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New Drug Regimens May Slow Advanced Breast Cancer Survival lengthened in studies of two experimental treatments By Amy Norton WEDNESDAY, Dec. 5, 2012 (HealthDay News) -- An experimental cancer drug may delay the progression of some advanced breast cancers, while a double dose of an existing cancer drug could help women live longer, according to separate studies reported Wednesday. In one study, of nearly 200 women, researchers tested the effects of adding the experimental drug -- known for now as PD 0332991 -- to Femara (letrozole), a hormonal therapy already used to treat certain breast cancers. They found that women on the combination had a much longer "progression-free survival" -- the time a cancer patient lives with the disease without it getting worse. For women on the combination therapy, that period was typically 26 months, versus less than eight months among women given Femara alone. "That's a dramatic difference," said lead researcher Dr. Richard Finn, associate professor of medicine at the University of California, Los Angeles, Jonsson Comprehensive Cancer Center. Finn noted that in oncology clinical trials, success is measured in very small steps. A new drug might extend patients' lives by a matter of a couple of months, for instance. The women in the trial all had advanced cancer that had spread beyond the breast. Their tumors were also estrogen-receptor positive, which means the cancer depends on estrogen to feed its growth and spread. "ER-positive breast cancer is the most common form of breast cancer," Finn said. "And while we do have effective therapies for it, we still need to improve upon them." The experimental drug is made by Pfizer, Inc., which also funded the trial. A larger trial is set to start next year, but Finn said these early results are "encouraging." He was scheduled to present the findings Wednesday at the 2012 San Antonio Breast Cancer Symposium in Texas. Data and conclusions of studies released at medical meetings are considered preliminary, since they haven't undergone peer review for publication in a medical journal. In a separate study reported at the meeting, researchers found that doubling the dose of an existing breast cancer drug, Faslodex (fulvestrant), lengthened women's lives by a few months. Like the other trial, this one focused on older women with advanced ER-positive cancer. Faslodex is an injected form of hormonal therapy that works by blocking the effects of estrogen on breast cancer cells; it's given to postmenopausal women whose cancer has worsened despite anti-estrogen therapies such as tamoxifen. Among more than 700 women in the trial, those randomly assigned to a 500-milligram dose of Faslodex typically lived about four months longer: 26 months versus 22 months among women given the standard 250-milligram dose. The higher dose extended lives without increasing side effects, said the researchers, led by Dr. Angelo Di Leo, head of medical oncology at the Hospital of Prato in Italy. Faslodex commonly causes side effects such as nausea, vomiting, diarrhea, headaches and hot flashes, and occasionally more serious problems, such as blood clots. In this trial, between 1 percent and 2 percent of women in each group had a serious side effect attributable to the medication. The trial was sponsored by AstraZeneca Pharmaceuticals, which makes Faslodex. The higher Faslodex dose has already become the "standard of care," based on earlier findings from the trial, said Dr. Kimberly Blackwell, director of the Duke Breast Cancer Clinic and a professor of medicine at Duke University School of Medicine. Blackwell, who was not involved in either new study, was more excited about the experimental Pfizer drug. "We always want to be cautious about a trial that involves fewer than 200 patients," Blackwell said. But, she added, "if this is confirmed in the Phase 3 trial, it could have a big impact on how we treat patients." What is new about the drug, Finn and Blackwell said, is how it works: It blocks the formation of certain proteins cancer cells need to divide and spread. Blackwell said the importance of those proteins has long been recognized, but until now, there hasn't been a drug that could safely block them. "This represents a brand-new way in slowing down breast cancer progression," Blackwell said. The combination did cause side effects, including fatigue and neutropenia -- a decrease in important disease-fighting white blood cells. But these "were manageable side effects," Finn said. Still, Blackwell said, the safety and ultimate effectiveness of the therapy "remain to be validated." According to the American Cancer Society, the average U.S. woman has a 12 percent chance of developing breast cancer in her lifetime. Death rates from the disease have dropped in recent decades because of better treatments and earlier detection, experts said. Learn more about breast cancer from the American Cancer Society (http://www.cancer.org/cancer/breastcancer/detailedguide/index ). SOURCES: Richard Finn, M.D., associate professor, medicine, University of California, Los Angeles, Jonsson Comprehensive Cancer Center; Kimberly Blackwell, M.D., director, Duke Breast Cancer Clinic, and professor, medicine, Duke University School of Medicine, Durham, N.C.; Dec. 5, 2012, presentation, San Antonio Breast Cancer Symposium, San Antonio, Texas

医学

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Search App assists in managing care records for complex conditions 6/10/2013 A beta version of an application called Hello Doctor is available in Apple's App Store to help people with complex medical conditions manage health records from multiple doctors and clinics. Patients and caregivers can use the app to send copies of records to health care providers by fax or e-mail. Forbes More Summaries: app store Related Summaries Rural, urban cancer survivors differ in health behaviors 6/7/2013 An analysis of data from the 2006-2010 National Health Interview Survey revealed that rural cancer survivors were more likely to have unhealthy behaviors such as smoking and physical inactivity than urban survivors. Thirty-seven percent of rural survivors said they have fair or poor health compared to 27% of their urban counterparts, researchers reported in the journal Cancer Causes and Control. Nurse.com Research organizations agree to share genetic data 6/7/2013 The NIH has joined about 70 medical, research and advocacy organizations across the globe in an initiative to create shared databases of genetic and clinical information. The coalition will agree on standards for representing and sharing genetic data as well as for obtaining patient consent. Researchers hope pooled data will allow them to understand and treat rare genetic mutations in cancer, pediatric diseases, heart disease and other conditions. The New York Times (tiered subscription model), Nature (free content) Lawmakers ready to renew national end-of-life care conversation 6/7/2013 U.S. lawmakers and health care providers may be ready to renew a national discussion about palliative and hospice care and advance care planning. Rep. Earl Blumenauer, D-Ore., said there has been an increase in support for advance care planning, and his Personalize Your Care Act would help people get the end-of-life care they want. Another House bill would increase palliative care faculty, while legislation to be introduced in both the Senate and House would support palliative care education and research. The Medicare NewsGroup More Summaries: palliative care Anxiety is common among cancer survivors, study says 6/5/2013 Data from 26 studies showed anxiety is the most common mental health issue for people who have had cancer and their spouses. Researchers from the Leicester Partnership Trust in Leicester, England, found depression among cancer survivors was not significantly different from a control group, but anxiety was more common among the study group. The findings indicate the importance of screening and treating patients for anxiety, experts said. MedPage Today (free registration) Novartis unveils 2 apps for patients with cancer 3/15/2013 Two free mobile applications were recently unveiled by Novartis Oncology. Patients with neuroendocrine tumors can use the My NET Manager app to learn more about the condition, be reminded about doctor consultations and medication refills, and more. The Clinical Trial Seek app helps patients and doctors look for cancer clinical studies in different locations. MobiHealthNews.com Get the News in your Inbox

医学

2016-36/3163/en_head.json.gz/10916

Nutrition Labeling Systems Promise to Drive Wellness Sales robertvosburgh.jpg Supermarkets are always trying to make shopping easier, faster and more manageable. They've pioneered solutions like online purchasing, personal scanners and self-checkouts, to name a few, each one designed to maximize the convenience factor. The thinking is that customers who save time, money and energy are happy customers, and happy customers always come back. If there's a monkey wrench capable of bringing the whole grand scheme to a crunching halt, it's health and wellness. Yep. The efficient engine that retailers have painstakingly built shifts into low gear when consumers start looking at natural, organic and special-claims products. The problem is that there's so much information on today's packages: low fat, heart-healthy, low cholesterol, gluten-free, grass-fed, USDA organic — the list goes on and on. And many sources contribute to the list. Manufacturers, trade associations, special-interest groups and even retailers themselves have developed these logos and on-pack label programs. The idea is sound and the goal admirable, but each program remains a unique, proprietary system applicable only to that one manufacturer's products, or to those sold by this one supermarket chain. Each labeling system is often based on different nutrition criteria, and therefore cannot be transferred or applied elsewhere, or to other products. None is universal. And that's where the slowdown starts. The labels become a detour, and consumers stall in the aisles as they attempt to interpret the various letters, symbols and descriptors printed on packages. So, it was exciting to learn that two systems covering every product in every store will soon be available for licensing. Both are profiled in the Spring 2008 edition of SN Whole Health accompanying this week's issue of SN. Topco Associates is handling marketing for the Yale-developed Overall Nutritional Quality Index, or ONQI, while Hannaford Bros. Supermarkets has announced it is offering its very own Guiding Stars nutrition rating program under similar terms. Both systems use complex mathematical formulas that reduce a food item's total nutrition to a single, indentifiable symbol — stars for Hannaford's program and numbers for ONQI. The retailers we interviewed for the story all talked about how these programs aren't about judging one manufacturer over another, or comparing the qualities of two competing products. It's about empowering consumers with the information they need to make their own decisions about which foods to buy. “All this is, is an objective, third-party system that's being applied equally to all products across the board,” Randy Skoda, executive vice president at Topco, told us. In five years, look how far we've traveled in the wellness movement. Supermarkets carry organic foods in every category, employ expert dietitians, conduct community outreach on a grand scale, and much more. Now, imagine supermarkets five years into the future, when every product has a nutritional rating that's easily understood. That's progress. Now, we're making shopping faster, easier — and truly better for you. Source URL: http://supermarketnews.com/blog/nutrition-labeling-systems-promise-drive-wellness-sales

医学

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Blood samples from family members and bone samples from graves are analyzed to find their DNA profiles at the ICMP laboratories in Sarajevo so the DNA can be compared in order to identify the missing. 1,345 Family Members Donate Blood Samples in US Campaign In hotel conference rooms in Dallas, Texas and Atlanta, Georgia, late Wednesday evening, blood collection teams from the International Commission on Missing Persons (ICMP) completed their North American drive to collect samples from family members of persons missing from the conflicts in the former Yugoslavia. The blood samples – just four small drops of blood collected on absorbent cards – will be analyzed to find the DNA profiles of the relatives for comparison with DNA profiles of remains found in mass graves across the former Yugoslavia in order to identify the missing. A DNA match within the ICMP system indicates identity with a certainty of at least 99.95 per cent. During their two-week blood collection drive, ICMP teams visited 12 states in the eastern United States and the mid-west, states selected because the highest concentrations of families of persons missing from the former Yugoslavia are currently living there. Many family members traveled for hours to reach the collection points, and family members living in Canada also traveled south to donate blood samples. A total of 1,345 family members donated blood samples during the campaign. The first results are expected by early in the New Year. “For a variety of reasons, there are many family members of the missing who are not able to travel back to the former Yugoslavia, where we would normally collect blood samples from them,” said Edin Jasaragic, Head of ICMP’s Identification Coordination Division and blood collection team-leader, speaking from Dallas. “We had an extremely positive response to this drive. Although family members living here have in many cases started new lives, it is still very important for them to know what happened to their missing loved-ones,” he said. ICMP was established in 1996 to help to address the missing persons issue in the former Yugoslavia following the recent conflicts there. In the late 1990s, faced with the task of identifying thousands of remains, ICMP scientists developed a system to identify large numbers of persons using DNA as the first tool in the identification process, rather than Giving a blood sample is simple and painless; ICMP collected 1,345 blood samples in its US blood collection drive 2005. to confirm or exclude a “presumptive” identification that had been made using more traditional means. This revolutionary step has led to DNA matches for 8,723 individuals in the former Yugoslavia, to date, with new DNA matches being found daily. Approximately 20,000 persons are still unaccounted for in the region. Some of those have already been exhumed from grave sites and await DNA matches with family members and many more remain in mass graves, which are still being discovered and exhumed. The ICMP blood collection teams visited Syracuse, New York; Hartford, Connecticut; Erie, Pennsylvania; Richmond, Virginia; Jacksonville, Florida; Des Moines, Iowa; Chicago, Illinois; Grand Rapids, Michigan; Bowling Green, Kentucky; and St. Louis, Missouri, as well as Dallas and Atlanta. ICMP’s unique expertise in extracting DNA profiles from bones and teeth, many of which have been buried for more than ten years, and in matching those profiles to reference DNA samples from family members, has also led to its participation in the identification of victims of last December’s Asian tsunami. From ICMP press release. Please go to the website for the International Commission on Missing Persons for more information http://www.ic-mp.org/home.php

医学

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Company told to revise cancer vaccine submission Updated November 08, 2006 21:14:00 PBS rejection ... Mr Abbott says the decision is a responsible one. (File photo) (Handout: AFP) PBS committee rejects cervical vaccine funding Frazer disappointed at vaccine's PBS rejection Map: Australia The federal Health Minister, Tony Abbott, has urged pharmaceutical company CSL to re-submit its cervical cancer vaccine for federal funding.The Pharmaceutical Benefits Advisory Committee (PBAC) has recommended the Federal Government refuse to subsidise the vaccine.The committee is concerned about the costs, long-term effectiveness and long-term side effects of the Australian-developed vaccine.Mr Abbott believes the committee's decision is a responsible one."It doesn't think that Gardasil is cost effective, but at a different price and with new information there's every reason to think they could come up with a different decision."Mr Abbott says CSL may get a different answer if it addresses the Committee's concerns."These expert committees owe it to taxpayers as well as to patients to try to ensure that we only subsidise drugs or put vaccines on the free list if we're confident that they are cost effective," Mr Abbott said.But the Australian Medical Association (AMA) wants the Government to find a way to subsidise the vaccine.The AMA president, Dr Mukesh Haikerwal, says it is a missed opportunity."I think we have to bang heads together, because this is a significant advance in the health of the nation," he said."It's actually one of the first times we can see a vaccine-preventable cancer, almost being prevented. So, what what we don't want to do is grab victory from the jaws of defeat."The vaccine was developed in Australia by Professor Ian Frazer, who was subsequently named Australian of the Year.Professor Frazer says the vaccine needs to be used widely for it to be most effective."We know the vaccine works, we know that given the right time it can prevent the infections that cause cervical cancer and the pre-cancer that needs to be treated, so really, it's a matter of what's the best way to use it for the public benefit is, and I think that would be best done by giving it as widely as possible." cervical-and-vulval-cancers, First posted November 08, 2006 18:55:00

医学

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Macaque monkey study: Drug may treat senior moments A drug already approved by the Food and Drug Administration (FDA) to treat high blood pressure may have an equally important effect on brain function, according to new research in monkeys. Friday, July 29, 2011 - 11:31 Mouse study will enable greater understanding of depressive disorders linked to low serotonin NIH-funded scientists have developed a strain of mice with a built-in off switch that can selectively shut down the animals' serotonin-producing cells, which make up a brain network controlling breathing, temperature regulation, and mood. Researchers look to dogs to better understand intricacies of bone cancer A new University of Minnesota discovery may help bone cancer patients fight their disease more effectively, according to new research published in the September issue of Bone. Thursday, July 28, 2011 - 13:18 Treating obesity via brain glucose sensing successful in lab mice In the July 26 issue of PLoS Biology, Dr. Dongsheng Cai and his research team at Albert Einstein College of Medicine describe a pathway that directs the brain to sense the body's glucose dynamics, and they find that a defect of this glucose sensing process contributes to the development of obesity and related disease. Wednesday, July 27, 2011 - 10:44 Sea squirt cells shed light on cancer development Delicate, threadlike protrusions used by cancer cells when they invade other tissues in the body could also help them escape control mechanisms supposed to eliminate them, a research group led by led by Bradley Davidson in the University of Arizona's department of molecular and cellular biology reports in Nature Cell Biology. Animal research finds that eliminating protein in specific brain cells blocks nicotine reward Removing a protein from cells located in the brain's reward center blocks the anxiety-reducing and rewarding effects of nicotine, according to a new animal study in the July 27 issue of The Journal of Neuroscience. The findings may help researchers better understand how nicotine affects the brain. Mouse study reveals pregnancy hormone has unprecedented effect on spinal muscular atrophy Researchers in Ottawa report new hope for the treatment of infants born with serious genetic disorder. Tuesday, July 26, 2011 - 10:00 New gene therapy to reverse heart failure ready for clinical trials A promising gene therapy developed, in part, at Thomas Jefferson University’s Center for Translational Medicine to prevent and reverse congestive heart failure is on the verge of clinical trials, after years of proving itself highly effective in the lab and a large animal study. Zinc ‘sparks’ fly from animal eggs within minutes of fertilization At fertilization, a massive release of the metal zinc appears to set the fertilized egg cell on the path to dividing and growing into an embryo, according to the results of animal studies supported by the National Institutes of Health. Thursday, July 21, 2011 - 11:50 Building a better mouse for research It has taken nearly a century, but mouse geneticists are finally finishing the work started by Abbie Lathrop. The former schoolteacher from Massachusetts bred many of what became the first laboratory strains of mice in the early 1900s. Working with mice, researchers identify genes vital to preventing childhood leukemia Researchers at The University of Western Ontario have identified genes that may be important for preventing childhood leukemia. Tuesday, July 19, 2011 - 12:25 Spinal cord repair restores independent breathing in mice A report in the journal Nature showed a nerve graft, coupled with a protein, could restore breathing. uman trials could begin soon, which the charity Spinal Research said could be "potentially life-changing". Nerve graft heals paralysis in rats A peripheral nerve graft and treatment with an enzyme blocker restored breathing in partially paralyzed rats. The finding, published today (July 13) in Nature, suggests that a similar technique could one day be used to treat quadriplegics, who usually need artificial respirators to breathe. Investigators discover new mechanism in lab mice that may be important for learning and memory New findings in mice suggest that the timing when the neurotransmitter acetylcholine is released in the brain’s hippocampus may play a key role in regulating the strength of nerve cell connections, called synapses. In animal models, scientists block glioblastoma cells from spreading The active ingredient in a traditional Chinese herbal remedy might help treat deadly brain tumors, according to a new study by researchers at the Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James). 30 research mice make history as part of last shuttle mission Thirty "micetronauts" rocketed into space Friday aboard the final shuttle flight as part of an Amgen experiment to regrow bone in space. Ingredient in common cough medicine improves multiple sclerosis symptoms in animal models. Researchers have discovered that an ingredient in common, over-the-counter cough syrups can alleviate symptoms of multiple sclerosis (MS), an inflammatory, autoimmune disease that affects about 2.5 million people worldwide.Researchers have discovered that an ingredient in common, over-the-counter cough syrups can alleviate symptoms of multiple sclerosis (MS), an inflammatory, autoimmune disease that affects about 2.5 million people worldwide. Monday, July 11, 2011 - 12:33 In lab mice, liver tumors contain stem cells responsible for cancer recurrence Liver cancers are embedded with a type of super cancer stem cells that make them resistant to chemotherapy, spread to other body parts and stage a comeback even after they are surgically removed, researchers in Hong Kong reported on Thursday. Friday, July 8, 2011 - 13:21 The space shuttle program’s oddest passengers--animal research in space. With the final space shuttle scheduled to launch July 8 carrying an iPhone and a mutant strain of salmonella, we're taking a look at some of the strangest things that have ridden along with the shuttle astronauts into space. Sunburn study in rats could lead to new arthritis pain relief Researchers at King’s College London have found a molecule in the body which controls sensitivity to pain from UVB irradiation, identifying it as a new target for medicines to treat pain caused by other common inflammatory conditions such as arthritis. Thursday, July 7, 2011 - 11:46

医学

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Iron loss threatens U.S. blood supply Michelle Fay Cortez / Bloomberg News Published Jul 16, 2013 at 05:00AM Dennis Gastineau started giving blood regularly when he was in medical school in the 1970s. The $25 he received bought almost enough groceries for a week. Now, it just seems like the right thing to do. It may also be bad for his health. Gastineau, who happens to be a hematologist, is among the 2.4 million donors who risk silent damage as a result of frequent giving. U.S. government research published last year found this group iron-deficient, which can lead to fatigue, compromised mental function and eventually anemia. Now, iron levels are being examined as part of an $87.2 million study the U.S. is funding on blood donation and transfusion safety. Seventy percent of the blood supply comes from repeat donors. Limiting their giving may hamper a system that already suffers shortages. The Mayo Clinic predicts a 10 percent drop in its supply from its restrictions on donors after finding that one-third had iron deficiency. “We want to make sure we don’t have a group of people walking around being iron-deficient,” said Manish Gandhi, the medical director of the Mayo Clinic’s blood donation center. “Blood donation in the U.S. is an altruistic thing. We need to focus on what we should be doing to protect these wonderful donors.” Almost 10 million Americans annually give blood. Still, that’s only 5 percent of those eligible, according to a national survey conducted by the U.S. Department of Health and Human Services. The agency’s REDS-III study, underway since 2011, is examining donors’ iron levels as part of an effort to improve blood banking and transfusion practices. Boosting the number of donors may be key to a healthier blood-banking system. Whole blood, which is divided into four components to treat everything from hemophilia to ulcers and accident victims, can now be given every two months, under rules set by the Food and Drug Administration. The question is whether that’s too often. The FDA, National Heart, Lung and Blood Institute and the AABB, a nonprofit that represents the transfusion medicine industry, are struggling to find a way to minimize iron loss in donors without reducing the total blood supply. Researchers are working on a test to identify donors susceptible to iron deficiency that can be done during blood drives. Using iron supplements can carry troublesome side effects such as an upset stomach and constipation. And while the American Red Cross generally encourages its donors to eat healthy meals to restore iron levels after giving blood, the metal is hard to absorb from food. “Right now no one knows what the right answer is,” Gandhi said in a telephone interview. For Gastineau, 61, a doctor specializing in blood cancers and bone marrow transplants at the Mayo Clinic in Rochester, Minn., the issue is professional and personal, he said in an interview. Several years ago, during a hike through the mountains of northern New Mexico, he became so fatigued that he struggled to complete a trail he previously did with ease, he said. The culprit was depleted iron levels in his blood. He stopped giving blood for a few months before each trek and his cut back donations to once or twice a year. Now he also takes iron for a month after each donation. “I found out the hard way it’s not a good idea to donate blood and then try to hike in the mountains the next weekend,” Gastineau said. “It’s the reverse of blood doping.” The Mayo Clinic where Gastineau works changed its policy in June after it found one-third of its donors had depleted iron stores. Now they must wait at least three months before giving blood to reduce the risks that can lead to anemia, a condition in which iron levels fall dangerously low. Blood drives already test for hemoglobin, the iron-carrying protein in red blood cells that ferries oxygen throughout the body. Hemoglobin levels, though, may be normal in the early stages of iron loss, when there are usually no symptoms, said Richard Benjamin, chief medical officer of the American Red Cross. “The early symptoms are very subtle,” Benjamin said by telephone. “It’s difficult to ask donors if they’re feeling tired, listless, depressed. Those are symptoms of the modern age.” The U.S.-funded study probing iron deficiency in blood donors was published in April 2012 in the medical journal Transfusion. It found 20 percent of women who started donating regularly had no iron reserves and 51 percent produced iron-deficient red blood cells. The risks were higher for those who were already regular donors, the study found, with 27 percent of women having absent iron stores and 62 percent producing iron deficient red blood cells. Eighteen percent of regular male donors had depleted iron stores and 47 percent produced iron- deficient red blood cells. The Red Cross, which provides 40 percent of the blood supply nationwide, changed its policies this winter. It now recommends men who donate three or more times a year and women of child-bearing age who give blood more than twice annually to consider iron supplements. It doesn’t provide them. “We changed our stance on the whole iron issue,” Benjamin said. “Research is being done through the National Institutes of Health, but we can’t really wait. We have to react now.” 3061340

医学

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Auspex Pharmaceuticals Receives U.S. Patent on Novel JAK Inhibitor SD-900 Tweet LA JOLLA, Calif., Nov. 15, 2012 /PRNewswire/ -- Auspex Pharmaceuticals, Inc. today announced that it has been granted U.S. Patent No. 8,299,084 covering the company's novel JAK kinase inhibitor SD-900, a deuterium-substituted analogue of tofacitinib."The issuance of a composition-of-matter patent for SD-900 is strong validation of Auspex's technological approach to the creation of important new drugs," said Lawrence C. Fritz, Ph.D., President and Chief Executive Officer of Auspex. "We believe that SD-900 can emerge as an important drug in the JAK inhibitor space, combining the efficacy of tofacitinib with improved metabolic properties." The JAK kinases have emerged as important targets for drugs to treat autoimmune diseases including rheumatoid arthritis, inflammatory bowel disease, and psoriasis as well as for the treatment of certain types of cancer. The JAK inhibitor drug tofacitinib was recently approved by the U.S. Food and Drug Administration for the treatment of rheumatoid arthritis and is also in clinical development for additional autoimmune diseases. Auspex believes that SD-900 will retain precisely the intrinsic pharmacological activity of tofacitinib but improve its pharmacokinetics. These properties may allow SD-900 to provide the efficacy of tofacitinib but at a reduced dose, and may also promote the development of a once-a-day JAK inhibitor for use in treating autoimmune diseases.Auspex's lead compound, SD-809, also incorporates deuterium into its structure and is entering phase 3 clinical trials for the treatment of hyperkinetic movement disorders, specifically, the chorea associated with Huntington's disease.About SD-900SD-900 is a novel "JAK inhibitor", a small molecule inhibitor of the Janus Kinase enzyme family. It is a specific deuterium-substituted analogue of tofacitinib. Deuterium is a safe, naturally occurring, non-radioactive form of hydrogen. Because the substitution of deuterium for hydrogen does not change the shape of a molecule or its electronic structure, it does not change the binding properties of a drug. However, in certain cases these substitutions can have a beneficial effect on increasing the half-life of the drug. Because of these properties of deuterium, Auspex believes that SD-900 will have equivalent efficacy to tofacitinib but with the prospect of improved pharmaceutical properties.About Auspex PharmaceuticalsAuspex Pharmaceuticals is a privately held biopharmaceutical company located in La Jolla, California. The company is a pioneer in the use of deuterium in medicinal chemistry, and its most advanced program is focused on the treatment of hyperkinetic movement disorders including Huntington's disease, Tourette syndrome and tardive dyskinesia. Its lead compound, SD-809, is a novel inhibitor of the vesicular monoamine transporter 2 (VMAT-2). This drug offers the potential for significant advantages over existing therapies including improved safety, reduced drug-drug interactions, and less frequent dosing. SD-809 is expected to enter phase 3 clinical testing in 2013. Auspex is also exploiting its deuterium chemistry approach to optimize drugs in several additional therapeutic areas. Included in the Auspex portfolio are SD-900, a JAK kinase inhibitor for the treatment of autoimmune diseases, SD-560 for the treatment of fibrotic diseases, as well as other compounds. For more information on Auspex, please visit the company's web site at http://www.auspexpharma.com.SOURCE Auspex Pharmaceuticals Auspex Pharmaceuticals Raises $25 Million India Revokes Roche (RHHBY) Patent in New Blow for Big Pharma Auspex Pharmaceuticals Signs Deal with Teva Pharmaceutical Industries Limited (TEVA) Involving a Deuterium-Containing Drug AtheroNova Inc. (AHRO.OB) Receives Notice of Issuance of Its U.S. Patent 8,304,383 Auspex Pharmaceuticals Raises $12 Million New Patent Covering PROLOR Biotech (PBTH)'s Reversible-Pegylation Platform Technology is Allowed by U.S. Patent Office Auspex Pharmaceuticals Appoints Michael Grey as Chief Executive Officer and R. Gary Gilmore as Chief Financial Officer SomaGenics Inc. Announces Issue of Key Patent for Its sshRNA Technology and Receipt of Two New Small Business Innovation National Institutes of Health (NIH) Grants Auspex Pharmaceuticals Strengthens Executive Management Team Tengion Inc. Issued Additional Notice of Allowance for U.S. Patent Application Covering Cell-Scaffold Regeneration for Its Neo-Urinary Conduit™ Product Candidate Please enable JavaScript to view the comments powered by Disqus. Auspex Pharmaceuticals Biotech/Pharma - Patent News

医学

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SRI International Research Points to Biomarker That Could Track Huntington's Disease Progression Tweet MENLO PARK, Calif., July 8, 2013 /PRNewswire/ -- A hallmark of neurodegenerative diseases such as Alzheimer's, Parkinson's and Huntington's is that by the time symptoms appear, significant brain damage has already occurredand currently there are no treatments that can reverse it. A team of SRI International researchers has demonstrated that measurements of electrical activity in the brains of mouse models of Huntington's disease could indicate the presence of disease before the onset of major symptoms. The findings, "Longitudinal Analysis of the Electroencephalogram and Sleep Phenotype in the R6/2 Mouse Model of Huntington's Disease," are published in the July 2013 issue of the neurology journal Brain, published by Oxford University Press.SRI researchers led by Stephen Morairty, Ph.D., a director in the Center for Neuroscience in SRI Biosciences, and Simon Fisher, Ph.D., a postdoctoral fellow at SRI, used electroencephalography (EEG), a noninvasive method commonly used in humans, to measure changes in neuronal electrical activity in a mouse model of Huntington's disease. Identification of significant changes in the EEG prior to the onset of symptoms would add to evidence that the EEG can be used to identify biomarkers to screen for the presence of a neurodegenerative disease. Further research on such potential biomarkers might one day enable the tracking of disease progression in clinical trials and could facilitate drug development. "EEG signals are composed of different frequency bands such as delta, theta and gamma, much as light is composed of different frequencies that result in the colors we call red, green and blue," explained Thomas Kilduff, Ph.D., senior director, Center for Neuroscience, SRI Biosciences. "Our research identified abnormalities in all three of these bands in Huntington's disease mice. Importantly, the activity in the theta and gamma bands slowed as the disease progressed, indicating that we may be tracking the underlying disease process."EEG has shown promise as an indicator of underlying brain dysfunction in neurodegenerative diseases, which otherwise occurs surreptitiously until symptoms appear. Until now, most investigations of EEG in patients with neurodegenerative diseases and in animal models of neurodegenerative diseases have shown significant changes in EEG patterns only after disease symptoms occurred. "Our breakthrough is that we have found an EEG signature that appears to be a biomarker for the presence of disease in this mouse model of Huntington's disease that can identify early changes in the brain prior to the onset of behavioral symptoms," said Morairty, the paper's senior author. "While the current study focused on Huntington's disease, many neurodegenerative diseases produce changes in the EEG that are associated with the degenerative process. This is the first step in being able to use the EEG to predict both the presence and progression of neurodegenerative diseases."Although previous studies have shown there are distinct and extensive changes in EEG patterns in Alzheimer's and Huntington's disease patients, researchers are looking for changes that may occur decades before disease onset. Huntington's disease is an inherited disorder that causes certain nerve cells in the brain to die, resulting in motor dysfunction, cognitive decline and psychiatric symptoms. It is the only major neurodegenerative disease where the cause is known with certainty: a genetic mutation that produces a change in a protein that is toxic to neurons.About SRI Biosciences SRI Biosciences carries out basic research, drug discovery, and drug development, and provides contract (CRO) services. SRI has all of the resources necessary to take R&D from initial discoveries to human clinical trials. SRI's product pipeline has yielded marketed drugs, therapeutics currently in clinical trials, and additional programs in earlier stages. In its CRO business, SRI has helped government and commercial clients and partners advance many drugs into patient testing. SRI is also working to create the next generation of technologies in areas such as diagnostics, drug delivery, medical devices, and systems biology. About SRI InternationalInnovations from SRI International have created new industries, billions of dollars of marketplace value, and lasting benefits to societytouching our lives every day. SRI, a nonprofit research and development institute based in Silicon Valley, brings its innovations to the marketplace through technology licensing, new products, and spin-off ventures. Government and business clients come to SRI for pioneering R&D and solutions in computing and communications, chemistry and materials, education, energy, health and pharmaceuticals, national defense, robotics, sensing, and more. Visit SRI's website and Timeline of Innovation to learn more about SRI.SOURCE SRI International Hey, check out all the engineering jobs. Post your resume today! Metabolic Pathways Collection at SRI International the Largest in the World Diagnosis of Parvovirus B19 in Pregnancy Enhanced With Launch of a Unique Highly Sensitive Molecular Assay, DiaSorin Inc. Reveals SRI International Licenses Bed Bug Detection Technology to Redcoat, a Virginia-Based Start-Up Company Urine Odor Test for Bladder Cancer, University of Liverpool and University of the West of England Study SRI International Sarnoff Introduces Iris on the Move® Drive-Up Biometric System at ISC West 2013 How Well Can You See With Your Ears? Device Offers New Alternative to Blind People, University of Bath Study Inscopix, Inc. and SRI International to Collaborate on Brain Imaging R&D Scientists Create Early Liver From Human Stem Cells, Nature Reveals SRI International Researchers Developing New Multiple Sclerosis Drug That Can Be Taken Orally Potential Biomarker for Cancer Diagnosis Identified, Salk Institute for Biological Studies Study Please enable JavaScript to view the comments powered by Disqus.

医学

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Study Suggests Way to Bring Stroke Treatment in From the Cold, University of California, San Francisco (UCSF) and San Francisco Veterans Affairs Medical Center Reveal 4/25/2011 6:57:52 AM University of California, San Francisco (UCSF) -- Investigating the mechanism behind a common emergency medical procedure known as therapeutic hypothermia, a team of researchers at the University of California, San Francisco (UCSF) and the San Francisco VA Medical Center (SFVAMC) has found a potential new target for drugs that would help protect patients against brain damage after heart attacks or stroke. When people suffer heart attacks and strokes, depriving their brains of oxygen-rich blood, one way doctors mitigate long-term brain damage is by artificially chilling the head, neck and spine. Doctors have known for years that such therapeutic hypothermia procedures improve outcomes for patients in later recovery – but nobody knew exactly why. Now the UCSF and SFVAMC team has discovered part of the reason for this protection: cooling the patients shuts down proteins, called “calcium-sensing receptors,” on the surfaces of neurons in their brains. In experiments in mice described at the 63rd Annual Meeting of the American Academy of Neurology in Hawaii last week, the researchers showed that having fewer calcium-sensing receptors helped mice survive with more neurons intact after ischemia. “This calcium receptor could be an important target to protect the neuron,” said UCSF and San Francisco VA Medical Center endocrinologist Wenhan Chang, PhD, a senior author on the study. From the Ground to the Bones The work started with a project looking at how the body maintains control over the concentration of blood calcium, one of the most abundant elements in the Earth’s crust and a crucial mineral for human health. Calcium is a key constituent of bones, and it also plays a role in cells throughout the body, helping to run the microscopic metabolic machinery that keeps our tissues working. The body maintains tight control over the levels of calcium in the bloodstream, and losing control over these levels can be dangerous. Too little calcium can deplete the bones of minerals and lead to osteoporosis. Too much, on the other hand, can be toxic to the body’s tissues. Years ago, Chang’s mentor, Dolores Shoback, MD, of UCSF and the VA Medical Center discovered that one of the key players in helping maintain the optimal balance is the calcium-sensing receptor – a protein that they found on cells in small bits of hormone-producing tissues in the neck known as the parathyroid glands. An endocrinologist by training, Chang spent years investigating how these proteins detect minuscule dips in the body’s calcium concentration and respond by inducing parathyroid cells to release more of the hormone that releases calcium from bones. It all seemed to make sense. A few years ago, however, Chang discovered something that did not make sense: these same receptors could also be concentrated in high levels on the surface of neurons in the brain. Wondering why, Chang formed a collaboration with neurologist Midori Yenari, MD, at UCSF and the San Francisco VA Medical Center. Working with research associates Jong Youl Kim, PhD, and Zhiqiang Cheng, MD, they discovered that the calcium-sensing receptor also plays an important role in ischemia. Protecting the Neurons In their study, Chang and Yenari showed that when mice have ischemia, preventing blood from reaching their brains, the levels of calcium-sensing receptor protein dramatically increase on the surface of neurons in their brains. They also found that these levels correlate directly with whether the neurons are likely to die as a result of the injury. When the brain is chilled, the cooling reduces the concentration of these calcium-sensing receptors, which protects the neurons. But Chang and Yenari reasoned that they might be able to achieve the same protection without the cooling – by blocking the expression or activity of these receptors in mice brains. Doing so, they found, protected mice against brain damage after ischemic injuries. Conversely, mice with an overabundance of these calcium-sensing receptors on the surfaces of their neurons were more prone to permanent brain damage from ischemia. Because inhibiting this receptor protects neurons, said Chang, “That provides an opportunity for us to use it as a pharmaceutical target.” The presentation, “Mild Hypothermia Suppresses Ischemia-Induced Extracellular Calcium-Sensing Receptor (CaSR) Induction: A Possible Therapeutic Target?” was authored by Jong Youl Kim, Nuri Kim, Wenhan Chang, Midori Yenari.

医学

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The next time you see your doctor could be online 43d5cf6c-ec18-475a-8758-575b674625fd By Christine Vestal, Stateline Demand for doctors � whether in person or via a computer screen � is expected to surge as millions more Americans become insured under the Affordable Care Act. About 10 million people already rely on telemedicine, often from doctors who live in another state. As a result,�more physicians are applying for medical licenses in multiple states � a costly and time-consuming proposition for some. Without a license to practice medicine in the patient�s state of residence, both doctors and patients may be at legal risk. Many states are embracing telemedicine by encouraging it in their Medicaid programs and requiring private insurers to pay for it. But they have made little progress in removing medical licensing barriers that proponents of the technology say have kept doctors and hospitals from expanding even more. Telemedicine was once the purview of small town doctors who needed to consult with specialists available only in larger urban areas. Today, telemedicine technology�is even being used to conduct surgeries using robotics, typically only in emergency situations such as during war. Most telemedicine consists of video teleconferencing between a doctor and a patient. Doctors also routinely use telemedicine technology to transmit and discuss diagnostic images and to remotely monitor patients with chronic diseases so they don�t have to leave their homes or nursing facilities. For some consumers, it is the primary way they receive medical care. Using Skype on a computer or FaceTime on an iPhone, patients discuss their symptoms and show their doctors any visible evidence of their conditions, such as a swollen eye or skin rash.�Patients most often conduct these consultations from home or their workplace.�In some cases, patients go to a medical facility and use high-end, secure equipment to teleconference with a doctor in another location. Much of the growth in telemedicine is expected to be in remote monitoring of patients with heart and�lung diseases and diabetes,�who have recently been discharged from a hospital. The aim is to detect health problems early enough to prevent them from being sent back to the hospital. States have argued that easing licensing requirements could jeopardize patient safety. If doctors practice in a state without obtaining a license there, regulators�maintain that they have no power to conduct an investigation or explore a consumer complaint.�Also, these doctors would not benefit from any legal protections the state may have against malpractice lawsuits. Proponents of telemedicine argue that since doctors take standardized�national exams�and most�requirements�are set by federal agencies such as the U.S. Department of Health and Human Services, states should�recognize other state licenses. They�say state medical boards are simply trying to shield doctors from out-of-state competition and preserve state revenues from licensing fees. At what cost? The cost to doctors of obtaining multiple licenses is estimated at $300 million a year, according to Gary Capistrant, public policy director at the American Telemedicine Association. That does not include the fees doctors pay for their primary licenses in their home states. For hospitals and medical practices that operate in multiple states, the burden of licensing limits the number of doctors who are willing to participate, he said. State medical licensing fees vary from a low of $150 in Michigan to a high of $1,290 in Rhode Island. Most range from $200 to $600, with lower renewal fees. Of the roughly 850,000 practicing physicians in the U.S., 17 percent have at least two state licenses and 6 percent have three or more, according to a 2010�survey. Now, under pressure from major telecommunications and health care firms that want to create nationwide telemedicine businesses, state medical licensing boards are set to consider an �interstate medical licensure compact� that would give doctors and patients legal protections in any state that signs on. Patients would have greater protection than exists now, because states that join the compact would share data on any ongoing investigations of licensed doctors. The proposal, to be considered at the�annual meeting�of the Federation of State Medical Boards in April, would expedite the licensing process for doctors who want to practice across state borders. Similar�interstate compactshave been used for other types of licensing, including driver�s licenses. Even the most pro-telemedicine states have not yet taken a stand. The compact, which was developed by a task force of 22 state medical boards, may represent the first step. Lisa Robin, chief advocacy officer for the federation, expects there will be some early adopters. �I believe there will be some proliferation,� she said. �We�ll see in April.� The federation�s compact is modeled on an�agreement�adopted by the�National Council of State Boards of Nursing�in 2000. That compact has been adopted by 24 states. Legislation is pending in Illinois, Massachusetts, Minnesota, New York and Oklahoma. In addition to reimbursement and licensing, proponents say states need to define what types of telemedicine may be practiced, whether patients need to sign special consent forms and when doctors can prescribe medications remotely. Several state�legislatures�are considering those issues this year. Since its beginnings in the mid-1980s, the number of patients cared for through telemedicine has risen from a few thousand to an estimated 10 million people in rural as well as urban settings. The vast majority of the growth has occurred in the last decade, according to the American Telemedicine Association. Market analyst�IHS�estimates U.S. telemedicine spending will grow to $2.2 billion in 2018 from $240 million this year. A new lobbying group, the�Alliance for Connected Care, formed last month to promote federal and state policy changes to spur the industry�s growth. Led by former U.S. Senate Majority Leaders Tom Daschle, Democrat from South Dakota, and Trent Lott, Republican from Mississippi,�the group�s members include health care and technology giants Verizon, WellPoint, CVS Caremark and Walgreens, as well as smaller companies Teladoc, HealthSpot, Doctor on Demand and MDLIVE that offer online access to medical services. Widely considered an effective way to reduce overall health care costs, increase patient access to care and improve overall health, telemedicine has broad support within state governments and Congress. At least five bills designed to further its use have bipartisan sponsorship in Congress. �Until we are able to attract more physicians to rural communities and tighten the access gap,� one bill�s sponsors�wrote, �the next best alternative is to use technology to connect health professionals with underserved populations � rural and urban � through telehealth networks.� Four of the bills under consideration would allow doctors who provide services under Medicare and TRICARE (the insurance plan for military personnel), and accompany sports teams when they travel from state to state to have just one state license. The�U.S. Department of Veterans Affairs, a vigorous proponent of telemedicine, already considers a medical license in one state sufficient to provide services in all 50 states. For soldiers returning from Iraq and Afghanistan, telemedicine is the primary way they�ve been receiving medical care already. �We�re fast becoming a 24/7 world,� said Capistrant. �People don�t just get sick 9 to 5. Many work at night. For some, finding a doctor that speaks their language can be a problem. Technology can help deal with some of those issues and we should use it.� The biggest issue at the federal level is that Medicare reimburses only for telemedicine services on a limited basis. To qualify, patients must meet a narrow definition of residing in a rural area, and even then the federal health plan for the elderly and disabled will pay for only certain types of services. The other huge government health program, Medicaid, pays for a wide range of telemedicine procedures for the poor, according to the�Center for Connected Health Policy, in all but Iowa, Massachusetts, New Hampshire, New Jersey and Rhode Island, where health care plans for the poor do not currently cover telemedicine services. Only 21 states and the District of Columbia require private plans to cover telemedicine, despite strong support from employers who want to see the cost of premiums go down as telemedicine is used more often to keep people out of hospitals. An added benefit for employers is that telemedicine allows workers to receive care without taking time off from work to go to a doctor�s office.

医学

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Injected vaccine could help eradicate polio Re-introducing a type of polio vaccine that fell out of favour in the 1960s could hasten eradication of the disease, according to new research. The study, by Imperial College London and the Christian Medical College in Vellore, India, suggests that the injected polio vaccine (IPV), which is rarely used today in countries affected by polio, could provide better and longer lasting protection against infection if used in combination with the more commonly used live oral polio vaccine (OPV). The findings are published today in The Lancet. Vaccination protects an individual against contracting polio, but they can still be infected by the virus, which replicates in the gut and can be passed to others through contact with infected faeces. This has led to serious polio outbreaks in Asia, Africa and Europe over the last 10 years and is hampering efforts to eradicate the disease. Most vaccination campaigns use multiple doses of OPV that provide some gut immunity, although this wanes over time. "Because IPV is injected into the arm, rather than taken orally, it's been assumed it doesn't provide much protection in the gut and so would be less effective at preventing faecal transmission than OPV," explains Dr Jacob John, Associate Professor at the Christian Medical College, who led the study. "However, we found that where the children already had a level of immunity due to OPV, the injected vaccine actually boosted their gut immunity. "In the 1960s there was extensive rivalry between the scientists who developed the two vaccines, with OPV eventually becoming the most popular. But it looks as if the strongest immunity can been achieved through a combination of the two." The study involved 450 children from a densely populated urban area in Vellore, India, all of whom had received the oral polio vaccine as part of a standard vaccination programme. Half of the children were given a dose of the injected vaccine and half given nothing. One month later, the children were given a 'challenge' dose of the live oral vaccine to simulate reinfection. Their stools were tested after seven days to see if the virus was present, specifically the two remaining serotypes of the virus which are resisting eradication - serotype 1 and serotype 3. In the children who had received the IPV, the researchers found that 38 per cent fewer had serotype 1 in their stool and 70 percent fewer had serotype 3, compared to those who had not been given the injected vaccine. "Our findings show that an additional dose of the injected vaccine is more effective at boosting immunity against infection than the oral vaccine alone," says Nick Grassly, Professor of Vaccine Epidemiology at Imperial College London, senior author of the study. "This implies that the IPV could be used to boost immunity in people travelling from or to polio-infected countries, such as Afghanistan, Pakistan and Nigeria. It could also replace some of the OPV doses in immunisation campaigns to boost gut immunity, particularly in areas of poor sanitation." In another study published this week in Proceedings of the National Academy of Sciences, Imperial researchers from the same group looked at whether expanding the age range of vaccination campaigns to include older children and adults would help to prevent polio transmission. Using a mathematical model to examine disease transmission in two major polio outbreaks in Tajikistan and the Republic of Congo in 2010, they found that older ages contributed significantly to transmission in Congo but not Tajikistan, which might be related to standards of sanitation and hygiene. However, launching mass immunisation campaigns more quickly in response to outbreaks would have a much bigger impact than expanding the age range, the study reported. Lead author Dr Isobel Blake from the Medical Research Council Centre for Outbreak Analysis and Modelling at Imperial College London said: "It can take over 70 days to send stool samples to the lab and get back a diagnosis of polio, which means by the time authorities discover an outbreak, many more people are already infected. These findings suggest that methods to detect outbreaks earlier would be hugely beneficial to eradication efforts."### The Lancet study was funded by the Bill & Melinda Gates Foundation. The PNAS study was supported by a grant from the Polio Research Committee of the World Health Organization, the Royal Society, and Centre funding from the Medical Research Council. Sam Wong Research Media Officer Imperial College London Email: sam.wong@imperial.ac.uk Tel: +44(0)20 7594 2198 Out of hours duty press officer: +44(0)7803 886 248 1. John et al. "Effect of a single inactivated poliovirus vaccine dose on intestinal immunity against poliovirus in children previously given oral vaccine: an open-label randomised controlled trial" The Lancet, 10 July 2014 D-14-02958R2 S0140-6736(14)60934-X http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60934-x/abstract 2. Blake et al. 'The role of older children and adults in wild poliovirus transmission.' PNAS, 7 July 2014. http://www.pnas.org/content/early/2014/07/02/1323688111.abstract 3. About Imperial College London Consistently rated amongst the world's best universities, Imperial College London is a science-based institution with a reputation for excellence in teaching and research that attracts 14,000 students and 6,000 staff of the highest international quality. Innovative research at the College explores the interface between science, medicine, engineering and business, delivering practical solutions that improve quality of life and the environment - underpinned by a dynamic enterprise culture. Since its foundation in 1907, Imperial's contributions to society have included the discovery of penicillin, the development of holography and the foundations of fibre optics. This commitment to the application of research for the benefit of all continues today, with current focuses including interdisciplinary collaborations to improve global health, tackle climate change, develop sustainable sources of energy and address security challenges. In 2007, Imperial College London and Imperial College Healthcare NHS Trust formed the UK's first Academic Health Science Centre. This unique partnership aims to improve the quality of life of patients and populations by taking new discoveries and translating them into new therapies as quickly as possible. Sam Wong sam.wong@imperial.ac.uk @imperialspark http://www.imperial.ac.uk/press More on this News Release DISEASE IN THE DEVELOPING WORLD

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Accretive Health asks for advice on collecting bills from Shalala, LeavittPioneer Press, May 16, 2012 The Chicago-based company that was subject of a scathing report in April from Minnesota Attorney General Lori Swanson is convening national policy leaders to set standards for how hospitals should inform patients about the money they owe for healthcare. In a news release issued Tuesday, May 15, Accretive Health Inc. said the discussion will be led by Michael Leavitt—a former governor of Utah and secretary of Health and Human Services during the George W. Bush administration—and will include input from former Sen. Tom Daschle, D-S.D., and other national policy leaders. The company's news release Tuesday said Donna Shalala, the Health and Human Services secretary during the Clinton administration, and former Sen. Bill Frist, R-Tenn., also have agreed to serve as advisers.Full story

医学

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Eric Sampson, Ph.D. Director Division of Laboratory Sciences Prioritizing Chemicals for Safety Determination before Committee on Energy and CommerceSubcommittee on Commerce, Trade and Consumer ProtectionUnited States House of Representatives Good morning Mr. Chairman and Members of the Subcommittee.My name is Dr. Eric Sampson. Thank you for the opportunity to testify concerning uses of biomonitoring in setting public health priorities related to chemical exposure. It has been my pleasure to serve for the last 25 years as the Director of the Division of Laboratory Sciences of the National Center for Environmental Health at the Centers for Disease Control and Prevention (CDC). During that time, our biomonitoring program has grown into the mature discipline of science that I will discuss today. My testimony will focus on the biomonitoring program at CDC, and public health uses of biomonitoring.CDC’s Biomonitoring ProgramBiomonitoring, as we define it, is the science of directly measuring chemicals in samples from people. Although the samples can be any tissue, we mostly use blood and urine. It is important to clearly differentiate biomonitoring from other important measurements conducted in environmental samples, such as air, soil, water, and food, and consumer products. Biomonitoring measurements have the advantage of indicating the amount of a chemical that actually gets into people, rather than extrapolating from measurements of environmental media. In addition, biomonitoring data tell us the amount of a chemical from all sources combined (e.g., air, soil, water, dust, food). Although biomonitoring is far ahead of the science of interpreting what exposures mean for health, biomonitoring data is valuable for a variety of public health purposes, such as identifying relative levels of exposure in the population, particularly in children or other vulnerable groups, and setting priorities for research into the health impacts of chemicals.Because CDC analyzes samples from people, we must deal with a host of considerations that may not arise in analysis of environmental samples. For example, we adhere to a human subjects review of all data collection protocols, as well as adherence to strict, statutorily required commitments to protect the subject confidentiality, as well as the good laboratory practice standards under the Clinical Laboratory Improvement Act (CLIA). CDC has highly-trained scientists who can assist on everything from sample collection and analysis to the interpretation of results. Almost all of our analytic measurements are conducted using an advanced technology, known as isotope dilution/mass spectrometry, which we consider the definitive, state-of-the-art method of measuring any chemical in blood and urine specimens. We work hard to produce accurate and precise laboratory measurements. We study the best way to measure a chemical of interest, such as how the chemical is metabolized in the body, and how to avoid environmental contamination, which might affect our results. We are aware that biomonitoring “personalizes” exposure to chemicals and can lead to a high level of interest and concern regarding exposures. I will address three aspects of CDC’s biomonitoring program: how we assess the U.S. population’s exposure to chemicals; targeted studies to examine vulnerable populations; and support of state biomonitoring programs.How we assess the U.S. population’s exposure to chemicals: Our laboratory measures chemicals or their metabolites in blood and urine samples from participants in the National Health and Nutrition Examination Survey (NHANES). NHANES, which is conducted by CDC’s National Center for Health Statistics, involves a complete physical exam, a detailed questionnaire that collects more than 1,000 pieces of information, and the collection of blood and urine samples. The survey has been conducted multiple times since the 1970s and became a continuous survey in 1999 with two-year survey cycles. Although NHANES is nationally representative of the U.S. population, it offers limited exposure information on young children, mostly due to the difficulty in obtaining a large enough blood and urine sample from young children. Currently lead, cadmium, and mercury are measured in children aged 1 year and older, and cotinine, which is a marker for environmental tobacco smoke exposure, is measured in children aged 3 years and older. Biomonitoring data from NHANES are included in the data files made publicly available in a form that does not permit the identification of individuals or their communities. In addition, CDC staff publishes findings in peer-reviewed publications, and then periodically publishes a summary report, the National Report on Human Exposure to Environmental Chemicals. The NHANES results, as reported in each National Exposure Report, provide a snapshot of the U.S. population, identifying the amounts of selected chemicals that get into Americans’ bodies. We plan to publish the Fourth Report by the end of 2009. Chemicals analyzed from the NHANES samples and reported in the Fourth Report were selected based on known or hypothesized exposure in the U.S. population; scientific data on the health effects known or thought to result from some levels of exposure; the need to assess the efficacy of public health actions to reduce exposure to a chemical with known health effects; the availability of an analytical method that is accurate, precise, sensitive, and specific; the availability of adequate blood or urine samples from the NHANES survey; and the analytical cost to perform the analysis. The choice of chemical analyses performed is also a function of requests or suggestions from other government agencies, who sometimes pay for those analyses. The Fourth Report will include data on 212 chemicals measured, including industrial chemicals, pesticides, flame retardants, a chemical related to tobacco use, combustion and disinfection by-products, and plasticizers. Targeted studies: Each year we partner with states, other federal agencies, academic institutions and international organizations on 50-70 studies that examine vulnerable populations, particularly newborns, children, pregnant women and population groups or communities known or likely to have higher exposures. For example, one important current partnership is with the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health. This partnership involves the National Children’s Study, which is designed to follow 100,000 children from conception to age 21. Our laboratory is collaborating on a pilot study of 525 pregnant women. We will measure chemicals in pregnant women’s blood and urine and, after delivery, in the newborn’s cord blood and mother’s breast milk. Cord blood is a promising way to assess prenatal exposure to certain chemicals. However, cord blood is not the best way to measure exposures to chemicals that pass through the body more quickly; these generally are best measured in urine. Support of state biomonitoring programs: State public health officials recognize the value of biomonitoring and of CDC's analysis of the samples from NHANES that are presented in the National Exposure Report. Many states are interested in conducting biomonitoring among residents within their own jurisdictions, and comparing their results with the national data published by CDC. In fiscal year 2009, CDC awarded a total of $5 million to three states -- California, New York and Washington -- for state-based biomonitoring programs. In addition, many states already have some capacity for biomonitoring because the same technology is used in emergency preparedness and response for chemical terrorism, which CDC funds through the Public Health Emergency Preparedness cooperative agreement. Forty-seven states received funding for instrumentation as well as training for detecting a limited number of chemicals in people. Finally, CDC’s Environmental Public Health Tracking Program funds some state targeted biomonitoring activities through their state tracking cooperative agreement program.Public Health Uses of BiomonitoringBiomonitoring offers a strong basis for prioritizing public health attention to certain chemicals. We use it to establish reference ranges in the population and to identify groups of people with higher levels of exposure than those typical for the U.S. population. In addition, by tracking exposures in the U.S. population we can detect trends in people over time, and assess whether a chemical is present in large numbers of people, or is disproportionately present in vulnerable subgroups, such as children. This information can be used by scientists and policy makers as one of the considerations in setting priorities for evaluating health impacts of chemicals.A National Research Council review of biomonitoring noted that it has been a key tool in some landmark public health actions (NRC, 2006). One example is lead. Our laboratory has been measuring lead in the NHANES blood samples since 1976. Lead poisoning can affect nearly every system in the body. It can cause learning disabilities, behavioral problems, and at very high levels, seizures, coma and even death. Our laboratory analysis of the NHANES samples, which showed that the American population’s blood lead levels were declining in parallel with declining levels of lead in gasoline, provided an impetus for the Environmental Protection Agency (EPA) regulations that reduced lead in gasoline (GAO, 2000). CDC and EPA have used this decline in blood lead levels over time to demonstrate that the removal of lead from gasoline had a dramatic impact on the levels of lead in the U.S. population. Today, the most common source of children's exposure to lead is dust from older homes that contain lead-based paint. In the late 1970s, CDC used the NHANES data to document that 88 percent of children had blood lead levels above the current level of concern. We collaborate with CDC’s Lead Poisoning Prevention Program, and our data demonstrate that public health efforts are working to reduce children’s exposure to lead. The most recent NHANES data, from 1999-2004, show that 1.4% of children aged 1 to 5 years have elevated blood lead levels. Biomonitoring also can be used to monitor the effectiveness of interventions designed to reduce exposures. In the early 1990s, our laboratory analysis of data from NHANES showed that 88 percent of the nonsmoking population was exposed to tobacco smoke. This finding was used by State and local areas as a justification for restricting smoking in public places. Over the past 15 years we have collaborated with CDC’s Office on Smoking and Health, and NHANES data have shown that exposure to secondhand smoke in nonsmokers has decreased about 70 percent, indicating that public health interventions to reduce exposure have been successful.And finally, another benefit of biomonitoring data is transparency. When used as a decision tool, it provides the public with valuable information about exposures. It also provides policy makers and regulators with accurate human exposure information on which to base their decisions.ConclusionCDC recognizes that biomonitoring is one important tool for helping to prioritize chemicals of concern. Biomonitoring fills a major gap in human exposure information that allows us to better identify and prevent health problems. Better exposure information means that we can make better decisions to protect our health. We are fully committed to working with other federal agencies and partners to improve the uses and benefits of biomonitoring.Thank you Chairman Rush and members of the Subcommittee. I look forward to answering any questions you might have. ReferencesNational Research Council (2006). Human Biomonitoring for Environmental Chemicals. The National Academies Press, Washington, D.C.United States General Accounting Office (2000). Toxic Chemicals: Long-TermCoordinated Strategy Needed to Measure Exposures in Humans. Washington, D.C. Last revised: June 18, 2013

医学

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Two local people have been treated for salmonella following the most recent nationwide outbreak. Two local people have been treated for salmonella following the most recent nationwide outbreak.One person in Otero County and one person in Crowley County reported salmonella illness related to live baby poultry.Last week, the Colorado Department of Public Health warned that handling live poultry or coming in contact with poultry cages or bedding can cause salmonella infection. At least 37 people in Colorado became ill this year during a nationwide outbreak of a strain of Salmonella Typhimurium linked to live baby poultry.State health officials in Colorado, several other state health departments and the CDC have been investigating the outbreak, which has sickened 316 people in 37 states. The New Mexico Department of Health announced this week they have matched the strain found in the nationwide outbreak to a sample taken at a poultry hatchery in New Mexico. The human salmonella infections are linked to contact with chicks, ducklings and other live baby poultry purchased from multiple feed stores.No deaths have been reported, but at least 51 people have been hospitalized. Sixty percent of the cases are in children aged 10 and younger.In Colorado, cases have been reported from the following counties: Adams (3), Crowley (1), Dolores (1), Douglas (1), El Paso (9), Jefferson (4), Mesa (1), Montezuma (1), Otero (1), Park (1), Pueblo (10), Teller (1) and Weld (3). Nine people have been hospitalized, including six children, and all are recovering. The most recent illness began July 15. As in the nationwide outbreak, two-thirds of cases occurred in children, and the median age of cases was 7 years old.Although salmonella infection usually is known as a foodborne illness, chicks, ducklings and other live poultry may have salmonella germs in their droppings and on their bodies (feathers, feet and beaks), even when they appear healthy and clean. While it usually doesn't make the birds sick, salmonella can cause serious illness when it is passed to people.State epidemiologists warn parents and caregivers to keep children 5 years of age and younger from handling live poultry, especially young birds such as chicks, ducklings, goslings and baby turkeys. Children are particularly at risk of illness because their immune systems are still developing, they are more likely to put their fingers or other items in their mouths and they are less likely than adults to wash their hands.“There is a lot parents and others can do to prevent these infections,” said Alicia Cronquist, department epidemiologist. “As adorable as baby chicks and ducklings look, they are not good pets for young children because of the health risks associated with handling them.”Cronquist advised people to follow these simple steps to protect themselves and others from getting sick:· Wash hands thoroughly with soap and water right after touching live poultry or anything in the area where live poultry live and roam. Adults should supervise hand-washing for young children.· If soap and water are not readily available, use hand sanitizer until you are able to wash your hands thoroughly with soap and water.· Clean any equipment or materials associated with raising or caring for live poultry outside the house, such as cages, or feed and water containers.· Never bring live poultry inside the house, into bathrooms, or especially into areas where food or drink is prepared, served or stored, such as kitchens or outdoor patios.· Do not snuggle or kiss the birds, touch your mouth, or eat or drink around live poultry.Salmonella infection symptoms usually begin one to three days after exposure and include diarrhea, fever and stomach pain. Illness usually lasts four to seven days, and most people recover without medical treatment. However, in some people the symptoms may be severe enough to require hospitalization. Infants, elderly people and those with weakened immune systems are more likely than others to develop severe illness. When severe infection occurs, salmonella may spread from the intestines to the bloodstream to other body sites and can cause death unless the person is treated promptly with antibiotics.

医学

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Filed Under: National, News Suffering in silence… 10th March 2014 · 0 Comments Suffering in silence… The stigma associated with mental illness, approved cash advance muskegon michigan mistrust of the healthcare system, and fear of ‘putting my business in the street’ are some of the factors preventing Black Americans from getting the help they need. By Jenise Griffin Morgan (Special to the NNPA from The Florida Courier) – The days of declaring that suicide is a white man’s disease are long over. Legendary “Soul Train” creator Don Cornelius, age 75, shot himself in the head on Feb. 1, 2012. Ten months later, Kansas City linebacker Jovan Belcher, 25, died the same way – after murdering the mother of his infant son. And just six months ago, 29-year-old former Disney star Lee Thompson Young similarly ended his life via a self-inflicted gunshot wound. The shocking deaths of these Black men continued to refute the Black “no suicide” belief that has existed for generations. The numbers belie that belief. Reports show that African-American men commit suicide at nearly five times the rate of Black women. Suicide is the third-leading cause of death for Black males between 15 and 24 – after homicides and accidents. Post-traumatic slave syndrome Although African Americans are less likely than whites to have a major depressive disorder, the condition tends to be more chronic and severe when they do have the disorder. Still, trying to get Black men to seek treatment when they have “more than the blues” remains a great hurdle. In their groundbreaking book, Lay My Burden Down: Suicide and the Mental Health Crisis among African-Americans, Dr. Alvin Pous­saint and Amy Alexander explored the subject of “post-traumatic slavery syndrome,” described as the unique physical and emotional perils for Black people that are the legacy of slavery and persistent racism. “The persistent presence of racism, despite the significant legal, social and political progress made during the last half of the twentieth century has created a physiological risk for Black people that is virtually unknown to white Americans. We call this ‘post-traumatic slavery syndrome.’ Specifically a culture of oppression, the product of this nation’s development has taken a tremendous toll on the minds and bodies of Black people.” Face of government Dr. Michael Brooks, president of the Association for Multicultural Counseling and Development and associate professor at North Carolina A&T State University, also puts the heightened stigma of mental health in a historical perspective. He states it plain and simple – Blacks just don’t trust the government. “Black personal loans nky people just haven’t ever been comfortable talking to anyone about their quote unquote, ‘personal business.’ That stigma has always been present and hasn’t really faded a whole lot,” he told the Florida Courier. “Mental health still has the face of government on it,” said Brooks, adding that some Blacks’ experience with getting treatment has been negative. “Who are the friends of the Black community?” he asked, answering that they have only been the Black Church and its civic and social organizations. Historical backlash “White people have a history of coming to their homes and not always leaving a good impression. There’s some historical backlash there.” He referred to the Tuskegee syphilis study, in which the U.S. Public Health Service tested Black men for 40 years, between 1932 and 1972. Informed that they were being treated for “bad blood,” their doctors had no intention of curing them of syphilis. In his insightful book published in 2004, Standing in the Shadows: Understanding and Overcoming Depression in Black Men,’ veteran journalist John Head wrote, “Racism is psychological warfare in the most literal sense of the term.” He believes that when racism’s humiliation and hopelessness is combined with a loss, depression often results. He told the Florida Courier this week: “It’s not surprising that many in Black communities look at mental health therapy and medications with distrust. The Tuske­gee experiment where Black men were denied the best available treatment for syphilis so doctors could study how the disease progressed is a lingering reminder that the healthcare system is always just about helping us and can do real harm. “Add to that the fact that in minority communities, mental health care most often is something that is either forced on people or used only when things reach a crisis point, and you can see why people would be leery.” Early challenges Dr. Vashaun Williams, a psychiatrist with Gracepoint, a wellness and behavioral organization based in Tampa, agrees that the stigma is heightened in the Black community. “I think without question the stigma exists for us nationally as a society and even to a greater degree within our African-Ameri­can communities,” he told the Courier. “Additionally, I think the perception in our society of manliness or manhood, to be able to handle all things…and not show any kind of weakness, hinders us from seeking any type of care or mental health long term monthly installment loans for bad credit care.” Williams noted that he often sees men who are facing a number of challenges at an early age. “Sometimes we have young people at the most stressful times in their lives” — whether it’s from poor judgment, behavioral issues, or criminal activity, he explained. “We have many referral sources that bring clients to us. Court-ordered (referrals) is one of the highest,” he said, adding, “some struggle with the law, with work. Sometimes they have struggles with relationships, then their family ends up bringing them” for psychological services. Black professionals needed The National Alliance on Men­tal Illness (NAMI) cites that “culture biases against mental health professionals and health care professionals in general prevent many African Americans from accessing care due to prior experiences with historical misdiagnoses, inadequate treatment and a lack of cultural under standing; only two percent of psychologists and four percent of social workers in the United States are African-American.” Brooks wants to see an increase in Blacks going to the mental health field. Talking about mental health is a humbling experience, he noted. “It takes a lot to be able to talk about things you’re struggling with.” It’s important, he says that his clients, have a “sense of rapport and comfort. Familiarity breeds a sense of comfort,” he remarked, adding that “there are some things that may be culturally easier for people to express and talk about” with some of the same ethnic background. Unattended PTSD Brooks added that Blacks experience PTSD (post-traumatic stress disorder) more than any other group of people. “People of color have more unattended PTSD,” he said, primarily from incidents of trauma they’ve experienced. “They are just walking around dealing with it. They are just walking around messed up.” He added that it’s up to counselors to create a more welcoming image. And while he continues to advocate that more counselors of color are needed, he adds that it’s imperative for Black men to seek treatment, highlighting that African Americans go to whites for other services. “People of color also must take a risk and make their mental health a priority. If the issue is bad enough, you’ll go to anyone you can get. Whenever you need help, you’ll go wherever you need to go.” This article originally published in the March 10, 2014 print edition of The Louisiana Weekly newspaper.

医学

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Learn about the art of healing at the Gibbes The Gibbes Museum of Art has partnered with Roper St. Francis to create a series of events – including conversations, panel discussions and workshops – that highlight the connection between art and healing. On Tuesday, Nov. 12 at 6 p.m., the museum will host a conversation and reception with USAF Surgeon Dr. Darrin Clouse, historian Dr. Walter Edgar and Gibbes Museum Curator of Exhibitions Pam Wall, moderated by Dr. Jeb Hallett, Roper St. Francis surgeon, around the Photography and the American Civil War exhibition. “We are honored to welcome this panel of experts to our ongoing Art of Healing series. The discussion will highlight the captivating connections between art, history and healing as seen through Photography and the American Civil War,” says Gibbes Museum Executive Director, Angela Mack. The panelists will include: An enthusiastic interpreter of South Carolina and Southern history, culture, and life, Dr. Walter B. Edgar does so in a public forum in his weekly radio series on South Carolina ETV Radio: Walter Edgar’s Journal, and as a frequent speaker to many historical, civic and other organizations in South Carolina, across the United States, and abroad.Dr. Darrin Clouse is consultant-emeritus to the USAF Surgeon General for vascular and endovascular surgery. He is professor of surgery at the Uniformed Services University of the Health Sciences (USUHS) and the University of California, Davis in Sacramento, and is co-director for the David Grant USAF Medical Center (DGMC) Joint Heart, Lung and Vascular center, Travis AFB, Calif. Currently, he serves as the military program director and associate program director of the integrated vascular surgery residency and fellowship at UC Davis, DGMC, and VA Northern California. He has served two tours in Iraq and two in Afghanistan as the theater consultant for vascular surgery.Pam Wall is the curator of exhibitions at the Gibbes Museum of Art. Prior to her tenure at the Gibbes, she worked at the Smithsonian Institution’s National Portrait Gallery in Washington, D.C. She holds a B.A. in Art History from Washington and Lee University and an M.A. in Art History from the University of South Carolina.The panelists will discuss the exhibition Photography and the American Civil War and the evolving role of the camera in the nation’s bloodiest war. Latest Videos

医学

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Drug Rehab Hawaii The page you are viewing is content from a previous version of our website. Learn more about the Narconon Drug Rehabilitation program. Get information on Signs & Symptoms of Drug Abuse. Learn about Narconon's Worldwide network. Or contact us. Drug Rehab for Hilo, Hawaii Since it is one of the major population centers of the Hawaiian Islands, Hilo is a target for those who wish to profit by distributing drugs to the area. According to State statistics, the majority of crimes committed in Hilo are related to drugs: possession, intent to distribute, use of a firearm during a drug offense and similar charges. From the Hilo region, all of those arrested were located in South Hilo. Like other cities in Hawaii, Hilo struggles with methamphetamine as a primary threat to peace and safety. The drug comes from Mexico and California, although the original route to the islands was from Asia. In Hilo, it’s usually smaller amounts that are seized, but it takes very little crystal meth to cause someone to become addicted. Rehabilitation from Crystal Meth Addiction While addiction to crystal meth is one of the most severe and destructive, it does not take a special drug rehab program to recover. The Narconon drug and alcohol rehab program has very good results with recovering crystal meth addicts from their addiction as well as addictions to other drugs. This long-term program enables people to undo the damage done by the drug both physically and mentally. Each person has a chance to come to terms with the harm they did to themselves and others and shape a new sober, moral life for the future. It doesn’t happen in thirty days. Most people complete the Narconon program in three to five months. Some people take longer. But rather than charging by the month, Narconon drug rehab facilities around the world charge only for the whole program, no matter how long it takes. So no one is discharged before they have completed this innovative curriculum that has been successful in creating sobriety for so many. Seven out of ten graduates stay sober after they return home, one of the best success rates in this field. Preventing Future Addiction From Kapolei, Narconon drug educators fan out across the islands to bring drug prevention services to schools and youth clubs. It has been proven by follow-up survey that this curriculum decreases the rate of substance abuse among the students who received it. By continuing to educate youth about the damage associated with drug abuse, future cases of addiction are reduced. Eliminating Drug Abuse in Hilo The vast majority of residents in the Hilo area do not want drug dealing and trafficking in their city. Recently, a number of citizens and local authorities combined their efforts to force out a houseful of drug dealers on West Kawailani Street. These residents were not even paying rent, but had a steady stream of customers arriving day and night. In this case, the drugs being distributed were crystal meth and marijuana. In some other cases, it’s meth and crack cocaine. Recent reports note an increase in the abuse of prescription drugs, particularly benzodiazepines, and “bath salts,” the dangerous synthetic drug that is said to have an effect like cocaine but that leads to hallucinations, violence and death in many cases. If you care for someone in Hilo or any city, who is abusing drugs and can’t get control of his (or her) addiction, contact Narconon to find out how this effective drug rehab program can bring him back the way he was before. It is possible to recover from addiction - it is not necessary to believe that one will always be an addict. Put addiction in the past where it belongs. **Contact Narconon to get the details on this effective drug rehab program and **get someone you loved started on the way to sobriety today. http://hawaii.gov/ag/cpja/main/rs/sp_reports_0306/psn.pdf Prosecutors Target Drug House in Hilo The Objectives

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Johnson & Johnson recalls birth control pills sold outside the U.S. New Brunswick-based Johnson & Johnson is voluntarily recalling millions of oral contraceptive packages outside the U.S.Associated Press file photo Johnson & Johnson is conducting a voluntary recall of millions of oral contraceptive packages in 43 countries outside the U.S., but says there's a "very low" risk that the flawed tablets could cause unplanned pregnancies. The birth control pills are being recalled — but only from pharmacies and wholesalers — because one of the two hormones in them is dissolving and entering the bloodstream slower than it should. CONNECT WITH US On mobile or desktop: • Like Star-Ledger Business on Facebook • Follow @ledgerbiz on Twitter And check out our redesigned mobile site by visiting NJ.com from any mobile browser. The recall includes all 179 lots, or batches, of the contraceptive Cilest that were distributed since 2011 in Europe, Asia and Latin America. Each lot contains about 180,000 monthly contraceptive packages, meaning more than 32.2 million packages are being recalled. It's the latest in a string of more than 40 recalls by the New Brunswick health care giant since 2009.

医学

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New University Medical Center would incur no state debt in latest plan Bill Barrow, The Times-Picayune A private health care consultant has recommended that the new University Medical Center, the Charity Hospital successor, be a $1.09 billion project constructed without assuming any state debt, a model that would reduce the long-projected price tag by almost $200 million and farm out part of the construction cost to a third party. The plan, authored by Verite Healthcare Consulting, does not reduce the size or scope of the previous 424-bed, $1.2 billion plan long advanced by the Louisiana State University System, and it projects an average annual state appropriation of $52.5 million during the first six years of operation, as much as half previous projections included in a separate analysis presented by Kaufman Hall & Associates in June. Verite's range goes from $44.1 million in 2015, the first year of operation, to $60.3 million in 2020. David Grunfeld, Times-Picayune archiveSite of proposed University Medical Center in Mid-City as it looked in January. A new consultant's report Gov. Bobby Jindal, who has forcefully supported the concept of a new academic medical complex but never committed to a specific model, hailed the Verite projections Tuesday. But it is worth noting that the latest numbers do not include any necessary borrowing for start-up costs and they are based on ambitious presumptions that LSU can recruit scores of new faculty and the University Medical Center can build new programs, all with the aim of attracting more patients with Medicare or commercial insurance. Verite, generally, is more optimistic than Kaufman Hall about variables that have long been at the core of the debate over how to make the Charity Hospital successor a financially viable entity. Verite representatives will present the plan in detail at a Thursday afternoon meeting of the UMC governing board, which has committed to vote on a final construction and financing scheme to be presented later this month to the Louisiana Legislature's Joint Budget Committee. That panel must grant its blessing to the state facilities office before it can launch construction. Legislative leaders have balked at the idea of obligating $100 million annually to a new hospital, though LSU administrators note that those costs probably would be spent anyway, either by maintaining the Interim LSU Public Hospital or paying other hospitals to care for state prisoners, the uninsured and the underinsured. Compare the reports Business Plan for University Medical Center (Verite Healthcare Consulting LLC, Sept. 6, 2011) University Medical Center – Proposed Business Plan Validation (Kaufman, Hall & Associates Inc., June 2, 2011) The Verite construction budget assumes that the state will use $930 million in cash to build patient towers, a trauma center, a utility plant and a diagnostics and treatment building. The LSU Physicians Foundation would finance, most likely through its own bonds, the $99.6 million ambulatory care center, effectively the clinic building. A developer -- possibly the foundation -- would finance the $25 million parking deck. The foundation and any other third party would lease the facility to the UMC, though the model does not state absolute terms. The plan also calls for $25 million in equipment leases. The Verite report projects bottom-line savings from cheaper construction costs and $82 million in savings by avoiding any financing costs. Financing for the facility has been an open question for several years. The state has dedicated $300 million in state taxpayer support to the project, along with about $474 million from the federal settlement for Hurricane Katrina damage to Charity Hospital. Previous estimates suggested that only $430 million would be available for the new project, with the balance needed to maintain Charity. The Verite report assumes all would finance UMC construction. Verite also assumes $155 million in additional federal money for Charity contents. The UMC board, acting on previous plans, had discussed borrowing as much as $400 million by issuing revenue bonds. But the project has been unable to win federal mortgage insurance that would have allowed for the lowest annual debt service. Abandoning that option also raised questions about whether the project could attract investors on the open bond market. At the very least, investors would have commanded significantly higher interest rates. Annual debt service had been projected to be at least $35 million annually, though Kaufman Hall noted in its June analysis that lease payments to third-party developers could command a similar sum. Verite assumed $14 million in annual operating savings by not paying off bonds. State Health Secretary Bruce Greenstein said the gap also is closed by not including less lucrative services, such as obstetrics. Though Verite on multiple occasions discusses plans for LSU to recruit new faculty members and researchers that will help develop "destination programs," the report does not detail those initiatives. Kaufman Hall projected in June that the initial borrowing would help cover start-up costs and provide a cash reserve equivalent to 100 days of operating expenses. The Verite report, without the start-up cushion included, assumes a 60-day operating margin. Greenstein said the hospital doesn't need as high a reserve balance since it does not have to attract private investors. Bill Barrow can be reached at bbarrow@timespicayune.com or 504.826.3452. midday extra Top stories from the morning delivered to your inbox each afternoon.

医学

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Category: E7DD2AA5AC5A4FA0AC635EA14F35745C 37372 L-Carnitine Supplements | L-Carnitine Products | Puritan's Pride l-carnitine, acetyl l-carnitine, acetyl l-carnitine or l-carnitine, l-carnitine or acetyl l carnitine, l carnitine supplements, l-carnitine supplement, supplement l-carnitine, l-carnitines, carnitine buy, l carnitine vitamin, buy carnitine, l carnitine buy, buy acetyl l carnitine, l carnitine vitamins, l-carnitine products, acetyl l-carnitine supplement, l-carnitine product Buy L-Carnitine. The heart relies on L-Carnitine for the production of energy from fat. L- Carnitine supports energy production & metabolism. http://www.puritan.com/l-carnitine-063 Source Naturals (3)remove clear all » L-Carnitine Share With Friends Shop L-Carnitine Learn More About L-Carnitine 3 Products in L-Carnitine L-Carnitine is an essential nutrient that’s important for heart health.**The heart relies on L-Carnitine for the production of energy from fat.** L-Carnitine supports energy production and metabolism.**L-Carnitine helps the body used stored energy to support endurance during recovery from high-intensity exercise.** Above Statements not applicable to all products below L-Arginine L-Citrulline Complex 750 mg / 250 mg Acetyl L-Carnitine 250 mg Even though carnitine isn't technically an amino acid, its chemical structure is close enough to amino acids that's it's usually categorized as one. (In the strictest sense, it's more like a B vitamin.) Carnitine is, however, derived from an amino acid. Carnitine occurs in the two standard forms D and L. These two styles are isomers of each other, meaning they contain the same molecules but that the molecules are arranged differently. They also have different properties. Only L-carnitine is active in the human body (or found in food) so that's the one we're focusing on in this program. The word carnitine is really a generic term for a number of compounds which includes L-carnitine, acetyl-L-carnitine, and proprionyl-L-carnitine. The name was taken from the Latin word carnus (meaning flesh), because L-carnitine was isolated from meat.Up to 95 percent of the carnitine in the body will be found in skeletal and cardiac muscle because those muscle systems depend heavily on fatty acids as dietary fuel.Acetyl-L-carnitine is a molecule that occurs naturally in the brain, liver, and kidney.Acetyl-L-carnitine helps transport fatty acids to cells involved in brain energy metabolism.Acetyl-L-carnitine helps promote cognitive function. Acetyl-L-carnitine supports nervous system health.The combination of alpha lipoic acid and acetyl-L-carnitine helps promote metabolic functioning to fight against free radicals and oxidative stress. Carnitine can support levels of natural antioxidants in the bodyFunctionsThe primary role of L-carnitine is straightforward and focused its job is to produce energy from fat. It accomplishes this by transporting long-chain fatty acids in cells of the body, where the cell's mitochondria burn the fat (in a process called oxidation) to produce ATP (adenosine triphosphate). It is the ATP which then becomes a source of energy. After the work is done, carnitine even cleans up after itself. It transports waste compounds produced during oxidation out of the cell so waste doesn't build up. A decline in mitochondrial function may be a factor in the aging process and carnitine levels may be involved in this. The concentration of carnitine in muscle tissue may decline with age.SourcesCarnitine is primarily found in animal products especially in meat, where the rule is, The redder, the better. The typical U.S. diet contains about 100 mg of carnitine per day, but vegetarians are likely to get much less so may want to consider supplementation. The best dietary sources are:Meat Ice cream Fish Cheese Poultry Whole wheat breadMilk Asparagus The structure function claims made on this website have not been evaluated by the Food and Drug Administration. These dietary supplement products are not intended to diagnose, treat, cure, or prevent any disease.

医学

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Mobile/Tablet Apps Tweet Follow @https://twitter.com/redbluffnews Smith to head St. Elizabeth Community Hospital By Special to DN Dignity Health formally announced Thursday that Todd Smith has accepted the position as president of St. Elizabeth Community Hospital in Red Bluff. Smith will assume his expanded role and responsibilities Monday. Smith excelled in his interview process, further reinforcing the confidence in his leadership abilities with board members, physicians and members of the North State leadership team. Smith will officially report to Mark Korth as Korth transitions into his new role as president of Dignity Health North State while continuing as president of Mercy Redding. Smith began his formal career at St. Elizabeth in 1985, and has attained progressive leadership experience throughout his past 27 years. Most recently, he has served at St. Elizabeth as its vice president and chief operating officer. Smith attained his Masters of Business Administration degree in 2006 and has a Bachelor of Arts degree in business and human resources management. As a hospital president, Smith will be responsible for the day to day leadership and oversight of St. Elizabeth Community Hospital as well as assisting Dignity Health North State in the growth of market share, collaboration, synergy and operational efficiency. Tweet Advertisement Red Bluff Daily News Copyright © Red Bluff Daily News

医学

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Elderly Victims Of Abuse Often Use Alcohol Or Drugs Victims of severe traumatic elder abuse are more likely to be female, suffer from a neurological or mental disorder, and to abuse drugs or alcohol, according to research published in the March issue of the Journal of the American Geriatrics Society. "Past studies have shown that alcohol abuse by the perpetrator plays a substantial role and is strongly associated with physical abuse," says Lee Friedman, assistant professor of environmental and occupational health sciences at the University of Illinois at Chicago and lead author of the study. "Our findings indicate that alcohol abuse among the victims may be an important contributing factor as well." Twenty-nine percent of abuse victims in the study tested positive for alcohol, compared to 13 percent of controls. Local researchers examined medical record data at two Chicago-area Level I trauma units from 41 cases of elder abuse and compared them to a random set of other over-60 patients between 1999 and 2006. The researchers found that elderly victims of physical abuse suffered more severe injuries than their non-abused counterparts. They also suffered disproportionately from pre-existing medical conditions such as heart disease, dementia and Alzheimer's disease, mental illness and alcohol abuse. All the key measures of injury severity -- length of hospital stay, treatment in an intensive care unit, assisted breathing, injury severity scores, in-hospital case fatality rates -- were higher in the abuse cases, according to the researchers, and are associated with long-term adverse outcomes. In the study, 20 victims of abuse returned to the environment in which the abuse occurred. In the majority of cases, the perpetrator had been arrested, but 17 percent of the victims expressed a desire to return to the perpetrator and not to press charges. Eighty-five percent of the perpetrators were family members or intimate partners. In most cases, the abuse was not identified until after the admission process or several days into hospitalization. The failure of medical staff to properly identify abuse victims and contact adult protective services in the majority of cases shows that clinicians need to better understand elder abuse, Friedman said.

医学

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About Seattle Children's Asthma Q-and-A With Dr. Jason Debley by Anita BrowningMay is Asthma Awareness Month, and members of the Children's team led by Dr. Jason Debley, an attending physician in Children's Pulmonary Division, raised $8,500 in the 2008 Puget Sound Asthma Walk. Dr. Debley is also leading some amazing research to help diagnose asthma as soon as symptoms begin to appear in children under 3 years old. His work has been featured in Children's quarterly publication, Connection. He had just finished submitting a grant proposal to continue this work when I met with him to do this interview.Anita: How did the grant application go?Dr. Debley: Well, I hope! We currently have National Institutes of Health (NIH) funding for a study that follows 50 wheezy infants and toddlers through age 3. We are trying to determine if the concentration of a molecule called nitric oxide in the breath can help diagnose asthma in infants and toddlers. In this study we measure exhaled nitric oxide and lung function using specialized infant lung function testing every six months. We just submitted a new grant to secure funding to follow this group of children through age 6 years, an age at which we can more confidently diagnose asthma using currently available means. Anita: How do you measure nitric oxide in a child's breath?Dr. Debley: With older kids, about 6 years old and up, we can have them breathe out into a specialized analyzer at a constant rate to make the measurement. The tricky part is acquiring the same data from younger children and babies who can't control their breath. As part of this study we have developed a new method to measure exhaled nitric oxide in an infant or toddler's breath either while awake or asleep.Anita: How do you make the measurements in infants and toddlers?Dr. Debley: We ask parents to help. They hold the child on their lap and, while the child is distracted with a video, for example, the parent holds a mask in place over the child's nose and mouth to "catch" the breath over a 30-to-60-second period.Anita: Why do you need that data — what does it tell you?Dr. Debley: Comparing the levels of nitric oxide in the breath of a healthy child to the levels in the breath of a child with asthma will hopefully lead to identifying a level that tells us the patient has asthma. In our cohort of infants and toddlers with recurrent wheezing we are studying whether a child's level of exhaled nitric oxide will predict which children with outgrow their wheezing and which have early persistent asthma. To treat any condition properly, we have to know what it is. So, developing an accurate and reliable diagnostic test for asthma is really important. Anita: Without a good way to diagnose asthma, what's happening with these wheezy infants and toddlers now? Dr. Debley: Right now, it is common to take a "wait-and-see" approach, meaning just stand by and wait for the child to outgrow the problem. Often, that's preferable to parents who don't want to see their child take daily medicine, usually an inhaled steroid, for a condition they might not have. Even though asthma controller medications are not harmful, nobody wants to give a child a daily medication, no matter how safe, if it is not necessary. Anita: I see. How is asthma different than the wheezing you mentioned earlier? Dr. Debley: Recurrent wheezing is quite common, affecting at least 20% of children from birth to age 3 or 4 years. Two-thirds of these children will outgrow it by the time they start school while the other third will develop chronic asthma.Anita: What, exactly, is asthma? Dr. Debley: Asthma is a blockage of bronchial tubes in the lungs caused by inflammation and swelling of the bronchial tubes, and spasm of the muscles surrounding the bronchial tubes. It is a chronic condition that can develop at any time, though 80% of school-age children with asthma developed their first symptoms before age 3 years.Anita: How big is the asthma problem? Dr. Debley: Asthma is one of the most common chronic conditions affecting children in the country, and Washington's asthma prevalence is one of the highest in the nation. About one in ten households with children in our state has a child with asthma. It is also the leading cause of school absenteeism. At Children's we see about 500 kids each year who are hospitalized with asthma — it's the No. 1 reason for inpatient admissions.Anita: If you are able to make a diagnosis of asthma early enough, what can you do to change the course of the condition?Dr. Debley: There is no cure for asthma. However, a lot of asthma attacks, Emergency Department visits, hospitalizations, missed school and symptoms that prevent a child from playing can be prevented if we are able to begin the appropriate treatment and educate the family as early as possible. Anita: Does anyone ever outgrow asthma?Dr. Debley: Some children seem to outgrow asthma; however, long-term follow-up studies suggest that many people that seemed to outgrow asthma as children have a recurrence of symptoms later in adulthood in their forties or fifties. Anita: What is an asthma attack?Dr. Debley: An attack is the immune system responding to an environmental trigger, pollen, another allergen or a viral infection, for example. It causes the muscles to tighten around the bronchial tubes, and the bronchial tube lining to become swollen and filled with mucus, making it very difficult to breathe.Anita: If allergies are also caused by environmental triggers, how is asthma different?Dr. Debley: That's still a mystery. We don't know. Half the general population has chronic allergies, but only about 10% have asthma. There is a strong connection, though, because allergies and a family history of allergies and asthma are risk factors for developing asthma. We think there may be a difference in the cells that line the airways of asthma patients. These cells — epithelial cells — are an important interaction point between the body and the environment. We are currently studying this theory with more research at Children's comparing airway epithelial cells from patients with asthma, allergic patients and healthy patients to see how cells from these different groups of patients respond when we infect the cells with the cold virus or stimulate them with biochemicals involved in allergic inflammation. Anita: How do you currently treat asthma?Dr. Debley: A person with persistent asthma usually needs to take a controller, or preventative, medication every day of their life, but if the condition is managed correctly and medication taken appropriately, most patients with asthma are able to live normal lives. The controller medications are primarily inhaled steroids that reduce the inflammation of the bronchial tubes. The quick-relief medications like albuterol that patients use when they are having an asthma attack are inhalers that relax the muscles around the airway. Anita: Is asthma life-threatening?Dr. Debley: People do die from asthma. About 100 people per year in Washington. Unfortunately, it is usually an issue of not managing asthma with appropriate controller medications, so in many cases these deaths are preventable.Anita: Why did you choose to focus on asthma in your career?Dr. Debley: In pulmonary medicine in general, a lot of the conditions we deal with are chronic, which is hard for families. It's also hard for physicians. But it is possible to make a huge difference in the quality of life for these kids. It is really satisfying to watch them grow up and thrive and reach their goals. As far as the scientific aspect, making an accurate diagnosis and treating a condition properly makes a dramatic difference in a young life. Because there is no cure for asthma and no good tool to assist in diagnosing it in very young children, I am driven by my passion to change that. Anita: Thanks so much for spending time with me! Teaching Resilience to Teens with Cancer, Diabetes 7.6.16 - University of Washington Institute of Translational Health Sciences The teenage years can be challenging under even the best of circumstances. But when serious illnesses like cancer and... Sorry, Scott Brown: A DNA Test Can’t Tell Us If Elizabeth Warren Has Native American Roots 6.29.16 - Before Scott Brown lost his Senate reelection bid to Elizabeth Warren in 2012, the race briefly centered on a weird topic:... Brain operation that saved boy's life will help others, too Everett Herald Before Alden Bernate's second birthday, surgeons separated the right and left halves of his brain to stop seizures that... August Tue KJR Kares A Thon September Fri Childhood Cancer Awareness Night at Safeco Field Science Block Party at Seattle Children’s Research Institute Vegas Baby: Let It Roll for Children’s

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Vanderbilt eyes expansion of children's hospital | Times Free Press Local Vanderbilt eyes expansion of children's hospital by The Tennessean in Local Regional News An $84 million, four-story inpatient tower is planned atop the Monroe Carell Jr. Children's Hospital at Vanderbilt, marking the latest expansion of the hospital. Photo by The Tennessean /Times Free Press. Chattanooga's children's hospital could also see a face lift or full out replacement in the near future. Erlanger Health System CEO Kevin Spiegel has announced tentative plans to either completely renovate or build a new campus for T.C. Thompson Children's Hospital at Erlanger. While no plans have been formally announced, the hospital has tapped renowned children's hospital architect and designer Bruce Komiske to serve in an advisory role during initial planning stages. "If it were to happen, we're years away," Spiegel said in a July interview. "But we want to make people aware that this can happen in this community. ... We can build something where patients would rather come here than somewhere else." Children's, founded in 1929, moved to its current downtown campus adjacent to Erlanger in 1975. The new tower is actually an element of a massive expansion plan that dates back several years but was put on hold during the Great Recession. Construction should start on the tower in early 2015, university officials confirmed. The new tower will feature four floors with 40,000 square feet each, including one floor with 36 patient beds. The other three floors will consist of shell space for future use, Vanderbilt officials said in a letter to state officials. Vanderbilt still needs the state's approval to modify its original plan and certificate-of-need request, which was initially approved in 2008. As part of the revised plan, the university asked for a four-year extension to the overall project timeline. The state's Health Services and Development Agency is expected to consider the request at its meeting Jan. 22. Nearly six years ago, the board granted Vanderbilt's original request for a certificate of need for a $248 million, nearly 400,000-square-foot expansion project that would have nearly doubled beds at the children's hospital to more than 400. At the time, hospital officials had said the expansion was needed to help ease a bed crunch and would be funded in part by a $20 million gift from the Carell family. However, they put those massive plans on hold and opted to expand in phases, starting with a $30 million, 33-bed expansion that officially opened in May 2012. "It just makes more sense to expand the hospital in phases as needed," said John Howser, Vanderbilt's spokesman, adding that the approach allows for building to suit projected needs of the patient population, while also allowing the hospital to adapt to new technology over time. Final details on plans for funding the construction are being developed, he said. The latest $84 million expansion will occur atop the southeast corner of the children's hospital. The hospital's helipad will be relocated to the roof of that new tower, Howser said. Becoming a 'national leader' Overall, the latest expansion would boost inpatient capacity of the children's hospital to nearly 1 million total square feet and grow the number of beds to more than 300. The expansion also would give Vanderbilt one of the 20 largest pediatric hospitals in the country, according to a 2013 listing from Becker's Hospital Review. The largest children's hospital in the country, by comparison, is Texas Children's Hospital in Houston with 589 beds, according to Becker's. "As we recognize the seismic economic forces impacting hospitals and health systems across the nation, we have chosen to make a strategic investment to increase Vanderbilt's support for the unique health care needs of children throughout the region," said Dr. Jeff Balser, vice chancellor for health affairs and dean of the Vanderbilt University School of Medicine. "The space and programs created in this expansion will allow (Vanderbilt) Children's to catapult forward as a national leader in health care, research and clinical training." The first floor of the new tower will have intensive care beds to care for more premature babies and other critically ill children, said Dr. C. Wright Pinson, Vanderbilt's deputy vice chancellor for health affairs. The children's hospital neonatal intensive care unit today is operating at nearly 90 percent capacity, and current projections indicate a 33 percent increase in demand for those services in coming years, according to data from Howser. He said it's possible that by the time the four new floors are completed, the children's hospital could already have a need identified for the three floors now planned as shell space. He wouldn't discuss any additional construction plans beyond the new $84 million phase. Plan follows layoffs The latest construction plans comes on the heels of Vanderbilt University Medical Center's "Evolve to Excel" program, which was designed to eliminate $250 million from VUMC's $3.3 billion operating budget by the end of the 2015 fiscal year. In addition to nonemployee budget cuts, the university laid off 400 employees and eliminated an additional 1,100 open positions. It also offered early retirement packages to more than 250 employees. Earlier in 2013, VUMC terminated 300 more employees, although these cuts were unrelated to "Evolve to Excel," university officials said. David Stewart, a principal and senior architect at Gresham Smith and Partners who works with hospital clients, said that after years of putting off building projects, hospital systems are starting to expand again. "When you've put it off for so long, the facilities are (either) deteriorating or new service lines are needed, so the hospitals like to either replace or expand their facilities to meet the growing need for health care services," Stewart added. Getahn Ward covers growth and development for The Tennessean. Contact him at 615-726-5968 or gward@tennessean.com. Follow him on Twitter @Getahn. Noted Chattanooga artist Jane Yelliott dies at 87 Chattanooga Update: What you need to know today

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Applauding the Best of TV Health Reports Mar 23, 2008 The Association of Health Care Journalists presents its awards at this week’s conference in Washington, honoring the best health reporting of 2007 in 10 categories covering print, broadcast and online media. The top TV winners are a diverse group covering a broad range of the health care universe. In the stories that follow, TelevisionWeek correspondent Allison J. Waldman profiles this year’s AHCJ award recipients in the television categories. AHCJ is an independent, nonprofit organization dedicated to advancing public understanding of health care issues. The association and its Center for Excellence in Health Care Journalism are based at the Missouri School of Journalism. What constitutes a health care story is not the role of the AHCJ. “Folks determine that when they submit a story,” said Julie Appleby of USA Today, who co-chairs the AHCJ contest. “There is a broad range of health care stories. We consider anything from a health care policy story to the latest treatment for this illness or that.” The AHCJ began presenting awards in 2004. “We started the awards because so many of the contests out there are sponsored by special-interest groups. We wanted to produce something that was for journalists, by journalists, not influenced by any outside money and focused on health care,” said Ms. Appleby. “I don’t know of any other contests that concentrate strictly on health care. Others may have a category or two, but ours is entirely on health care.” The TV division includes categories for both small markets and large markets. “We’ve been trying to figure out the right mix, but we do want to differentiate because obviously people in the top 20 markets and the lower 20 markets have different resources available to them, so that was a way to compensate for some of those differences,” she explained. “The caliber of entries this year has been really good. There were nearly 400 entries—that shows health journalism is really a very vibrant part of journalism in the U.S. today. It’s so important that we support and encourage it because people are very, very concerned about health care.” The awards are judged by 44 journalists; to ensure the integrity of the awards, board members and contest committee members are not eligible to enter the contest. “We have pre-screeners who get all the entries from a category. They go through them and separate the top 10 to 12 that they think are the best. We send those to the final judges. They decide first place, second place and third place,” said Ms. Appleby. In the TV/radio top-20 markets, first place went CNN for a feature by Elizabeth Cohen, Jennifer Pifer and Amy Morelly, “Where’s Molly?” It used the documentary of the same name by Jeff Daly as the basis for a story about how for decades, tens of thousands of American children were locked in institutions and erased from their families because they were retarded or mentally disabled. Their piece shone a light on a man who defied legal hurdles and his family’s wishes to find Molly, his little sister, who’d been institutionalized when she was just 3 years old. Fifty years later, they were reunited. The second-place winner in the top-20 category was “Nick’s Choice,” by Joe Fryer and Brett Akagi. These two Minnesota reporters, for NBC affiliate KARE-TV in Minneapolis, shared the story of 9-year-old Nick Nelson, who was born with the rare popliteal pterygium syndrome, in which webs form on the backs of the legs, preventing him from straightening them. Although he was just a child, Nick wanted his doctor to amputate his right leg after 15 surgeries failed to straighten it. KARE’s story followed his journey. The third-place winner in the top-20 category recognized a story about the toxic trailers given to Katrina victims that turned out to be made with materials that are emitting formaldehyde. HDNet’s “Dan Rather Reports” told that story, including the fact that the Federal Emergency Management Agency was aware of the problem before it delivered a single trailer. Former CBS anchorman Dan Rather collaborated on the comprehensive report with Chandra Simon and Resa Matthews. In the below-top-20 markets, the winners included two radio pieces. First place went to “North Carolina Voices: Diagnosing Health Care” by North Carolina Public Radio-WUNC. In a series of reports, journalist Emily Hanford discussed how diabetes in eastern North Carolina, a poor, rural part of the state, has been on the rise and why. The other radio winner, WFCR Public Radio, earned third place for “Love, War and PTSD: Anna and Peter Mohan” by reporter Karen Brown. The piece told the story of a young couple, Peter and Anna Mohan, whose lives were changed forever when Peter returned from a tour of duty in Iraq suffering from post-traumatic stress disorder. Second place went to WCPO-TV in Cincinnati, an ABC affiliate, for “Care-less Denials.” I-Team reporters Hagit Limor and Phil Drechsler discovered that Anthem, a major insurance company in Ohio, had cut the reimbursement rates midyear so severely that many psychiatrists, psychologists and counselors had either dropped off the panel or wouldn’t accept new patients, leaving mentally ill patients in the lurch. All the winners of the AHCJ award receive a signed and framed certificate. First-place winners also receive $500 plus registration and hotel accommodations at the annual conference. “The first-place winners sit on a panel and discuss how they got that story, because part of what we’re trying to do here is help other journalists think of story ideas, think about resources they can use in their communities to do similar stories. We want them to share how they did it, the research, the obstacles, that type of thing,” said Ms. Appleby. Awards will be presented at the AHCJ luncheon on March 29. Elizabeth Edwards, wife of former Democratic presidential candidate Sen. John Edwards, will be the keynote speaker. Recovering from Crisis Mentality On the Trail of Deadly Drugs Share this Post : 11 Comments William Murphy June 11, 2008 at 16:33 pm, Reply I watched Ch 9, Cincinnati (WCPO) between 5:00 and 6:30. There was a short item on “Your Health” about the Esophagus. The announcer said to get more infor, go to the WCPO web site. 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I have bookmarked your website so that I can come back & read more in the future as well. plz do keep up the quality writing Youtube Backgrounds December 21, 2010 at 23:12 pm, Reply You make blogging look like a walk in the park! I’ve been trying to blog daily but I just cant find writing material.. you’re an inspiration to me and i’m sure many others! December 22, 2010 at 10:54 am, Reply I would like to start my own blog one day. This was a really nice blog that you made here. Keep up the success 😛 December 28, 2010 at 11:58 am, Reply Definitely subscribing to comments. Regards. Link Building Services December 28, 2010 at 19:33 pm, Reply I really like the colors here on your blog. did you design this yourself or did you outsource it to a professional? Get Backlinks December 29, 2010 at 15:52 pm, Reply Dreamin. I love blogging. You all express your feelings the right way, because they are your feeling, focus on your blog it is great.

医学

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School The University Record, April 19, 1999 Lichter will be recommended to head Medical School By Sally Pobojewski Health System Public RelationsPending approval of his appointment by the Regents, Allen Lichter will become the 14th dean of the Medical School in May. Allen S. Lichter, professor of radiation oncology and interim dean of the Medical School, will be recommended to Board of Regents in May for appointment as the School's 14th dean, according to Gilbert S. Omenn, executive vice president for medical affairs. The recommendation will be made by Omenn and Provost Nancy E. Cantor and, pending approval, will be effective May 1. The Dean's Search Advisory Committee described Lichter as a "surpassing choice" with the experiences and ability to be an "exceptional dean." His appointment has the enthusiastic approval of President Lee C. Bollinger. "The dean's search enabled us to learn more about some of our most outstanding peer institutions and some of our leading figures in our own Medical School," Omenn said. "During the past four months, Dr. Lichter has served as our interim dean. He has a clear understanding of the strengths of the Medical School and the Health System and the challenges facing academic medicine nationally and locally. He is a wonderfully able, positive and forward-looking individual with high values, keen interest in all of the missions of the Medical School and a commitment to diversity. I look forward to working with him as a key member of our Health System leadership team for many years to come." "Dr. Lichter is president of the American Society of Clinical Oncology--only the second time a radiation oncologist has been honored with this leadership position in the field of cancer care," Omenn added. "He is a pioneer in using three-dimensional X-ray imaging technology to precisely plan radiation therapy. These research advances have had an enormous impact in breast-saving treatment of women with breast cancer. And he has served for 13 years as chair of what has become one of the nation's most outstanding departments of radiation oncology, with faculty ranging from clinicians to radiation physicists and biologists." "I am delighted to join with Gil Omenn in recommending this appointment to the Regents," said Nancy E. Cantor, who also executive vice president for academic affairs. "It has been a true pleasure to collaborate with Allen Lichter over the last four months and I know that I speak in this regard with the support of all the deans. Allen has represented the Medical School admirably in cross-campus initiatives, seeing the potential for educational and research collaborations of great benefit to the entire university. His ideas and goals for the Medical School fit very well with our values and ambitions for the life sciences at Michigan. "I am confident that Allen will provide vigorous and enlightened leadership, supporting new programmatic initiatives, recruiting and retaining outstanding faculty, pushing forward on innovations in medical education and fostering the tradition of excellence in service to the community. My colleagues in the Office of the Provost and I look forward to working closely and productively with Allen and Gil in these endeavors." "I am looking forward to working with Dr. Omenn, Provost Cantor, Larry Warren [executive director, U-M Hospitals] and our department chairs and faculty," Lichter said. "With the proposed Life Sciences Initiative, the next few years should be one of the most exciting times for biomedical science in the University's history. The Medical School and Health System are extremely strong, with solid leadership and solid resources. Using our strengths and investing in our future, we can advance medical research and education while enhancing patient care as we move our school into the highest ranks of medical schools in the nation." Internationally known for research in the treatment of breast cancer, Lichter is president of the American Society of Clinical Oncology and a member of the board of directors of the American Society of Therapeutic Radiology and Oncology. He was chair of the Department of Radiation Oncology in 1984-97 and director of the Breast Oncology Program at the Comprehensive Cancer Center in 1984-91. Before joining the U-M in 1984, Lichter was director of the radiation therapy section of the National Cancer Institute's Radiation Oncology Branch and a faculty member at the Johns Hopkins University School of Medicine. An early advocate of the lumpectomy approach to the treatment of breast cancer, Lichter conducted one of the first clinical trials that found use of lumpectomy and radiation therapy to be as effective as traditional mastectomy treatment. Under his leadership, the U-M developed new three-dimensional X-ray imaging technology, which allows physicians to direct radiation to tumors more precisely and reduce damage to healthy tissue. This pioneering technology is now in use at cancer centers across the United States. The author of numerous scientific articles and editor of several books on breast cancer, Lichter is co-editor of a textbook on clinical oncology, which was published in 1994. For the past 12 years, he has been an associate editor of the Journal of Clinical Oncology, the world's leading clinical cancer journal. A native of Detroit, he received his B.S. from the U-M in 1968 and his M.D. degree from the Medical School in 1972. In 1976, he completed his residency in radiation oncology at the University of California, San Francisco.

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More Unsafe drugs stay on market too long, study findsSharon Kirkey, Postmedia News 01.28.2014In 2003, the year before Vioxx was removed from the market, it was the 10th most prescribed drug in Canada.VioxxSpencer Platt/Getty Images / Postmedia NewsShareAdjustCommentPrintDangerous drugs often remain on the market in Canada for more than three years before eventually being pulled from drugstore shelves over serious safety risks, new Canadian research shows.The study, by Dr. Joel Lexchin, an emergency physician and York University professor of health policy, found that about four per cent of new drugs approved by Health Canada between January 1990 and December 2009 were eventually withdrawn for safety reasons.The median time between approval and withdrawal was 1,271 days.Some drugs received a serious safety warning within 20 days of being approved.“How is it that you need to issue a serious safety warning within two to three weeks of the drug coming on the market,” Lexchin said. “What does that say about how well the safety data was scrutinized before the drugs were approved?”For his study, published this week in the journal Open Medicine, Lexchin compiled a list of all drugs that were approved between 1990 and 2009 and subsequently withdrawn as of October 2013. The date of approval, the date the first serious safety warning was issued (if one was issued) and the date of withdrawal from the market were recorded for each drug.Of the 528 new drugs approved during the study period, a total of 22 were eventually withdrawn. They included cholesterol-lowering drugs, anti-depressants, blood pressure medications, weight-loss drugs and anti-inflammatories. The drugs were pulled primarily because of cardiovascular risks or liver toxicity.Of the 22 drugs pulled from the market, 11 first had a serious safety warning; 11 had none.“Was Health Canada unaware of any safety issues associated with these products before they were withdrawn,” Lexchin writes in Open Medicine.“And what happens when, within a month of a serious safety warning, it’s all of a sudden decided the drug is so unsafe that it shouldn’t be kept on the market at all,” he said.“What is the process behind the decision-making? The answer is, we don’t know, because Health Canada isn’t transparent enough.”It’s also not known how many people are exposed to drugs before they are withdrawn, he said. In 2003, the year before Vioxx was removed from the market, it was the 10th most prescribed drug in Canada.For the 11 drugs in Lexchin’s study with a prior safety warning, the median time between the warning and withdrawal from the market was 329 days. Two of the drugs — sitaxsentan for high blood pressure and the anti-inflammatory valdecoxib — received a safety warning 20 days after approval.“A lot of new drugs are very heavily promoted to doctors,” Lexchin said. “Just as soon as they hit the market, drug companies are trying to ramp up the sales, and that’s when people are most vulnerable early on, because that’s when we have the least amount of knowledge about drug safety.”Most new drugs are only ever tested in similar groups of patients, Lexchin. “But when there’s massive promotion they get prescribed to all sorts of people they were never tested in,” he said.Lexchin found no change over the 20-year period in the percentage of drugs that are eventually withdrawn for safety reasons, suggesting there has been no improvement in Health Canada’s ability to “detect serious safety issues and keep those drugs off the market.”“Unless the drug raises people from the dead, or unless there is nothing else available for that serious medical problem, my advice to doctors and patients is, don’t prescribe the drug and don’t take the drug until it’s been on the market for three or four years,” Lexchin said.“I’m not saying that these new drugs should never be prescribed. But I am saying that they should be used much more cautiously than they are now (because) if the drugs are heavily prescribed there can be a large number of people harmed before there is any chance to do anything about it.”Only one in 10 newly approved drugs represent a “major therapeutic advance,” he added.In 2008, Lexchin appeared as an expert witness for the federal government in its defence against a lawsuit challenging the ban on direct-to-consumer drug advertising. In 2010, he was an expert witness for a law firm representing the family of a patient who allegedly died from a drug reaction to a product made by Allergan.skirkey@postmedia.comTwitter.com/sharon_kirkey xShareUnsafe drugs stay on market too long, study finds

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Special report: Covering the high costs of hearing aids Bill would require hearing aid coverage for adults There is a movement under way to help thousands of Mainers living cut off from much of the world because they can't afford the technology to help them hear. Maine requires insurance companies to pay for hearing aids for children, but right now most adults are on their own.Traditionally, insurance companies have not reimbursed customers for the cost of hearing aids, and the full implementation of the Affordable Care Act won't change that.Poll: Do you think insurance companies should help cover the costs of hearing aids for adults?That is why some are pushing for changes to state law that would benefit adults like Summer Noyes, of Auburn, who is 87 percent deaf in both ears because of a childhood illness."If you were to turn on music, I can hear the beat, but I can't hear the people singing," said Noyes.Her hearing aid is her only link to the world of sound many take for granted."I should be wearing two, but I haven't worn two hearing aids in maybe 15 years," said Noyes.That is because the cost of two hearing aids is too much for the 33-year-old mother to afford.Noyes said her one hearing device costs about $2,700."I think that people assume that, because it's a medical condition, it's going to be insured by medical insurance," said Noyes.However, in just about all cases hearing aids are not covered.Most states don't require insurance companies to cover the costs of hearing aids, so most companies don't.That forces many who need hearing devices to go without, according to hearing aid specialist Kelly Nelson.Nelson works at Marty Layne Audiology in Scarborough.She said hearing aids can be life-changing."I have put hearing aids on people and they just start bawling because they're amazed at how well they can hear," said Nelson.Maine already requires insurance companies to cover hearing aids for children under the age of 18. A bill before the Legislature would expand that coverage to everyone."Very well-intentioned. We just want the legislature to understand that there is going to be a cost to this," said Chris Dugan of Anthem Blue Cross and Blue Shield.Anthem is Maine's largest health insurance provider.The company opposes expanding hearing aid coverage because Dugan said it will end up costing all customers more."It's really a cost issue. Premiums continue to rise. Cost of care continues to rise, and what we're really making sure the Legislature understands is that if you pass a bill like this, there is a cost to that. It's borne by all of the people who pay premiums," said Dugan.Executive Director of the Maine Center of Deafness Elissa Moran said the issue is particularly important in Maine, the nation's oldest state."The need is just enormous and does nothing but grow every day," said Moran.Noyes said she worries how long the one hearing aid she can afford will last."It's always over my head, so it's looming because, at any point, at any given time, it could stop working," said Noyes.Lawmakers have tabled the bill that would require hearing aid coverage for adults until the next legislative session in order to conduct a study on the issue.

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Home › News › Consumer News › Studies... All NewsConsumerPharmaNew DrugsPipelineClinical TrialsFDA AlertsStudies Suggest Link Between Smog, Joint Disease Tweet SATURDAY Nov. 5, 2011 -- Exposure to certain types of air pollution is associated with an increased risk for the painful joint disease known as rheumatoid arthritis, new research suggests. This link is strongest for sulfur dioxide, one of the six most common air pollutants in the United States, according to the findings from two studies scheduled to be presented Wednesday at the American College of Rheumatology annual meeting, in Chicago. In the studies, investigators looked at 2,092 rheumatoid arthritis patients and more than 93,000 people without the disease in the United States and Sweden, and used their home addresses to estimate their long-term exposure to several common air pollutants, both gaseous (for example, carbon monoxide, sulfur dioxide and nitrogen dioxide) and particulate (soot or dust). There was no evidence of increased risk of rheumatoid arthritis associated with particulate air pollution. But increasing exposure to sulfur dioxide and oxides of nitrogen in the 10 and 20 years prior to onset of rheumatoid arthritis was associated with increased risk of the disease among the Swedish participants, the investigators found. Low-, medium- and high-exposure to sulfur dioxide, nitrogen dioxide or nitrogen oxide were associated with an up to 7 percent, 11 percent and 7 percent increased risk for rheumatoid arthritis, respectively, according to the Swedish study. These increased risks of rheumatoid arthritis were higher in people with less than a university education than in those with at least a university education. Education levels are a measure of socioeconomic status. People "with a lower socioeconomic status are more likely to live in houses where more air pollution leaks in from the outside or other factors such as general health status that may make them more susceptible to the effects of air pollution," Dr. Jaime Hart, an instructor in medicine at Brigham and Women's Hospital in Boston, said in an American College of Rheumatology news release. Hart was lead investigator of the U.S. study and was scheduled to present the U.S. and Swedish findings at the meeting. The U.S. study found that only exposure to sulfur dioxide was associated with modest increases in rheumatoid arthritis risk. Those with a high exposure to sulfur dioxide had a 5 percent greater risk of rheumatoid arthritis than those with low exposure. But Hart noted that the U.S. participants were part of the Nurses' Health Study, which meant they may have had a higher overall socioeconomic status than the Swedish participants. Study data and conclusions presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal. About 1.3 million Americans have rheumatoid arthritis, which typically affects women twice as often as men. Previous research has suggested a connection between environmental factors and rheumatoid arthritis. The American Academy of Family Physicians has more about rheumatoid arthritis. Posted: November 2011Recommended for you

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Most Popular 1 For Optimal Health, Mind Your Oral Microbiome and Avoid Fluoride, Harsh Mouth Rinses and Amalgam Fillings What Is Cupping, and What Can It Do for You? Toxic Cookware Chemicals Have Polluted Drinking Water for Millions Insurance Companies Use Bait-and-Switch Tactics to Maintain the Status Quo of Mercury Amalgams The Many Health Benefits of MCT Oil Expert Pediatrician Exposes Vaccine Myths The Danger of Excessive Vaccination During Brain Development Flu Vaccine Exposed Why Am I Seeing These Ads? Next Article The Vaccines That Worry Parents Most Spread the Word to By Sharing this Article. Print A study conducted at the University of Michigan shows that, although parents overwhelmingly share the belief that vaccines are a good way to protect their children from disease, these same parents express concerns regarding potential adverse effects of vaccines. They especially seem to question the safety of new vaccines. The study is based on a survey of more than 1,500 parents that was conducted last year. About 12 percent of parents said they had refused to allow their children to receive a vaccine that a doctor recommended. Those parents tended to shy away from four vaccines: Human papillomavirus (HPV) vaccine, because of concerns about side effects Vaccine for meningococcal diseases, because of the risk of Guillain-Barré syndrome, an immune system disorder The shot for measles, mumps and rubella (MMR), because of potential autism risk Chickenpox (varicella) vaccine Of those who said they had refused a certain vaccine for their child(ren), the greatest share of parents said their concerns were based on something they had read, or heard, about the vaccine. An almost equal number said they believed that the risk for adverse effects from the vaccine was too great. The study’s authors concluded that this finding indicates that current public health education campaigns on vaccine safety have not been effective, and that officials should make a better attempt at assuaging parents’ safety concerns. The authors also suggested that the use of newer social marketing techniques (Twitter, Facebook, etc.) might be potential strategies for spreading the word about vaccines. Dr. Mercola's Comments: It’s ironic that this study found that health officials aren’t doing a good job at addressing parents’ concerns about vaccine safety. I happen to agree – but not for the same reasons as this study’s authors. Contrary to what the study concludes, parents ARE getting the message health officials want them to hear. From pediatricians to schools, to legislators to local and national news outlets, the mantra that vaccines are good for you and as safe as can be is coming through loud and clear. The only problem is, this is the age of the Internet. Unlike the old days, when parents had to unquestioningly accept everything health officials said as gospel truth, today they can think for themselves. If their 12-year-old athlete suddenly develops a neurological problem and is bedridden after the HPV vaccine, they can get online and find thousands of articles and blogs about HPV adverse reactions. Or, more often than not, they do the research before their child gets a vaccine, by going online and scanning professional journals, or visiting health websites like this one. Then, when they’re in their pediatrician’s office, they’re armed with a wealth of information that, for certain, they wouldn’t get otherwise. Much of that information has to do with vaccine safety – or lack thereof. So the problem is not that parents don’t know the truth about vaccine safety. For public health officials, the real problem is that they DO. Do You Know YOU Can Use Patient Compiled Vaccine Injury Database VAERS? VAERS is a national surveillance database to which anyone can post. It was established in 1990 as a direct result of the National Childhood Vaccine Injury Act (NCVIA) of 1986, which requires health professionals and vaccine manufacturers to report to the HHS specific adverse events that occur after the administration of routinely recommended vaccines. An important aspect of VAERS, however, is that anyone can both read and post vaccine adverse events to this database. So if your doctor discounts your concerns when your child regresses or gets ill after a vaccine, you can report them yourself – and that’s what people are doing in record numbers. You can access VAERS here. Or, you can go to Medalarts.org, which provides an easy, powerful search engine for looking up specific reactions or vaccines in the VAERS database. Medalerts also gives monthly analyses and yearly summaries for VAERS. For example, if you go to the January, 2010 summary you can see that 2009 was a record-breaking year for the number of VAERS reports. You will also see that Medalerts has graphed a 20-year history of several vaccine reports – and that the very vaccines parents voiced concerns about in the Michigan study are some of the ones with the highest adverse reaction numbers. So What are the Most Dangerous Vaccines? With over 70 vaccines included, VAERS is an excellent tool that can help you easily identify which vaccines are associated with the most side effects. It is important to know though that only a tiny fraction of the reactions are actually reported. Studies have estimated that a maximum of 10 percent, to as little as ONE percent of side effects are ever reported, so the true side effects are easily FAR higher than the statistics show. Still, the VAERS database shows that, in the past three years, vaccine adverse reaction reports in general have shot through the roof. For example, the top vaccine that parents in the Michigan survey were concerned about – the HPV vaccine -- has 68 deaths and nearly 18,000 events reported in conjunction with it. No wonder parents are concerned about this vaccine! In less than a handful of years, adverse reactions reported on the HPV vaccine – mainly Gardasil, since Cervarix was just recently approved for use in the US – number in the thousands, and are growing. The Graphs Tell the Story If you go back and look at the Medalerts graphs, you will see why parents are so worried about several of the vaccines on the market. Looking at the chart, you will see that the reports were fairly low in 1990, as they would be since that was the year VAERS began. You’ll notice a steady increase in reports through the years – and then a sudden spike beginning in 2007, when several new vaccines came out, such as HPV and rotavirus. If you look at those spikes, as well as the very highest lines on the graph, you will see that right up near the top are the newer vaccines parents said they are worried about – HPV, meningococcal (meningitis) and varicella. But according to Medalerts, the “old” vaccines, including MMR and polio, are maintaining a significantly high, but steady, level too. So what are the other top vaccines that are being reported to VAERS? Tetanus, Diphtheria, Pertussis (DPT), hepatitis, pneumonia, varicella, HPV, shingles, meningitis, and rotavirus. They are all vaccines that have been in the news, and which I have warned about many times. US Supreme Court to Hear Case about Side Effects Earlier in March, the US Supreme Court decided to rule on whether drug makers can be sued by parents who believe their children were harmed by a vaccine. USA Today reported March 8 that Robalee and Russell Bruesewitz asked the court to intervene, after the 3rd U.S. Circuit Court of Appeals in Philadelphia ruled that federal law bars them from such suits. The parents filed the lawsuit originally against Wyeth, after their daughter, Hannah, suffered debilitating seizures within hours of getting her third DPT shot. Hannah is now a teenager, and suffers from residual seizure disorder. The court is expected to hear the case in the fall – and all eyes will be on it. Proof That Vaccines Didn’t Save Us In the past few weeks HHS, the CDC and the FDA have been redesigning their websites. If you are a frequent visitor to these sites as I am, you will find that direct links to important information, such as vaccine manufacturers’ package inserts, which provide a wealth more information on possible side effects, are harder to find than they used to be. However, the good news is, thanks to the Internet, you can still find all the vaccine information you’re looking for. And you can still make reports to VAERS, and look them up. Through numerous websites such as the National Vaccine Information Center, as well as blogs and subject-specific websites, including my site, you can still access “the rest of the story,” such as this excellent report showing that, contrary to health officials’ claims, vaccines did NOT eradicate diseases in the developed world. This excellent website shows in clear detail that the very diseases health officials say could kill us without vaccines not only were already on the decline when the relevant vaccines were introduced, but practically bottomed out. Not only that, as this website explains, the disease graphs also: “… illustrate that increases in the number of governmental mandated vaccines correlates with significant increases in death rates for children under the age of five (5); and that the practice is linked to sudden infant death syndrome; various degenerative diseases, including diabetes; and appears to cause general immune system impairment in infants and children. Evidence also points to the practice of immunization as a principal factor in the recent massive increases in neurodegenerative conditions such as autism in children.” If you compare the disease incidence charts to the Medalerts graphs, the striking thing you will see is that we have traded a bottomed-out disease incidence for runaway vaccine adverse events reports! And they call that progress? It only makes me wonder why health officials don’t acknowledge truth, when it is all right here. The data shows vaccines haven’t done a thing to stop disease in the US. But don’t just take my word for it. Instead of ending this article on a sour note, I’d like to call your attention to an uplifting report that, perhaps, government health officials weren’t counting on. It just came out, in the form of a commentary in the March 10 edition of the New England Journal of Medicine. In “The Missing Voice of Patients in Drug-Safety Reporting,” this well-respected science-based, peer-reviewed journal suggests that it’s time for ostrich-like thinking in drug research and adverse reporting to come to an end. The journal says: “The current drug-labeling practice for adverse events is based on the implicit assumption that an accurate portrait of patients’ subjective experiences can be provided by clinicians’ documentation alone. Yet a substantial body of evidence contradicts this assumption, showing that clinicians systematically downgrade the severity of patients’ symptoms, that patients’ self-reports frequently capture side effects that clinicians miss, and that clinicians’ failure to note these symptoms results in the occurrence of preventable adverse events.” No kidding! We Need to Do a Better Job of Representing the Data The purpose of the Michigan study was to find out what health officials can do to convince parents that vaccines are safe. They concluded that officials needed to do a better job at representing the data by selling safety through pediatricians and social marketing. I couldn’t agree more. Whether it’s through pediatricians, the media or social marketing, we do need to do a better job of representing the data – with one caveat: we also need to listen to the patients and their parents, and take their vaccine concerns seriously. It’s time for health officials to recognize that parents want – and deserve – to be shown the science and the real data, and be given a choice when it comes to vaccinating themselves and their children. CDC Wants to Muzzle the Media Unfortunately, I see no signs of this actually happening. On the contrary, the US Health and Human Services secretary Kathleen Sebelius recently told Reader's Digest that health officials had decided to tackle the problem of increasing concerns about vaccines causing autism by suppressing the press. Yes, you read that right: in a March Reader's Digest interview in connection with H1N1 vaccines, Sebelius said: “There are groups out there that insist that vaccines are responsible for a variety of problems despite all scientific evidence to the contrary. We have reached out to media outlets to try to get them to not give the views of these people equal weight in their reporting to what science has shown and continues to show about the safety of vaccines.” [Emphasis mine.] Not give them equal weight in their reporting? Isn’t telling both sides of an issue what “objective” journalism is all about? The saddest part of this is that Sebelius is serious. Health officials’ latest answer to parents’ vaccine concerns is, if they can’t manipulate and fool you outright, then they’ll just muzzle the media. Folks, you simply must realize that there’s no substitute for doing your own homework, especially on important topics such as this one. And always remember, you have the power to take control of your health, and the health of your children. Use it! Print [+] Sources and References AOL News March 1, 2010 [+] Comments (31) Previous Article Next Article Leave a comment... Sort Comments by : Discover the comments that have the most impact on our readers. View this article’s most recent comments. Read your fellow readers’ comments arranged from oldest to newest. See what our top posters have to say about this article. (2000 Characters only.) Characters remaining: * Please enter your comment! Edit Your Comment Comment deleted violating the aspect of our terms of use Subscribe to The World's #1 Natural Health Website† Thank you! Your purchases help us support these charities and organizations. Mercola Community FAQ Mercola Social Responsibility Special Info Sites Disclaimer: The entire contents of this website are based upon the opinions of Dr. Mercola, unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Mercola and his community. Dr. Mercola encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. If you are pregnant, nursing, taking medication, or have a medical condition, consult your health care professional before using products based on this content. †The World's #1 Natural Health Website claim is based upon Alexa Natural Health Website rankings. © Copyright 1997-2016 Dr. Joseph Mercola. All Rights Reserved.

医学

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U.S. & WorldLast-minute health insurance shoppers given grace period as administration pushes Monday deadline back By Carla K. Johnson Associated Press Published: Dec. 23, 2013 12:30 p.m. Comments You should not wait until tomorrow. If you are aiming to get coverage Jan. 1, you should try to sign up today. —Julie Bataille, spokeswoman Today marks key enrollment deadline; health plan sticker shock ahead for some buyers Here's a look at the good, the bad and the ugly for the health law so far what's next? CHICAGO — Anticipating heavy traffic on the government's health care website, the Obama administration effectively extended Monday's deadline for signing up for insurance by a day, giving Americans in 36 states more time to select a plan. The grace period — which runs through Tuesday — was the latest in a series of pushed-back deadlines and delays that have marked the rollout of the health care law. But federal officials urged buyers not to procrastinate. "You should not wait until tomorrow. If you are aiming to get coverage Jan. 1, you should try to sign up today," said Julie Bataille, a spokeswoman for the federal agency in charge of the overhaul. Bataille said the grace period was being offered to accommodate people from different time zones and to deal with any technical problems that might result from a last-minute rush of applicants. The HealthCare.gov site had a disastrous, glitch-prone debut in October, but the government reported on Twitter that it was running smoothly Monday morning. It had no immediate estimates of how many people visited the site. Monday had been the deadline for Americans in the 36 states served by the federal website to sign up if they wanted coverage upon the start of the new year. The remaining states operate their own online marketplaces, and some of them have also extended their deadlines slightly. The extra day will add incrementally to the already daunting administrative problems for insurance companies, such as inaccuracies on applications, said health care industry consultant Robert Laszewski. "Insurers would like to have two to three weeks to process applications. Now they're going to have a week, less one more day," he said. "When the day is done, it doesn't help." President Barack Obama himself signed up for health insurance through the Washington marketplace over the weekend — a purely symbolic move since he will continue to get health care through the military as commander in chief. The White House said he enrolled to show support for the marketplaces, and he chose a less-expensive "bronze" plan. Obama said on Friday that more than 1 million Americans had enrolled for coverage since Oct. 1. The administration's estimates call for 3.3 million to sign up by Dec. 31, and the target is 7 million by the end of March. After that, people who fail to buy coverage can face tax penalties. The government's original deadline already had been pushed back a week because of the technical problems that plagued the website, but hundreds of upgrades to storage capacity and software have cut error rates and wait times. As the Monday deadline drew new, last-minute health insurance shoppers called help lines and attended enrollment events. More than 1 million people visited the website over the weekend, and a federal call center received more than 200,000 calls. "It's just nonstop now. Everybody knows about it. Everybody wants it," said Florida enrollment counselor Madeleine Siegal. She said her organization in Fort Lauderdale was slammed with walk-ins and appointments Friday, had several weekend enrollment events and opened its doors an hour early on Monday. Roger Colyn, 60, of Des Moines, Iowa, was happy when he left his Monday morning appointment with a state enrollment navigator. She helped him sign up for a "silver" plan that will cost him $10.79 in monthly premiums after government aid is factored in. "I feel relieved," Colyn said. Others said they will let the date pass without making a decision. "I'm in no hurry, though it'd be nice to be able to visit a doctor without stress," said Kyle Eichenberger, an uninsured 34-year-old from Oak Park, Ill., who said he hit a wall on the website when he first tried to enroll early on. "I'm an Obamacare supporter, though I think it is full of problems," Eichenberger said. "I'd like to see the whole system streamlined to be more user-friendly. Keep the basic idea, but don't make me feel like I'm navigating a maze to get a simple checkup." Minnesota, one of the states running their own insurance exchanges, also had a Monday deadline. But amid problems with its website and extra-long hold times to reach its help center, it extended the cutoff date eight days, through Dec. 31. Maryland has also extended its deadline, to Dec. 27. Associated Press writers Catherine Lucey in Des Moines, Kelli Kennedy in Fort Lauderdale, Fla., Patrick Condon in St. Paul, Minn., Brian Witte in Annapolis, Md., and Donna Blankinship in Seattle contributed to this report. Associated Press Medical Writer Carla K. Johnson can be reached at http://www.twitter.com/CarlaKJohnson

医学

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Posts tagged with: Gerontology 7 Figures: What You Should Know About Global Life Expectancy in 2016 Thursday, May 26, 2016By Joe Carter The U.N’s World Health Organization (WHO) recently released it’s latest version of World Health Statistics, a definitive source of information on the health of the world’s people. Here are seven figures from the report about life expectancy that you should know: 1. Life expectancy increased by 5 years between 2000 and 2015, the fastest increase since the 1960s. Those gains reverse declines during the 1990s, when life expectancy fell in Africa because of the AIDS epidemic and in Eastern Europe following the collapse of the Soviet Union. 2. The increase in life expectancy was greatest in the African Region of WHO where life expectancy increased by 9.4 years to 60 years, driven mainly by improvements in child survival, progress in malaria control and expanded access to antiretrovirals for treatment of HIV. Fewer Babies, Longer Lives Friday, July 18, 2014By Jordan J. Ballor The Transom links today to a piece about how Proctor & Gamble is ramping up product lines aimed at older adults. “The flip side of the low birthrate is we’re all living longer,” said corporate exec Tom Falk. In fact, the global trend over the last two hundred years has been toward longer lives and fewer babies. This trend really gathered momentum in just the last half-century or so. Consider this short video I put together for a talk at last month’s Acton University. The two axes correspond to fertility (horizontal) and life expectancy (vertical). So in the bottom right we are having more children and shorter lives, while in the upper left we are having fewer children and living longer. Each of the countries in the world is represented by a circle, whose size is determined by size of population. Each region is also color coded. What you’ll see as we move forward through the last two centuries is a gradual shift toward the upper left, which turns into a rush after about 1950. There are a few lagging countries in Africa, which still are moving toward the upper left, just a bit more slowly. Watch it again, and note the brief drops in life expectancy corresponding to each of the twentieth-century world wars. Where we start in 1800 was just about where humans have been for recorded history: short lives and lots of kids. Now within the last 50 years we’ve seen a monumental shift that really is unprecedented on a global scale. Think for a few minutes about the complex causes of this shift and the massive changes in social, political, and economic dynamics that undergird it and also flow out of it. We really have never seen its like before. Acton Rome event on Ethics, Aging and Health Care Monday, December 6, 2010By Kishore Jayabalan Last Thursday at Rome’s (but technically part of Vatican City) Pontifical Lateran University, Istituto Acton held a day-long conference on “Ethics, Aging and the Coming Healthcare Challenge.” It was a successful event, if a bit unusual compared to some of our other Roman gatherings. It’s not often that an Acton conference is so focused on the finality of death, after all; we often stick to the other “inevitability” of life, i.e. taxes. Yet in both spiritual and economic terms, there’s no sense in denying it. The conference covered many different aspects of the changing demographics affecting health care, ranging from declining fertility rates to pharmaceutical research to pensions to hospice care. One of the main objectives of the conference was to help participants understand how both ethics and economics can work together to help us confront the challenge of aging populations. The conference was co-sponsored by the Pontifical Council for the Family, the John Paul II Institute for the Study of Marriage and Family, the Centro di Orientamento Politicio, Associazione Famiglia Domani, Human Life International, and Health Care Italia. As you can tell from the nature of these organizations, we sought to place health care issues in the context of the family, following Catholic social teaching’s emphases on this fundamental institution and the principle of subsidiarity. Here are audio clips from three of our speakers who appeared on Vatican Radio’s English World News service: Bishop Jean Laffitte, secretary of the Pontifical Council for the Family, click here Dr. Daniel Sulmasy of the University of Chicago, click here Dr. Michael Hodin, executive director of the Global Coalition on Aging, click here For the first time, we live-streamed a conference on the Acton website, and we’ll soon post the conference papers and presentations as well as related media on the Istituto Acton webpage.

医学

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About Marla W. Deibler, PsyD Marla W. Deibler, Psy.D., is a clinical psychologist and nationally-recognized expert in anxiety disorders and the obsessive-compulsive spectrum, including trichotillomania and other body-focused repetitive behaviors, obsessive-compulsive disorder, hoarding, and tic disorders. She is the Founder and Executive Director of The Center for Emotional Health of Greater Philadelphia in New Jersey, an outpatient facility specialized in providing evaluation and evidence-based, cognitive-behavioral therapies for these and other difficulties. She currently serves on the Board of Directors of OCD-NJ, the New Jersey affiliate of the International OCD Foundation (IOCDF). Dr. Deibler gained her formative clinical experiences at the National Institute of Mental Health (NIMH) at the National Institutes of Health (NIH), Children’s National Medical Center, and the Kennedy Krieger Institute at Johns Hopkins University Medical Center. She gained specialized behavior therapy experience in the treatment of obsessive-compulsive spectrum disorders at the nationally-recognized Behavior Therapy Center of Greater Washington. Dr. Deibler served as a clinician at the National Center for Phobias, Anxiety, and Depression. She also served as Director of Behavioral Sciences at the Temple University School of Dentistry and served on the clinical faculty at Temple University Schools of Medicine and Allied Health as well as Temple University Children’s Medical Center. Dr. Deibler has published scientific research in peer-reviewed journals and has presented clinical training seminars and research findings at national and international meetings. She has appeared on the Dr. Oz Show, A&E’s “Hoarders”, TLC’s “Hoarding: Buried Alive”, CBS News, ABC News, FOX News, It’s Your Call with Lynn Doyle (CN8, Retirement TV), and CBS’s “Swift Justice with Nancy Grace”. She has been quoted by media outlets, including the Wall Street Journal, CNN, Philadelphia Inquirer, Philadelphia Daily News, and the Connecticut Post, among others. Dr. Deibler holds licenses to practice psychology in New Jersey (Lic. No. 35S100438000) and Pennsylvania (Lic. No. PS0157790). She is an active member of the American Psychological Association, Trichotillomania Learning Center, International OCD Foundation, OCD-New Jersey, Association for Behavioral and Cognitive Therapies, and Anxiety Disorders Association of America. Dr. Deibler resides in suburban Philadelphia with her husband (who is also a psychologist) and three children. Subscribe to this author's RSS Feed Visit this author's website Articles by Marla W. Deibler, PsyD: Is Abnormal the New Normal? Normal Behavior or Mental Illness? Redefining Success: Today, It’s Personal. A Quiz to Help You Uncover Your Level of Anxiety The Key to Why YOU Get Anxious Stress & Anxiety: In Plain English 4 Great Apps to Release Tension 6 Inspiring Mental Health TED Talks (Video) The Neglected Side of Hoarding Bipolar Disorder in Children: Misunderstood and Misdiagnosed Winter Blues Got You Down? Panic Disorder: Therapy That DOESN’T Work A Parent’s Guide to Child & Adolescent Anxiety A New Year…A New You…A New Psychology? New Year’s Resolutions 101 NAC Shows Promise for Hair Pulling (Video) The Sorrow of a Nation: Coping After Tragedy Help for Hoarding Hoarding: Compulsion or Addiction? Buried in Stuff: Understanding Compulsive Hoarding 10 Tips to Beat Holiday Stress Effective Mental Healthcare for All: Improving Mental Health Disparities What are Mental Health Disparities? Managing Stress in a Tough Economy Case Files: Sara and her Hair Pulling (Trichotillomania) Case Files: Max and his Strep-Induced Psychiatric Illness When Infection Triggers OCD Sensationalism at its Best: Psychiatric Illness on TV Sensationalism in the Media: Distortions of Psychiatric Illness on TV 5 Tips to Weather the Storm: Hurricanes, Tornados, and Lightening, Oh My! How YOU Can Find an Effective Therapist Finding Therapy That Works How to be Happy A Parent's Guide to Child & Adolescent Anxiety Improving the Diagnosis of Bipolar Disorder in Children 4 Great Apps to Release Tension Recent Comments Virginia: What test can be done on children 10 and under to see if this is what ur dealing with?.. We have had a... Melanie Pienaar: I’m South-African and suffered traumatic brain injury.I had to train my brain all the... Marla W. Deibler, PsyD: Quite the contrary, this does not mock the DSM-5. These problems are real, but often... huffsw: Maria, This article is interesting though leaves a bit to be desired. My wife, also named Maria is plagued... mdlfcrsz: “This new disorder’s hallmark criteria are “temper outbursts that are grossly out of proportion in...

医学

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Inotropic Drugs: What You Need to Know by Jill Ferguson Health | Medications NEXT PAGENEXT Inotropic drugs alter the strength of your heartbeat. Plush Studios/Riser/Getty Images An inotropic drug is a medicine that alters the force or strength of the heart's muscular contractions (heartbeats). There are two different types of inotropic drugs: negative and positive. Negative inotropic drugs make the heart beat less strongly, and positive inotropic drugs make the heart beat more strongly. Both kinds are used in the management of various conditions that affect the function of the heart. One of the most important factors affecting the strength of the heart's muscular contractions is the level of calcium in the fluid inside the heart's muscle cells. Calcium is one of the most common electrolytes in the human body. Other common electrolytes are sodium, potassium, chloride and magnesium. We need the right balance of these electrolytes for proper functioning of the heart, nerves, muscles and kidneys. Profits and Pills: The Most Expensive Drugs Quiz How Bee Sting Therapy Works Are expired over-the-counter drugs OK to use? 10 Off-label Uses of Antidepressants Are fish antibiotics safe for humans? Electrolytes are minerals that come from the foods we eat and fluids we drink. They're found in the fluids throughout the body -- not only in the blood and urine, but also inside the body's cells and in the space surrounding the cells. Like their name suggests, electrolytes have an electrical charge, and they conduct electrical impulses (electricity). Electrical impulses generate muscle contractions. The level of each of the electrolytes must be kept within a narrow range in order for the body to function properly. In particular, it's important to maintain precise differences between the levels of electrolytes in the fluids inside the cells and outside the cells. It's these differences that allow our cells (especially nerve, heart and muscle cells) to maintain electrical voltages across their cell membranes, generate electrical impulses and produce muscle contractions. Calcium plays an important role in the process of heart muscle contraction. In general, calcium levels are increased by positive inotropic drugs and decreased by negative inotropic drugs. But different types of inotropic drugs change calcium levels in different ways. Next, we'll learn about the different kinds of inotropic drugs. What happens if you go to the ER and don't have insurance? ER Quiz Is surgery changing baseball? 5 Realities of a Post-antibiotic World Will we ever be able to transplant DNA? How Robotic Surgery Will Work

医学

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More breast cancer patients opt for double mastectomies By Tiffany O'Callaghan Oct. 08, 2009 Share Despite the lack of evidence suggesting that double mastectomies can improve long-term survival rates for women diagnosed with cancer in one breast, many more women in this position opting for the procedure, according to a study published late last month in the journal Cancer. The analysis, which considered all of the mastectomies performed throughout New York state between 1995 and 2005, found that, though overall mastectomies were down by nearly one third during that period, the number of women diagnosed with cancer in one breast who chose to go through with a double mastectomy more than doubled—from 295 to 683. In the meantime, though much has been made of women with the breast cancer genes BRCA1 or BRCA2 opting for preemptive mastectomies, the number of cancer-free patients undergoing double mastectomies remained fairly stable during the study period, at about 100 women per year.

医学

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Alcoholics Learn To Make Their Own Beer In Canadian Program By Bill Chappell Feb 21, 2014 ShareTwitter Facebook Google+ Email Tyler BigChild, a board member of Vancouver's Drug Users Resource Center, is also part of its Brew Co-Op. The group teaches alcoholics how to make beer and wine, in the hopes that they'll stop risky behavior such as drinking rubbing alcohol. Portland Hotel Society Originally published on February 21, 2014 5:59 pm Call it a new twist on the old "teach a man to fish" adage. A group in Vancouver, British Columbia, is teaching inveterate alcoholics to brew their own beer and make their own wine, in an attempt to keep them from drinking unsafe liquids to get an alcoholic high. The project is the work of the Portland Hotel Society, which works to help people who suffer from mental illness and addictions in downtown Vancouver. News of the beer and wine project is spreading weeks after the publicly funded group's Drug Users Resource Center unveiled a coin-operated machine that dispenses crack pipes for 25 cents. The Portland Hotel Society's leaders say they want to provide safe alternatives to people who might otherwise be forced into risky and unsafe behavior — everything from shoplifting booze to drinking any substance they can find that contains alcohol. "Obviously, we'd rather they didn't drink," the society's executive director, Mark Townsend, tells the Vancouver Sun. "But if they do, we'd rather they didn't drink hand sanitizer." The brewing program, which began about six months ago, requires participants to make several commitments in exchange for about five liters of home-brewed beer. Townsend says that in addition, they also get a sense of pride and achievement in making their own beer. The brewers each pitch in $10 and work in groups of four to produce beer or wine in a style of their choosing — this week, they were making Dutch lager and a honey lager; a chardonnay was to be uncorked Friday, reports Canada's National Post. During the process, they're supervised by a brewmaster. The participants must also attend the regular Friday-night meetings of the "Drinker's Lounge," a support group that also includes an alcohol-swapping program that Townsend compares to a gun amnesty system. Members can bring containers of rubbing alcohol, for instance, and exchange them for regular drinks. "We're just trying to do what we can with no resources to make them a bit safer, make our community a bit safer, hopefully keep them alive for another day," Townsend told the Sun, "and with a possibility of not drinking in the way they do." The brew-your-own program has been a hit. One participant tells the National Post that it's "more economically viable than buying it at a liquor store." Soon the program will move past the brewing kits it's been getting from a home-brew supply store nearby, and make the beer from scratch. And the folks at the Portland Hotel Society say the brewing program is growing. "As the drinking community becomes aware of what we're doing, we're obviously having to expand the program," Drug Users Resource Center Director Kailin See tells the National Post.Copyright 2014 NPR. To see more, visit http://www.npr.org/. View the discussion thread. © 2016 KRWG

医学

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E-Magazine Archives Lung Cancer Center Online Reprints Partnerships/Alliances ADVANCE Discourse: Lab Lab Quality Advisor New to the Lab Stepwise Success Learning Scope ADVANCE Focus on Education Genetic Testing for Melanoma Personalized medicine is rapidly changing the cancer treatment scene By Rebecca Mayer Knutsen View Comments (0)Print Article Section Sponsored by: An emphasis on personalized medicine through genetic screening can help customize treatments for patients with melanoma. Depending on the genetic profile of the patients receiving anti-cancer drugs, the outcome can vary greatly in both efficacy and onset of side effects. Researchers at the University of Pittsburgh Cancer Institute (UPCI), a partner with UPMC CancerCenter, are working diligently to uncover the genetic key to customized treatments for melanoma. One of the researchers' most recent trials, funded by the National Institutes of Health (NIH), showed that the cancer immune therapy drug ipilimumab appears most likely to prevent recurrence in patients whose cancer shows high expression of immune-related genes. Ipilimumab, a monoclonal antibody developed by Bristol-Myers Squibb, activates the immune system by targeting CTLA-4, a protein receptor that downregulates the immune system. "Genetic testing in this study was meant to investigate the tumor microenvironment for biomarkers of potential therapeutic predictive value," explained Ahmad A. Tarhini, MD, PhD, the study's lead investigator and associate professor of medicine and translational science, University of Pittsburgh School of Medicine, University of Pittsburgh Cancer Institute. The researchers aimed to discover biomarkers that may ultimately predict which patients are more (or most) likely to benefit from a certain therapeutic agent and who should be spared the unwanted drug toxicities because of a low likelihood of clinical benefit. "Our data is preliminary and requires additional testing and validation in larger studies," Tarhini said. "However, we believe we're on the right track towards a more personalized approach to cancer immunotherapy." Study Specifics Tarhini and fellow UPCI investigators Yan Lin, PhD, Hui-Min Lin, MS, Cindy Sander, BS, William A. La Framboise, PhD, and John M. Kirkwood, MD, tested the hypothesis that molecular characterization of the tumor microenvironment through gene expression profiling may generate biomarkers of therapeutic predictive value in relation to clinical benefit from ipilimumab in patients with locally/regionally advanced melanoma. In the study, Dr. Tarhini and his colleagues ran genetic tests on obtained tumor biopsies both before and after ipilimumab treatment. The tumors were drawn from 32 patients with advanced, stage 3 melanoma who were treated by UPMC. Tarhini acknowledged that access to tumor tissue during genetic testing could pose a challenge in some patients. All patients received standard-of-care surgery, including complete surgical removal of an advanced tumor. The investigators discovered patients had a significantly lower risk of cancer recurrence after surgery when their tumors revealed higher levels of expression of a group of immune-related genes, either before or soon after treatment with ipilimumab. According to Tarhini, gene expression profiling identified molecular pathways and genes related to inflammation and autoimmunity that are significantly associated with clinical benefit from ipilimumab at baseline (before ipilimumab) and early on-treatment (after initiation of ipilimumab). "A tumor microenvironment 'immune-related' gene expression signature was found to be significantly associated with ipilimumab therapeutic benefit in this patient population," Tarhini observed. Personalized Medicine is on the Rise "Personalized medicine as a field is generating a revolution in cancer patient care," Tarhini said. "The fact that we can better target therapeutic agents towards specific patient populations is having a major impact on the care of our patients and the overall economic cost of cancer therapy." This field will continue to grow at a rapid pace, Tarhini told ADVANCE. "We've reached a point in the treatment of melanoma -- and cancer in general -- where we're making major improvements in the outcomes of patients through personalized medicine," he observed. Tarhini and his fellow investigators have turned their attention to identifying biomarkers that may predict the risk of developing certain serious side effects in patients treated with the new generation of cancer immunotherapy. The team aims to develop "biomarker signatures" to help physicians customize melanoma treatment plans. "Anti-cancer therapy can be associated with significant side effects and economic costs," Tarhini said. "Therefore, we have a major interest in the development of tests that may allow us to predict which treatment regimen is most likely to help certain patients, while sparing others the unwanted side effects and cost of medications that are unlikely to work." The team recently reported preliminary findings on a test that may predict the risk of developing diarrhea and colitis in melanoma patients treated with ipilimumab at the 2014 American Society of Clinical Oncology (ASCO) Annual Meeting. "We live in exciting times in anti-cancer therapy that are destined, in a matter of a few years, to finally create a huge and meaningful impact on cancer patient care," Tarhini observed. "We are grateful to our patients and their families whose volunteering and efforts have made such advances possible. We are also thankful to the NIH and the industry for providing us with needed resources to allow us to carry on our cancer research work." Rebecca Mayer Knutsen is on staff at ADVANCE. Contact: rknutsen@advanceweb.com Articles Archives

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Number of people susceptible to painful mosquito-borne virus increasing, says leading researcher July 24, 2014 by Lindsey Elliott in Medicine & Health / Diseases, Conditions, Syndromes In just two weeks, the number of Americans infected with the mosquito-borne virus chikungunya has almost doubled and the virus has now been found in mosquitoes in the United States, something that is very concerning to a Kansas State University professor who is a leading researcher of the virus. At least 243 travel-related cases of chikungunya have been reported to the Centers for Disease Control and Prevention in 31 states, with the number expected to grow. The first case acquired in the United States was reported in Florida, seven months after the mosquito-borne virus was recognized in the Western Hemisphere. Stephen Higgs, one of the world's leading researchers of the virus and director of Kansas State University's Biosecurity Research Institute, says many more people are now at risk of becoming infected. "Those travelers have come back from an infected area, most likely the Caribbean, and they've become infectious to mosquitoes because they are carrying chikungunya in their blood," Higgs said. "They have been bitten by mosquitoes in the United States and those mosquitoes have become infected. The mosquitoes go through an intrinsic incubation period and then have enough virus to transmit to new people in the United States." Higgs, who also serves as Kansas State University's associate vice president for research, a university distinguished professor and the Virginia and Perry Peine biosecurity chair, has been studying the chikungunya virus for almost 10 years. He says the two types of mosquitoes that transmit chikungunya, Aedes aegypti and Aedes albopictus, are widely distributed in the U.S. While mosquitoes don't transmit the virus directly to one another, they indirectly spread the virus by biting humans. "It transmits from person to mosquito to person to mosquito and so forth," Higgs said. "Mosquito biting can be intense and one person can be bitten by dozens of mosquitoes in just a small amount of time. One person could infect lots and lots of mosquitoes and then, unfortunately, the virus can spread from there. Each one of those mosquitoes can infect multiple people." Chikungunya is an African Makonde word that means "to bend up." It describes a crippling arthritis that can be so intense that it actually causes the person to bend up in pain, Higgs said. No vaccine or treatment for the virus is available. It will usually go away after days, but sometimes can take weeks or even longer. The best way to prevent getting the virus is to avoid getting bitten by mosquitoes. Do not go outside at dusk and at dawn, when mosquito activity is high. Also use repellant when you do go outside. Get rid of standing water around your house, such as in potted plants, because this is a breeding ground for mosquitoes. Check the CDC website for information before traveling to infected areas. If you think you may have been infected, contact your doctor. Provided by Kansas State University "Number of people susceptible to painful mosquito-borne virus increasing, says leading researcher" July 24, 2014 http://medicalxpress.com/news/2014-07-people-susceptible-painful-mosquito-borne-virus.html

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Columbia University in the City of New York Email Cubmail CUIT Web Outlook Access LionMail Manage My UNI Columbia News Directory of Classes Employment at Columbia . Sorry, there are no search results for "". - of total results. Race Sociology Education Brazil Public Health View all » You are hereHome Medical School Dean Explains How Our Survival Genes Are Killing Us Some of the same key survival traits that have kept us alive for thousands of generations are killing us today. That is the thesis of cardiologist Lee Goldman, dean of the College of Physicians and Surgeons, chief executive of Columbia University Medical Center and executive vice president for Health and Biomedical Sciences at Columbia University, in a new book aptly titled Too Much of a Good Thing. Goldman, the author of hundreds of medical articles and the lead editor of a bestselling medical textbook, has not written for a general readership before. But he was inspired to do so after decades of questions from patients, family, friends and even brief acquaintances who asked for medical advice about diet, weight loss and blood pressure and what medications they should be taking. “As I thought back about the answers to those questions, I realized that many of them linked back directly to our DNA—who we are, and the difficulty of living in the modern world with genes that, by and large, were designed for tens of thousands of years ago,” said Goldman, the Harold and Margaret Hatch Professor for Health and Biomedical Sciences. Can’t stick to a diet? That’s a holdover from when humans roamed the plains and gorged when food was plentiful, storing the rest as fat for when it wasn’t. High blood pressure? Much of the blame is the excess salt found in today’s diets, a problem that did not exist generations ago, when salt was a precious commodity in short supply. Anxiety is a descendant of the fight-or-flight response, which kept us alive when faced with a woolly mammoth but is something that we less often need today. And the ability of our blood to clot, which keeps us from bleeding to death, is now a root cause of unneeded clots that block arteries and result in heart attacks and strokes. “For each of these four conditions, the risks have long since flipped,” Goldman said. “These protective genes that helped keep our ancestors alive now paradoxically account for about 40 percent of deaths in modern America—far, far more than the number they prevent.” Is there a solution? “I come to the controversial and not very politically correct conclusion that, whether we like it or not, we are going to have to rely to a greater extent on scientific advances to help us,” he said. Goldman looks to a new kind of science, one that he has helped put into practice at the Medical Center with Columbia’s Precision Medicine Initiative, which Columbia President Lee C. Bollinger announced last year to help treat and even prevent disease by looking at a patient’s genes. “The concept is that you’re different than I am, and there may be a treatment that works better for you and one that will work better for me,” he said. For example, he points out, there is a range of medications for high blood pressure, but if doctors knew exactly what triggered a particular patient’s condition, they could specifically target that problem. And there are common genes that it might be possible to change. He cites a study that found a woman whose level of LDL, the bad cholesterol that triggers a build-up of plaque in the walls of blood vessels, was 14. By usual American standards, an ideal level is between 100 and 129, and anything over 190 is considered very high. Even in people who have had a heart attack, the usual treatment goal is 50 to 70. She was apparently missing both copies of a gene that controls low-density lipoprotein, but to no ill effect. “We had never seen that, ever.” That gene is a leftover from a prior era, thousands of years ago, when it was instrumental to be sure we formed enough cholesterol to create and maintain healthy cell membranes. “But this person is perfectly healthy and proof that we don’t need either copy of that gene anymore,” he said. “If everyone’s LDL was 14, we probably wouldn’t have any heart attacks.” Unfortunately, we’re not under any survival pressure for these genes to change since the resulting conditions don’t kill us until after we’ve had children who can perpetuate the human species—as well as these now-adverse genes. Another potential treatment approach—using will power—is often worth trying, but typically has relatively little success. “There is a lot of hope and oftentimes hype that we can dramatically change our behavior,” Goldman said. “A lot of health advice focuses on that today, but if it was commonly successful, I wouldn’t have written this book.” Indeed, if it did, 38 percent of Americans wouldn’t be obese, 14 percent wouldn’t have diabetes, a third wouldn’t have high blood pressure, and heart attacks and strokes wouldn’t be two of the five leading causes of death in America. “Behavior change is a virtue worthy of an attempt, and I wish I could predict that it would solve these problems. But we shouldn’t feel guilty if we can’t beat our genes, and we shouldn’t look down upon people who can’t beat theirs,” Goldman said. “That’s just not the way we’re built.” — By Bridget O'Brian Healthcare, Genetics, Precision Medicine More from Columbia News 5 Questions: Alondra Nelson on Race, Ethnicity and the ‘Social Life of DNA’ Faculty Q&A with Wendy Chung: Exploring Genetic Approaches to Medicine Precision Medicine Diagnoses a Child’s Rare Neurodegenerative Disease Handheld Diagnostics @Columbia Tweets by @Columbia Columbia in the News Harlem Students Set to Pitch Inventions to Leaders in Biotech Industry DNA Info, August 25, 2016 Why the Earthquake in Italy Was So Destructive The Washington Post, August 24, 2016 Why One Neuroscientist Started Blasting His Core The Atlantic, August 24, 2016 This Earth-like Planet Orbits the Sun’s Nearest Neighbor Every 11 Days PBS Newshour, August 24, 2016 Subscribe to Columbia News Manhattanville Campus Columbia's Manhattanville campus will be a vibrant center of academic and civic life, ensuring that Upper Manhattan remains a world-class center of pioneering research and teaching. Learn more » 116th Street and Broadway, New York, NY 10027 © 2016 Columbia University Contact Us

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Five Questions With: Dr. Michael Fine By Richard Asinof Contributing WriterTwitter: @RichardAsinof Director of the R.I. Department of Health talks about the Primary Care Trust Initiative. health care Five Questions With: Dr. Michael Fine “If we can lower health care and health insurance costs, health care in Rhode Island becomes a business incubator and not a business tax.” COURTESY R.I. DEPARTMENT OF HEALTH Print Monday, February 4, 2013 4:55 am By Richard Asinof Contributing WriterTwitter: @RichardAsinof In 1996, Dr. Michael Fine, the director of the R.I. Department of Health, was a member of a small primary care group practice located on East Street in Pawtucket. “I was sitting there, trying to figure out what it cost to deliver primary care for about 4,000 patients,” he told student who attended his talk on Nov. 27, 2012, as part of the University of Rhode Island honors colloquium. “I did the math three or four times,” he continued, because he couldn’t believe the numbers. Per patient per year, the cost was $106; yet the cost of health insurance was about $4,000. In other words, patients were paying $4.000 for $106 in value. As a result that “eureka” moment, the realization that the health care market was “at war with health,” Fine has spent much of his career trying to change the paradigm of health care in Rhode Island. His latest initiative is called “The Primary Care Trust,” which would create neighborhood health centers in Rhode Island communities with 10,000 residents. Providence Business News asked Fine to share his plans. PBN: What is your vision for the primary care trust in Rhode Island? How would it work? FINE: The Primary Care Trust will create and fund “Neighborhood Health Stations” in each Rhode Island community of 10,000, which will serve as medical homes for the entire community, and offer wellness visits, sick visits, dental care, and healthcare services. '); The Primary Care Trust and Neighborhood Health Stations concept will build on the pioneering work of Rhode Island's Community Health Centers, primary care providers, and the Chronic Disease Sustainability Initiative, including the ground-breaking work that has made Rhode Island first in the nation in the percentage of primary care providers recognized as patient-centered medical homes. These Neighborhood Health Stations will see people the same day they are sick, and will be open during hours that are convenient for patients on both weekdays and weekends. Neighborhood Health Stations will provide medical and mental health, home health, and perhaps even dental services. For example, a Neighborhood Health Station might include primary care physicians, pediatricians, internists, family physicians, dentists, nurse practitioners, physician assistants, mental health workers, social workers, physical therapists, pharmacists and home health workers. The flexibility of the Primary Care Trust will allow each Neighborhood Health Station to tailor its services to meet the needs of the particular community it serves. PBN: Can you provide some numbers about what would be the potential return on investment, i.e., better health outcomes, lower costs, better prevention? FINE: The Primary Care Trust will transform the way health professionals are paid, using financial incentives to encourage improved care and better health outcomes for individuals and communities. It will make Rhode Island the first state in the nation to take full advantage of cutting-edge developments in health policy and health care system design that have studied the advantages of treating the whole individual, the whole family, and the whole community, at a predictable and controllable cost. PBN: How would this system of community primary care facilities serve as a economic engine for Rhode Island? FINE: Each Neighborhood Health Station will function as the anchor of local economic development. Each station is a $20 million to $30 million per year business and will bring business activity to between 75-100 neighborhoods and communities. PBN: What are the next steps to make this primary care trust initiative happen? What do you see as the potential forces of resistance? FINE: We are in the process of sharing the wealth of data that exists about the value and public purpose of primary care. We’ll be talking about this approach, and listening to the thoughts of collaborators. Our goal is to build on Rhode Island's areas of strength. We have great Community Health Centers and primary care providers in this state. The Primary Care Trust builds on the seeds already planted and reflects on our ability to create better health outcomes for all Rhode Islanders at lower costs than we now pay. PBN: Why should the business community become advocates for the primary care trust in Rhode Island? FINE: If we can lower health care and health insurance costs, health care in Rhode Island becomes a business incubator and not a business tax. If Rhode Island has lower healthcare costs than Massachusetts and Connecticut, we can draw new businesses here. Healthier Rhode Islanders also mean a healthier workforce and an increasing number of Rhode Islanders who are ready and able to work. Lower healthcare costs mean more opportunities to invest capital in improving our state's public services – libraries, schools, public safety, housing, and the environment – investments that also serve to strengthen our workforce.

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Massachusetts Health Policy Official Discusses Priorities By Paul Tuthill Mar 28, 2013 ShareTwitter Facebook Google+ Email Massachusetts ,which pioneered universal access to health insurance, is now beginning the next phase of healthcare reform: reining in the run-away costs. The executive director of the new agency responsible for implementing the state’s cost containment law was in Springfield on Thursday. Credit Leon Brooks Listen Listening... / 3:18 The Executive Director of the Health Policy Commission, David Seltz, told a Chamber of Commerce luncheon audience that it will be a huge challenge to restrict the annual growth in health care spending to no more than the total growth in the state’s economy, as the new law demands. For 2013, the benchmark is 3.6 percent. Seltz, on the job for just two months, is confident the goal will be met. The law does not mandate reductions in insurance rates or government reimbursements to healthcare providers. It calls for a gradual change in the volume driven fee-for-service payment system to one that is based on outcomes. It provides incentives for wellness programs and funding for pilot programs to encourage innovations that led to lower costs without sacrificing quality. Seltz said making the health care system more efficient, and ridding it of fraud and abuse could reduce costs by as much as 30 percent. A priority for the new agency is to make the healthcare system more transparent so people can shop for value. The cost containment Massachusetts is undertaking comes against the backdrop of changes in health are mandated by the federal Affordable Care Act. Seltz does not believe the state’s efforts and the federal reforms will clash. Jeff Ciuffreda, President of the Affiliated Chambers of Commerce of Greater Springfield said meeting with Seltz helped reassure him the state is on the right course Spending on healthcare in Massachusetts increased by 59 percent in the last decade and was projected to more than double in the next 10 years, without the cost containment efforts Seltz also toured Mercy Medical Center in Springfield. The hospital has initiated a pilot program in managing patient care. Dan Keenan, Senior Vice President of Government Relations with the Sisters of Providence Health Systems, which operates Mercy, said the program involves tracking patients from the moment they enter the hospital. A dilemma facing Massachusetts is how to curb the growth of costs without harming the healthcare industry, which is one of the state’s largest employers. Related Program: WAMC Northeast ReportTags: healthcareHealth Care Reform Critics Slam Health Care Financing Plan 3 years ago Vermont Health Exchange Receives Conditional Federal Approval 3 years ago View the discussion thread. © 2016 WAMC

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Careers Baylor Charles A. Sammons Cancer Center at Dallas Text Size Share Baylor Health Care System > Physicians & Locations > Dallas > Specialties & Services > Cancer Care > Cancer in the News > Record Donation to Benefit New Cancer Center Cancer Center and Cancer Hospital Cancer Events & Free Screenings Cancer in the News Cancer Support & Education Chest Cancer Research and Treatment Center Hereditary Cancer Risk What's New in Cancer? Blood Cancer Research and Treatment Center Breast Cancer Research and Treatment Center Cancer Boutique Clinical Oncology Research Coordination Genitourinary Cancer Research and Treatment Center Neuroendocrine Cancer Research and Treatment Center Oncology Evaluation & Treatment Center Pancreatic Cancer Research and Treatment Center Skin Malignancy Research and Treatment Center Find a Physician Find a Location Find a Class or Event Record Donation to Benefit New Cancer Center The Baylor Health Care System Foundation announced gifts exceeding $20 million for what will be North Texas’ largest outpatient cancer center and first dedicated hospital focusing on cancer patients. This donation is made possible through the generosity of the men and women of Sammons Enterprises, Inc. and the estate of founder Charles A. Sammons, who quietly provided significant philanthropic support to Baylor University Medical Center for more than 50 years. These extraordinary contributions will benefit the new cancer complex at the Baylor Charles A. Sammons Cancer Center at Dallas which was previously announced in September 2008. National Renowned Cancer Care Destination “The development of these facilities will ensure that all patients in North Texas have convenient access to the advanced screening, diagnosis, and treatment they need to overcome cancer,” said Joel T. Allison, president and chief executive officer of Baylor Health Care System. “This gift will help us continue to provide advanced cancer treatments and conduct clinical research to reach our goal to be a destination for cancer care. The Baylor Health Care System is most grateful for the generosity of the Sammons family and companies.” The outpatient cancer center and inpatient cancer hospital are key components of a $350 million investment. The inpatient cancer hospital will feature 120 beds and the new outpatient cancer center will provide a full range of cancer-related services, including physician offices, radiation, chemotherapy, and pain management in a new ten-story, 450,000 square foot building. A Legacy of Giving “We’ve had more than 50 years to observe Baylor as good stewards of the contributions made initially by Mr. Sammons, the Sammons family and the Sammons companies,” said Robert W. Korba, chairman of Sammons Enterprises. “And we have had more than 30 years to watch how they have made a difference to the people of Dallas and North Texas who have been touched by cancer. In honor of Mr. Sammons and his tradition of philanthropy, we are pleased to make this current gift that will deliver high-quality care to cancer patients and continue the impressive cancer research and treatment at the new Baylor Charles A. Sammons Cancer Center.” With an entrepreneurial business sense that was evident when he was a teenager, Charles Sammons quietly built an enterprise that ranks among the largest privately-owned companies in the world. Charles Sammons was a visionary whose lifelong support of Baylor University Medical Center and commitment to improving health care began after both of his sisters were afflicted with cancer. For more than 50 years, Sammons and his companies have made a number of contributions to the hospital and he often served as a catalyst for philanthropy in Dallas by donating money as “challenge gifts” meant to inspire others to give. Headquartered in Dallas, Sammons Enterprises is a privately-held multi-billion dollar global holding corporation that owns and operates businesses across a diverse range of industries including insurance, finance, equipment distribution, hospitality and real estate. The company also manages a large investment portfolio. “Baylor has been fortunate to be the beneficiary of some extraordinary gifts over the decades. However, none have had the profound, transformational impact as the generosity of Charles A. Sammons, his family, and the men and women of the enterprise built by him. We are deeply grateful for their abiding concern and generous spirit. We are most appreciative for this gift which is the largest gift in Baylor’s history and one of the largest single corporate donations to be received in North Texas.”

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Public Release: 22-Mar-2011 Hippocampal volume and resilience in posttramatic stress disorder Philadelphia, PA, 22 March, 2011 - The hippocampus, a brain region implicated in memory and interpreting environmental contexts, has been the focus of a controversy in posttraumatic stress disorder (PTSD). Early MRI studies suggested that the volume of the hippocampus was reduced in some people with chronic PTSD. This observation was interpreted as suggesting that stress produced atrophy within the hippocampus, consistent with a body of research conducted in animals. Supporting this hypothesis, it appears that the same region of the hippocampus that is most-sensitive to stress effects in animals, the CA3 region, may show the greatest volume reductions in people with PTSD. More recently, the non-traumatized identical twins of people with PTSD were shown to have smaller hippocampal volumes, suggesting that a small hippocampus might be a risk factor for PTSD. This hypothesis relates to the role that the hippocampus plays in drawing inferences about one's environmental context, such as evaluating the safety of the environment. The hippocampus also provides some inhibitory control of hypothalamic centers that control the levels of the stress hormone cortisol. Now, a new study in Biological Psychiatry has found that larger hippocampal volume is associated with recovery of PTSD. Brigitte Apfel and colleagues used structural magnetic resonance imaging to study hippocampal volume in Gulf War veterans who recovered from PTSD in comparison to veterans with chronic PTSD and to control participants who never had PTSD. They found that recovered veterans had, on average, larger hippocampal volumes than those with chronic PTSD and similar volumes compared to the control participants. "These results need to be interpreted with caution because we did not measure brain changes over time. However, the finding suggests that hippocampal damage in PTSD is reversible once the symptoms remit," explained Dr. Apfel. "If our finding can be confirmed, it might suggest that treatment of PTSD could be viewed as brain restoration rather than primarily a way to ease symptoms." Does this finding help to resolve the conundrum of whether the hippocampus is a target of stress or a contributor to stress response? This finding would appear to support the hypothesis that a small hippocampus is a risk factor for the persistence of PTSD, because people with larger hippocampi seemed better able to recover. This finding may be consistent with the observation that some gene variants associated with emotional resilience in response to stress are also associated with larger hippocampal volume. Alternatively, it is possible that smaller hippocampi reflect early life stress or other environmental factors that compromise resilience in adulthood. A major remaining question is whether treatment-related increases in hippocampal volume mediate aspects of the therapeutic responses to PTSD treatments. A prior study reported that six months of antidepressant treatment increased hippocampal volume in people with PTSD. "It may be time to view hippocampal volume as both a modulator of stress resilience and as a target for the negative impact of stress and the positive effects of treatments," commented Dr. John Krystal, Editor of Biological Psychiatry. "This more complex view might explain how the negative effects of stress "feed forward" to worsen outcomes in the face of subsequent stressors, while treatments would similarly cumulatively promote resilience." The article is "Hippocampal Volume Differences in Gulf War Veterans with Current Versus Lifetime Posttraumatic Stress Disorder Symptoms" by Brigitte A. Apfel, Jessica Ross, Jennifer Hlavin, Dieter J. Meyerhoff, Thomas J. Metzler, Charles R. Marmar, Michael W. Weiner, Norbert Schuff, and Thomas C. Neylan. Apfel, Ross, Metzler, and Neylan are affiliated with Mental Health Service, Veterans Affairs Medical Center, San Francisco, California. Apfel, Ross, and Neylan are also with the Department of Psychiatry, University of California, San Francisco, California. Hlavin, Meyerhoff, Weiner, and Schuff are affiliated with the Center for Imaging of Neurodegenerative Diseases, Veterans Affairs Medical Center, San Francisco, California. Meyerhoff, Weiner, and Schuff are also with the Department of Radiology and Biomedical Imaging, University of California, San Francisco, California. Marmar is from the Department of Psychiatry, New York University, New York, New York. The article appears in Biological Psychiatry, Volume 69, Number 6 (March 15, 2011), published by Elsevier. The authors' disclosures of financial and conflicts of interests are available in the article. John H. Krystal, M.D. is Chairman of the Department of Psychiatry at the Yale University School of Medicine and a research psychiatrist at the VA Connecticut Healthcare System. His disclosures of financial and conflicts of interests are available at http://journals.elsevierhealth.com/webfiles/images/journals/bps/Biological-Psychiatry-Editorial-Disclosures-7-22-10.pdf. Full text of the article mentioned above is available upon request. Contact Chris J. Pfister at c.pfister@elsevier.com to obtain a copy or to schedule an interview. About Biological Psychiatry This international rapid-publication journal is the official journal of the Society of Biological Psychiatry. It covers a broad range of topics in psychiatric neuroscience and therapeutics. Both basic and clinical contributions are encouraged from all disciplines and research areas relevant to the pathophysiology and treatment of major neuropsychiatric disorders. Full-length reports of novel results, commentaries, case studies of unusual significance, and correspondence judged to be of high impact to the field are published, particularly those addressing genetic and environmental risk factors, neural circuitry and neurochemistry, and important new therapeutic approaches. Concise reviews and editorials that focus on topics of current research and interest are also published rapidly. Biological Psychiatry (www.sobp.org/journal) is ranked 4th out of 117 Psychiatry titles and 13th out of 230 Neurosciences titles in the 2009 ISI Journal Citations Reports® published by Thomson Reuters. The 2009 Impact Factor score for Biological Psychiatry has increased to 8.926. About Elsevier Elsevier is a world-leading publisher of scientific, technical and medical information products and services. The company works in partnership with the global science and health communities to publish more than 2,000 journals, including The Lancet and Cell, and close to 20,000 book titles, including major reference works from Mosby and Saunders. Elsevier's online solutions include SciVerse ScienceDirect, SciVerse Scopus, Reaxys, MD Consult and Nursing Consult, which enhance the productivity of science and health professionals, and the SciVal suite and MEDai's Pinpoint Review, which help research and health care institutions deliver better outcomes more cost-effectively. A global business headquartered in Amsterdam, Elsevier employs 7,000 people worldwide. The company is part of Reed Elsevier Group PLC, a world-leading publisher and information provider, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange). Chris J. Pfister C.Pfister@elsevier.com @elseviernews http://www.elsevier.com More on this News Release DEPRESSION/ANGER MEMORY/COGNITIVE PROCESSES STRESS/ANXIETY

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Child Maltreatment: Strengthening National Data on Child Fatalities Could Aid in Prevention GAO-11-599: Published: Jul 7, 2011. Publicly Released: Jul 12, 2011. Kay E. Brown(202) 512-3674contact@gao.gov Office of Public Affairs Children's deaths from maltreatment are especially distressing because they involve a failure on the part of adults who were responsible for protecting them. Questions have been raised as to whether the federal National Child Abuse and Neglect Data System (NCANDS), which is based on voluntary state reports to the Department of Health and Human Services (HHS), fully captures the number or circumstances of child fatalities from maltreatment. GAO was asked to examine (1) the extent to which HHS collects and reports comprehensive information on child fatalities from maltreatment, (2) the challenges states face in collecting and reporting this information to HHS, and (3) the assistance HHS provides to states in collecting and reporting data on child maltreatment fatalities. GAO analyzed 2009 NCANDS data--the latest data available--conducted a nationwide Web-based survey of state child welfare administrators, visited three states, interviewed HHS and other officials, and reviewed research and relevant federal laws and regulations. More children have likely died from maltreatment than are counted in NCANDS, and HHS does not take full advantage of available information on the circumstances surrounding child maltreatment deaths. NCANDS estimated that 1,770 children in the United States died from maltreatment in fiscal year 2009. According to GAO's survey, nearly half of states included data only from child welfare agencies in reporting child maltreatment fatalities to NCANDS, yet not all children who die from maltreatment have had contact with these agencies, possibly leading to incomplete counts. HHS also collects but does not report some information on the circumstances surrounding child maltreatment fatalities that could be useful for prevention, such as perpetrators' previous maltreatment of children. The National Center for Child Death Review (NCCDR), a nongovernmental organization funded by HHS, collects more detailed data on circumstances from 39 states, but these data on child maltreatment deaths have not yet been synthesized or published. States face numerous challenges in collecting child maltreatment fatality data and reporting to NCANDS. At the local level, lack of evidence and inconsistent interpretations of maltreatment challenge investigators--such as law enforcement, medical examiners, and child welfare officials--in determining whether a child's death was caused by maltreatment. Without medical evidence, it can be difficult to determine that a child's death was caused by abuse or neglect, such as in cases of shaken baby syndrome, when external injuries may not be readily visible. At the state level, limited coordination among jurisdictions and state agencies, in part due to confidentiality or privacy constraints, poses challenges for reporting data to NCANDS. HHS provides assistance to help states report child maltreatment fatalities, although states would like additional help. For example, HHS hosts an annual NCANDS technical assistance conference, provides individual state assistance, and, through NCCDR, has developed resources to help states collect information on child deaths. However, there has been limited collaboration between HHS and NCCDR on child maltreatment fatality information or prevention strategies to date. State officials indicated a need for additional information on how to coordinate across state agencies to collect more complete information on child maltreatment fatalities. States are also increasingly interested in collecting and using information on near fatalities from maltreatment. GAO recommends that the Secretary of HHS take steps to further strengthen data quality, expand available information on child fatalities, improve information sharing, and estimate the costs and benefits of collecting national data on near fatalities. In its comments, HHS agreed with GAO's findings and recommendations and provided technical comments, which GAO incorporated as appropriate. Recommendations for Executive Action Status: Closed - Implemented Comments: On September 30, 2011, the Child and Family Services Improvement and Innovation Act (42 USC 1305) was passed into law. The Act requires states to describe the various sources of data on child fatalities and, if applicable, why information is not included from other relevant agencies, such as state vital statistics, child death review teams, law enforcement agencies, and offices of medical examiners or coroners. The additional information required by the Act will assist in improving the comprehensiveness and quality of national data on child fatalities from maltreatment. HHS noted the new act's requirements for state reporting in the most recent Child Maltreatment report for 2011, and issued Program Instructions (ACYF-CB-PI-13-04) in April, 2013, requiring states as part of their 2013 Annual Progress and Services Report to address the sources of information used to report child fatality data and to describe efforts to expand the sources of information used to report such data. HHS stated that this information will be used to continue discussions with states in improving the quality and completeness of fatality information reported through NCANDS. These new program instructions and any related discussions with states should help strengthen the completeness and accuracy of child fatality data by fostering states' use of cross-agency data sources. Recommendation: To improve the comprehensiveness, quality, and use of national data on child fatalities from maltreatment, the Secretary of HHS should identify ways to help states strengthen the completeness and reliability of data they report to NCANDS. These efforts could include identifying and sharing states' best practices, particularly those that foster cross-agency coordination and help address differences in state definitions and interpretation of maltreatment and/or privacy and confidentiality concerns. Agency Affected: Department of Health and Human Services Status: Closed - Implemented Comments: For 2011, HHS's annual Child Maltreatment report made public additional information about child fatalities from maltreatment than in its earlier 2009 report: A new table provides information on child fatalities among caregivers with selected risk factors, such as alcohol abuse, and another table provides data on child fatalities by single-year age rather than by age group. HHS previously noted that some NCANDS information is not provided in the report when there is insufficient data from the states. In FY13, as part of its review of NCANDS child maltreatment data, the Office Of Management and Budget approved the addition of one fatality-related data element: the exact date of death. In addition, the program instructions to the states also revised HHS's public disclosure policy: HHS now requires states to provide the public with a minimum of information about child fatalities and near-fatalities. Specifically, states are to release, when appropriate, with certain exceptions, information about the cause and circumstances about the fatality or near-fatality, and any previous investigations, reports, or services. This new information and public disclosure policy should help strengthen the comprehensiveness of data and understanding of the circumstances surrounding child fatalities from maltreatment. Recommendation: To improve the comprehensiveness, quality, and use of national data on child fatalities from maltreatment, the Secretary of HHS should expand, as appropriate, the type and amount of information HHS makes public on the circumstances surrounding child fatalities from maltreatment. Status: Closed - Not Implemented Comments: In March 2015, HHS released a request for public comment in the Federal Register on policy interpretation under the Child Abuse Prevention and Treatment Act (CAPTA) concerning the public disclosure of findings or information about a case of child abuse or neglect which results in a child fatality or near fatality. The notice sought comments on 2012 revisions to the Child Welfare Policy Manual on state procedures for releasing information about the cause and circumstances regarding a fatality or near fatality, among other things. The notice included questions about any challenges stakeholders have had obtaining information about child maltreatment fatalities and near fatalities; whether the state offered a public report of the child fatalities review panel; and if so, whether the public report contains the required disclosure of information. It also asks state agencies about the challenges they've had implementing the 2012 policy as well as challenges in applying the disclosure policy while also ensuring that the state adheres to confidentiality protections. However, public disclosure requirements serve a different purpose than federal information sharing. While seeking comments on the implementation of public disclosure policies should be helpful to HHS in assessing the efficacy of its policies, HHS's notice is not a means by which HHS can routinely share analyses and expertise on the circumstances of child maltreatment deaths so as to aid in prevention. HHS did not report any additional actions to address this issue. Recommendation: To improve the comprehensiveness, quality, and use of national data on child fatalities from maltreatment, the Secretary of HHS should use stronger mechanisms to routinely share analyses and expertise with its partners on the circumstances of child maltreatment deaths, including insights that could be used for developing prevention strategies. Status: Closed - Implemented Comments: In 2014, HHS noted that it had concluded conversations with the states concerning the costs and benefits of collecting data on children's near-fatalities in national data on abuse and neglect. The outcome of these federal and state considerations was that HHS does not plan to collect data from the states on near-fatalities. In 2013, members of the Children's Bureau and the NCANDS Technical Team sought input and recommendations from the states through webinars, working groups, and annual technical assistance meetings about collecting near fatality data, according to HHS. At the State Liaison Officers meeting in April 2013, Children's Bureau and data team members conducted a presentation on Applying Lessons Learned from Child Fatality Reviews to Preventing Fatalities and Near Fatalities that included group discussions on 2-year goals for improving the identification, data tracking, and critical action steps related to near-fatality cases. According to HHS, in discussing the costs and benefits of collecting near-fatality data through NCANDS, states cited administrative and cost burdens as reasons for not supporting data collection on near-fatalities. Recommendation: To improve the comprehensiveness, quality, and use of national data on child fatalities from maltreatment, the Secretary of HHS should estimate the costs and benefits of collecting national data on near fatalities and take appropriate follow-up actions. Find Recent Work on Worker and Family Assistance » Supplemental Nutrition Assistance Program: Policy Changes and Calculation Methods Likely Affect Improper Payment Rates, and USDA Is Taking Steps to Help Address Recipient Fraud [Reissued on July 8, 2016]GAO-16-708T: Published: Jul 6, 2016. Publicly Released: Jul 6, 2016. Social Security Disability: SSA Could Increase Savings by Refining Its Selection of Cases for Disability ReviewGAO-16-250: Published: Feb 11, 2016. Publicly Released: Mar 14, 2016. Temporary Assistance for Needy Families: Update on States Counting Third-Party Expenditures toward Maintenance of Effort RequirementsGAO-16-315: Published: Feb 10, 2016. Publicly Released: Mar 10, 2016. Unaccompanied Children: HHS Can Improve Monitoring of Their CareGAO-16-429T: Published: Feb 23, 2016. Publicly Released: Feb 23, 2016. Foster Care: HHS Could Do More to Support States' Efforts to Keep Children in Family-Based CareGAO-16-85: Published: Oct 9, 2015. Publicly Released: Nov 9, 2015. Child Welfare: Steps Have Been Taken to Address Unregulated Custody Transfers of Adopted ChildrenGAO-15-733: Published: Sep 16, 2015. Publicly Released: Sep 16, 2015. Older Americans Act: Updated Information on Unmet Need for ServicesGAO-15-601R: Published: Jun 10, 2015. Publicly Released: Jun 15, 2015. Supplemental Security Income: An Overview of Program Integrity and Management ChallengesGAO-15-632T: Published: Jun 3, 2015. Publicly Released: Jun 3, 2015. Unemployment Insurance: States' Reductions in Maximum Benefit Durations Have Implications for Federal CostsGAO-15-281: Published: Apr 22, 2015. Publicly Released: May 21, 2015. Temporary Assistance for Needy Families: An Overview of Spending, Federal Oversight, and Program IncentivesGAO-15-572T: Published: Apr 30, 2015. Publicly Released: Apr 30, 2015. Explore our Key Issues on Worker and Family AssistanceAffordable Rental HousingEmployment in a Changing EconomyHomelessnessSSA Service Delivery ChallengesExplore our other Key Issues here

医学

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Insight & Intelligence™ : Mar 15, 2011 Arresting Disorderly Proteins for Disease Treatment Finding a molecule to target each miscreant protein will take a while. Targeting aberrant proteins by replacing them, controlling post-translational modifications that affect their function, or preventing them from interacting with their targets have proven effective approaches to disease treatment. Several companies are also seeking novel therapies that aim to fix the misfolded proteins that cause serious, currently incurable diseases. These diseases range from neurodegenerative disorders to enzyme deficiencies. Alzheimer disease, Parkinson disease, Huntington disease, amyotrophic lateral sclerosis, and prion diseases such as Kuru and mad cow disease all involve misfolded proteins that eventually form the pathogenic aggregates characteristic of these neurodegenerative disorders. Misfolded proteins may be nonfunctional, may function suboptimally, may be easily degraded, or can expose parts of themselves leading to dysfunctional interactions with other proteins. Little by little, a better understanding of the mechanisms that drive protein interactions and some definition of the states in which proteins become pathogenic is emerging. Two quality control systems that operate in cells ensure accuracy of protein folding. A chaperone system prevents the aggregation of partially folded proteins and facilitates complete folding. The second is a sort of protein garbage disposal system that identifies and degrades improperly folded and damaged proteins. Proteins are also the ultimate moving targets for potential therapeutics. Under normal physiological conditions, native proteins don’t adopt a single static conformation. Rather, a protein’s true native state includes small fluctuations around the native conformation, partially unfolded forms, and even globally unfolded forms. Leveraging the Garbage-Disposal System Basic scientists and drug development companies are chasing misfolded proteins down several cellular paths. A nonspecific approach involves ridding the cell of toxic proteins by taping into the cell’s waste-management system. Cells create and discard proteins continuously, a process that relies on a balance between how quickly proteins are created and damaged ones destroyed. To achieve the balance, cells use proteasomes, protein-degrading enzyme complexes consisting of multiple subunits that exist in the cell nucleus and cytoplasm. Protein destruction occurs by marking proteins for disposal by tagging them with ubiquitin, a small protein that latches onto the proteins, often forming long chains. The proteasome then recognizes these ubiquitinated proteins and breaks them down. Attachment of one single ubiquitin molecule to a protein signals other ligase enzymes to attach additional ubiquitin molecules. The result is a polyubiquitin chain that is bound by the proteasome, allowing it to degrade the tagged protein. Harvard University researchers reported results on a study that focused on proteasome activity in the September 2010 issue of Nature. Their work was funded by the Harvard Technology Development Accelerator Fund, Johnson & Johnson, Merck & Co., and NIH. They found that when the ligase Usp14 is activated, it interrupts the ubiquitin chain, thereby slowing the proteasome’s ability to rid the cell of undesirable proteins. As a result the cell makes new proteins faster than it rids itself of the old ones, leading to a buildup of misfolded proteins. The investigators then screened 63,000 compounds and reportedly identified a Usp14 inhibitor, IU1, that when added to cells increased proteasome activity apparently due to its ability to trim the ubiquitin tail. As of September 2010, patents were pending for IU1 and the assay used to identify the molecule. Using Chaperones Amicus Therapeutics approaches treatment of human genetic diseases by using its pharmacological chaperones, or small molecule drugs that selectively bind to the target protein. Once bound, these molecules increase the protein’s stability and encourage it to fold into the correct 3-D shape. Amicus’ lead candidate is in Phase III trials to treat Fabry disease. The company, along with partner GlaxoSmithKline (GSK), is conducting a Phase III study and expects preliminary results in mid-2011. In February Amicus announced positive data from its ongoing Phase II extension study. Fifteen subjects have been treated for more than three years, seven subjects have been treated for more than four years, and 17 continue to receive treatment in the ongoing extension study. Renal function is a key efficacy endpoint for Fabry disease treatments. The trial showed that estimated glomerular filtration rate, a measure of kidney function, remained stable out to 3–4 years for all subjects continuing in the extension study. Reduced 24-hour urine protein levels, another measure of renal function, was observed with a mean 21% and median 34% reduction from baseline in patients identified as responders. Apart from GSK, another big pharma company made a major commitment in the protein folding space. Pfizer acquired FoldRx Pharmaceuticals in September 2010 for its pipeline of preclinical and clinical products to treat diseases caused by protein misfolding. Lead product, tafamidis, is being developed for TTR amyloidosis, a disease linked to mutations in the transthyretin (TTR) protein. TTR amyloidosis manifests in two clinical forms: ATTR-PN, a sensory neuropathy that starts in the lower extremities and progresses to include both autonomic and motor dysfunction, and ATTR-CM, characterized by amyloid deposits that infiltrate the heart and result in a potential fatal restrictive cardiomyopathy. ATTR-CM generally occurs in individuals over 60 years of age. ATTR-PN affects about 5,000–10,000 patients worldwide, while ATTR-CM affects about 400,000 patients in the U.S alone. Tafamidis works to prevent the dissociation of native TTR tetramer into monomers. This results in the inhibition of amyloid fibril formation that leads to amyloid deposition. The last report on clinical investigations was made in 2009. FoldRx said preliminary results from the first randomized, controlled trial showed that treatment significantly halted disease progression in ATTR-PN, reduced the burden of disease after 18 months, and appeared to be safe and well-tolerated. Pfizer has filed an MAA and is currently in communication with the FDA to define its path for filing in the U.S. Tafamidis has orphan drug designation in both the U.S. and EU as well as Fast Track designation in the U.S. for the treatment of ATTR-PN. The Protein Homeostasis Proteostasis Therapeutics is working to discover small molecules that restore protein folding, trafficking, and clearance pathways and is developing them as drugs for neurodegenerative and orphan diseases. Together, these pathways make up the protein homeostasis (proteostasis) network. Founded in 2008 to develop Proteostasis Regulator™ drugs, the company raised $45 million in a 2010 Series A financing. Peter Reinhart, Ph.D., the company’s president and CSO, defined proteostasis as a “recent concept that brings together a number of pathways and protein complexes that have previously been viewed separately without the emergent understanding that comes from the realization that they form an interconnected network. The proteostasis network, composed of about 1,000 proteins, contains the ubiquitin proteasome system, chaperones, membrane trafficking pathways, and autophagy. “It is the cellular machinery positioned between the birth of a new polypeptide chain and the protein’s final conformation, helping to maintain the folded protein at the correct location and at the appropriate concentration for all of its interactions and functions.” The functionality of the proteostasis network is compromised by cellular stress and declines with age. Dr. Reinhart says that the company studies the proteostasis network in its entirety, focusing on 10 to 12 different pathways, to build network signatures that define disease progression. “We are getting these signatures by focusing on specific target diseases like cystic fibrosis and Huntington, Parkinson, and Alzheimer diseases. “We collect high-quality, well-annotated human postmortem tissues to analyze how the proteostasis network is altered during disease progression. We can then find pathways and individual proteins that change early in the disease as well as others that change much later during disease progression, providing us a very dynamic view of the changing capability of cells to fold and traffic proteins or remove misfolded and aggregated proteins.” As progress continues toward fixing misfolded proteins the question remains whether each misfolded protein will require its own specific therapeutic or whether a global, network-focused approach will be needed. Either approach, however, may provide some hope for treating previously intractable human diseases. While a fertile field for drug discovery, finding each miscreant protein form and a molecule to target it will take a while.

医学

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Louisiana set to ban telehealth abortionBill would outlaw abortion pill prescriptions via webcam consultations By Erin McCannApril 18, 201310:51 AM A Louisiana state bill that would ban telemedicine as means to prescribe the abortion pill to women living in rural or remote areas has been backed by the state's Senate Health and Welfare Committee and now heads to the Senate for a vote. The bill, sponsored by Sen. Fred Mills (R-Beaux Bridge), was introduced April 8 and was reported with amendments this Wednesday. The Senate will vote on the bill Thursday afternoon. Bill provisions would make it illegal for physicians to prescribe the abortion pill via telemedicine consultations and instead would require women to be present in the same room as the physician to receive a prescription. [See also: Telemedicine for reproductive health.] "We feel this bill is very appropriate for the health, welfare and safety of the pregnant lady," said Mills, the Associated Press reports. Advocates of this telemedicine service, however, say it helps extend services to women living in rural or remote areas who would otherwise have to travel long distances to receive the prescription. For instance, the subject of December study published in the American Journal of Public Health, a four-year-old Heartland, Iowa-based telemedicine program aimed at improving a woman's access to medical abortion services, has both reduced the number of surgical abortions throughout the state and expanded care to women living in more rural areas. The telemedicine service "doesn't make more women get abortions, which makes sense," said Daniel Grossman, co-author of the study, in an interview with Healthcare IT News. "I don't think women have abortions because they're easy to access, but it does improve access so it helps women get in earlier." A bill like Louisiana's SB 90 could have far reaching consequences for not only women's reproductive rights but also for the number of surgical abortions performed if medical abortions are more difficult to obtain for women, some officials say. "This bill imposes medically unnecessary requirements on abortion providers with the intent of eliminating access to abortion for women in Louisiana and falsely claims that non-surgical abortion is unsafe," wrote Melissa Flournoy, Louisiana state director of Planned Parenthood Gulf Coast, in a statement to Healthcare IT News. However, as the Associated Press reports, Dorinda Bordlee, an anti-abortion attorney who testified in support of SB 90, disagrees. She said it's about ensuring safety, in case complications were to arise. "This is a dangerous situation for women," Bordlee told the AP. This story has been updated. Topics: Telehealth Zipnosis scores $17 million to bring telehealth platform to market Telemedicine market to soar past $30B Cloud, mobile among top EHR trends to watch in 2016, consultant says International Space Station teaches healthcare about telemedicine Meridian taps Teladoc for telehealth consults Predictive technology expanding reach Research

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ISRN OncologyVolume 2013 (2013), Article ID 624794, 13 pageshttp://dx.doi.org/10.1155/2013/624794 Review Article Epigenetic Influences in the Aetiology of Cancers Arising from Breast and Prostate: A Hypothesised Transgenerational Evolution in Chromatin Accessibility Francis L. Martin Centre for Biophotonics, Lancaster Environment Centre, Lancaster University, Bailrigg, Lancaster LA1 4YQ, UK Received 9 December 2012; Accepted 26 December 2012 Academic Editors: L. Mutti, M. Stracke, T. Yokoe, and Y. Yu Copyright © 2013 Francis L. Martin. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. AbstractEpidemiological studies have consistently supported the notion that environmental and/or dietary factors play a central role in the aetiology of cancers of the breast and prostate. However, for more than five decades investigators have failed to identify a single cause-and-effect factor, which could be implicated; identification of a causative entity would allow the implementation of an intervention strategy in at-risk populations. This suggests a more complex pathoaetiology for these cancer sites, compared to others. When one examines the increases or decreases in incidence of specific cancers amongst migrant populations, it is notable that disease arising in colon or stomach requires one or at most two generations to exhibit a change in incidence to match that of high-incidence regions, whereas for breast or prostate cancer, at least three generations are required. This generational threshold could suggest a requirement for nonmutation-driven epigenetic alterations in the F0/F1 generations (parental/offspring adopting a more westernized lifestyle), which then predisposes the inherited genome of subsequent generations to mutagenic/genotoxic alterations leading to the development of sporadic cancer in these target sites. As such, individual susceptibility to carcinogen insult would not be based per se on polymorphisms in activating/detoxifying/repair enzymes, but on elevated accessibility of crucial target genes (e.g., oncogenes, tumour suppressor genes) or hotspots therein to mutation events. This could be termed a genomic susceptibility organizational structure (SOS). Several exposures including alcohol and heavy metals are epigens (i.e., modifiers of the epigenome), whereas others are mutagenic/genotoxic, for example, heterocyclic aromatic amines; humans are continuously and variously exposed to mixtures of these agents. Within such a transgenerational multistage model of cancer development, determining the interaction between epigenetic modification to generate a genomic SOS and genotoxic insult will facilitate a new level of understanding in the aetiology of cancer.

医学

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Informa Infection Control Today Magazine U.S. Spends Far More for Healthcare Than 12 Industrialized Nations but Quality Varies Quality Improvement, Healthcare Economics The United States spends more on healthcare than 12 other industrialized countries yet does not provide "notably superior" care, according to a new study from The Commonwealth Fund. The U.S. spent nearly $8,000 per person in 2009 on healthcare services, while other countries in the study spent between one-third (Japan and New Zealand) and two-thirds (Norway and Switzerland) as much. While the U.S. performs well on breast and colorectal cancer survival rates, it has among the highest rates of potentially preventable deaths from asthma and amputations due to diabetes, and rates that are no better than average for in-hospital deaths from heart attack and stroke. Higher prices and greater use of technology appear to be the main factors driving the high rates of U.S. spending, rather than greater use of physician and hospital services, finds study author David Squires, senior research associate at The Commonwealth Fund. His report, "Explaining High Healthcare Spending in the United States: An International Comparison of Supply, Utilization, Prices, and Quality," presents analysis of prices and health care spending in 13 industrialized countries. U.S. healthcare spending amounted to more than 17 percent of gross domestic product (GDP) in 2009, compared with 12 percent or less in other study countries. Japan's spending, which was the lowest, amounted to less than 9 percent of GDP. High U.S. spending on healthcare does not seem to be explained by either greater supply or higher utilization of healthcare services. There were 2.4 physicians per 100,000 population in the U.S. in 2009, fewer than in all the countries in the study except Japan. The U.S. also had the fewest doctor consultations (3.9 per capita) of any country except Sweden. Relative to the other countries in the study, the U.S also had few hospital beds, short lengths of stay for acute care, and few hospital discharges per 1,000 population. On the other hand, U.S. hospital stays were far more expensive than those in other countries—more than $18,000 per discharge. By comparison, the cost per discharge in Canada was about $13,000, while in Sweden, Australia, New Zealand, France, and Germany it was less than $10,000. "It is a common assumption that Americans get more health care services than people in other countries, but in fact we do not go to the doctor or the hospital as often," says Squires. "The higher prices we pay for healthcare and perhaps our greater use of expensive technology are the more likely explanations for high health spending in the U.S. Unfortunately, we do not seem to get better quality for this higher spending." Prices for the 30 most commonly used prescription drugs were a third higher in the U.S. compared to Canada and Germany, and more than double the amount paid for the same drugs in Australia, France, the Netherlands, New Zealand, and the United Kingdom. Magnetic imaging (MRI) and computed tomography (CT) scans were also more expensive in the U.S., and American physicians received the highest fees for primary care office visits and hip replacements. Healthcare in the U.S. also seems to involve greater use of expensive technology than in many other countries. The U.S. performed the most MRI and CT exams among countries for which data were available (Japan had the most MRI and CT scanners, but no data was available on the number of exams performed there). Knee replacements were also performed more often in the U.S. than any country except Germany—though hip replacements were not as common as in most of the other study countries. High spending in the U.S. might be explained, in part, by the nation's high rates of obesity and the associated medical costs. However, at the same time, the U.S. also has a very young population and few smokers relative to the other study countries—factors that could offset higher spending linked to obesity, the report notes. High spending in the United States does not always translate into high-quality care. According to the report, the U.S. had the highest survival rates in the study for breast cancer, as well as the best survival rates, along with Norway, for colorectal cancer. However, cervical cancer survival rates in the U.S. were worse than average and well below those of Norway. Compared to other countries in the study, the U.S. had high rates of asthma-related deaths among people ages 5 to 39 and, along with Germany, very high rates of amputations resulting from diabetes. U.S. rates of in-hospital deaths after heart attack and stroke were average. All of the countries in the study, except for the U.S., provide universal health care, and all struggle with rising health costs. The level of health care spending in the U.S., however, stands apart. If the U.S. were to spend the same share of its GDP on health care as the Netherlands—the country spending the next-largest share of GDP—the savings would have been $750 billion in 2009. Japan offers an interesting model for controlling costs. Although its healthcare system shares certain features with the U.S., Japan is the lowest-spending nation of the group ($2,878 per capita in 2008). Japan operates a fee-for-service system, while offering unrestricted access to specialists and hospitals and a large supply of MRI and CT scanners. Rather than containing costs by restricting access, Japan instead sets healthcare prices to keep total health spending within a budget allotted by the government. In the U.S., individual payers negotiate prices with healthcare providers, a system that leads to complexity—and varying prices for the same goods and services, according to the report. "The Affordable Care Act gives us the opportunity to build a healthcare system that delivers affordable, high-quality care to all Americans," says Commonwealth Fund president Karen Davis. "To achieve that goal, the United States must use all of the tools provided by the law—including new methods of organizing, delivering, and paying for healthcare that will help to slow the growth of healthcare costs, while improving quality." The Commonwealth Fund is a private foundation supporting independent research on health policy reform and a high performance health system. Surgeon Who Discriminated Against HIV-Positive Patient Loses Federal Funding SHEA Applauds Obama Administration's Request for Funding to Address Antimicrobial Resistance Macomb Innovation Fund Awards Start-ups Including Hand Hygiene Technology Global Vaccine-Development Fund Could Save Thousands of Lives, Billions of Dollars NYU Langone Medical Center to Spearhead Multi-Institutional MRSA Research Funded by the NIH Latest Articles Healthcare Reform: A Primer for the Infection Preventionist Making the Business Case for Technology at the Intersection of Cost and Quality Surveillance Comes Full Circle: Past, Present and Future Trends Surveys Reveal How C-Suite, IPs View Hand Hygiene Compliance The Role of Behavior Change Theory in Healthcare Risk Management Please enable JavaScript to view the comments powered by Disqus.

医学

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Medical Explorer Drugs A to Z : A B C D E F G H I J K L M N O P R S T U V W X Y Z Medicinal Ingredients : A B C Beauty Products : A B C D E F G I M N O P R S T V Aging Allergies Alzheimer's Arthritis Asthma Bacteria Cancer Chickenpox Colds Constipation Diabetes Epilepsy Fatigue Fever Genetics Haemorrhoids Headaches Hepatitis Immunity Infection Insomnia Leprosy Menopause Obesity Osteoporosis Other Diseases Pain PMS Parasites Sinusitis Stroke Toxicology Urology Arthritis medications Medicinal food Protaxos INN: Strontium Ranelate TRADE NAME OF THE MEDICINAL PRODUCT PROTAXOS 2g granules for oral suspension QUALITATIVE AND QUANTITATIVE COMPOSITION Each sachet contains 2g of strontium ranelate. PHARMACEUTICAL FORM Granules for oral suspension Yellow granules Treatment of postmenopausal osteoporosis to reduce the risk of vertebral and hip fractures. POSOLOGY AND METHOD OF ADMINISTRATION The recommended daily dose is one 2g sachet once daily by oral administration. Due to the nature of the treated disease, strontium ranelate is intended for long-term use. The absorption of strontium ranelate is reduced by food, milk and derivative products and therefore, PROTAXOS should be administered in-between meals. Given the slow absorption, PROTAXOS should be taken at bedtime, preferably at least two hours after eating. The granules in the sachets must be taken as a suspension in a glass of water. Although in-use studies have demonstrated that strontium ranelate is stable in suspension for 24 hours after preparation, the suspension should be drunk immediately after being prepared. Patients treated with strontium ranelate should receive vitamin D and calcium supplements if dietary intake is inadequate. Use in the elderly The efficacy and safety of strontium ranelate have been established in a broad age range (up to 100 years at inclusion) of postmenopausal women with osteoporosis. No dosage adjustment is required in relation to age. Use in renal impairment No dosage adjustment is required in patients with mild-to-moderate renal impairment (30-70 ml/min creatinine clearance). Strontium ranelate is not recommended for patients with severe renal impairment (creatinine clearance below 30 ml/min). Use in hepatic impairment As strontium ranelate is not metabolised, no dosage adjustment is required in patients with hepatic impairment. Use in children and adolescents The efficacy and safety of strontium ranelate have not been established in children and adolescents and use in these age groups is not recommended. CONTRA-INDICATIONS Hypersensitivity to the active substance or to any of the excipients. SPECIAL WARNINGS AND PRECAUTIONS FOR USE In the absence of bone safety data in patients with severe renal impairment treated with strontium ranelate, PROTAXOS is not recommended in patients with a creatinine clearance below 30 ml/min. In accordance with good medical practice, periodic assessment of renal function is recommended in patients with chronic renal impairment. Continuation of treatment with PROTAXOS in patients developing severe renal impairment should be considered on an individual basis. In phase III placebo-controlled studies, strontium ranelate treatment was associated with an increase in the annual incidence of venous thromboembolism (VTE), including pulmonary embolism. The cause of this finding is unknown. PROTAXOS should be used with caution in patients at increased risk of VTE, including patients with a past history of VTE. When treating patients at risk, or developing risk of VTE, particular attention should be given to possible signs and symptoms of VTE and adequate preventive measures taken. Strontium interferes with colorimetric methods for the determination of blood and urinary calcium concentrations. Therefore, in medical practice, inductively coupled plasma atomic emission spectrometry or atomic absorption spectrometry methods should be used to ensure an accurate assessment of blood and urinary calcium concentrations. PROTAXOS contains a source of phenylalanine, which may be harmful for people with phenylketonuria. Treatment with PROTAXOS should be discontinued in case of serious allergic reaction. Cases of severe hypersensitivity syndromes, including, in particular, drug rash with eosinophilia and systemic symptoms (DRESS), sometimes fatal, have been reported with the use of PROTAXOS. The DRESS syndrome is characterised by rash, fever, eosinophilia and systemic involvement (e.g. adenopathy, hepatitis, interstitial nephropathy, interstitial lung disease). Time to onset was usually around 3-6 weeks and the outcome in most severe cases favourable upon discontinuation of PROTAXOS and after initiation of corticosteroid therapy. Recovery could be slow and recurrences of the syndrome have been reported in some cases after discontinuation of corticosteroid therapy. Patients should be informed to stop PROTAXOS immediately and permanently when a rash occurs and to seek medical advice. Patients who have stopped treatment due to hypersensitivity reactions should not re-start therapy with PROTAXOS. INTERACTIONS WITH OTHER MEDICAMENTS AND OTHER FORMS OF INTERACTION Food, milk and derivative products, and medicinal products containing calcium may reduce the bioavailability of strontium ranelate by approximately 60-70%. Therefore, administration of PROTAXOS and such products should be separated by at least two hours. An in vivo clinical interaction study showed that the administration of aluminium and magnesium hydroxides either two hours before or together with strontium ranelate caused a slight decrease in the absorption of strontium ranelate (20-25% AUC decrease), while absorption was almost unaffected when the antacid was given two hours after strontium ranelate. It is therefore preferable to take antacids at least two hours after PROTAXOS. However, when this dosing regimen is impractical due to the recommended administration of PROTAXOS at bedtime, concomitant intake remains acceptable. As divalent cations can form complexes with oral tetracycline and quinolone antibiotics at the gastro-intestinal level and thereby reduce their absorption, simultaneous administration of strontium ranelate with these medicinal products is not recommended. As a precautionary measure, PROTAXOS treatment should be suspended during treatment with oral tetracycline or quinolone antibiotics. No interaction was observed with oral supplementation of vitamin D. No evidence of clinical interactions or relevant increase of blood strontium levels with medicinal products expected to be commonly prescribed concomitantly with PROTAXOS in the target population were found during clinical trials. These included: nonsteroidal anti-inflammatory agents (including acetylsalicylic acid), anilides (such as paracetamol), H2 blockers and proton pump inhibitors, diuretics, digoxin and cardiac glycosides, organic nitrates and other vasodilators for cardiac diseases, calcium channel blockers, beta blockers, ACE inhibitors, angiotensin II antagonists, selective beta-2 adrenoceptor agonists, oral anticoagulants, platelet aggregation inhibitors, statins, fibrates and benzodiazepine derivatives. Cardiovascular Guide Treatment of Cancer Common Childhood Illnesses Prescribed Drugs

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Home > Press > Targeting Metastatic Cancer From the Inside: Epeius Biotech Reveals a New Generation of Tools for Medical Gene Delivery Epeius Biotechnologies Corporation today announced the publication of another landmark paper describing recent technological advances in medical gene delivery. The latest scientific paper, entitled "Targeting metastatic cancer from the inside: A new generation of targeted gene delivery vectors enables personalized cancer vaccination in situ," was published in the October issue of the International Journal of Oncology (IJO). The paper describes the new state-of-the-art in tumor-targeting biotechnology, nanotechnology, and therapeutic gene delivery developed for clinical applications in the field of oncology. The paper lays the scientific, preclinical and clinical foundations for new applications of personalized medicine, specifically for patients with metastatic cancer. Targeting Metastatic Cancer From the Inside: Epeius Biotech Reveals a New Generation of Tools for Medical Gene Delivery SAN MARINO, CA | Posted on October 6th, 2008 Based on recent breakthroughs in pathotropic (or disease-seeking) tumor targeting technologies, a new generation of anti-cancer agents is currently being developed. Anti-cancer agents such as Rexin-G can be delivered by simple intravenous infusion, yet are designed to seek out and accumulate in primary and metastatic lesions that have spread throughout the body. Rexin-G is essentially a pathotropically targeted nanoparticle of genetic medicine that is guided by a proprietary targeting technology and is designed to deliver a killer-gene selectively to tumor cells and their associated (proliferative) blood supply. Representing the first and so far only targeted genetic medicine proven to be both safe and effective in the clinic, Rexin-G is commercially available in the Philippines -- for use in all solid tumors that are refractory to standard chemotherapy -- and is currently in clinical trials in the USA for several cancer indications.Following the validation of its lead product in the clinic, Epeius Biotech has developed a second tumor-targeted anti-cancer agent, named Reximmune-C, designed to work in concert with Rexin-G by providing a localized cancer vaccination aimed at gaining additional tumor control. According to Dr. Erlinda M. Gordon, Medical Director of Epeius Biotech, "Based on the clear survival benefits of Rexin-G that we are seeing in our clinical trials, we felt obligated to advance this new product to provide an opportunity for personalized cancer vaccination in patients who may still be at risk for recurrence." Reximmune-C is a tumor-targeted gene delivery vector delivering an immune-stimulating cytokine gene directly to residual tumors, with the intent of generating a localized vaccination to encourage a lasting anti-tumor immunity. The IJO paper summarizes the preclinical studies, pilot clinical studies, and the elegant vector design engineering embodied in Reximmune-C, which make this clinical application possible. ####About Epeius Biotechnologies CorporationEpeius Biotechnologies Corporation is a privately held biopharmaceutical company dedicated to the advancement of genetic medicine with the development and commercialization of its proprietary targeted delivery systems.For more information about Rexin-G, Reximmune-C, on-going clinical trials in the USA and abroad, and/or Epeius pathotropic (disease-seeking) gene delivery systems, contact Dr. Erlinda M. Gordon: For more information, please click here Contacts:Frederick L. Hall, Ph.D.President & CEO475 Huntington Drive,San Marino, California 91108Tel: 626-441-6695Fax: 626-441-6692 Copyright © PR Newswire Association LLC. Johns Hopkins scientists track metabolic pathways to find drug combination for pancreatic cancer August 25th, 2016

医学

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CultureSwine Flu: Why Not to Hoard Anti-Flu Drugs By Newsweek Staff On 4/30/09 at 8:00 PM CultureWhen Kelly Kimura came down with an ordinary case of the flu last Sunday, her husband, Darren, called the local pharmacy, hoping to fill her prescription for Tamiflu by the end of the day. He was surprised by the clerk's response: because of a flood of requests during the week, the pharmacy, a branch of Longs Drugs (owned by CVS) in Mililani, Hawaii, had none of the antiviral drug left in stock. They were also unable to find Tamiflu or Relenza, a similar medication taken with an inhaler, at other Longs and Walgreens locations nearby. By Monday afternoon, after driving a total of 60 miles around the island of Oahu with no success, the couple was frustrated and panicked."[The pharmacists] said they'd never seen anything like it," says Darren. Retailers on Oahu, Hawaii's most populous island, told Kimura that the shortage was caused by a surge of buyers likely hoping to stockpile drugs after reports of swine-flu cases in several mainland U.S. states. The Kimuras were lucky; by the time they returned to their local Longs store on Monday night, the pharmacist had found a single box of Tamiflu that hadn't shown up in his computer system. But as swarms of anxious patients ask their doctors for Tamiflu and Relenza prescriptions "just in case"—the government announced plans on Monday to release 12 million doses of oseltamivir phosphate (the generic name for Tamiflu) from its 50 million-dose reserve—some prescription holders are unable to find the drugs in pharmacies. Representatives for both Longs and Walgreens confirmed that their retail stores have been seeing increased demand and that some had "temporary stock outages" over the weekend. The scene in Hawaii, a state with no reported cases of swine flu so far, is repeating itself across the country. CVS reports increased demand in New York City, while Walgreens has seen interest spike in New York, California, Texas and Illinois.Generally, people who seek prescription medications but can't find them at pharmacies may resort to one of three options, according to Jeffery Goad, an associate professor of clinical pharmacy at the University of Southern California. Buyers with a prescription may shop at online pharmacies based in the United States, many of which are certified by the National Association of Boards of Pharmacy. Those without prescriptions may try to buy online from companies based in Europe, Latin America and Asia, which claim to offer the same drugs (or their generic equivalents), but violate U.S. law by shipping products across the border without certification. Another, more immediate option is the informal black market: the same word-of-mouth network that traffics in illegal substances and prescription drugs like Vicodin. Try Newsweek for only $1.25 per week Brad Walbrun is an old hand at stockpiling. The 35-year-old Illinois native buys antibiotics online without a prescription and keeps them on hand for his frequent ear and sinus infections. After hearing about swine flu last week, he checked his usual online sources and, aside from a few small doses of Relenza, found them wiped out. Walbrun considered talking to his underground contacts, but decided it wasn't worth the risk—or the cost. "Tamiflu is like gold right now," he says, adding that, in his experience, antiviral, antibacterial and other "useful" medications are difficult to find on the black market anyway.With the World Health Organization warning countries to prepare for a possible swine-flu pandemic, that might change. When concerns about avian flu sent Tamiflu flying off the shelves in 2005, an illicit market for the drug quickly developed online—in one three-week span that year, Customs agents in San Francisco intercepted more than 50 packages of fake Tamiflu shipped by Asian suppliers to unsuspecting Internet buyers. U.S. Customs and Border Protection officials say they haven't seen any counterfeit flu medications in the past year, but said in a statement to NEWSWEEK that they are "monitoring enforcement statistics" in light of recent swine-flu developments. And spammers are already active as well. According to Dave Marcus, director of security research at McAfee Inc., e-mails with subject lines that included "swine flu" accounted for 4 to 5 percent of all spam on Wednesday morning, up from 2 percent on Monday. "Before this weekend," he says, "we never saw the words 'swine' and 'flu' together … The bad guys read the same news that you and I do."Goad explains that the unique nature of flu medications makes the market particularly vulnerable in situations like this one. Tamiflu and Relenza "never took off as a commercial product," he says, because they are used by only a small percentage of the population for a few months each year. When panic strikes, "very few pharmacies have it [in stock]. They wouldn't usually have it." The U.S. government, which controls 25 percent of the country's supply of flu medication, isn't much help to would-be stockpilers: all the doses released by the Department of Homeland Security will go to public clinics and support teams, not private distributors. Faced with empty pharmacy shelves, Goad expects consumers to buy drugs wherever they can—and, once they find them, to buy as much as possible.But while the idea of collecting a private antiviral stash might be reassuring to some, public health experts say hoarding consumers likely won't be better off than the rest of us and may, in fact, be doing more harm than good. Those who buy drugs from foreign sources run the risk of taking ineffective or possibly dangerous substances. Goad also warns that even those who get prescriptions ahead of time are likely to misdiagnose themselves later—mistaking a bad cold for the flu, for instance—and take drugs they don't need. That can help existing strains of the flu virus develop resistance to commonly prescribed medications, which makes them more difficult to treat in the future. In a press briefing on Thursday, acting Centers for Disease Control and Prevention Director Richard Besser acknowledged that the public is facing a "situation filled with uncertainty," but told reporters that individuals should focus on controlling the spread of the virus with preventive measures such as hand-washing and limiting nonessential travel to Mexico.When it comes to drugs that are always in short supply, like Tamiflu and Relenza, Goad emphasizes that it's best to avoid alternative markets and to leave supplies available for those who, based on CDC guidelines, are most at risk for any type of flu: young children, the elderly, travelers and health-care personnel. Kelly Kimura, the flu sufferer in Hawaii who had an ordinary (non-swine) case, was able to take her prescription within the recommended 48-hour treatment period, but one swine-flu patient in New York City told NEWSWEEK she had to skip her dosage when she couldn't find it in drugstores. With pharmaceutical companies Roche (Tamiflu) and GlaxoSmithKline (Relenza) ramping up production, and Cipla, an Indian company, promising 1.5 million doses of a generic drug in the next four to six weeks, the global market should be able to handle the next wave of swine-flu sufferers. Everyone else should take basic health precautions and resist the urge to run to the doctor's office. For now, "just in case" just doesn't cut it.Request Reprint or Submit Correction Join the Discussion Most Read

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University at Buffalo Unveils HOK Design for Downtown Medical School State-of-the-art medical school and integrated transit station will anchor vibrant mixed-use district. View of NFTA station entrance and the Allen Street pedestrian portal “HOK’s design for UB’s medical school creates the heart for the new Buffalo Niagara Medical Campus while integrating and connecting to the surrounding communities," said Kenneth Drucker, FAIA, design director for HOK’s New York office. Buffalo and New York, NY (PRWEB) The University at Buffalo (UB) has unveiled HOK's dramatic design for its new School of Medicine and Biomedical Sciences building on the Buffalo Niagara Medical Campus. The seven-story medical school will bring 2,000 UB faculty, staff and students daily to downtown Buffalo and, at more than 500,000-square-feet, will be one of the largest buildings constructed in Buffalo in decades. HOK’s design features two L-shaped structures linked to create a six-story, light-filled glass atrium that includes connecting bridges and a stairway. Serving as the building’s main interior “avenue,” the atrium will be naturally illuminated by skylights and two glass walls, one along Washington Street and one at the terminus of Allen Street. The building, which HOK is designing for LEED Gold certification, will have a facade clad with a high-performance terra-cotta rain-screen and a glass curtain wall system that brings daylight deep inside. Incorporating the NFTA Allen Street transit hub into the medical school’s ground floor provides convenient mass transit access, furthering the development of a sustainable, vibrant community. The new medical school will help the university achieve objectives critical to the UB 2020 strategic plan: creation of a world-class medical school, recruitment of outstanding faculty-physicians to the university and transformation of the region into a major destination for innovative medical care and research. “The new design allows us to grow our class size from 140 to 180, educating more physicians, many of whom will practice in the region,” said Michael E. Cain, MD, vice president for health sciences at UB and dean of the medical school. “It allows UB to hire more talented faculty, bringing to this community much-needed clinical services and medical training programs.” “HOK’s design for UB’s medical school creates the heart for the new Buffalo Niagara Medical Campus while integrating and connecting to the surrounding communities," said Kenneth Drucker, FAIA, design principal for the project and design director for HOK’s New York office. "The building’s atrium will be the focal point for bringing together clinical, basic sciences and educational uses fostering collaboration.” The building’s first two floors will house multipurpose educational and community spaces for medical school and community outreach programs. A second-floor bridge will link to the new John R. Oishei Children’s Hospital and the Conventus medical office building under construction along High Street adjacent to UB’s new medical school. The third, fourth and fifth floors of the medical school will feature core research facilities and approximately 150,000 square feet of state-of-the art research laboratories. “The new lab spaces will allow us to efficiently group faculty by thematic research areas," said Cain. "Because they are modular, we can change their size and configuration as needed." The sixth floor will house some of the country's most advanced specialized medical education facilities, including an expanded patient care simulation center that will feature the Behling Simulation Center currently located on UB’s South Campus. It also will house a surgical simulation center where medical students can conduct surgeries in a simulated operating room. A robotic surgery simulation center will train students and physicians in remote control surgery technologies. The medical school’s administrative offices and academic departments will be located on floors three through seven. The seventh floor will house gross anatomy facilities. “From the new school’s active learning environments to the highly flexible research laboratories supporting multidisciplinary teams of investigators, the design supports a range of global trends for the design of academic and research facilities,” said Bill Odell, FAIA, HOK’s director of science and technology. "The building layout brings together academia and research to foster collaboration and interdisciplinary patient care,” added Jim Berge, AIA, principal-in-charge for the project and HOK’s director of science and technology in New York. “There will be many opportunities for students, faculty, researchers, administrators and members of the local medical community to interact.” The $375 million medical school is funded in part by NYSUNY 2020 legislation. Groundbreaking is scheduled for September 2013 and construction is expected to be complete in 2016. HOK’s Science + Technology group has designed medical schools and research laboratories for Florida State University, the University of Alberta, Washington University in St. Louis and The Commonwealth Medical College in Scranton, Pa. The firm served as lead designer for The Francis Crick Institute's cardiovascular and cancer research center in central London and won an international competition to design the Ri.MED Biomedical Research and Biotechnology Center in Palermo, Sicily. HOK is a global design, architecture, engineering and planning firm. Through a network of 24 offices worldwide, HOK provides design excellence and innovation to create places that enrich people's lives and help clients succeed. In 2012, for the third consecutive year, DesignIntelligence ranked HOK as the #1 role model for sustainable and high-performance design. Corinne Drobot HOK 212 981 3754 HOK architectural model of the University at Buffalo School of Medicine and Biomedical SciencesMain entrance at Main and High StreetsA view of the new medical school from Main StreetAtrium with donor wall on the leftView of NFTA station entrance and the Allen Street pedestrian portal

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Are Breast Implant Surgeries Taking A Back Seat To Lifts? [ Watch the Video: Breast Lifts Outpace Implants 2 To 1 ] Brett Smith for redOrbit.com - Your Universe Online While breast implants are still the most popular plastic surgery among women, breast lifts have been growing in popularity in recent years, according to new statistics released on Monday by the American Society of Plastic Surgeons (ASPS). "Many women are looking for a youthful breast by using the tissue they already have," said Dr. Robert X. Murphy, president of the ASPS, in a press release. "The breast lift procedure is way up in my practice," said Dr. Anne Taylor, an ASPS-member plastic surgeon in Columbus, Ohio. "More women are coming to us who've had children, whose breast volume has decreased and who are experiencing considerable sagging. For many of them, we are able to get rid of excess skin and lift the breasts back up where they're supposed to be." According to the society’s own statistics, breast lift operations have grown by 70 percent since 2000, outpacing implants two-to-one. The ASPS also said women between the ages of 30 and 54 made up nearly 70 percent of the more than 90,000 breast lift procedures performed in 2013. Many women lose breast tissue as they age and coupled with natural sagging over the years – some women may feel they need cosmetic surgery to address the issue. A breast lift procedure, also known as mastopexy, involves raising the breasts by removing skin and reshaping the surrounding tissue. In its official website, the ASPS warns that a breast lift does not increase the size of the breast or round out the upper part of the breast. "The ideal candidate for a breast lift is a woman who has a good amount of breast tissue left, who doesn't necessarily want to have implants," Murphy said. "Many women aren't sure if they are a candidate for this type of surgery, but a simple pencil test can tell them if they are.” Murphy said a pencil test is self-test that can be performed by a woman simply placing a pencil under her breast. "If the breast tissue holds the pencil in place against the chest, that implies that there's a hanging nature to the breast that can be fixed with a lift,” Murphy said. According to the ASPS statistics, less than 53,000 breast lifts were performed in 2000. Last year marked first time that number eclipsed 90,000. However, breast implants are still the most popular plastic surgery procedure for women. In 2013, there were more than 290,000 breast augmentation procedures conducted by ASPS member surgeons – representing a growth of 37 percent since 2000, just less than half the rate of breast lifts. Earlier this month, it was reported that the rate of breast reconstruction after mastectomy has increased over the years, up more than 20 percent since 1998. While some said the news was a positive sign that more women are becoming aware they have the option of breast reconstruction after a mastectomy, some surgeons said it might not all be good news after all. “It is great to see that more women are becoming aware of the option for breast reconstruction after mastectomy,” said Dr. Chet Nastala of the PRMA Center for Advanced Breast Reconstruction. “Unfortunately, the study also suggests that women are mostly being offered breast implants rather than tissue flap techniques.”

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Dr. Johnson's Bio Inspirational Nuggets Contact Dr. Johnson Sandra K. Johnson, Ph.D. GREGORY: The Life of a Lupus WarriorAn inspiring story of strength, love and devotion ** FOR IMMEDIATE RELEASE **Sandra K. Johnson, Ph.D.Toll Free No: 855-771-4033Email: drsandrakj@sandrakjohnson.comFighting for Life with Tenacity and CourageLate Man’s Sister Finishes the Story of the Life of a Lupus Warrior in New Book (Cary, North Carolina – June, 2008) “I knew something was not right with my whole body. I was too young to be feeling like this….I was getting very frustrated now.” These are the words of Gregory Garland Johnson at the age of 20, as he described his failing body and his fight to overcome Lupus. The new book, GREGORY: The Life of a Lupus Warrior, is the story of Gregory’s life and his efforts to live a rewarding life in the midst of his tremendous medical hardship. During the same time period, Gregory says “I was growing up quickly. I had total control of my life. I was making my own decisions now, without any outside interference. I made mistakes, but they were my own….I was learning to be a man and to be responsible on my own.”Gregory lived for 35 years. The book chronicles his tragic and uplifting life as a Lupus warrior. In the early years before his diagnosis, Gregory was young, vibrant, full of energy, exhibiting a passion for life and a promising future. After his diagnosis, Gregory was slow and reserved, and his future was unknown. The book is written in two parts, the first is an autobiography, the second a biography. Gregory died before he completed this work, and his sister, Sandra, completed it on his behalf.Gregory’s story is one of love, compassion and service. In spite of his medical condition, Gregory’s spirit was warm and inviting. He rose above his circumstances to live a good life, with wonderful friends and family who loved him. It is a story of the triumph of the human spirit when in difficult circumstances. Gregory’s story will renew your own desire to help your fellow man, whatever your circumstance. As you read the story of this warrior who fought for life, the warrior in you will be encouraged to let your light shine until your day is done.Sandra K. Johnson was diagnosed with non-life-threatening discoid Lupus nine months after Gregory’s death. She is a technology trailblazer and the first Black woman to earn a Ph.D. in Electrical Engineering. During her 20 years at IBM, she has accumulated over 35 patents and patent applications and is a Fellow of the Institute of Electrical and Electronics Engineers. Sandra has a passion for encouraging and inspiring others, and was encouraged to complete Gregory’s story to share with others. AuthorHouse is the world leader in publishing and print-on-demand services. Founded in 1997, AuthorHouse has helped more than 20,000 people worldwide become published authors. For more information, visit www.authorhouse.com. -- ORDER NOW --$12.00, plus $3.00 shipping and handlingOrder GREGORY by mailfor PayPal orders, click on the Add to Cart button below:

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Home > News Articles Study Shows Aspirin Can Reduce Colorectal Cancer Risks For Those With Specific Gene By News Staff | April 23rd 2014 03:56 PM | Print | E-mail | Track Comments Tweet The humble aspirin may have just added another beneficial effect beyond its ability to ameliorate headaches and reduce the risk of heart attacks: lowering colon cancer risk among people with high levels of a specific type of gene. The extraordinary finding comes from a multi-institutional team that analyzed data and other material from two long-term studies involving nearly 128,000 participants. The researchers found that individuals whose colons have high levels of a specific gene product — 15-hydroxyprostaglandin dehydrogenase (15-PGDH) RNA — dramatically reduce their chances of developing colorectal cancer by taking aspirin. In contrast, the analgesic provides no benefit to individuals whose colons show low levels of 15-PGDH. The findings appear in the April 23 edition of Science Translational Medicine. While previous trials and prospective studies had indicated that aspirin could reduce colorectal cancer risk, this retrospective study provides the first evidence to help explain why aspirin benefits some people, but not others. The research team included researchers from Case Western Reserve University School of Medicine, Dana Farber Cancer Institute, Harvard University, Massachusetts General Hospital, and University Hospitals Case Medical Center. "If you looked at the folks from the study who had high 15-PGDH levels and took aspirin, they cut their risk of colon cancer by half," said senior author Sanford Markowitz, MD, PhD, Ingalls Professor of Cancer Genetics at Case Western Reserve School of Medicine. "If you looked at the folks from the study that were low for 15-PGDH, they did not benefit at all from taking aspirin. These findings represent a clean Yes-No about who would benefit from aspirin." Funded in part by the Entertainment Industry Foundation's National Colorectal Cancer Research Alliance (NCCRA), the discovery represents precisely the kind of advancement that Katie Couric and her colleagues sought when they founded the initiative in 2000. She lost her 42-year-old husband, Jay Monahan, to colon cancer in 1998 and has been a steadfast advocate for colon cancer prevention efforts in the years since. "Prevention, early detection and effective treatments are key to conquering cancer," Couric said. "This finding that aspirin can prevent colon cancer in certain individuals is an easy and cost-effective addition to our arsenal in the fight against the second-leading cancer killer. I am proud to see this valuable research advancing patient care for those at risk of colon cancer resulting from NCCRA support." According to the American Cancer Society, colorectal cancer is the second leading cause of cancer-related deaths in the United States, with predictions that 137,000 Americans will develop the disease and 50,000 will die from it in 2014. Thanks to regular screenings, the death rate from colorectal cancer has dropped in the past 20 years, and members of this research team have been dedicated to finding additional measures to help reduce risk and ultimately eradicate the disease. In this latest effort, the scientists sought to build on earlier research that indicated that regular use of non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin, reduces the chances of developing colon cancer for some individuals, but not in all. Their question: Why? What is different between those helped by aspirin, and those who saw no effects? Markowitz, also the head of the Cancer Genetics Program at the Case Comprehensive Cancer Center and a medical oncologist at University Hospitals Case Medical Center joined lead co-senior author Andrew T. Chan, MD, PhD, of Massachusetts General to explore whether the presence of 15-PGDH led to different outcomes in terms of which individuals developed colon cancer. Their goal: to see whether it is possible to develop a test that would help guide physicians and patients in determining whether an aspirin regimen would be of benefit. The team examined tissues of 270 colon cancer patients culled from 127,865 participants followed for over three decades in the Harvard-based Nurses' Health Study (NHS) and Health Professionals Follow-up Study (HPFS). Previous reports from the Massachusetts General/Dana-Farber team indicated that participants in these studies who regularly took aspirin had a lower risk of colorectal cancer. In earlier research, the Case Western Reserve investigators, along with Monica Bertagnolli, MD, of Brigham and Women's Hospital, had found that the presence of 15-PGDH appeared to enhance the ability of celecoxib, an anti-inflammatory medication commonly known as Celebrex, to prevent colon tumors in mice and in 16 humans tested. But when 15-PGDH was low or not present, celecoxib did not prevent colon tumors in mice or humans. In this latest study, the investigators combined forces in a much larger study to examine whether 15-PGDH levels might also be associated with the colon cancer-preventing benefits of aspirin, which is already taken by many individuals and does not have the cardiovascular side effects of celecoxib . The Massachusetts General and Dana-Farber team dissected normal colon tissue from the pathology specimens of NHS/HPFS participants who developed colon cancer over the studies' follow-up period. The team at Case Western Reserve then analyzed these colon tissues to identify which among them had high or low levels of colon 15-PGDH. The investigators at Massachusetts General and Dana-Farber examined how the data on participants' aspirin use and levels of 15-PGDH related to the risk of colorectal cancer to address the question the larger group had set out to answer: Were individuals who developed colorectal cancer while taking aspirin more likely to have low or high levels of colonic 15-PGDH? The study is among the first examples of the type of test that could allow more personalized decisions about treatment to prevent colorectal cancer. It also allows those whose 15-PGDH levels indicate aspirin would have little impact to avoid the potential gastrointestinal challenges — such as stomach ulcers — that can accompany aspirin use. Additional researchers involved in the study included first authors Stephen Fink, PhD, an instructor at Case Western Reserve; Mai Yamauchi, PhD, and Reiko Nishihara, PhD, research fellows at Dana-Farber Cancer Institute; and senior authors Charles S. Fuchs, MD, MPH, and Shuji Ogino, MD, PhD, MS, also from the Dana-Farber Cancer Institute. Chan is a gastroenterologist at Massachusetts General and Associate Professor of Medicine at Harvard Medical School. The researchers' next steps are two-fold: first, the development of a cost-effective and accessible test for measuring 15-PGDH in the colon, and second, a prospective clinical trial to further confirm these findings. Chan and Markowitz both consider the first step well within reach of current medical practice. "During a colonoscopy, a gastroenterologist could easily and safely take an additional biopsy from the colon in individuals for whom preventive aspirin treatment might be appropriate," Chan said. Added Markowitz, "There would be no reason why a good hospital pathology laboratory could not establish the test for 15-PGDH." The study authors are also hopeful that publication of these findings will draw the interest from funders and other researchers in developing a confirmatory randomized, prospective clinical trial in which high-risk patients would be identified, treated with aspirin or a placebo, depending on their 15-PGDH levels, and monitored for development of colorectal tumors. The mechanisms of action in the 15-PGDH gene and in aspirin make them key players in the colon cancer discussion. Prostaglandins promote development of colon cancer, and aspirin helps prevent colon cancer development by preventing prostaglandins from being generated. 15-PGDH also helps prevent colon cancer development by catalyzing the reaction that "chews up" prostaglandins. Markowitz refers to 15-PGDH as the body's genetic form of aspirin. The study shows that both aspirin and 15-PGDH must work together to effectively prevent colon cancer, with aspirin benefitting most individuals who also have high levels of 15-PGDH. "This study highlights the benefits of the relatively new practice of molecular pathological epidemiology, or MPE," said co-senior author Ogino of Dana-Farber, an Associate Professor of Pathology at Harvard Medical School. "The molecular pathology part relates to analysis of 15-PGDH gene expression level in normal colon to classify cancer based on molecular pathogenesis, while the epidemiology part relates to collection and analysis of aspirin use data in population. MPE is an integration of these analyses." Source: Case Western Reserve University Breast Milk Sugar May Protect Babies Against Group B Streptococcus News Releases From All Over The World, Right To You... Related Articles on Science 2.0Vitamin D Linked To Colon Cancer SurvivalVitamin D Boosts Immune System, Protects Against Colorectal Cancer - StudyAspirin To Prevent Colon Cancer?CDK8 Gene Implicated In Many Colon CancersAspirin's Role In Cancer Prevention "germs, microbes, bacteria, etc.apparently cannot feed on pg, vg, or nicotine. The flavorings commonly..." AmazonSWAG W

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Staten Island woman hit for co-pay on ambulance gurney As she lay on an ambulance gurney, ready to be taken to the hospital after suffering a heart attack, 76-year-old Barbara Antonelli saw a receptionist from her Sunnyside doctor's office running toward her. Mrs. Antonelli figured she had left something behind or that the employee simply wanted to wish her well. Instead, the stricken woman was asked for her $5 co-pay, and the ambulance was held up while she scoured her purse for the money. "Stupid me, I gave her the five dollars," said Mrs. Antonelli, while resting yesterday at her Dongan Hills home. "This was an emergency ... and they asked for a lousy $5. They could have billed me. I never thought they would have the audacity to ask." Mrs. Antonelli visited the Staten Island Physician Practice (SIPP) on Jan. 14 to make sure she was OK after having chest pains the day before. After an electrocardiogram showed that she had suffered a heart attack, Dr. Jonathan Okum ordered an ambulance from Richmond University Medical Center so that Mrs. Antonelli could undergo further testing at the hospital. Dr. Jack D'Angelo, associate medical director at SIPP, called the incident "ugly" and said he would investigate to find out who had asked for the co-pay and why. "This is not an issue of policy, it was an issue of poor judgment by the receptionist," he said when reached yesterday. "We will take the appropriate steps to assist this employee and the remainder of our staff to learn from this event and assure that all of our patients are treated like we would like our parents to be treated." Without being specific, Dr. D'Angelo said the receptionist responsible likely will be reprimanded. Workers at SIPP were appalled when they learned of what had happened to Mrs. Antonelli, calling it "insane" and "crazy." "It's not our policy," said Sally Cohen, center administrator for SIPP, who was surprised that someone would worry about payment on the spot instead of billing the patient after the fact. She said she will investigate what happened and address the situation with the employee. "We're all in this for medicine. If it is an incident, I will take care of that." Mrs. Antonelli's son, Thomas, rushed to RUMC after she was brought there and was stunned when he heard the story from his mother. "She's on a stretcher and they're worrying about five dollars," he said, pointing out that if the receptionist was acting against policy, some of the other workers could have stopped her on her way out the door. "It's insane. When I go there [over the weekend], I'm definitely going to go in and find out who that woman was." In the end, Mrs. Antonelli -- a widow with a history of heart problems who had quadruple bypass surgery 10 years ago -- was fine. She has since visited her cardiologist and has a sonogram scheduled for today to identify any complications. Her doctor increased her heart medication and she's feeling better. Despite the treatment, Mrs. Antonelli doesn't have immediate plans to switch doctors -- Dr. Okum had nothing to do with the situation and didn't even know it happened, she said. "It's was just a shame that had to happen," Thomas Antonelli said.  -- Contributed by Glenn Nyback

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"Mexico City" Policy Affecting International Clinics, Hurting HIV/AIDS Prevention Efforts, Report Says The so-called "Mexico City" policy, which prevents federal funding from going to foreign family planning groups that provide any abortion-related services, has forced the closure of some clinics in developing countries and has hurt HIV/AIDS prevention efforts, according to a report released on Wednesday by Population Action International, Planned Parenthood Federation of America and IPAS, with assistance from EngenderHealth and Pathfinder International, Reuters reports. The report, titled "Access Denied: U.S. Restrictions on International Family Planning," surveyed clinics in Ethiopia, Kenya, Romania and Zambia. "Health services have been scaled back and closings of reproductive health clinics have left some communities with no health care provider," the groups said in a statement. In addition, many men and women do not have access to contraceptives that can help prevent unwanted pregnancies and HIV infection because of clinic closures, according to the report (Fox, Reuters, 9/23). The Mexico City policy -- which was originally implemented by President Reagan at a population conference in Mexico City in 1984, removed by President Clinton and reinstated by President Bush on the first day of his presidency -- bars U.S. money from international groups that support abortion, even with their own money, through direct services, counseling or lobbying activities. Bush last month issued an executive order that prevents the State Department from giving family planning grants to international groups that provide abortion-related counseling, effectively extending the Mexico City policy, which previously applied only to USAID. However, the new order exempts agencies in Africa and the Caribbean that would benefit from Bush's five-year, $15 billion global AIDS initiative (Kaiser Daily Reproductive Health Report, 9/2). The Mexico City policy, which is referred to as the global gag rule by opponents, is "taking a toll on the lives and health of women, children and families around the world," the report says. Five clinics operated by nongovernmental organizations in Kenya have had to close because they violated the policy and were denied funding by USAID, according to the report. "The NGOs have also had to cut their staffing by as much as 30%, reduce services in remaining clinics and raise fees in order to remain viable," the report says. The report also notes that the Lesotho Planned Parenthood Association, which received from USAID 426,000 condoms between 1998 and 2000, no longer receives the contraceptives from USAID because the organization refuses to agree to the policy. In Romania, women may be more likely to undergo abortions because the rule prevents more women from receiving information on contraceptives, the report says. PPFA President Gloria Feldt said, "This is the real face of Bush's compassionate conservatism -- a war on the world's most vulnerable women and children, who bear the brunt of Bush's obsession with appeasing his domestic political base" (Reuters, 9/23). PAI President Amy Coen said, "The policy shows no respect for scientific evidence and proven public health practices and no compassion for the millions of women around the world engaged in a daily struggle for existence" (PAI release, 9/24). Supporters of the rule say that taxpayers should not have to fund abortions overseas, whereas opponents of the rule say that abortion is legal in the United States and elsewhere and that counseling including information on abortion is part of a comprehensive message women need to protect their health, according to Reuters (Reuters, 9/23). Back to other news for September 25, 2003 California Gov. Davis Undecided on Whether to Sign Bill Requiring Physicians to Offer HIV Testing to Pregnant Women Kaiser Daily HIV/AIDS Report Summarizes Editorials, Opinion Pieces on Global AIDS Funding

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Will 2026 be the finishing date of new hospital? Storytelling: Where you are from can help with where you are going Walk so Kids Can Talk held in Pasadena Dear Editor: The new regional hospital has been an election promise for about a decade with politicians being elected on the coattails of these promises. The original plans were scrapped in favour of new and improved plans, at lower cost, but without badly needed radiation unit for cancer treatment, PET scanner, basic cardiac unit to do angiograms (dye test) and angioplasties (stents to open heart blockages). The new and improved includes proposed “mobile” ultrasound machines, not an ultrasound lab unit now present in our hospitals. Earlier this year, Minister Susan Sullivan described this new and improved plan as a “flagship” for a more improved, efficient hospital, to meet the needs of all the west coast, Northern Peninsula and Labrador Strait. The flagship hospital is a flag ship sunken in place even before leaving port. Sullivan comments that she is not saying no to a radiation unit, just not right now. That is double talk. She says she recognizes the biggest issue for cancer patients on the west coast is having to travel to St. John’s for radiation treatment. She says she absolutely understands the pressures and challenges that travel creates for people, but justifies it by saying the numbers of patients travelling for treatments are low. Regarding numbers, there are many patients needing radiation treatment who cannot afford to travel to St. John’s. They are mainly low income people and pensioners. Practically every week there are fundraisers initiated by family and friends of the sick to help defray the costs associated with travel and accommodations. The provincial government has some cost assistance available but it’s not enough. Residents without education, computer experience and family help may not be aware of this assistance. Those who can afford it sometimes travel to mainland Canada because of long waiting lists and need for immediate care here on the island, not only for cancer treatments but also for cardiac, pulmonary and other life threatening crises. In the article entitled “Functional plan for city’s new hospital nearing completion,” Sullivan says she is hoping to see construction of the new hospital start in the fall of 2015. Coincidence? That is also provincial election year. She expects the functional plan for the facility to be completed within the next few weeks. Dr. Cathi Bradbury, associate deputy minister of Health and Community Services, states that the functional plan’s focus is to decide on the volume of services needed and the numbers of rooms, etc. Minister Sullivan adds that the plan “includes looking at the demographics of the area and projecting it out to at least 2026.” Based on my experience of political promises, this most likely means that 2026 is the finishing date of new hospital. Sullivan says, “The patient is at the centre of all the work that we do, but it’s basically intended to improve patient flows.” Dr. Bradbury states that another efficiency measure would involve bringing services like blood work and ultrasounds to the patient. Isn’t blood work service already being carried out at the patient’s bedside? I understand mobile ultrasounds don’t work properly without the proper lighting, which it would have in the main ultrasound laboratory unit. Without proper lighting, this would be similar to looking at a television screen with the sun shining on it. Bradbury says she knows the department will be increasing the footprint and more “sneaker time” for staff and the scenario of a “larger footprint” is critical for patient care. To a staff already overstressed, run off their feet (sneakers) with 12-hour shifts, plus being on call, this doesn’t sound too comforting for them or the vulnerable patients. My interpretation of this plan for improving patient care flows is get them in and out quicker with a large sneaker footprint on patients’ derrières. Michael Hackett, Port au Port Dear Editor, Health and Community Services Geographic location: Northern Peninsula, Canada, Port au Port 1

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Older Americans Look Forward to Aging, but Aren’t Prepared Seniors report confidence, but aren’t preparing physically, financially More than a fifth of those 60 and older get little or no exercise. Americans are upbeat but uncertain about aging, The National Council on Aging and UnitedHealthcare found in a survey of people 60 and older, released Wednesday. The survey, “The United States of Aging,” found more than three-quarters of people between ages 60 and 69 say they expect their quality of life will stay the same or get better in the next five to 10 years. More than a quarter say their health is better than normal. Across all age groups, the “vast majority” say their health will get better or stay the same over the next five to 10 years. The majority of respondents are managing stress well, and 84% say they’re confident they can do what it takes to stay healthy. That confidence doesn’t necessarily translate to action, though. Just over half of seniors say they exercise at least four days per week. Ten percent say they only exercise a few days a month, and 11% don’t exercise at all. “It’s encouraging that so many of our survey respondents feel confident and empowered to maintain their health as they age, but it’s important that this positive mindset doesn’t prevent them from taking the necessary steps to counter the epidemic of obesity among our senior population, such as exercising most days of the week to help maintain a healthy weight,” Rhonda Randall, chief medical officer for UnitedHealthcare’s medicare and retirement business, said in a statement. That confidence-action gap can be seen in seniors’ financial lives, too. A majority of respondents said they felt financially secure, but nearly a quarter have difficulty paying monthly expenses. Nearly 20% are “one major financial event away from a fiscal crisis.” Maybe it’s good news, then, that the percentage of respondents with no retirement plan is relatively small: 8%. Financial and health concerns intersect at long-term care. A third of respondents say they’re unprepared to pay for such care. What’s troubling is that the survey found the people most likely to need care, low- and moderate-income seniors, are least likely to be able to afford it. Seventy-two percent of respondents in those income groups have a chronic health condition. “The most vulnerable older adults, who are also most in need of health care, economic help and support services to remain independent and ‘age in place,’ are the least confident they will be able to get the help they need,” Rick Birkel, Ph.D., acting senior vice president for healthy aging and director of the NCOA’s Self-Management Alliance, said in a statement. “But even small increases in benefits, reduced-cost services or reduced expenses can go a long way in helping vulnerable seniors remain independent.” Unsurprisingly, the majority of respondents would like to stay in their homes as they age, and 85% are confident they can do that without making major changes to their house. The survey stresses the importance of being prepared for needing care in the future, though. Although nearly two-thirds of boomers say living on their own is easy, just 43% of respondents 70 and older agreed. About 20% of respondents in that age group say they can’t live on their own or undertake daily tasks without assistance. The report was conducted by Penn Schoen Berland among 2,250 Americans 60 and older. It was sponsored by the National Council on Aging, UnitedHealthcare and USA TODAY. Social Security Pulls Back on Requiring Two-Factor Authentication How to Target Affluent Clients Online National Council on Aging

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Archive of Press Releases Media Resource Directory Nurses In the News Home > About Us > Newsroom > 2013 Press Releases > Lymphedema treatment pioneer David Chang, MD, joins plastic and reconstructive team at the University of Chicago Medicine David W. Chang, MD, FACS, a leading authority on surgical treatment of lymphedema, has been appointed professor of surgery at the University of Chicago Medicine, effective Sept. 11, 2013. Chang has been a key player in introducing lymphaticovenular bypass, a novel treatment for lymphedema, to U.S. operating rooms. He is one of a few surgeons in the country, and the only one in Illinois, who performs it routinely. As many as 25 to 30 percent of women who have breast cancer surgery with lymph node removal and radiation therapy develop lymphedema, a disorder in which lymph fluid accumulates, leading to chronic swelling in the upper arm. There is no cure. A lymphaticovenular bypass helps relieve the problem by allowing excess fluid to drain into nearby blood vessels. Surgeons, working under the microscope, use minute instruments to connect blocked lymphatic vessels -- as small as 0.3 mm in diameter -- to a nearby vein. Chang, 52, comes to the University of Chicago from the University of Texas MD Anderson Cancer Center in Houston, where he was a professor of plastic surgery, deputy chair of the department, and director of the plastic surgery clinic and the center for microsurgery research and education. He also held adjunct teaching roles at Baylor College of Medicine and Rice University, both in Houston. Chang has published nearly 100 original research articles, about 60 review articles and book chapters, and 100 research abstracts, primarily focused on breast reconstruction, lymphedema and microsurgery. He has been named a best doctor or top surgeon by various publications. He is a member of the editorial boards of several of the field's leading journals. He has lectured throughout the United States, Europe, South America and Asia, and participated in humanitarian missions to Sierra Leone, Kenya, Gabon, Haiti, China, Thailand, Vietnam, Bangladesh, Bolivia, Peru and North Korea. In addition to teaching, he has served as a faculty mentor for medical students, residents, and clinical and research fellows. Chang earned his undergraduate degree in molecular biology and biochemistry with honors in 1983 and his medical degree in 1987 at the University of Wisconsin-Madison. He completed his general surgery residency at the University of Illinois at Chicago in 1991, followed by a residency in plastic and reconstructive surgery in 1993 at Albert Einstein College of Medicine in New York. He then did a fellowship in microsurgery and hand surgery at California Pacific Medical Center's microsurgical replantation transplantation service in San Francisco. After two years as an instructor at Albert Einstein College of Medicine, he joined the faculty at MD Anderson in 1998.UCH_036362 (3) » Request an appointment » Request a second opinion Find a cancer expert 1-855-702-8222UCH_024800 (6) David Chang, MD Lymphedema SurgeryUCH_036365 (3) YouTubeUCH_028223 (2)

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> Hawaii State Center for Nursing announces updates on workforce issues Hawaii State Center for Nursing announces updates on workforce issuesUniversity of Hawaiʻi at MānoaContact:Eleni Davis, (808) 956-3962Communications Specialist, Hawaii State Center for NursingPosted: May 6, 2014Nurses Week Facebook Cover PageNational Nurses Week (May 6-12, 2014) is a time to recognize and celebrate all that nurses do to make life better for others. This year’s theme, Nurses Leading the Way, is a reminder of the key roles that nurses play at the hospital bedside, in long-term care and the community, and in leadership positions influencing health-care delivery. To celebrate these contributions, the Hawai‘i State Center for Nursing (HSCN) is releasing Fast Facts about nursing in Hawaiʻi – the what, where, when and how nurses make a difference every day.The Hawai‘i State Center for Nursing is proud to support Hawai‘i’s nurses and is committed to convey information statewide. “We are excited to share our passion for nursing, our commitment to support Hawai’i’s nurses and the outcomes of our work at the Center,” said Sandra A. LeVasseur, PhD, RN, associate director at the Center.Community collaboration is a key to the success of HSCN. The Center spearheads programs where nurse, education and employer partnerships flourish, producing statewide benefits. The Fast Facts acknowledge the collaborations and highlight some key nursing center successes.The Hawai‘i State Center for Nursing focuses include collecting and disseminating nursing workforce data in Hawaiʻi, recruitment and retention of nurses, and research on best practices and quality care outcomes. The Center is located at the University of Hawai‘i at Mānoa's School of Nursing and Dental Hygiene, and has an advisory board appointed by the Governor. HSCN is funded by Hawai‘i nurses through a surcharge on licensing fees.For more information about the Hawai‘i Center for Nursing, visit http://hawaiicenterfornursing.org/.To download the “2013 Annual Report: A Report to Governor Neil Abercrombie and the Hawai‘i State Legislature," go to http://hawaiicenterfornursing.org/annual_reports/.

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Home / Health News Toronto man diagnosed with rabies TORONTO, April 17 (UPI) -- For the first time since 1931, a Toronto resident is hospitalized and being treated for rabies, the Canadian Broadcasting Corp. reported Tuesday. The broadcaster said the victim was a 41-year-old man who had been working as a bartender in the Dominican Republic until he flew home a week ago with symptoms of the viral disease. Police were summoned when he reportedly began acting strangely at a Canada Customs checkpoint and he was taken to the neurological intensive care unit at Toronto Western Hospital, the Toronto Star said. Rabies in humans causes difficulty in swallowing and "hydrophobia," or a fear of water. It is almost always passed to humans through wild animals, health officials said. Regardless, the people in close contact with the man are undergoing vaccinations as a precaution, the CBC said. The last reported case of rabies in the country's largest city was a 3-year-old girl who was bitten by an infected bat in 1931, the reports said. Nationally, there have been three cases of rabies reported in the past 12 years, all caused by bats. Eight-year-old survives rabies Mass. man who had rabies from bat dies

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Morriston Hospital Woman left with life-threatening injuries after being hit by own car in hospital car park Alicia Melville-Smith A car collided with the woman and a man in a car park at Morriston Hospital yesterday Get daily news by email Morriston Hospital, where a woman was seriously injured A woman left with life-threatening injuries after being hit by a car in Swansea’s Morriston Hospital was hit by her own car, it has emerged. The 69-year-old is currently being treated in hospital and a 79-year-old man is also hurt. It is understood the two were a couple. The man was injured as the woman parked their Audi A4 and she was hit by the same vehicle after getting out to try to help him. They are both being treated at Morriston Hospital following the incident which happened near the hospital’s busy burns and plastic surgery unit at 12.10pm on Monday. South Wales Police are currently appealing for any witnesses to the accident to contact them. A spokesman for the force said: “As a result of this collision, the female has sustained life threatening injuries, the male sustaining lesser injuries.” South Wales Police said other parked vehicles in Morriston Hospital’s grounds were damaged in the incident. The pair were immediately taken to Morriston Hospital’s accident and emergency unit for treatment after the accident. Police are requesting any witnesses who saw the crash or the vehicle being driven earlier in the day to contact them on 101 quoting Incident number 1400263387. Pub staff and customers thanked after trying to save a pensioner's life An inquest heard how staff tried to help 83-year-old Patrick Kissane when he visited the Bank Statement in Swansea in March. Newlyweds thank surgeon who helped the groom to walk down the aisle with a £1,000 donation from their wedding guests Two men treated for serious burns after blast at Carmarthenshire house Jury set to be sworn in for trial of woman accused of murdering Richard Craddock The trial will start on Wednesday of Katie Ann Jenkins, 23, who is pleading not guilty to murdering the 51-year-old from the Sandfields area of Swansea Motorcyclist, 32, killed and seven-year-old boy injured in Llanelli crash Six-year-old girl dies shortly after police and paramedics are called to house where she became 'seriously ill'

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How does the Spinal Cord Function? Motor neurons are nerve cells that transmit signals between the brain and the spinal cord. The central nervous system, which consists of the brain and spinal cord, receives and transmits signals to the nerves in the peripheral nervous system, which is composed of the nerves in the organs and muscles of the body. The spinal cord runs the length of the spine. Vertebrae and the spinal cord. The spinal cord is responsible for transmitting messages to the body from the brain. T. Carrier Edited By: Angela B. The spinal cord is a track of nerves in the back. This crucial member of the central nervous system utilizes nerve cells and nerve tracts to function in several important ways. Vital spinal cord functions include providing a brain-body connection, directing movement, and housing the body’s reflex system. Several parts compose the spinal cord, and each plays a crucial role in spinal cord function. Nerve cells are contained in gray matter in the spinal cord, and this matter surrounds an inner canal filled with spinal fluid that provides the cord with density and a cushion. The tracts that lead to and from the brain reside within an outer layer of white matter. These tracts are made of sensory and motor neurons. Three layers of membrane tissue and protective vertebrae bones encase the delicate nerves vital to spinal cord function. Segments of the spinal cord give rise to pairs of spinal nerves that branch from the cord. The roots of these nerves communicate with other cells within the central nervous system. They then help transfer this information to other nerves throughout the body. In turn, incoming information from the peripheral nervous system makes its way to the brain via these nerves. The most important spinal cord function is this gateway between the brain and the rest of the body. Ad Brain-and-body interaction means another vital spinal cord function is its ability to coordinate body movements. The sensory neurons found within the spinal cord respond to the body’s five senses and convert stimuli from the outside environment into electrical impulses. These impulses are then sent to the central nervous system for processing. In turn, motor neurons convert central nervous system information into electrical impulses that are directed to muscles and organs, thus controlling movement. If any section of the spinal cord is injured, body paralysis can result. The spinal cord also contains the reflex arc. When receptor nerves in the skin are triggered by an extreme sensory stimulus such as intense heat or burning, the receptors send a warning impulse to the spinal cord. Further, motor or gland nerves that connect to the spinal cord unleash a reflex depending on the type of stimulus. Reflexes can either affect the skeletal system or the heart and other organs. Its role in these instinctual responses means the spinal cord is crucial in the nervous system’s fight-or-flight response pattern. Ad What Are the Denticulate Ligaments? What Is Spinal Cord Transection? What Is the Function of White Matter in the Spinal Cord? What Is the Relationship between the Spinal Cord and the Nervous System? What is the Anterior Horn? What is a Nerve Plexus? What are White Matter Tracts?

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Home > Find Services Near You > Fibromyalgia Questions and Answers About Fibromyalgia Fibromyalgia syndrome is a common and chronic disorder characterized by widespread pain, diffuse tenderness, and a number of other symptoms. Questions and answers cover causes, diagnosis, and treatment of fibromyalgia, and what you can do to feel better. Review Date: Friday, November 30, 2012 NIH National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse Fibromyalgia is defined by chronic widespread muscular pain and tenderness, and affects 2 to 4% of the population, especially women. Find out about the causes and treatment of fibromyalgia, tips on living with this condition, and a listing of medical experts (rheumatologists) who treat it. American College of Rheumatology Find a Rheumatologist This page will help you find a rheumatology health professional in your geographic area. Guide to Fibromyalgia Management- (PDF) This document discusses drug therapies, physical rehabilitation, chiropractic, exercise, cognitive behavioral therapy and other treatments to help those who suffer from fibromyalgia. National Fibromyalgia Partnership, Inc. Support Group Directory: National Fibromyalgia Association The NFA has created the FM Support Group Directory as a service to the fibromyalgia communities’ patients and caregivers to assist them in finding the nearest support group. National Fibromyalgia Association

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Life. Worth. Living. Keeping Meals and Treatment Fresh May 12, 2016 - 1:38pm Rogers Memorial Hospital–Oconomowoc and Rogers Memorial Hospital–West Allis have been growing some of their own produce to help children and teen patients connect plant growth to their personal changes, reduce food avoidance and keep meals and seasonal treats tasting great. John Williams, director of dining services at Silver Lake Outpatient Center in Oconomowoc, WI, makes a point to include children from the Child Center and Adolescent Center when he grows the produce that will be used in their meals and other dishes at Silver Lake Outpatient Center. “I believe that if I can get their hands working with food from soil forward, it can help patients with their transitions here at Rogers,” says Williams. “Exposing the kids to the growing process can help reduce their picky eating tendencies, since they’ve been hands-on with the food from its early stages.” Williams began growing herbs such as oregano, thyme, sage, mint, green onions, cilantro and more on the Oconomowoc campus when he joined Rogers in May 2015. He incorporates all of the produce into dishes at the Oconomowoc and Silver Lake locations—including sauces, flatbreads and chicken meals to name a few. He explains that growing your own produce is also a great way to save. “Herbs can cost as much as $8 a pound and growing your own is a way to get that fresh taste for a low cost,” says Williams. Patients also enjoy the sensory experience of growing their own plants. “We encourage the kids to pick the plants and taste them as they grow,” says Williams. “Some of the kids may have never grown plants before and it’s a wonderful new experience for them and will hopefully create some healthy habits that will carry over into their adulthood.” For three years, Rogers’ West Allis location has been growing produce such as peppers, tomatoes and strawberries to showcase in their garden show held every June. Patients in Rogers’ West Allis day treatment program for children and partial hospitalization program for adolescents are involved in the entire process from the first planting to enjoying the harvest. “We talk about gardening in general as an excellent coping skill which helps decrease depression,” says Nancy Goranson, PsyD, attending psychologist at Rogers Memorial Hospital–West Allis. “It’s a positive family activity and helps young people learn responsibility because they have to regularly care for something outside of themselves.” Dr. Goranson also explains that gardening helps patients learn that by taking small steps, they can achieve large accomplishments. “The commitment needed to water a plant daily, pull weeds, and enjoy the beauty of flowers or delicious food that results from this work helps our patients see that they can take daily steps to meet their program goals.” The Rogers’ team has hopes to expand the gardening possibilities in the years to come. The dietary services team at Rogers Memorial Hospital–Brown Deer plans on growing produce with patients for the first time this spring and Williams would like to increase the number of Rogers’ locations that garden. “It’d be great to eventually have tomato plants here in Oconomowoc or gardening space at the Eating Disorder Center in Delafield,” says Williams. “Now that we have the greenhouse in Oconomowoc, it’s going to be exciting to see how the patients grow alongside the produce they care for.” Read More Your Mental Health Story: To Share or Not to Share May 6, 2016 - 10:54am When a teen breaks a bone, friends and family often ask for “the story” of how the bone broke, how long it will take to heal and may even ask to sign the cast. But when a child is challenged with a mental health difficulty, it can be tricky for him or her to decide whether to share their journey, when to share it or how to share it. Wisconsin’s Initiative for Stigma Elimination (WISE) created a program—“ Honest, Open, Proud-High School” (HOP-HS)—to proactively empower teens to make thoughtful decisions about disclosing their story. “HOP-HS helps teens in grades 8-12 who have faced a mental health challenge, whether or not they have a formal diagnosis,” says Sue McKenzie, co-director of Rogers InHealth . “In a series of five sessions lasting an hour each, teens practice skills for reversing their hurtful ‘self-talk’ and take a deep look at the costs and benefits of talking to others in various settings such as work, school or with friends.” Suzette Urbashich , co-director of Rogers InHealth, explains that not every child makes the decision to disclose. “But for situations where the teen does decide to share their challenges and strengths, the program helps prepare them to respond to unanticipated reactions,” she says. “One month after the initial sessions, the group re-convenes for a check-in session to see how things are going.” Program facilitators are being trained across Wisconsin to implement HOP-HS, helping teens assess the story they tell themselves about their journey and to draft a version of their story to begin shaping and reshaping for various audiences. Key concepts explored in the training include the five levels of disclosure: Isolation: teens may separate themselves from friends and family, feeling that they are alone in their journey Secrecy: fearful of showing weakness, youth may develop a persona to disguise their pain or difficulty even to those closest to them Disclosure: teens may chose “safe” or trusted people to share their struggles with, such as a parent, which can give a child the confidence to share their story with more people who can offer support or tell them they are not alone Indiscriminate Disclosure: a teen feels confident enough to discuss their mental health journey with people that may react negatively Full Disclosure: youth feel comfortable discussing their story with all people, not only to help themselves, but to help others McKenzie explains that HOP-HS was adapted from an adult version of the program, originally created by Patrick Corrigan, PsyD. “As WISE began using the program, we realized that a key age group was missing from the HOP suite of programs: youth,” she says. “So, WISE partnered with Corrigan to develop a version of the program that would be relevant to high schoolers.” The evidence-based adult version of the program demonstrated a statistically significant reduction in stigmatizing attitudes about self and others with mental illness, a decrease in depressive symptoms and anxiety about disclosure, as well as an increased willingness to seek help. “Sharing one’s story isn’t a simple decision. It requires careful thought and support,” says Urbashich. “HOP-HS guides youth to develop the strategic disclosure skills they need to make the daily decisions of if, what and to whom to disclose.” According to McKenzie, there are plans to enhance the program in the future. “We hope to increase the number of trained HOP facilitators throughout the state, conduct randomized controlled trial research, collect data and share the program nationally and internationally,” she says. “To increase involvement and awareness about the program, Suzette and I have begun presenting at state-wide and out-of-state conferences. This March, we attended the 29th Annual Research and Policy Conference on Child, Adolescent, and Young Adult Behavioral Health in Tampa, FL, to share the program on a national level—which was very exciting.” On May 25, 2016, a HOP-HS facilitator training session will be held in Oconomowoc, WI. To find a HOP program facilitator in your area or to be trained as a facilitator, contact wise@wisewisconsin.org. Read More Patient Triumphs Represented through Experiential Therapy April 22, 2016 - 12:27pm For some, having a mental illness can feel like you’re caged by a monster, leaving you unable to participate in the daily activities that you would like to engage in. That is the metaphor that Ashley Samson, experiential therapist at Rogers Behavioral Health–Chicago, started with in December 2015 when she designed new projects for her patients. Over time, that metaphor was adjusted to be more relevant to the different patient age groups in Skokie, IL. “When each patient attends their first experiential therapy group at Rogers–Chicago, he or she is offered the opportunity to visually track their progress,” says Samson. “The children and teens enrolled in the obsessive-compulsive disorder (OCD) and anxiety partial hospital and intensive outpatient programs record their personal growth with ‘freedom balloons.’” Using dry-erase markers, Samson draws balloons on the window of the experiential therapy room as a space for each child to collect their successes and share with others. “The children write down what they’re proud of that session on their balloons, whether it be the completion of an exposure or an accomplishment that gets them one step closer towards their treatment goal or discharge,” she says. “The freedom balloons help the kids display a sense of pride and share their successes against the ‘monster’ or disorder that has held them captive.” Samson adapted the metaphor for adults with OCD enrolled in the partial hospital and intensive outpatient programs and FOCUS partial hospital program. “When our adult patients first arrive, they are given a clear ornament, which we refer to as a ‘progress globe,’” she says. “During check-in, each patient creates a handwritten note of personal success or finds a small object that represents their positive change and puts it in their globe. Our adult patients usually prefer to be more private than our younger patients about tracking their accomplishments, so the globes were a way to continue the metaphor in a more reserved way.” Upon discharge, patients can take their globe home as a token of their achievements or smash the globe if they wish to shift the metaphor toward reclaiming their freedom from their mental illness. “It can be helpful for many patients to see and feel their progress as tangible objects,” says Samson. “These simple traditions are a wonderful way for patients to see that even small successes like coming to treatment on time or completing an exposure can add up to increased confidence and a greater sense of pride in their hard work.” According to Samson, one patient who started a progress globe decided to continue higher level treatment at Rogers Memorial Hospital–Oconomowoc before returning to outpatient programming in Skokie. “When I asked her whether she’d like to take her globe with her or leave it at our clinic, she told me that she’d prefer we held onto it for her as a ‘place-keeper’ or personal reminder that she would be back to continue her journey to wellness.” Read More Celebrate Mental Health Month With Us! April 19, 2016 - 12:16pm Mental Health Month, organized by Mental Health America and their affiliates, is a national observance recognized each May that reaches millions of people through the media, local events and screenings. Now is a great time to raise awareness, fight mental health stigma and learn more about: 11 common signs of mental illness in children Horticultural therapy and its natural healing properties Sharing Your Story Our locations in Wisconsin, Florida, Tennessee, Illinois and Minnesota are all recognizing Mental Health Month in their own way—showing support and advocacy for those we care for and their families. Check it out on Facebook and Twitter!Show us what you’re doing to celebrate Mental Health Month on social media! Have you created an art project to embody your journey with mental illness? Is there an inspirational quote or message about mental health that you want others to know? Is there a common misconception that people have about your illness? Read More Specialized Post-Detox Treatment: Preparing for a Journey April 13, 2016 - 1:52pm Many adults wrongly believe that once they complete their detox treatment, they will immediately be freed from their drug or alcohol addiction. Beth Shaw, counselor, addiction intensive outpatient program at Rogers Memorial Hospital’s Lincoln Center Outpatient Center in West Allis, knows the work has just “When patients first come to our addiction intensive outpatient program, many of them don’t understand how deadly their disease is or how much power it has over them,” she says. “Many patients mistakenly think that the physical pain of going through detox will be the hardest part of their journey to recovery, but the real work comes afterwards in post-detox treatment.” While patients receive inpatient care or residential treatment, they may have temporary protection from many of their outside stressors. “Patients live in somewhat of an artificial world before they get to an intensive outpatient program,” Shaw says. “They don’t have contact with those who helped facilitate their addiction or many of the triggers that caused them to abuse drugs or alcohol, which means that we have to address these issues in the intensive outpatient program while they have connections to the outside world.” Many of Shaw’s patients have a family history of addiction, abuse, neglect or other emotional issues. “Family sessions play a major role in our program—not only to form a solid support network for the patient, but to bring to light any underlying family problems that may have caused the patient to find an unhealthy coping mechanism,” she says. Once patients begin treatment in the intensive outpatient program, they often find that the program is not the intimidating experience they might have expected. “Our patients quickly realize that the treatment team isn’t here to tell them they’re ‘bad people’ or scold them for their addiction,” says Shaw. “They see people with similar struggles and realize they are not the only ones with this disease.” Shaw explains that the group therapy sessions in the program help create a sense of accountability. “I’ve heard over and over again how patients thought about giving up, closed their eyes and pictured the faces of those in their group therapy,” she says. “Then they realize that the treatment team and those in their group are all ‘in this together.’” The specialized treatment available at Rogers Memorial Hospital gives patients an advantage, Shaw believes. “An obsessive-compulsive disorder consult is two doors down from my office. Having speedy access to specialized treatment gives patients more complete care,” she says. “Rogers works hard to find solutions for patients, including those with ‘difficult cases.’” Read More Early Treatment for Teens with Mental Illness and Substance Abuse March 15, 2016 - 1:04pm According to the National Alliance on Mental Illness (NAMI), about one-third of people with mental illness also experience substance abuse—meaning that they have a “dual diagnosis.” Amy Kuechler, PsyD, attending psychologist for the adolescent dual diagnosis program at Rogers Memorial Hospital–Brown Deer, explains that teens with mental illness—such as depression, attention deficit hyperactivity disorder (ADHD), anxiety or trauma—may be even more susceptible to substance abuse. “There are a few reasons why teens may be more susceptible to use substances,” she says. “The adolescent brain is not fully developed, so teens struggle to consider the consequences of their behaviors and instead respond to immediate gratification—like the immediate high from substance abuse. Teens also test ways to separate themselves from their families and place more importance on their peer relationships and ‘fitting What’s especially concerning is how accessible many substances are for teens to use to get high. “Many parents are unaware that products in their home are commonly abused by teens, such as over-the-counter cough medicine or various aerosol cans.” These substances are easy to find, legal to use and many can be purchased online. Dr. Kuechler explains that unhealthy habits formed in adolescence have a good chance of carrying over into adulthood. “Ninety percent of adult substance abusers started using substances in their teens with fifty percent starting before the age of 15,” she says. “This is important to note because early treatment and intervention are potentially the key to prevention.” If your teen abuses substances, Dr. Kuechler suggests looking for common warning signs of mental illnesses commonly associated with dual diagnosis: Increased isolation and withdrawal from activities your teen used to enjoy Increased moodiness, particularly increased irritability and argumentativeness More secretive behaviors, lack of motivation Truancy at school, difficulty with authority or increased interactions with law enforcement Associating with a new group of friends Lying, stealing, cheating or manipulating Changes in sleep patterns or appetite According to Dr. Kuechler, both disorders in a dual diagnosis should be treated simultaneously because they are often related. “If only one disorder is treated, there’s a good chance symptoms of the untreated disorder will increase,” she says. “For example, someone who is struggling with alcohol abuse and depression may manage their depressive symptoms through drinking. If the person’s treatment only focuses on stopping their excessive drinking, there’s a possibility they may learn to deal with their depression through another unhealthy strategy, while never truly addressing the underlying issue.” Rogers Memorial Hospital’s adolescent dual diagnosis program is based in cognitive behavioral therapy (CBT) and motivational interviewing (MI), which are evidence-based techniques. “We start by using MI as a therapeutic strategy that encourages teens to develop a desire to make changes in their lives and become active in their treatment,” she says. “Then we focus on using CBT to help teens understand that their thoughts, feelings and behaviors are all related. By changing just one of those things, the whole dynamic of how they live their lives can be changed.” Rogers offers various individualized, comprehensive partial hospital and intensive outpatient dual diagnosis programs for teens and adults at multiple Wisconsin locations including Oconomowoc, Brown Deer, West Allis, Kenosha and Madison. The adolescent dual diagnosis partial hospital and intensive outpatient programs at Brown Deer are Rogers’ first offering for that age group and are clearly serving a need. “Overall, we are teaching adolescents that they have the power to improve their lives and the way they see the world,” says Dr. Kuechler. Read More Rogers Specialists to Present at 2016 Anxiety and Depression Conference March 11, 2016 - 10:40am Five clinical leaders from Rogers Behavioral Health will share their insights at the 2016 Anxiety and Depression Conference in Philadelphia, PA, sponsored by the Anxiety and Depression Association of America (ADAA).“ADAA is one of the leading conferences that focuses on anxiety, obsessive-compulsive disorder (OCD) and depressive disorders where researchers and clinicians from throughout the world convene to share ideas,” says Eric Storch, PhD, clinical director of Rogers Behavioral Health–Tampa Bay and a Morsani College of Medicine professor. “The ADAA annual meeting is unique because it brings together the top researchers and top clinicians in the world for the purpose of improving the way we treat, someday cure and prevent the suffering caused by the disorders related to anxiety and depression,” adds Karen Cassiday, PhD, clinical director of Rogers Behavioral Health–Chicago and president of the ADAA.Rogers’ presenters will offer their insight on the following topics. The full schedule is available online:Dr. Cassiday will chair the roundtable, “Taming Treatment-Refractory Situations: Hot Tips for Clinicians with Difficult Cases,” with Dr. Storch as a presenter on family accommodation;Dr. Cassiday is the primary presenter for the workshop session, “What if I die? Overcoming Health Anxiety in Kids and their Parents,” and the roundtable, “Exposures Uncut: Challenges Faced When Conducting Exposures With Children and Adolescents;”Dr. Storch is one of the presenters in the roundtable, “Effective, Essential Therapist-Prescribing Clinician Collaboration in the Treatment of OCD: An Expert Roundtable Discussion,” and the symposium, “Advances in Intensive Cognitive-Behavioral Therapy for Anxious Youth;”Jerry Halverson, MD, medical director of Rogers Memorial Hospital–Oconomowoc and FOCUS adult mood disorders programs, and Rachel Leonard, PhD, clinical supervisor of FOCUS, will co-present a workshop session, “Multi-Modal Residential Treatment for Individuals Struggling to Transition into Adulthood due to Symptoms of Depression and Anxiety;Dr. Halverson is a co-presenter in the symposium, “Focal Brain Stimulation: Practical Considerations for the Clinician;”Dr. Leonard is among the distinguished list of presenters in the Ignite symposium session, “Increasing the Effectiveness of Intensive/Residential Treatment Models for OCD Across the Lifespan;” andDavid Jacobi, PhD, clinical supervisor of the Child Center, is one of the presenters in the roundtable, “Woulda, Coulda, Shoulda: Lessons Learned From Treatment ‘Failures.’"As expected, Rogers’ specialists are eager to share their knowledge with others in the field. “A workshop Dr. Jerry Halverson and I are presenting discusses treatment for individuals struggling to transition into adulthood due to their depression and anxiety—these individuals are often characterized as experiencing ‘failure to launch,’” says Dr. Leonard. “The transitional period of time between adolescence and adulthood is characterized by high rates of depression, often with other co-occurring disorders, so identifying treatments that target the needs of this unique population is incredibly important.”Stephanie Eken, MD, regional medical director, and national outreach representatives Blair McAnany and Rick Ramsay will attend the conference as representatives of Rogers Behavioral Health. Rogers’ specialists will also be available at our exhibit table to answer programming questions at the following times:Dr. Storch, Friday, April 1, from 9-10 a.m. and Saturday, April 2, from 11 a.m.-noon.Dr. Leonard, Friday, April 1, from 10-11 a.m. and Saturday, April 2, from 9-10 a.m.Dr. Eken, Friday, April 1, from 10:30-11 a.m.Dr. Jacobi, Friday, April 1, from 12:30-1:30 p.m. and Saturday, April 2, from 9-10 a.m.Dr. Halverson will be available for much of the conference Read More Making Comfort More Complete during Treatment March 8, 2016 - 8:03am Since childhood, many of us have known that it’s important to be a good host—whether that means offering a refreshing beverage or the softest seat in the house. When children, teens and adults seek treatment at any of our locations, we strive to treat them as we would want our own friends and family to be treated. A team of care providers at Rogers Memorial Hospital–Brown Deer felt that they could do more to be hospitable to children and teens when experiencing difficult times during treatment. When youth are enrolled in programming in Brown Deer, WI, and various other locations, a “comfort room” is available for patients as an environment to wind down in and practice coping skills learned in treatment. “The idea of the comfort rooms are great, but the rooms at our location had blank white walls and made some patients a bit nervous,” says Josh Larson, an art therapist at Rogers–Brown Deer. “We wanted the kids to enjoy being in the room and feel like it was a safe space, but the room’s appearance wasn’t allowing that to happen.”So, a team of four art therapists, one recreation therapist and one mental health practitioner came to Heather Hodorowski, manager of experiential therapy at Rogers–Brown Deer, with a proposal. “Staff expressed that they wanted to create purposeful murals in the comfort rooms,” says Hodorowski. “I was proud that they wanted to fit the project into their regular work schedule and I was impressed with their initiative—so, I gave them the tools to run with the idea.”The planning process incorporated the entire treatment team at Brown Deer. “I sent out a survey for naming the child and adolescent treatment tracks and the team decided on “Lotus” for the children and “Phoenix” for the teens. Then those involved with creating the murals naturally incorporated those images into the comfort rooms,” says Hodorowski. “We often use the metaphor that even though lotus flowers flourish in the mud, they still have the ability to rise above the surface. The phoenix represents regeneration, growth and technique development for moving forward with anxiety, depression or psycho-social stressors.”Once the mural ideas were decided on, staff were eager to get to work. “We agreed that using bold, cool-colored earth tones would be more likely to offer a calming effect than other colors,” says Larson. “We each took turns picking up a paintbrush whenever we had spare time and after 110 hours of painting, the project was complete.”Hodorowski explains that staff have already seen a major impact in the way children and teens accept the rooms. “The comfort rooms finally live up to their name and are actually popular among our patients,” she says. “We’ve found that they’re more willing to speak up and ask for ten minutes to spend in the room until they feel more prepared to continue treatment than they were before.”“The comfort room also offers another way for patients to interpret their therapy and connect what they hear in group throughout the day,” adds Larson. “Visualizing what is discussed in therapy can be beneficial for children or teens who learn better with imagery.” In the future, staff at Brown Deer hope to create murals in the comfort rooms of the child and adolescent day treatment and adult inpatient programs. Read More Our Patients Speak: Stories of Recovery from Eating Disorders February 26, 2016 - 11:53am This Eating Disorders Awareness Week, countless people from around the country will share their stories of recovery to reduce mental health stigma, encourage others to get a screening, raise awareness and even help in their own healing process. Since anorexia nervosa, binge eating disorder, bulimia, and other eating disorders affect all ages, genders and races, you might already expect that each person’s eating disorder journey is as unique as they are. But you may not expect the complete mind, body and soul transformation that each person undergoes on their path to wellness. Mari’s StoryFor college students who are balancing school, athletics, work and family responsibilities, life can be challenging enough. But for Mari, her obsessive dieting and exercise routines put a strain on her body and mind that was greater than any final exam or conference championship could ever have done.As an eager college freshman, Mari began taking courses at the University of Wisconsin–Stout in September 2013, hoping to one day earn her degree in dietetics. She always had a passion for living a healthy and active lifestyle, so it was no surprise when Mari made the university’s tennis team as well. With so much going for her, Mari had only a promising future ahead, but then things got more complicated during Mari’s first winter break at home. “I noticed that I had gained a few pounds, only a few, and I felt something switch inside of me,” says Mari. “I started to feel really insecure about myself and I felt myself becoming more conscientious and aware of my weight.” Like many young adults who gain a little weight their freshman year, Mari thought it was something that could easily be solved by dieting and maintaining an active routine. But as a year passed and her disordered eating progressed, Mari’s family began to notice how dangerously thin she’d become. “My family had expressed concern for my health, but it wasn’t until I had two menstrual periods in one month that I realized my body wasn’t well internally—so then I decided to visit my school’s clinic,” says Mari. “The doctor who I was scheduled with had done my physical exam for the tennis team the year before. When she saw me, she immediately knew that something was wrong and ran an EKG and other tests.”After realizing the severity of Mari’s symptoms, as well as her progressing heart failure, Mari’s physician suggested that she seek professional treatment. Mari says it wasn’t until she received a feeding tube in Rogers Memorial Hospital’s inpatient program in Oconomowoc, WI, that she realized anorexia nervosa had taken over her behaviors. Emily’s storyNot all people immediately realize the severity of their eating disorder when they first begin treatment. That was the case for Emily, another young college student.“I began seeing a psychiatrist my junior year of high school for my anorexia, which had begun to develop when I was ten years old,” says Emily. “I also received treatment in an inpatient program, but I put a lot of effort into convincing my family and my doctor that I had been restricting my diet for attention—that I didn’t really have an eating disorder. I became very good at tricking myself and others, but in reality my life revolved around the personal list I had made on ‘How to Be Perfect.’”When Rogers began offering eating disorder services close to Emily’s home in Tampa, FL, her psychiatrist suggested that she try the more intensive treatment available at Rogers Behavioral Health. Emily agreed, “I decided that this would be my ‘practice run’ for taking treatment seriously.”After taking a semester off of school and work, Emily was ready to fully commit to her wellness. When Emily met her treatment team in Tampa’s partial hospital program, she realized that she could no longer remain emotionally disengaged. “Right away, my team knew that I needed help creating an emotional baseline and they developed an ‘emotion wheel’ that I still use today to help express what I’m feeling,” she says. While in treatment, Emily found great help from her group therapy sessions, her faith, and her family. “Even now, when I sit at the dinner table and feel myself struggling with a certain food, my little brother looks up at me with the biggest smile because he knows when I need the extra reassurance,” says Emily. “And that’s enough to help me stay on track.” Denise’s storyNot all people with eating disorders like Emily and Mari are college-aged, female, or even have the support that comes with living with parents and siblings. Rogers is known for its treatment of males with eating disorders, and Denise represents the less stereotypical older woman with these challenges.At the time, Denise was a mother in her mid-twenties when she had a conversation with a friend about purging and decided that it might be a good way to get back to her pre-baby weight. “I had four kids and I hadn’t gotten any results from dieting,” she says. “What started out as my method for weight loss eventually turned into a pattern of binging and purging up to 20 times a day, for 15 years.”In Denise’s early forties, she developed depression after experiencing an “empty nest,” which caused her to lose her appetite. With no desire to eat, Denise’s bulimia was replaced with anorexia nervosa. Still believing that she didn’t have an eating disorder, Denise lost consciousness while driving her daughter. Her daughter then grabbed the wheel and steered them both to safety from the passenger seat. “It wasn’t until I began receiving residential treatment at the Eating Disorder Center that I began to acknowledge that I had an eating disorder,” she says. “While receiving treatment and doing a lot of personal discovery, I found out a lot of the reasons of why I had an eating disorder. I always say that my birth certificate says ‘Rogers’ on it.”Moving forwardDenise says she learned a lot from both younger patients like Mari and Emily, as well as middle-aged patients like herself. “I also found that the art therapy I received brought out feelings in me that I didn’t realize I had,” she says. “At first, the thought of creating art was scary, but I found out that I’m actually pretty creative. Today I create mosaics, I’ve illustrated a children’s book and I’ve even written my own book.”Emily has found that she continues to make progress in her recovery by sharing her story and donating her time to others. “It’s so rewarding for me to volunteer in the Tampa community and right now I’m a mentor at a girl’s juvenile facility,” she says. “People who have really changed my life were complete strangers to me and I want to continue sharing my faith and my experience with others.”Mari has also emerged from her treatment transformed with a newfound career choice and personal cause. “Because of the treatment I received at Rogers, I’ve changed my major from dietetics to psychology,” she says. “My family and I can’t believe how far I’ve come and I’m just so passionate about eating disorder treatment that I want to be dedicated to this my entire life. I know I’ve already touched lives and I just want to continue to give hope to other people.” Read More This Eating Disorders Awareness Week: A Call to Action February 23, 2016 - 12:14pm February 21 through 29 is Eating Disorders Awareness Week, an observance organized by the National Eating Disorder Association (NEDA). This year’s theme: “3 Minutes Can Save a Life: Get Screened. Get Help. Get Healthy.” promotes early intervention and education about the causes, dangers and treatments for eating disorders. Brad E.R. Smith, MD, medical director of eating disorder services at Rogers Memorial Hospital–Oconomowoc, explains that this national observance is a great opportunity to seek out available programming options.Whether you realize it or not, it is very likely that you or someone you know is affected by an eating disorder. “Up to 30 million men, women and children in the United States suffer from anorexia nervosa, binge eating disorder, bulimia, or other eating disorder,” he says. “People with eating disorders also have a higher mortality rate than those with any other mental illness.” So what are some of the factors that make this such a dangerous disease?“One of the biggest challenges we face is that people who have eating disorders may not recognize that they are ill and so they may be resistant to accept treatment,” says Dr. Smith. “People with eating disorders have a tendency to minimize, rationalize, or hide their eating disorder symptoms and behaviors. They might also seek out a variety of specialists and interventions that address the serious medical consequences of their behavior without tackling their underlying problem—because in all cases, it is never just about the food.”Rogers Memorial Hospital offers multiple levels of care for eating disorder treatment, including inpatient, residential, partial and intensive outpatient programs. “A number of effective treatments for eating disorders exist for children, teens and adults,” he says. ”This includes cognitive behavioral therapy (CBT), a type of psychotherapy that addresses an individual's thoughts, behaviors, and feelings to make changes.” Even with the right treatment approach and a multidisciplinary team, achieving lasting recovery still takes time. “Recovery doesn’t happen overnight because we are interrupting harmful eating behaviors that have become deeply engrained and almost unconscious for many,” says Dr. Smith. “Treatment helps people with eating disorders to change what they do, normalize their eating habits and reframe the irrational thoughts that sustained their disordered eating behaviors.”Call 800-767-4411 to schedule a free screening today. 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医学

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Barbaro's care illustrates veterinary profession's capabilities Colt's recovery from injury stirs positive media attentionBy Allison RezendesPosted July 1, 2006 Just two weeks after clinching the Kentucky Derby, Barbaro suffered a broken hind limb shortly after the start of the Preakness Stakes, May 20. Though the injury was career-ending, the 3-year-old colt's positive strides toward recovery—and the willingness of the involved veterinary team to share details of the horse's care—have made it possible to showcase the capabilities of veterinarians to a concerned public. Top radio and TV programs and print media from around the country have interviewed veterinarians at the University of Pennsylvania School of Veterinary Medicine's New Bolton Center, where Barbaro was transferred soon after the accident in Baltimore. At the center of many interviews was Dr. Dean W. Richardson, chief of surgery at the center's George D. Widener Hospital for Large Animals. Dr. Richardson repaired Barbaro's fractured limb during a six-hour surgery, May 21. "The sort of minor inconveniences of getting interviewed all the time and so forth is really out weighed by the good press that the profession is getting," Dr. Richardson said. "I don't think that the veterinary profession can get out there enough, particularly the equine side of things." "Sometimes people think veterinarians are just sort of doing whatever is easy and convenient, and I don't think that that's the case," he continued. "I think that there are lots of people that work hard to do what's best for the animal." Dr. Larry Bramlage fielded media questions almost immediately following Barbaro's injury. He was the spokesperson for the American Association of Equine Practitioners' On Call Program, which provides accurate veterinary information to the broadcast and print media during live network races. "More than anything else, it shines a light on our capabilities as a profession," Dr. Bramlage said about the positive media attention that followed Barbaro's surgery. "The general public tends to view medical progress as giant leaps, such as the discovery of penicillin. In fact, medical progress is a progressive accumulation of knowledge over time," he continued. "Prominent events such as this focus the attention on how far we have come." Broken and shattered Barbaro reportedly injured himself 50 to 75 yards after leaving the starting gate. The horse suffered a lateral condylar fracture of the cannon bone, which alone probably might have been career-ending, Dr. Richardson said. "He also shattered his long pastern bone. That was in 20-plus pieces. Then on top of that, he also broke one of his proximal sesamoid bones," he continued. "The most important ligament he tore was the intersesamoidean ligament." The horse's fetlock was also partially dislocated. "The degree of bone injury was dramatic," said Dr. Bernd Driessen, chief of the Large Animal Anesthesia Service at New Bolton Center, who with another colleague, a resident, and an anesthesia nurse managed Barbaro's anesthesia during the lengthy surgical procedure. "I definitely have never seen such a severe multiple-bones-affecting fracture." "The fact that this horse fractured the leg so early in the race made the case more difficult, as Dr. Bramlage had pointed out early on, insofar as Barbaro was still very energy-loaded," Dr. Driessen said. He said injuries to horses are more likely to occur toward the end of a race, and for that reason the horses are oftentimes more exhausted. On the other hand, he said, one advantage of the horse injuring itself earlier in the race is that dehydration was less of a concern. Dr. Driessen said Barbaro was unusually calm immediately following the injury. "Normally, horses get very excited if they suffer those types of injuries. As soon as the jockey jumped off, the horse was pretty easily controllable, from what I could see on the (TV) images." Dr. Driessen observed Barbaro the morning of the surgery and was pleased to see that the horse was much calmer than he had anticipated. "He was even capable to lie down for short periods without significant problems and then to stand up by himself," he said. During the surgery, 27 screws and one locking metal compression plate were placed in Barbaro's limb, and a cast was set. Once the surgery was completed, Barbaro was moved into an equine recovery pool at New Bolton Center. The pool is used primarily for horses undergoing major orthopedic or trauma surgery. It allows a disoriented animal to awaken suspended in a specially engineered harness which together with the horse, is lowered into a large raft modified with four long rubber sleeves to accommodate the limbs of the horse. The pool raft recovery system allows the animal to move its limbs forward or flail in the warm water until fully conscious, reducing the risk of reinjuring the newly repaired limb. Once awake, the horse is hoisted from the raft and moved to a recovery stall. Dr. Driessen said the pool proved invaluable for the immediate postanesthetic management of Barbaro. Although Barbaro received epidurals for analgesia for a period after the surgery, the horse's pain management regimen as of June 2 was 1g of phenylbutazone in the morning and 1g at night, Dr. Richardson said. Potential complications While Barbaro continued to do well in the initial postoperative period, a long road to recovery lies ahead. Dr. Richardson said laminitis in the opposite hind limb will be a concern for months to come. He said, "It's not rare to have a horse with this type of injury that actually founders on their good foot six to eight weeks after or more." Though the skin was not broken in the initial injury, infection remained a concern. "I would say the chances of a catastrophic infection at this point are diminishing because of the fact that we've got a horse that has had a normal body temperature for basically the whole time he's been here. His blood work has been consistently good. He's showing no lameness," Dr. Richardson said. "But that doesn't rule out the possibility that we could get some infection that could slow up fracture healing and end up being a major complication." Dr. Richardson also noted that the internal fixation could fail. "The horse just walking and eventually fatiguing the metal to the point where some portion of it breaks—that's always a possibility when you're talking about internal fixation techniques, particularly if they're in an extremely unstable situation, like we have in Barbaro." Cast changes will also be a challenge. Dr. Richardson said Barbaro will be in a cast for at least eight to 10 weeks. During the cast changes, the surgeon plans to take radiographs to assess the progression of fracture healing. Given Barbaro's calm temperament and cooperative nature, Dr. Driessen said, he anticipates that the cast can be changed when the horse is suspended in an Anderson sling and merely under heavy sedation. "Should this not be possible, Barbaro could also be anesthetized in this sling and then gradually woken up from this short-term anesthetic in the sling till he regains sufficient muscle strength and coordination capacity that he can be walked back to his stall," he said. With numerous obstacles to overcome in the next few months, Barbaro seems to be up to the challenge. "He's a very well-behaved horse and does pretty much anything you want him to do, which for a 3-year-old colt is a pretty good trait, because they don't always behave that well," said Dr. Liberty Getman, a second-year surgery resident who takes care of the horse on a daily basis. "He's a pretty smart horse; he takes care of himself very well," added Dr. Steven T. Zedler, a first-year surgical resident assigned to Barbaro's care. "All in all, he's been an excellent patient. I think that that's definitely in his advantage insofar as his recovery is concerned." Cost figures in Dr. Driessen feels the positive coverage in the media of Barbaro's case could push veterinary orthopedic surgery a "big step forward." The field has benefited from technical advancements, he said, but many horse owners don't pursue orthopedic repair procedures of this type because of the cost. "It means that for a long period of time, you are not sure that the animal will survive ... and yet you have to invest an enormous amount of money," he said. Dr. Richardson estimated the medical treatments for Barbaro would cost tens of thousands of dollars. "I think it's very important for the public to recognize that in fact, the surgery that was done on (Barbaro) is really ridiculously inexpensive compared with what would be charged for the same effort, same materials, same everything, in treating a human with a similar fracture." Aside from the dollars and cents, Dr. Richardson believes repairing Barbaro's limb was just part of his job as a veterinarian. "There are many things that can be done for horses, and lots of veterinarians and owners who will do whatever it takes, within reason, to save animals and give them a good quality of life." For updates on Barbaro's condition, visit the University ofPennsylvania veterinary school's Web site at www.vet.upenn.edu.

医学

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Health & Fitness Celebrations House & Home Fashion Personals Message Boards For Sale Your Photos Barbara F. Meltz writes the Globe's Child Caring column. She is author of "Put Yourself in Their Shoes, Understanding How Your Children See the World," and a frequent speaker to parent groups. Join her chat on the first and third Monday of the month at noon. NEW: Talk about child rearing issues and pregnancy in our Parents forum. Child Caring Archives Week of: October 14 Week of: October 7 Week of: September 30 Week of: September 9 - Subscribe - Add to My Yahoo - About RSS « For parents of children with visual/hearing impairments | | Internet safety & cyber-bullying » Who can you turn to in a crisis? Some days, being a parent is, well, plainly painful. I'm including this column, "How secrecy shuts out vital support," on my golden oldie list because it generated a lot of response at the time from parents who had struggled with feelings of shame or guilt from a teens' behavior. It appeared in 2000. HOW SECRECY SHUTS OUT VITAL SUPPORT By Barbara F. Meltz, Globe Staff Chances are that at some point between the time your child enters the teenage years (12, 13, 14, or 15) and comes out the other side (17, 18, 19, or 20), she'll do something that deeply shames you. Judith Warren's turn came in 1996 and '97, when her son was a sophomore and junior in high school. A progression of events that began with him hanging with an older group of boys led to his smoking marijuana and his arrest on drug and weapon charges. Warren, who lives in a small south-central Massachusetts town, normally thinks of herself as a high-energy, empowered parent. But even as she stood by her son literally, in court, and through his emotional struggle, there were days when she was so ashamed she couldn't pick herself up off the couch to eat or sleep, couldn't control the trembling in her limbs or the paralyzing fear that immobilized her thoughts. "I felt that I had failed as a parent," she says. Except for her ex-husband and sister-in-law, Warren told no one of her son's problems and her feelings, partly to protect him, partly out of shame. It became her secret. "If I went to a community event, I felt that others must know [what he did] and be thinking what a terrible parent I was," she says. "It was isolating. It was horrible." Warren's experience resonates for psychologist Jodie Kliman, and not just because she's heard it from clients. A parent of teens herself, she says, "There are times when I've felt I'm a failure, too. Knowing I'm not unique is very comforting." She also understands the instinct to keep things to yourself. "We live in a society that is quick to blame parents," says Kliman, who is coordinator of family therapy training at the Center for Multicultural Training at Boston Medical Center. When we make our teens' transgressions our secrets, however, even for the sake of family- or self-preservation, we hurt ourselves, losing out on support from others as well as their perspectives or ideas for coping. What humiliates one parent may not be what disgraces another, of course. But no matter what issue pushes your button, from a failing grade to a wrecked car, "shame is the hardest emotion to cope with. It's when we are most apt to make mistakes," says psychologist Norine Johnson. She is an adolescent specialist at Boston University School of Medicine and president elect of the American Psychological Association. Shame immobilizes us and undermines our parenting. "It makes you pull away from the relationship and minimize the issues rather than help the person struggle with them. And when that person is a teen who may also feel ashamed of what she's done, it can be a disaster," says Kliman. A parent's first task, of course, is to deal with whatever fallout the transgression creates. If that's all we do, however - if we don't talk about it again with our child - there's no positive interpretation a teen can spin. She may conclude either, "My parents don't care," "It's not a big deal," both of which give her permission to do it again, or "What happened is so shameful, they can't even talk about it." The last increases her own sense of shame and failure, says family and child psychologist Sharon Gordetsky of Brookline. "Most teens know they have done something wrong. They don't want us to blow it out of proportion, but they do want us to deal with it," she says. There are two ways parents typically find out that a teen is in trouble. The first is to sense something is wrong and go snooping. If the search yields fruit, many parents feel remorseful for spying and ashamed of failing. That double whammy is so powerful it keeps us from confronting our child at the same time that it alters our view of him. That, in turn, affects our relationship: Perhaps we're more distant, quicker to jump on him. We may or may not sense this change. A teen will for sure, and it's exactly what she doesn't want, says Johnson. "The reason she keeps something from you in the first place isn't just because she fears punishment, but also because she's afraid it will hurt your relationship," she says. Now her fear is coming true, only it's happening in secret, without any discussion, for reasons she's not entirely sure of. The second way we learn about trouble is if it stares us in the face: He comes in drunk, leaves a joint around, stays out all night. A teen who transgresses so blatantly wants you to find out, says Johnson. It's as if he's saying, "Pay attention!" If we notice but keep silent, his only recourse is to escalate the behavior. Even if we do notice, even if we have constructive, soul-searching conversations, if we keep silent to the rest of the world as if nothing is different or wrong, that makes the behavior a secret. Here's how a teen likely interprets that: What I've done is too shameful to speak of; Mom and Dad are hypocrites: They care more about what their friends think than they do about me; Only perfection is good enough; Mom and Dad can't face the truth. Johnson says teens turn these messages on themselves. "They'll see your silence as reflecting on them: 'Underneath, I'm so bad, even they have given up on me.' For girls, that can fuel depression and eating disorders. For boys, it turns into anger and more acting out." If we consider this a matter of privacy, boundaries, and respect rather than secrecy, which implies shame and failure, the picture changes dramatically. "We all have situations we don't want to share outside the family," says child psychologist Carolyn Newberger of Judge Baker Children's Center. "That's not the same as denying problems exist." She says the best outcomes occur when we talk with our teen about whether, who, and how anyone not involved in the situation needs to know. Many teens will say, "I don't want anyone to know," and that's a decision we should respect as far as their friends go, says Newberger. It is not a teen's decision, however, to keep it from the other parent. Except if that parent has a history of being explosive and could harm a child, keeping the problem from him or her gives a teen a sense of extraordinary power and creates an unhealthy alliance between the two of you. Your agreement to secrecy also endorses that parent's inadequacies, according to Gordetsky. "It's very destructive," she says. A response she recommends: "Your father needs to know about this too, so we can work together to help you." As for telling other people, Johnson suggests what she calls participatory parenting: "Once the problem is stated out loud - 'You got arrested for drunk driving' - and there's a plan in place for discipline, prevention and/or reparation, then you can say, 'We need to talk about whom to tell.' For instance, 'Can Grandpa handle this?' " Talk also about whom you want to tell for your own needs: "I want to tell Aunt Peg. I trust her, and she's a good sounding board for me." Or: "I have feelings about this, too. I need to talk to a few people I trust." It's OK, indeed healthy, to want to protect your child and to be realistic with him, says psychologist Mary Ann Rafoth, who is chair of educational psychology at Indiana University of Pennsylvania. She suggests saying, "There are some people who will think less of you if they know about this. We know you're not a bad kid, and we don't want other people to jump to conclusions. Whom do you think we can trust with this?" If the transgression is public knowledge, acknowledge that there may be nasty gossip: "This is hard stuff, what you're going through right now. But we know how hard you're working to undo the damage, and we love you and believe in you." Gordetsky says that by making these decisions collaborative, there's no room for the insidious, negative messages that secrets spawn. The conversations can even be healing, she says: "They're important statements about your family. That you take things seriously, face things together, and work together." It is nearly four years since Judith Warren's son's troubles surfaced. In that time, she's worked through her sense of shame, and he's worked through his problems. "He became an Eagle Scout, graduated high school, is self-employed and off drugs," she says proudly. She speaks today in the hope that other parents won't repeat her mistake. "What I wanted more than anything," she says, "was someone to support the hope inside of me that everything would turn out OK. It was a desperate hope based on my love that the core inside him was good and he could get back to that." She's grateful to her sister-in-law, but one person was not nearly enough: "There is help and support out there, but you have to be trusting enough to look for it." SIDEBAR The compassionate parent Don't leave a younger sibling in the dark. If the transgression is public, he needs to know what people might say, and how to respond. If it's something that can be kept within the family, tell him, "What your brother did was wrong, and we're taking steps to make sure it never happens again. It's up to him and us to decide whether to tell anyone outside the family." Reassure siblings that a teen is safe: "I know you've learned how bad drugs are. Josh realizes how bad they are now, too, and we're getting him help so he'll never do drugs again." If it's appropriate, be clear that Josh is taking responsibility for his actions: "He's working to pay for what he stole." If you want to share a secret from your teenage years, along the lines of "I did the same thing once," be clear about why you're sharing: "I'm telling you not because it's OK to do this but because I realized what a bad choice I made." Otherwise, a teen may throw it in your face later on: "Well, you did it!" Don't blow out of proportion a mistake made by a good kid who learns his lesson. The typical teen will be grateful if you say, "OK, that's done. Let's move on." At the same time, be clear that if there is a repeat, you will need outside help. The more support parents have before a crisis, the better. School psychologist Mary Ann Raforth encourages schools to set up occasional informal discussion groups so parents can be connected to one another and clued in to peer issues. Posted by Barbara Meltz at 03:54 PM Print | E-mail to a friend | Permalink | Subscribe via rss feedback form | help | site map | privacy policy | rss © The New York Times Company

医学

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Home→Collections→SurgeryMedical bungling most likely killed GarfieldUnsanitary conditions probably resulted in an infectionOctober 15, 2011|By Frederick N. Rasmussen, The Baltimore SunBaltimoreans were astonished to find resting on their porches and steps early on the morning of July 3, 1881, an "Extra" edition of The Baltimore Sun. This was a first time in The Sun's 44-year history that the paper had been printed on a Sunday, and it was for urgent reasons. (It would not regularly start publishing a Sunday edition for another 20 years, on Oct. 6, 1901.) The gravity of the extra was instantly obvious. It told of the attempted assassination of President James A. Garfield in a Washington railroad station, as he was about to board a train with his two sons for a visit to his wife, Lucretia, who was recuperating from a case of malaria on the Jersey Shore at Elberon. Ominous headlines said it all: TELEGRAPHIC NEWS. FROM WASHINGTON. ATTEMPTED MURDER OF THE PRESIDENT. ARREST OF THE ASSASSIN. GRAPHIC ACCOUNT OF THE SHOOTING. A SKETCH OF THE WOULD-BE MURDERER. THE PRESIDENT STILL ALIVE. HIS CONDITION HOPEFUL. "The change from the busy but to most men the trifling rivalries and intrigues of political life at the nation's capital to the sharp, clear-cut occasion when a pistol-shot echoes through the world and brings all suddenly to a reality that all men can appreciate, to life and death, is a change not often made here," reported the newspaper. "These few occasions are the cameos of history, cut and set into the solid stone that makes imperishable history. The mad attempt upon the life of James A. Garfield, President of the United States, by Charles Guiteau, at the depot of the Baltimore & Potomac Railroad yesterday, was such an occasion." Medical bungling, which would claim Garfield's life 80 days later, began immediately when the stricken president, still lying on the station floor, was attended by Dr. Smith Townsend, the first physician to arrive on the scene. He probed Garfield's wound, inserting an unsterilized finger, in search of the bullet. He almost certainly introduced "an infection that was far more lethal than Guiteau's bullet," writes Candice Millard in her recently published "Destiny of the Republic." Removed to a second-floor room, Garfield turned to another physician, Dr. Charles Purvis, and asked what his chances were. "One chance in a hundred," Purvis replied. "We will take that chance, doctor, and make good use of it," said the president. Standing in the room was Robert Todd Lincoln, son of the murdered president and Garfield's secretary of war. He suggested that Dr. D. Willard Bliss, who had attended his father, be brought into the case. Lincoln, in addition to being present when his father died, was in the station that morning with Garfield and was also with President William McKinley when he was assassinated in Buffalo, N.Y., in 1901. Like Townsend, Bliss, who was considered something of a quack, had little regard for the theories of Dr. Joseph Lister, who had founded and was a vocal proponent of antiseptic surgery, at a time when surgeons wielded unsterilized instruments in multiple surgeries while dressed in bloody gowns. At the time, the seriously ill or injured naturally feared hospitals, which were considered nothing more than pesthouses from which few souls who entered emerged alive. Garfield was transported to the White House from the station. There for the next 80 days, doctors — who grew to a team of 10, all of whom had unwashed hands — probed the wound, unsuccessfully searching for the elusive bullet, while removing particles of bone and fabric. Alexander Graham Bell, inventor of the telephone, arrived in Washington with an electrical device he called the Induction Balance. Medical advisers reassured Bell that there was no metal in the bed that would throw off the probe, but they failed to realize that underneath the horsehair mattress were steel wires. Bell was unable to locate the bullet. If Garfield had had the benefits of X-ray, which came 15 years later, the bullet, lodged beneath the back in the fatty tissue near the pancreas, would have been instantly located and removed, ensuring his survival. Wishing to go to Elberon, N.J., Garfield was transported on Sept. 6 by a special Pennsylvania Railroad train. To minimize the president's discomfort, a 3,200-foot spur had been hastily constructed so the train could stop at the front door of the presidential cottage. Garfield's medical condition, as a raging infection overwhelmed him, deteriorated over the intervening days, until his death Sept. 19. He was 50 and had served a little over five months. THE END OF A NOBLE LIFE, opined The Sun. Garfield's funeral train would pass through Baltimore twice, on the trip from Elberon to Washington, and then on Sept. 23 from Washington to Cleveland for burial. After making a brief stop for an engine change, the six-car train departed Baltimore at 5:16 p.m., going westward over the Northern Central Railroad, as city church bells tolled and crowds witnessed its "melancholy passage through the northern suburbs of Baltimore," reported The Sun. Guiteau, dressed in a freshly pressed suit and shined shoes, was executed June 30, 1882, in the yard of the District Jail. At the conclusion of a prayer he had written — "I am going to the Lordy, I'm so glad" —Guiteau dropped the poem, and the executioner sprang the trap. fred.rasmussen@baltsun.com MORE:Why expansion tank is neededHere are seven of the basic rules for getting your ducts in a rowAgora's marketing tactics bring success, accusationsMinor's future arrives early Rookie didn't expect to make a start at third this seasonMichael Phelps and his high-altitude sleeping chamberIn his father's footsteps Related ArticlesExhibit documents the death of a presidentJuly 30, 2006Time since 1963, Thanksgiving tomorrow...November 21, 1990Assassin stalks President GarfieldOctober 7, 2011Rodgers Forge artist's latest book is about the deaths of...March 26, 2011Find More Stories AboutSurgeryGarfieldIndex by Keyword|Index by Date|Privacy Policy|Terms of ServicePlease note the green-lined linked article text has been applied commercially without any involvement from our newsroom editors, reporters or any other editorial staff.

医学

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In her own words: living with Crohn's disease Jane was diagnosed with Crohn’s disease in August of 1998. She is married, has two stepchildren and two children of her own. She runs a business out of her home, making presentation pieces for parties, weddings, and other special events. Her flu-like symptoms led to a diagnosis of Crohn’s disease. She was in remission for two years before having a flare up that landed her in the hospital. A few weeks after leaving the hospital, she was diagnosed with breast cancer. Now, two years later, Jane is in remission from both the Crohn’s disease and breast cancer. “I’ve learned to not take life for granted. Life is a precious gift.” I had flu-like symptoms. I had a low-grade temperature, no energy, and diarrhea. But the diarrhea was somewhat normal for me. I would get diarrhea before my period, or if I had a lot of stress. So I never thought twice about the fact that the diarrhea was an indication that something was wrong. But then I started experiencing severe abdominal pain. I would take Tylenol, and that would take the edge off, but then I would feel horrible again. I was having tests done along the way. I had also started to lose some weight. Then it got to the point where every time I ate, I had pain. I also got a case of iritis, which is an inflammation of your iris. My father-in-law is a gastroenterologist, so I was describing my symptoms to him. He said, “I think you have Crohn’s,” and I just laughed at him. A few weeks later, the pain had gotten so bad, it was unbearable. I went the next day to my internist and I told her I had Crohn’s. She was skeptical, but went ahead and scheduled a small bowel follow-through. I was told by several people not to expect a diagnosis right away because they often can't see it just from this test. However, my condition was raging enough that they were able to make the diagnosis of Crohn’s. My initial reaction was “Thank God, I'm not going crazy.” My next reaction was “Now what?” I knew there was no cure for the disease, and it's prone to flaring up. I was scared. I was someone who had been healthy; I was never really sick; I never had habits I had to break; I was never in the hospital except to have a baby. I was freaked out by having to be on an enormous amount of medication. I was the kind of person that if I got a cold, I would drink orange juice and chew vitamin C instead of taking pills. I was also someone who could only swallow one pill at a time. Now, I can throw down eleven at once. I guess I was scared, a little angry. But the fear and the anger made me realize that I had to be an advocate for myself. I had to learn as much as I possibly could, and make sure I asked my doctor lots of questions. At that point, I felt like the only control I had was knowledge. How is Crohn’s disease treated? I'm still on medication. When I had my flare up that put me in the hospital, I altered my diet substantially. I altered my diet when I was first diagnosed, but I made more significant changes after leaving the hospital. I take 20–25 medications a day. That includes a vitamin and iron pill, but I also take many medications related to the Crohn’s. I had a flare up in April of 2000, which put me in the hospital for six days. I was having the same symptoms that I initially had before the diagnosis. I was constantly uncomfortable, and I had lost a lot of weight. They did a CAT scan, and the next day they put me in the hospital. I was on IV fluids and IV antibiotics. They chose to treat it medically, instead of surgically. Did you have to make any lifestyle or dietary changes in response to having Crohn’s disease? It was hard to go out places. There were many things I couldn't eat, like salads. When you go to someone’s house you don't want to say, “Hey, can you just fix me a baked potato?” It required that I learn to deal with that kind of situation. I had to stay away from things like popcorn and other foods that are hard to digest. Because it was awkward, for a long time I just didn’t go out. I wanted to stay close to home. As I began to tell people, it was easier to get out and do things. My husband and I used to love to eat Chinese food, but now there is nothing that makes me more nauseous. I didn’t look forward to meals. For four years, I ate very cautiously. There were so many foods that made me hurt. Now that I'm in remission, I just try to be careful, but I don't deprive myself of some of the foods I really enjoy. I discovered the Crohn’s and Colitis Foundation because my doctor gave me a free membership. I went to a symposium, and at that symposium, I met my best friend. She's fabulous, and she has Crohn’s. She understands me and I understand her. If I didn’t have her, I would be six feet under. The Crohn’s and Colitis Foundation is great! My husband and my doctors have also been very supportive. Does having Crohn’s disease have any impact on your family? I just was not available to do what I usually do. I tried really hard to do as much as I could, but it was very difficult. I had very little energy. My girls were frequently frustrated by my inability to do things for them. They were too young to fully “get” what was going on. They were 9 and 10 at the time. They weren't real sensitive, and that really bothered me. It hurt. My husband on the other hand, was so supportive, and so understanding. Constantly trying to even things out for me. I'm very fortunate. My extended family was also very wonderful. It's a very difficult thing to deal with because it's chronic. It was frustrating during the process of trying to find out what was wrong. Then once they knew, they had to deal with it and accept it. What advice would you give to anyone living with Crohn’s disease? I would tell them to seek out someone who's been through it. Someone who could talk about gas and farts, and not be embarrassed. It's not a visible disease, so it's very easy to feel alone. Get involved and raise awareness. It's a way to feel like you have control. Do as much as you can to help. Be part of the solution. I kept a journal, which was helpful for me to express how I was feeling, as well as to have an accurate record to share with my doctor. The biggest thing is to find a way out of the fear.

医学

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Medical Groups Clash Over Missouri Bill Creating New Class of Health Provider By Alex Smith Jul 2, 2014 ShareTwitter Facebook Google+ Email Missouri legislators have approved a plan creating a new class of health provider to address the shortage of physicians in rural areas. Credit Alex Smith / KCUR Listen Listening... / 5:27 Over a fifth of Missourians, especially those who live in rural areas, don't have adequate access to doctors, according to the Department of Health and Human Services. Now the state Legislature has approved a plan to address the problem by creating a new kind of health occupation. The first such plan in the country, it has pitted health providers against one another amid concerns about its effect on the health of patients and the dilution of professional standards. Medically underserved Richard Oswald is a 64-year-old farmer who grows corn and soybeans in Atchison County, Mo., in the northwest corner of the state. At the end of a recent workday, he explains that, once again, his corn is coming up early this year. “The old axiom is ‘knee high by the Fourth of July’ and that’s not true anymore,” Oswald says. “It’s head high by the Fourth of July these days.” The growing season is not the only thing that has changed in Atchison County. When Oswald was younger, most small towns in the area had their own doctor — even ones who made house calls — but those days are long gone. “The last time I tried to get an appointment with the local doctor, I was told it would be about three weeks out,” he says. Atchison County is classified as a medically underserved area by the government, and the lack of doctors has forced Oswald to leave the state in search of one. “That’s why I did what I did and went across the Missouri river to a town called Auburn, Nebraska,” Oswald says. Assistant physicians One possible solution to the problem faced by places like Atchison County was proposed on the opposite side of the state by St. Louis plastic surgeon Edmond Cabbabe. He says he realized that many recent medical school graduates were having trouble finding residencies. “They’re sitting there idle,” Cabbabe says. “They cannot earn any living. They cannot gain any experience, and there was no solution available to them.” Of more than 17 thousand medical school graduates in the United States this year, about 600 didn’t match for a residency. Cababbe’s plan would allow these graduates to work in medically underserved areas in Missouri as primary care doctors. While most med school graduates go on to spend at least three years getting additional training as resident physicians, these recent graduates would be licensed as so-called assistant physicians. Ten percent of their work would be reviewed by a fully-licensed doctor. “So they are not going to be doing the practice on their own,” Cabbabe says. “They’re going to be supervised a little bit. They’re going to have to be trained a little bit before they can get into the system.” The plan won the support of the Missouri State Medical Association, and a bill to create assistant physician licensing was sponsored by state Rep. Keith Frederick, a Rolla Republican who is an orthopedic surgeon. Frederick explains that Missouri already has a program that offers tuition reimbursement to doctors who agree to work in underserved areas. “But there’s still a great need, particularly in our rural areas, where we just haven’t been as successful as we would like,” he says. Physician assistants If members of the public are likely to be baffled by the name similarity between "assistant physician" and "physician assistant," a recognized occupation, they're not alone. “I’m just sort of confused,” says Paul Winter, president of the Missouri Academy of Physician Assistants. About 900 physician assistants work in Missouri, and their group opposes the assistant physician plan. It's not just the similar names, says Winter. Last year Representative Frederick championed a plan that loosened restrictions on physician assistants to make it easier for them to practice in rural areas. That plan was passed into law and hopes were high that physician assistants would help fill the rural healthcare gap. Winter believes a lot can be done with physician assistants under the new laws, and he was surprised that Frederick has proposed what seems to be the creation of a competing position. “If we’re not fully utilizing PAs to their maximum ability in the state of Missouri, then I have to question — Why are we inventing a new profession?” he asks. Despite the concerns of Winter’s group, the bill to allow assistant physicians was approved by the state Legislature on the final day of the session. National attention Since then, the plan has attracted the attention of national groups, concerned not just with its statewide implications but its possible spread to other states. In mid-June, the American Medical Association House of Delegates passed a resolution rejecting the assistant physician concept. “We should not replace a hardship with a danger,” one delegate said. The American Academy of Physician Assistants also weighed in, encouraging Missouri Governor Jay Nixon to veto the bill. The academy’s Ann Davis says the group's main concern is the potential lowering of medical standards because of people’s rural location. “Groups that have some of the biggest problems with access to care now are being offered a professional that otherwise would not be licensed in Missouri or anyplace else,” she says. Cabbabe dismisses those concerns. He notes that, with four years of medical school, which includes two years of clinical rotation, assistant physicians would have more than enough training for the work. “For the role they are playing, they are much more qualified than an actual physician assistant or a nurse practitioner,” he says. Crucial need Back in Atchison County, concerns over quality and job title don't matter as much to Richard Oswald as the glaring lack of health providers. Remembering a handful of health scares when his children were growing up, he supports the assistant physician plan, if only as a way to fill a crucial need. “I think anything to bring better health care and more availability here is undoubtedly going to save lives,” he says. Gov. Nixon has until July 14 to sign or veto the bill creating assistant physicians. Without action from him, it automatically becomes law. Tags: physician assistantKeith FrederickHeartland Health Monitor Bill Expands Opportunities For Physician Assistants In Missouri 3 years ago View the discussion thread. © 2016 KCUR

医学

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Will Americans quit smoking for the love of their pets? February 10, 2009 | 10:19 If smokers won't quit for their own health, or even for the health of their (human) families, will they quit for their pets? The authors of a new study published today in the journal Tobacco Control think they just might. Our colleague Shari Roan at the Booster Shots blog has the details:Secondhand smoke is as dangerous for pets as it is for the non-smoking people who live with smokers. Non-smokers who live with smokers have to worry about the risk of lung cancer and respiratory diseases. But even dogs and cats exposed to secondhand smoke have an increased risk of lung cancer, allergies, eye and skin diseases and respiratory problems. Few smokers realize the health impact on their pets, however, said the authors of the study. The researchers, from the Center for Health Promotion and Disease Prevention at the Henry Ford Health System in Detroit, conducted an online survey of 3,300 people, 1 in 5 of whom were smokers and 1 in 4 of whom lived with a smoker. More than one-quarter of the smokers said that knowing that smoking was bad for their pets would motivate them to give it up. Among nonsmokers who lived with smokers, 16% said such knowledge would prompt them to ask their partners to quit. Almost 20% of the smokers and 40% of the nonsmokers said they would not allow smoking inside the house if it imperiled their pets."It's not necessarily that people love their pets more than they love themselves or their children, it's just another motivational factor for people to consider quitting smoking," Sharon Milberger of the Henry Ford Health System, who led the research, told Reuters. About 20% of American adults identified themselves as smokers in a 2007 study (the most recent one available), according to the American Cancer Society. -- Lindsay Barnett Photo: Dimas Ardian /Getty Images

医学

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RESEARCH IN PULMONARY HYPERTENSION "PHA's research program has yielded an explosion of understanding about PH that was not known before." – John Newman, MD, Vanderbilt University Medical Center Twenty years ago there were no pulmonary hypertension treatments available. Through focused research there are now fourteen PH-specific treatments with more in development. But we know that your ultimate wish is for a cure, and that is why PHA will continue to support the work of researchers until the day when no one suffers from PH. PHA’s Research Program PHA's Research Program has committed more than $17 million for PH research by leveraging partnerships with the National Heart, Lung, and Blood Institute (NHLBI) and the American Thoracic Society (ATS). We have supported 70 promising researchers through four independently reviewed, cutting-edge research programs. PH Treatments: What's on the Horizon View a recording on PHA Classroom of a May 2015 webinar in which Dr. Ioana Preston of Tufts Medical Center covers the current treatments available for PH as well as new treatments in the pipeline. Current Treatments PHA’s Scientific Leadership Council’s Education Committee has put together comprehensive fact sheets on all the treatments available for pulmonary hypertension. Stay informed about ongoing clinical research pertaining to evaluation and treatment of pulmonary hypertension through PHA's PH clinical trial listings, and be sure to post information about the PH clinical trial work you are doing. Research Corner in Pathlight Every issue of Pathlight, PHA’s quarterly magazine, features a Research Corner with information about some of the latest research.

医学

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Psychotherapy Improves Long-term Survival of Patients With Gastrointestinal Cancer “You have cancer.” Once the initial shock wears off, patients deal with a barrage of emotions (fear, uncertainty, denial, anger); concerns (How will my life change now? What will happen to my family?); and questions (How long will I live? What’s my best treatment option?). It stands to reason that some sort of emotional support might help during this trying time. But could psychotherapy do even more than that—could it actually improve long-term survival? In a study published in the July 1, 2007 , researchers compared long-term survival in patients with gastrointestinal cancer who did and did not receive psychotherapy in addition to standard care. They found that patients who received psychotherapy were significantly more likely to remain alive ten years after their cancer diagnosis than patients who did not receive psychotherapy. The researchers enrolled 271 men and women who had been diagnosed with cancer of the colon/rectum . Half of the patients had surgery to remove the cancer and then routine care during their hospital stay. The other half also had surgery and routine care, but in addition, they participated in one-on-one sessions with a psychotherapist before and after surgery. The goal of the psychotherapy was to foster a fighting spirit in the patients and to discourage hopelessness and helplessness. The researchers tracked patient survival for ten years following surgery. At ten years, 29 of 136 patients who received psychotherapy were still alive, compared to 13 of 135 patients who received standard care. This was a significant difference. The difference remained significant even after researchers took the site of the tumor, the stage of the cancer, and other indications of disease severity after surgery into consideration. This study suggests that psychotherapy received at the time of surgical treatment for cancer may improve long-term survival. The reasons for this observation remain unclear, especially since the researchers did not document whether or not patients continued in psychotherapy. It is also unknown whether or not this effect applies to other non-gastrointestinal cancers. When you are diagnosed with a gastrointestinal (or any) cancer, your world can change in an instant. You’re suddenly forced to make decisions about treatment, to deal with your emotions and those of your loved ones, and to consider that your future may not be what you had planned. Psychotherapy may not only provide the support you need to adjust to this major life event, it may actually help you survive your cancer diagnosis. Küchler T et al. Impact of psychotherapeutic support for patients with gastrointestinal cancer undergoing surgery: 10-year survival results of a randomized trial. J Clin Oncol

医学

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iTunes Play Store Children's environmental health Menu Children's environmental health Coordination of cohorts Global Plan of Action for Children's Health and the Environment The call for action to address children’s environmental health at the Third WHO International Conference on Children's Health and the Environment in Busan, Republic of Korea (June 2009) asked WHO to facilitate the development of a global plan of action to improve children's environmental health and regularly monitor and report on its progress. This draft Global Plan of Action is designed to provide a road map for WHO, governments, intergovernmental and non-governmental organizations, and all concerned stakeholders to contribute to the attainment of the Millennium Development Goals (MDGs) and other internationally agreed development declarations, commitments and goals, in particular those related to reducing infant mortality (MDG 4) and ensuring environmental sustainability (MDG 7). As recognized in the Busan Pledge, the successful implementation of this global plan of action requires strong partnerships and close networking. Collaboration between and among WHO collaborating centres and international organizations, such as UNICEF and UNEP, national and regional organizations, regulatory bodies, governmental agencies and non-governmental organizations is essential for putting into action the specific components of the proposed plan and gaining the most benefit from limited resources. Children's environmental health activities have multiple links with other parallel activities, such as environmental protection, climate change adaptation, primary health care, specialized hospital-based health care, emergency response, disaster risk reduction, school activities and housing initiatives, and many other activities. It thus becomes clear that collaborative links have to be set up for each one of the objectives in this plan. Also, strong collaboration across WHO programmes and with the WHO Regional and Country Offices will be necessary in order to ensure success. Global Plan of Action for Children's Environmental Health: 2010-2015pdf, 94kb If you would like to contribute to the Global Plan of Action, please respond to childrensenvhealth@who.int identifying the specific part(s) of the plan to which you can contribute. Related links Working together: WHO collaborating centres for children’s environmental health Children's environmental health Quick Links

医学

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THE WORLDWIDE HIV/AIDS PANDEMIC With Thomas C. Quinn, M.D. (Professor of Medicine, Johns Hopkins University School of Medicine) Listen GRAND OLD PARTY: A HISTORY OF THE REPUBLICANS With Lewis L. Gould (Professor Emeritus in American History, University of Texas at Austin) Listen PARTY OF THE PEOPLE: A HISTORY OF THE DEMOCRATS With Jules Witcover (journalist who has covered the Democratic Party in books and newspapers for more than half a century) Listen With Evan Imber-Black (Director of the Center for Families and Health, and Senior Faculty member of the Ackerman Institute for the Family in New York City) Listen THE ROARING NINETIES: A NEW HISTORY OF THE WORLD’S MOST PROSPEROUS DECADE With Joseph E. Stiglitz (winner of the 2001 Nobel Prize in Economics) Listen FLYBOYS: A TRUE STORY OF COURAGE With James Bradley (Writer) Listen NUCLEAR NORTH KOREA: A DEBATE ON ENGAGEMENT STRATEGIES With Victor D. Cha (Chair in Asian Studies and professor of government in the Edmund A. Walsh School of Government at Georgetown University), and David C. Kang (professor of government at Dartmouth College) Listen FRANKLIN AND WINSTON: AN INTIMATE PORTRAIT OF AN EPIC FRIENDSHIP With Jon Meacham (managing editor of Newsweek) Listen Helping The Reluctant Reader With Marilyn Kay (Director of The Reading Group, Urbana) Listen REFORM OF AGRICULTURAL TRADE With Robert L. Thompson (recently retired Director of Rural Development with the World Bank) Listen

医学

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All about each symptom of menopause HomeMenopause Symptoms Topics About:Burning Tongue Burning Tongue Overview Articles:Burning Tongue Articles Understanding Burning Mouth and TongueFollow us + Burning mouth and tongue is a painful condition characterized by a burning sensation or soreness of the tongue, but may also include the gums, lips, inside of the cheeks, or the roof of the mouth. What makes this painful condition so frustrating is the complete absence of obvious cause, such as lesions or disease in the mouth.Though not as well-known as hot flashes or mood swings, this symptom is surprisingly common during menopause - up to one-third of menopausal women will experience it, and 90% of those with burning mouth syndrome are postmenopausal. This condition is poorly understood, but its prevalence during this time period leads experts to believe that fluctuating hormones play a key role.Read on for more information about burning mouth and tongue and how to treat them. What Exactly Does Burning Mouth Feel Like?When experiencing burning mouth syndrome, a painful burning sensation is usually focused on the tongue, but may affect other parts of the mouth. The pain may range from moderate to severe, even disrupting daily life or sleep. Most patients report a gradual increase in intensity throughout the day. Other symptoms may include:Possible occurrence of dry mouthChange in the sense of tasteChange in quantity or quality of salivaBitter or metallic taste in the mouthPain may decrease when eating (especially cold foods), but it is associated with spicy food, excess talking, and stress. Burning mouth and tongue are often spontaneous, they also usually clear up on its own, sometimes a few months or years later.Who Is Affected by Burning Mouth and Tongue?Women are 90% more likely to develop burning mouth and tongue than men, and while it can occur anywhere between the ages of 27 and 87, the average age of occurrence is 61.Furthermore, burning mouth seems to occur more often in smokers or people with the following conditions:Parkinson's diseaseGastrointestinal or urogenital diseaseDepressionAnxietyBipolar disorderWhat Causes Burning Mouth?Burning mouth remains much of a mystery to researchers, as it doesn't present any obvious cause - unlike other forms of pain in the mouth. But its prevalence in menopausal women lead experts to believe that the decrease of estrogen and progesterone may have an effect. These hormones interact closely with the neurological and nervous systems, and may cause neuroprotective steroids to decline, which in turn may lead to the degeneration of certain nerve fibers. However, there are other possible causes of a sore tongue or burning sensation in the mouth:Local factors. Dry mouth, oral infection, lesions, parafunctional habits like clenching, and allergic reactions may lead to a burning sensation.Systemic factors. Diabetes, hormone imbalance, vitamin deficiency, medications, and hyposalivation conditions may induce this sensation.Psychological factors. Depression, anxiety and related disorders, and psychosocial stress are indirect causes of burning tongue.How Is Burning Mouth Treated?Similar to its elusive cause, burning mouth syndrome is difficult to treat. However, there are a few promising suggestions:Drink plenty of fluidsTake B-complex vitamins and zincAntioxidantsPain relieversCognitive behavioral therapyAnxiety and stress-reduction techniquesRead more information about combating burning mouth and tongue. Share Tweet Share Learn more: Burning Tongue Overview Burning Tongue Treatments Burning Tongue SyndromeRead on for more information about burning tongue syndrome and how to treat it. How to Recognize Burning TongueAlthough there is no definitive cure for burning tongue, there are several ways to cope with the pain.Sources:Buchanan, John AG, & Zakrzewska, Joanna M. (2008). BMJ Clinical Evidence: Burning mouth syndrome. Retrieved on May 20, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907957/Dahiya, Parveen, et al. (2013). International Journal of Preventive Medicine: Burning Mouth Syndrome and Menopause. Retrieved on May 20, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3570906/Gurvits, Grigoriy E, & Tan, Amy. (2013). World Journal of Gastroenterology: Burning mouth syndrome. Retrieved on May 20, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3574592/Vaidya, Rama. (2012). Journal of Mid-life Health: Burning mouth syndrome at menopause: Elusive etiology. Retrieved on May 20, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3425145/ Find us on:Our ManifestoWe strive to be the most informative menopausal health website. Over the years we've helped millions of women go with knowledge through the menopause transition. We encourage everyone to read and learn about menopause in order to achieve a healthy lifestyle.Additional Information About usPrivacyTerms of use©Copyright 2016. Understanding Burning Mouth and Tongue. All rights reserved.The content of these informational pages is for educational purposes and health care support only and does not intend to be used for diagnosis or treatment of a health problem or as substitute for consulting a licensed medical professional.

医学

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The ADHD Report (One Year Subscription) Russell A. Barkley, Ph.D.& Associates One-year subscription (6 Issues) This accessible newsletter provides a single reliable guide to the latest developments, newest topics, and current trends in ADHD. An indispensable resource, the ADHD Report examines the nature, definition, diagnosis, developmental course, outcomes, and etiologies associated with ADHD, as well as changes occurring in the fields of education and clinical management. It includes handouts for clinicians and parents, as well as annotated research findings. Outside the U.S., add $8.50 for one year subscription. (Will not be calculated in total)Reviews "The ADHD Report provides a highly readable, interesting, and enjoyable way for professionals and lay persons alike to keep up with developments in the field. Articles are authored by well-recognized experts in the field and are timely and original. Topics run the full gamut, including diagnosis, treatment, accompanying symptoms and impairment, long-term outcome, and etiology, as well as advocacy and public policy." -Mary V. Solanto, PhD, Director, ADHD Center, The Mount Sinai Medical Center, New York, NY "As manager of psychological services in a large school district, I have found The ADHD Report to be a valuable tool in promoting understanding of ADHD and other behavioral disorders. Our school psychologists value the Report's research and empirical data, which often translate into immediate school-based application." -Robert Templeton, EdD, Manager, Psychological Services, School District of Palm Beach County, Florida "The ADHD Report is an excellent resource for clinicians, teachers, and parents. Importantly, the Report does not shy away from controversial studies and treatment methods, but includes reviews of such methods as well as evidence of their effectiveness. This willingness to review all types of treatments and refute weak claims and data is science at its best. Dr. Barkley's contributions to ADHD research are impressive, and his efforts to transmit the latest knowledge to subscribers are to be commended. I recommend the ADHD Report to anyone who seeks to stay up to date in this field." -Rachel Brown-Chidsey, PhD, School Psychology Program, University of Southern Maine "I have been receiving and thoroughly enjoying the ADHD Report since the very first issue. As a developmental/behavioral pediatrician with a practice primarily devoted to ADHD and learning disabilities, I have found this newsletter to be a tremendous aid to my practice. The mix of practical articles, research updates, and reviews, including coverage of cutting-edge findings and debates, have greatly enhanced my ability to serve my patients. It is amazing how much useful material can be crammed into 16 pages." -Martin Baren, MD "The educational information in The ADHD Report is infinitely valuable in helping me raise my own 7-year-old boy. It is also of vital importance to the nearly 300 parents with whom I come in contact all year through this support group. This newsletter is informative, well-written, professional, and interesting." -Cindi Wolfe, Director, Parents Helping Parents of San Luis Obispo, ADHD Support Group

医学

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Schwarzenegger vetoes Medi-Cal AIDS drugs spending By August 03 2004 12:00 AM EDT California governor Arnold Schwarzenegger on Saturday used his line-item veto power to cut $750,000 from the state's 2005 budget that would have maintained Medicaid reimbursement rates for anti-HIV medications distributed at local clinic pharmacies, the Los Angeles Times reports. The veto won't affect the drug prices charged to Medicaid patients but could reduce how much clinic-based pharmacies are reimbursed by the state for the Medi-Cal medications they disburse to HIV-positive patients. That could force many to simply stop participating in the state Medi-Cal program to avoid financial losses, AIDS advocates say. While HIV patients would still be able to get their medications at pharmacies that continue to participate in Medi-Cal, particularly at large chain pharmacies, it would eliminate "one-stop shopping" services offered at community-based AIDS clinics. The Los Angeles-based AIDS Healthcare Foundation, the nation's largest provider of HIV care, plans to challenge the veto in court. "The [Schwarzenegger] administration is attempting to save money to the Medi-Cal program through pharmacy rate restructuring," AHF president Michael Weinstein told the Times. "But driving very ill patients away from clinic-based pharmacies...is just bad policy and bad medicine." Schwarzenegger and state lawmakers were praised by AIDS activists for boosting spending on the state's AIDS Drug Assistance Program by $27 million in 2005. The funding increase will allow the program to avoid capping its enrollment to keep costs down. Schwarzenegger had originally proposed capping enrollment in the program at its current level of 23,900 enrollees. Activists say the enrollment cap would have created a waiting list of more than 1,400 people by the end of 2005. Tags: Health, Health READER COMMENTS ()

医学

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Zebrafish are the new guinea pig for medical research The stereotypical picture of a scientist includes a white lab coat and a laboratory full of petri dishes, beakers and test tubes. However, some research questions can only be answered using the complexity of living, breathing multicellular organisms. In these cases, preliminary studies use animal models, and if successful, the final stages of development for a new drug or therapy are conducted using human subjects. Tuesday, December 4, 2012 - 15:53 Using mice, University of Minnesota researchers find new target for Alzheimer’s drug development Researchers at the University of Minnesota’s Center for Drug Design have developed a synthetic compound that, in a mouse model, successfully prevents the neurodegeneration associated with Alzheimer’s disease. Tuesday, December 4, 2012 - 13:10 NIH study shows improvements in animals with Down syndrome characteristics Mice with a condition that serves as a laboratory model for Down syndrome perform better on memory and learning tasks as adults if they were treated before birth with neuroprotective peptides, according to researchers at the National Institutes of Health. Using mice, UI researchers discover newcause for Hydrocephalus Researchers at the University of Iowa have discovered a new cause of hydrocephalus, a devastating neurological disorder that affects between one and three of every 1,000 babies born. Working in mice, the researchers identified a cell signaling defect, which disrupts immature brain cells involved in normal brain development. Tuesday, November 20, 2012 - 15:28 Nose cell transplant enables paralysed dogs to walk Scientists have reversed paralysis in dogs after injecting them with cells grown from the lining of their nose. Monday, November 19, 2012 - 16:37 Parasitic Worm Eggs Ease Intestinal Ills by Changing Gut Macrobiota Intestinal issues are not just for us humans. Whereas the inflammatory bowel disease (IBS) now afflicts some 1.4 million people in the U.S., a similar condition often besets captive monkeys. But these animals are providing new insights about a cure for this condition in both species—and that cure is worms. Friday, November 16, 2012 - 15:27 Using mice, UPenn team unravels a Parkinson's mystery Parkinson's disease appears to spread through the brain by means of a simple, yet insidious mechanism, according to research to be published Friday by University of Pennsylvania scientists.When molecules of a certain protein become corrupted in the brain, they can pass on their distorted shape to healthy proteins through nothing more than physical contact.Like something out of a bad science-fiction movie, more and more healthy proteins latch onto the ones that have gone bad, adopting their "misfolded" configuration until deadly clumps build up in brain cell after brain cell, the Penn team found in its study of lab mice. Watching the developing brain in mice, scientists glean clues on neurological disorder UNC researchers track a gene’s crucial role in orchestrating the placement of neurons in the developing brain. Their findings help unravel some of the mysteries of Joubert syndrome and other neurological disorders. Thursday, November 15, 2012 - 16:14 Targeted peptide-estrogen combination found effective and safe for treating obesity in mice Scientists at Indiana University and international collaborators have found a way to link two hormones into a single molecule, producing a more effective therapy with fewer side effects for potential use as treatment for obesity and related medical conditions. Wednesday, November 14, 2012 - 10:57 Jellyfish-inspired device that captures cancer cells from blood samples could enable better patient monitoring Tumor cells circulating in a patient's bloodstream can yield a great deal of information on how a tumor is responding to treatment and what drugs might be more effective against it. But first, these rare cells have to be captured and isolated from the many other cells found in a blood sample. How surgery for pets could save human lives Many devoted pet owners are happy to spend thousands on operations for their cats and dogs – and these procedures could help teach scientists about human diseases, too. Monday, November 12, 2012 - 17:25 Ear powered batteries: researchers harvest enough energy from guinea pig’s inner ear to run tiny sensor Researchers use the electric potential of a guinea pig’s inner ear to harvest enough energy to run a tiny sensor. In-sync brain waves hold memory of objects just seen. Brain's code for visual working memory deciphered in monkeys The brain holds in mind what has just been seen by synchronizing brain waves in a working memory circuit, an animal study supported by the National Institutes of Health suggests. The more in-sync such electrical signals of neurons were in two key hubs of the circuit, the more those cells held the short-term memory of a just-seen object. Friday, November 9, 2012 - 12:23 Rats control human avatars Biologists are well-known for using lab rats in experiments, but a few may now have the chance to work with rats in a unique way.A team of engineers has set up a system that lets lab rats control a human-shaped avatar in a virtual environment, while humans control a rat-size robot inside the rat's cage. The result? A six-foot human and a six-inch rat get to interact with each other remotely, and they get to each get to see either a virtual avatar or a robot that's close to their own size. In mice, a treatment for lung cancer For mice, the Goliath of lung cancer has a vanquisher in the form of a tiny David. In a study published in the November issue of Cancer Research, Yale biology researchers Frank J. Slack and Andrea Kasinski revealed that short strands of microRNA, non-coding RNA inhibiting protein translation, were successful in both preventing and curing lung adenocarcinoma in mice. The research is the first to propose that, in a clinical trial using mice, microRNA can be used as a therapeutic to suppress the activation and expression of oncogenic, or cancer-causing, proteins. Thursday, November 1, 2012 - 15:52 Hurricane Sandy's lesser-known victims: Lab rats Among the smaller but still important casualties of Hurricane Sandy were thousands of laboratory rodents, genetically altered for use in the study of heart disease, cancer and mental disorders like autism and schizophrenia, that drowned in basement rooms at a New York University research center in Kips Bay. Thursday, November 1, 2012 - 15:51 Primates' brains make visual maps using triangular grids Primates' brains see the world through triangular grids, according to a new study published online Sunday in the journal Nature. Scientists at Yerkes National Primate Research Center, Emory University, have identified grid cells, neurons that fire in repeating triangular patterns as the eyes explore visual scenes, in the brains of rhesus monkeys. Wednesday, October 31, 2012 - 10:02 Scientists create first mouse model of typhoid fever Columbia University Medical Center (CUMC) researchers have created the first true mouse model of typhoid infection. The development promises to advance the study of typhoid and the creation of new vaccines against the infection, which remains a major health threat in developing countries. The paper was published today in the online edition of the journal Cell. Friday, October 26, 2012 - 10:55 The ethic of care - Respect for animals guides their treatment in teaching and research The three rats snoozing in Cage 57 don’t know it, but they could someday help save thousands of human lives. OHSU researchers test new gene therapy method in human cells...and it works Oregon Health & Science University's development of a new gene therapy method to prevent certain inherited diseases has reached a significant milestone. Researchers at the university's Oregon National Primate Research Center and the OHSU Department of Obstetrics & Gynecology have successfully demonstrated their procedure in human cells. It's believed that this research, along with other efforts, will pave the way for future clinical trials in human subjects.

医学

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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 . 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. 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. Friday, May 4, 2012 - 15:08 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. Blind Mice Given Vision Lead Wave of Regenerative Medicine Tools Mice got new vision and revived heart muscles and monkeys were able to flex muscles in paralyzed hands in research reported today that has extended the boundaries of regenerative medicine beyond the test tube. Friday, April 20, 2012 - 15:52 Blood Test Derived from Rats Helps Diagnose Depression in Teens A Northwestern Medicine scientist has developed the first blood test to diagnose major depression in teens, a breakthrough approach that allows an objective diagnosis by measuring a specific set of genetic markers found in a patient’s blood.

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Igniting the conversation about rare diseases (BPT) - Each year, people across the world are invited to join together to raise awareness about rare diseases. Unlike more common conditions such as diabetes and breast cancer, many of these diseases, as well as the people affected by them, are not recognized by their own awareness initiatives throughout the year. Yet for people living with rare diseases and their loved ones, the path to a confirmed diagnosis, adapting to new treatment regimens, and facing the day-to-day challenges of these diseases can often be overwhelming.The goal of Rare Disease Day is to provide awareness of lesser known diseases, and to recognize each respective patient community while highlighting the great strides that are being made in medical research. This year, disease education activities will take place Feb. 28, with local events held across the globe to help build community support and awareness.By definition, a rare disease is an illness that affects fewer than 200,000 people in the U.S. While individually, each of these approximately 6,800 such diseases in the U.S. are defined as rare, when considered together they impact nearly 30 million Americans or almost one in 10 people, according to the National Institutes of Health.“Our organization understands the importance of Rare Disease Day and aims to provide a voice for patients and families to bring to light the need for continued development of new treatments,” says Mary Dunkle, Vice President for Communications, National Organization for Rare Disorders (NORD). “For example, people affected by rare diseases such as chronic myeloid leukemia or Cushing’s disease can feel alone, and share the burdens of minimal treatment options.”Breakthrough research has sometimes put a more public face on rare diseases, such as chronic myeloid leukemia (CML), a cancer of the blood and bone marrow characterized by the presence of an abnormality called the Philadelphia (Ph) chromosome. Worldwide, CML is responsible for 10 to 15 percent of all adult cases of leukemia, with an incidence of one to two cases per 100,000 people per year. During the past decade, researchers have refined increasingly sensitive tests to detect traces of cancer in patients treated with new medicines.The rare endocrine disorder, Cushing’s disease is a form of Cushing’s syndrome, in which excess cortisol production is triggered by the presence of a non-cancerous pituitary tumor. Cortisol is a vital hormone that regulates metabolism, maintains cardiovascular function and helps the body respond to stress. While incidence is one to two patients per million per year, Cushing’s disease is a serious, debilitating disorder. It most commonly affects adults from 20 to 50 years old and affects women three times more often than men. Cushing’s disease may present with weight gain, central obesity, a round, red full face, severe fatigue and weakness, striae (purple stretch marks), high blood pressure, depression and anxiety. It can cause severe illness and death with mortality up to four times higher than in the healthy population.Rare Disease Day was originally created by EURORDIS, The European Organization for Rare Diseases, in 2008 and expanded to include the U.S. the following year with help from NORD. Since the inception, there have been significant advances in management of diseases that are defined as rare. The goal is to continue this momentum and keep the conversation going to encourage more progress. To learn more information about CML, visit www.CMLEarth.com. To learn more about Cushing’s disease, visit www.cushingsdisease.com.

医学

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This new estimate formula, developed from a study that will appear in the Journal of the American Society of Nephrology in March, could prove a valuable tool for adjusting fluids, antibiotics and chemotherapy and more accurately assessing kidney function in children battling chronic kidney disease (CKD). This formula can be used to estimate glomerular filtration rate (GFR) the rate at which fluid is filtered through the kidneys quickly and without infusing any synthetic substances. It was developed from a multi-site NIH-funded study for which the University of Rochester serves as the central biochemistry laboratory. "Most other formulas used to estimate kidney function in children with CKD are singular to their institutions or hospitals. In addition, most clinicians are unaware of what biochemical analyses are being used by their institutions to measure waste products excreted by the kidney, such as creatinine and blood urea nitrogen (BUN), and different analyses would yield different estimate formulas," said George J. Schwartz, M.D., chief of Pediatric Nephrology at the University of Rochester Medical Center's Golisano Children's Hospital at Strong and director of University of Rochester's biochemistry lab. "An accurate estimate is crucial to properly treat children with acute and chronic kidney problems and the scale of this study makes its findings quite significant." The study included 349 patients from more than 50 institutions across North America and was based on data collected by the CKiD Study, which was funded by the National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health. Schwartz is a principal investigator in the Chronic Kidney Disease in Children (CKiD) Cohort Study. The new GFR formula generated by the study is based on height and gender, serum creatinine and BUN, and cystatin C a ubiquitous protein that is well-correlated with kidney function. These factors can be quickly and easily measured in a clinical setting without the need for radioactivity or urine collection. "Clinicians can easily specify the gender and height of a child during a regular clinical visit. A basic chemistry panel on a very small sample of blood will determine the level of serum creatinine and BUN, while a slightly more complicated method of collection will yield the cystatin C result. These five variables can effectively assess how well a child's kidney functions," said Schwartz. In addition, the study developed a quick bedside calculation that offers a good approximation of the GFR formula from the child's height in centimeters, serum creatinine level and a constant that relates this estimate to the measured level of GFR. The new Schwartz formula uses an updated method of measuring creatinine. The enzymatic analysis can measure creatinine much more accurately than the older Jaffe method, which utilized a less specific color change. The Jaffe method was used in an earlier estimated GFR formula that Schwartz developed in the mid-1970s. The study focused on finding a more precise GFR estimate formula for children with CKD because chronic kidney disease does not go away and tends to worsen over time, eventually resulting in kidney failure. "Because children with CKD are more in danger of progressing to kidney failure than children with normal kidney function, we decided it was imperative to find an accurate estimate of GFR for children with CKD before studying other populations," said Schwartz.. "It will also be important to determine if such a formula will apply to children and infants with higher levels of kidney function, so that any harm that might come from antibiotics, chemotherapeutic drugs and dehydration can be minimized in these populations as well." '/>"/>Contact: Katie Sauer Katie_Sauer@URMC.rochester.edu University of Rochester Medical CenterSource:Eurekalert0GOODRelated biology news :1. Biochemistry of human physiology in health and disease is focus of updated clinical text2. New infant formula safety advice could prevent infant suffering3. UBC study establishes formula for predicting climate change impact on salmon stocks4. Link possible between pet food contamination and baby formula contamination5. Formula discovered for longer plant life6. Researchers study facial structures, brain abnormalities to reveal formula for detection of autism7. Louisiana Tech researchers feature drug reformulation in prestigious journal8. New formula for combating the greenhouse gas nitrous oxide9. University of Pennsylvania researchers develop formula to gauge risk of disease clusters10. Ecologists report quantifiable measures of natures services to humans11. NIAID announces 25 new awards to develop radiation countermeasures

医学

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Pharmatest Services Ltd Opens U.S. Sales Office in Cambridge, Mass. Tweet CAMBRIDGE, Mass. / TURKU, Finland – March 5, 2013 – Finnish company Pharmatest Services Ltd (Pharmatest) announced today that it has opened a new U.S. sales office in Cambridge, Mass., near Boston. The new office, located in the Cambridge Innovation Center (CIC) in Kendall Square, will provide an excellent opportunity for Pharmatest to contact and serve customers in the Massachusetts area. Pharmatest offers clinically predictive preclinical efficacy services for the pharmaceutical industry for testing their drug candidates in the fields of oncology and skeletal diseases. The company has already a wide customer base in the U.S. With the new sales office and increased U.S. sales and marketing efforts, Pharmatest expects to rapidly grow the number of U.S. customers and sales figures. “I am very excited for the opportunity to work for Pharmatest,” said Cambridge new-hire Andrew Heiniluoma, Pharmatest U.S. Sales Representative. “Cambridge is a perfect site for a U.S. sales office, and the Boston area is unique in the U.S. in terms of the presence of the pharma industry, providing an outstanding opportunity for attracting new customers for Pharmatest.” “The U.S. has the biggest market potential for our services, and we now have a clear strategy to focus on increasing our U.S. market share,” said Jussi Halleen, CEO of Pharmatest. “We are very happy to have Andy on board in Cambridge, which allows us to get closer to our customers. I am convinced that this will boost our U.S. revenues in the coming years.” “Investing in education, innovation and infrastructure is a winning growth strategy for Massachusetts and is the reason we lead the world in life sciences,” said Governor Deval Patrick. “We welcome Pharmatest to the Massachusetts biotech supercluster and look forward to the jobs and economic opportunities they bring.” Through the Massachusetts Life Sciences Center, Massachusetts is investing $1 billion over 10 years in the growth of the state’s life sciences supercluster. These investments are being made under the Massachusetts Life Sciences Initiative, proposed by Governor Patrick in 2007, and passed by the State Legislature and signed into law by Governor Patrick in 2008. “We are excited to welcome Pharmatest to the fast-growing Massachusetts life sciences supercluster,” said Susan Windham-Bannister, Ph.D., President & CEO of the Massachusetts Life Sciences Center. “Pharmatest is part of a growing community of international life sciences companies that have chosen Massachusetts as the best place to expand and do business. We are confident that Pharmatest, as a contract research organization, will find in Massachusetts the partners and client base they need to be successful.” Pharmatest is among a growing group of international companies that have recently picked Massachusetts as the place to expand their business in the U.S. “I am pleased to learn of Pharmatest’s new office in Cambridge,” said Senator Anthony Petruccelli. “Kendall Square and the City of Cambridge continue to be the most attractive environment for our life sciences industry.” “I'm thrilled to see another global company creating jobs in Cambridge,” said Representative Timothy Toomey. “Pharmatest's solid performance record is clear, and I welcome them to our community.” “I join the Governor in welcoming Pharmatest to Massachusetts,” said Tom Gradel, Manager of Business Development and Protocol Officer at the Massachusetts Office of International Trade & Investment. “Pharmatest will join a broad and deep ecosystem in the global hub of life sciences.” “Massachusetts has become the destination for the world’s most innovative companies across the entire life sciences spectrum,” said Robert K. Coughlin, President & CEO of MassBio, a 600+ member life sciences trade association. “We are thrilled to welcome Pharmatest and know they will play a very important role in our world-class life sciences ecosystem.” Pharmatest’s new U.S. office is based at: Pharmatest Services Ltd Cambridge Innovation Center Andrew Heiniluoma U.S. Sales Representative andrew.heiniluoma@pharmatest.com Angus G. McQuilken Vice President for Communications & Marketing Massachusetts Life Sciences Center amcquilken@masslifesciences.com About Pharmatest Services Ltd Pharmatest's headquarters and preclinical research unit are located in Turku, Finland, where the company operates in modern facilities, including fully-equipped research laboratories and barrier-type animal facilities. In addition to its newest office in Cambridge, Massachusetts, USA, Pharmatest has a sales office in Guangzhou, China. Pharmatest can help establish the proof-of-efficacy of cancer drug candidates with clinically predictive cell culture assays, organotypic 3D models, orthotopic animal models, and disseminated cancer models. Our models of skeletal diseases include clinically predictive bone cell culture assays and animal models of osteoporosis and osteoarthritis that can also be used for bone safety testing. For more information, visit www.pharmatest.com. About the Massachusetts Life Sciences Center The Massachusetts Life Sciences Center (MLSC) is a quasi-public agency of the Commonwealth of Massachusetts tasked with implementing the Massachusetts Life Sciences Act, a 10-year, $1-billion initiative that was signed into law in June of 2008. The MLSC’s mission is to create jobs in the life sciences and support vital scientific research that will improve the human condition. This work includes making financial investments in public and private institutions that are advancing life sciences research, development and commercialization as well as building ties among sectors of the Massachusetts life sciences community. For more information, visit www.masslifesciences.com. Onyx Pharmaceuticals, Inc. (ONXX) to Extend South San Francisco Campus Again VIVUS, Inc. (VVUS) Quietly Rents Big New Headquarters Pfizer Inc. (PFE) Lays Foundation Stone for Factory in Saudi Arabia Scheer Partners, Inc. Represents Macrogen in 6,800-Square-Foot Lease at 1330 Piccard Drive in Rockville Amgen (AMGN) Invests $200 Million in Singapore Monoclonal Antibody Facility Polaris of San Diego to Build $50 Million Facility in Chengdu Procter & Gamble (PG), Teva Pharmaceutical Industries Limited (TEVA) Break Ground on $90 Million Plant Immunotech Laboratories Relocates to New Research & Development Laboratory Facility Columbia Laboratories, Inc. (CBRX) to Relocate to Boston Area Pharmatek Laboratories, Inc. Announces Facility Expansion Please enable JavaScript to view the comments powered by Disqus. Biotech/Pharma - Real Estate Biotech/Pharma - Real Estate (World)

医学

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Special Report Day 2 | The Affordable Care Act: Uninsured for years, Lafayette Johnson and Gail Knox have heard about the health-care law spearheaded by President Barack Obama. But they didn’t know the 2010 law could give them access to health-insurance coverage through Illinois’ Medicaid program. State officials know that many people in this new population know little to nothing about whether or how they will benefit. This is the second day of a five-day series where GateHouse Medial Illinois heath care reporter Dean Olsen examines the Affordable Care Act and its expected impact. This series will be posted in its entirety at http://bit.ly/ACAseries. If you have questions about the ACA, email them to dean.olsen@sj-r.com. Olsen will round up the best questions and publish the answers in the newspaper and online in the coming days.Online resources* Summary of the Affordable Care Act* Online calculator to estimate premium subsidies offered through the ACA* Enroll America* Receive email and/or text message updates on the ACA***SPRINGFIELD -- Uninsured for years, Lafayette Johnson and Gail Knox have heard about the health-care law spearheaded by President Barack Obama. But they didn’t know the 2010 law could give them access to health-insurance coverage through Illinois’ Medicaid program.“I didn’t really know it would help me,” Johnson, who is single and unemployed, said as he and his friend, Knox, waited to see a doctor at Springfield’s Salvation Army at 530 N. Sixth St.Both knew they could qualify for Medicaid if they had children at home, or were elderly or disabled. But since neither fits into one of those categories, it was a surprise for them to learn that the federal Affordable Care Act (also known as Obamacare) could give them Medicaid coverage, with no monthly premium, at annual income levels below 138 percent of the federal poverty level, or less than $15,860 for one person and $21,405 for a couple.“It sure would help me a lot,” said Johnson, 54.State officials know that many people in this new population know little to nothing about whether or how they will benefit.“We’ve got a big job over the next six months or so,” Deputy Gov. Cristal Thomas said. “We think there are a lot of people who don’t know what’s happening with the Affordable Care Act.”Swelling enrollmentAn estimated 342,000 low-income Illinoisans — mostly single, childless adults — will be added to 2.7 million people already on Medicaid across the state as a result of expanded eligibility for the program, with the cost almost completely funded by the federal government the first three years.Almost 6,000 Springfield residents will qualify for the expansion, according to estimates by Chicago-based Health & Disability Advocates.Another 167,600 people statewide — and an unknown number locally — who already are eligible for Medicaid under current guidelines but haven’t signed up in the past are expected to join the program by 2017.Many people who are currently eligible are expected to sign up because of the health-care law’s mandate that most people have health insurance or face tax penalties. Others will sign up in response to an outreach campaign publicizing the ACA that is about to be launched in Illinois and across the country, according to Gov. Pat Quinn’s administration.The Medicaid expansion originally was expected to cover 16 million of the 32 million uninsured people to be served by the ACA nationwide; the other 16 million are expected to buy private insurance through insurance exchanges in Illinois and other states, often with federal assistance to reduce out-of-pocket costs.The number of additional people likely to join Medicaid nationwide has dropped since last summer, when the U.S. Supreme Court made the expansion optional for individual states. So far, Illinois and 22 other states, along with the District of Columbia, are moving forward with the expansion. Twenty-one states have declined to expand Medicaid, and the debate on whether to participate is ongoing in six states.The Democratically controlled Illinois General Assembly approved the Medicaid expansion this spring without a single Republican vote and with some Democrats voting “no” in the Illinois House on Senate Bill 26.Quinn, a Democrat and strong supporter of the ACA, signed the bill into law July 22. Enrollment based on the new eligibility rules is scheduled to begin Oct. 1, and the coverage will start Jan. 1.Opponents of the expansion in Obama’s home state focused on the potential cost to state government, which already has a multibillion-dollar deficit and takes six to nine months to pay many Medicaid providers.Opponents also say expanding Medicaid isn’t the best way to cover the uninsured. They say many doctors and dentists have stopped seeing Medicaid patients or are refusing to see new patients.Supporters of the expansion point out that 100 percent of the estimated cost to cover the newly eligible Medicaid recipients, or a total of $4.6 billion from 2014 through 2016, will be paid by the federal government.The federal share of the cost for the newly eligible will begin to drop in 2017, when it is reduced by 5 percentage points. But the ACA calls for the federal share of the cost of the newly eligible to remain at 90 percent in 2020 and beyond.The Illinois legislation says the Medicaid expansion is automatically rescinded if the federal subsidy drops below 90 percent. Opponents say it would be difficult politically for state officials to withdraw coverage for so many people, even if the federal government reneges on its funding commitment.Supporters say the expansion will generate more than $12 billion in matching funds for the state from 2014 through 2020 while costing the state $573 million.Lead to lower costs?Even though health-care providers complain that Medicaid often doesn’t cover the cost of care, many of those same providers support the Medicaid expansion because they say that some reimbursement is better than nothing.For example, even though the ACA is being funded, in part, by a total of $8.4 billion in Medicare cuts to Illinois hospitals over a 10-year period, the Illinois Hospital Association lobbied hard for the expansion.IHA spokesman Danny Chun said the expansion will reduce uncompensated care and the practice of “cost-shifting,” in which the rates paid by insured patients are increased to cover the cost of uninsured patients. Low-income patients with Medicaid coverage will be more likely to get preventive care and address problems earlier, when their conditions can be treated less expensively, he said.“It’s a huge difference for improving the health of people,” Chun said. “It will lead to healthier people, and it could lead to lower health-care costs.”The liberal-leaning group Families USA estimates that the Medicaid expansion will lead to the creation of 19,800 more Illinois jobs in health care and other parts of the economy, and $2.6 billion in annual increased “economic activity.”Critics, however, point to the Quinn administration’s own estimates of direct costs to the state.In addition to the $573 million for covering the newly eligible through 2020, the administration says the state’s cumulative cost for covering the currently eligible who will enroll in Medicaid — known as the “woodwork effect” — will be $2.3 billion through 2020.That’s because the federal government covers 50 percent, not 90 percent or 100 percent, of the cost of care for the currently eligible.Quinn administration officials say the woodwork effect will happen regardless of the Medicaid expansion, and they say the expansion is worth it even if the state’s backlog of unpaid bills grows in the short term.The expected increase in people applying for Medicaid is one of the reasons the Illinois Department of Human Services is hiring 600 more caseworkers statewide to add to the current 1,870 caseworkers, DHS spokeswoman Januari Smith said.The additional caseworkers will cost the state $13.5 million this fiscal year, but 50 percent to 75 percent of that cost will be reimbursed by the federal government, Smith said.Support dividedThe divided views that come through in public opinion polls on the ACA are reflected in the legislature.Rep. Rich Brauer, R-Petersburg, said the Medicaid program in Illinois already is too generous and discourages people from buying private coverage even though many could afford it.Among the 55 members of the Illinois House who voted against the expansion were eight Democrats, including Rep. Sue Scherer of Decatur, whose legislative district includes some of Springfield’s most impoverished neighborhoods.Of all the House Democrats and Republicans who voted against the expansion, Scherer’s district has the highest number of uninsured residents who will become eligible for Medicaid, according to an analysis by Health & Disability Advocates. The not-for-profit group says 6,660 residents in Scherer’s district will be newly eligible, representing 52 percent of the district’s uninsured population.Regardless, Scherer said she doesn’t regret her vote. She doesn’t trust the federal government to keep its promise of paying for no less than 90 percent of the cost of the expansion. She said she is uncomfortable supporting an initiative that may squeeze an already-strapped state budget.“I feel that it is totally irresponsible to vote for a bill when we don’t know what its final cost will be to the taxpayers,” Scherer said. “The cost of health care keeps going up. This is just too much of a risk.”Quinn administration officials say the expansion will reduce health-care costs for local organizations such as township governments.Sangamon County’s Capital Township, for example, spent $182,000 last year in property-tax revenue to pay for prescription drugs and doctor visits for the uninsured. However, Capital Township Supervisor Thomas Cavanaugh said he doesn’t yet know whether the Medicaid expansion will reduce demand for township assistance.The traditionally conservative Illinois Chamber of Commerce supported the expansion because the option of low-income uninsured employees qualifying for Medicaid will reduce the total federal tax penalties that employers will face under the ACA.Without the expansion, the Illinois Hospital Association estimates, the state’s employers would have faced annual penalties of $71 million to $106 million.Take the pressure offLafayette Johnson and Gail Knox, 45, said they are interested in the expansion because Medicaid coverage could help them afford medicine, counseling and visits to specialists.Knox, who also is single and unemployed, has asthma, high blood pressure, depression, anxiety and back problems. She and Johnson were waiting at The Salvation Army to see a doctor supplied by Springfield’s Central Counties Health Centers, which treats homeless and other low-income patients.Both said Medicaid coverage would help them avoid becoming desperate and seeking care in local hospital emergency rooms. They said coverage also would make them less likely to avoid care out of fear of owing a bill they couldn’t pay.“It will help people feel more positive about themselves and their health,” Knox said.Johnson has sleep apnea, but can’t afford a CPAP machine to use at night. He also can’t afford to fill a Lipitor prescription for high cholesterol.He credited Central Counties’ medical care with saving his life by providing good follow-up care after he was stabbed 11 times in a fight in 2006. The care that the not-for-profit organization provided has cost him a nominal amount of money, but he estimated that he owes $10,000 to a variety of other health-care providers.Johnson still receives phone calls from upset creditors wanting him to pay up.“You can’t squeeze blood from a turnip,” he said.Having at least Medicaid coverage would “take a lot of pressure off of you,” he said.Dean Olsen can be reached at (217) 788-1543. Follow him at twitter.com/DeanOlsenSJR.

医学

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Print Email Font ResizeCalifornia, national shortage of primary care physicians will become more severe as national health reforms take effectBy Sandy KleffmanBay Area News GroupPosted: Dr. George Kent checks some medical records on his laptop at Family Medicine Associates of San Jose, Inc. in San Jose, Calif. on Thursday, Nov. 15, 2012. (Dan Honda/Staff) «1234»The response was anything but subtle when Kate Goheen mentioned during her medical school training that she wanted to become a family doctor. "You're making the biggest mistake of your life," several physicians and professors told her, encouraging her to seek a much higher-paying -- and, some said, more prestigious -- specialty.Goheen ignored the advice, but experts are concerned that primary care doctors like her -- who get to know their patients intimately and often oversee the health of families for decades -- are increasingly in short supply.A nationwide shortage is expected to grow more severe when an additional 2 million to 4 million Californians, and 32 million people nationally, obtain insurance in 2014 under the national health reform law. "What we want to avoid is a situation where people have insurance coverage, but don't have access to care," said Dr. Steve Green, president of the California Academy of Family Physicians.Adding to the demand: Baby Boomers will require increased medical attention as they age.And they're not the only group getting older. Nearly one-third of all physicians are expected to retire in the next decade, just as more Americans seek care.Estimates of the need are sobering: 45,000 additional primary care doctors across the country within 7 years, including 2,000 or more in California.The national health reform law emphasizes primary care as a way to keep people healthy and control costs by preventing serious medical problems.Advertisement Yet only about 20 percent of American medical students go into primary care, according to the Council on Graduate Medical Education. Primary care typically includes family medicine, general internal and general pediatric medicine.Medical schools often have students spend more time with hospital specialists using the latest high-tech equipment than they do with family doctors. "Part of the solution is bringing medical students out into the community so they have more exposure to primary care," said Dr. George Kent, associate director of family medicine residency at O'Connor Hospital in San Jose.Such doctors will be on the front lines of carrying out the national health reform law, yet the shortage will worsen "if we don't train, recruit and retain more primary care physicians," said Dr. Rick Minh-Luan To, a San Jose family medicine doctor.Everyone could be affected as doctors attempt to squeeze in more patients."People should be expecting longer waits and shorter appointment times," said Callie Langton, director of workforce policy for the California Academy of Family Physicians.Americans may need to rethink how they value the profession so that more people will enter the field, experts say.Goheen, now in her third year of family medicine residency at Contra Costa Regional Medical Center in Martinez, said she has no regrets about her decision. She enjoys that in one day she may deliver a baby, meet with parents of young children and treat people in their 90s."I really like getting to know patients and seeing them for a long time," she said. "I'm seeing kids that are 2 now that I delivered, and it's just an amazing experience."But she understands the financial pressures that lure people to specialties, especially since she has $175,000 in student loan debt.Nationwide, the average primary care doctor earned $156,000 to $165,000 in 2011, the lowest pay of all the physicians surveyed, according to a Medscape study.Many specialists made twice as much: gastroenterologists earned $303,000, urologists and anesthesiologists $309,000, and cardiologists $314,000. Radiologists and orthopedic surgeons topped the list at $315,000.Salaries trend higher in the Bay Area, but the disparities are similar.Dr. Sergio Urcuyo originally planned to become an ear, nose and throat specialist but changed his mind after his mother was diagnosed with pancreatic cancer. He saw how hard it would have been for her to navigate the health system without a primary care doctor to help oversee her care."For the first time in my life, I saw the health care system from the patient's side," he said. "Her primary care doctor was the one she relied on to help her get through her illness."Urcuyo graduated from Contra Costa Regional's family medicine residency program in June and is now a faculty member there, with nearly $300,000 in student loans to repay.In California, the shortage of primary care physicians is most severe in rural areas. Bay Area counties generally have the recommended 60 to 80 primary care doctors per 100,000 people, but the region will be challenged to meet the coming need, said Dr. Kevin Grumbach, chairman of the department of family and community medicine at UC San Francisco.And not everybody has access to even the existing physicians. Many Bay Area doctors will not see Medi-Cal patients, and only Kaiser members have access to Kaiser primary-care physicians, Langton noted.Groups such as the California Academy of Family Physicians are seeking more funding for residency training, arguing that the state's 309 openings each year for doctors to begin a family medicine residency are not nearly enough.Medicare pays for most of such training nationwide, but Congress froze the number of residencies in 1996.The national health reform law earmarked an additional $168 million to train 890 more primary care doctors than in the past, but this will not come close to offsetting the shortage of such physicians.Today, Contra Costa Regional Medical Center receives 700 applications a year for the 14 annual openings in its family medicine residency program. O'Connor Hospital in San Jose gets 400 applications for its 8 positions.On the bright side: The renewed focus on primary care is beginning to generate more interest among medical students, said Dr. Jeremy Fish, who directs Contra Costa Regional's family medicine program.And salaries for family physicians rose by 6 percent last year because of the increased demand.Kent says more medical students will be attracted to the field if they learn more about it."Those of us who are in primary care, despite the heavy workload, are generally very happy," he said. "I can't imagine doing anything else."Sandy Kleffman covers health. Contact her at 510-293-2478. Follow her at Twitter.com/skleffman.NEEDED: PRIMARY CARE DOCTORSThe nation needs 45,000 additional primary care doctors within 7 years, including 2,000 or more in California.WHY:Two to 4 million Californians, and 32 million people nationally, will obtain insurance in 2014 under the national health reform law.RESPONDING TO THE CALL:About 20 percent of American medical students go into primary care, which includes internal medicine, pediatrics and family medicine.Print Email Font ResizeReturn to Top Watch: Jack Del Rio explains why he pulled Derek Carr in middle of 3rd quarter driveCal Bears in Australia attract 61,000 fans to Sydney gameRaiders rookies DeAndre Washington, Jalen Richard step up • Article commenting rules of the road

医学

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

医学

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Alzheimer’s Drug Curbs Compulsive Buying in Shopaholics 0 Updated at 4:26 am, May 30th, 2012 By: ABC Digital Share This Story We MatchedBrand X Pictures/Thinkstock(MINNEAPOLIS) — A drug used to treat the symptoms of Alzheimer’s disease may curb compulsive buying in shopaholics, a new study found. The drug, called memantine, helps people with Alzheimer’s disease think more clearly by reducing overactivity in the brain. But it also eases impulsivity, a trait tied to rash decisions and impractical purchases. “In a way, compulsive buying is similar to other addictions in that people are thinking about the immediacy of the reward without considering the consequences,” said study author Dr. Jon Grant, a professor of psychiatry at the University of Minnesota in Minneapolis. “We asked: Could we use a medication to essentially enhance decision-making as a way to help them with their behavior?” Grant and colleagues recruited eight compulsive buyers, all women, to take memantine for 10 weeks, and used cognitive tests and surveys to track impulsive thoughts and spending. In the end, they found significant reductions in both. “People with compulsive spending don’t think through the full range of consequences of their behavior, and that improved with this medication,” said Grant. The study, published in the May issue of Annals of Clinical Psychiatry, gives hope to an estimated six percent of Americans who struggle with the euphoric highs and guilt-ridden lows of compulsive buying. “It can interfere with people’s jobs, their marriages,” said Grant, describing how compulsive buyers squander their savings and invent lies to explain their actions. “All of this leads to incredible personal distress. A person might feel depressed and even suicidal because they don’t know how to control their behavior and feel bad about being dishonest.” Despite being widely recognized as a disorder on par with alcoholism or gambling addiction, compulsive buying is not listed in the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) and there is no standard treatment. “There is some evidence that cognitive behavioral therapy can benefit people with this problem,” said Grant, describing the psychotherapeutic technique that aims to replace dysfunctional behaviors with healthier habits. “Antidepressants have also been tried but were largely unsuccessful. But this study represents at least a possible pharmacological approach.” Before memantine can be approved for the treatment of compulsive shopping, it has to be tested against a placebo in clinical trials, said Grant, adding that the drug is also being tested in other impulse disorders, including alcoholism and obsessive compulsive disorder. Stories You May Be Interested In:Alzheimer’s Drug Curbs Compulsive Buying in ShopaholicsAlzheimer’s Drug Curbs Compulsive Buying in ShopaholicsAlzheimer’s Drug Curbs Compulsive Buying in ShopaholicsAlzheimer’s Drug Curbs Compulsive Buying in Shopaholics Images in the news

医学

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Getting a Good Night's Sleep With Menopause Is Your Brain Fog From Menopause, Dementia, or ADHD? Does Menopause Cause Osteoporosis? Lost That Lovin' Feeling? 5 Lessons From the Largest Scientific Study on Women Why Was Hormone Replacement Approved for Menopause? Ask Dr. Marcie Richardson The Best Exercises for Menopause 6 Foods to Avoid During Menopause Sign Up for Our Women's Health Newsletter Thanks for signing up! Monday, October 06, 2008 Now that we know about the serious risks associated with hormone replacement therapy for menopause, it makes me wonder why it was ever approved in the first place. Do you have any thoughts about why these risks weren't recognized earlier? This is a complicated question about which books could be and have been written. Furthermore, there is still much controversy about estrogen and its risk, to say nothing of the fact that there is much we still don’t know. The executive summary is this: Estrogen was initially used to treat the symptoms of menopause (hot flashes, for example), and this was before the FDA had a very tight approval process. Then some studies suggested estrogen should be used in all women to prevent heart disease and osteoporosis. The National Institutes of Health funded the Woman’s Health Initiative (WHI) to try to prove or disprove this. This led to the realization that for women whose average age was 63, Premarin (conjugated estrogens) and Provera (medroxyprogesterone) increased their incidence of heart disease, strokeand breast cancer. Clearly Premarin and Provera were not good for all women. However, the risks are small, and for some women, the symptoms of menopause are so bad that they choose to use estrogen. Now more analysis of the WHI suggests the heart disease risk of hormones is different for women depending on how close to menopause hormone therapy is started. And furthermore it is thought that different kinds and doses of hormones may have different risks. In summary the estrogen/hormone story is like an epic movie, and we are moving from frame to frame, but the end is a ways away. If you would like to read more about the hormone therapy, I suggest you look on the North American Menopause Society Web site for its position statement on estrogen and progestogen use in the postmenopausal woman. Last Updated: 10/6/2008 Dr. Marcie Richardson is an obstetrician and gynecologist at Harvard Vanguard Medical Associates and Beth Israel Deaconess Hospital in Boston. top Using the Pill to Treat Menopause

医学

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Concussions may lead to Alzheimer's brain plaques Print People who suffer concussions may be at a higher risk of developing plaques on the brain found in people with Alzheimer’s disease, according to a study featured in the journal Neurology. The new research released today examines the relationship between concussions and amyloid beta plaques in the brain. While the study couldn’t prove causation, it helps shed light into the possible long-term effects of traumatic brain injuries. Know the Risk Factors for Alzheimer’s Disease Trauma's Effect on the Brain Study author Michelle Mielke, a researcher at the Mayo Clinic, scanned the brains of 589 people ages 70 or older. Of those, 141 had symptoms of mild cognitive impairment. All were asked about whether they’d suffered a concussion in the past. Researchers found the 17 percent of the 448 people without thinking or memory problems reported a brain injury, while 18 percent of the 141 people with memory problems reported a concussion or other head trauma. The brain scans reveled no differences among the people without memory and thinking impairments, regardless of past head trauma. Those with memory and thinking impairments and a history of head trauma, however, had an average of 18 percent more amyloid beta plaques—the hallmark of Alzheimer’s disease—than those with no history of head trauma. “Interestingly, in people with a history of concussion, a difference in the amount of brain plaques was found only in those with memory and thinking problems, not in those who were cognitively normal,” Mielke said in a statement. “Our results add merit to the idea that concussion and Alzheimer’s disease brain pathology may be related.” Mielke did note that any relationship between head trauma and amyloid plaque development is likely complex. What’s the Difference Between Alzheimer’s and Dementia? More Research Required Calling the study’s findings “intriguing,” Keith Fargo, director of publications and outreach for the Alzheimer’s Association, said it raises more questions than it answers and that more studies are needed, particularly long-term ones that follow people throughout their lives. “It’s an interesting piece of an overall puzzle,” he said. “We’re glad people are doing research in this area. We need to know more about head injury and dementia later in life.” According to the Alzheimer’s Association, previous research has been linking brain injuries to dementia and other cognitive problems for more than 30 years. Emerging research in athletes who participate in high-contact sports—football, boxing, hockey, etc.—show that repeated blows to the head make them more likely to develop a specific form of dementia called chronic traumatic encephalopathy. Learn the Symptoms of Alzheimer’s Disease Advertisement

医学

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Generation of tanners see spike in deadly melanoma Tue Jul 29th, 2014 12:41pmNews By Anne Flaherty Associated Press WASHINGTON — Stop sunbathing and using indoor tanning beds, the acting U.S. surgeon general warned in a report released Tuesday that cites an alarming 200 percent jump in deadly melanoma cases since 1973. The report blames a generation of sun worshipping for the $8 billion spent to treat all forms of skin cancer each year. Rear Adm. Boris Lushniak said state and local officials need to do more to help people cover up, such as providing more shade at parks and sporting events. Schools should encourage kids to wear hats and sunscreen and schedule outdoor activities when the sun is low in the sky. And colleges and universities should eliminate indoor tanning beds on campus much as they would prohibit tobacco use, he added. “We need more states and institutions on board with these policies that discourage or restrict indoor tanning by our youth,” Lushniak said. “Tanned skin is damaged skin.” The surgeon general’s “call to action” plan is part of a broader push this year by government officials and public health advocates to raise awareness on what they say has become a major public health problem. While other cancers such as lung cancer are decreasing, skin cancer is rising rapidly. According to the Department of Health and Human Services, 5 million people are treated for skin cancer each year. And the number of Americans with skin cancer in the past three decades eclipse the number of all other cancers combined. Melanoma is the deadliest form of skin cancer with 9,000 people dying each year from the mostly preventable disease. Stacey Escalante of Las Vegas, Nevada, blames years of sunbathing with baby oil and using indoor tanning beds for her melanoma diagnosis in 2005. The mother of two was a 34-year-old television reporter training for a marathon when she found a small red growth the size of a pencil eraser on her lower back. By the time she saw a doctor, the cancer had traveled to her lymph node, requiring two surgeries that left an 8-inch scar. She then spent two years on an experimental drug. Escalante said she realizes now that she was lucky to survive, and was foolish to think she was immune to skin cancer because her father was Hispanic and she tanned well. Now an advocate for early detection, Escalante is pushing for state legislation prohibiting minors from using indoor tanning beds. The Melanoma Research Foundation says exposure to tanning beds before age 30 increases a person’s risk of developing melanoma by 75 percent. “If only I had first gone to the doctor, when I first saw that spot, instead of ignoring it, I would have saved my family and myself … the emotional, physical and financial burden of skin cancer,” she said. “It was absolutely overwhelming.” Howard Koh, assistant secretary for health for the Department of Health and Human Services, said skin cancer prevention needs to become a bigger part of daily American life. “We need to change the social norm with respect to tanning and shatter the myth that tanned skin is somehow a sign of health,” Koh said. Doctors recommend doing regular skin checks for new moles and seeing a doctor if any change in size, shape or color. Doctors also recommend applying at least 1 ounce of sunscreen with an SPF of 30 or more to exposed skin and reapplying every two hours, more if swimming or sweating. Children in particular should be protected because bad sunburns in childhood are thought to greatly increase risk later in life.

医学

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Merlene Davis: Obesity-fighting program needs community support For more than 14 years, Dr. Antronette "Toni" Yancey had been trying to get America to move more. Yancey created a program called "Instant Recess" in which workers in corporate America, in churches, neighborhoods and schools take about three 10-minute exercise breaks throughout the day. And it might be coming to Lexington. The late Dr. Antronette "Toni" Yancey created "Instant Recess." Merlene Davis - Herald-Leader columnist For more than 14 years, Dr. Antronette "Toni" Yancey tried to get America to move more. Yancey created a program called "Instant Recess" in which workers in corporate America and people in churches, neighborhoods and schools take about three 10-minute exercise breaks during the day. Last fall, Yancey and other public health researchers at the University of California, Los Angeles were awarded a $20 million, five-year grant from the Centers for Disease Control and Prevention to take their program throughout the country. In Lexington, UCLA chose Ahava Center for Spiritual Living to lead the project. "UCLA hand-picked us," said Louise Tallen, who was to be the director of the program in town. "Then the CDC said no." Tallen said the CDC refused them because it wants proof that a variety of community partners from the education, corporate, community sectors are on board. Before re-submitting her proposal, she needs to submit demographics detailing the amount of physical activity and healthy eating habits of the targeted demographics: racial and ethnic minorities in Lexington. The problem is, the CDC notified her Friday, and the proposal must be returned by May 31. "Usually, you have four to six months to present a grant proposal," Tallen said. She said she has gone from taking baby steps in contacting leaders who have inroads into the minority community to an all-out race to the finish line. But the program is worth it, she said. Yancey, a former athlete, model and poet, co-founded the Fielding School's UCLA Kaiser Permanente Center for Health Equity and was committed to ensuring that research was related to community programs that would change lives. Research revealed that exercising for 30 minutes five days a week, and sitting for the rest of the day either in front of a TV or at work, didn't have the effect needed to ward off chronic diseases such as high blood pressure and diabetes. What worked better was 10 minutes of aerobic bouts of exercise through the day. "Today, lack of movement is a fundamental part of dying," Yancey said. "We move as human beings when we have to move. We've got to make it obligatory." Short bouts of physical activity, what she called "Instant Recess," results in a shrinking waistline, lower blood pressure and decreased percentage of body fat. The exercise also suppresses appetite and increases our desire for fruits, vegetables and other water-bearing foods and beverages. None of that means much unless people get up off their duffs. And that's where the grant comes in. Yancey was diagnosed with lung cancer a few months before the grant was awarded last year. She died in April at age 55, one of a growing number of young non-smokers to succumb to that disease. Tallen doesn't want Yancey's vision to die as well. Yancey wrote a book, Instant Recess: Building a Fit Nation 10 Minutes at a Time, and there are videos on YouTube.com of players on the WNBA's Los Angeles Sparks team creating exercises. In the office, the result has been that employees take fewer sick days. Yancey sold the recess breaks as, "What is good for the waistline is good for the bottom line." Ten to 15 organizations that can get started quickly in their communities will be selected to reduce chronic-disease disparities experienced by African Americans, Latinos, American Indians, and Asian Americans, according to the proposal. "This is a strength-based project," she said in a YouTube video promoting the program. "You work with people's strengths and find out what is working right, and improve on that. We want to tap into existing programs." If you have a program that targets obesity in minority neighborhoods, Tallen hopes to partner with you to make Lexington one of a national network of community-based organizations that tries to change social or cultural norms. "Instant Recess is a powerful and important tool that can change lives and communities," she said. "I will do my best to get this started." If you know of an organization, agency or company that can help bring Instant Recess, an obesity-fighting exercise program and lifestyle change, to Lexington, call Louise Tallen at (562) 833-7993, or email her at tallen.let@gmail.com. Choose physical therapy to help with pain management

医学

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Twelve-year-old girl suffering from painful rickets because mom smothered her in sunscreen Sunday, March 13, 2011 by: David Gutierrez, staff writerTags: rickets, sunscreen, health news http://www.naturalnews.com/031682_rickets_sunscreen.html (NaturalNews) A 12-year-old girl living on the Isle of Wright in southern Britain developed a severe vitamin D deficiency verging on rickets because her mother never let her go outside without sunscreen on.Rickets is a painful and potentially deformity-causing bone softening disease caused by vitamin D deficiency. The body produces vitamin D upon exposure to ultraviolet radiation from sunlight, but too much time indoors or sunscreen higher than SPF 8 can prevent it from producing enough.Twelve-year-old Tyler Attrill first began suffering pain and weakness in her legs three years ago, after a series of operations to correct an unrelated problem with her hip bones. She did not realize at the time that she was suffering the warning signs of developing rickets."It would make [my] legs feel all heavy, [I] couldn't move them," she said. "It made my whole body feel really ill and achy."Eventually, the ongoing pain reduced her to tears and she was referred to the Children's Orthopedic Unit at Southampton General Hospital."We've been back and forwards to doctors and the hospital over the years, but it wasn't until November that they did a test for vitamin deficiency," her mother said. "We're lucky it was caught in time otherwise it could have developed into rickets."It was then that Tyler's doctor told her mother that overuse of sunscreen had probably caused Tyler's vitamin deficiency."We live right by the beach so Tyler was outside with her friends every day last summer," Tyler's mother said. "I've always been very careful with her and her brother, and nagged them to wear hats and suncreen when it's hot. I thought I was doing the right thing."Rickets is on the rise across England, even in sunny regions like the Isle of Wright. Concern over this trend recently caused British doctors to reverse course on decades of advice to avoid the sun; they now recommend 15 to 30 minutes of unprotected sun exposure three to five days a week.Tyler has improved with vitamin D supplements and more time spent outdoors."It makes me feel guilty," her mother said of the experience, "but parents are encouraged to use [SPF] 50 on their children to prevent skin cancer later in life."I thought I was doing the right thing."To learn more about the importance of vitamin D, read the free NaturalNews.com report "The Healing Power of Sunlight & Vitamin D" at http://www.naturalnews.com/rr-sunlight.html.Sources for this story include: http://news.bbc.co.uk/local/hampshire/hi/peo... ; http://www.dailymail.co.uk/health/article-13... More news on rickets Five ways to get more vitamin D through natural sourcesVitamin D deficiency symptoms explained: the top 9 warning signsThe Syndrome: New film exposes scam to imprison parents based on phony medical scienceScience proves that avoiding sunshine doubles your risk of deathSubpar levels of vitamin D a global problemVitamin D compound may help skin lotions reduce DNA damage by up to 80 percentReversing the trend of childhood tooth decay: How parents can make lifestyle changes to improve the health of their children's teeth

医学

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Home > Content Library of Adult English Medical Content > Bone Disorders Avascular Necrosis What is avascular necrosis? Avascular necrosis is a disease that results from the temporary or permanent loss of blood supply to the bone. It is also called osteonecrosis, aseptic necrosis, or ischemic bone necrosis. When blood supply is cut off, the bone tissue dies and the bone collapses. If avascular necrosis occurs near a joint, collapse of the joint surface may occur. Avascular necrosis may occur in any bone, but most commonly occurs in the ends of a long bone. It may affect one bone, several bones at one time, or different bones at different times. What causes avascular necrosis? Avascular necrosis may be the result of the following: Traumatic causes (including injury, fracture, or damage to blood vessels) Nontraumatic causes (including long-term use of medications, such as corticosteroids, or excessive, long-term use of alcohol) Other theories and associations have been suggested as risk factors. What is a risk factor? A risk factor is anything that may increase a person's chance of developing a disease. It may be an activity, such as smoking, diet, family history, or many other things. Different diseases have different risk factors. Although these factors can increase a person's risk, they do not necessarily cause the disease. Some people with one or more risk factors never develop a disease, while others develop the disease and have no known risk factors. But, knowing your risk factors to any disease can help to guide you into the appropriate actions, including changing behaviors and being clinically monitored for the disease. What are the risk factors for avascular necrosis? Suggested risk factors for avascular necrosis include the following: Blood disorders, such as sickle cell anemia Decompression disease What are the symptoms of avascular necrosis? The following are the most common symptoms for avascular necrosis. However, each individual may experience symptoms differently. Symptoms may include: Minimal early joint pain Increased joint pain as bone and joint begin to collapse Limited range of motion due to pain The symptoms of avascular necrosis may resemble other medical conditions or bone problems. Always consult your doctor for a diagnosis. How is avascular necrosis diagnosed? In addition to a complete medical history and physical examination, diagnostic procedures for avascular necrosis may include the following: Imaging procedures, such as: X-ray. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film; to determine bone changes. Computed tomography scan (also called a CT or CAT scan). A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays. Radionuclide bone scan. A nuclear imaging technique that uses a very small amount of radioactive material, which is injected into the patient's bloodstream to be detected by a scanner. This test shows blood flow to the bone and cell activity within the bone. Biopsy. A procedure in which tissue samples are removed (with a needle or during surgery) from the body for examination under a microscope; to determine if cancer or other abnormal cells are present; to remove tissue from the affected bone. Functional evaluation of bone. Tests, that usually involve surgery, to measure the pressure inside the bone. Treatment for avascular necrosis Specific treatment for avascular necrosis will be determined by your doctor based on: Extent of the disease Location and amount of bone affected Underlying cause of the disease Expectations for the course of the disease The goal of treatment for avascular necrosis is to improve functionality or to stop further damage to the affected bone or joint. Treatments are necessary to keep joints from breaking down, and may include: Medications. These are used to control pain. Assistive devices. These are used to reduce weight on the bone or joint. Core decompression. A surgical procedure in which the inner layer of bone is removed to reduce pressure, allow for increased blood flow, and slow or stop bone and/or joint destruction. Osteotomy. A surgical procedure to reshape the bone and reduce stress on the affected area. Bone graft. A surgical procedure in which healthy bone is transplanted from another part of the patient's body into the affected area. Arthroplasty (total joint replacement). A surgical procedure to remove and replace an arthritic or damaged joint with an artificial joint (called a prosthesis); may be considered only after other treatment options have failed to provide adequate relief from pain and/or disability. Other treatments for avascular necrosis may include electrical stimulation and combination therapies to encourage the growth of new bone. Click here to view the Online Resources of Bone Disorders 족부 수술Outpatient Guide to Orthopedic SurgeryOsteoporosis Knee Replacement SurgeryInfectious ArthritisSoft-Tissue Injuries HealthGrades Names New York Hospital Queens Among the Top 5% in the Nation for Joint Replacement and Maternity Care10/21/2011Free Community Symposium on Bones, Muscles and Joints with a Focus on Hips and Knees03/14/2011New York Hospital Queens Opens Specialty Orthopaedics Service in “Queens Crossing”11/12/2010New York Hospital Queens and Met Oval Foundation Announce Association to Provide Assistance to Soccer Players02/04/2010뼈, 근육, 관절 및 관절염을 주제로 한 지역 사회 심포지엄이 뉴욕병원 퀸즈(NYHQ)에서 개최되었습니다.01/25/2010Medical Experts at New York Hospital Queens To Discuss “Bones, Muscles, Joints and Arthritis” at Upcoming Symposium for Public01/21/2010New York Hospital Queens Hosts Open House at Orthopaedics and Rehabilitation Center01/07/2010Free Community Symposium on Bones, Muscles and Joints, and Arthritis to be held at New York Hospital Queens on January 25, 201001/04/2010New Orthopaedic Techniques and Treatments Now Available in Queens11/20/2009New Specialized Surgeons Increase Access to Orthopaedic Care and Rehabilitation in Queens11/20/2009New York Hospital Queens Cuts Ribbon on New Orthopaedics and Rehabilitation Center06/30/2009New York Hospital Queens to Cut Ribbon on New Orthopaedics and Rehabilitation Center06/25/2009

医学

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BooksAuthorsSeriesAbout Us Michael Murray M M Michael T. Murray, N.D., is widely regarded as one of the world’s leading authorities on natural medicine. He is a graduate and faculty member of Bastyr University in Seattle, Washington, and the co-author of the Encyclopedia of Natural Medicine, the definitive consumer guide to naturopathic medicine. In addition to more than twenty other books, Dr. Murray has written numerous articles for major publications, appeared frequently on radio and TV programs, and lectured to hundreds of thousands of people nationwide. Sign me up for news about Michael Murray Books by Michael Murray The Complete Book of Juicing, Revised and Updated How to Prevent and Treat Diabetes with Natural Medicine How to Prevent and Treat Cancer with Natural Medicine The Pill Book Guide to Natural Medicines Doctor Murray’s Total Body Tune-Up

医学

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Fighting PH Becomes a Family Affair Josephine Maggio passed away in 1963, after developing pulmonary hypertension while she was ten weeks pregnant. Her family had no idea that PH could be familial. But years later Josephine’s sister Anne and her husband John learned the sad truth when their own children, John and Joanne, were diagnosed. With their children now living with pulmonary hypertension, Anne and John made a promise to do everything they could to find a cure for PH. Since then, they have been generous and frequent donors to PHA ’s research fund, giving as much as they can afford. Anne and John aren’t the only family activists, however. Joanne, a member of PHA’s Board of Trustees and patient liaison to PHA’s Scientific Leadership Council, led the way by starting a support group on Long Island and organizing the annual New York Fun Walk for PH. The whole family gets very involved in the event. They also write letters to their Congressmen and volunteer at PHA’s International Conferences. For their family, finding a cure for PH is literally a matter of life and death. When her own children were diagnosed, Anne reflected on stories her father told about how his mother died when he was very young and how several of his brothers and sisters passed away from a mysterious illness, leading her to believe that previous generations were also affected. Return to Donor Stories Index Page

医学

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Health Canada: BPA is safe in food packaging Mike Verespej OTTAWA (Oct. 1, 12:45 p.m. ET) — A report by Health Canada says there is no health risk from exposure to bisphenol A in food packaging — even though the Canadian government banned BPA from baby bottles four years ago. “Based on the overall weight of evidence, the findings of the previous assessment remain unchanged and Health Canada’s Food Directorate continues to conclude that current dietary exposure to BPA through food packaging uses is not expected to pose a health risk to the general population, including newborns and young children,” said the Bureau of Chemical Safety of Health Canada in its report that was quietly issued Sept. 27. Studies by the Canadian government at the time the ban was put into place in October 2008 also had concluded the chemical was not likely a health risk. But it was still banned as a precautionary measure because some studies had suggested potential health risks from effects of low levels of exposure to BPA. In the United States, 11 states, the city of Chicago and four counties have banned the use of BPA in polycarbonate baby bottles and sippy cups. All major baby bottle manufacturers that make products for the U.S. market agreed in 2009 not to make or sell baby bottles or sippy cups that contain BPA. This past July — in response to an industry petition — FDA agreed to exclude baby bottles and sippy cups from regulations that permit companies to use BPA in food-contact applications. BPA is used to make polycarbonate and epoxy resins. The materials are used to line metal cans and are found in thermal printer paper and some dental composites and sealants. It is estimated that more than 8 billion pounds of BPA are produced worldwide every year.

医学

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Fertility Specialist Obehi Asemota, MD Joins Advanced Fertility Center of Chicago Reproductive endocrinologist and reproductive surgery specialist Obehi Asemota, MD joins the Advanced Fertility Center of Chicago's fertility and IVF clinic with Dr. Richard Sherbahn and Dr. Michelle Catenacci. Dr. Obehi Asemota, Fertility Specialist I am passionate about helping couples struggling with infertility build a healthy family. My goal is to provide the highest quality of care that empowers and educates patients so that they understand all current fertility treatment options. Obehi Asemota, MD, an infertility specialist with extensive state of the art training has joined the Advanced Fertility Center of Chicago team. Dr. Asemota specializes in all aspects of reproductive medicine, including ovulation induction, IVF/ICSI, fertility preservation (egg and embryo freezing) third party reproduction (egg donation and gestational carrier), recurrent pregnancy loss, LGBT reproduction and diminished ovarian reserve. She is also an expert surgeon with experience in the most up-to-date minimally invasive surgical techniques with experience in traditional laparoscopy and operative hysteroscopy for treatment of fibroids, uterine septums, and uterine adhesions. “We are very excited to have Dr. Asemota join our team. She possesses an excellent blend of top-notch education and knowledge with a strong passion for providing outstanding personalized care,” says board-certified reproductive endocrinologist Richard Sherbahn, MD, director of the center's in vitro fertilization (IVF) program. "The Advanced Fertility Center of Chicago has been widely recognized for many years for achieving consistently high IVF success rates. In 2012, our live birth success rate for women under 35 was 55% per egg retrieval, a rate substantially higher than the national average of 43%. For treatments using donor eggs we had a live birth rate of 82% vs. the national average of 57%." Dr. Asemota was an Instructor at Albert Einstein College of Medicine while completing her fellowship in Reproductive Endocrinology and Infertility at Montefiore Institute of Reproductive Medicine in Hartsdale, NY. She earned her medical degree and completed her residency in obstetrics and gynecology at Drexel University College of Medicine in Philadelphia, serving as the academic chief resident during her last year of training. Dr. Asemota graduated from University of Chicago with a bachelor of science in Biology. She has written articles and chapters in various journals and books including Obstetrics & Gynecology, and Fertility & Sterility and has been the recipient of numerous scholarships, honors, and awards throughout her academic career and medical training. Dr. Asemota is a member of both the American College of Obstetrics and Gynecology and the American Society for Reproductive Medicine “I am excited to join the Advanced Fertility of Chicago, a prestigious world class center that offers the full spectrum of advanced reproductive technology services including in-vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), pre-implantation genetic diagnosis, egg donation and egg freezing. Being part of a team that offers all of these services and also demonstrates consistently high IVF success rates is important to me.” Dr. Asemota sees patients at the Advanced Fertility Center of Chicago offices in Gurnee and Crystal Lake. For more information or to make an appointment, contact Dr. Asemota’s office at (847) 662-1818. The website is advancedfertility.com, where you can see details about the services offered and learn from over 300 articles on various fertility issues and IVF. Richard Sherbahn Advanced Fertility Center of Chicago +1 (847) 662-1818 Advanced Fertility Center of Chicago 847-662-1818

医学

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Negative BPA Effects Begin When Metabolized By Body by Alan McStravick for redOrbit.com - Your Universe Online Alan McStravick for redOrbit.com - Your Universe Online Roughly 9 out of 10 Americans are walking around with a highly toxic synthetic chemical surging through their systems. Bisphenol A (BPA) is a petroleum-based chemical that is widely used in the production of plastic products such as bottles, food can linings and water supply lines. And as these plastics degrade over time, humans ingest more and more BPA. Less than 3 months ago, the FDA acted upon evidence found in several studies and banned the use of BPA in baby bottles and sippy cups. The European Union had already banned the use of BPA in products used for the feeding of smaller children after testing showed that laboratory animals exposed to the chemical, either in the womb or very early in life, experienced noticeable detrimental affects to their neural development. BPA is even used in a powdered form on thermal cash register receipts. The chemical is able to be transmitted to the holder of the receipt in statistically significant amounts in a relatively short amount of time. And new study has shown that BPA can also cause pregnant women and their newborn boys to suffer from reduced levels of thyroid hormone. An imbalance in thyroid hormone levels has been linked to negative changes in cognitive abilities, behavior and growth. BPA resembles estradiol on a molecular level, a naturally occurring steroid that is part of the estrogen family. While the exact reasons why the thyroid hormone reduction is noticed in newborn boys and not girls is unknown, researchers have hypothesized that its resemblance to estradiol may be the key. They believe boys are less able to detoxify the estrogen-like BPA from their systems than girls. In the most recent study of this chemical compound, researchers from the University of California, San Diego School of Medicine (UCSD) suggest that metabolic changes that take place once the BPA has broken down inside the body is where the greatest threat to our health lies. Their findings were published yesterday in the open journal PLOS ONE. Thanks to BPA´s close resemblance to estradiol, it is able to bind to estrogen receptors, causing a disruption of estrogen signaling. The human body´s receptors are designed to bind with naturally occurring estrogens. When a look-alike comes along and fools the receptor, the outlook isn´t good. Even if the look-alike only has a weak bond with that receptor. Particularly for fetuses, newborns and toddlers, BPA toxicity can cause disruptions to the endocrine and hormone systems. The real culprit, according to Dr. Shin´ichi Yoshihara and his colleagues at Hiroshima International University, is not actually the BPA that is in its original form when it is ingested. Rather, the dangers arise from a compound created by your body when BPA is metabolized in your system. Yoshihara has dubbed this new compound MBP, and his research has shown that it is capable of binding much more tightly with our natural estrogen receptors. The co-authors of the UCSD study, Michael E. Baker, PhD, professor of medicine, and Charlie Chandsawangbhuwana, graduate student in the UCSD Department of Bioengineering, began their study where Yoshihara left off. They wanted to learn just why the compound MBP is able to make such a strong connection with estrogen receptors. Baker and Chandsawangbhuwana utilized three-dimensional computer modeling of MBP and BPA to learn why and how the new compound adhered so strongly to the receptors. Their findings showed that BPA was a shorter molecule that only makes contact with the receptor at one end, which explains its weak connection. MBP, on the hand, has a longer structure which allows both ends to have interaction with the receptor in much the same way as estradiol does. "In other words, MPB is basically grabbing onto the estrogen receptor with two hands compared to just one hand for BPA," explained Baker. "Two contact points makes a much stronger connection." Baker says that their 3D modeling supports the idea "that BPA is not the endocrine disruptor culprit. Instead, MBP is one (of perhaps several BPA metabolites) that causes disruption of estrogen signaling in humans and other animals." Baker believes that these findings suggest that MBP measurements need to start being collected via urine and blood analysis from patients whose health issues are thought to be related to BPA toxicity. Baker goes on to say that obtaining that data may fuel development of a new therapeutic treatment for conditions linked to excessive estrogen levels and activity that include forms of breast and prostate cancers. Speaking on new therapeutic advances in pharmaceuticals, Baker said, "One could use MBP, which has a novel structure, as a template to develop a new class of chemicals that could bind to the estrogen receptor with high affinity. The goal would be to have these chemicals inhibit the action of estradiol instead of activating the estrogen response. These chemicals could control unwanted growth of estrogen-dependent tumors."

医学