explanation. However, the idea that any teen is necessarily safe from drinking was shattered by the testimony of “Sid,” a community member whose experiences as a teen may seem disturbingly familiar to many parents on Long Island. A consistent straight-A student, Sid started drinking in order to deal with his shyness, and found he didn’t want to stop. During college, Sid’s drinking problem was reinforced by the drinking-heavy culture of upstate New York and reached new lows, including a trip to the hospital, where he was assumed dead for a brief period before his vitals came back on-line. Nevertheless, Sid was still able to perform well in school. Years later, Sid was able to maintain a steady job while drinking heavily. Eventually, Sid realized that his life was worth more than drinking and is currently sober, but not before the tragic loss of his wife and son.Sid’s story highlighted the fact that even teens who seem to take everything in stride will sometimes start drinking; his experience is also especially relevant for local parents who intend to send their kids upstate for college. Academic merits aside, the amount of drinking that takes place at schools in upstate New York (and many other nearby areas) is notorious. Even teens who have no intention of drinking will be exposed to frequent opportunities to start doing so. At the meeting, some of the conventional wisdom about dealing with teens was criticized “It’s not about lecturing, it’s about talking,” said Lisa Kessler, director of the Community program at Central Nassau. All of the speakers emphasized the importance of promoting positive, fun activities for teens rather than expressly forbidding behavior. “If you tell a kid “no,” chances are they’re going to go do whatever it was you just told them not to do,” commented Sid. Everyone agreed that putting up posters in schools with phrases like “Don’t Drink,” and other traditional tactics, was ineffectual. “When you put a no on something, kids don’t see the ‘no’- they ignore it,” commented Barbara Bartell, LCSW and CEO of Central Nassau. “That’s why ‘Say No To Drugs’ never worked.”However, the emphasis on positive reinforcement does not mean that there is no place for discipline. In the end, there is no substitute for simply knowing what your teen is up to. “You’re their parents, not their best friend,” said Kessler. While encouraging teens to pursue their interests in the form of hobbies and clubs can do a lot to lower the risk of underage drinking, parental involvement is a huge factor in preventing kids from drinking; not only are kids with active parents less likely to drink, but if they start, it’s much more likely that the early warning signs of a drinking problem will be noticed.If you know that a teen is drinking but are not in a position of authority, confronting them is not the answer, according to the information presented at the program. Instead, tell a parent, teacher, or school administrator if applicable. The soundest advice may fall on deaf ears when coming from an individual. “You can’t make them be ready, the person has to be ready themselves,” added Sid, who suggested that telling an authority figure helps to set up a dedicated support network, which will then have the influence and resources to make a difference.If you’d like to learn more about how to protect the children and teens in your life from underage drinking, you can get in touch with the Central Nassau Guidance and Counseling Services through their website at www.CentralNassau.org. The organization was recently awarded the first “Nonprofit Organization of the Year” award from the Hicksville Chamber of Commerce.

医学

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Tag Archives: Too Little Salt as Bad as Too Much Salt When it comes to salt, too little may be just as bad as too much We know that high levels of sodium in our food supply are a serious problem. As also know that most of the sodium we consume daily isn’t coming from the salt shakers on our kitchen tables. Instead sodium resides in the myriad of processed foods residing on our grocery store shelves. High salt intake is in the news often with reports of a variety of health problems that can result from a high-sodium diet. But now, it appears that too little daily sodium might be bad for us too. If the body takes in too much salt, there is a higher risk of hypertension, kidney problems, heart failure, stroke, and heart attacks. In a study focused on the effects of salt on blood pressure, nutritionists found out that those with moderate salt intake did not benefit from lessening their salt consumption as much as those who have high salt intake did. In another study that focused on heart disease and death, researchers concluded that those with extremely low salt diets are not necessarily healthier. In fact, they said that extremely low salt intake can lead to health hazards. A third study, however, said that there is a connection between less salt intake and better health. All three studies were published on the August 14 issue of the New England Journal of Medicine. According to the American Heart Association (AHA), it is recommended that a person consume less than 1,500 mg of sodium per day, TIME reports. To have an idea, a teaspoon of salt has about 2,300 mg of sodium. One of the things that all three studies have in common is that they all confirm that too much salt is indeed bad for the body. New York Daily News reports that the average daily consumption of salt worldwide is about 7.5 to 15.0 grams, which translates to three to six grams of sodium. The number is well above the limit of 1.5 to 2.4 grams of sodium that is recommended by different organizations. Dr. Andrew Mente of the McMaster University in Ontario and the chief author of the blood pressure study said: “If people are eating a very high level of sodium and they reduce their intake, you get a large reduction in blood pressure. But if you’re eating moderate level of sodium—about what most North Americans eat—and you reduce it to a lower level, you’re not really getting much in return as far as blood pressure reduction is concerned.” With the debate on salt still ongoing, one thing is for sure. The average salt intake worldwide is more than the recommended amount, and it should be changed. Dr. Dariush Mozaffarian of the Friedman School of Nutrition Science and Politcy at Tufts University said: “The big picture is that high sodium is bad and should be reversed, and there’s just some controversy over how low you should go. Whether it should be 2 grams or 1.5 grams or 2.5 grams per day, that’s all theory. Right now it’s close to 4 grams per day. Let’s get it down below 3, and the we can argue how low it should go. But right now it’s clearly way too high.” FoodFacts.com understands that the debate over the “perfect” amount of sodium we should consume daily may not yet be agreed upon by the experts. And while we understand the importance of that debate – especially in light of these new studies – we strongly believe and advocate for the preparation of fresh, whole foods at home in our own kitchens. The less we rely on processed products, the easier it will be for all of us to achieve a perfect balance of sodium in our daily diets. http://www.inquisitr.com/1416601/salt-debate-too-little-salt-is-bad-too/#rQYF8IxstfDLzbU4.99 This entry was posted in Healthy Diet, healthy eating, Healthy Habits, Healthy Lifestyle, High Salt Diets, salt, sodium and tagged food facts, Lower Sodium Intake but not too much, nutrition data, nutrition facts, nutritional information, Too Little Salt as Bad as Too Much Salt, Too Little Salt Causes Health Problems on August 18, 2014 by LuanneBannon. Search for:

医学

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« Fear and frustration as Guinea struggles to contain Ebola outbreak | | Mali suspects first Ebola cases as regional death toll tops 90 » Hong Kong: CHP reports imported H7N9 case Pulling away from Ebola for a moment, the Centre for Health Protection has issued a news release: Imported human case of avian influenza A(H7N9) under CHP investigation. Excerpt: The Centre for Health Protection (CHP) of the Department of Health (DH) is today (April 4) investigating an imported human case of avian influenza A(H7N9) affecting a man aged 65. The patient, with underlying illnesses, lives in Longgang, Shenzhen alone. He developed fever, cough, blood-stained sputum and diarrhoea on March 31 in Shenzhen. His symptoms persisted and he was found to have fever and sore throat upon arrival in Hong Kong at Lo Wu Control Point on April 3 afternoon. He was directly transferred to the Accident and Emergency Department of North District Hospital (NDH) by ambulance and was admitted for management on the same day. The clinical diagnosis was pneumonia. His sputum specimen was tested positive for avian influenza A(H7N9) virus upon laboratory testing by the CHP's Public Health Laboratory Services Branch this evening. The patient is currently isolated in Princess Margaret Hospital under treatment in stable condition. Initial epidemiological investigation revealed that he had recently bought slaughtered pigeons from a wet market near his residence in Shenzhen. The CHP's investigations and contact tracing are ongoing. So far, there are no close contacts identified while other contacts including relevant healthcare workers, ambulance staff, and officers at Lo Wu Control Point will be traced for exposure assessment and medical surveillance. April 04, 2014 at 07:53 AM in Animal to human diseases, H7N9 | Permalink

医学

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HomeDonateAbout UsAn Evening of ThanksStories & InterviewsCare ConsultationsDepressionTeens/KidsWorkplaceTrainingsVolunteerResourcesBooksMemoirsBooks for TeensBooks for FamiliesBooks for ProfessionalsLinksPodcastsGet HelpCare For Your MindPublications & WorkshopsBlogToolsContact Us PDF | Print | E-mail When Art was diagnosed with multiple sclerosis in the summer of 2000, it didn't take the energetic entrepreneur and software engineer long to swing into action. Frustrated by the slow progress toward a cure, Art founded the Accelerated Cure Project to identify research needs and serve as a repository for information about Multiple Sclerosis. "My one word to describe myself is 'passionate,'" he says. "I was always up, always energized about something. If a barrier was put up, I could just bounce through it, around it or over it." But in the months following his MS diagnosis, he found his passion waning. He started declining invitations for him and his wife Debbie to socialize with friends and spent increasing amounts of time surfing the Internet. Debbie noticed he would sit on the couch and stare into space, something he wasn't likely to do before. He occasionally had thoughts of suicide. "But I wasn't really noticing," he says. "One day Debbie said, 'I can't take it anymore; you're so depressed.' "She really snapped it into focus," he says. "It was like, 'Oh yeah, I didn't used to be like this.' But my depression prevented me from wanting to fix the problem. That's when I decided to talk to my neurologist about it." People with MS experience higher rates of depression than the general population. Scientists aren't sure exactly why, although evidence points to multiple factors, including physiological effects of the disease on the central nervous system; the psychological impact of living with a chronic, often debilitating condition; MS medication side effects and sleep disturbances. Although Art has a history of depression in his family, he hadn't experienced it himself until he began taking an interferon-based drug soon after his MS diagnosis. Interferon is known to cause depression in some patients. His neurologist prescribed an anti-depressant, one that had worked for a relative of Art's. It helps, but he still has spells of depression, only they're not continuous. Debbie says she first noticed that Art's "spark" was missing. "I just looked at Art and realized something had changed," she says. Depression raised a lot of emotions for her as well. "I felt frustration." Prior to his diagnosis, she attributed his lack of interest in their usual social activities as being uncooperative or difficult. Now that she has a better understanding, she often feels anger at the situation, but sadness for Art. "You hate to see the person you love in pain." She says she stops short of feeling resentment. "I think we give depression the credit it deserves. We don't push it. If Art doesn't feel like doing something, we don't do it." In addition to taking his medication, Art says he has learned to recognize the signs that he's going into a depressive state. "I recommend using a structured approach to monitoring your depression, especially when you are first getting a handle on it," says Art. "For example, the Families for Depression Awareness Adult Depression Wellness Guide, has an excellent section on monitoring with sample worksheets." Today, when he identifies a change in how he's feeling, he warns his wife and tells himself that it's going to go away in a few days or weeks. "It seems weird to think I didn't notice, but in the beginning, I just couldn't tell when it was happening." In addition to monitoring his mood, Art has also found that keeping a seven-day pillbox next to his bed helps him maintain his medication regimen. "I was bad about forgetting before I started doing that. I'd forget for several days and then feel really bad." Debbie says she is grateful for his high level of self-awareness and how direct they can be with each other. "As soon as I raise the question, 'Are you feeling depressed?', he's very quick to acknowledge that, 'Yes, this is the depression I'm feeling; it's not directed toward you." For Art, the hardest part about depression has been "accepting that it's not something I can use willpower to push through; it's not like being sore or tired or stressed out." At times he is fearful about the future. "I feel like it's turning me into a different person and not necessarily a person I would like. I'm concerned about how my relationships will be impacted if I'm not me--or who I consider me to be."

医学

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HomeDonateAbout UsAn Evening of ThanksStories & InterviewsCare ConsultationsDepressionTypes of DepressionSymptoms of DepressionCoping after a TragedyHelp Someone Who Has DepressionTeens/KidsWorkplaceTrainingsVolunteerResourcesPodcastsGet HelpCare For Your MindPublications & WorkshopsBlogToolsContact Us Cassandra: Age 19, Major Depression, with mother Cassandra was in the seventh grade when she first experienced major depression. "I was in a really low mood all the time," she recalls. "I liked school. I had a nice group of friends. My home life was good. But, I was depressed. Nothing had happened to trigger it, which was the worst part. I put on a really good front, so nobody knew anything was wrong. I was very good at hiding my feelings." In an attempt to reduce her pain, Cassandra started cutting. "The first time I self-injured, I thought this is gonna be trouble. I never used drugs or alcohol, but I continued cutting throughout seventh grade and kept it a secret from everyone." Soon, Cassandra's arms and legs were etched with small, blood-stained slashes, while her inner turmoil worsened. To everyone else though, she continued to appear well adjusted. Her friends came to her with their problems because she had good advice. Her teachers, even her family, were unaware of her pain. Then, Cassandra's little sister started asking questions. After Cassandra told her about what she was going through, her sister told her parents. "I was partly relieved and partly not," Cassandra remembers. "I was glad my parents knew, but I was scared, too." Cassandra's parents immediately sought treatment for their daughter. Cassandra learned an approach called dialectical behavioral therapy (DBT). "Before I learned DBT, I thought cutting was helping me, but it wasn't," Cassandra says. "It was making everything ten times worse. I had to hide from everyone and lead a double-life. When I was depressed, I didn't think I was going to make it. I couldn't see the future. Now, I'm excited about school. I'm especially excited about helping people and easing their pain. When I have a bad day, I feel more confident because I have skills I can use and I also have a support system. My parents have been very supportive." Another positive step Cassandra has taken is volunteering to help young people recognize depression, as a teen speaker for Families for Depression Awareness. Cassandra has spoken in front of groups of students in high school health classes and at parents' forums in the Boston area. "I feel good telling my story because I like helping other people. I wish someone had come into my school and told me about depression and cutting when I was in high school so I could have known what to do." "Learning DBT skills is hard at first," explains Cassandra. "But after a while, they become second nature. I'm learning to recognize negative situations instead of being overwhelmed by them or hiding from them. Another skill I learned is to ask for what I need by talking to someone or calling my therapist. A skill I like a lot is called opposite-to-emotion-action. You do something you are totally not in the mood to do, like go to the movies when you want to stay home and be alone. I use that skill a lot." Today, Cassandra is a freshman in college. She hasn't been depressed in a while and hasn't relapsed in over a year. She continues to work with her therapist and says that she is "pretty happy right now." Cassandra's mom, Leslie, says parents need to know that they aren't alone. "Hang in there. Persevere. There is a light at the end of the tunnel," she says. "It's not about feeling guilty. There's no blame involved. It's not your fault or your kid's fault. It's about acceptance, understanding, and listening. I have five kids and I think that gives me a pretty good overview. I think people are born with or have a predisposition to mental illness. Having a support system is vitally important. Families for Depression Awareness is a great starting point."

医学

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Ravi Kalhan, MD Ravi Kalhan, MD, MS is an Assistant Professor of Medicine at Northwestern University Feinberg School of Medicine and Director of the Northwestern Asthma and Chronic Obstructive Pulmonary Disease (COPD) Program where comprehensive care is provided to patients with asthma and COPD at all stages of severity. Dr. Kalhan additionally serves as director of the Alpha-1-Antitrypsin Deficiency Clinical Resource Center at Northwestern. Dr. Kalhan attended college at Brown University in Providence, RI where he majored in modern American history. He subsequently entered medical school at Case Western Reserve University School of Medicine and completed his internal medicine residency at the Hospital of the University of Pennsylvania. He then came to Chicago where he pursued his fellowship training in Pulmonary and Critical Care Medicine at Northwestern Memorial Hospital, and has been on the Northwestern faculty since 2006. Dr. Kalhan's clinical interests are in the care of patients with both asthma and COPD as well as alpha-1-antitrypsin deficiency. His research interests relate to respiratory epidemiology, in particular identification of early risk factors that impact the vulnerability of certain cigarette smokers to develop COPD. He is also involved in clinical trials of new therapies for both asthma and COPD. Case Western Reserve University School of Medicine - 2000 Hospital of the University of Pennsylvania - 2003 Northwestern Mcgaw / Northwestern Memorial Hospital - 2006 http://www.nm.org/ 675 N. St. Clair Galter 18-250 Alpha - 1 Antitrypsin Deficiency Emphysema (COPD) Obstructive Airway Disease

医学

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Ending Homelessness for Veterans and their Families: the Importance of SSVF HomePopulationVeteransVeteran Homelessness In FocusEnding Homelessness for Veterans and their Families: the Importance of SSVF As agencies across the federal government accelerate their work towards the 2015 goal of ending homelessness among Veterans, the Department of Veterans Affairs (VA) has increased its investment in services for Veterans and their families with a tripling of funding in the Supportive Services for Veteran Families program. Supportive Services for Veteran Families (SSVF) is the only program administered by VA that awards grants to local non-profit organizations to provide services and cash assistance not only to Veterans, but to their families as well. Unlike most services provided by VA, an individual only needs to have served in the military one day to qualify for services and not have a dishonorable discharge. SSVF is crucial in filling gaps in services funding for Veterans that other VA programs are not able to fund, helping to move Veterans permanently out of homelessness in a faster and more efficient way. VA is presently accepting applications from community-based organizations with the expectation of awarding up to $300 million in grants in 2013 (an increase from $100 million in 2012). While between ten percent and 30 percent of all homeless Veterans meet the federal definition of chronic homelessness, most homeless Veterans leave homelessness in less than one year. Some preliminary data reports that one third of all homeless Veterans leave homelessness within 30 days.The strong investment in permanent housing vouchers (via the HUD-VASH program) has helped to provide a successful exit for Veterans who have extensive homeless histories as well as histories of mental illness and substance abuse. SSVF can be a flexible service line to support Veterans who can more quickly get back on their feet and to prevent them from becoming chronically homeless. During this important time in the SSVF application process for potential grantees and with an increased focus on this program because of the large increase in investment for next year, it is important that we highlight successful SSVF programs that may spark innovations and collaborations for other communities across the country. An example of a successful SSVF program is Southwest Solutions in Wayne County, Michigan. Southwest Solutions has been serving people living with mental illness and in poverty since 1970. The agency grew out of the vision of Monsignor Clement Kern, a visionary leader in the Detroit area who passionately advocated for the improvement in the conditions of people living with mental illness and poverty. Southwest Solutions provides direct service through its Southwest Counseling (SWCS) agency and has provided housing services through Southwest Housing Corporation since 1979. Southwest Solutions received funding as an SSVF provider two years ago and received approximately one million dollars in 2012 with the expectation of serving 450 Veterans. Since 2010, SWCS has provided a diverse array of services for Veterans. In addition to cash assistance to provide move-in costs and rent stabilization, SWCS provides services as diverse as funding for car repair, substance abuse treatment, skills building, job training, and case management. In the past year, SWCS has served 467 families at a cost of about $900 per family. More than 70 percent of the services provided have been rapid re-housing, an intervention that has proven successful at stabilizing families as evidenced by the outcomes among rapid-rehousing programs funded through the Homeless Prevention and Rapid Rehousing Program at HUD. For those living unsheltered with longer-term homelessness, Southwest Solutions workers with an outreach model based on harm reduction principles that uses a “snowball” recruiting method, following the word of Veterans to find other Veterans wherever they may be. Southwest Solutions staff also attend and engage Veterans during Stand-Down events in the area. Because of the variety of services offered, the organization is able to assist families who may only need short-term assistance to get back on their feet while also reaching out to and serving Veterans who have greater barriers to stability. SWCS employs two senior level social workers and six outreach and engagement case managers. Southwest Solutions staff actively search out Veterans under bridges and in abandoned houses. “Because of the collapse of the housing market in Detroit,” many Veterans are moving into run-down, abandoned buildings,” says Jamie Ebaugh, Director of the Housing Resource Center for Southwest Solutions. While squatting in abandon homes has allowed some homeless Veterans to escape the full brunt of living unsheltered, it has only further marginalized people with mental illness who could benefit from support and treatment because they are more difficult to locate, with hundreds of abandoned buildings in the city. Southwest Solutions staff actively engage people living on the streets or in abandoned buildings to assist them into decent, supported housing so that they can have the dignity and respect they deserve. SWCS staff also collaborates with VA staff, with frequent joint training and case conferencing. Referrals are a two-way street between SWCS and the local Veterans Affairs Medical Center (VAMC) where clients go from SWCS to the VAMC for medical care, benefits and enrollment into HUD-VASH, and VAMC refers people to SWCS for assistance with down payment for permanent housing, stabilization services, prevention, and rapid re-housing services. The two-way street is made possible by having leadership of both institutions committed to fostering the relationship and having a strong agreement on the foundation of practice, including employing a Housing First model throughout their programs. In addition to assisting Veterans to access VA benefits, Southwest Solutions has actively supported Veterans to access mainstream government resources such as Medicaid and Social Security payments for Veterans that qualify for these services. In addition, SWCS participates in the local Continuum of Care process so that mainstream housing resources are available for Veterans who cannot qualify for VA services. Tapping into mainstream services is a key function expected of SSVF grantees to leverage the funding coming from the VA and further expand the impact of these services. Southwest Solutions also regularly meets with the local Grant and Per Diem (GPD) providers, to assist Veterans in finding permanent housing as they are exiting these programs, capitalizing on the improvement in their substance use disorders achieved during treatment in a GPD program to a successful transition to permanent housing. Overall, Southwest Solutions is an example of an agency that has taken its initial mission and expanded its reach to serve Veterans and their families. Southwest Solutions has the diversity of services so that it can leverage mainstream resources and be flexible enough to respond to the changes in the local economy. While also working with chronically homeless Veterans who are able to leave homelessness using HUD-VASH, Southwest Solutions uses the SSVF funding to attend to the needs of people who have relatively brief periods of homelessness and prevent a brief episode of homelessness from becoming a long-term crisis. At present, VA is accepting applications for the SSVF program, with the deadline for applications on February 1, 2013. New and established providers are encouraged to apply as the federal investment in this program is greater than ever. With this increased investment there is an outstanding opportunity for traditional Continuum of Care providers to participate in services working with Veterans and to bring their expertise to this population, further integrating services and intervention models across the spectrum of homeless individuals and families.

医学

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Invasive heart test being dramatically overused, study shows An invasive heart test used routinely to measure heart function is being dramatically overused, especially among patients who recently underwent similar, more effective tests, according to a new study from the Stanford University School of Medicine. "This adds both risk to the patient and significant extra cost," said first author of the study Ronald Witteles, MD, assistant professor of cardiovascular medicine and program director of Stanford's internal medicine residency training program, who called the rates of unnecessary use "shockingly high." The procedure, called left ventriculography or left ventriculogram, was developed 50 years ago to assess how well the heart functions by using a measurement method called "ejection fraction" — the percentage of blood that gets squeezed out with each heartbeat. The investigators found that it is routinely performed as an add-on procedure during a coronary angiogram, a separate heart-imaging test, at an extra cost of $300. Over the years, several less-invasive and often superior methods of measuring ejection fraction have emerged, such as echocardiograms and nuclear cardiac imaging, making the use of left ventriculography questionable at times, the study states. The study appears online this month in the American Heart Journal. Several years ago when Witteles was a cardiac fellow, he and his colleagues noticed a great deal of variation in whether cardiologists would order the procedure, often in similar patient cases, he said. This seemingly arbitrary use of left ventriculography led to the idea for this study. Researchers first set out to determine exactly how often the procedure was conducted. They examined a national database of about 96,000 patients enrolled in Aetna health benefits plans in 2007 who underwent a coronary angiogram during that year. The data showed left ventriculography was performed 81.8 percent of the time whenever an angiogram was done — a surprisingly high rate, Witteles said. Next, they wanted to determine how high that figure was in a population of patients for whom it would almost never be medically justified to perform the procedure. So they looked at those patients who had very recently — within the 30 days prior to having a coronary angiogram — undergone another imaging study that would have given practitioners the same, and usually better-quality, information. (They excluded patients who had intervening diagnoses of new problems during those 30 days, such as heart failure, heart attack or shock.) Among the remaining 37,000 patients, the researchers found that not only did the majority still get the unnecessary left ventriculography procedure, but the rate actually jumped to 88 percent. "If a patient recently had an echocardiogram or a nuclear study, it didn't make them less likely to have the left ventriculography procedure — it made them more likely," Witteles said. "That is impossible to explain from a medical justification standpoint. "It is extremely unusual, in these types of cases, to need another assessment. The only logical conclusion is that a practice pattern is being defined in which tests beget more tests, whether they're necessary or not. It would be bad enough if the figure stayed at 81 percent, but our findings showed that it went up." Even more concerning than the added costs are the medical risks from performing an unnecessary procedure. For left ventriculography, this can include side effects from injecting contrast dye (which can be particularly harmful for patients with kidney dysfunction or diabetes), increased radiation exposure and an increased risk of abnormal heart rhythms and stroke. During a coronary angiogram, a catheter is threaded through the blood vessels to the heart, contrast dye is inserted and X-rays are taken. The add-on left ventriculography procedure involves moving the catheter across the aortic valve of the heart and inserting another dose of contrast dye. This allows visualization of the left ventricle and its contractions. "The biggest downside is that the catheter goes across the valve into the heart," Witteles said. "There's always a risk of dislodging a blood clot, causing a stroke. The procedure only takes five minutes, but it increases the risk of arrhythmias. And then there is the added cost. But the real big-picture issue is how often an unnecessary, invasive test is being routinely ordered." Women at higher risk than men of kidney damage after heart imaging test Women are at higher risk than men of developing kidney damage after undergoing a coronary angiogram, according to a Henry Ford Hospital study. New tool could prevent needless stents and save money, cardiologist says Doctors may be implanting too many artery-opening stents and could improve patient outcomes — and ultimately save lives — if they did more in-depth measurements of blood flow in the vessels to the heart. That's the finding ... New test for coronary artery disease linked to higher rates of cardiac procedures and greater costs A new, noninvasive diagnostic test for coronary artery disease is associated with a higher rate of subsequent invasive cardiac procedures and higher health-care spending. That's according to an observational study of Medicare ... New heart scan may speed up diagnosis with less radiation New technology appears to provide faster, more accurate heart scans for both viewing blood vessels in the heart and measuring blood supply to the heart muscle, while exposing patients to less radiation, researchers report ... Heart scan could replace angiogram for some patients A study published today in the journal Circulation showed that a cardiac magnetic resonance (CMR) scan is as accurate as an angiogram in diagnosing the causes of heart failure in patients with dilated cardiomyopathy. The ... Good news, bad news: The amount of trans fats we eat has declined over the last 30 years, but we're still consuming more than recommended. A large international clinical trial has shed new light on the effectiveness of current hospital protocols for managing blood pressure in stroke patients. ASHG: MI without substantial CAD is minimally heritable (HealthDay)—The presence of myocardial infarction (MI) without substantial coronary artery disease (CAD) is not familial, according to a study presented at the annual meeting of the American Society of ... Study suggests a novel approach for treating non-cardiac chest pain Chest pain doesn't necessarily come from the heart. An estimated 200,000 Americans each year experience non-cardiac chest pain, which in addition to pain can involve painful swallowing, discomfort and anxiety. Non-cardiac ... Novel bi-directional cannula that prevents severe complications following cardiac surgery A novel bi-directional cannula that prevents severe complications following cardiac surgery has been developed by School of Clinical Sciences' Mr Randall Moshinsky. New treatment for inherited cholesterol At the London Olympics in 2012, South African swimmer Cameron van den Burgh dedicated his world record-breaking win in the 100m breast stroke to one of his biggest rivals and closest friends, Alexander Dale ...

医学

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Biomarkers for antidepressant treatment response (Medical Xpress)—Researchers from King's College London's Institute of Psychiatry (IoP) have identified new biomarkers for antidepressant treatment response, an important step towards developing personalised treatments for depression. The study, published today in Neuropsychopharmacology, is the first to identify blood biomarkers for antidepressant response in a clinical controlled study and is part of Genome-Based Therapeutic Drugs for Depression (GENDEP) project. Professor Carmine Pariante, lead author of the study at the IoP at King's says: 'We've identified biomarkers in the blood which could help identify individuals less likely to respond to basic antidepressant treatment. This is a small study, but the findings are promising. Personalised treatments for depression could help us avoid the current 'trial and error' way of prescribing antidepressant medication. 'The study confirms previous evidence that increased inflammation is part of the mechanism leading to depression, especially to particular forms of depression that are less responsive to antidepressants. The study shows that we could use a blood-based "test" to personalise the treatment of depression. If a patient had high levels of inflammation, they could immediately begin with a more intensive treatment programme, such as combining antidepressants or stepping up the doses.' Researchers aimed to identify two types of biomarkers: ones which could predict future response to antidepressant treatment (predictors), and others which are targeted by antidepressants and change over the course of treatment (targets). Within human cells, information from genes is transcribed into m-RNA before the effect is visible as a physical or biochemical characteristic. Previous research has shown that depression interferes with three key biological systems: the glucocorticoid receptor (GR) complex, inflammation levels and neuroplasticity. The researchers therefore monitored how mRNA was produced for 15 specific genes linked to these three systems. The study involved 74 depressed patients. Their levels of mRNA expression were tested before and after 8 weeks of treatment with either escitalopram (n=38) or nortriptyline (n=36). Escitalopram, a serotonin reuptake inhibitor and nortriptyline, a tricyclic antidepressant, are both commonly prescribed first line antidepressant treatments in the UK. Individuals who did not respond well to treatment displayed significantly higher levels of three inflammation markers before treatment (IL-1B +33%; MIF +48% and TNF-a +39%), suggesting that these three biomarkers could be used to identify individuals who are least likely to respond to antidepressant treatment. Individuals who underwent successful antidepressant treatment displayed reduced levels of inflammation (IL-6 -9%) and GR function (FKBP5 -11%) markers and higher levels of neuroplasticity markers (BNDF +48% and VGF +20%). These 'target' markers are different from the 'predictor' markers, suggesting that antidepressants do not adequately target the high levels of inflammation displayed in hard to treat individuals. Professor Pariante adds: 'Additionally, these findings provide novel mechanistic insight into mRNA gene expression changes associated with antidepressant response which is likely to generate new ideas for novel and more effective antidepressants.' More information: Cattaneo, A et al. 'Candidate gene expression profile associated with antidepressants response in the GENDEP study: differentiating between baseline "predictors" and longitudinal "targets"' Neuropsychopharmacology (19th September) doi: 10.1038/npp.2012.191 Journal reference: Neuropsychopharmacology Are older antidepressants better for depression in Parkinson's disease? A new study shows that antidepressant drugs which only affect serotonin, often used as first choice treatments, may not be best for depression in people with Parkinson's disease. The new research is published in the December ... Popular antidepressant associated with a dramatic increase in suicidal thoughts amongst men Nortriptyline has been found to cause a ten-fold increase in suicidal thoughts in men when compared to its competitor escitalopram. These findings are published in the open access journal BMC Medicine. Dual medications for depression increases costs, side effects with no benefit to patients Taking two medications for depression does not hasten recovery from the condition that affects 19 million Americans each year, researchers at UT Southwestern Medical Center have found in a national study. New study replicates association between genetic variation and antidepressant treatment response Pharmacogenetics, the study of genetic variation that influences an individual's response to drugs, is an important and growing focus in all of medical research, including psychiatry. It is a complex field, however, revealed ... Ibuprofen, aspirin, other anti-inflammatory drugs reduce effectiveness of SSRI antidepressants Scientists at the Fisher Center for Alzheimer's Disease Research at The Rockefeller University, led by Paul Greengard, Ph.D., and Jennifer Warner-Schmidt, Ph.D., have shown that anti-inflammatory drugs, which include ibuprofen, ...

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Program in Neurodevelopment and Regeneration Participating Departments Hanna E Stevens MD PhD Assistant Professor in the Child Study Center; Associate Director, Albert J. Solnit Integrated Training Program Biographical InfoHanna Stevens joined the faculty of the Child Study Center in 2010. She is currently directing a program of research on model systems of early brain development. She is particularly interested in the impact of prenatal genetic and environmental factors on childhood behavioral problems and how early events in brain development relate to the onset of major mental illness, such as depression and schizophrenia, in adolescence and adulthood. The long term goals of her research program are to better understand the etiologies of child and adult mental illnesses and to improve outcomes for pregnant mothers affected by mood and anxiety disorders. Dr. Stevens is also the associate training director of the Child Study Center's innovative psychiatry residency program. The Solnit Integrated Program provides psychiatrists-in-training with the opportunity to integrate general, child and research psychiatry across all stages of their career and will be a major pathway by which the next generation of academic leaders in child psychiatry are developed. See link below University of Illinois at Urbana-Champaign (2003) University of Illinois (2004) Psychiatry Residency and Child and Adolescent Psychiatry Fellowship Yale School of Medicine, Yale Child Study Center (2004 - 2010) Psychiatry, Board Certified (2010) Child & Adolescent Psychiatry, Board Certified (2011) Young Investigator Memorial Travel AwardAmerican College of Neuropsychopharmocology (2009) Young Investigator AwardNARSAD (2009) Seymour Lustman Resident Research AwardDepartment of Psychiatry, Yale School of Medicine (2009) Robinson-Cunningham AwardAmerican Academy Child & Adolescent Psychiatry (2009) Ira R. Levine Award for Clinical ExcellenceDepartment of Psychiatry, Yale School of Medicine (2007) P.E.O. Scholar AwardP.E.O. International Sisterhood (2002) Alpha Omega AlphaUniversity of Illinois College of Medicine (2003) FellowGroup for the Advancement of Psychiatry (2007) Associate Editor, Frontiers in Psychiatry Editorial Board, Journal of the American Academy of Child and Adolescent Psychiatry Stevens Lab Solnit Integrated Training Program Journal of the American Academy of Child and Adolescent Psychiatry Frontiers in Psychiatry

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Medicine and Health > History of Medicine Grady Baby A Year in the Life of Atlanta's Grady Hospital Jerry Gentry The Great Stink of Paris and the Nineteenth-Century Struggle against Filth and Germs David S. Barnes Late in the summer of 1880, a wave of odors emanated from the sewers of Paris. As the stench lingered, outraged residents feared that the foul air would breed an epidemic. Fifteen years later—when the City of Light was in the grips of another Great Stink—the landscape of health and disease had changed dramatically. Parisians held their noses and protested, but this time few feared that the odors would spread disease. Historian David S. Barnes examines the birth of a new microbe-centered science of public health during the 1880s and 1890s, when the germ theory of disease burst into public consciousness. Tracing a series of developments in French science, medicine, politics, and culture, Barnes reveals how the science and practice of public health changed during the heyday of the Bacteriological Revolution. Despite its many innovations, however, the new science of germs did not entirely sweep away the older "sanitarian" view of public health. The longstanding conviction that disease could be traced to filthy people, places, and substances remained strong, even as it was translated into the language of bacteriology. Ultimately, the attitudes of physicians and the French public were shaped by political struggles between republicans and the clergy, by aggressive efforts to educate and "civilize" the peasantry, and by long-term shifts in the public's ability to tolerate the odor of bodily substances. This fascinating study sheds new light on the scientific and social factors that continue to influence the public's lingering uncertainty over how disease can—and cannot—be spread. Happy Pills in America From Miltown to Prozac David Herzberg Valium. Paxil. Prozac. Prescribed by the millions each year, these medications have been hailed as wonder drugs and vilified as numbing and addictive crutches. Where did this “blockbuster drug” phenomenon come from? What factors led to the mass acceptance of tranquilizers and antidepressants? And how has their widespread use affected American culture? David Herzberg addresses these questions by tracing the rise of psychiatric medicines, from Miltown in the 1950s to Valium in the 1970s to Prozac in the 1990s. The result is more than a story of doctors and patients. From bare-knuckled marketing campaigns to political activism by feminists and antidrug warriors, the fate of psychopharmacology has been intimately wrapped up in the broader currents of modern American history. Beginning with the emergence of a medical marketplace for psychoactive drugs in the postwar consumer culture, Herzberg traces how “happy pills” became embroiled in Cold War gender battles and the explosive politics of the “war against drugs”—and how feminists brought the two issues together in a dramatic campaign against Valium addiction in the 1970s. A final look at antidepressants shows that even the Prozac phenomenon owed as much to commerce and culture as to scientific wizardry. With a barrage of “ask your doctor about” advertisements competing for attention with shocking news of drug company malfeasance, Happy Pills is an invaluable look at how the commercialization of medicine has transformed American culture since the end of World War II. Healing and Society in Medieval England A Middle English Translation of the Pharmaceutical Writings of Gilbertus Anglicus Originally composed in Latin by Gilbertus Anglicus (Gilbert the Englishman), his Compendium of Medicine was a primary text of the medical revolution in thirteenth-century Europe. Composed mainly of medicinal recipes, it offered advice on diagnosis, medicinal preparation, and prognosis. In the fifteenth-century it was translated into Middle English to accommodate a widening audience for learning and medical “secrets.” Faye Marie Getz provides a critical edition of the Middle English text, with an extensive introduction to the learned, practical, and social components of medieval medicine and a summary of the text in modern English. Getz also draws on both the Latin and Middle English texts to create an extensive glossary of little-known Middle English pharmaceutical and medical vocabulary. Health, Hygiene and Eugenics in Southeastern Europe to 1945 Edited by Christian Promitzer, Sevasti Trubeta, and Marius Turda This volume is a collection of chapters that deal with issues of health, hygiene and eugenics in Southeastern Europe to 1945, specifically, in Bosnia-Herzegovina, Bulgaria, Croatia, Greece and Romania. Its major concern is to examine the transfer of medical ideas to society via local, national and international agencies and to show in how far developments in public health, preventive medicine, social hygiene, welfare, gender relations and eugenics followed a regional pattern. This volume provides insights into a region that has to date been marginal to scholarship of the social history of medicine. History and Health Policy in the United States Putting the Past Back In Rosemary A. Stevens In our rapidly advancing scientific and technological world, many take great pride and comfort in believing that we are on the threshold of new ways of thinking, living, and understanding ourselves. But despite dramatic discoveries that appear in every way to herald the future, legacies still carry great weight. Even in swiftly developing fields such as health and medicine, most systems and policies embody a sequence of earlier ideas and preexisting patterns.In History and Health Policy in the United States, seventeen leading scholars of history, the history of medicine, bioethics, law, health policy, sociology, and organizational theory make the case for the usefulness of history in evaluating and formulating health policy today. In looking at issues as varied as the consumer economy, risk, and the plight of the uninsured, the contributors uncover the often unstated assumptions that shape the way we think about technology, the role of government, and contemporary medicine. They show how historical perspectives can help policymakers avoid the pitfalls of partisan, outdated, or merely fashionable approaches, as well as how knowledge of previous systems can offer alternatives when policy directions seem unclear.Together, the essays argue that it is only by knowing where we have been that we can begin to understand health services today or speculate on policies for tomorrow. History, Medicine, and the Traditions of Renaissance Learning Nancy G. Siraisi A major, path-breaking work, History, Medicine, and the Traditions of Renaissance Learning is Nancy G. Siraisi's examination into the intersections of medically trained authors and history in the period 1450 to 1650. Rather than studying medicine and history as separate disciplinary traditions, Siraisi calls attention to their mutual interaction in the rapidly changing world of Renaissance erudition. Far from their contributions being a mere footnote in the historical record, medical writers had extensive involvement in the reading, production, and shaping of historical knowledge during this important period. With remarkably detailed scholarship, Siraisi investigates doctors' efforts to explore the legacies handed down to them from ancient medical and anatomical writings and the difficult reconciliations this required between the authority of the ancient world and the discoveries of the modern. She also studies the ways in which sixteenth-century medical authors wrote history, both in their own medical texts and in more general historical works. In the course of her study, Siraisi finds that what allowed medical writers to become so fully engaged in the writing of history was their general humanistic background, their experience of history through the field of medicine's past, and the tools that the writing of history offered to the development of a rapidly evolving profession. Nancy G. Siraisi is one of the preeminent scholars of medieval and Renaissance intellectual history, specializing in medicine and science. Now Distinguished Professor Emerita of History at Hunter College and the Graduate Center, City University of New York, and a 2008 winner of a John D. and Catherine T. MacArthur Foundation Fellowship, she has written numerous books, including Taddeo Alderotti and His Pupils (Princeton, 1981), which won the American Association for the History of Medicine William H. Welch Medal; Avicenna in Renaissance Italy (Princeton, 1987); The Clock and the Mirror (Princeton, 1997); and the widely used textbook Medieval and Early Renaissance Medicine (Chicago, 1990), which won the Watson Davis and Helen Miles Davis Prize from the History of Science Society. In 2003 Siraisi received the History of Science Society's George Sarton Medal, in 2004 she received the Paul Oskar Kristellar Award for Lifetime Achievement of the Renaissance Society of America, and in 2005 she was awarded the American Historical Association Award for Scholarly Distinction. "A fascinating study of Renaissance physicians as avid readers and enthusiastic writers of all kinds of history: from case narratives and medical biographies to archaeological and environmental histories. In this wide-ranging book, Nancy Siraisi demonstrates the deep links between the medical and the humanistic disciplines in early modern Europe." ---Katharine Park, Zemurray Stone Radcliffe Professor of the History of Science, Harvard University "This is a salient but little explored aspect of Renaissance humanism, and there is no doubt that Siraisi has succeeded in throwing light onto a vast subject. The scholarship is wide-ranging and profound, and breaks new ground. The choice of examples is fascinating, and it puts Renaissance documents into a new context. This is a major book, well written, richly learned and with further implications for more than students of medical history." ---Vivian Nutton, Professor, The Wellcome Trust Centre for the History of Medicine, University College London, and author of From Democedes to Harvey: Studies in the History of Medicine "Siraisi shows the many-dimensioned overlaps and interactions between medicine and 'history' in the early modern period, marking a pioneering effort to survey a neglected discipline. Her book follows the changing usage of the classical term 'history' both as empiricism and as a kind of scholarship in the Renaissance before its more modern analytical and critical applications. It is a marvel of erudition in an area insufficiently studied." ---Donald R. Kelley, Emeritus James Westfall Thompson Professor of History, Rutgers University, New Brunswick, and Executive Editor of Journal of the History of Ideas The History of American Homeopathy From Rational Medicine to Holistic Health Care John S. Haller Jr. The History of American Homeopathy traces the rise of lay practitioners in shaping homeopathy as a healing system and its relationship to other forms of complementary and alternative medicine in an age when conventional biomedicine remains the dominant form. Representing the most current and up-to-date history of American homeopathy, readers will benefit from John S. Haller Jr.'s comprehensive explanation of complementary medicine within the American social, scientific, religious, and philosophic traditions. A History of Organ Transplantation Ancient Legends to Modern Practice Foreword by Clyde Barker and Thomas E. Starzl. The first book of its kind, A History of Organ Transplantation examines the evolution of surgical tissue replacement from classical times to the medieval period to the present day. This volume will be useful to undergraduates, graduate students, scholars, surgeons, and the general public. Both Western and non-Western experiences as well as folk practices are included. 70. History of the Medical College of Georgia Phinizy Spalding Phinizy Spalding traces the development of Georgia’s oldest medical school from the initial plans of a small group of physicians to the five school complex found in Augusta in the late 1980s. Charting a course filled with great achievement and near-fatal adversity, Spalding shows how the life of the college has been intimately bound to the local community, state politics, and the national medical establishment. When the Medical Academy of Georgia opened its doors in 1828 to a class of seven students, the total number of degreed physicians in the state was fewer than one hundred. Spalding traces the history of the Academy through its early robust growth in the antebellum years; its slowed progress during the Civil War; its decline and hardships during the early half of the twentieth century; and finally its resurgence and a new era of optimism starting in the 1950s. Research Areas Medicine and Health

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before I read the middle Skip to content Review: The Body Hunters, Sonia Shah Somebody recommended The Body Hunters when I reviewed Bad Pharma earlier this year, and I’m pleased that I was able to get and read it so soon! The author, an investigative journalist, here examines the ethics of biomedical research — specifically, of American drug companies outsourcing clinical trials to companies with laxer ethical requirements than the US and large populations of sick patients to run tests on. It’s a fairly widespread practice that only gets wider-spread with each passing year. I am an inveterate note-checker in my nonfiction. I already sort of was to begin with, and then I read Cordelia Fine’s book Delusions of Gender, which talks about how citations can be slapdash to the point of misleading. These days, if you hand me a nonfiction book and a computer, I’ll check endnotes until my fingers cramp (or until I decide the author’s reliable). That sort of fact-checking is exactly the level of tedium that pleases me, and anyway I like to know that my sources are dependable before I go quoting them hither and yon like I’m some sort of science expert. (I mean, ideally. In my own life, I repeat things willy-nilly that I think are interesting, and then disclaim responsibility for them by forgetting where I read them. It’s the magpie approach to knowledge.) The Body Hunters doesn’t do the thing Cordelia Fine rages over, of citing studies that say green in support of a statement that says red, but it also doesn’t adequately back up all of its points. In the third chapter, for instance, Shah says, “Shigella is a disease-inducing bacterium that kills one million people around the world every year.” The citation for this claim is a press release from a pharmaceutical company. The press release was most likely getting its information from a 1999 study published in the Bulletin of the World Health Organization, but still, I’d rather let’s cite the study itself than cite somebody citing the study, particularly since I can easily look up the study if I know where to look for it and care enough to bother. (If you’re concerned about shigellosis, the happy news is that a WHO study published in 2010, after The Body Hunters‘s publication, found that only about 14,000 people die from shigellosis-related causes every year. Deaths caused by this bacterium are still disproportionately likely to happen in Asia rather than anywhere else.) It took me five minutes to find the original study and the updated study and add that information to this post for your delectation and delight; but Sonia Shah cited a press release from a pharmaceutical company. That is lazy. Or here’s another one: “In 1985, a long-running government study on cardiovascular risk — the Framingham Heart Study — reported a correlation between low cholesterol levels and increased longevity.” The citation for this is a 1985 Washington Post article. It’s not hugely important here to cite the primary source, but since we’re citing things, why not cite a primary source? They’re easy to find. The Framingham Heart Study has a website. Or if it’s something that’s just known, like the dates of the Civil War, then don’t cite anything. That is also okay sometimes. It feels churlish to complain about a book like The Body Hunters, which is a friendly and easy-to-digest account of some of the ethical problems plaguing pharmaceutical research. It’s important to have such an account available, and I truly do understand that there are times when you have to cite secondary sources, even though you’d prefer to cite primary ones. And speaking generally, these lazy citations showed up in support of background information rather than in support of the main points Shah was making. But having them at all leads to this thing, you know, where I got done with The Body Hunters and felt that I had gained a broad, vague sense of the story of testing drugs in third-world nations, but that I couldn’t depend on any specific piece of information I had been given (particularly scientific information). Perhaps not surprisingly, Shah is at her best when she’s talking about the sociology of science, rather than the science itself. The chapter about the hunt for a cheaper AIDS treatment for patients in countries poorer than the US is both fascinating and well-documented, as is the one about AIDS denialism in South Africa under Thabo Mbeki. (Which, look. That was bad and he was wrong, but it is not insane to mistrust Western scientists when it comes to ethical and accurate research in Africa.) Given that almost a decade has passed since the publication of The Body Hunters, I’d love to read another book on the same topic that takes on the last ten years. Has drug testing on third-world patients expanded wildly, as Shah grimly predicted it would? Have ethical standards been modified and improved? If you know of any recentish books that address this, let me know in the comments! I am interested in ethical quandaries and would gladly read many more books about this one in particular!

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riversideonline.com Home » MayoClinic.com Health Library » Ear, Nose & Throat MayoClinic.com Health Library Slide show: How you hear 1|2|3|4|5|6|7 An auditory wonder Your ears appear to be relatively simple structures. But they are, in fact, only part of the complex auditory system — passageways, vibrating structures, nerves and specialized areas of the brain that work together to gather and interpret sound. In people with normal hearing, the ears can detect a child's whisper or a crack of thunder, the single call of a songbird or the entire range of instruments in an orchestra. Take a look at the structures of the auditory system, and discover how it makes sense of the sounds around you. Three parts of the ear The ear is made up of three primary parts: the outer ear, middle ear and inner ear. Each section is composed of structures that play distinct roles in the process of converting sound waves into signals that go to the brain. Outer ear The outer ear is composed of the visible part of the ear (pinna), the ear canal and the eardrum. The cup-shaped pinna (PIN-uh) gathers sound waves from the environment and directs them into the ear canal. When a sound wave strikes the taut, but somewhat flexible eardrum (tympanic membrane), the eardrum vibrates. The middle ear is an air-filled cavity that holds a chain of three bones: the hammer, anvil and stirrup. The middle ear is connected to the back of your nose and upper part of your throat by a narrow channel called the auditory tube, or eustachian tube. The tube opens and closes at the throat-end to refresh the air in the middle ear, drain fluids and equalize pressure in the ear. Equal pressure on both sides of the eardrum is important for normal vibration of the eardrum. Bones of the middle ear The middle ear contains three tiny bones, including the: Hammer (malleus), which is attached to eardrum. Anvil (incus), which is in the middle of the chain of bones. Stirrup (stapes), which is attached to the oval window, the membrane-covered opening to the inner ear. The vibration of the eardrum triggers a chain of vibrations through the bones. Because of differences in the size, shape and position of the three bones, the force of the vibration increases by the time it reaches the inner ear. This increase in force is necessary to transfer the energy of the sound wave to the fluid of the inner ear. The inner ear contains a group of interconnected, fluid-filled chambers. The snail-shaped chamber, called the cochlea (KOK-le-uh), plays a role in hearing. Sound vibrations from the bones of the middle ear are transferred to the fluids of the cochlea. Tiny sensors (hair cells) lining the cochlea convert the vibrations into electrical impulses that are transmitted along the auditory nerve to your brain. The other fluid-filled chambers of the inner ear include three tubes called the semicircular canals (vestibular labyrinth). Hair cells in the semicircular canals detect the motion of the fluids when you move in any direction. They convert the motion into electrical signals that are transmitted along the vestibular nerve to the brain. This sensory information enables you to maintain your sense of balance. Traveling to the brain Electrical impulses travel along the auditory nerve and pass through several information-processing centers. Signals from the right ear travel to the auditory cortex located in the temporal lobe on the left side of the brain. Signals from the left ear travel to the right auditory cortex. The auditory cortices sort, process, interpret and file information about the sound. The comparison and analysis of the all the signals that reach the brain enable you to detect certain sounds and suppress other sounds as background noise. PreviousLast Updated: 2011-04-23 © 1998-2014 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "Mayo Clinic Health Information," "Reliable information for a healthier life" and the triple-shield Mayo logo are trademarks of Mayo Foundation for Medical Education and Research.

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Document outlines protocol for medical marijuana News Service of Florida Published: July 4, 2014 TALLAHASSEE — Winners of Florida’s five, highly sought-after medical marijuana licenses could be selected through lotteries, according to a draft rule released late Wednesday by the Department of Health. The 16-page document comes in advance of an agency workshop Monday in Tallahassee that is drawing heavy attention. The draft rule, generally considered a starting point, outlines how the state intends to implement a new law, signed by Gov. Rick Scott, that made Florida one of nearly two dozen states that permit some sort of marijuana. Florida’s law restricts legal marijuana to strains that are low in euphoria-inducing tetrahydrocannabinol, or THC, and high in cannabadiol, or CBD. The low-THC, high-CBD strain is purported to eliminate or dramatically reduce life-threatening seizures in children with severe epilepsy. The law also allows patients who suffer from severe muscle spasms or cancer to be put on a “compassionate use registry” for the low-THC product as long as their doctors approve. The Florida law also requires that cultivation, processing and distribution of the final product take place at the same locations and allows for one dispensary in each of five regions of the state. Growers are limited to nurseries that have been doing business in Florida for at least 30 years and are producing at least 400,000 plants. Currently, 41 nurseries meet that criteria, according to the Florida Department of Agriculture and Consumer Services. If there is more than one applicant within a region, “a public lottery will be held to determine the order in which applications are considered,’’ according to the draft rule. The first complete application that meets all of the eligibility requirements would be the winner. The chosen dispensary would have 30 days to pay $150,000 for a license and post a $5 million performance bond. If the applicant fails to meet the financial obligations, the department would start the selection process over again. Applicants would have 10 days to apply after the rule goes into effect, a short window of time for those trying to break into the state’s newest regulated industry. Under the rule, dispensaries would have to be open a minimum of 30 hours a week and operate between 7 a.m. and 10 p.m. And the rule would also bar sales of edible products like cookies or candy. Applicants would also have to provide documentation that they have the ability to obtain the premises, resources and personnel necessary to operate as a dispensing organization, including maps showing the location of facilities; site plans drawn to scale of the cultivation, processing and dispensing areas; and photographs showing the parking lot and entryways into the building. Also, applicants would be required to include a list of staff members, who must all be 21 or older, and prove that they have passed background screenings. The application must also include proof that individuals who are owners have passed background screenings. According to the proposed rule, the department could refuse to renew a license if a dispensary is within 500 feet of a school that existed before the organization submitted its initial application. Applications could also be revoked if a dispensing organization does not begin cultivation within 60 days of approval or does not begin dispensing within 120 days. The products would have to be tested to verify the THC-CBD content and for the presence of chemical additives. Any sample that has more than 0.8 percent THC or less than 10 percent CBD would have to be reported immediately to law enforcement officials, according to the rule. The entire batch would be destroyed. The rule also includes protocols for inventory of the pot. Dispensaries would have to document each day’s beginning inventory, seeds and cuttings, harvest, processed products, sales, disbursements, disposal of unusable plants or products and ending inventory. Growers would also have to keep track of the cannabis harvests, including the harvest number; whether the harvest originated from seeds or cuttings; the origin and strain of seeds or cuttings; number of seeds or cuttings; lists of chemical additives; number of plants grown to maturity; date of harvest; final harvest yield weight; disposal of plants or plant parts not used for production; and the reason and methods of disposal. Subscribe to The Tampa Tribune

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Dental Education Caravan Talks Tooth Damage from Sports, Energy Drinks By: Megan Johnson Email Posted: Sat 10:48 PM, May 12, 2012 By: Megan Johnson Email Home / Article Keeping a dental license means keeping up with continuing education hours. That's why the UNMC College of Dentistry has hit the road the past 25 years with a dental education caravan. 350 continuing education hours have been doled out to more than 8,000 attendees over that time. "It's part of our mission to try to provide for all the state and we're very pleased that we can do this," says Dr. John Reinhardt, Dean of UNMC College of Dentistry. "It's not a chore to be out doing the dental caravan, it's a joy, we really enjoy it." UNMC officials say that dentistry is an ever-changing field, and they want professionals to have the latest information to help their patients, like research that shows that after that workout if may be more beneficial for your teeth to forgo the sports drink and take a sip of water instead. "They say that 62% of teenagers today drink sport drinks or energy drinks and we don't know sometimes what the effect that those drinks are going to have on their teeth," says Dr. Paul Hansen, Director of the Prosthodontics Section at the College of Dentistry. Hansen says when tooth structure loss isn't a result of tooth decay, it might also be from those drinks, or from eating acidic foods, having gastric reflux, or could even be a symptom of bulimia. Dental professionals also got a refresher on handling a medical emergency that might crop up during a patient visit. "That could be anything from just fainting in the chair all the way to having a heart attack or stroke," says Dr. Lindsay Mundil, associate professor at the College of Dentistry and dental hygienist. "It's good to kind of just keep updated with it and have reviews every now and then just to keep yourself fresh on how to handle those situations since we don't typically deal with them." Dentists say that with advances in computer scanning and new materials used in restorations, there's always something new to learn. Officials also say the dental field is growing, and there's a need for dentists and dental hygienists, especially in rural areas. With Flu Season Upon Us, Doctors Say Soap and Water is the Best Formula Comments are posted from viewers like you and do not always reflect the views of this station.

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Aspirin Helps Protect against Cancer in Zebrafish Using translucent zebrafish larvae the researchers were able to visualise how white blood cells interact with the early cancer cell formation as they arise in tissues. Monday, June 4, 2012 - 15:45 Paralyzed Rats Walk Again, Thanks to Electricity, Chemicals—And Chocolate Wearing a robotic harness, paralyzed rats have been made to walk again, according to a new study—albeit with an oddly upright, humanlike gait and while stimulated by judicious jolts of electricity and chemicals. It's the first time severely injured spinal cords have been reawakened, say researchers, who add that the technique might hold some promise for disabled people. Friday, June 1, 2012 - 09:11 Vitamin D and TB vaccine fight bladder cancer in mice The tuberculosis vaccine is often used as a treatment for bladder cancer, and adding vitamin D might improve the vaccine’s effectiveness, according to new research from the University of Rochester Medical Center . Thursday, May 24, 2012 - 15:54 NIH-supported study shows how immune cells change wiring of the developing mouse brain Researchers have shown in mice how immune cells in the brain target and remove unused connections between brain cells during normal development. This research, supported by the National Institutes of Health, sheds light on how brain activity influences brain development, and highlights the newly found importance of the immune system in how the brain is wired, as well as how the brain forms new connections throughout life in response to change. Surgical removal of abdominal fat reduces skin cancer in mice Is it possible that liposuction or other fat removal procedures are beneficial for treating obesity and reducing the risk of cancer?When it comes to humans, scientists can’t answer that question. They know that obesity increases the risk of heart disease, diabetes and cancer. But there have not been clinical studies to determine if the surgical removal of fat tissue would decrease cancer risk in humans. Zebrafish could hold the key to understanding psychiatric disorders Scientists at Queen Mary, University of London have shown that zebrafish could be used to study the underlying causes of psychiatric disorders. Monday, May 21, 2012 - 16:27 Using Mouse Model, Connecticut Teen Takes Top NIDA Addiction Science Award A project that maps dopamine circuits in the prefrontal cortex through optogenetic manipulation was given top honors in this year's annual Addiction Science Awards at the 2012 Intel International Science and Engineering Fair (ISEF) — the world's largest science competition for high school students. Friday, May 18, 2012 - 14:47 Mice with big brains provide insight into brain regeneration and developmental disorders Scientists at the Ottawa Hospital Research Institute (OHRI) and the University of Ottawa (uOttawa) have discovered that mice that lack a gene called Snf2l have brains that are 35 per cent larger than normal. The research, led by Dr. David Picketts and published in the prestigious journal Developmental Cell, could lead to new approaches to stimulate brain regeneration and may provide important insight into developmental disorders such as autism and Rett syndrome. How the worm knows where its nose is For decades, scientists have studied Caenorhabditis elegans – tiny, transparent worms – to glean clues about how neurons develop and function. A new Harvard study suggests that the worms' nervous system is much more capable and complex than previously thought, and has a way to monitor its own motion, a model one day could serve to develop treatments for disorders like schizophrenia. Wednesday, May 16, 2012 - 16:14 Immune cell therapy cures diabetic mice, researchers find An experimental therapy that reprograms the immune system then spurs the growth of healthy insulin-producing cells reversed late-stage diabetes in mice and may lead to a cure for people, researchers said. Tuesday, May 15, 2012 - 14:27 OHSU researchers develop new animal model for one of the least understood medical issues: ADHD According to a 2011 statement by the Centers for Disease Control and Prevention, nearly one in 10 American children is diagnosed with ADHD. To better understand the cause of ADHD and to identify methods to prevent and treat it, researchers at Oregon Health & Science University (OHSU) and OHSU's Oregon National Primate Research Center have developed a new form of specially bred mouse that mimics the condition. Monday, May 14, 2012 - 15:53 Cell Found in Mice has Key Role in Treatment-resistant Asthma U-M team shows cellsrole in inflaming airways in mice, and finds similar cells in the blood of humans with asthma, pointing to a possible target for treatment. Thursday, May 10, 2012 - 14:31 Scientists find new pieces of hearing puzzle using mice models Researchers funded by the Biotechnology and Biological Sciences Research Council (BBSRC) have gained important new insights into how our sense of hearing works. Their findings promise new avenues for scientists to understand what goes wrong when people experience deafness. Wednesday, May 9, 2012 - 15:51 Bad Fat Turned to Good in Mice In the battle against obesity, brown fat appears to be our friend and white fat our foe. Now a team of researchers led by Jorge Plutzky, MD, director of The Vascular Disease Prevention Program at Brigham and Women's Hospital (BWH) and Harvard Medical School has discovered a way to turn foe to friend. Tuesday, May 8, 2012 - 15:44 Awake mental replay of past experiences critical for learning - in rats Awake mental replay of past experiences is essential for making informed choices, suggests a study in rats. Without it, the animals’ memory-based decision-making faltered, say scientists funded by the National Institutes of Health. Monday, May 7, 2012 - 15:38 Stem Cell Therapy Fights HIV in Mice UC Davis Health System researchers are a step closer to launching human clinical trials involving the use of an innovative stem cell therapy to fight the virus that causes AIDS. Halting Enzyme Can Slow Multiple Sclerosis in Mice Researchers studying multiple sclerosis (MS) have long been looking for the specific molecules in the body that cause lesions in myelin, the fatty, insulating cells that sheathe the nerves. Nearly a decade ago, a group at Mayo Clinic found a new enzyme, called Kallikrein 6, that is present in abundance in MS lesions and blood samples and is associated with inflammation and demyelination in other neurodegenerative diseases. In a study published in Brain Pathology, the same group found that an antibody that neutralizes Kallikrein 6 is capable of staving off MS in mice. Glycogen accumulation in neurons causes brain damage and shortens the lives of flies and mice Collaborative research by groups headed by scientists Joan J. Guinovart and Marco Milán at the Institute for Research in Biomedicine (IRB Barcelona) has revealed conclusive evidence about the harmful effects of the accumulation of glucose chains (glycogen) in fly and mouse neurons. Wednesday, May 2, 2012 - 16:01 Anxious Mice Face Higher Cancer Risk Anxious mice get more serious cancer than their calmer counterparts, according to a new study that could have implications for human cancer treatments. Studies involving mice and monkeys reveal potential for novel treatments in regenerative medicine. Three separate studies involving mice and monkeys have revealed significant potential for novel, non-stem cell-related treatments in regenerative medicine.

医学

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Palm trees are seen along Kuwait’s road. Kuwait acts to confront Ebola Citizens warned KUWAIT CITY, Aug 7, (Agencies): Director of Public Health Department at the Ministry of Health Yusuf Mandakar announced Thursday that the Ministry has taken a number of precautionary and preventive measures to confront the spread of the deadly epidemic Ebola disease. In statements to KUNA, Mandakar said that the measures include monitoring the health conditions of people coming from virus-infected countries at air, sea and land border posts. A suspected case would be quarantined for 21 days to make sure necessary medical checks to know if he/she carries the virus or not, Mandakar said. He pointed out that the Ministry of Health, in coordination with ports, border and civil aviation authorities, will offer health guidance and advice to travelers to the infected countries. Mandakar stated that a circular was distributed to medical staff in public and private hospitals detailing the symptoms of the disease and how to deal with and report the suspected cases. Measures The ministry issued a circular on hygienic and disinfection measures and health education for those who could have close contact with infected cases, he said. He added that the Ministry is continuing contacts with the World Health Organization to follow up the latest developments of the disease and international medical organizations recommendations to confront it. The Ministry of the Interior has also stopped issuance of visas for workers coming from infected areas. Earlier, Kuwait Health Ministry issued a statement affirming that Kuwait is free of the virus, but it urged the citizenry not to travel to Guinea, Liberia and Sierra Leone due to rising numbers of people infected with Ebola virus there amidst fears of spreading to other African countries. The ministry, on its website, urged the Ministry of Interior to suspend granting of visas to workers coming from these countries. Meanwhile, Kuwait Red Crescent Society (KRCS) expressed readiness to offer all support to the West African nationas grappling to stop the spread of the epidemic and deadly Ebola virus disease. “The KRCS is closely following up the development of the disease and is ready to offer all support and help to the infected countries,” KRCS Deputy Chairman Anwar Al-Hassawi told KUNA following a meeting with ambassadors of Senegal, Liberia and Sierra Leone in Kuwait. For their part, the ambassadors said that they have briefed the KRCS officials about the latest developments of the epidemic disease in their respectively countries. They stated that they are ready to provide KRCS with all required data and information about the disease. Elsewhere, overwhelmed west African nations called states of emergency on Thursday as the death toll from a fast-spreading Ebola epidemic neared 1,000 and an elderly Spanish missionary was evacuated for treatment at home. In Liberia, where the dead lay in the streets, lawmakers gathered to ratify a state of emergency while Sierra Leone sent troops to guard hospitals and clinics handling Ebola cases. Nigeria held out hope it could receive an experimental US-developed drug to halt the spread of the virus. Since breaking out earlier this year, the epidemic has claimed 932 lives and infected more than 1,700 people across west Africa, according to the World Health Organisation. Ebola causes severe fever and, in the worst cases, unstoppable bleeding. It is transmitted through close contact with bodily fluids, and people who live with or care for patients are most at risk. As African nations struggled with the sheer scale of the epidemic, Spain flew home a 75-year-old Roman Catholic priest, Miguel Pajares, who contracted the disease while helping patients at a hospital in the Liberian capital Monrovia. The missionary was the first patient in the outbreak to be evacuated to Europe for treatment. A specially equipped military Airbus A310 brought him to Madrid’s Torrejon air base along with a Spanish nun, Juliana Bonoha Bohe, who had worked at the same Liberian hospital but did not test positive for the deadly haemorrhagic fever, the Spanish government said. Immediately after landing on Thursday morning, ambulances took the pair to Madrid’s Carlos III Hospital, which specialises in tropical diseases. The priest was stable and showing no sign of bleeding while the nun appeared to be well but would be retested for Ebola just in case, health officials said. Two Americans who worked for Christian aid agencies in Liberia and were infected with Ebola while taking care of patients in Monrovia were taken back to the United States for treatment in recent days. They have shown signs of improvement after being given an experimental drug known as ZMapp, which is hard to produce on a large scale. The vast majority of those infected face a far inferior level of healthcare at home. There is no proven treatment or cure for Ebola and the use of the experimental drug has sparked controversy as Ebola experts call for it to be made available to African victims. Liberia President Ellen Johnson Sirleaf declared a state of emergency of at least 90 days on Wednesday, saying extraordinary measures were needed “for the very survival of our state”. “The scope and scale of the epidemic, the virulence and deadliness of the virus now exceed the capacity and statutory responsibility of any one government agency or ministry,” she said. Liberia’s parliament is to ratify the decision on Thursday. In Sierra Leone, which has the most confirmed infections, 800 troops including 50 military nurses were sent to guard hospitals and clinics treating Ebola patients, an army spokesman said. The parliament was to meet to ratify a state of emergency declared last week. Fears are growing that the disease is also taking hold in Nigeria after the death of a nurse in Lagos, a megacity of more than 20 million. It was the second Ebola death in Nigeria, where another five people have tested positive for the disease. Nigeria’s Health Minister Onyebuchi Chukwu told reporters he was in contact with the US Center for Disease Control on the possibility of getting drugs from them. “I said we are getting reports that this experimental drug seems to be useful. Is it also possible that we can have access for our people presently being treated and under incubation?” he said on Wednesday. Chukwu said all seven confirmed cases in his country had “primary contact” with a Liberian finance ministry employee who brought the virus to Lagos on July 20 and died later in hospital. US President Barack Obama said it was too soon to send experimental drugs for the treatment of Ebola to west Africa, however, urging officials instead to focus on building a “strong public infrastructure”. “I think we have to let the science guide us. And I don’t think all the information is in on whether this drug is helpful,” Obama said on Wednesday. Spain said it had not asked the United States for the serum. “We do not know of the scientific evidence, the scientific basis, the results that this serum can provide,” Antonio Alemany, director general of primary health care for the Madrid region, told a news conference. “Obviously, if the serum is effective then the Spanish government will make contact to be able to use this treatment.” The WHO is holding an emergency session behind closed doors in Geneva to decide whether to declare an international crisis. A decision is expected on Friday. First discovered in 1976 and named after a river in what is now the Democratic Republic of Congo, Ebola has killed around two-thirds of those infected, with two outbreaks registering fatality rates approaching 90 percent. The latest outbreak has a fatality rate of around 55 percent. Read By: 6829

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HomeArthritis informationResearchSupport usEventsNewsShopAbout us My accountMy basketRegisterContact us Arthritis news Simple test 'may give early indication of arthritis risk' Scientists have developed a simple test that could provide an early indication of whether or not a person is likely to develop osteoarthritis. At present, the degenerative joint disease can only be diagnosed after a person has started to display symptoms, at which point treatments may be less effective. But scientists at the University of Missouri in the US have discovered that specific biomarkers in a person's joint fluid can be used to detect and predict arthritis prior to the onset of symptoms. The test requires a single drop of fluid from the patient's joint, which can be obtained using a small needle. This fluid is then assessed to measure levels of specific proteins that can accurately determine whether the person is developing arthritis, as well as how severe their condition is likely to become. Dr James Cook, professor of orthopaedic surgery and a researcher in the university's College of Veterinary Medicine, said: "With this biomarker test, we can study the levels of specific proteins that we now know are associated with osteoarthritis. "Not only does the test have the potential to help predict future arthritis, but it also tells us about the early mechanisms of arthritis, which will lead to better treatments in the future." The new test, which is detailed in the Journal of Knee Surgery, is currently being reviewed by the US Food and Drug Administration, which plays a similar role to the UK's National Institute for Health and Clinical Excellence (NICE). Dr Cook added: "Being able to tell patients when they are at a high risk for developing arthritis will give doctors a strong motivational tool to convince patients to take preventive measures including appropriate exercise and diet change." Arthritis Research UK scientists in Cardiff and Oswestry are carrying out similar work to identify biomarkers that could predict osteoarthritis. Several candidate markers have been investigated in the last ten years, but none have been proved to be ideal. A spokeswoman for Arthritis Research UK commented: “Currently, although several candidate markers have been investigated in the last ten years, none have been proved to be ideal and there are no definitive means for diagnosing and monitoring the onset of osteoarthritis. This is a disadvantage to clinicians in identifying patients at different stage or different types of the disease, and also to researchers and drug companies trying to understand the disease and develop new ways of treat it. “Our researchers, and those from industry and other research bodies, are engaged in investigating a number or possible biomarkers that can predict disease, as we’re aware this is an important area of research. We’re also looking for the best ways of identifying people at risk of osteoarthritis by tracking down the genes responsible so that ultimately we could devise a genetic test to predict who is likely to develop osteoarthritis and how severely. “It will be interesting to see if this particular test proves to be clinically useful, as so far it has only been tested on dogs.” Search our... Arthritis Today archive Latest arthritis news archive Arthritis Research UK news archive FundraisersHealth professionals and studentsPolicy makersPeople with arthritisResearchers Accessibility|Contact us|Our privacy and cookies policy|Sitemap|Terms and conditions © Arthritis Research UK 1998-2013 All rights reserved | Registered Charity No. 207711, SC041156 Follow usFacebookTwitterYouTubePinterest Our site works best with JavaScript enabled

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News > Osteoporosis treatment questioned Related Features Long-Term Use of Osteoporosis Drugs May Increase Fracture Risk Two studies shed light on the rise of a rare femur fracture in patients who take bisphosphonates. 03/11/2010 | By Jennifer Davis Two studies presented at the 2010 conference of American Academy of Orthopaedic Surgeons (AAOS) are highlighting health concerns with long-term use of bisphosphonate medications, which are used to treat the bone loss caused by osteoporosis. The studies suggest that when the medications are taken for longer than four years, the drugs, which are designed to strengthen bones, may actually make them weaker, leading to an increased risk of fractures in the femur, the long bone of the thigh. In response to the studies, the Food and Drug Administration (FDA) has stated that it is conducting an ongoing review of the safety of this class of medications, which includes the popular drugs alendronate sodium (Fosamax), ibandronate sodium (Boniva), risedronate sodium (Actonel) and zolendronic acid (Reclast), to see if the increased risk of femur fractures outweighs the proven benefits. And people like Jennifer P. Schneider, MD, PhD, a doctor of internal medicine in Tuscon, Ariz., say they feel validated by the results of the new studies. In 2001, Dr. Schneider was riding the subway while visiting New York City when one wrong step changed her life. “The train jolted. I stepped hard on that leg and it buckled. The femur broke, and I fell,” she says. At the age of 57, Dr. Schneider was hospitalized for weeks, needed two surgeries and had to use a walker for a year-and-a-half. It was years before she learned the bizarre fracture caused in a low-impact situation could have been related to the long-term affects of the prescription medication alendronate sodium (Fosamax) that she had been taking for about seven years to treat osteoporosis. “I had pain in my thigh for several months before that, and back then, nobody even suspected it was connected to Fosamax, and the doctor didn’t think anything was wrong with my leg. But I was walking around with an undiagnosed stress fracture of the femur,” she says. On March 1, 2010, the FDA approved a change to the patient labeling for Fosamax that informs people taking the drug about the risk of low-energy femoral fractures. Merck, the company that makes Fosamax, says it updated the labeling to reflect the experiences reported by patients, not to “reflect a conclusion that post-marketing event is caused by the product,” says Ron Rogers, a company spokesman. “Just because a post-marketing event has been reported doesn't mean there's a causal relationship. In fact at this point, no causal relationship has been established between bisphosphonates and low femural fractures,” Rogers says. He continues, “In clinical studies, which are the gold standard for assessing the benefits and risks of medications, Fosamax has not been associated with an increased fracture risk at any skeletal site. “ New research sheds light on rise in rare fracture Bisphosphonates are a type of drug designed to prevent and treat osteoporosis by building bone and stopping calcium loss. Many previous studies have shown that short-term use of these medications is very successful early on at stopping the outflow or destruction of bone and preventing fractures of the hip and spine. But with long-term use of these medications, doctors have been seeing a growing number of patients suffering from a rare type of thigh fracture as a result of little or low trauma. Such trauma can happen from stepping off a curb too hard, for example, or from a relatively minor fall. Two new studies presented at the 2010 AAOS conference in March are trying to understand why. “For the first time we’re having some explanation for what up until now has only been a hypothesis,” Dr. Schneider says. Melvin Rosenwasser, MD, a surgeon who is the director of the orthopaedic hand and trauma service at New York-Presbyterian Hospital, is the lead author of one of those studies. He found that long-term bisphosphonate treatment changes the structure of bone and leads to fractures in some patients. “It’s a drug that works. But at some point a burden has been assumed by use of it that may be leading some patients to have a complication of the treatment,” he says. “We may be homing in on a group of patients who’ve been on the drug for a long time and may be vulnerable to the fractures.” Dr. Rosenwasser and his colleagues identified 112 postmenopausal women with primary osteoporosis. Sixty-two had been taking bisphosphonates for at least four years, while 50 in a control group took only calcium and vitamin D supplements. Doctors used a series of X-ray scans to evaluate the structure of women’s femurs over time, looking at measures of strength and structural integrity. They discovered that the longer the treatment, the more structural integrity declined. It went from 3.8 percent above pretreatment baseline to 1.3 percent after at least four years on the medication. There were also declines in the control group, which was expected since those patients were only taking supplements. Dr. Rosenwasser says his team’s conclusion is that bone properties change after long-term bisphosphonate use in a way that makes them more likely to fracture. “We think something is happening over time that may be changing the character of the bone,” Dr. Rosenwasser says. “I don’t want to be too alarmist. It’s not 100 percent of patients at seven years are breaking their femurs. But some are,” Dr. Rosenwasser explains. “They are all losing something, but not at the same rate or speed or level. It’s not homogenous. They are individuals. That’s why some people’s would break and someone else who’s weak but not critically weak won’t break.” Rosenwasser says he and his colleagues have not yet identified the point someone is likely to fracture. He says that will require further study. “There is some magic number that we don’t have yet. Is five years OK, but six years bad? I don’t know. I just know as they go farther and farther into a treatment plan we see this effect more and at some point with some patients, the bone breaks,” Dr. Rosenwasser says. For the second study, Joe Lane, MD, an orthopaedic trauma surgeon at the Hospital for Special Surgery in New York City, studied patients who had already fractured or broken their legs. He took bone biopsies of the fractured femur of 21 postmenopausal women who had been using bisphosphonates for an average of eight-and-a-half years. After analyzing the data, he found that mineral properties were reduced in the biopsied tissue by about 30 percent, which researchers believe contributes to the risk of these kinds of fractures. Essentially, the medication they say is changing the ability of the bone to remake, remodel and strengthen itself over time. “What they found was that even though the study had limitations of small numbers and people were on the drugs for several different years that varied, they did find some specific changes they felt could account for the fractures,” Dr. Schneider says. “It’s extremely validating,” she says. Bone drugs may have other, important benefits Complicating the picture for patients, other news in March 2010 has found that bisphosphonate drugs may reduce the risk breast cancer in patients who take them for more than two years. In a study published in the British Journal of Cancer, researchers followed nearly 6,000 women between the ages of 20 and 69 in Wisconsin, half of whom had been diagnosed with invasive breast cancer. They discovered that women who had taken bisphosphonates for more than two years saw a nearly 40 percent reduction in their risk for breast cancer. “Definitely for women who use these drugs we observed about a one-third reduction in the risk of breast cancer,” says Polly Newcomb, PhD, the lead author and head of the Cancer Prevention Program at the Fred Hutchinson Cancer Research Center in Seattle. Researchers don’t know exactly how these drugs are helping to prevent breast cancer, but previous research has shown that in addition to their effects on bone, bisphosphonates appear to speed the death of cancer cells. The researchers note that women who were obese did not appear to get this benefit from the drugs, and they think that may be due to elevated estrogen levels in obese women, which increase cancer risk. Weighing benefits and risks So what are patients on bisphosphonates to do? “These drugs are associated with some benefits and some risks, so certainly, you would never take these drugs to reduce your risk of breast cancer,” Dr. Newcomb says. “If other studies support this, then this might be a good side effect, but these drugs also have serious side effects, too.” Dr. Rosenwasser agrees. “My only recommendation is to discuss this with their doctor if they’ve been on it chronically. Not to stop it right away,” especially if you’re just getting started on the treatment, Dr. Rosenwasser says. “If you are diagnosed today and your doctor says to go on it, you should because this study doesn’t say anything bad happens to patients initiated on the drug. In fact, it’s the reverse. It helps. Short-term patients had good parameters.”

医学

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Marrow match sought for leukemia patient Show Caption By Eric Galvan, Eyewitness News BAKERSFIELD, Calif. (KBAK/KBFX) — A Bakersfield woman is in need of a bone marrow transplant, so a marrow donor registry drive was held from 10 a.m. to 2 p.m. Saturday in hopes of finding a match. While attending Southern Nazarene University in Oklahoma, 20-year-old Malorie was diagnosed with AML (acute myeloid leukemia). No one in her family is a match for the needed transplant. Family members said Malorie was too weak to attend the event, as she's getting treatment in Southern California. Be the Match officials say it only takes a quick cheek swab to join the donor registry. Anyone between the ages of 18 and 44 is encouraged to become a donor. To find out more, click here. To make a donation click here. Kern health officials say local facilities working on new Ebola guidelines

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I give CCA permission to contact me by email. Colon Cancer Alliance Welcomes Experienced Cancer Advocate to its Team WASHINGTON, D.C. / August 6, 2008 -- The Colon Cancer Alliance (CCA) is pleased to announce that Jasmine Thomas Greenamyer has joined the CCA team as Director of Community Engagement and will play a key role in the continued growth and success of the Alliance. “Patients and caregivers have a unique passion around, and insight into, fighting colorectal cancer—the second leading cause of cancer death in the United States," said Tim Turnham, CEO of the Colon Cancer Alliance. “Jasmine's experience in developing and implementing national programs makes her the ideal fit to support and direct our growing network of volunteers who have been personally touched by this disease." At CCA, Greenamyer will oversee the expansion of the more than 100 volunteer groups nationwide who advocate for colorectal cancer support in their communities and engage in fundraising activities on behalf of the organization. Drawing on her past experience in developing and implementing national programs, she will recruit, train and support CCA volunteers, allowing the program to grow in size and sophistication. Greenamyer comes to CCA with over eight years of experience in project management and national program leadership and development. Before joining CCA, she was the Director of Communications for the Prevent Cancer Foundation in Alexandria, VA where she was responsible for the state-level Dialogue for Action programs. During her career, she worked with the Centers for Disease Control and Prevention, the U.S. Department of Education, the National Institute for Drug Abuse, and the National Institute for Health to develop educational programs, conferences and materials. The Colon Cancer Alliance (CCA) is a national patient advocacy organization dedicated to ending the suffering caused by colorectal cancer. In order to increase rates of screening and survivorship, CCA provides patient support, education, research and advocacy across North America. As the Voice of Survivors, CCA works as an advocate for colorectal cancer patients and their families. CCA offers information and support from the first-hand experience of survivors and others whose lives have been touched by this disease. Today, CCA has over 37,000 members. Our help line receives an average of 700 calls monthly, and our support networks have assisted over 150,000 people. The growth and success of the organization is due in large part to caring volunteers who devote considerable time, skill and energy to achieving CCA's vision. ©2014 Colon Cancer Alliance Newly Diagnosed | Friends & Family | Programs & Events | Prevention About Us | About Colon Cancer | Get Involved | Support Us | Shop CCA | News | Español | Contact Us | Home 1025 Vermont Ave., NW, Suite 1066, Washington, DC 20005

医学

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News & Events > Details NewsInformation on Delta Premier fee reductionEventsUpdateExecutive BulletinPress RoomVideo Library CDA Cares volunteer changes young patient’s life California dentists provide a tremendous amount of pro bono work to those who experience barriers to care. In fact, dentists across the state provide oral health care services worth an estimated $388 million each year ($15,668 per dentist). One such example occurred recently at the CDA Cares San Jose program. Dental decay can be a problem for people of all ages, and no one knows that better than the family of Esmy, a 3-year-old girl whose severe early childhood caries had done so much damage to her teeth that she had begun to cover her mouth when smiling. Every photo and every opportunity to smile big or talk caused the young girl to shield her mouth, said her grandmother, Ruby Smallwood. But that was before she attended the CDA Foundation’s CDA Cares program in San Jose in May and had her life changed by a generous pediatric dentist who practices in Redlands. Rick Nichols, DDS, volunteered in the children’s area at CDA Cares, a program that allows volunteer dentists, with the assistance of other dental professionals, to provide dental services at no charge to patients who experience barriers to care. Most patients wait in line over night to receive care and many suffer from severe pain and infection. Ruby and her daughter-in-law Jessica brought Esmy to CDA Cares San Jose from Sacramento. Jessica, Esmy’s mother who also needed treatment, had traveled all the way from Texas at the request of Ruby. After an overnight sleep outside of the San Jose Convention Center, Esmy ended up in Nichols’ chair. It only took a short time for him to discover that the young girl needed serious work, work that would require IV sedation to complete — something that is beyond the scope of services that can be performed at CDA Cares. (CDA Cares provides fillings, cleanings, extractions and a limited number of dentures.) Esmy was suffering from generalized moderate to severe dental decay. “I told them that there are a couple of pediatric dentists in Stockton and Sacramento who I could refer them to, but her mom was genuinely desperate,” Nichols said. “Sometimes you meet people who are in serious need and you know you have to do the right thing.” That’s when Nichols offered to take Esmy in as a patient in his own practice. “At that point, my daughter-in-law was crying so hard, she was so grateful because other than that, there was no option,” Ruby recalled. Three weeks after CDA Cares, the family took Nichols up on his offer and drove nearly 8 hours from Sacramento to his practice in Redlands. Considering the amount of treatment needed and the fact that IV sedation was necessary, Nichols also paid for Esmy and her mother to stay in a nearby hotel the night before and the night of the treatment. “He was a huge blessing. He paid for the hotel for the night, he did all the work in the morning; it was amazing what he did,” Ruby said. Nichols treated 14 of Esmy’s teeth during a sedation case that lasted two hours. For Nichols, this was the first patient he had adopted from long distance, but adopting patients is nothing new for him. He has been involved with the local chapter of the Give Kids a Smile Program for years and has adopted patients through that program. He also served as the chair of the Tri-County Dental Society’s Give Kids a Smile program for five years. Nichols says he has an ethical and moral obligation to the communities he serves. “The reality is that there are a lot of people out there hurting and many of us do our share. I have a moral and ethical obligation to give back to my community; there are people out there who are so thankful for anything we can do to help them,” said Nichols, who hopes that more dentists who volunteer at CDA Cares offer to adopt patients and provide them a dental home. Esmy and her family are certainly thankful, as she is no longer covering her smile. “She smiles a lot more, as well as nonstop talking and laughing, with no concern about her teeth. So much that we sit through a whole hour meal just listening to her go on and on,” Ruby said. “Dr. Nichols was a godsend. He took it upon himself to do this, there are not enough thank-yous that I can give for what he has done for both of them [Esmy and her mother].” One of the main goals of the CDA Cares program is to educate the patients and the public about the importance of good oral health. Nichols made sure to get that point across to the family as well, so much so that Esmy is now the one instructing her grandmother about how to take care of her teeth. “Now she says things like, ‘No you have to brush them this way.’ That is pretty cool,” Ruby said. “I know Jessica is really promoting it too; this was life changing for both of them.” CDA Cares was life-changing for Nichols, who plans to volunteer in San Diego in December. “I hope to see everyone down in San Diego. You will find that after you volunteer for things like this, you usually get more out of it than what you have given,” Nichols said. To date, with the help of 4,559 volunteers, CDA Cares has provided $4.4 million in care to 5,878 patients. CDA Cares will be in San Diego Dec. 7-8, Vallejo April 24-25, 2014, and Pomona Nov. 20-21, 2014. For information about the CDA Cares program and to volunteer or donate, visit cdafoundation.org/cdacares. Topics: CDA Foundation, Community, CDA Cares

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Soaring Prices Keep Leukemia Drugs From Patients, Experts SaySoaring Prices Keep Leukemia Drugs From Patients, Experts Say04/25/13THURSDAY, April 25 (HealthDay News) -- Pricey cancer medications prevent many Americans with chronic myeloid leukemia (CML) from receiving lifesaving treatment, an international team of experts claims.These drugs can cost more than $100,000 a year for patients with CML, once considered a death sentence but now highly treatable with ongoing treatment, according to a commentary penned by 120 specialists in more than 15 countries and published online April 25 in the journal Blood. "Patients with CML have a much better outlook today than ever before, thanks to advances that have greatly improved survival rates. But these patients now face dire financial struggles as they try to maintain their treatment regimen with the drastically inflating cost of care," corresponding author Dr. Hagop Kantarjian, chairman of the leukemia department at the University of Texas MD Anderson Cancer Center in Houston, said in a journal news release. "Since CML treatments must be taken on an ongoing basis, we are concerned that the surging prices are potentially harming patients," Kantarjian added. In the United States, the CML survival rate is about 60 percent, significantly less than in Sweden, where survival odds are roughly 80 percent. That's likely because drug costs are managed in Sweden, the doctors noted.Patients with other types of cancer who require ongoing treatment likely face the same barrier to treatment, Kantarjian added.Eleven of 12 cancer drugs approved by the U.S. Food and Drug Administration in 2012 were priced above $100,000 a year, the report noted. And average monthly cancer drug prices have nearly doubled over the past decade -- from $5,000 a month to more than $10,000 a month, according to the news release.Moreover, cancer care is a key factor in the massive cost of health care in the United States, estimated at 18 percent of the U.S. Gross Domestic Product, compared with less than 10 percent in much of Europe, the researchers added.The drugs for CML include Gleevec from Novartis; Pfizer Inc.'s Bosulif; Sprycel from Bristol-Myers Squibb and Synribo from Teva.How prices are set lies at the heart of the issue, according to the experts."In many cases, it makes sense to let the market govern the price; however, when a product is directly related to a patient's survival over a period of years, it is critical to set a price that allows companies to profit and ensures that patients can afford their treatment," said Kantarjian. Drug makers argue that the stratospheric prices reflect the cost of research and development and the "value of a drug to patients," according to the New York Times. In the Blood article, the authors noted that the reported cost of bringing a new cancer drug to market is roughly $1 billion, although not all experts agree on that high a figure.Yet, Gleevec's sales were $4.7 billion in 2012 alone, the Times reported.Noting the pricing and maintenance issue is "complex," Novartis said in a statement Thursday that it would "welcome the opportunity to be part of the dialogue."This isn't the first time cancer specialists have banned together to oppose high drug prices, according to the Times. Last fall, doctors at Memorial Sloan-Kettering Cancer Center in New York City announced they wouldn't use the Sanofi colon cancer drug Zaltrap because it cost twice as much as another drug and wasn't an improvement. Subsequently, Sanofi cut the price of the drug in half. More informationTo learn about chronic myeloid leukemia, visit the U.S. National Cancer Institute. Health News Copyright © 2013 HealthDay. All rights reserved. Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.Editorial Policy |

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HFCS: Changing the Name Doesn’t Change the Product UPDATE [9/14/2011]: Although it may take the FDA another year to decide to approve the Corn Refiner’s Association’s (CRA) request to use the term “Corn Sugar” instead of “High Fructose Corn Syrup,” groups representing sugar producers are suing the CRA over an ad campaign that promotes the idea that “your body can’t tell the difference” between the two sweeteners. The Associated Press reports that a ruling to dismiss the case will be decided by U.S. District Judge Consuelo Marshall soon, but a time frame has not yet been determined. Health experts remain in disagreement over the dangers of high fructose corn syrup, but many have pointed out that changing the name won’t change the nutritional profile of substance. “Whether they decide to call it ‘High Fructose Corn Syrup’ or ‘Corn Sugar’, its the same processed sugar and 60 calories per tablespoon,” tweeted Joy Bauer, MS RD CDN, this afternoon. The Corn Refiner’s Association of American has decided that the negativity surrounding the name High-Fructose Corn Syrup is harming the sale of the product. As a result, they’ve moved to make the name more consumer-friendly. High-Fructose Corn Syrup will now be known as “Corn Sugar”, if the CRA has its way. The CRA applied for an official name change on Tuesday, but the approval could take more than two years. That’s of no concern to the CRA, however, who has already created a web site and begun to refer to the product as Corn Sugar in television commercials. Consumption of HFCS has reached a 20 year low, with consumers avoiding the product due to a concern with the products effect on the health of the nation. The CRA is capitalizing upon the consumer who looks for the words “cane sugar” and hopes to show that sugar is sugar, no matter the source. The American Medical Association has declared that there is not enough evidence yet to restrict the use of HFCS, but they have requested more research. However, many Americans have decided to avoid HFCS in their daily diets, and even Michelle Obama has been against the use of the product. She’s been a firm supporter of the removal of HFCS from her family’s diet. In 2009, the average American ate more than 35 pounds of HFCS. That represents a 21% reduction from the more than 45 pounds reported at the end of the last decade. Cane and beet sugars have remained steady at 44 pounds per person per year. The CRA has requested the change to better reflect the actual composition of the product. While the research may technically still be out, we all know that eating whole fruits and vegetables from natural sources, rather than processed foods

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Kragel Likes Challenge of Being Interim Dean Dr. Peter Kragel. Photo by Cliff Hollis. GREENVILLE, N.C. (Mar. 1, 2001) — If you need to schedule an appointment with Dr. Peter Kragel, try calling one of his three offices: there's one he has as chairman of the Department of Pathology and Laboratory Medicine, the other in the Pitt County Memorial Hospital laboratory as chief of pathology and then the newest in the dean's office of the Brody School of Medicine at East Carolina University. Following the resignation of Dr. James Hallock in December, ECU Chancellor Richard Eakin named Kragel interim dean of the medical school. In addition to being dean, Hallock was also vice chancellor for health sciences. Dr. Ann Jobe is serving in that position in the interim. Why does Kragel think he was chosen for the job? He feels an important aspect of the dean's role is to support departments and faculty and provide an environment where they can excel. "I've been supportive of many departments since I've been here," he said. His record of support was likely an important consideration in his selection for the interim position, he added. Kragel joined the medical school as chairman of the Department of Pathology and Laboratory Medicine in July 1998. At the time, he also was named chief of pathology at PCMH. For the eight years before coming to ECU, he was with the Truman Medical Center/University of Missouri-Kansas City, joining the pathology department as an associate professor and leaving as professor and chairman of the department. He was also director of the pathology residency program and the pathology course director. According to Dave McRae, chief executive officer of University Health Systems of Eastern Carolina, Kragel's experience makes him an excellent choice for interim dean. "We're exceptionally pleased with Dr. Kragel being named interim dean for the medical school. He brings tremendous experience as chairman for an important department serving the hospital. Also, his personal maturity and judgment will be an asset in the coming months as the hospital and School of Medicine deal with the complex health care issues facing us today." Dr. Paul Phibbs, who has served as a member of the Executive Committee of the medical school with Kragel, said he believes the decision by the chancellor to name his colleague as interim dean was well thought out. Phibbs, who came to ECU in 1986 as chairman of the Department of Microbiology and Immunology, admitted some surprise when he first heard that a rather new department chairman had been named interim dean. "But because of my interaction with him on the Executive Committee, it didn't surprise me after thinking about it," he said. "I think he has rapidly learned the details of the administration of the school. He has immersed himself in complex negotiations with the hospital for interactions that are vital for the two institutions," Phibbs said. "He also served effectively as acting chairman for the Department of Radiation Oncology while doing his own job as chairman of his department. And I think he was an extremely effective member of the Executive Committee, and that gave me confidence that he was a good choice. I'm sure he will do a really good job." The Executive Committee is made up of six department chairmen and a handful of other medical school administrators. Kragel will no longer serve as a member of the Executive Committee in his new position; however, as interim dean he's free to attend the meeting at any time. Dr. Ralph Whatley, chairman of the Department of Medicine, has filled Kragel's vacancy on the committee. Phibbs added that Kragel's specialty, pathology and laboratory medicine, allows him to have a connection with all faculty members. "I think he is a good person for communicating with the basic science and the clinical sides of the school. He has always shown strong interest in both the basic and the clinical sciences," he said. And Kragel's demeanor lends itself to the daily hurdles of Contact: Jeannine Hutson

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Contact: Anne Banner abanner@gwumc.edu GW researcher awarded NIH grant to identify molecular mechanisms to predict neurological and psychiatric diseases Anthony-Samuel LaMantia, PhD, professor in the Department of Pharmacology and Physiology and Director of the GW Institute for Neuroscience in the School of Medicine and Health Sciences has been awarded a grant from the National Institutes of Health to identify molecular mechanisms that define embryonic olfactory epithelium (OE) stem cells. These stem cells, once established in the developing nose, regulate lifelong genesis of olfactory receptor neurons�the cells that mediate the sense of smell�and are likely pathogenic targets for neurological and psychiatric diseases, including Parkinson's and Alzheimer's diseases and schizophrenia. "Olfactory epithelial stem cells are the only neural stem cells in humans that constantly make new neurons that make new connections over a lifetime. If we can understand how the nervous system establishes stem cells that can provide for ongoing replacement and repair, we will be able to create an outline of how one might harness the same mechanisms to repair parts of the brain that do not normally regenerate or recover after damage," said Dr. LaMantia. Stem cells in the embryonic vertebrate olfactory epithelium generate critical peripheral chemosensory and central neuroendocrine neurons essential for feeding, social interactions, and reproduction. Dr. LaMantia and his colleagues defined the identity of these stem cells over the past several years. Nevertheless, the mechanisms for establishing and maintaining these olfactory epithelial stem cells remain unknown. Now, GW researchers, lead by Dr. LaMantia will define molecular mechanisms that the network of genes essential to define OE stem cell identity and their ability to make the mautre neurons that insure the sense of smell throughout a lifetime. Dr. LaMantia places this work in the larger context of understanding neurodegenerative and psychiatric diseases: "It is likely that the decline of the sense of smell early in the course of diseases like Alzheimer's, Parkinson's and schizophrenia is due to disruptions in the genetic network that keeps olfactory epithelium stem cells able to do their job of making new olfactory neurons. Some of the same mechanisms most likely keep neurons healthy elsewhere in the nervous system, or manage the more limited ongoing repair of connections that must occur to keep a brain healthy and functioning". Dr. LaMantia and his team were awarded $1.6 million in total costs over 5 years. To learn more about the work of the GW Institute for Neuroscience: http://www.gwumc.edu/neuroscience/ About the GW School of Medicine and Health Sciences: Founded in 1825, the GW School of Medicine and Health Sciences (SMHS) was the first medical school in the nation's capital and is the 11th oldest in the country. Working together in our nation's capital, with integrity and resolve, the GW SMHS is committed to improving the health and well-being of our local, national and global communities.

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Defective generic pill revives quality concerns Thursday - 10/4/2012, 6:31pm EDT By MATTHEW PERRONE AP Health Writer WASHINGTON (AP) - More Americans than ever are taking generic drugs, as blockbuster medicines like Plavix and Lipitor become available in low-cost versions. But the government's revelation this week that it mistakenly approved a defective generic antidepressant could stoke longtime concerns about the quality of knockoff drugs. The Food and Drug Administration on Wednesday asked Teva Pharmaceuticals to withdraw its drug Budeprion XL 300 after testing showed the drug did not properly release its key ingredient. The drug is supposed to be equivalent to GlaxoSmithKline's popular antidepressant Wellbutrin XL, which is prescribed to treat depression, anxiety and symptoms of nicotine withdrawal. The announcement marked an about-face for regulators, who said in 2008 that the two drugs were essentially the same, despite hundreds of complaints from patients who said they experienced side effects such as headaches, anxiety and insomnia after switching to the generic drug. The FDA has withdrawn generic drugs before, but this appears to be the first case driven by consumer complaints, which continued to pile up after the FDA said the drug was working correctly. "The lesson is that everyone _ from pharmacists to physicians to the FDA _ needs to take these reports seriously," said Dr. Tod Cooperman of ConsumerLab, a privately-held company that independently tests drugs and nutrition products. Cooperman added that the vast majority generic drugs work appropriately but that, "consumers will be the first to know when there is a problem." ConsumerLab first drew attention to the issue with Budeprion XL in 2007. The company published an analysis of the two drugs, indicating Budeprion XL released its active ingredient at a much faster rate than Wellbutrin. The FDA completed its own study in August that confirmed those findings. But FDA officials said Thursday it would have been irresponsible to make scientific decisions based on patient reports, which can be influenced by a host of individual factors, including their disease. "When these reports come in we don't know exactly what is going on with the patient," said David Read, regulatory counsel for the FDA's office of generic drugs. "Is it a failure of the drug or is it a coincidence they are experiencing some sort of problem? It's something to discuss between them and their physician." Read pointed out that in the last five years the FDA has only had to correct itself on the equivalence of three drugs. Two cases involved drugs from Dr. Reddy's Laboratories: an antidepressant and an antifungal medication. The third case involved an anti-seizure drug from Upshur-Smith Laboratories. The FDA approved the first generic versions of Wellbutrin XL in 2006, including Budeprion. The generic drug is made by U.S.-based Impax Laboratories Inc. and sold by Israel-based Teva Pharmaceutical Industries Ltd. Teva said Wednesday that it halted shipments of the drug last Thursday after being contacted by the FDA. The company pointed out that there is no safety issue with the pill. The Generic Pharmaceutical Association, a trade group for generic drugmakers, moved quickly to defend the track record of both the FDA and its companies. "There are approximately 10,000 FDA-approved interchangeable generics in the U.S.," said Ralph Neas, the group's CEO and president. "The recall by a single manufacturer of one strength of a generic drug should in no way cast doubt on the impeccable reputation of the generic industry or the FDA." The generic pharmaceutical industry has never been more successful. With prices 50 to 70 percent below the original product, generic drugs are favored by government and private insurers, pharmacies and patients. Last year, generic drugs made up 80 percent of the 4 billion prescriptions written in the U.S., an all-time high driven by a wave of patent expirations. In the last year some of the best-selling drugs ever made have gone generic, including the high cholesterol pill Lipitor and the blood thinner Plavix. And complaints about generic drugs are rare, although they have cropped up before. The FDA's stance has been that generic drugs are chemically and medically equivalent to the original products. The agency has hammered home that message in pamphlets and posters with slogans like "Generic Drugs Make the Grade," and "Generic Drugs Measure Up." But the same streamlined process that makes generic drugs so cheap can open the door to problems like those seen with Teva's antidepressant. Developing and testing an original prescription drug can take more than a decade and cost upwards of $1 billion dollars, according to the Pharmaceutical Research and Manufacturers Association. The high price tag on most new drugs reflects the cost of years of trials that often involve hundreds of patients. 1 2 Next page » Comment

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Search Health Information Alzheimer's-Linked Gene May Have More Effect on WomenStudy looked at common gene variant and brain disruption TUESDAY, June 12 (HealthDay News) -- A common genetic risk factor for Alzheimer's disease disrupts brain function in healthy older women but has little effect in men, a new study has found. People with two copies (one from each parent) of the ApoE4 gene variant are at extremely high risk for Alzheimer's. Only 2 percent of people have two copies of the variant, while about 15 percent of people carry a single copy. In this study of 91 healthy older people, researchers looked at those with a single copy of the ApoE4 variant and found that women, but not men, exhibited two characteristics that have been linked to Alzheimer's disease. The women had a signature change in their brain activity and elevated levels of a protein called tau in their cerebrospinal fluid. The study, published June 13 in the Journal of Neuroscience, is the first to identify this gender difference in healthy older adults with one copy of the ApoE4 variants, according to a Stanford University news release. The findings suggest that men who carry a single copy of the gene variant shouldn't be assumed to be at increased risk for Alzheimer's disease. The findings also may help explain why women are more likely than men to develop Alzheimer's disease, said Dr. Michael Greicius, assistant professor of neurology and neurological sciences and medical director at the Stanford Center for Memory Disorders, and colleagues. Alzheimer's disease affects nearly 5 million people in the United States and nearly 30 million people worldwide, the news release noted. For every three women with Alzheimer's, about two men have the disease. The U.S. National Institute of Neurological Disorders and Stroke has more about Alzheimer's disease. Stanford University, news release, June 7, 2012 Copyright © 2012 HealthDay. All rights reserved. Finger Lakes Health 196 North Street, Geneva, NY 14456 315-787-4000

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A Clearer Regulatory Pathway for Cell Therapy May Help Improve Investment In the U.S. and the U.K., gov’t and foundations play a key funding role as investors try to avoid the risk. Alex Philippidis Basic research on issues like how cells interact with their environment and migrate could help steer regulation and direct money to the field. [© Sebastian Kaulitzki - Fotolia.com] Cell therapy took an important step forward recently in the U.S. when the Centers for Medicare & Medicaid Services (CMS) suggested that the federal government reimburse older men who use Dendreon’s drug Provenge for the approved hormone-refractory prostate cancer indication. A final decision is expected on June 30. If the proposed decision stands Provenge could be among the most expensive drugs covered by Medicare. It costs $31,000 per treatment, with three treatments the norm. High treatment costs are one of the key challenges—but not the only one—faced by developers of cell therapies, especially in the U.S. Cell therapy has also struggled to find interest among venture capitalists and other investors—more so since the science is relatively new. Compared to traditional therapies, financing cell therapies “is a lot harder because investors are not sure yet what the regulatory environment or the intellectual property environment is in the cell therapy space,” Baiju R. Shah, president and CEO of BioEnterprise, a business formation, recruitment, and acceleration initiative, told GEN. FDA and Cell Therapy FDA has implemented a risk-based approach to the regulation of human cells, tissues, and cellular and tissue-based products (HCT/Ps). Regulation focuses on three general areas: limiting the risk of transmission of communicable disease from donors to recipients; establishing manufacturing practices that minimize the risk of contamination; and requiring an appropriate demonstration of safety and effectiveness for cells and tissues that present greater risks due to their processing or their use. The only cell therapies approved by CBER are Genzyme's Carticel (autologous cultured chondrocytes) to repair knee injuries and Dendreon's Provenge, an autologous cellular immunotherapy for the treatment of asymptomatic or minimally symptomatic metastatic hormone-refractory prostate cancer. “We all know what we need to establish. What the field doesn’t know, and I’m sure the FDA doesn’t have all the answers, is what the best pathway is for establishing safety and efficacy,” Elona Baum, general counsel for the California Institute for Regenerative Medicine, told GEN. Baum cited several potential regulatory uncertainties: a lack of suitable animal models, the fact that living cells interact with the environment they are in and have the potential to migrate, and in many cases, a lack of a good understanding of the mechanism of actions, which makes it difficult to satisfy the safety and efficacy standards set by FDA. “Beause of the scientific complications of this field, it’s harder to establish what, for instance, the pharmaceutical industry has been establishing for years in terms of safety and efficacy,” Baum said. “There is just a larger area of complication, scientifically, and we need to develop the science so that we have methods for answering these regulatory questions as best as possible.” “I believe that at some point in time, the patient advocates will probably get more involved earlier in the development pipeline, because there will have to be a risk assessment for first in human studies,” Baum added. U.S. Financing Shah pointed out that given those types of challenges, “there aren’t that many firms out there that are interested in financing cell therapies.” BioEnterprise itself has helped nurture several cell therapy developers in recent years. One is Athersys, a stem-cell therapy developer that in January said it would raise $13.1 million by selling shares to undisclosed private investors. Another BioEnterprise-nurtured cell therapy developer is SironRx, a Juventas Therapeutics spinout and developer of therapies exclusively licensed from Juventas and Cleveland Clinic. SironRx raised $500,000 from the clinic’s corporate venturing arm, Cleveland Clinic Innovations, and Northeast Ohio economic development group JumpStart as part of a larger initiative to raise $2.5 million. The half-million dollars allows for the launch of a Phase II study of its lead product, SRX-100, which uses stem cells to accelerate wound repair and prevent scarring. The involvement of Cleveland Clinic, a co-founder of BioEnterprise, reflects how cell therapies often originate within research institutions using federal NIH funds for basic research. “Cell therapy companies have to become very creative in their sources of financing,” Shah said. “They have to leverage governmental sources that are available. You have a high degree of interest, particularly in the defense department, because these types of therapies can obviously be significant for both healing our wounded military as well as veterans, and that’s a source of financing that can’t be overlooked when you’re developing these types of technologies.” Baum agreed and said cell therapy developers need support from a variety of public and private sources. “What we are seeing more and more is the need to get some sort of government entity or foundation support for early-stage research, and that is where agencies or institutes like CIRM come in. “This is also where foundations such as Juvenile Diabetes Research Foundation are very important. When we build these public-private relationships and models, we will be able to foster the development of this industry,” said Baum. U.K.Funding In the U.K., cell therapy research has also taken in government funds and private dollars from disease foundations. The UK Stem Cell Funders Forum has sought in recent years to align research councils with charities, government departments, and regulatory agencies to discuss common concerns. On the private side, in February the British Heart Foundation launched its £50 million Mending Broken Hearts Appeal to fund stem cell research intended to improve chronic heart failure treatment. And since 2005, the UK Stem Cell Foundation has worked to raise £100 million. On the public side is the Medical Research Council (MRC). Its Translational Stem Cell Research Committee has committed to awarding at least £10 million annually. MRC also funds stem cell centers of excellence in Cambridge and Edinburgh. Regulation in the U.K. Additionally, MRC and the U.K.’s Department of Health maintain an online UK Stem Cell Tool Kit designed to navigate cell therapy developers through the country’s numerous regulatory agencies. The toolkit was developed with six regulatory agencies, two of which have been proposed for extinction since last year as part of the U.K.’s ongoing budget-cutting under the coalition government of Prime Minister David Cameron. The Human Tissue Authority (HTA) regulates stem cell research, overseeing the use of organs and human tissue for therapeutic purposes. The Human Fertilisation and Embryology Authority (HFEA) regulates and oversees the use of gametes and embryos in fertility treatment and research including human embryonic stem cell (hESC) research. A new health research agency recommended by the Academy of Medical Sciences would take over their oversight role in research, while the healthcare-related licensing operations of HFEA and HTA would continue through the new Care Quality Commission, created to regulate health and social care in the U.K. But advancing stem and other cell therapies will require more than the proverbial shuffling of government agencies and their duties. The U.K. government’s Business and Innovation Skills department is crafting a “stock-take” study examining the kingdom’s regenerative medicine effort, Dr. Catriona Crombie, MRC program manager for stem cells, developmental biology, and regenerative medicine, told GEN. “We’re looking at all of the issues and what the barriers might be, whether it is skills gaps or getting people to carry out multidisciplinary work, which is going to be essential to getting this field moving forward,” Dr. Crombie said. One barrier that has not arisen in the U.K. as in the U.S. is the restriction of research using hESCs on ethical grounds. Dr. Crombie said MRC joined with other funders of cell therapy research to actively promote the benefits of stem cell research, which she credited with a 2008 amendment to the Human Fertilisation and Embryology Act allowing the use of hESCs. Critics of the amendment said the destruction of embryos entailed in the research was immoral and have since cited progress in research using adult and induced pluripotent stem cells. “By and large, we found the general public is supportive of stem cell research for serious conditions. But people do want cures to serious diseases,” Dr. Crombie said. “I don’t think we avoided the controversy. We probably have a slightly more pragmatic approach to it.” Alex Philippidis is senior news editor at Mary Ann Liebert, Inc., and Genetic Engineering & Biotechnology News. KEYWORDS: Biotherapeutics Stem Cell Therapeutics FDA Sanctions NYBC’s Cord Blood Hematopoietic Progenitor Cells for Transplantation 7 Biotech Trends for the Coming Year Understanding FDA Oversight of Cell Therapies

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HOMEABOUTINNOVATIONSUPPORTJOINCONTACT Beta Lactamase Testing, Tuberculosis Diagnostic Test, Biophotonic Technology Our Technology Revolutionizing TB Diagnostics Our TB diagnostic platform incorporates an innovative biophotonic detection technology that utilizes Reporter Enzyme Fluorescence (REF) to detect β-lactamase produced by live bacteria. The first application of the technology being pursued by GBD is the development of diagnostic assays that allow the sensitive and specific detection of Tuberculosis. The platform was developed by researchers at the Texas A&M Health Science Center College of Medicine, Texas A&M University and Stanford University. The conceptual research conducted by Texas A&M and Stanford was funded by the Bill and Melinda Gates Foundation. Commercialization and product development of a point of care application of the technology is proceeding through a co-development agreement with the Foundation for Innovative New Diagnostics (FIND) based in Geneva, Switzerland. The company owns the worldwide exclusive license to develop, manufacture and sell products that are based on the platform technology. The technology has both in vitro diagnostic and in vivo research applications. The in vivo platform promises to provide a new, cost-effective, rapid tool for pharmaceutical companies and researchers to measure the efficacy of their experimental therapeutic compounds. Our Mission and VisionOur TechnologyOur PhilosophyOur TeamNews & EventsInvestorsTechnical Papers GBD TB REaD™ POCGBD in Vivo Research Product SupportResourcesJoin UsContact Us © 2014 GlobalBioDiagnostics.com Web Design & Development by IT Hands

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English | عربي International and Private Patients Great Ormond Street Hospital Sections International and Private Patients Service Our relationship with the NHS Gulf office Parent endorsements Patient and parent feedback Coming to hospital Coming for an outpatient appointment Staying in London Support during your stay State-of-the-art facilities Charges and payment Birthdays and religious festivals Information for embassies Information for clinicians Coming as an outpatient Coming as an inpatient Top tips What to bring Medical people Mohammed's story The story of Abdul Rahman Al Otaibi Our international work International education programme Kuwait project Dubai visiting programme Our clinical team Our nursing team Our play specialists Our patient service team Our Arabic interpreting assistants Breakthroughs in children's medicine Research achievements International and Private Patients Service Mission and values Our relationship with the NHS Governance Gulf office Parent endorsements Giving feedback Patient and parent feedback Press and news International and Private Patients Service Great Ormond Street Hospital is an international centre of excellence and is recognised as one of the few truly world-class hospitals for children. Great Ormond Street Hospital has been a pioneer in paediatrics ever since it admitted its first patients in 1852 and continues to be a global leader in the treatment of sick children. The hospital's many world-firsts and groundbreaking medical developments give new hope to children and families around the world. In the United Kingdom (UK), under the patronage of Her Majesty Queen Elizabeth II, Great Ormond Street Hospital is the leading research hospital for children and has the widest range of children's specialists under one roof. In partnership with the UCL Institute of Child Health (ICH), we are in the top five research institutions for children in the world and play a key role in training children's health specialists for the future. Top benchmarks The Children's Hospitals International Executive Forum (CHIEF) is a group of all the world's leading children's hospitals. They rate us as one of the four leading paediatric research hospitals in the world. For the last three years, Great Ormond Street Hospital, together with the ICH, has been in the top five centres in the world for research published. Being a world leader means having a world-leading team, and at Great Ormond Street Hospital, some of the top clinical and research experts are working to find new and better ways to treat the children in our care. In fact, we have more than 50 different clinical specialties, the widest range of any hospital in the UK. This uniquely enables us to diagnose and pioneer treatments for children with highly complex, rare or multiple conditions. We have more than 240,000 patient visits each year and see children ranging in age from newborn babies to 18-year-olds, many of whom have life-limiting or life-threatening conditions. In the International and Private Patients Service, we treated children from over 90 different countries in 2013/14. More than 17,000 patients (including over 9,000 from the Middle East region) visited the international divsion for treatment in the same period. Here are just a few of the reasons that make Great Ormond Street Hospital a world leader: It is the largest centre for children with heart problems in the UK and one of the largest centres for children's heart transplants in the world. It is the largest centre for children needing brain surgery in the UK - for example, the largest epilepsy surgery centre in Europe. With the University College London Hospital (UCLH), it is the third largest centre for children with cancer/leukaemia in the western world and the largest in Europe. It has the largest range of children's specialties in one institution in the UK. It is the country's only specialist biomedical research centre for paediatrics. It is the leading centre in the world for gene therapy in children. It is the leading centre in Europe for the management of conjoined twins (so-called, 'Siamese twins'). It has trained many of the children's cardiac surgeons currently practising in the United States. Our teams tackle the most complex conditions, including kidney transplants, childhood cancers, conjoined twins, epilepsy surgery, brain tumours, infectious diseases, cleft lip and palate and immunodeficiency disorders. Most of our patients require expert help from at least two specialist teams; many patients need help from five specialist teams or more. Our doctors and nurses are uniquely qualified and trained to treat unusual and severe disorders that sometimes require pioneering treatment not available in other hospitals, for example bone marrow transplants and gene therapy. Here are a few of the hospital's recent research achievements: New techniques for open heart surgery and bone marrow transplants. New drug therapies to treat epilepsy, juvenile arthritis and HIV-AIDS. New developments in keyhole surgery for children. Improved life support techniques for children in intensive care. Other advances have been made in areas such as pain management and also in the importance of play therapy to prepare a child for procedures and surgery, for example by using distraction therapy for magnetic resonance imaging scans (MRI) instead of anaesthetic. Involving the patient and family Breakthroughs and medical expertise are essential to the treatment of our patients, but we also place a great emphasis on the support we provide around the children in our care. Our aim is to provide an open and supportive atmosphere, ensuring that both parents and patients are informed and involved throughout the treatment process. For this reason, we support parents taking part in their child's care and also encourage older children to participate in certain aspects of their own care. We look beyond a child's medical condition and seek to care for all his or her needs, as well as those of their family. We try to adhere to their routine and meet their cultural, psychological and social needs. In addition, we see parents as our guests. Their comfort, privacy and peace of mind are important to us. We want to make their stay with us as comfortable and pleasant as we possibly can. They are valued members of their child's healthcare team and their child's safety is our utmost priority at all times. During your stay with us, you and your child will receive the highest standards of care and attention from our expert team of medical and support staff. We will aim to treat you with respect, trust, concern and openness. In addition, our staff will always make time to listen and help you. The hospital is located in central London, close to the West End and easily reached by public transport. Great Ormond Street Hospital International and Private Patients Service is based in the Harris International Patient Centre. This is a state-of-the-art unit where we care for children from overseas requiring specialist treatments unavailable in their own countries, and for private patients from the UK and around the world. Great Ormond Street Hospital for Children The Harris International Patients Centre The Octav Botnar Wing Great Ormond Street London, WC1N 3JN privateinfo@gosh.nhs.uk Dubai Health Care City P.O.Box: 505050, Dubai gulfoffice@gosh.nhs.uk About us Parents and visitors Refer a patient Children Our international work Meet our staff Research and innovation Work here Useful Links Accessibility Privacy Terms and Conditions Contact Us © 2011 Great Ormond Street Hospital for Children NHS Foundation Trust

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Physicians - Spotlight Comprehensive Stroke Center Designation Doesn't Come Easily Joe Cantlupe, for HealthLeaders Media, January 10, 2013 There is much talk about alignment in healthcare, not only with physicians, but with nurse practitioners in coordinating care. That was evident in the Joint Commission's review, Carter says. "It wasn't good enough to say, ‘We have a nurse educator.' We had to show what the practitioner did, and they made us prove we did what we said we were doing." The Joint Commission review also showed that despite the hospital's progress, there were still lessons to be learned, with specific details of stroke care that will continue to be reviewed and evaluated. "They made us look at every process," Carter says. "Is this a necessary process? Or, is this just a historical process that we've done?" As a result of the Joint Commission's detailed review, the San Diego hospital, for instance, evaluated its use of CAT scans. "We found small things contributing to delays (in care), such as the way the CAT scans were ordered," he says. Eventually, the hospital adjusted its electronic medical record [system] to improve "time and efficiency" in using CAT scans as well as other procedures, Carter adds. While there are now 12 comprehensive stroke centers, Carter anticipates that there may eventually be dozens more, as well as more than 1,000 primary care stroke centers "when this all shakes out with the Joint Commission." Unfortunately, not all stroke centers, despite their designation, work together as a team to provide stroke care. That should change, Carter says. All stroke centers need to better coordinate care for stroke patients, especially under emergency conditions. Carter equates such an effort as similar to trauma centers. "When there's an auto accident, it's immediately known where to send the patient," Carter says, noting that EMS crews immediately decide what's necessary for an injured motorist, and what hospital is equipped to provide best treatment. That's been successful," Carter says. "The same should be done for a stroke patient."Joe Cantlupe is a senior editor with HealthLeaders Media Online. 1

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National Survey on Drug Use and Health, 2008 (ICPSR 26701) Alternate Title: NSDUH 2008 The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates of drug use in the United States. Detailed NSDUH 2008 documentation is available from SAMHSA. The surveys are designed to provide quarterly, as well as annual, estimates. Information is provided on the use of illicit drugs, alcohol, and tobacco among members of United States households aged 12 and older. Questions included age at fir... (more info) The National Survey on Drug Use and Health (NSDUH) series (formerly titled National Household Survey on Drug Abuse) primarily measures the prevalence and correlates of drug use in the United States. Detailed NSDUH 2008 documentation is available from SAMHSA. The surveys are designed to provide quarterly, as well as annual, estimates. Information is provided on the use of illicit drugs, alcohol, and tobacco among members of United States households aged 12 and older. Questions included age at first use as well as lifetime, annual, and past-month usage for the following drug classes: marijuana, cocaine (and crack), hallucinogens, heroin, inhalants, alcohol, tobacco, and nonmedical use of prescription drugs, including pain relievers, tranquilizers, stimulants, and sedatives. The survey covered substance abuse treatment history and perceived need for treatment, and included questions from the Diagnostic and Statistical Manual (DSM) of Mental Disorders that allow diagnostic criteria to be applied. The survey included questions concerning treatment for both substance abuse and mental health related disorders. Respondents were also asked about personal and family income sources and amounts, health care access and coverage, illegal activities and arrest record, problems resulting from the use of drugs, and needle-sharing. Questions introduced in previous administrations were retained in the 2008 survey, including questions asked only of respondents aged 12 to 17. These "youth experiences" items covered a variety of topics, such as neighborhood environment, illegal activities, drug use by friends, social support, extracurricular activities, exposure to substance abuse prevention and education programs, and perceived adult attitudes toward drug use and activities such as school work. Several measures focused on prevention-related themes in this section. Also retained were questions on mental health and access to care, perceived risk of using drugs, perceived availability of drugs, driving and personal behavior, and cigar smoking. Questions on the tobacco brand used most often were introduced with the 1999 survey. For this 2008 survey, Adult mental health questions were added to measure symptoms of psychological distress in the worst period of distress that a person experienced in the past 30 days and suicidal ideation. A split-sample design also was included to administer separate sets of questions to assess impairment due to mental health problems. Background information includes gender, race, age, ethnicity, marital status, educational level, job status, veteran status, and current household composition. (2,170 MB) large dataset Questionnaire.pdf (showcards) Subject Terms: addiction, alcohol, alcohol abuse, alcohol consumption, amphetamines, barbiturates, cocaine, controlled drugs, crack cocaine, demographic characteristics, depression (psychology), drinking behavior, drug abuse, drug dependence, drug treatment, drug use, drugs, employment, hallucinogens, health care, heroin, households, income, inhalants, marijuana, mental health, mental health services, methamphetamine, pregnancy, prescription drugs, sedatives, smoking, stimulants, substance abuse, substance abuse treatment, tobacco use, tranquilizers, youths noninstitutional group quarters such as college dormitories, group homes, shelters, rooming houses, and civilians dwelling on military installations. Although the design of the 2008 survey is similar to the design of the 1999 through 2001 surveys, there are important methodological differences since 2002 that affect the 2008 estimates. Each NSDUH respondent since 2002 has been given an incentive payment of $30. This change resulted in an improvement in the survey response rate. In addition, in 2002 new population data from the 2000 decennial Census became available for use in NSDUH sample weighting procedures. Therefore the data from 2002 and later should not be compared with data collected in 2001 or earlier to assess changes over time. For selected variables, statistical imputation was performed following logical inference to replace missing responses. These variables are identified in the codebook as designation "IMPUTATION-REVISED" in the variable label when the statistical procedure was also performed. The names of statistically imputed variables begin with the letters "IR". For each imputation-revised variable, a corresponding imputation indicator variable indicates whether a case's value on the variable resulted from an interview response or was imputed. Missing values for some demographic variables were imputed by the unweighted hot-deck technique used in previous surveys. Beginning in 1999, imputation of missing values for most variables was accomplished using predictive mean neighborhoods (PMN), a new procedure developed specifically for this survey. Both the hot-deck and PMN imputation procedures are described in the codebook. To protect the privacy of respondents, all variables that could be used to identify individuals have been encrypted or collapsed in the public use file. To further ensure respondent confidentiality, the data producer used data substitution and deletion of state identifiers and a subsample of records in the creation of the public use file. Previously published estimates may not be exactly reproducible from the variables in the public use file due to the disclosure protection procedures that were implemented. The setup and dictionary files for Stata are designed to be compatible with StataSE, Version 8. This is a large data file requiring that approximately 250 megabytes of Random Access Memory be allocated to Stata. Operations within Stata, including conversion of the ASCII data to Stata format, are likely to be slow. Analysts may wish to download subsets of data from the SAMHDA Survey Documentation and Analysis (SDA) system for use with Stata. In the income section, which was interviewer-administered, a split-sample study had been embedded within the 2006 and 2007 surveys to compare a shorter version of the income questions with a longer set of questions that had been used in previous surveys. This shorter version was adopted for the 2008 NSDUH and will be used for future NSDUHs. states and the District of Columbia has been used since 1999. The 2005 NSDUH was the first survey in a coordinated five-year sample design. Although there is no overlap with the 1999-2004 samples, the coordinated design for 2005 through 2009 facilitated a 50 percent overlap in second-stage units (area segments [see below]) between each two successive years from 2005 through 2009. This design was intended to increase precision of estimates in year-to-year trend analyses because of the expected positive correlation resulting from the overlapping sample between successive survey years. The 2008 design allows for computation of estimates by state in all 50 states plus the District of Columbia. States may therefore be viewed as the first level of stratification as well as a reporting variable. Eight states, referred to as the large sample states, had a sample designed to yield 3,600 respondents per state for the 2008 survey. This sample size was considered adequate to support direct state estimates. The remaining 43 states (which include the District of Columbia) had a sample designed to yield 900 respondents per state in the 2008 survey. In these 43 states, adequate data were available to support reliable state estimates based on SAE methodology. Within each state, sampling strata called state sampling (SS) regions were formed. Based on a composite size measure, states were partitioned geographically into roughly equal-sized regions. In other words, regions were formed such that each area yielded, in expectation, roughly the same number of interviews during each data collection period. The eight large sample states were divided into 48 SS regions each. The remaining states were divided into 12 SS regions each. Therefore, the partitioning of the United States resulted in the formation of a total of 900 SS regions. Unlike the 1999 through 2004 surveys, the first stage of selection for the 2005 through 2009 NSDUHs was Census tracts. The first stage of selection began with the construction of an area sample frame that contained one record for each Census tract in the United States. If necessary, Census tracts were aggregated within SS regions until each tract had, at a minimum, 150 dwelling units in urban areas and 100 dwelling units in rural areas. These Census tracts served as the primary sampling units (PSUs) for the coordinated five-year sample. One area segment (one or more Census blocks) was selected within each sampled Census tract. In advance of the survey period, specially trained listers had visited each area segment and listed all addresses for housing units and eligible group quarters units in a prescribed order. Systematic sampling was used to select the allocated sample of addresses from each segment. Beginning in 2002, each respondent who completed a full interview was given a $30 cash payment as a token of appreciation for his or her time. To improve the precision of the estimates, the sample allocation process targeted five age groups: 12 to 17 years, 18 to 25 years, 26 to 34 years, 35 to 49 years, and 50 years or older. The size measures used in selecting the area segments were coordinated with the dwelling unit and person selection process so that a nearly self-weighting sample could be achieved in each of the five age groups. The achieved sample size for the 2008 survey was 67,928 persons. The public use file contains 55,739 records due to a subsampling step used in the disclosure protection procedures. A key step in the data processing procedures established the minimum item response requirements in order for cases to be retained for weighting and further analysis (i.e., "usable" cases). These requirements, as well as full sampling methodology, are detailed in the codebook. Weight: Due to unequal selection probabilities at multiple stages of sample selection and various adjustments, such as those for nonresponse and poststratification, the 2008 NSDUH sample design is not self-weighting. Analysts are advised to use the final sample weight when attempting to use the 2008 NSDUH data to draw inferences about the target population or any subdomains of the target population. All estimates published in SAMHSA reports (such as the results from the 2008 NSDUH) are weighted using the final analysis weight for the full sample (ANALWT). For the public use file, the corresponding final sample weight is denoted as ANALWT_C, with the "C" denoting confidentiality protection. This sample weight represents the total number of target population persons each record on the file represents. Note that the sum of ANALWT_C, over all records on the data file, represents an estimate of the total number of people in the target population. In the mental health module of the 2008 NSDUH, the adult sample was split into sample A (MHSAMP08 = 1) who received the World Health Organization-Disability Assessment Scale (WHODAS) questions LIREMEM through LIAD68, and sample B (MHSAMP08 = 2) who received the Sheehan Disability Scale (SDS) questions MHAD66a through MHAD68. The mental health adult split-sample weight (MHSAWT_C) was created to accommodate analysis using either one of the split samples, and it is the product of person-level analysis weight (ANALWT_C) and a poststratification adjustment that was done separately for both sample A and sample B. The mental health adult split-sample weight for both sample A and sample B was controlled to the Census population estimates for the civilian, noninstitutionalized population aged 18 or older. It is noted that the MHSAWT_C was set to zero for all 12 to 17 year olds and the 10 adults who were not assigned to either of the split samples. The MHSAWT_C can be used for generating mental health estimates when using just sample A data or when using just sample B data separately. However, if mental health estimates are generated using both sample A and sample B combined data, then the person-level analysis weight (ANALWT_C) should be used. Mode of Data Collection: audio computer-assisted self interview (ACASI), computer-assisted personal interview (CAPI), computer-assisted self interview (CASI) Response Rates: Strategies for ensuring high rates of participation resulted in a weighted screening response rate of 88.62 percent and a weighted interview response rate for the CAI of 74.24 percent. (Note that these response rates reflect the original sample, not the subsampled data file referenced in this document.) 2014-09-05 Changed the Stata system data file from version 13 to version 12 for compatibility on a wider range of systems. Updated codebook to include correct frequencies from the data. 2014-06-13 Since the release of the previous version of the 2008 Public Use Data File and Codebook a number of variables have been added. Some of the additional variables are revised versions of previous variables and replace the ones removed from the data file.A model to predict adult mental illness was revised in the 2012 NSDUH to produce more accurate estimates. The mental illness variables included in the 2008 NSDUH data files are based on the revised 2012 model.One new geographic variable(PDEN00), has been added to the data file to replace the previous PDEN variable. In this case, the only difference is the variable name. The variable has been renamed to indicate which census data was used in its construction. 2012-12-10 The 2008 NSDUH public-use data file has been updated to include 23 new variables related to non-medical drug usage and adult depression. Please view Table 4 of the codebook for more information on these variables. 2009-12-16 Corrections were made to misspelled variable labels for variables CPNPSYYR and CPNPSYMN. Becker, W.C., Meghani, S., Tetrault, J.M., Fiellin, D.A. Racial/ethnic differences in report of drug testing practices at the workplace level in the U.S.. American Journal on Addictions. Cavazos-Rehg, Patricia A., Krauss, Melissa J., Spitznagel, Edward L., Grucza, Richard A., Bierut, Laura Jean Youth tobacco use type and associations with substance use disorders. Addiction. 109, (8), 1371-1380. 3.1 Million Adults with Mental Illness Were Unemployed. NSDUH Report. Half of Adults with Serious Thoughts of Suicide Did Not Receive Mental Health Services. NSDUH Report. Chang, Man-Chun, Warner, Lynn A. The impact of HIV on behavioral health service utilization: Propensity score analysis of nationally representative household durvey data. Society for Social Work and Research 2014 Annual Conference. San Antonio, TX. Chen, Lian-Yu, Crum, Rosa M., Martins, Silvia S., Kaufmann, Christopher N., Strain, Eric C., Mojtabai, Ramin Patterns of concurrent substance use among nonmedical ADHD stimulant users: Results from the National Survey on Drug Use and Health. Drug and Alcohol Dependence. Choi, Namkee G., DiNitto, Diana M., Marti, C. Nathan Risk factors for self-reported driving under the influence of alcohol and/or illicit drugs among older adults. Gerontologist. Treatment use, perceived need, and barriers to seeking treatment for substance abuse and mental health problems among older adults compared to younger adults (R2). Drug and Alcohol Dependence. Colpe, Lisa J., Pringle, Beverly A. Data for building a national suicide prevention strategy: What we have and what we need. American Journal of Preventive Medicine.

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National Jan 22, 2013 2:16 PM by Patricia Collier Golden retrievers key to lifetime dog cancer study (AP) - When Jay Mesinger heard about a study seeking golden retrievers to help fight canine cancer, he immediately signed up 2-year-old Louie. He and his wife know firsthand the toll of canine cancer: Louie is their fourth golden retriever. The first three died of cancer. "They all had long lives but were taken by complications from one kind of cancer or another," said the Boulder, Colo., businessman.For Louie and 2,999 other purebred goldens, it will be the study of a lifetime. Their lives - usually a 10-to-14-year span - will be tracked for genetic, nutritional and environmental risks to help scientists and veterinarians find ways to prevent canine cancer, widely considered the No. 1 cause of death in older dogs, said Dr. Rodney Page. The Golden Retriever Lifetime Study will be the largest and longest dog study ever conducted, said Page, the study's principal investigator, a professor of veterinary oncology and the director of the Flint Animal Cancer Center at Colorado State University.The study will focus on three cancers that can be fatal to the dogs, including bone cancer, lymphoma (cancer of the lymph nodes) and a cancer in the blood vessels called hemangiosarcoma, Page said. He also expects the data to yield information about other dog diseases, like arthritis, hip dysplasia, hormonal and skin disorders and epilepsy, he said. The Morris Animal Foundation, a 64-year-old group based in Denver, is providing much of the $25 million needed for the study. The rest will be funded through online public donations that allow people to sponsor one of the 3,000 canine volunteers.The study is recruiting purebred golden retrievers under the age of 2 whose pedigree can be traced back at least three generations. The breed was chosen because "they are very common. They are the fourth- or fifth-most common dog recognized by the American Kennel Club. They are wonderful companions for people and found in every walk of human endeavor," Page said. Researchers were seeking young dogs because "knowing the history of their lives provides huge advantages," Page said. Those involved in the study compared the work to the Framingham Heart Study, which has tracked a group of humans and their descendants from Framingham, Mass., since 1948. Dr. Nancy Bureau, Mesinger's veterinarian at the Alpine Animal Hospital in Boulder, said that given the condensed lifespan of a dog, it might not take a decade to see results from the study. Before this group of volunteer dogs has left this world, hopefully we will have data to help even them," she said. A pilot study of 50 dogs started in August 2012, and Page said preliminary results from that first group should be ready soon and reportable results could be possible in a year. Work on the study started about four years ago. After funding was approved, scientific and research teams were formed, the database was set up, a bio-lab found to store the samples and a questionnaire was written. The recruitment of volunteer dogs was expected to be done in two years, with most of it spent on verifying eligibility and participation. Page said it takes about four weeks to verify pedigree and health, and make sure a dog's owner and veterinarian will participate. So far, 200 dogs have accepted the invitation, and 600 others are on a waiting list. Bureau, who also has a golden retriever client on the waiting list, said it's a privilege to be part of a groundbreaking study. Aside from researchers, participating veterinarians probably have the most work - they have to submit samples of blood, urine and hair during annual exams and report whenever they treat a volunteer dog for any reason. Study leaders will not intervene or recommend any treatment, Page said. "We will work with the vets working with the pets. We will catalog all the things that happen, the medical history, the diet, environment and exposures." The vets hope the study eventually will benefit humans. Researchers will pay particular attention to early onset obesity in dogs to see how it is related to diabetes, Page said. Dog-years are a benefit to researching ailments found in both dogs and humans, because studying a dog for 10 years is akin to studying a human for 60 or 70 years, said Dr. Wayne Jensen, the Morris Animal Foundation's chief scientific officer and executive director."There are many examples where risk factors in dogs have also been found in people," said Jensen. The study will also try to measure factors in a dog's life, such as how fun and an owner's love affect the animal's health and longevity. That will be attempted through questions about the number of children or other pets in the owner's family, the amount of time spent together - and the dog's sleeping spot. Mesinger knows the answer to that one off the top of his head: "In bed, with my wife and I." »Comments Most Popular

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Home > Living With Cancer > Mind Body Side Effects > Nutrition Fads Fade Fast But Healthy Eating Sticks By Joan Daniels, R.D., andNancy Burke, R.D.Did you notice that leg warmers made a comeback this winter? Chances are, though, love'em or hate'em, wearing leg warmers won't impact your health. But your diet will. Think about it: Would you let the same folks who advised a generation of women to plaster their bangs up sky-high also tell you what you should eat? Didn't think so. When cancer is a part of your life, eating healthy is critical. But figuring out what that means gets confusing.People look to food for all kinds of answers: to help them lose weight, to brighten their mood, to stop cancer. It's important to remember, though, that food is just that: food. It's not medicine, and although scientists are working hard to understand the chemical properties that make some foods healthier than others, the best thing to do is to keep your eye on the broader picture.So rather than providing a list of "rules" for a healthy diet, we put together a list of guiding principles. The classics never go out of style.Guiding Principles for Eating WellEat your fruits and vegetables!Your mother said it, and she couldn't have been more right. Plants contain vitamins, minerals and nutrients called "phytochemicals." Phytochemicals fight cancer. And since scientists still don't fully understand how they all work together to keep you healthy, it's best to get your phytochemicals from food rather than supplements.Try it; you might like it.Yes, your mother told you that, too, and again, she was right. Phytochemicals come in almost as many forms as there are fruits and vegetables. Increased variety equals decreased risk. And if you don't like it the first time, give it a second chance. As you'll see from the recipes we've offered on our Web site, there's more than one way to skin an asparagus spear.Cook more, if possible.We know everyone's lives are busy, but making time to cook dinner is one of the best ways you can improve your diet. Prepackaged food and carry-out options usually don't offer much in the way of fruits and vegetables. Also, they're more likely to contain hidden ingredients like extra fat, salt and sugar.Moderation is key.If you don't have the best eating habits, don't try to change them all overnight. Don't obsess over "good" and "bad" foods. As you gradually introduce healthier foods into your diet, you'll find you crave fat, sugar and salt less and less.Use common sense.We all know deepfried foods and desserts should be rare treats. Remember, a cookie is still a cookie, even if the package says it's healthy.Try out some new recipes (opens as a .pdf document).Return to topThrive Issue: Spring, 2007

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Study Indicates Targeted Strategies Needed to Find, Prevent and Treat Breast Cancer among Mexican-Origin Women Half of study participants had disease diagnosed before age 50MD Anderson News Release 09/01/10Specific prevention and education strategies are needed to address breast cancer in Mexican-origin women in this country, according to a study at The University of Texas MD Anderson Cancer Center, which was published online in the journal Cancer.Among the Mexican-origin women with breast cancer who were surveyed, half were diagnosed before age 50, years earlier than the national average for non-Hispanic white women. This puts them outside the recently released U.S. Preventive Task Force guidelines that recommend screenings, including mammograms, begin at 50 for the general population. The guidelines have been controversial, and MD Anderson opted to continue to recommend screening beginning at age 40."Under the revised Task Force guidelines, up to half of Mexican-origin women with breast cancer may be undiagnosed or diagnosed in late stages, possibly increasing disparities in rates of breast cancer mortality," said Patricia Miranda, Ph.D., a Kellogg Health Scholar post-doctoral fellow in the Center for Research on Minority Health in the Department of Health Disparities Research at MD Anderson and the study's lead author. "Hispanic women are not recognized in the guidelines as a high-risk group, and we would like to see that decision revisited."One-Size-Fits-All Approach Falls ShortBreast cancer is the leading cause of death among Hispanic women in the United States. Previous studies have shown they are more likely to be diagnosed with advanced breast cancer and 20 percent more likely to die from the cancer than non-Hispanic white women.Hispanics are the nation's largest and fastest growing minority group. According to the American Community Survey, more than 45 million Hispanics live in this country. By 2050, the population - which has the lowest rate of insurance coverage - is expected to reach 132 million."As the new national health care policy is implemented, if a one-size-fits all screening recommendation is implemented as the Task Force recommends, we fear a huge number of breast cancer cases won't be picked up at an early stage, especially with the growth of the Hispanic population in this country," said Melissa Bondy, Ph.D., professor in the Department of Epidemiology and senior corresponding author.The study, which is among the first to use a non-clinical, population-based sample to examine the risk of breast cancer in this group, identified 714 Hispanic women in the Houston area from MD Anderson's Mano a Mano Mexican-American Cohort Study: 119 with breast cancer and 595 without cancer.Several factors were compared including:Age at diagnosisFamily history of breast cancerMarital status, number of children and educationHealth insurance statusLanguage acculturation (ability to speak English)Country of birth (U.S. or Mexico)Family History, Acculturation Raise RiskWomen at highest risk for breast cancer - 2-1/2 times other women surveyed - had a family history of the disease, spoke English well and were born in Mexico.The strongest risk factor was family history, which increased odds fourfold and was found to be true of 15 percent who had breast cancer. This indicates that women with a strong family history of breast cancer should receive earlier and more frequent screening, Bondy said.The role of acculturation was striking too. Women who were born in Mexico and spoke English well had 2-1/2 times the risk of women born in Mexico who did not. Single women were almost twice as likely as married women to develop breast cancer, and women without insurance were 1-1/2 times more likely than those with insurance to be diagnosed. Women who do not have insurance are less likely to be screened.Although the study is fairly small, researchers believe it shows the need for clear action on several fronts."Going forward, we believe it's essential to create education programs specifically for this population, especially if any of the screening guidelines change," Miranda said.In addition, the study recommends assistance with acquiring health insurance, which may increase access to screening and early detection, and working with affected communities to help formulate policy agendas.More Research PlannedAlthough Hispanics are the fastest growing group in the country, they are markedly under-represented in medical research. MD Anderson, which has been studying Mexican-American health through the Mano A Mano study for 10 years, is involved in a major study of Hispanic women in Mexico, Arizona and Texas."We are looking at reasons these women are getting breast cancer earlier and tend to develop later stage breast cancer," Bondy said. "We're hoping to find answers that will help save lives."Co-authors with Miranda and Bondy on the study include: Anna Wilkinson, Ph.D.; Carol Etzel, Ph.D. and Renke Zhou; all of MD Anderson's Department of Epidemiology, and Lovell Jones, Ph.D., director of the Center for Research on Minority Health in the Department of Disparities Research at MD Anderson; and Patricia Thompson, Ph.D. from the University of Arizona, Arizona Cancer Center. The research was supported in part by the Kellogg Health Scholars Program, the National Cancer Institute, the Caroline W. Law Fund for Cancer Prevention, the Duncan Family Institute for Cancer Prevention and Risk Assessment, and the National Center on Minority Health and Health Disparities. In addition, funds collected pursuant to the Comprehensive Tobacco Settlement of 1998 and appropriated by the 76th legislature to MD Anderson provided funding. 09/01/10 Global NavigationAbout UsLocationsCalendarCareersHow You Can HelpChildren's Art ProjectDirectoryContact UsSitemapPatient and Cancer InformationmyMDAndersonCancer InformationPatient InformationCare Centers & ClinicsChildren’s Cancer HospitalServices & AmenitiesClinical TrialsNews and PublicationsNewsroomPublicationsEducation and ResearchDepartments, Programs & LabsResearch at MD AndersonEducation & TrainingResources for ProfessionalsFor EmployeesEmployee ResourcesDoing BusinessVendors & SuppliersPartners & AffiliatesState of TexasState of Texas Home PageStatewide Search (TRAIL)State Comptroller - Where the Money GoesTexas Homeland SecurityThe University of Texas SystemInstitution ResumeLegal, Policy and ReportsReports to the StateLegal Statements & Site PoliciesStay ConnectedFacebookTwitterGoogle+PinterestLinkedInYouTubeFlickrInstagramRSSiTunes U#endcancerEmergency AlertsEmergency Alert Information

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Dr. Chad's Health Factoids A daily dose of healthy knowledge about your well-being The X Factor: Final Four Compete for the Finals About this blog By Dr. Chad Laurence Owner and educator Dr. Chad Laurence is in private family practice at Corrective Chiropractic in Hockessin. After earning his doctorate from Life University of Chiropractic in Marietta, Ga., Dr. Laurence began practicing chiropractic in 2000. Owner and educator Dr. Chad Laurence is in private family practice at Corrective Chiropractic in Hockessin. After earning his doctorate from Life University of Chiropractic in Marietta, Ga., Dr. Laurence began practicing chiropractic in 2000. Before his chiropractic studies, Dr. Laurence received a BS degree in Microbiology from Pennsylvania State University. Dr. Laurence is one of only two doctors in Delaware who is certified in Chiropractic Biophysics, and is a Distinguished Fellow of the CBP technique. With a focus on chiropractic, structural spinal correction, nutrition, education, specific training, and massage therapy, Dr. Laurence is able to relieve symptoms for individuals suffering with physical problems, including neck and low back pain, carpal tunnel syndrome, headaches, arthritis, and intestinal difficulties. His approach is also particularly successful at helping children with chronic ear infections, asthma, allergies, ADD/ADHD, bed-wetting issues, colic and immune system disorders. Dr. Laurence is an experienced presenter who has been invited to speak in a variety of venues. He has published articles in regional health publications and area newspapers. Dr. Laurence and Corrective Chiropractic have been voted “Best Chiropractor in Delaware” by readers of several local newspapers. He currently serves on the boards of the Southern Chester County Chamber of Commerce, Arthritis Foundation of Delaware, and is a long-standing member of Longwood Rotary. For more information about Dr. Laurence or Chiropractic Biophysics (CBP), call Corrective Chiropractic at (302) 234-1115 or visit www.correctivechiro.net. It's all up to the audience now.The final four contestants on The X Factor sang their hearts out Wednesday night for a spot in next week's final, and audience votes alone will determine which act gets eliminated on Thursday night and which three will advance - with no sing-off or judges' votes to decide. Additionally, the show isn't going to reveal the rankings of the Top 3, meaning that viewers won't know who the frontrunner is heading into the finals.Who is the best TV actor of 2012?For the second week in a row, the acts each performed two songs - one of their choosing and one selected by them and their mentor (though Demi Lovato is the one judge with no contestants remaining). Here's a breakdown of each performance.Tate StevensFor his pick, the last man standing from L.A. Reid's Over 25s went full redneck with a boot-stompin', old-school country throwback rendition of Craig Morgan's "Bonfire," complete with pyrotechnics onstage. By this point, Stevens knows it's his country shtick that differentiates him from the rest of the field and it's clear he's going to milk it for all it's worth (as is Reid, who donned a cowboy hat for the performance). Not a bad move. Reid, Simon Cowell and Lovato said it was Stevens' best performance to date. Britney Spears was the only dissenter, but her lukewarm feedback drew boos from the crowd and a loud, high-pitched gasp from Reid.Stevens' second number was "Fall" by Clay Walker, which he dedicated to his wife (again). Another traditional country song, it was a more subdued performance than his first outing, but no less commendable. Spears called it a "direct hit," and Cowell put it even more bluntly. "There is about as much chance of you going back to your old job as me flying to the moon tomorrow night," he told Stevens. "Let's be clear. You've made your mark here. I think you've done enough to get into the final, and you thoroughly deserve it." Do you agree?Carly Rose SonenclarThe 13-year-old sensation from Britney Spears' Teens chose Elton John's "Your Song" for, um, her song and offered an expectedly polished take on the classic. Lovato called the choice of an adult contemporary ballad "predictable," but said she loved the performance anyway, and Reid also praised Sonenclar's "risky" decision. Cowell said it wasn't Sonenclar's best performance in the competition but said she'd likely redeem herself in her second outing of the night.Who was the best actress of 2012?For that, Spears selected John Lennon's "Imagine," and had Sonenclar both sing and play the piano for the introduction. It was a ... let's say "interesting" arrangement of the classic, one that attempted to give Sonenclar numerous opportunities to belt out notes on a song that doesn't really call for much belting. Reid and Lovato praised the rendition, but Simon had problems with it, calling the arrangement and staging (with Sonenclar leaving and then returning to the piano) "overcomplicated."Emblem 3Paying particular attention to Lovato's criticism that they were getting predictable and not working the stage enough in their performances, the first of Simon Cowell's two Groups made a point of spreading out and high-fiving members of the audience during Peter Frampton's "Baby, I Love Your Way." The strategy worked - with both Lovato and Cowell saying that the performance reminded them of the group's original audition, when they first showed the judges that they had something special. Reid called it the trio's "big 5 million dollar moment," and Spears told them, "It would be unfair to call you a boy band, because you're way more than that."On their second number, the guys paid tribute to the original boy band, taking on The Beatles' "Hey Jude," which, let's face it, could have been a disaster of a performance. But Emblem 3 pulled it off with aplomb, seriously working the crowd during the song's "na-na-na-na" outro. All of the judges had nothing but good things to say, even frequent criticizer Lovato. "I was prepared to just rip you to shreds, because doing a Beatles song is very presumptuous," Reid told them afterwards. "That was risky business ... but you did a great job."Fifth HarmonyTrying to show that they could both harmonize and perform a choreographed dance number, the second of Cowell's Groups first tackled Ellie Goulding's "Anything Could Happen." While their stage show was unconvincing at best, the girls again reinforced their individual and collective vocal talents. In fact, Reid told them it was "the very best vocal performance you've ever done." But will that be enough to keep them in the competition? Cowell seems to think so. Acknowledging the quintet had come into the semifinals as "underdogs" due to their fourth place ranking, he said after the song, "To get into the final is going to take a miracle ... but after that performance, like the lyric of that song just said, anything now can happen."The group next opted for Shontelle's "Impossible," which they previously performed during the judges' homes round, and decided to incorporate Spanish lyrics into the song to gain some more votes. (Somebody paid attention to post-presidential election analysis!) Reid called the song selection "lazy" since they had already done it once, and all the judges (except for Simon) agreed that the performance was good but not great. "I would be really surprised if you guys are here next week," Spears said flatly. "I'm a little worried too," Lovato agreed. But remember - the judges don't get a say in this week's elimination.So, who do you think will make it to the finals and who will be sent home Thursday? Weigh in below!View original The X Factor: Final Four Compete for the Finals at TVGuide.comOther Links From TVGuide.com Britney SpearsSimon CowellL.A. ReidDemi LovatoThe X FactorCarly Rose SonenclarEmblem 3Fifth HarmonyTate Stevens

医学

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Consumer-Staffed Monitoring Teams In Managed-Care Assessment by E. Clarke Ross, D.P.A., NAMI deputy executive director for public policy The need to document consumer satisfaction is a core premise of managed care. But who does the documenting is fundamental to the meaningfulness of measures of satisfaction. And the concept itself-satisfaction-is questionable; many advocates have concluded that dissatisfaction and the health plan's ability to immediately respond to dissatisfaction are much more significant than satisfaction. All healthcare systems-not just managed care-must incorporate valid mechanisms to document and affirmatively respond to dissatisfaction. The use of independent, third-party, consumer- and family-staffed organizations is basic to NAMI's evolving agenda to ensure accountability by all participants in the healthcare arena-payers, purchasers, health plans, management agents, delivery systems, and providers. Fortunately, several public mental health systems are launching the use of consumer- and family-staffed consumer-interview teams to assess-and to obtain when lacking-health plan responsiveness to dissatisfaction. Massachusetts, Michigan, Ohio, and Pennsylvania are rolling out such consumer-based initiatives as part of their managed care accountability approaches. Alabama, Georgia, Washington, and Wisconsin are also using such teams in limited areas of their public mental health systems. First funded by the county, one of the very first in the nation, and probably the most advanced in terms of operational experience is Philadelphia's Consumer Satisfaction Team, Inc., whose executive director is the immediate past-president of NAMI-Pennsylvania, Loretta Ferry. In 1990 the city of Philadelphia, which has been developing a consolidated mental health service system and today operates a citywide single managed behavioral healthcare system, developed a consumer satisfaction team (CST). The mission of the CST, as articulated by Loretta, is to try to understand and communicate back to the funder of services what consumers like or do not like about those services. Recognizing that it often takes a long time to build trust with a person with serious and persistent mental illness, the CST in Philadelphia conducts multiple interviews with the same consumers over the course of a year. CSTs provide written documentation of each consumer visit and hold regular meetings with the payer. With Philadelphia's development of a managed care program in 1996, the CST expanded its responsibility to include consumer outreach and education. Also in 1996, the scope of the CST was broadened to include people with addictive disorders as well as those with serious mental illness. In early 1996 the Center for Mental Health Services' (CMHS) Mental Health Statistics Improvement Project (MHSIP) introduced a prototype consumer-oriented report card for consumers to use to evaluate managed care. NAMI board of directors member J. Rock Johnson, J.D., was actively involved in this effort, and Elizabeth Edgar of the NAMI staff is NAMI's link with the MHSIP. There has been much debate about the feasibility of collecting uniform data for this report card. A core premise underlying MHSIP is that information focused on the consumer's individual life situation should be the basis of any report card effort. NAMI goes further and argues that those directly affected by mental illness should collect information about consumers. Most managed care organizations (MCOs) use their own internal marketing or, hopefully, quality-assurance teams to determine consumer satisfaction. Whether marketing or quality-improvement staff, they are internal employees of the organization. Marketing staff tend to focus on overall satisfaction, and they assume that when overall rates of satisfaction are high, everything is basically OK. Quality-improvement staff tend to focus on areas of operation requiring improvement. This is helpful, but still skewed by the situation of internal staffing. Some MCOs use outside agencies, most frequently university departments or professional surveying organizations, which avoids the internal staffing bias; however, they may not fully understand the situations of consumers and family members directly affected by mental illness. NAMI board of directors member Fred Frese, Ph.D.; NAMI Ohio President Velma Beale, M.A.; and NAMI Ohio former Executive Director Krista Magaw have been directly involved in the development of an Ohio Department of Mental Health project that has lead to the publication of Vital Signs: A Statewide Approach to Measuring Consumer Outcomes in Ohio's Publicly Supported Community Mental Health System. (Dr. Frese has also been involved in a three-site Veterans Administration consumer-team approach.) Ohio holds that "outcomes should be measured primarily from the perspective of consumers" and that this process should be an innovative and incremental addition to Ohio's benchmarking, database, and continuous-quality-improvement strategies. A recommended advocacy strategy Numerous research studies have verified the validity and usefulness of patient-satisfaction measures in assessing the efficacy of clinical care. So, what should every NAMI organization advocate for with every health plan, whether public, private, managed care, or fee-for-service? The creation of an independent, third-party monitoring team of family members and consumers to assess the dissatisfaction enrollees have with their health plan. (It will always be a challenge to determine the difference between substantial and frivolous dissatisfaction.) The commitment of the health plan to routinely meet with the consumer/family interview teams and to immediately work to correct identified problems. Immediate response is crucial. The collection and aggregation of health-plan and provider-performance dissatisfaction data, the documentation of health-plan and provider responses to dissatisfaction, and the public release of resulting information to help individuals make informed choices about enrollment in the health plan and about providers.

医学

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Health Highlights: July 9, 2014 Heroin, Painkiller Abuse Targeted in 2014 White House Drug Control Policy Reducing heroin use and prescription painkiller abuse are among the main goals in the 2014 drug control policy announced Wednesday by the White House. Another major objective is to promote drug treatment programs, CBS News/Associated Press reported. The drug control policy will continue to emphasize expanded health interventions and "smart on crime" alternatives shown to reduce drug use, according to Michael Botticelli, acting director of the Office of National Drug Control Policy. There will also be increased emphasis on preventing overdoses from opioids, which include heroin and prescription painkillers, CBS News/AP reported. Pets Harmed by Secondhand Smoke Secondhand smoke poses a serious threat to pets' health. It can cause malignant lymphoma in cats, lung and nasal cancer in dogs, and respiratory problems and allergies in both species, according to studies conducted at Tufts University's School of Veterinary Medicine in Massachusetts and other schools, the Associated Press reported. The 2006 U.S. Surgeon General's report warned that secondhand smoke puts animals at risk, and the American Society for the Prevention of Cruelty to Animals urges pet owners to have smoke-free homes. There are no statistics on how many pets die each year due to secondhand smoke, but veterinarians do know that secondhand smoke causes inflammation, allergic reactions, and nasal and pulmonary cancers in pets, Dr. Kerri Marshall, chief veterinary officer for Trupanion pet insurance, told the AP. Even electronic cigarettes pose a threat to dogs, who will grab e-cigarette nicotine cartridges from the trash. "You wouldn't think dogs would eat such things, but they do," Liz Rozanski, a Tufts researcher who specializes in respiratory function in small animals, told the AP. Implantable Memory-Restoring Device Being Developed by Researchers U.S. scientists are working on an implantable device that will help restore memory. The $2.5 million project at the Lawrence Livermore National Laboratory in California is being funded by The Defense Advanced Research Projects Agency, NBC News reported. The small wireless device would be implanted in regions of the brain involved with memory. An external device worn around the ear will store information. The first patients to use the device will be those with traumatic brain injury (TBI), such as soldiers who've survived bomb blasts, NBC News reported. "Currently, there is no effective treatment for memory loss resulting from conditions like TBI," project leader Satinderpall Pannu said.

医学