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Beijing Academy of Artificial Intelligence 864

2016-36/3163/en_head.json.gz/19227

Home | About | Donate/Volunteer | Contact | Jobs| Early Schizophrenia Screening Test Why do schizophrenics hallucinate, hear voices? Mapping uncovers brain shrinkage Schizophrenia Update, December 2002 By: Veronique Mandal, Star Health-Science Reporter Cutting-edge brain mapping techniques have allowed scientists here to link schizophrenia to a shrinkage of grey matter, proving definitively that the disease is no less physical than cancer or diabetes. The deterioration can begin at childhood and amplifies with each psychotic episode, researchers at the Montreal Neurological Institute of McGill University have found. "There is such a terrible stigma about this disease but it is actually no different than any other physical brain disease," said researcher Dr. Tomas Paus. In one of the most advanced labs in North America, worth $35 million, Paus and his team used advanced MRI equipment and Positron Emission Tomography (PET) scanners to track what schizophrenia does to grey matter. The effects on children were espcially profound. Patients with early-onset schizophrenia had a much greater loss of grey matter, especially in the frontal and temporal lobes, as those who contracted it later in childhood, according to the Paus research, published in the Archives of General Psychiatry. "This is consistent with evidence suggesting that abnormalities in frontal and temporal lobe connections underlie the symptoms of schizophrenia," said Paus. "Thus a specific pattern with schizophrenia develops across the adolescent years." Deterioration in the prefrontal cortex of the brain affects verbal memory, attention, reasoning, aggression and meaningful speech, helping explain why schizophrenics sometimes babble incoherently. Overactivity in the frontal and right temporal lobes was associated with auditory hallucinations, a common and debilitating symptom of schizophrenics who claim they hear voices. Loss of volume in the temporal lobe also affects the limbic system, located deep in the brain and containing the hypothalmus, amygdala and hippocampus. Those are responsible for emotions and memory and abnormalities are associated with the delusions, hallucinations and disordered thinking common among schizophrenics. Research labs around the world have added to the bank of physical evidence that explains schizophrenic behaviour. Studies at the University of Toronto and other centres show an overproduction of the chemical dopamine, which is closely linked to psychotic symptoms in schizophrenia. Research at Johns Hopkins University, using a newly developed 3-D diffusion tensor MRI, points to evidence that schizophrenia involves decreased communication between the right and left sides of the brain and that miswiring between nerve cells impairs information processing and co-ordination of mental functions. Evidence that parts of the brain are not communicating is also found in the corpus callosum, which connects the two halves of the brain and is responsible for relaying information back and forth. It is thicker and longer in the schizophrenic brain. The ventricles, hollowed out cavities containing cerebrospinal fluid, are also enlarged, causing emotional flatness, lack of expression and a lack of pleasure or interest in life. Children whose mothers were underweight at the end of pregnancy had a three- to four-times greater chance of developing schizophrenia, according to research in Finland. Low birth weight and thinness during childhood also increased risk of the disease. Researchers from the New York State Institute of Psychiatry, writing in the Archives of General Psychiatry, found in one study that children whose fathers were age 50 and over at the time of their birth were also likely to have a psychotic episode. At the University of Florida's Brain Institute, researchers have discovered subtle differences in 10 brain structures which could indicate schizophrenia. The influenza virus is also under scrutiny. A study by researchers at King's College Hospital in London, England, found the virus present in 13.2 per cent of mothers who had children with schizophrenia. All but two occurred during the fourth, fifth and sixth months of pregnancy. The area affected is responsible for language, processing information, reasoning, planning and abstract thought. A study published in 2001 in Proceedings of the National Academy of Sciences, reported that retroviruses, which contain RNA instead of DNA, may play a role in the development of schizophrenia in some individuals. Adding to the suspicion that viruses or infection affect fetal brain development, scientists have observed that more schizophrenics are born in winter and early spring and in cities with very cold winters. GRAPHIC: AFFECTED AREAS OF THE BRAIN: Source: www.diseases-explained.com. Star graphic: Susan Thomson-Stamcoff; CEREBRAL SLEUTH: At his lab in Montreal, neuroscientist Tomas Paus scans the brain. Photo special to The Star: Marcos Townsend Advertisement Copyright 1996-2004. Schizophrenia.com. All Rights Reserved.

医学

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Hair Concerns Coarse Hair Crusty Scalp Curl Enhancers Dry Scalp Hair Coloring Hair Staightening Impetigo of the Scalp Itchy Scalp Scalp Eczema Scalp Hair Scalp Psoriasis Unmanageable Hair Unruly Hair Naturally, crusting, redness and yellow scaling rashes on a newborn baby’s scalp can cause worry. Fortunately there’s no need for alarm. This is most likely a condition called cradle cap. Also referred to as infantile seborrheic dermatitis, cradle cap is a common condition among newborn babies and infants that’s harmless and not indicative of other medical problems. Up to half of all babies are affected by the condition during the first three months of life.What Causes It?Glands on the skin and scalp called sebaceous glands produce a thick, sticky substance called sebum, which helps to protect the skin from moisture loss. When these glands produce too much sticky sebum, skin cells become trapped in it and aren’t sloughed off normally and pores become clogged with dead skin cells. This leads to the crusty rash, redness and scaling that is typically seen with cradle cap. Poor skin hygiene is not believed to be a cause of cradle cap.What causes the sebaceous glands to produce too much sebum? Hormones from mom are still circulating in a young baby’s bloodstream for a few weeks after birth. Experts believe these hormones stimulate the sebaceous glands to over-produce sebum and clog the hair follicles. Cradle cap is more common in families with allergic conditions such as asthma and eczema. In some cases, the affected areas can become infected with bacteria, causing redness, swelling and blisters that drain fluid. Yeast growing in the excess sebum may also be a contributing factor for cradle cap.There’s some thought that cradle cap may be related to a deficiency of the B-vitamin biotin, but there’s not enough evidence to support supplementing with biotin.Cradle cap isn’t a cause for alarm, and it can usually be treated at home as long as the areas aren’t infected. The scaly rash usually resolves on its own in six months or less, although some cases can last up to a year. The symptoms will resolve over time without treatment and the areas are typically not painful or itchy, but many new mothers want to treat the areas for cosmetic reasons or their own reassurance. In some cases, the rash and scaling will spread to other parts of the body, particularly around the eyes, eyebrows or behind the ears. Some doctors may recommend a mild hydrocortisone cream.The best way to treat the affected areas is to rub the scales and crusts with mineral oil to soften and loosen them up. Use a soft toothbrush to massage the scales to gently remove them. Follow up by shampooing baby’s head with a mild baby shampoo. If the areas become inflamed, some doctors will recommend a dandruff or anti-fungal shampoo. If the areas are infected, they may prescribe an antibiotic.Talk to your baby’s doctor before using medicated shampoos since some of the ingredients can be irritating to a baby’s eyes. The areas are not typically itchy, although some babies pick at the scales and cause irritation that can lead to itching. If this is the case, some doctors may recommend a mild hydrocortisone cream. Shampooing every other day may help with the scaling, but always use a mild shampoo to avoid irritating the scalp.Cradle cap is a harmless and common condition that goes away within the first year of life, but babies who have this condition may be at greater risk for seborrheic dermatitis or dandruff later in life.The Bottom Line?Infantile seborrheic dermatitis or cradle cap is a benign condition that’s not harmful or irritating to a baby. It’s one of the most common conditions seen in newborn babies and babies under three months of age. It usually resolves on its own within six months to a year, although babies who have it may be more susceptible to seborrheic dermatitis or dandruff later in life. Cradle cap is also more common in families where allergies are common, so it may be a marker for an increased risk of allergies later on.Even though treatment isn’t necessary in most cases, gently removing the scales and shampooing with a mild shampoo every other day can markedly improve the appearance of baby’s scalp – and that’s a good thing for new moms who want to show off the new member of their family.

医学

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Newslink Home Madrid, Spain Campus Visit SLU August 02, 2013Riya V. Anandwala ranandwa@slu.edu New Clinical Trial at SLU to Assess Gene Therapy in Patients with Poor Heart FunctionST. LOUIS — Saint Louis University has enrolled its first patients in a new clinical trial that will further assess the efficacy of gene therapy in patients with advanced heart failure. Paul Hauptman, M.D., professor of internal medicine at SLU is the principal investigator of the study. The new study, "CUPID 2b", follows the initial exploratory study, "CUPID" that enrolled 40 patients nationally and tested whether MYDICAR — a genetically-targeted regulatory protein replacement therapy — could repair heart muscle that was damaged by a prior heart attack or cardiomyopathy, a heart muscle disease. The new trial will enroll a total of 200 patients in 52 sites worldwide. "This trial is the next important step in advancing gene therapy as a treatment for advanced heart failure," said Paul Hauptman, M.D., professor of internal medicine at Saint Louis University School of Medicine and principal investigator of the study. "With this new study we will now be able to assess whether the early impressive improvements seen in CUPID can be replicated in a much larger number of patients." Michael Lim, M.D., director of the division of cardiology at SLU, performs the catheterization procedure. The therapy involves infusing a gene — a type of regulatory protein called SERCA-2a — down the coronary arteries that may help the heart cells better utilize calcium, which is similar to an engine getting better gas mileage. This outpatient procedure is performed in a cardiac catheterization lab and aims to increase the level of SERCA-2a, which is reduced in the individual heart muscle cells in patients with heart failure and can thereby change the way those cells function "This study provides a truly novel therapy to help the heart improve its ability to function for patients who are suffering from symptoms related to poor heart function," said Michael Lim, M.D., who serves as director of the division of cardiology at Saint Louis University and performs the catheterization procedure. "A patient will undergo a heart catheterization procedure to have the therapy delivered, which will not be any different from a catheterization procedure that they have received before." SLU is the only medical center in the region and one of only 33 in the nation that is participating in the study. To participate in the trial, please contact the Cardiology Research Office at Saint Louis University at 314-577-8876. Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: infectious disease, liver disease, cancer, heart/lung disease, and aging and brain disorders.

医学

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Tuesday, 27 July 2010 20:47 Groundbreaking to be held for hospice facility An “old-fashioned” groundbreaking will be held July 30 for the new Homestead hospice inpatient facility, complete with a working mule and plow and banjo music. The hospice has raised $2.8 million of the $3.6 million needed to build and equip the facility through two generous grants, community donations and a donation from the Bernice Medford estate. The new facility will house six beds for hospice patients, offering families with a dying loved one a choice in between hospitalization and in-home care. The groundbreaking will be held at 10 a.m. near the construction site on the hospital campus. Marc Pruett of the Balsam Range will provide bluegrass music for the occasion. Construction on the inpatient facility is expected to be completed by Sept. 2011. Clark & Leatherwood construction company of Waynesville is slated to serve as contractors for the project. The second phase of the project will eventually be the end-of-life outreach center, which will focus on outpatient services and community outreach programs, including space for medical professionals, therapists, clergy and volunteers to collaboratively manage care for patients in the home care hospice program. There will be private rooms for counseling services and bereavement therapy, a reference library for resources related to terminal diseases and end-of-life issues, and a community education center with multimedia capability. A courtyard will connect the two buildings, and memorial gardens will provide for intentional counseling through gardening and for memorial butterfly and dove releases.

医学

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NHS Trust faxed patient data to the wrong number for three months Posted on May 21, 2012 by Andrea Letitia Colander - Business A London Community Healthcare trust has been slapped with a fine of £90,000 after the Information Commissioner’s Office found it in serious breach of the Data Protection Act. The watchdog, which had its website hacked last week amid accusations that it didn’t protect citizen’s privacy enough, first became aware of the NHS Trust’s wrong doings back in March 2011. This was after after patient lists from the Pembridge Palliative Care Unit, intended for St John’s Hospice, were faxed to the wrong recipient. The patient lists were said to contain sensitive personal data relating to 59 individuals. This including medical diagnoses and information relating to their domestic situations and resuscitation instructions. The individual informed the Trust in June that they had been receiving the patient lists, which consisted of around 45 faxes over a three month period. However, they claimed that to protect privacy, they had shredded them. The ICO conducted an investigation that found the trust had failed to have sufficient checks in place to ensure sensitive information sent by fax was delivered to the correct recipient. It also barked at the trust for failing to provide robust data protection guidance, and training to the members of staff that had accidentally sent the faxes. Stephen Eckersley, the ICO’s Head of Enforcement, said that the fact that this information was sent to the wrong recipient for three months without anyone noticing made the case “all the more worrying”. Tags: anonymous, breach, ddos, dpa, fines, ICO, London, security, trust, website breach Search for:

医学

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Guide to Living With HIV Report Says African Mothers Confused Over Infant-Feeding Options to Prevent HIV Transmission Some women in African nations are "dangerously confused about the best nutritional path to protect their children from contracting [HIV]," a new report, based on research by community health workers from Cameroon, Cote d'Ivoire, Ethiopia, and Nigeria, shows, PlusNews reports. Though the most recent WHO guidelines (.pdf) on infant-feeding options for HIV-positive mothers in Africa have been adopted in many countries, the recommendation that infants be exclusively breastfed for their first six months has not reached local health care workers or policymakers, according to the report, which was launched this week at the 16th International Conference on AIDS and STIs in Africa (ICASA) in Addis Ababa, Ethiopia. The report also "found that prevention of mother-to-child transmission programs were focused too narrowly on the provision of [antiretrovirals (ARVs)] to HIV-positive pregnant women, rather than more comprehensive approaches that involved family planning, maternal health care and exclusive breastfeeding," according to the news service (12/9). Addressing Gender-Based Violence Through PEPFAR Programs CSIS Report Examines Reaching Women, Girls Through Global Health Initiative in Malawi Breastfeeding & HIV/AIDS Copyright © 2007-2016 Remedy Health Media, LLC. All rights reserved. Newly Diagnosed? Words of Encouragement from HIV-Positive Women What Did You Expect While You Were Expecting?

医学

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Equine Narcolepsy By Lee Benson Narcolepsy Print Email As Jennifer Johnson stood in the lineup awaiting the judge's decision with her recently acquired Quarter Horse mare Dobie Breeze, the last thing she expected was that her mount suddenly would collapse in a heap beneath her. But that's just what happened. Moments later, the mare scrambled back onto her feet and calmly resumed her normal stance, while her startled and perplexed owner looked on. Fortunately for Jennifer, the mystery of the mare's strange behavior was solved practically on the spot when a spectator informed her that her horse appeared to be narcoleptic. Research confirmed the diagnosis in the following days. Although the episodes continued, Jennifer showed Dobie successfully for many years after that initial incident (the mare earned a place on the AQHA Register of Merit). During events that required a lot of standing still, such as showmanship and halter classes, she learned to spot the signs--drooping eyelids, a slight lowering of the head--in time to give the mare a pinch or rattle the reins and snap her back to full consciousness. When picking out her tail, Jennifer would remain watchful and ready to jump out of the way in case Dobie started to fall. Crashing sounds during the night often summoned Jennifer to the stable. There, she would find Dobie standing calmly, often with a few new scrapes and scuffs acquired from a dive into the manger minutes earlier. Dobie Breeze, now retired from showing, was fortunate to fall into the hands of a kind, patient owner who was willing to work with this otherwise healthy and athletic horse throughout a lifetime that would be oddly punctuated with attacks of equine narcolepsy. One must remember that equine narcolepsy is an extremely dangerous disease, and only professional horse people should work with these horses. The consequences of an attack can be devastating and life threatening to the person around a narcoleptic horse. Narcolepsy, The Disease Narcolepsy is a rare and severe sleep disorder that has been reported in many mammals. In humans, it affects approximately one to two in 2,000; in horses the incidence probably is even lower. Although narcolepsy was identified in humans almost 100 years ago, like many sleep disorders research was not initiated until the early 1970s. All that we know of sleep disorders in animals stems from studies on the condition in humans, and even today relatively little time and money is available for research on sleep disorders. Ironically, it is estimated that the consequences of sleep disorders have a larger impact on the North American economy than any other physical affliction, mainly due to people missing work. The causes of narcolepsy remain largely a mystery, although scientists have come to understand something of the processes involved. Sleep was once thought to be nothing more than a simple slowing down of the brain and body. We now know that sleep and its various phases are a complex orchestration of neurochemicals, hormones, biological clocks, and various body chemicals and systems. We also know that certain neurotransmitters--such as adrenaline, serotonin, and dopamine--play a large role in gov-erning the sleep process and its patterns. A neurotransmitter is a chemical manufactured by the nervous system and stored in the body's nerve cells. When a nerve cell releases a neurotransmitter (fires), an electrochemical reaction takes place. In narcolepsy, the neurotransmitters related to sleep fire improperly or off-cue. Some theories about the cause of narcolepsy blame depleted levels of neurotransmitters, or the body's inability to produce sufficient amounts of them. Studies of narcolepsy in humans have revealed that there are four components of the condition. The first component is excessive daytime drowsiness, during which periods of rapid eye movement (REM) sleep might invade waking consciousness. REM sleep is the phase of sleep during which we dream. It is so named because the eyes move rapidly back and forth during this period. The second component is cataplexy, which is a sudden and temporary loss of muscle tone while conscious. Cataplexy is one of the most baffling aspects. In humans, an attack might be triggered by sudden surges of emotion, especially laughter, anger, or surprise, causing victims to buckle at the knees and collapse. After a few moments, they can stand again. Sleep paralysis is the third component, and perhaps the most frightening for victims. During sleep paralysis, a narcoleptic might awaken during the night and find that he or she is totally paralyzed. The paralysis usually lasts no longer than a minute but might seem to last for hours to the victim. Daytime hallucinations and/or extremely terrifying dreams are the fourth component. Narcolepsy In Horses The first two components of human narcolepsy (the sudden onset of REM sleep and cataplexy) have been witnessed in horses. As horses are unable to tell us whether they dream, hallucinate, or experience sleep paralysis, we will never know if the other two components play a part or not. In narcoleptic horses, the sudden onset of REM sleep usually occurs during periods of inactivity--while the horse is in his stall, at pasture, or standing relaxed in a run-in shed. Typically, the horse will drop his head quite low and spread his front legs for balance while the hindquarters sag. The horse's eyes might be closed or half-open, and eye movement (REM) is visible. Most horses remain standing during attacks, but some, particularly ponies, sit down on their haunches and might roll onto their sides. Attacks can last from a few seconds to 10 minutes. Some horses can be aroused easily, others not at all. In all cases, horses awake calmly and resume their normal behavior immediately as if nothing happened. Cataplexy is a more problematic and potentially dangerous aspect of narcolepsy in horses, simply because of the size of the animal. While emotions have proven to be attack-triggers in humans, simple actions such as stroking the head and neck, leading a horse out of his stall, hosing or bathing after exercise, or the intake of the first mouthful of water or grain at feeding time, can cause a narcoleptic horse to buckle suddenly at the knees, stumble, and possibly collapse. As in humans, the cardiac and respiratory muscles continue to work normally during the episode, while all other muscle groups lose function to varying degrees. Forcing a horse to try to walk his way out of a cataplectic episode can cause him to become ataxic (lose control of all muscle functions). The best approach is simply to stand back and let the episode run its course. Within minutes, or even seconds, the horse will regain control and return to normal. Most literature on equine narcolepsy agrees that episodes, particularly cataplectic episodes, do not occur during exercise; however, reports from owners differ. Jennifer Johnson's mare Dobie had two foals. One of them, now an eight-year-old gelding, is a narcoleptic who regularly collapsed under saddle at slower gaits. However, the faster he went, the less likely he was to suffer an attack. His owners decided to take a pragmatic approach and turn him into a barrel racer, and have had few problems since. Accounts such as this one suggest that narcolepsy is a genetic disorder and a heritable one. This might explain why certain breeds, such as Thoroughbreds, Quarter Horses, Standardbreds, Morgans, Appa-loosas, and Welsh ponies, appear to be more susceptible to narcolepsy than other breeds. Narcolepsy also has been known to run in certain families of Suffolks and Shetlands in the United Kingdom, where the condition is sometimes referred to as "fainting disease." In horses, as in humans, narcolepsy generally declares its presence early in life. The first episodes often occur in foals around six months of age, although adult-onset cases have been reported. Sometimes foals can outgrow it, but often it is with them for life. A predictable pattern to the attacks, including their frequency and duration, usually is established within two weeks of the initial episode. Diagnosis And Treatment One of the most troubling aspects of narcolepsy is that it can be mistaken for other conditions that are much more serious and require immediate intervention--such as shock, poisoning, snake bite, botulism (especially in foals), heat stroke, seizures, or exhaustion. Narcolepsy can strongly resemble hyperkalemic periodic paralysis (HYPP--a genetic muscle stimulation disorder that causes varying levels of intermittent paralysis) in Quarter Horses. That certainly would elicit panic in a horse owner. Narcolepsy is rare enough that most vets have not had any experience with the condition, and since attacks usually occur during rest and are short-lived, it is rare that veterinarians get to witness the episodes. However, knowledgeable, well-read veterinarians will be able to make a diagnosis based on a detailed account of the horse's actions and physical attitude. If there is serious doubt, a test involving the administration of physostigmine salicylate can be done by a veterinarian. In narcoleptic horses, physostigmine will cause a cataplectic attack within three to 10 minutes of administration. The test also can induce a colic attack, so it only should be used when other life-threatening conditions cannot be ruled out by any other means. There is no cure for narcolepsy in humans or horses, and treatments for the disease can cause a multitude of other problems. In human patients, the disease can be curtailed with lifestyle adjustments to reduce stress, combined with the well-timed use of stimulants and antidepressants. Knowledge of how the disease works and learning to identify possible triggers can help patients dramatically in coping with and avoiding attacks. Obviously, such approaches would not work with equine patients. On the drug therapy side, imipramine, a tricyclic antidepressant, has been used to treat narcoleptic horses with inconsistent results, while atropine sulfate has been shown to relieve the condition in horses for up to 30 hours. Both drugs can cause severe colic attacks, so the risks far outweigh the benefits. There is some good news to report in drug therapy options. Recently, Sharon Doolittle, DVM, whose practice is based in Johnston, R.I., has had success treating narcoleptic horses with the antidepressant amitriptylene. Doolittle treated four horses with the drug with excellent results in three of them (the fourth horse was sold before she could make an assessment). In each of the cases, the owners reported that their horses would become drowsy, suddenly fall asleep, then crash to the ground while standing in cross-ties, being groomed, waiting between classes at horse shows, or standing in their paddocks. The owners were concerned that their horses might injure themselves, perhaps severely, by collapsing so suddenly. Doolittle did not witness any of the incidents, and all of the owners declined the physostigmine test, fearing side effects. After doing blood work (a complete blood cell count and chemical profile) and considering the owners' descriptions, she made presumptive diagnoses of narcolepsy and began administering amitriptylene, a drug that had been recommended to her by researchers at Tufts University. One horse responded with a complete cessation of symptoms. A second horse responded with 80-90% f ewer epi-sodes, while a third horse had to be given the maximum dosage to achieve a 50-60% reduction in the fre-quency of the attacks. While amitriptylene can cause colic, none of the horses treated by Doolittle experienced negative side effects. An owner's decision to use drug therapy should be made only after thorough consultation with a veterinarian. The frequency and severity of the attacks, the potential for injury, and the risks of drug treatment must be weighed before deciding on the best course of action. In some cases, the wisest approach might be to follow Jennifer Johnson's lead and simply learn to live with it. With or without drug therapy, narcoleptic horses will require a little more monitoring and attention to their environment than normal horses. If you suspect you've got a "sleeper" on your hands, consider these management tips: Invest in break-away snaps for your lead shanks and cross-ties. Install rubber padding on the walls and floor of the horse's stall. Remove any objects from the paddock, stable, and stall that could injure the horse if he were to collapse on or near them. If you don't already know how to tie a quick release knot, learn now. A team of researchers at Stanford University has identified the gene that causes narcolepsy in dogs (Lin, L.; Faraco, J.; Li, R.; Kadotani, H.; Rogers, W.; Lin, X.; Qiu, X.; de Jong, P.J.; Nishino, S.; Mignot, E. The Sleep Disorder Canine Narcolepsy Is Caused by a Mutation in the Hypocretin (Orexin) Receptor 2 Gene. Cell, 98 (3); 365-376). The result of a 10-year study, this breakthrough has enormous implications and might prove to be a crucial step in the development of new treatments and cures for various sleep disorders in humans and animals. About the Author Lee Benson Lee Benson is a communications consultant, editor and freelance writer living near Orangeville, Ontario. She is the managing editor of Horse-Canada.com and Racing Quarterly magazines. Neurologic Problems in the Foal Horse Sleep Disorders and Seizures Reviewed for Equine Vets Sleep and Sleep Disorders in Horses, AAEP 2008 Narcolepsy in Horses Equine Collapse Reviewed Concerning Collapse Taming the Beast: A Review of Equine Neurologic Disease Fainting Foals, Sleepy Horses Sleep-Crashing PrevNext

医学

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Lesson 1: Overview of environmental health principles Epidemiologic triangle model of disease causation A common model used in public health illustrates the relationships among an agent, a host and the environment. It applies to biological, chemical and physical agents. For a disease or injury to occur, the basic elements of disease or injury causation and an adequate chain of transmission (i.e. environmental pathway) must be present. View example 1 and example 2 to learn more. Disease occurs when an outside agent capable of causing the disease or injury meets a host that is vulnerable to the agent in an environment that allows the agent and host to interact. These basic concepts help guide the selection of health strategies to prevent health problems. One of the key jobs for the EH professional is to intervene at any point in order to reduce the hazard to health. (Source: CDC) Move your mouse over the above links to learn more. When done, click the forward arrow to continue . View script Chain of transmission Agent, host, and environment alone are not sufficient to cause an epidemic; an adequate chain of transmission must be present. This process requires a source for the agent, a portal of exit, a mode of transmission, and a portal of entry. Here are two examples of this model. Agent This is an entity that causes the injury or disease. An agent can be biological, chemical or physical. For example, Campylobacter bacteria present on raw chicken is an agent. Anhydrous ammonia in a storage tank is also an agent. Radioactive waste stored at a nuclear power plant is an agent. The host is the human, or, more generically, the organism, that is susceptible to the agent. Some hosts are more susceptible than others. Children are more vulnerable to many agents than healthy adults. Immuno-compromised individuals, such as people on chemotherapy, are more susceptible to some agents. The host's response to exposure can vary widely, from showing no effect to manifesting sub-clinical disease, atypical symptoms, straightforward illness, or severe illness. The environment consists of the conditions that are not part of either the agent or the host, but that influence their interaction. A wide variety of factors, including physical, climatologic, biologic, social, and economic conditions can come into play. Example 1: Biological Agent Agent: Camplyobacter bacteria Host: Humans working at a disaster scene Environment: A disaster scene at which food brought by volunteers is served to people working on the disaster Source for the agent: Chicken that was not properly prepared or was undercooked, was delivered to the disaster scene and was not held at proper temperature Portal of exit: Chicken is served by volunteers to workers at the disaster Mode of transmission: Chicken juices with infective quantities of Campylobacter Portal of entry: Oral, if a person eats contaminated food and ingests enough bacteria to become “sick” Intervention: The best intervention at this point for an EH professional is to embargo the chicken when it is found to be at improper temperature, and to dispose of it. This would break the chain of transmission between the source and the portal of exit. During a disaster, a foodborne illness among disaster workers would make the situation worse. Example 2: Chemical Agent Agent: Anhydrous ammonia, a chemical stored in liquid form that becomes gaseous when exposed to air Environment: Minot, ND Host: Humans living near the scene of the disaster Source for the agent: Tank cars containing the anhydrous ammonia Portal of exit: A train derailment that caused tank cars containing the agent to break open, releasing the chemical Mode of transmission: Through the air as a toxic cloud. Inhalation of ammonia can cause irritation and burns of the respiratory tract, chest pain, and shortness of breath, and may lead to suffocation Portal of entry: Inhaling vapors through the Intervention: Following the derailment the best intervention is to evacuate people from the area. This would break the chain between the mode of transmission and the portal of entry.

医学

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Calendar of EventsAll NewsPublicationsSocial MediaMedia ResourcesSubscribeContact Us Spector’s Research and Teaching Leads to Visible EP Model and Spin-Off Company Peter Spector, M.D., Professor of Medicine and Director of Electrophysiology at Fletcher Allen Health Care (Photo by Jeff Clarke) Physician scientists can find inspiration – and solutions – in every corner of an academic medical center: the clinic, the research arena, or while teaching. That’s how Peter Spector, M.D., a University of Vermont professor of medicine and director of electrophysiology at Fletcher Allen Health Care, came to co-develop – with Professor of Medicine and engineer Jason Bates, Ph.D. – a three-dimensional computational model of a human heart called Visible EP. The software technology that Spector and Bates built is as remarkable as their collaboration. Spector came to the table with the vision of the final product and a deep understanding of electrophysiology and how the heart works, but was unfamiliar with the programming process. Bates possessed programming skills and expertise in computational models. Together, they produced a technology that very accurately models the electrical behavior of the human heart, to the smallest level of detail. Bates and Spector created Visible EP (which stands for “electrophysiology”) as a means to gain a better understanding of how to cure the most common abnormal heart rhythm – atrial fibrillation (AF) – which afflicts more than five million people in the U.S. alone. To date, says Spector, treatment has been less than adequate. The result of their teamwork is a program that mimics the behavior of the heart from every aspect, as well as features the ability to provide unpredictable responses – a phenomenon called emergent behavior. While the parts of the heart and the rules of interaction have been programmed into the system, the computational heart model’s reaction is entirely emergent, says Spector. “We’ve made, essentially, a living, breathing, interactive human heart,” he says. “It will sit there and beat in what would be the equivalent of a normal rhythm; you can induce every sort of abnormal heart rhythm that you can imagine that a patient could have, and it’s all happening on a computer screen.” Visible EP’s emergent behavior feature makes it an attractive tool for medical education, as well as research applications. Because it can’t be readily seen, electrophysiology has been regarded as a particularly difficult specialty to teach; the field was waiting for just such a teaching tool as Visible EP. Spector and Bates were recognized with an award for licensing Visible EP at the 2013 Vermont Invention to Venture conference, an annual day-long event co-organized by UVM’s Office of Technology Commercialization. In summer 2013, Spector officially set up shop as founder and director of his spinoff, Visible Electrophysiology, LLC, a medical simulation company whose staff includes a chief technology officer and educational product manager at Visible EP. Spector uses the Visible EP technology in his arrhythmia research lab, where his team consists of three biomedical engineering doctoral students and a postdoctoral MD research fellow. Using this computer model, combined with studies of the real human heart, the group has proposed a new approach to analyzing an individual patient’s electrical activity and to using this information to guide a new type of ablation. In addition, the team has developed a new catheter, signal processing algorithms and a mapping approach for treatment of AF. This work has been sponsored by a generous grant from the Evslin Foundation and has led to the submission of eight patent applications through the University’s Office of Technology Commercialization. Note: Look for a more in-depth story about Spector and other UVM College of Medicine faculty members working with the Office of Technology Commercialization in the next issue of Vermont Medicine.

医学

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What Is the Function of Compact Bone? A diagram of the anatomy of a bone, showing the compact bone. A cross section of a compact bone shows concentric circles called lamellae. Compact bone can be found throughout the human skeleton. Victoria Blackburn Edited By: Jessica Seminara Compact and cancellous — or spongy — bone are the two types of tissue found within most bones. Due to its function, compact bone is also referred to as strong bone; due to its structure, it is referred to as cortical bone. The two tissues serve different purposes in bones, with the main function of compact bone being to provide strength and protection to the bone. Cancellous bone also provides strength, but due to its structure, it has a much lower mass than compact bone. When compact bone is studied, it is found to be made up of concentric circles called lamellae. Within each lamella, collagen is mixed with inorganic minerals like magnesium, calcium and phosphorus and layered around a Haversian canal. An artery, a vein, lymph vessels and nerve fibers are found within each Haversian canal. Osteocytes, or bone cells, are found in lacunae, which are spaces within the lamellae. The components of the lamellae and the Haversian canal are referred to as a Haversian system. Most think that bone is a dead tissue, but this is not the case. It provides protection and support to the rest of the body, so must be able to grow, as well as repair and replace any damage. The very outer areas of bone are composed of compact bone. When stress is placed on a bone, a function of the compact bone is to provide inorganic components so that new bone tissue can be formed. Ad Although compact bone is made up of Haversian systems, it is almost solid. This makes it very dense, so it has a high mass. Even though the function of compact bone is extremely important to protecting a bone from damage, the mass of this type of bone is what limits it. If bones were made completely of compact bone, they would become too heavy for efficient use by the body. As well as providing strength and support to the bone where it is found, there is another function of compact bone. The lamellae act as reserves for the inorganic molecules stored there. Not only are these molecules used to produce new bone cells, but they act as a reservoir for calcium and phosphorus for the body. The function of compact bone is to help to keep the levels of these minerals at constant within the blood. The arteries and veins that run through the Haversian canals provide a means to transport the minerals to and from the compact bone. The minerals are deposited for storage within the lamellae when blood levels are high. When levels are low, minerals are absorbed out of the lamellae and transported throughout the body. Ad What Is the Structure of Compact Bone? What Are the Different Types of Compact Bones? What Is the Biomechanics of Bone? What Is a Leg Bone? What is the Haversian System? What is the Clavicle Bone? What are the Different Skeletal Functions? DanceShiya What happens to compact bone when certain minerals are at an all-time low if not completely removed from the body? Is this possible, and if so what are the effects? Post your comments

医学

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Local Plastic Surgeon Accused of Using Fake Botox By Courtney Hayes | Posted: Wed 8:45 AM, Jan 19, 2005 | Updated: Wed 8:45 AM, Jan 19, 2005 Federal Food and Drug Administration investigators say they found Panama City plastic surgeon Daniel Daube's name on an invoice as a purchaser of botulinum neurotoxin, which has become popular with some doctors because it is much cheaper than Botox. The Arizona company that sells the toxin says it's intended for research only, not for human use in place of Botox. Florida Department of Health officials say Daube treated 14 patients since he bought the toxin, but he told investigators he didn't know which ones received Botox and which got a doze of the unapproved toxin. The material, which is similar to what's used to make Botox, is blamed for paralyzing a doctor and three people he injected in Ft. Lauderdale. In a written statement Daube says he purchased the toxin by a company he thought was reliable. He says he found out about a month ago by media reports that the product was not approved and discontinued its use. Daube says he's confident he will be cleared of any wrongdoing. State health investigators say Daube's license will remain suspended until the medial board takes up the investigation, which won't be anytime before April of this year.

医学

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Life. Worth. Living. Hope for Adolescents with Mood Disorders as Rogers New Residential Program Opens February 19, 2016 - 11:21am Imagine a 16-year-old girl sitting in her room, overwhelmed by her own emotions. She was once outgoing and involved in high school sports and clubs, but now she finds herself wanting to just be alone. She carries around thoughts in her head that confuse and exhaust her, feeling like she can’t connect with her family or friends. This is just one example of the type of situation a teenager may be in that Rogers can help with its new FOCUS Adolescent Mood Disorders Program planned for opening in March. This program offers comprehensive residential treatment for adolescents age 13 to 17 struggling with primary mood disorders, bipolar disorder, depression and co-occurring disorders. The program becomes Rogers’ eighth residential treatment program on the campus of Rogers Memorial Hospital–Oconomowoc.Peggy Scallon, MD, who joined Rogers in February, will serve as medical director. She has spent much of her 20 years in psychiatry treating children and adolescents. “I love to work with children and teens because they are so honest and engaging. They have their whole lives ahead of them, so the positive impact of effective treatment will be with them for decades,” says Dr. Scallon. “I am so excited about the new FOCUS Adolescent Mood Disorders unit because I want to make a meaningful difference in the lives of our patients and their families. We have an enthusiastic team and we will transmit our passion for working with youth into change for the better.”This new program will complement Rogers’ existing treatment specialties. “The FOCUS Adolescent Program will expand Rogers’ current programming for anxiety, obsessive-compulsive disorder (OCD) and eating disorders, to address youth with depressive disorders,” says Dr. Scallon. “We recognize that adolescents with depressive disorders may have a complicated mental health situation that can also include trauma, family difficulties and experimentation with substances. This program will be able to address the multiple factors that may be contributing to a teen’s mental health difficulty.”“This FOCUS program is different from Rogers’ other adolescent residential programs because it provides treatment to teens who are experiencing more severe symptoms than we’d normally serve in our other programs,” says Eddie Tomaich, PhD, manager of the FOCUS adolescent program. “Staff in this program will be cross-trained to handle more complex cases, such as teens that may have anxiety coupled with severe depression.”Treatment involves evidence-based cognitive behavioral therapy (CBT) and is supported by behavioral activation, mindfulness skills and strong family involvement. “We’ve found that when patients practice behavioral activation, or gradually reboot their activity levels, such as through exercise or public outings, they become less likely to isolate themselves and experience a decrease in their depressive symptoms,” says Dr. Tomaich. Through this program, our patients’ families have access to Parent University, a program that educates families and prepares them with skills to help their child make a more successful transition from our care to home life.Dr. Scallon explains the goal of the FOCUS adolescent program is to teach teens techniques they can use to better cope with life’s challenges. “In the program, we will use individual, group and family therapy strategies that build upon existing strengths and teach new skills,” she says. “Our emphasis upon psychotherapy will empower our residents to leave the program, and return to their lives healthier and happier.” Read More Computer-Based Therapies: One Study Doesn't Speak for All February 3, 2016 - 10:52am An article published by National Public Radio (NPR) discusses a study based in the United Kingdom that researched two online programs that were created to treat depression. The results showed that the programs were ineffective, mostly because the patients weren’t likely to keep up with the program or remain engaged. The article goes on to suggest that face-to-face, traditional psychotherapy should be the method of choice for consumers. At the same time, other recent blogs and articles claim that online therapy is becoming more desirable among patients. So what should you believe? Bradley Riemann, PhD, clinical director of the OCD Center and cognitive behavioral therapy (CBT) services at Rogers Memorial Hospital—Oconomowoc, explains how there are two sides to every coin.“The biggest issue that people have to be aware of is that you can’t generalize all computer programs, applications and other software into one pile. Just because these particular programs were found to be unsuccessful, doesn’t mean others wouldn’t be,” says Dr. Riemann. “The first thing you have to sort out is whether there is any data supporting the application you’re interested in. When we go to a doctor and ask for an antidepressant, we’re going to get a medication that has been thoroughly studied and found to be helpful for most people. But when purchasing an application or online therapy, that luxury is not automatically given to us and we have to be proactive and savvy consumers.”Besides researching the program, Dr. Riemann recommends that consumers: Explore the computer program’s website Look for published outcomes, journals or articles on their website Stay away from programs that use unclear language to describe their outcomes Remember that if a group says their product is tested, it doesn’t mean their outcomes were positive in that test Dr. Riemann explains that if the researchers from the U.K. would have changed certain variables in their study, they may have found different results, possibly showing that the programs could be successful under different circumstances. “If the researchers had gotten their subjects from a psychological clinic, versus a primary care clinic, those seeking that type of treatment might be more likely to do the computer-based treatment and you might find very different outcomes. The programs might not have worked in this design, but they might work in a different design.”Some claim that online therapies will cause patients, especially those suffering from depression, to isolate themselves even more than their condition causes them to—but Dr. Riemann presents an alternate possibility. “If a person is depressed and isolating themselves as a result of that depression, they may not be able to go out and seek ongoing counseling or even leave their house. Classic, traditional forms of psychotherapy or even going to a psychiatrist’s office for medications may be very difficult if not impossible,” says Dr. Riemann. “But, if a program works, it’s going to lower their depression enough to allow them to leave their house and seek further treatment.”Although online therapy could be a useful tool, Dr. Riemann explains there is natural healing aspect to social interaction. “Human interaction is helpful for more than just treating depression, it’s helpful for any psychiatric condition because we’re social beings by nature. Social support, whether it be friends, family or licensed clinicians, helps us to cope with our problems and buffers us from the stressors of the day,” he says.However, our current technology has begun to blur the lines of what is considered human interaction. “Telepsychiatry, a therapy method which allows a patient to talk with their doctor on a television or computer screen, who could be thousands of miles away in theory, has been found to be quite helpful for patients,” says Dr. Riemann. “I’m not recommending telepsychiatry be used as a replacement for traditional therapy, but there are some people who can’t access face-to-face therapy because they don’t live near therapists, costs are too high or their condition doesn’t allow them to leave the house.”He goes on to explain that increasing access to therapy, no matter the mode, may be helpful for many. “The fact of the matter is: the vast majority of people have access to computers, smartphones and tablets, but some people don’t have access to well-trained clinicians and psychiatrists. As a result, anything we can do to increase access to treatment is a positive thing, as long as that treatment has been found to work.” Read More Starting at your Own Medicine Cabinet to Prevent Addiction January 18, 2016 - 9:41am An article published by New York University discusses recent research that found an increase in the number of American high school seniors who abuse prescription opioids, or drugs that your doctor may prescribe to relieve pain. The study also found that for many of those students, their prescription drug abuse put them at increased risk of transitioning to heroin. The article explains that teens may begin using prescription opioids because they are relatively easy to access at home. Despite this study’s findings, Ian Powell, MD, addiction specialist, says that Rogers Memorial Hospital–West Allis is not currently experiencing this significant increase in adolescent opioid addiction.“As is often the case, by the time a study’s research is published, that data is usually about two years old already,” says Dr. Powell. “We are not currently seeing a large population of young patients in our withdrawal management program and intensive outpatient program that started out using prescription opioids,” says Dr. Powell. “Instead, we have seen a population of adolescents that have transitioned straight to heroin. In many ways the problem is already here, but we aren’t seeing the specific pattern that the article suggests for a number of reasons.”Dr. Powell explains that the number of doctors and dentists who are educated about prescription drug abuse is growing, as is the available technology to help decrease drug abuse. “The Wisconsin Prescription Drug Monitoring Program, for example, is a tool that practitioners in Wisconsin can use to monitor the drugs their patients are receiving from other doctors,” says Dr. Powell. “It makes it easier for practitioners to share information across the state and will help reduce the current 30 to 40 percent of adults and teens in Wisconsin who use prescription opioids and transition to heroin.”So what can parents do to help prevent this problem? “You should make it a habit to throw out your or your child’s pain prescriptions when the injury has healed,” says Dr. Powell. “Saving your medications because you think you might need them later only increases the risk that you or someone else in your household may abuse the prescription.”Dr. Powell also offers advice from the provider’s perspective. “Our primary goal, as physicians, is to relieve our patients’ pain—whether it be physical, mental or emotional,” he says. “But we do have to be aware of these dangers and take the appropriate actions to reduce widespread addiction.”People seeking addiction services may not always suffer from addiction alone. Sometimes, a person with a metal illness uses drugs or alcohol to cope with their mental illness and develop an addiction—this is called dual diagnosis or co-occurring disorders. Amy Kuechler, PhD, attending psychologist at Rogers Memorial Hospital–Brown Deer, explains that although there is no single reason why a person develops co-occurring disorders, those with mental illness are more susceptible to developing a substance use disorder. “One reason for the increased risk is because substances may be used as a way to cope or attempt to manage the symptoms of the mental illness,” she says.At Rogers’ Brown Deer campus, the most common drugs used among the adolescent patients with a dual diagnosis are synthetic marijuana and cough medicine because they are fairly easy to obtain. “In our treatment center, we have treated limited cases of heroin use, because many of our patients were still abusing opiate pain medication when they reached out for treatment and had not progressed to heroin,” says Dr. Kuechler. “But, that doesn’t mean other treatment centers aren’t experiencing an increase.”When someone has a dual diagnosis, it’s important that their conditions are treated at the same time, such as Rogers does. “One of the main reasons we treat both substance use disorders and mood disorders concurrently is because they really are contributing factors to one another, so to only treat one disorder could result in an increase of symptoms for the other disorder,” says Dr. Kuechler. “Rogers Memorial Hospital–Brown Deer offers one of the only dual diagnosis partial hospitalization programs for adolescents available in southeastern Wisconsin, as well as an intensive outpatient program for dual diagnosis,” she says. “In addition to helping patients, these programs emphasize family support and education for their child’s treatment, because dual diagnosis is not only a patient concern—it is a family system issue.” Read More Dr. Storch on Effective Components of Behavioral Therapy for OCD or Anxiety January 14, 2016 - 12:37pm This fall, Eric Storch, PhD, clinical director at Rogers Behavioral Health–Tampa Bay, along with other clinical and medical practitioners from Rogers, participated in the Association for Behavioral and Cognitive Therapies’ (ABCT) 49th Annual Convention. Among the variety of symposiums, presentations and displays he attended, two symposiums in particular shared a message Dr. Storch feels very passionate about: that exposure therapy (ERP) is the best practice for treating obsessive-compulsive disorder (OCD) and anxiety.ERP, a therapy technique that gradually exposes a patient to feared thoughts, images or impulses, has been shown to reduce anxiety and distress over time. At Rogers, ERP has been used as an active component of cognitive behavioral therapy (CBT) and our treatment outcomes have shown this method is effective for treating OCD and anxiety. Though some OCD and anxiety treatment providers use CBT without the ERP component, Rogers continues to use ERP as a part of CBT because of the method’s proven effectiveness. Sessions on “New Measurement Targets and Tools in Pediatric Anxiety and OCD” and “Improving CBT for Childhood Anxiety Disorders Through a Focus on Mechanisms of Change” discussed the importance of exposure and response prevention as a core component of treatment for OCD and anxiety. “It’s great that professionals in our field are always trying to find new techniques to achieve better results, but the current research in the field shows that exposure therapy is still the tried-and-true evidence-based approach and should continue to be the foundation of treatment,” says Dr. Storch.“These are not easy cases. Sometimes providers use a ‘kitchen sink method’ and hope that one of the many techniques used will help their patient,” says Dr. Storch, “But it’s important that we continue to focus on what works best in the case of OCD and anxiety—that’s exposure therapy.”Presenters at these symposiums also discussed techniques for tailoring treatment to each patient’s needs. “It’s important that behavioral health professionals learn how to adapt their treatment to the diverse group of patients they’re going to treat over their careers,” says Dr. Storch. “It isn’t effective to use a one-size-fits-all approach to OCD and anxiety treatment and that’s why we offer each patient an individualized treatment plan at Rogers.”Dr. Storch also explains that national conventions, like ABCT, are a valuable opportunity for professionals to share knowledge with each other and add to the field’s development. “The conference is important because it disseminates information and makes the research and discussions more accessible to a greater number of people,” he says. “It helps build professional relationships and collaborations to further facilitate progress in behavioral healthcare treatment.” Read More Telepsychiatry Increases Access to Care January 8, 2016 - 12:34pm When most people think of seeing a psychiatrist or psychologist, they picture talking face-to-face with someone. That is getting harder with a national shortage of psychiatrists. However, more providers of behavioral health—and their patients—are turning to and accepting an alternative: telepsychiatry. Rogers Behavioral Health is among those finding two-way video can work. And some patients even prefer it. Telepsychiatry, or telemedicine, allows patients to receive treatment from their psychiatrist through a video conference program, similar to Skype or FaceTime, but with heightened security. Under the supervision of nursing staff, patients use the program at Rogers’ campuses to speak with a psychiatrist, who could be hundreds of miles away.“Kenosha, Wisconsin, is a community that has a psychiatry shortage that is more significant than the national average,” says Debbie Minsky-Kelly, director of partial hospital operations at Rogers Memorial Hospital–Kenosha. Minsky-Kelly and the rest of the Kenosha team have led the way for Rogers in improving access by using telepsychiatry beginning about 18 months ago. “Before we had telepsychiatry, our patients’ face-to-face therapy time was limited because our psychiatrists had to travel to see patients and sometimes harsh weather conditions made traveling dangerous,” says Minsky-Kelly. “The technology has made our psychiatrists more readily available to provide care, including in emergency situations, which has helped to increase our patient safety.”At the Kenosha clinic, two physicians are exclusively using telespychiatry to treat patients, but all members of Kenosha’s medical staff are being trained to use the technology. “After our staff quickly became comfortable working with the system, it was easy to see the value of this resource and the full potential it could have,” says Minsky-Kelly. “Without this program and our clinic’s teamwork, we would not have been able to increase our services and recruit some of the best physicians available both on-site and off.”In addition to the staff, patients and their families have also been highly satisfied with the technology. “We’ve found that many of our patients actually prefer using telepsychiatry over face-to-face psychiatry,” says Susan Johnson, a registered nurse at Rogers–Kenosha. “Sometimes, when patients have never received behavioral health treatment before, the thought of being in a room with a psychiatrist can be a little intimidating. Some patients are more comfortable speaking with their psychiatrist through technology instead of face-to-face interaction, which can be a big leap for many who have trouble working up the courage to seek help.”Children as young as six years old to patients that are well into adulthood have been using the system. “If a patient is nervous about using telepsychiatry for the first time or is fairly young in age, our nursing staff is happy to hold a practice session for a patient to help familiarize them with the routine,” says Johnson.Like all technology, there can sometimes be minor glitches or setbacks to the system. “We have experienced the occasional internet connection failure, but we’ve worked hard to prevent those issues and are sharing our knowledge throughout Rogers’ system,” says Minsky-Kelly. “Any minor issues we encounter are similar to the hiccups we face in face-to-face therapy, but the benefits to using telepsychiatry and the increased time patients have with their psychiatrists have far outweighed our little bumps along the way.”When using a video program, a doctor may not be able to gather the same information about a patient that he or she would normally be able to in a face-to-face session, such as the presence of alcohol on a patient’s breath. “The registered nurses assess patients prior to every telemedicine session and pass along any important health information that the doctor may not have been able to gather from their computer screen,” says Johnson. “The nurses help to pick up where the technology may fall short and together we create a more comprehensive approach.” Strong patient satisfaction scores support expanded use of telemedicine when needed and appropriate, Minsky-Kelly says. Rogers currently has 13 psychiatrists certified for telemedicine across our system, with plans to add more. Various intensive outpatient and partial hospital programs use telepsychciatry at Rogers’ Wisconsin-based locations. Our regional locations in Chicago, Nashville and Tampa Bay also regularly use the technology in their outpatient programs as well. Read More Making Positive Change Last this New Year January 4, 2016 - 8:23am Statistics show that this time of the year, 45 percent of us are going to make a New Year’s resolution, but of that percentage, only 26 percent will maintain our resolution past the first six months. It seems as though the odds are stacked against most of us when it comes to changing our ways and making major life changes, but Sue McKenzie, co-director of Rogers InHealth, insists that achieving lasting change is possible not only for New Year’s resolutions, but for achieving mental health as well. “We have to spend some time honoring our good reasons for our bad habits, which may sound a little peculiar, but what happens if we don’t do that is we can fall back into our old tendencies. We can make a change and maintain it for a short time, but the minute we have a problem with that change, we are going to go back to our bad habits,” says McKenzie.If we do take the time to make these acknowledgements, the effects can be life-changing. McKenzie says, “When we do acknowledge our good reasons for our bad habits, we can gradually begin to move into making the change we want to make and get serious about how we’re going to maintain that change over a lifetime.”The hardest part may be deciding to seek treatment and end our unhealthy habits which may stem from an eating disorder, addiction or other mental health concern. “Most of us are either on the fence about a change or are working hard to maintain it,” says McKenzie.So what can we do to help ensure that our changes will last? “There’s two things to remember that we can all do in our lives,” McKenzie says, “Have people that you trust and respect that you can check in with every once in a while. Typically, someone who knows and loves you can see that something problematic is going on before you even do. The person you check-in with could offer a simple adjustment that allows you to have a better quality of life.”The second tip McKenzie has is: “If you’re the person that sees a harmful tendency in someone that you love and trust, be a gentle, nonjudgmental mirror. Meaning, have a conversation with that person and try saying, ‘I’ve noticed things are different for you lately and I want you to have more joy in your life, can we talk about it?’”The team at Rogers has seen the benefits of family members helping a patient identify an issue, McKenzie says. “We know that a family’s unconditional support and willingness to talk about a problem can be a key part of making the decision to seek professional help. Families can also provide a source of hope and a unique perspective on their loved one’s life, knowing that their life could be a lot better.” Read More Sharing Your Recipe for Peace this Holiday December 18, 2015 - 7:31am Every year, we are faced with the challenge of maintaining our traditional holiday routine, while also taking on new activities. As our to-do list piles up, it can take a toll on our mental health. The unrealistic expectations of what our holiday is “supposed” to be like, including how we are “supposed” to feel can sometimes be too much to handle. “We look at the holiday season with the expectation that we’re going to be filled with a lot of joy,” says Chad Wetterneck, PhD, cognitive behavior specialist for posttraumatic stress disorder programs. “While that may be true for some people, it’s really a time with a lot of strong emotion based off of how holidays have been for us in the past.”“For those who have experienced a lot of joy during their past holidays, the season is a positive time. For others who have not found joy in previous holidays, the season can be a negative experience,” he says. “Even those who are usually joyful during the holidays can experience some grief. This year may be different because family or friends are unable to join them or because someone they love has passed away.”When trying to keep up with holiday expectations, some put their own well-being on hold for the sake of others, which can become risky. “Overspending is something that some people are going to encounter this holiday. The best way to combat it is to think about whether you can set up a budget ahead of time,” says Dr. Wetterneck. “If you don’t have the financial resources this year, try telling friends and family that you’re going to give a gift that means a lot and talk about the meaning when you give it—rather than focusing on the dollar amount.”With all the hustle and bustle of the season, it can be easy to jump to commit to an activity with loved ones without realizing how booked you already are. “It’s helpful to think ahead of time about what you’ll actually be able to accomplish or have a trusted friend who can help you decide what to commit to,” he says. “When someone asks you to join them for an activity, try telling them, ‘Let me get back to you,’ so you have more time to consider your schedule.” Some of us are likely to sacrifice our own self-care during this busy season. “Build some time in for yourself or even for the group you’re spending time with,” says Dr. Wetterneck. “Try suggesting that your group spend 15 minutes listening to holiday music or taking a walk to enjoy the holiday lights.”Sue McKenzie, co-director of Rogers InHealth, explains that many people battle with their own internal stigma or personal expectations. “When some people face a challenging time, such as during the holiday season, they may tell themselves that should be able to ‘just tough it out,’ that they ‘should be able to handle it’ on their own,” she says. “People may avoid reaching out for help because they fear what it may say about themselves—but in reality, it’s healthier to ask for help than to set unrealistic personal expectations.”McKenzie suggests that we help each other this holiday season by passing along our personal advice for coping with the stress. “We share our recipes with friends and family during the holidays, so why don’t we share our recipes for peace, for handling the holidays and for inner acceptance?” Read More Experiential Therapy Takes Alternative Route to Recovery December 11, 2015 - 7:51am Experiential therapy is a hands-on experience-based approach that assists in healing and overcoming mental or emotional challenges. At Rogers, there’s a variety of experiential therapy approaches available to patients, including art and music therapy, recreational therapy, yoga, horticultural therapy and adventure therapy—which uses challenge courses at various campuses.“All of the experiential therapies at Rogers engage groups through interactive experiences which can deepen their understanding of their treatment,” says Mike Hoelzer, art therapist at Rogers Memorial Hospital—Oconomowoc. “Patients could be using experiential therapy to work on their emotional awareness and expression, learning coping skills or developing new leisure skills.” Experiential therapy puts people in situations they may never have been in and the results of this therapy technique are encouraging. “I’ve seen so many people come into our program and express feelings that they may never have expressed before, learn new skills that they didn’t think they were able to accomplish, build new relationships, take healthy risks and learn to trust people,” says Hoelzer. “It’s quite an incredible way to work with people in a treatment setting.”Although the activities used for art therapy sound like fun, there are difficult topics and realizations that patients have to face during their sessions. “The projects and tasks we do can be very exciting, but there is a lot of work going on in the therapy process, no matter what type of experiential therapy our patients may be participating in,” says Hoelzer. “At first, patients may be defensive about revealing their emotions, but when people start opening up in treatment, their defenses go down and their feelings start to become more readily expressed. Having the bravery to show true emotion is extremely important to begin problem solving and developing skills to cope.”Hoelzer explains that through the creative process in art therapy, the patient and therapist may be able to pinpoint the exact stressor that caused the patient to seek treatment, talk about that moment and discuss how they may be able to improve their skills. “Others have used art therapy to express that after seeking treatment, they no longer feel alone and have been able to connect with others who face similar issues,” says Hoelzer. “Creating a piece of art can also serve as a great reminder for patients who want to hold onto the skills they learned in treatment and make those techniques a regular part of their life and activities.”“When training parents, teachers and other adults in the community, we help them to understand how times when our children and youth are involved in movement, art and other activities are unique opportunities to connect at deeper levels,” says Sue McKenzie, co-director of Rogers InHealth. “Rather than see these times as breaks for the caregiver, they are times when we want to be more attentive and ready to listen.” Experiential therapists know that such experiences can be healing for the patient and in day-to-day life, they can be nourishing for relationships.Rogers InHealth offers patient stories about facing challenges and new experiences, such as those available through experiential therapy. Read More Helping Someone Who May Have Disordered Eating this Holiday December 9, 2015 - 8:57am During the holiday season, many people make the annual trip to gather with their families and share in a special meal. You may notice that a loved one has developed unusual eating habits since the last time you saw her or him. It’s only natural to want to help, but Maxine Cimperman, registered dietitian at Rogers Memorial Hospital—Oconomowoc, explains that you shouldn’t immediately jump to conclusions. “It’s important to understand that you should not base suspicion that a friend or family member has an eating disorder off of one meal,” she says. “Eating disorders need to be diagnosed by a trained clinician and are based on a prolonged pattern of behaviors.”That being said, the holidays can be a particularly difficult time for individuals who struggle with an eating disorder. “They will likely struggle with anxiety around the meal, and will often avoid social gatherings around food altogether,” says Jordan Murray, registered dietitian at Rogers’ Oconomowoc location. “Take note if your family member or friend avoids entire food categories, like carbohydrates or fats, or consistently avoids eating in with a group. Individuals with eating disorders may be overly selective of what types of food they will eat.” According to the National Eating Disorders Association (NEDA), 20 million women and 10 million men in the United States suffer from an eating disorder at some point in their life, which equals about 1 in 10 Americans. “What’s especially troubling is that the prevalence of eating disorders continues to climb, particularly in adolescents,” says Cimperman. So how do you find help for someone who may have an eating disorder? “Start by talking to the loved one that you’re concerned about,” says Murray. “Opening the lines of communication gives them an opportunity to ask for help. Open-ended questions are best, as a confrontational approach may lead to defensiveness. Try saying, ‘It seems like you are struggling to enjoy food like you used to, is there anything you want to talk about?’”Parents can also be on the lookout for possible warning signs of an eating disorder. “They should keep an eye on their child’s exercise pattern, dieting, food avoidance or any dramatic changes in weight,” says Cimperman. “The number one risk factor to developing an eating disorder is dieting. When a parent steps in and tries to help their child by pushing food or monitoring their child’s food intake, it can create a power struggle between the parent and child—which may worsen the problem.”Murray emphasizes the importance of not stereotyping people with eating disorders. “You cannot make the assumption that someone has disordered eating patterns simply based on their physical appearance,” he says. “Many who eat normally may naturally maintain a low body weight, while someone who struggles with an eating disorder may be at a very normal body weight.”“Eating disorders occur across all ethnic groups and in males as well, although males may be less likely to seek help for the problem,” adds Cimperman. “Help may also be less available for males as many treatment centers do not work with males, but the residential Eating Disorder Center at Rogers’ Oconomowoc location is one of the few that does.”Request a free screening for someone who may need professional help for an eating disorder here. Read More Miller Helps Draft Policy on Marijuana and More on a National Stage December 1, 2015 - 7:55am Michael M. Miller, MD, medical director of the Herrington Recovery Center at Rogers Memorial Hospital and attending physician for the adult dual diagnosis partial hospitalization program at Rogers’ new Silver Lake Outpatient Center in Oconomowoc, has served a leadership role in the research and writing process of the American Society of Addiction Medicine’s (ASAM) new policy statement on marijuana, cannabinoids and legalization. The statement was written to inform Congress, the media, the general public and especially physicians and other healthcare professionals about cannabis and cannabis products and the health impact of expanded access to these substances. Taking several months to draft, the policy statement addresses the most recent research from medical science on the potential positive and negative health effects of marijuana use, the climate of the current national debate over legalization, the differences between policy initiatives of decriminalization and full legalization, and possible future public health and safety measures.As more states begin legalizing marijuana use for medicinal or recreational purposes, some public leaders believe there are no reasonable arguments to limit the public’s access to marijuana and they look to legal, commercial sale as a means of generating tax revenues. The writing committee that Dr. Miller led and the Board of Directors of ASAM sought to inform decision-makers that there are potential harms that they and the society believe require further research and cannot be ignored. “This new policy this can help educate young people, parents and others that America’s relationship with marijuana are more benign than is justified by the medical facts,” he says.Dr. Miller strove to assure balance in the document to provide an accurate account of the medical and psychiatric actions of cannabinoids including THC, cannabidiol and synthetic cannabinoids, as well as the potential health consequences of expanded access, especially for youth.“This policy might be useful as a patient education document in any clinical setting where persons with addiction or psychiatric conditions are receiving treatment.” Besides the possibility of developing an addiction, several long-term health effects of marijuana use have been documented, including adverse psychiatric effects, such as impairment of motivation and learning. “Identifying at-risk groups is an important prevention strategy. Children and adolescents are particularly vulnerable to health risks and they should not use these products,” says Dr. Miller.With an extensive history of providing addiction treatment, Dr. Miller was able to add another experienced medical opinion to the committee. Other members of the writing team were Norman Wetterau, MD, the president of the New York Society of Addiction Medicine, and Jeff Wilkins, MD, the past president of the California Society of Addiction Medicine. “It was an honor to be asked to take the lead in drafting a document that we expect will be referenced quite often. I have known each of my colleagues in the writing team for a number of years, but this was one of our closest and most important collaborations,” he says.Rogers provides comprehensive, evidence-based treatment for individuals suffering from cannabis use disorder as well as a wide range of psychiatric conditions and other aspects of substance abuse or drug addiction. Read More Pages« first

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Home › News › Consumer News › With Rare... All NewsConsumerPharmaNew DrugsPipelineClinical TrialsFDA AlertsWith Rare Disorders, Misdiagnosis and Desperation Prevail Tweet SATURDAY March 20, 2010 -- People diagnosed with cancer have a difficult and scary battle ahead of them, but there's comfort to be found in the multitude of patient groups, medical associations, research facilities and hospitals dedicated to improving treatment of their disease. But what if a person suffers from thalassemia, a blood disease that affects hemoglobin? Or cystic fibrosis, a disease that causes mucus to clog the lungs and pancreas? Or jumping Frenchmen of Maine, a disorder that causes an extreme startle reaction to unexpected noises or sights? These conditions all fall into the category of "orphan diseases" -- conditions so rare that they attract little attention and few research dollars. People who have an orphan disease often find themselves misunderstood and misdiagnosed, and with no immediate support available to them. "We get phone calls from literally desperate people," said Stefanie Putkowski, a registered nurse and clinical information specialist for the National Organization for Rare Disorders, a nonprofit group dedicated to orphan diseases. "I don't know if they are hopeless. They are desperate. They can feel very isolated." The U.S. Food and Drug Administration categorizes a medical condition as a rare disease if it affects fewer than 200,000 Americans at any given time. There currently are more than 6,000 known rare diseases that affect more than 25 million Americans. "That's almost one in 10 Americans," said Mary Dunkle, vice president of communications for the rare disorders group. "Even though the diseases are rare, when you put them all together, a lot of people are affected." People affected by a rare disease all have remarkable tales, their own personal odyssey through a health-care system that cannot figure out what's wrong with them, Dunkle and Putkowski said. Putkowski related a conversation she had with a young mother who had spent six years trying to figure out why she was suffering repeated incidents in which she could not catch her breath. Doctors puzzled over it for years. They prescribed steroids and inhalers, but her symptoms only worsened. Some doctors threw up their hands, said it was all in her head and urged her to see a psychiatrist. The young woman finally went to one of the nation's top pulmonary hospitals. After spending 12 days there, doctors figured out that she had Churg-Strauss syndrome, a very severe disease that causes inflammation of the blood vessels. The disease often tricks doctors because it presents as a lung disease when really it's a vascular condition. "She was told in another six months she would not have been treatable," Putkowski said. "She ended up getting a real, true diagnosis. But, by that time, she had lost her job and was living in public housing on public assistance." Getting a solid diagnosis is just step one of the ordeal faced by a person with an orphan disease. Because the diseases are so rare, they lack the support groups and national organizations that have formed around more common illnesses. The young woman had called the National Organization for Rare Disorders because she wanted to find out if there were any support groups or treatment grants for Churg-Strauss syndrome, Putkowski said. Orphan diseases also don't attract as many research dollars because, by comparison, few people are affected by the diseases. For pharmaceutical companies, there's less chance for a good return on their investment. "Very little money goes into these orphan diseases because there's very little money to be made in the end," said Pat Girondi, founder of the Orphans Dream Foundation. "The patient base is too low." Girondi, a Chicago businessman, founded his nonprofit group to help support research into orphan diseases. His son, Rocco, was diagnosed in 1992 with thalassemia at age 2. Girondi said he spent years taking his son around the world -- California, Canada, Italy -- looking for treatments for the disease. Rocco, who is now 19, survives by receiving blood transfusions about twice a month, and his father's group is funding cutting-edge research into treating thalassemia with stem cells. His is not an isolated case. Other families of people ill with an orphan disease have also sponsored research into the affliction that's harming their loved one. "What we have found ... is that one of the main ways these rare disorders get research funding is through the patients themselves," Putkowski said. "Either the patient or the patient's family will mobilize themselves. For example, they'll put donation cans out in local gas stations. We've had the most remarkable stories of people who have started just like that and have come a long way in raising research funds." Girondi's foundation and Putkowski's group both help people find support for their disease and try to direct research funding toward developing treatments and cures for orphan diseases. Though research into orphan diseases might seem specialized, it holds the potential for paying big dividends toward medical science as a whole. Doctors looking into rare disorders might learn things that would apply to a broader range of people. Dunkle gave the example of a research team now studying a very rare bone disease. "The more they learn about that disease, it will teach them more about things as simple as fixing a broken arm because they are researching how bone grows," she said. The Office of Rare Diseases Research at the U.S. National Institutes of Health has more on orphan diseases. Posted: March 2010

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HomeStories by TopicCalendarFacesMedicine MagazineUAB MedicineContactInternship Application Researchers discover possible treatment for incurable lung disease March 21, 2013 Researchers discover possible treatment for incurable lung disease Written by Bob Shepard Investigators at the University of Alabama at Birmingham have unlocked another piece of the puzzle surrounding idiopathic pulmonary fibrosis, an often fatal lung disease with no cure and no effective treatments. In findings published March 1, 2013, in the Journal of Clinical Investigation, the research team has discovered a new pathway that contributes to fibrosis, or scarring in the lungs. More importantly, they may have also found a potential treatment to block that pathway. The key is something the researchers call mechanosensitive signaling of myofibroblasts. Myofibroblasts are cells responsible for wound healing in the body. In healthy tissues, myofibroblasts assist with wound repair then die in a pre-programmed process known as apoptosis. Fibrosis involving the lungs or other organs occurs when myofibroblasts fail to undergo apoptosis, resulting in a persistent repair process. Idiopathic pulmonary fibrosis, or IPF, occurs when lingering myofibroblasts secrete too much collagen in the air-sacs of the lungs, leading to scarring and stiffening of the surrounding matrix tissue. The researchers report that a protein called Rho kinase, known as ROCK, may contribute to the failure of myofibroblasts to undergo apoptosis. ROCK activates a mechanical signaling pathway causing the myofibroblasts to respond to mechanical cues. This promotes the survival of myofibroblasts and leads to more scar tissue formation, creating a vicious cycle of non-resolving repair. “Fibrosis begets more fibrosis in a sort of feed-forward mechanism,” said Victor Thannickal, M.D., director of the Division of Pulmonary, Allergy and Critical Care Medicine and senior author of the study. “The ROCK pathway ultimately helps to keep the myofibroblasts alive and evade apoptosis.” Previous studies have shown that cells have the ability to detect and respond to mechanical cues and changes in the stiffness of their immediate surroundings. A cell in contact with a soft matrix will respond differently than a cell in contact with a hard or stiff matrix. “We can think of ROCK as a sort of enabler for myofibroblasts, sustaining them beyond normal timeframes and promoting mechanosensitive signaling,” said Yong Zhou, M.D., assistant professor in the Division of Pulmonary, Allergy and Critical Care Medicine and first author of the study. “The good news is this may also provide targets to interfere with the ROCK pathway and provide a viable therapy.” One such possible therapy is a stroke drug called fasudil, which is a ROCK inhibitor. In animal models and in human IPF tissue studied in cell culture, fasudil blocked ROCK activation and promoted normal apoptosis of myofibroblasts. In healthy cells, ROCK is believed to be responsible for smooth muscle function and controlling blood pressure. Blocking it systemically with fasudil may have some side effects, mostly a risk of a decrease in blood pressure. Zhou says this potential risk could be averted through the development of therapeutics to deliver the drug locally to the lung, perhaps inhaled. “As this research continues and we learn more about the ROCK signaling pathway, we would anticipate the development of other ROCK inhibitors that might provide much the same mechanism of activity with less potential side effects,” said Zhou. Thannickal says this approach may have utility in other diseases or conditions in which apoptosis of myofibroblasts is disrupted. “Dysfunctional apoptosis is implicated in a number of diseases, such as cancer, autoimmune diseases and inflammatory and fibrotic diseases,” he said. “This discovery of the ROCK pathway and its specific role in mechanosensitive signaling and controlling apoptosis opens up intriguing new avenues for research.” UAB is a leader in research and treatment for idiopathic pulmonary fibrosis. A member of the federally funded IPF Clinical Research Network, UAB is actively engaged in finding therapies for this condition that has no FDA-approved treatments. In the United States, IPF is estimated to affect between 132,000 and 200,000 people, with approximately 50,000 new cases diagnosed each year. As many as 40,000 Americans die from IFP each year, with survival rates ranging from 2.5 to 3.5 years following diagnosis. The study was funded by a grant from the National Heart, Lung and Blood Institute, one of the National Institutes of Health. Read 6254 times Tweet Related items A summer of research at UAB, in eight short weeks Dubose ‘embodies all that is genuinely good about working at UAB’ UAB Hospital expands addiction recovery program Mountz, Singh win prestigious awards from the American College of Rheumatology back to top Accessibility| Web Pages Policy|

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Community Health > Influenza Story from the Field Name of Health Department/Agency: Boston Public Health Commission Vaccine Planning and Administration Issue Summary: Utilizing electronic records management and GIS resources to best manage H1N1 vaccine distribution. Description of Issue(s): The Boston Public Health Commission (BPHC) has used an innovative records management system to collect and examine data produced during its mass vaccination campaign. The system allows a level of analysis regarding vaccine distribution that exists nowhere else in Massachusetts. Actions taken to address the issue(s): The BPHC's Records Management System also allows for public health officials to meet the mandated reporting required by state and federal health agencies. The system, adapted from technology originally developed for large-scale disasters and tested under the auspices of Boston Emergency Medical Services, assigns each person vaccinated a unique identifier, and allows for the collection of limited patient medication and demographic information. Bar-code scanning devices capture the required information for every vaccination and avoid time consuming paper-based collection. The system also allows for the electronic management of vaccine by formulation, a critically important function given that H1N1 vaccine was produced by multiple companies and in multiple formulations. By having all public clinic records available in electronic format, planners were able to rapidly produce reports, providing a better understanding of whom the Commission was serving and whether they were reaching targeted neighborhoods (those hardest hit in the first wave of illness). In addition, the patient address information has allowed for incorporation of Geographical Information System (GIS) mapping. Maps of the city indicating vaccine receipt by census block have been utilized by BPHC planners to monitor coverage in Boston's neighborhoods--an important feature given that outbreak intensity has varied by neighborhood. Outcomes that resulted from actions taken: The system has automated a significant portion of the data collection work required by state and federal health agencies, and has made the ability to respond to adverse vaccine events more efficient. Boston now has a consistent, near real-time, records management system that can be used during a public health response. All aspects of the health care structure in Boston are now familiar with the system. Please see attached sample GIS map in NACCHO's H1N1 toolkit at: http://www.naccho.org/toolbox/tool.cfm?id=1922. Search for more "Stories from the Field"

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In Her Own Words: Living With Infertility Cathy, 29, and her husband have been married 10 years and truly want to be parents. When the Kansas couple wasn't able to conceive naturally, they sought medical help. Six years ago, we started trying to have a baby. Nothing happened. My OB-GYN reassured me and said for us to try on our own for a year. We took my temperature daily or used an ovulation predictor while waiting. My OB-GYN did some preliminary checks on my husband and myself. Everything was fine. He recommended we see a specialist. When we did, we got a little freaked out by what was involved and decided to hold off on treatment. About three years ago, we started going through testing again with our current reproductive endocrinologist. I had an hysterosalpingography (HSG) and a laparoscopy. He could not find any reason why we could not conceive. I've never been so scared, asking myself if my body would ever work like it's supposed to. I wanted a child. I'm very religious, so dealing with why God hadn't blessed us was difficult. I questioned and dealt with "Why is this happening to me?" and "What have we done not to be blessed?" But knowing there was an end—whether it would be a pregnancy through treatment or a miracle or adoption—helped. Also, I saw people who adopted and loved their child as much as my mother loved me. That helped me realize adoption would be OK. One way or the other, I knew we would be parents. I finally came to a place where I could rest in that fact. How is infertility treated? For three months after the laparoscopy, I had intrauterine inseminations (IUIs), sometimes called artificial inseminations. They were not successful. I knew the next step was in vitro fertilization (IVF). I took fertility drugs and underwent an egg retrieval procedure. My husband's sperm count was high, so we did traditional IVF, putting my 12 eggs and his sperm together to fertilize. The next day, the doctor called, saying none of my eggs had fertilized. It was a huge blow. They tried a rescue intracytoplasmic sperm insertion (ICSI). In this procedure, single sperms are inserted into individual eggs. Seven fertilized. We had an embryo to transfer, but the pregnancy test was negative. That was hard. Not only couldn't we get pregnant naturally, it was like our bodies were fighting each other. But at least we had an answer about why conception wasn't happening naturally. We tried again, this time doing the ICSI immediately. There was good fertilization and transfer. Then I found out I was pregnant with twins. We're very excited and feel blessed. Did you have to make any lifestyle or dietary changes in response to infertility? I left a job I loved and people I loved working with for an employer with health insurance that pays for four tries of IVF. It was a huge decision. But I wasn't willing to go into major debt if I didn't have to. I also made all the recommended lifestyle changes. While trying to conceive, I rarely had a glass of wine. I don't smoke or drink caffeine. And I eat healthful foods. I saw a counselor, because I started feeling angry at the world, myself, God, my family. I went to a monthly educational meeting at RESOLVE: The National Infertility Association and started to volunteer. The peer support group allowed me to talk to other people going through infertility, which helped enormously. I can't imagine going through this without the friends I've made through RESOLVE. It's great to have someone to call. They help you think through things, like what your friend with four kids just said. Does infertility have any impact on your family? My husband wanted children as much as I did. My angry stage was hard for him. But infertility has made our marriage stronger. We've had to come together and talk things over, make joint decisions, and set stopping points. We've made huge ethical decisions, like what to do with our embryos. We talk about things most married couples don't discuss. We've had bumpy times, but that has made us stronger. Dealing with our families is harder. At every family reunion, we were asked when we were going to have children. We didn't want to get into an infertility discussion. That was our personal business. We made the choice not to go to family reunions, because we couldn't deal with it. What advice would you give to anyone living with infertility? If you want to be a parent, you will be, whether through treatment or adoption. Get plugged in with RESOLVE. And go to a reproductive endocrinologist, not just an OB-GYN.

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6202.0 - Labour Force, Australia, Dec 2009 Quality Declaration Previous ISSUE Released at 11:30 AM (CANBERRA TIME) 14/01/2010 SummaryDownloadsExplanatory Notes Explanatory Notes Glossary Quality Declaration - Summary What If Standard Errors Data Source QUALITY DECLARATION - SUMMARY INSTITUTIONAL ENVIRONMENT Labour Force statistics are compiled from the Labour Force Survey which is conducted each month throughout Australia as part of the Australian Bureau of Statistics (ABS) household survey program. For information on the institutional environment of the ABS, including the legislative obligations of the ABS, financing and governance arrangements, and mechanisms for scrutiny of ABS operations, please see ABS Institutional Environment. The Labour Force Survey provides monthly information about the labour market activity of Australia's resident civilian population aged 15 years and over. The Labour Force Survey is designed to primarily provide estimates of employment and unemployment for the whole of Australia and, secondarily, for each state and territory. The Labour Force Survey enumeration begins on the Sunday between the 5th and 11th of the month, except for the Christmas and New Year holiday period. In December enumerations starts between the 3rd and 9th (4 weeks after November enumeration begins). In January enumeration starts between the 7th and 13th (5 weeks after December enumeration begins). Key estimates from the Labour Force Survey are published in two stages. The first, Labour Force, Australia (cat. no. 6202.0), is released 32 days after the commencement of enumeration for the month, with the exception of estimates for December which are published 39 days after the commencement of enumeration. The second stage includes detailed data that were not part of the first stage and are published in Labour Force, Australia, Detailed - Electronic Delivery (cat. no. 6291.0.55.001) and Labour Force, Australia, Detailed, Quarterly (cat. no. 6291.0.55.003). The second stage is released 7 days after the first stage. The Labour Force Survey is based on a sample of private dwellings (approximately 29,000 houses, flats etc) and non-private dwellings, such as hotels and motels. The sample covers about 0.33% of the Australian civilian population aged 15 years or over. The Labour Force Survey is designed primarily to provide estimates of key labour force statistics for the whole of Australia and, secondarily, for each state and territory. Two types of error are possible in an estimate based on a sample survey: non-sampling error and sampling error. Non-sampling error arises from inaccuracies in collecting, recording and processing the data. Every effort is made to minimise reporting error by the careful design of questionnaires, intensive training and supervision of interviewers, and efficient data processing procedures. Non-sampling error also arises because information cannot be obtained from all persons selected in the survey. The Labour Force Survey receives a high level of cooperation, with an average response rate for the last year being 97%. Sampling error occurs because a sample, rather than the entire population, is surveyed. One measure of the likely difference resulting from not including all dwellings in the survey is given by the standard error. There are about two chances in three that a sample estimate will differ by less than one standard error from the figure that would have been obtained if all dwellings had been included in the survey, and about nineteen chances in twenty that the difference will be less than two standard errors. Standard errors of key estimates and movements since the previous month are available in Labour Force, Australia (cat. no. 6202.0). The standard error of other estimates and movements may be calculated by using the spreadsheet contained in Labour Force Survey Standard Errors, Data Cube (cat. no. 6298.0.55.001). The ABS has been conducting the Labour Force Survey each month since February 1978. While seeking to provide a high degree of consistency and comparability over time by minimising changes to the survey, sound survey practice requires careful and continuing maintenance and development to maintain the integrity of the data and the efficiency of the collection. The changes which have been made to the Labour Force Survey have included changes in sampling methods, estimation methods, concepts, data item definitions, classifications, and time series analysis techniques. In introducing these changes the ABS has generally revised previous estimates to ensure consistency and coherence with current estimates. For a full list of changes made to the Labour Force Survey see Chapter 20 in Labour Statistics: Concepts, Sources and Methods (cat. no. 6102.0.55.001). INTERPRETABILITY The key estimates from the Labour Force Survey are available as original, seasonally adjusted and trend series. Seasonal adjustment is a means of removing the effects of normal seasonal variation from the series so other influences on the series can be more clearly recognised. Seasonal adjustment does not aim to remove the irregular influences which may be present and therefore month-to-month movements may not be reliable indicators of underlying behaviour. To assist in interpreting the underlying behaviour, the ABS produces the trend series by smoothing the seasonally adjusted series to reduce the impact of the irregular component. For further information, see A Guide to Interpreting Time Series - Monitoring Trends (cat. no. 1349.0). Further information on the terminology and other technical aspects associated with statistics from the Labour Force Survey can be found in the publication Labour Force, Australia (cat. no. 6202.0), which contains detailed Explanatory Notes, Standard Error information and a Glossary. Please see the Related Information tab for the list of products that are available from this collection. This page last updated 10 February 2010

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Foundation Fighting Blindness Grants RetroSense Therapeutics $250,000 for Research into Using Genes from Algae to Reverse Severe Vision Loss 2/10/2012 2:03:54 PM Columbia, MD (February 10, 2012) – The Foundation Fighting Blindness, a national nonprofit dedicated to driving research for retinal degenerative diseases, announces a $250,000 research grant to Ann Arbor, Mich.-based RetroSense Therapeutics for developing a treatment that delivers the genes of blue-green algae to the retina for restoring vision. The funding supports RetroSense’s lab research in preparation for a clinical trial of the gene therapy in two to four years. “Imagine if the secret to reversing blindness lies in the DNA of pond scum,” says Stephen Rose, Ph.D., chief research officer, Foundation Fighting Blindness. “This field of research, known as optogenetics, is a very promising and creative approach to restoring sight in people with severe vision loss or complete blindness due to inherited retinal diseases. RetroSense has outstanding technology, and it has achieved impressive results in lab studies. We are pleased to support the company in its effort to move the treatment into a clinical trial.” In initial pre-clinical work, RetroSense has demonstrated that its treatment restores vision in mice with highly degenerated retinas. The current funding will help advance the initial studies toward a stage where the company could seek authorization for a Phase I clinical trial to confirm the therapy’s safety. The genetic treatment is delivered to retinal ganglion cells, which survive long after rods and cones, the cells that normally provide vision, are lost to advanced retinal degenerations like retinitis pigmentosa (RP). The treatment contains copies of an algal gene called channelrhodospin-2, which makes the ganglion cells light-sensitive. Normally, ganglion cells don’t provide vision; rather they help fine-tune the visual information generated by rods and cones. “One big advantage of optogenetic treatments, including RetroSense’s, is that, because they are independent of the genetic defects causing disease, they will likely work for a variety of retinal degenerations,” says Dr. Rose. “It is exciting to support a therapeutic approach that has the potential to benefit many people.” The company’s gene therapy uses an adeno-associated virus, or AAV, for delivering the therapeutic gene to the cells of the retina. The technology has performed well thus far in vision-restoring clinical trials of gene therapy for people with Leber congenital amaurosis. More than 40 people have been successfully treated in those studies. The Foundation is also funding an optogenetic therapy project to revive cone cells — the cells in the retina that provide color and central vision. That effort is being led by Dr. José-Alain Sahel, director of the Foundation-funded Paris Research Center for the Study of Retina Degenerative Diseases, and Dr. Botond Roska of the Friedrich Miescher Institute for Biomedical Research in Switzerland. About the Foundation Fighting Blindness The Foundation Fighting Blindness is a national nonprofit driving research that will lead to preventions, treatments and cures for retinitis pigmentosa, macular degeneration, Usher syndrome and the entire spectrum of retinal degenerative diseases that affect more 10 million Americans. In its 40-year history, the Foundation has raised more than $450 million as the leading non-governmental funder of retinal research. Breakthrough Foundation-funded studies using gene therapy have restored significant vision in children and young adults who were previously blind, paving the way for using this method to treat a wide variety of retinal degenerative diseases, and proving a cure is in sight. With a network of nearly 50 chapters, the Foundation also provides support and resources to affected individuals and their families in communities across the country.

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GALESBURG — Pharmacies are not immune to the state's backlog in vendor payments, but the transferring of some patients to a new Medicare plan has helped smaller shops keep their doors open. Read the latest article in GateHouse Media's "Deadbeat Illinois" series. GALESBURG — Pharmacies are not immune to the state's backlog in vendor payments, but the transferring of some patients to a new Medicare plan has helped smaller shops keep their doors open.With the creation of Medicare Part D, pharmacists filling some publicly funded prescriptions now get paid through an insurance company, which is easier to work with and more prompt with payments, some pharmacists said.Of the $9 billion in backlogged payments to various agencies and private businesses, Illinois owes the medical industry over $2 billion, with pharmacists being owed $377 million for prescriptions the state helps fund.The delayed payments have hurt pharmacies, especially the mom-and-pops, some of which have a substantial amount of their business tied to public healthcare plans. Quite a few of the drug stores have qualified for expedited pay and get refunded faster than other vendors waiting on the state, but that designation has not cured the pharmacies' problems.Walgreens can withstand a deferred payment for longer than an independent because its business isn't wholly dependent on prescriptions, said Garth Reynolds, executive director of the Illinois Pharmacists Association."It especially hurts the locally owned stores who can't spread the debt to other departments or even other locations," he said.George Burgland, owner of Burgland Drug Store in Galesburg, said his outstanding bills with the state once totaled $150,000. His business saw some relief after 2006, when Medicare Part D went into effect. Part D subsidizes drug prescriptions for Medicare enrollees, but the payment for those prescriptions now comes through a private insurance company. Burgland said three-fourths of Medicare patients he sees are enrolled in Part D, after the state transferred a considerable amount of public aid patients to the program."That simplified my life quite a bit," he said. "It took the state out of being the primary and onto someone who has to pay more promptly."Burgland said the most he is out now is $25,000. What about the irony that insurance agencies are easier to work with than the state?"Illinois is Illinois," Burgland said. "If that's the way it is, you just have to deal with it."Because his business is about 95 percent prescription based, Burgland qualified for expedited payments from the state.About 600 pharmacies in the state qualify for more speedy payments, which stipulates that the business must be paid within 25 days, Reynolds said."Twenty-five days helps a lot, but it's still a long time to wait," Reynolds said.Burgland did about $250,000 worth of business with the state in 2012, according to the Comptroller's Office. He said he has considered lessening the amount of his business dealing in public healthcare plans, but eventually thought otherwise."It could be a lot worse," he said. "Part of what I do could be considered a public service, but it would be nice to be paid faster. I'm not complaining too often."One pharmacy owner in Peoria did scale back his public aid business.Mike Minesinger of Alwan Pharmacy said about one-fourth of his business is funded through the state, which is less than it was in the past after his business suffered due to the backlog in payments."They just don't have the money," Minesinger said of the state. "We diversified our business a couple years ago. Public aid patients account for less of our business than even two years ago."Minesinger said he has had to wait up to 120 days for a payment. Despite that, he said his business has stayed steady, and even opened a second store in Morton last summer. To keep his business afloat in the lean times, Minesinger kept a cash reserve, but even that wasn't enough at times."That reserve was getting a little bit low," he said. "We went out and got a line of credit, but we didn't use it. It was out of extreme caution."Local legislators have said paying down some of the backlogged bills is a priority in the current legislative session, but finding a solution to the state's unfunded pension system has taken priority. Januari Smith, communications manager for the Department of Healthcare and Family Services, said solving that problem will help ease the unpaid bills problem.Joe Ward can be reached at (309) 343-7181 or jward@register-mail.com.

医学

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CDC Response: A Year In Review Overview of a Pandemic Background on Influenza Tracking Influenza Preparing for a Pandemic Detection of the 2009 H1N1 Virus Impact of 2009 H1N1 Accomplishments (1) Accomplishments (2) Accomplishments (3) Conclusion General Info H1N1 Flu & You What to Do If You Get Sick Caring for Someone Sick About H1N1 Flu Spread of Flu Germs H1N1 More Serious for Some Make a Sick Room Follow Sick Room Rules Clean the Sick Room Prevent Fluid Loss Check for Fluid Loss When to Get Medical Help for Fluid Loss Medicine Safety Medicine Safety & Children Treat Fever Treat Dry Cough Treat Other Symptoms Facemasks & Respirators H1N1 Flu in Animals Info for Specific Groups State, Local & Tribal Health Officials Laboratorians Parents & Caregivers Day and Residential Camps Community &Faith-based Organizations People at High Risk People 65 Years and Older People with HIV/AIDS People with Disabilities People With Cardiovascular Disease People With Asthma People With Arthritis Adults With HIV Infections African Americans Cancer Patients and Survivors Businesses & Employers Travelers & Travel Industry People in Contact with Pigs Guidelines - Noncommercial Settings With Pigs Guidelines - Commercial Settings With Pigs Vaccine General Info Info for Professionals Info for Planners H1N1 Flu: Free Resources Vaccine Safety Information Vaccine Supply Status National Influenza Vaccination Week (NIVW) NIVW Activities NIVW Submit Your Event NIVW Toolkit NIVW Web Tools NIVW Professionals NIVW Matte Articles Treatment (Antivirals) Antiviral Recommendations Antiviral Safety Information Situation Update U.S. Situation Update International Situation Update Past Situation Updates MMWR Reports Epidemiological Pubs Emergency Use Authorization Other Flu Sites Canine Flu Swine Flu (in Pigs) Swine Flu Info Content on this page was developed during the 2009-2010 H1N1 pandemic and has not been updated. The H1N1 virus that caused that pandemic is now a regular human flu virus and continues to circulate seasonally worldwide. The English language content on this website is being archived for historic and reference purposes only. For current, updated information on seasonal flu, including information about H1N1, see the CDC Seasonal Flu website. The 2009 H1N1 Pandemic: Summary Highlights, April 2009-April 2010 Pandemic Preparedness, Background A Virus Emerges Response Ramps Up World Braces for Possible Pandemic CDC Laboratories Bolster Nation’s Testing Capacity CDC Shares Personnel, Guidance, Early Results of Studies A Pandemic is Declared Ongoing Surveillance & Response 2009 H1N1 Vaccination A Summary of Communication Activities Updated: June 16, 2010 This document summarizes key events of the 2009 H1N1 pandemic and CDC’s response activities for historical purposes. This document is a summary; it is not a comprehensive account of all CDC actions and activities nor is it intended to represent response efforts by other agencies and partners. The 2009 H1N1 influenza (flu) pandemic occurred against a backdrop of pandemic response planning at all levels of government including years of developing, refining and regularly exercising response plans at the international, federal, state, local, and community levels. At the time, experts believed that avian influenza A (H5N1) viruses posed the greatest pandemic threat. H5N1 viruses were endemic in poultry in parts of the world and were infecting people sporadically, often with deadly results. Given that reality, pandemic preparedness efforts were largely based on a scenario of severe human illness caused by an H5N1 virus. Despite differences in planning scenarios and the actual 2009 H1N1 pandemic, many of the systems established through pandemic planning were used and useful for the 2009 H1N1 pandemic response. CDC’s response to the 2009 H1N1 pandemic response was complex, multi-faceted and long-term, lasting more than a year. This document seeks to document for the public the key events of the pandemic as they unfolded and CDC’s response. The following is a summary narrative of highlighted CDC-related events from the 2009 H1N1 pandemic. 2009 H1N1 was first detected in the United States in April 2009. This virus was a unique combination of influenza virus genes never previously identified in either animals or people. The virus genes were a combination of genes most closely related to North American swine-lineage H1N1 and Eurasian lineage swine-origin H1N1 influenza viruses. Because of this, initial reports referred to the virus as a swine origin influenza virus. However, investigations of initial human cases did not identify exposures to pigs and quickly it became apparent that this new virus was circulating among humans and not among U.S. pig herds. Infection with this new influenza A virus (then referred to as ‘swine origin influenza A virus’) was first detected in a 10-year-old patient in California on April 15, 2009, who was tested for influenza as part of a clinical study. Laboratory testing at CDC confirmed that this virus was new to humans. Two days later, CDC laboratory testing confirmed a second infection with this virus in another patient, an 8-year-old living in California about 130 miles away from the first patient who was tested as part of an influenza surveillance project. There was no known connection between the two patients. Laboratory analysis at CDC determined that the viruses obtained from these two patients were very similar to each other, and different from any other influenza viruses previously seen either in humans or animals. Testing showed that these two viruses were resistant to the two antiviral drugs amantadine and rimantadine, but susceptible to the antiviral drugs oseltamivir and zanamivir. CDC began an immediate investigation into the situation in coordination with state and local animal and human health officials in California. The cases of 2009 H1N1 flu in California occurred in the context of sporadic reports of human infection with North American-lineage swine influenza viruses in the United States, most often associated with close contact with infected pigs. (During December 2005 – January 2009, 12 cases of human infection with swine influenza were reported; five of these 12 cases occurred in patients who had direct exposure to pigs, six patients reported being near pigs, and the source of infection in one case was unknown). Human-to-human spread swine influenza viruses had been rarely documented and had not been known to result in widespread community outbreaks among people. In mid-April of 2009, however, the detection of two patients infected with swine origin flu viruses 130 miles apart, raised concern that a novel swine-origin influenza virus had made its way into the human population and was spreading among people. CDC remained in close contact with the international health community as the outbreak unfolded and on April 18, 2009, under the International Health Regulations (IHR) the United States International Health Regulations Program reported the 2009 H1N1 influenza cases to the World Health Organization (WHO). The cases also were reported to the Pan American Health Organization (PAHO), Canada and Mexico, as part of the Security and Prosperity Partnership of North America. CDC worked closely with state and local animal and human health officials on epidemiological investigations by tracing contacts of both patients to try to determine the source of their infection and by examining whether there was any link between the patients and pigs. Surveillance also was enhanced to try to detect additional cases of human illness with this virus. Based on the geographic location of the first cases, lack of contact between these cases and swine, and data collected through contact tracing and laboratory testing, CDC epidemiologists suspected that human-to-human transmission of this virus had taken place. In an article entitled Swine Influenza A (H1N1) Infection in Two Children --- Southern California, March-April 2009 published on April 21, 2009 in the Morbidity and Mortality Weekly Report (MMWR), CDC described the cases and requested that state public health laboratories send to CDC all influenza A specimens that could not be subtyped. That same day CDC responded to media inquiries related to the MMWR from medical reporters. Within a day, three additional samples of this new virus were identified in San Diego County and Imperial County California hospitals and sent to CDC for further testing. CDC laboratory testing confirmed that these samples also were positive for the virus that would come to be called “2009 H1N1.” By April 21, 2009, CDC had begun working to develop a virus that could be used to make vaccine to protect against this new virus (called a candidate vaccine virus). There are many steps involved with producing a vaccine – the first step is getting a good high yield vaccine virus. A high-yield vaccine virus is a sample of the virus that is used to grow the virus in mass quantities in chicken eggs. Once the virus is grown in mass quantities, the virus particles are then purified to make vaccine. Recognizing that 2009 H1N1 was a new flu virus – and, like all flu viruses, unpredictable - CDC simultaneously pursued multiple scientific methods to create a high-yield virus. A virus isolated at CDC, (called A/California/07/2009) was eventually chosen to be the vaccine virus used to make vaccine. CDC sent the vaccine virus to vaccine manufacturing companies so that they could begin vaccine production, in the event that the U.S. government should decide a vaccine was necessary. CDC activated its Emergency Operations Center (EOC) on April 22, 2009, to coordinate the response to this emerging public health threat. Response activities were organized into a team structure according to the National Incident Management System (NIMS)These teams had different areas of focus including but not limited to: surveillance, laboratory issues, communications, at-risk populations, antiviral medications, vaccine, and traveler’s health issues. As the outbreak unfolded, team structures and staffing were periodically assessed for functionality and utility. On April 23, 2009, samples submitted by Texas revealed two additional cases of human infections with 2009 H1N1, transforming the investigation into a multistate outbreak and response. At the same time, CDC was testing 14 samples from Mexico, some of which had been collected from patients who were ill before the first 2 U.S. (California) patients. Results from seven of the samples were positive for 2009 H1N1 and similar findings were reported for specimens submitted by Mexico to Canada. It had now become clear that cases were occurring in multiple countries and human to human spread of the virus appeared to be ongoing. That same day CDC held the first formal full press briefing to inform the media and guide the public and health care response to the rapidly evolving situation. CDC held nearly 60 press briefings during the 2009 H1N1 response. On April 24, 2009, CDC uploaded complete gene sequences of the 2009 H1N1 virus to a publicly-accessible international influenza database, which enabled scientists around the world to use the sequences for public health research and for comparison against influenza viruses collected elsewhere, and an updated report on the outbreak was published online in the MMWR. On Saturday, April 25, 2009, under the rules of the International Health Regulations, the Director-General of WHO declared the 2009 H1N1 outbreak a Public Health Emergency of International Concern and recommended that countries intensify surveillance for unusual outbreaks of influenza-like illness and severe pneumonia. Also on April 25, 2009, New York City officials reported an investigation into a cluster of influenza-like illness in a high school, and CDC testing confirmed two cases of 2009 H1N1 influenza infection in Kansas, and another case in Ohio shortly after. On April 26, 2009, the United States Government determined that a public health emergency existed nationwide; CDC’s Strategic National Stockpile (SNS) began releasing 25% of the supplies in the stockpile that could be used to protect and treat influenza. This included 11 million regimens of antiviral drugs, and personal protective equipment including over 39 million respiratory protection devices (masks and respirators), gowns, gloves and face shields, to states (allocations were based on each state’s population). As part of the nation’s pre-pandemic planning efforts, by April 2009 the Federal Government had purchased 50 million treatment courses of antiviral drugs – oseltamivir and zanamivir – for the SNS, and states had purchased 23 million antiviral regimens. After the determination of the public health emergency, FDA also took action to expand possible usage of antiviral drugs oseltamivir and zanamivir by issuing Emergency Use Authorizations (EUAs). The EUAs allowed for use of the products in a manner different from what they were FDA-approved for. This included allowing for off-label use of: oseltamivir to treat children younger than 1 year of age and to help prevent influenza in children 3 months to 1 year of age, and; oseltamivir and zanamivir to treat patients who are symptomatic for more than two days before initiation of treatment, or who had complicated illness requiring hospitalization. On April 27, the WHO Director-General raised the level of influenza pandemic alert from phase 3 to phase 4, based primarily on epidemiological data demonstrating human-to-human transmission and the ability of the virus to cause community-level outbreaks. Based on reports of widespread influenza-like-illness and many severe illnesses and deaths in Mexico, CDC issued a travel health warning recommending that United States travelers postpone all non-essential travel to Mexico. As in past influenza seasons, CDC urged the public and especially those people at highest risk of influenza-related complications, to protect themselves by taking antiviral drugs early in their illness when recommended by their doctor; CDC also advised that everyone take every day preventive actions like covering coughs and sneezes and staying home from work and school when ill to help reduce the spread of illness. On April 29, 2009 WHO raised the influenza pandemic alert from phase 4 to phase 5, signaling that a pandemic was imminent, and requested that all countries immediately activate their pandemic preparedness plans and be on high alert for unusual outbreaks of influenza-like illness and severe pneumonia. The U.S. Government was already implementing its pandemic response plan. CDC continued to post and update guidance for states, clinicians, laboratories, schools, partners and the public on topics ranging from the non-pharmaceutical measures communities could take to limit spread of disease, to how to evaluate a patient for possible infection with 2009 H1N1 influenza, to how to care for children who might be sick with 2009 H1N1 influenza. On April 30, 2009, CDC issued an MMWR Dispatch describing the initial outbreak of 2009 H1N1 influenza in Mexico. Findings in Mexico indicated that transmission in Mexico involved person-to-person spread with multiple generations of transmission. CDC also issued an MMWR Dispatch on the outbreak of 2009 H1N1 influenza infection in a high school in New York City, that was, at the time, the largest reported cluster of 2009 H1N1 cases in the United States. The Dispatch suggested that the high school age students had respiratory and fever symptoms similar to those caused by a seasonal flu, but in addition, about half had diarrhea, which is more than expected with seasonal flu. As the details of the outbreak unfolded, the Federal response continued in high gear. Also on April 30, 2009, HHS announced that the Federal government would purchase an additional 13 million treatment courses of antiviral drugs to help fight influenza. The additional treatment courses would be added to the SNS. As the outbreak spread, CDC began receiving reports of school closures and implementation of community-level social distancing measures meant to slow the spread of disease. School administrators and public health officials were following their pandemic plans and doing everything they could to slow the spread of illness. (Social distancing measures are meant to increase distance between people. Measures include staying home when ill unless to seek medical care, avoiding large gatherings, telecommuting, and implementing school closures). CDC Laboratories Bolster Nation’s Testing Capacity While initial efforts were underway to develop a safe and effective vaccine to protect people against 2009 H1N1, work also was being done at CDC to help laboratories supporting health care professionals to more quickly identify the 2009 H1N1 virus in samples from patients. The real-time PCR test developed by CDC was cleared for use by diagnostic laboratories by FDA under an Emergency Use Authorization (EUA) on April 28, 2009, less than two weeks after identification of the new pandemic virus. Prior to the availability of this EUA, public health laboratories had been able to identify whether influenza A viruses were seasonal influenza viruses or were a novel strain, but the new diagnostic kits allowed labs to confirm a virus as 2009 H1N1. On May 1, 2009, CDC test kits began shipping to domestic and international public health laboratories. (Each test kit contained reagents to test 1,000 clinical specimens). From May 1 through September 1, 2009, more than 1,000 kits were shipped to 120 domestic and 250 international laboratories in 140 countries. Once labs had the test kits and verified that their testing was running properly, they were able to identify new cases more quickly than before and no longer needed to send samples to CDC for lab confirmation. The transition away from CDC lab confirmation testing didn’t happen overnight though - between April 23 and May 31, 2009, CDC influenza laboratory analyzed about 5,000 influenza virus samples, five times the number that were processed in a similar timeframe in 2008, and more than during any previous influenza season. By May 18, 2009, 40 states had been validated to conduct their own 2009 H1N1 testing, with eight states having multiple laboratories able to do their own testing. CDC alerted the public that the expansion in testing capacity would likely result in a jump in the number of 2009 H1N1 cases, but that this would actually present a more accurate picture of the true scope of 2009 H1N1 influenza in the United States. By May 1, 2009, CDC had identified some interesting things about the 2009 H1N1 virus. Researchers had confirmed earlier testing that the 2009 H1N1 influenza virus was a quadruple-reassortant virus, meaning that it contained virus genes that originated from four different influenza virus sources. Some of the gene segments originated from North American swine influenza viruses, some gene segments originated from North American avian influenza viruses, one gene segment originated from a human influenza virus, and two gene segments were normally found in swine influenza viruses from Asia and in Europe. Testing of a number of the virus samples submitted to CDC showed that they were very similar, which means they likely originated from the same source. Laboratory testing showed that the 2009 H1N1 influenza virus did not have any 1918-like markers that had been associated with increased risk of severe disease. Testing also did not find genetic markers that were previously associated with high death rates in people infected with the avian influenza A (H5N1) virus in other countries. On May 4, 2009, CDC shifted from reporting confirmed cases of 2009 H1N1 to reporting both confirmed and probable cases of 2009 H1N1. At that point, more than 98% of “probable” flu virus samples were testing positive for 2009 H1N1, indicating the ever-growing scale of the outbreak. Probable cases were reported to CDC by state health departments and occurred in people who tested positive for influenza A and negative for seasonal influenza A(H1N1) and A(H3N2) subtypes at their state health department laboratory, but whose samples had not had confirmatory testing for the 2009 H1N1 influenza virus. CDC deployed a large number of staff to the field to support the outbreak response; by May 1, 2009, 50 staff people were deployed, and that number climbed to more than 100 by May 11, 2009, before gradually declining as field teams returned from deployment to complete studies, analyze collected data, and help inform policy decisions for the prevention and control of 2009 H1N1 influenza. Over the course of the outbreak, more than 3,300 people from throughout CDC would support the response. On May 6, 2009, CDC distributed recommendations for the use of influenza antiviral medicines to provide guidance for clinicians in prescribing antiviral medicines for treatment and prevention (chemoprophylaxis) of 2009 H1N1 influenza. CDC recommended that testing and antiviral treatment be prioritized for people with severe respiratory illness and people at high risk of complications from seasonal influenza. This included children younger than 5 years old, pregnant women, people with chronic medical conditions, and people 65 years and older. On May 8, 2009, CDC issued an MMWR updating the situations in Mexico, the United States, and worldwide, and on May 15, 2009, CDC’s Travel Health Warning recommending against non-essential travel to Mexico, in effect since April 27, 2009, was downgraded to a Travel Health Precaution for Mexico. By this point in the outbreak, about half of all influenza viruses being detected through laboratory surveillance were 2009 H1N1 viruses, with the other half being regular seasonal influenza viruses, including seasonal influenza A H1N1, influenza A H3N2 and type B viruses. Surveillance reports indicated that the largest number of 2009 H1N1 influenza confirmed and probable cases (about 57% of cases) were occurring among people between 5 years and 24 years of age, and 41% of the hospitalizations were occurring among older children and young adults. The highest rates of hospitalization were among children younger than 5 years of age; the next highest hospitalization rate was in people 5 years to 24 years of age. Based on data from previous influenza pandemics and seasonal influenza, pregnant women had been recognized as a high-risk group early in the outbreak. Early data on 2009 H1N1 illness among pregnant women was reported in an article published as an MMWR Dispatch on May 12, 2009. This article emphasized the importance of empiric treatment (treatment without confirmatory testing) of pregnant women suspected to have 2009 H1N1. People with other previously recognized medical conditions that placed them at high risk of complications from seasonal influenza also appeared to be at increased risk of complications from 2009 H1N1 influenza. In this report, seventy-one percent (71%) of hospitalized patients had one or more underlying chronic medical conditions. Reported deaths had occurred in people ranging in age from 22 months old to 57 years old. Also, only 13% of hospitalizations had occurred in people 50 years and older, and there were few cases and no deaths in people older than 65 years, which was unusual when compared with seasonal flu. Early results of an antibody study conducted by CDC indicated that children had no existing cross-reactive antibody to the 2009 H1N1 influenza virus, while about one-third of adults older than 60 years of age had cross-reactive antibody against the 2009 H1N1 flu virus. One possible explanation for this pre-existing antibody in older adults was that they may have had previous exposure, either through infection or vaccination, to an influenza A H1N1 virus that was more closely related to the 2009 H1N1 flu virus than contemporary seasonal influenza A (H1N1) viruses are. Data from a similar study suggested that seasonal influenza vaccine would not provide any significant protection against 2009 H1N1 influenza virus. On June 11, 2009, WHO signaled that a global pandemic of 2009 H1N1 influenza was underway by further raising the worldwide pandemic alert level to Phase 6. That day, CDC held its first press conference with the new CDC Director Thomas Frieden, MD, MPH. The press conference had a total of 2,355 participants. At the time, more than 70 countries had reported cases of 2009 H1N1 infection, and community level outbreaks of 2009 H1N1 were ongoing in multiple parts of the world. The WHO decision to raise the pandemic alert level to Phase 6 was a reflection of spread of the virus in other parts of the world and not a reflection of any change in the 2009 H1N1 influenza virus or associated illness. To date, most people in the United States who had become ill with 2009 H1N1 influenza had not become seriously ill and had recovered without hospitalization. After the WHO declaration of a pandemic on June 11, the 2009 H1N1 virus continued to spread and the number of countries reporting cases of 2009 H1N1 nearly doubled from mid-June 2009 to early July 2009. Significant levels of 2009 H1N1 illness continued, with localized and in some cases intense outbreaks occurring. By June 19, 2009, all 50 states in the United States, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands had reported cases of 2009 H1N1 infection. The United States continued to report the largest number of 2009 H1N1 cases of any country worldwide, although most people who became ill recovered without requiring medical treatment. By late June more than 30 summer camps in the U.S. had reported outbreaks of 2009 H1N1 influenza illness, and CDC released guidance for day and residential camps to reduce the spread of influenza. At the June 25, 2009 Advisory Committee on Immunization Practices Meeting, CDC estimated that at least 1 million cases of 2009 H1N1 influenza had occurred in the United States. In early July, 2009, three 2009 H1N1 influenza viruses that were resistant to the antiviral drug oseltamivir were detected in three countries. (Antiviral resistance is when a virus changes in such a way that the antiviral drug is less effective in treating or preventing illnesses caused by the virus.) CDC and WHO partners continued to conduct surveillance for antiviral resistance, although instances of antiviral resistance continued to be detected very rarely. Also in July 2009, CDC reported findings in the MMWR that indicated a striking prevalence of obesity in intensive care patients who were confirmed to have 2009 H1N1 influenza. Throughout the pandemic, CDC would continue to examine the relationship between 2009 H1N1 influenza, obesity, severe disease and other underlying risk factors. CDC continued to work with the Council of State and Territorial Epidemiologists (CSTE) to enhance surveillance for 2009 H1N1 influenza. As 2009 H1N1 cases continued to occur through the spring and summer, the task of counting cases became increasingly difficult. On May 12, 2009, CDC transitioned from reporting individual confirmed and probable cases of 2009 H1N1 influenza to reporting aggregate counts of 2009 H1N1 lab confirmed and probable cases, hospitalizations and deaths with the launch of an aggregate reporting web site. Once the numbers of cases increased beyond the point where counting of individual cases was practical, on July 23, 2009, CDC reported the number of 2009 cases for the last time. Reporting of 2009 H1N1 hospitalizations and deaths continued. In addition, CDC continued using its traditional surveillance systems to track the progress of the 2009 H1N1 influenza outbreak. Traditional surveillance systems do not count individual cases, but instead monitor activity levels and virus characteristics through a nationwide surveillance system. CDC worked closely with countries in the Southern Hemisphere to monitor and enhance surveillance for influenza viruses throughout the summer months. The Southern Hemisphere’s influenza season began in May 2009 and countries there reported that 2009 H1N1 virus was spreading and causing illness along with regular seasonal influenza viruses. After mid-July, disease activity in most countries decreased, and by November, temperate regions of the Southern Hemisphere were reporting very little 2009 H1N1 disease activity. In general, the experience of the Southern Hemisphere with the 2009 H1N1 virus was similar to what is usually seen during a regular influenza season and did not seem to excessively impact the health care systems in the Southern Hemisphere. Also, surveillance systems did not find significant changes in the 2009 H1N1 influenza viruses circulating in the Southern Hemisphere as compared to viruses isolated from people in the Northern Hemisphere. These findings provided the U.S. with valuable clues related to what the 2009-2010 influenza season in the United States might be like. Importantly, the lack of significant changes in the virus indicated that the 2009 H1N1 vaccine being manufactured would closely match the currently circulating 2009 H1N1 viruses and likely provide people with good protection against 2009 H1N1 influenza. 2009 H1N1 influenza summer activity peaked in the United States during May and June and declined during July and early August. However, levels of influenza activity would remain above normal throughout the summer months with localized outbreaks. During the last two weeks of August, 2009 H1N1 influenza activity again began to increase United States. In August 2009, CDC reported an additional two instances of oseltamivir-resistant virus infection in two immunosuppressed patients in Seattle, Washington. Later, in mid-September, CDC reported two additional cases of oseltamivir-resistant 2009 H1N1 influenza in two summer campers in North Carolina. CDC and partners continued to carefully track 2009 H1N1 influenza antiviral resistance. As of June 2010 the 2009 H1N1 virus remains susceptible to the antiviral drugs oseltamivir and zanamivir, with rare exception. Cases of antiviral resistance are carefully tracked and updated numbers are posted each week as part of the CDC publication FluView. In late August, CDC began working with the commercial supply chain (manufacturers, distributors, retailers) for certain influenza countermeasures to monitor national inventory levels of critical supplies (antivirals and respiratory protective equipment) on a weekly basis. This visibility provided important data to guide SNS decision-making leading to the release of additional SNS countermeasures. FDA and the manufacturer of the antiviral drug Tamiflu® (oseltamivir) recognized that commercial and stockpiled supplies of Tamiflu® oral suspension (liquid formulation meant for children) were limited in October 2009. CDC worked with partners to reach pharmacists with background information, updates on antiviral drug supplies, and instructions on how to compound oral suspension from Tamiflu® capsules meant for adults (Compounding is the mixing of drugs by a health care professional to fit the unique needs of the patient). CDC also provided instructions for parents and caregivers on how to make a medicine mixture for their child using adult Tamiflu® capsules and thick, sweetened liquid. CDC also analyzed related surveillance data and based on the analysis over 500,000 bottles of pediatric oral suspension were distributed from the CDC SNS to states to fill production gaps and meet the increasing demand for the formulation. On October 23rd, 2009, FDA issued an Emergency Use Authorization (EUA) for Peramivir IV. Peramivir IV is an investigational intravenous antiviral drug used to treat people who have been hospitalized due to severe flu illness. This drug was held in the Strategic National Stockpile (SNS) and distributed by CDC under an EUA. Licensed clinicians were able to request this product through the CDC website electronic request system, and product was delivered directly to hospital facilities. Also in October, HHS authorized the release of an additional 59.5 million N95 respirators. CDC closed out reports of 2009 H1N1 hospitalizations and deaths for the 2008-09 season in late August. On August 30, 2009, reporting modifications were implemented to allow states to report hospitalizations and deaths associated with any influenza or to report hospitalizations and deaths using a pneumonia and influenza syndromic case definition through the Aggregate Hospitalizations and Deaths Reporting Activity (AHDRA). This change in reporting was implemented in order to provide a fuller picture of the burden of serious flu illness and deaths during the pandemic. The new reporting season for the 2009-2010 flu season began on August 30, 2009, and the first new numbers for the 2009-2010 season were reported in the September 11, 2009 issue of FluView. Over the course of the pandemic, CDC refined and revised its surveillance methods, eventually developing a methodology based on surveillance data to estimate the range of 2009 H1N1 cases, hospitalizations and deaths in the United States. CDC released its first official estimates for 2009 H1N1 cases, hospitalizations and deaths on November 12, 2009, and updated these on December 10, 2009, January 15, 2010, February 12, 2010, March 12, 2010, April 19, 2010 and for the final time on May 14, 2010. The emergence and spread of the 2009 H1N1 virus resulted in extraordinary influenza-like illness activity in the United States throughout the summer and fall months of 2009. During this period, influenza activity reached its highest level in the reporting week ending October 24, 2009, with 49 of 50 states reporting geographically widespread disease. A cornerstone of the U.S. Government response to the 2009 H1N1 pandemic was the launch of the national influenza 2009 H1N1 vaccination campaign that began in October. Much activity led up to the launch of the vaccination campaign. Starting in early June 2009, weekly calls were held to provide state and local planners with vaccine-related updates, and on July 8, 2009, CDC issued guidance for state and local public health departments to assist them in planning for the 2009 H1N1 influenza vaccination campaign. On July 9, 2009, the Department of Health and Human Services, the Department of Homeland Security, the Department of Education, and the White House held an influenza preparedness summit for federal, state, local and tribal officials to discuss existing pandemic plans, lessons learned, and preparedness priorities. At the summit, the Federal government announced the availability of $350 million in supplemental funding for use by state, local and territorial health departments to bolster their response activities to the 2009 H1N1 influenza pandemic and strongly encouraged state, tribal and local partners to be ready to begin a 2009 H1N1 influenza immunization program by mid-October 2009. The 2009 National Influenza Vaccine Summit, a partnership of public and private stakeholders committed to achieving the Healthy People 2010 goals for influenza vaccine, convened on June 29. During the 2009 Summit, attendees were provided updates by experts in several professional fields, including private medicine, public health, health communication, vaccine manufacturing, vaccine distribution, and vaccine-related policy. CDC has been a cosponsor of this event, along with the American Medical Association, since 2001. In preparation for the 2009 H1N1 influenza immunization program, on July 22, 2009, the National Institutes of Health (NIH) announced the start of a series of clinical trials to test pilot lots of two manufacturers’ versions of 2009 H1N1 influenza vaccine in healthy people, as well as people with underlying health conditions like asthma and HIV. Preliminary results from the clinical trials were announced publicly. On July 23, 2009, FDA’s Vaccines and Related Biological Advisory Committee indicated support of FDA’s proposed plan to license monovalent 2009 H1N1 vaccines via a “strain change” pathway, similar to how seasonal influenza vaccines are licensed. This meant the 2009 H1N1 vaccine would be made in the same way using the same standards already in place for seasonal vaccines; it also allowed licensure to proceed more quickly since it did not require immunogenicity data or additional safety (except for the live attenuated vaccine) data for licensure. On July 29, 2009, the Advisory Committee for Immunization Practices (ACIP) met to make recommendations for 2009 H1N1 vaccine. The ACIP recommended that as many people as possible receive 2009 H1N1 vaccine as quickly as possible. Certain groups of people were targeted to receive initially limited supplies of the 2009 H1N1 vaccine based on epidemiologic and virologic data indicating they were at higher risk for infection or for severe influenza complications. The initial target groups for vaccination were estimated to consist of about 159 million people and included: pregnant women, people who live with or care for infants younger than 6 months of age, health care and emergency medical services personnel, infants 6 months through young adults 24 years of age, and adults 25 through 64 years of age who are at higher risk for 2009 H1N1 complications because of chronic health disorders or compromised immune systems. The ACIP also recommended that local public health authorities and health care practitioners have flexibility to determine at the local level how quickly and when to expand vaccination to other groups because vaccine availability and demand would likely vary by area. CDC convened three public engagement sessions in mid-August in ten regions of the United States with the purpose of soliciting citizen input into vaccination planning. The public provided opinions to CDC regarding how vaccine should be provided in the U.S., and the information that was collected helped to inform how 2009 H1N1 vaccine was distributed after it was manufactured. Ultimately, it was decided that vaccine should be distributed as soon as it was ready so that people could be protected against influenza as soon as possible, versus waiting to distribute vaccine until large quantities were prepared. In late August, CDC published a study in the MMWR that summarized an investigation of laboratory-confirmed cases of 2009 H1N1 influenza identified during April 24-July 25, 2009 in Chicago, Illinois. The study found that the overall attack rate was highest among children aged 5-14 years (147 per 100,000 population), which was 14 times higher than for adults older than 60 years of age. A total of 205 (13%) patients were hospitalized, with the highest rate observed among children aged 0-4 years (25 per 100,000), followed by children aged 5-14 years (11 per 100,000). These findings would also provide input into vaccination strategy. By the end of August 2009, prototype vaccines to prevent 2009 H1N1 virus had been developed but were not yet licensed. Production of the enormous quantities of vaccine necessary to protect the entire U.S. population was underway. CDC expanded its contract for the childhood Vaccine for Children program in the United States (McKesson Specialty Distribution), to provide centralized distribution of 2009 H1N1 vaccine. Available vaccine supplies were allocated to states proportional to their total populations and shipped to public and private provider vaccination sites based on orders placed by the states. Participating providers were asked to sign a Provider Agreement assuring they intended to meet state requirements for administering vaccine. On September 3, 2009, CDC published in the MMWR a study that had analyzed data related to 2009 H1N1 influenza pediatric deaths reported to CDC from April to August, 2009. Data showed that as of August 8, 2009, 477 deaths with laboratory confirmed 2009 H1N1 flu in the United States had been reported to CDC, including 36 children younger than 18 years of age. Sixty-seven percent (67%) of children who died with 2009 H1N1 influenza had at least one high-risk medical condition. CDC continued to urge parents to recognize 2009 H1N1 in their children early and to seek medical attention when needed. CDC also reiterated that all children 6 months or older and caregivers of children younger than 6 months should receive the 2009 H1N1 vaccine when it became available. On September 10, 2009, the HHS Secretary and CDC Director joined the National Foundation for Infectious Diseases (NFID) in a news conference to stress vigilance against seasonal influenza in an unusual season and urged Americans to get their seasonal flu vaccine early. In addition to NFID, HHS and CDC, the news conference was held in collaboration with the American Medical Association (AMA), American Academy of Pediatrics (AAP), American College of Physicians (ACP), AARP, and the National Influenza Vaccine Summit. On September 15, 2009, the Food and Drug Administration (FDA) announced its approval of four 2009 H1N1 influenza vaccines, and later, on November 16, FDA announced its approval of a fifth 2009 H1N1 vaccine to protect against the 2009 H1N1 flu virus. The NIH announced on September 21, 2009, that early results from clinical trials of 2009 H1N1 influenza vaccine in children looked promising. Preliminary analysis indicated that the vaccines were safe, and that only one dose of 2009 H1N1 vaccine for the majority of 10 to 17 year olds would be needed to generate a sufficient immune response to be protective against 2009 H1N1 influenza virus, but younger children generally had a less robust early response to the vaccine. CDC recommended that children younger than 10 years receive two doses of 2009 H1N1 influenza vaccine. Results of trials conducted among adults were later published in December, and the data indicated that the immune response among vaccinated adults was excellent. The safety data from these trials also indicated that vaccine side effects were similar to those seen with the seasonal flu vaccines. On September 30, 2009, states were able to place their first orders for the 2009 H1N1 vaccine; forty-seven states placed orders on that day, and by October 9, 2009, all states and the District of Columbia had placed orders for vaccine. The first doses were administered on October 5, 2009. Because initial supplies of vaccine were limited, most state and local health departments requested that vaccine be given only to those in the initial target groups, and many restricted use to those in sub prioritization groups that had also been outlined by ACIP. The first six weeks after vaccines were initially released where characterized by high demand for vaccine and limited availability. On October 23, the ACIP discussed pandemic vaccine issues, including suitability of the initial target groups developed in July 2009, and concluded that the July guidance remained appropriate. The ACIP continued to emphasize the role of local decision-making in determining when to begin offering vaccine to persons outside initial target groups. As vaccine supply increased, by late November and early December most states had begun easing restrictions for 2009 H1N1 vaccine use, and by late December vaccination had been opened up to anyone who wanted it. Also beginning in December 2009, the HHS Center for Faith-Based Neighborhood Partnerships partnered with the HHS Regional Offices to host eleven teleconferences to engage community and faith-based organizations in the 2009 H1N1 flu response. Since most states were easing vaccination restrictions, these calls presented an opportunity to remind key partners that they should check with their local health departments to determine availability of vaccine. By the week of December 22, distribution of 2009 H1N1 vaccine had been opened up to retail pharmacies so that they could place orders for vaccine directly, thereby expanding the reach and availability of vaccine. In December 2009, CDC published in the MMWR preliminary safety results for the 2009 H1N1 vaccines from the first months of reports received through the U.S. Vaccine Adverse Event Reporting System (VAERS), a national voluntary reporting surveillance system and data from the Vaccine Safety Datalink. Results indicated that the vast majority (95%) of adverse events reported to VAERS after receipt of the 2009 H1N1 vaccine were not serious (e.g., soreness at the vaccine injection site). Of the 3,783 reports, 204 (5%) were reports that involved what would be coded as serious health events (defined as life threatening or resulting in death, major disability, abnormal conditions at birth, hospitalization, or extension of an existing hospitalization). The percentage of reports involving what would be considered serious health events was not substantially different between 2009 H1N1 and seasonal influenza vaccines. The 2009 H1N1 influenza vaccine was manufactured in several formulations, using the same manufacturers and the same manufacturing practices used to produce seasonal influenza vaccine. Monitoring the safety of the flu vaccine continues to be a top priority. CDC and the Food and Drug Administration (FDA) worked with other agencies to establish and enhance existing surveillance systems to rapidly detect any unexpected adverse events among persons who are vaccinated and to adjust the vaccination program, if necessary, to minimize risks and maximize benefits from vaccination. Two important systems used to monitor vaccine safety that have been active for 20 years, are the Vaccine Adverse Events Reporting System (VAERS), jointly operated between CDC and FDA, and the Vaccine Safety Datalink (VSD) , a collaborative project between the CDC and eight managed care organizations covering more than nine million members(about 3% of the US population). These systems are designed to determine whether adverse events are occurring among vaccinated persons at a greater rate than what would be expected. CDC worked with FDA and other partners to strengthen these vaccine safety monitoring systems and develop new ways to monitor vaccine safety. In addition, based on the recommendation of the National Vaccine Advisory Committee (NVAC), HHS established the H1N1 Vaccine Safety Risk Assessment Working Group to review 2009 H1N1 vaccine safety data as it accumulates. This working group of outside experts conducts regular, rapid reviews of available data from the federal safety monitoring systems and presents them to NVAC and federal leadership for appropriate policy action and follow-up. Also in December 2009, HHS joined with the Ad Council to launch a new nationwide Public Service Announcements campaign called Together We Can Fight the Flu that encouraged Americans to get vaccinated against the 2009 H1N1 virus. The week of December 18, 2009 marked the first 100 million doses of 2009 H1N1 vaccine available for ordering. The year 2010 began with the National Influenza Vaccination Week (NIVW). NIVW is a national observance that was established to highlight the importance of continuing influenza vaccination after the holiday season into January and beyond. The President of the United States proclaimed the week of January 10-16, 2010, National Influenza Vaccination Week, and encouraged all Americans to observe the week by getting the 2009 H1N1 flu vaccine and by asking their families, friends and coworkers to do the same. CDC and HHS - in conjunction with the states and many other partners, both public and private - launched a comprehensive NIVW campaign with the objective of raising vaccination awareness, providing educational opportunities, free resources, as well as vaccination clinics. Every year, certain days during NIVW are designated to highlight the importance for certain groups; this year’s Week was dedicated to highlighting the importance of vaccination for the general public and health care workers, people with chronic health conditions that put them at high risk of serious influenza-related complications, children, pregnant women, and caregivers of infants less than 6 months old, young adults 19 through 24 years old, and people 65 years and older. For example, the events on Tuesday, January 12 centered on people with chronic medical conditions that put them at higher risk of serious influenza-related complications. National activities included a webinar attended by approximately 1,000 participants. This joint effort was hosted by HHS, CDC, the American Cancer Society, the American Diabetes Association, and the American Lung Association. In addition, Secretary Sebelius participated in two press conference calls announcing new public service announcements (PSAs) tailored to African American and Native American audiences. The Director of the Indian Health Service joined the Secretary in stressing the importance and benefits of vaccination. On January 15, 2010, CDC published an article in the MMWR on influenza A (H1N1) 2009 monovalent vaccination coverage in the United States between October and December 2009. Results of the study indicated that efforts to get available vaccine to target groups had largely succeeded. Early on during the 3-month period, 85% of available vaccine reached people within those initial target populations. By the end of December, with many programs expanding their vaccine efforts to all populations, 74% of all vaccine given during the program had gone to people in the initial priority groups. On February 18, 2010, the World Health Organization (WHO) published recommendations for the composition of influenza virus vaccines for the upcoming season in the Northern Hemisphere (November 2010-April 2011). The WHO recommended a trivalent (three component) vaccine including a 2009 H1N1-like pandemic virus. In February of 2010, the components of the 2010-2011 influenza vaccine were announced. The 2010-2011 flu vaccine will protect against a 2009 H1N1-like virus in addition to an influenza A H3N2 virus and an influenza B virus. The United States experienced its second wave of 2009 H1N1 activity in the fall with activity peaking during the second week in October. After that, activity declined quickly to below baseline levels in January, but persisted for several more months at lower levels. However, by May, influenza activity levels in the United States were low across key flu indicators. Reporting for the 2009-2010 influenza season was finalized on May 28, 2010. Even as flu activity reached normal summer-time levels in the U.S., CDC continued to recommend influenza vaccination, particularly for high risk persons, because of reports of ongoing sporadic cases of 2009 H1N1, ongoing spread of 2009 H1N1 in the Southern Hemisphere and the possibility that 2009 H1N1 viruses might circulate early during the upcoming flu season. CDC Communication Activities During the 2009 H1N1 Pandemic The CDC response to the 2009 H1N1 pandemic was led by science and continually evolved to meet the nation’s needs as events unfolded and as more information became available. However, a consistent underlying communications strategy underscored the entire CDC response. The strategy is based on the emergency risk communications principles of quickly, proactively and transparently communicating accurate information to the public and to partners. This strategy included CDC clearly stating its goals and actions in response to the evolving situation and acknowledging what was not known, as well as what was known. Another important part of the strategy was CDC setting the expectation that information and advice would change rapidly as the situation evolved. From the earliest days of the pandemic, CDC regularly articulated its goals to “reduce transmission and illness severity, and provide information to help health care providers, public health officials and the public address the challenges posed by the new virus.” Throughout the response, in an effort to provide the most helpful information in the most effective ways possible, CDC drew on existing knowledge but also worked with partners to conduct ongoing scientific research and evaluation of people’s knowledge, attitudes and practices related to a number of topics including 2009 H1N1 flu, infection control guidance, and vaccine. Especially during the early days of the outbreak, the release of information from CDC and exchange of information with partners was conducted on a 24-hour cycle. This included frequent updates to media and the public, the consistent use of a core group of spokespersons, daily information outreach to partners, and rapid establishment and ongoing maintenance of an extensive Web site dedicated specifically to the emergency response for 2009 H1N1 flu. The goal was not only to be as transparent as possible in all activities related to managing the public health response, but also to maintain credibility and continue to be a trusted source of information for the public and for partners. Beginning early in the response and continuing throughout the year and into 2010, special care was taken to keep state and local public health partners informed of CDC’s activities. Key messages were regularly provided to help maintain consistent, clear communication across the response. Special care also was taken to regularly collect feedback from state and local public health partners to help ensure that CDC recommendations were finely tuned to what was happening in the field. Regularly scheduled conference calls with the Association of State and Territorial Health Officials, the National Association of City and County Health Officials, and the National Public Health Information Coalition proved to be an effective way to share information. In addition, on April 24, 2009, CDC held the first of more than 30 Clinician Outreach and Communication Activity (COCA) calls presented on a variety of 2009 H1N1-related topics. COCA is designed to reach a diverse group of health care providers and provide a system through which clinicians can communicate their educational needs to CDC and receive answers to questions about related emerging diseases. At the peak of the 2009 H1N1 response, COCA had more than 41,100 listserv subscribers. CDC also worked hard to keep the policy community informed. CDC provided responses to congressional requests for information and briefings on 2009 H1N1-related issues, and also provided email and web-based informational updates as the pandemic unfolded. In all, CDC participated in 14 hearings, provided technical assistance in another 12 hearings, issued over three dozen 2009 H1N1 newsletters to policymakers, arranged for over 40 congressional briefings or speaking engagements and fielded over 350 congressional inquiries during the pandemic. There was a concerted effort to get information out as soon as possible and to keep the public and partners aware of developments as they unfolded, even as guidance was changing quickly. For example, when relatively few cases of human infection with this virus were lab confirmed and severity of the pandemic was not known, on April 28, 2009, CDC posted guidance for schools and advised that they close if they had a suspected or actual case of the flu in order to lessen the risk of spreading 2009 H1N1 into their communities. As more information became available suggesting a lower risk of severe illness and death from 2009 H1N1, six days later the recommendation was changed to recommend against school closure for community mitigation purposes. The development of CDC guidance is an example of the collaborative communication and sharing of information that took place between CDC, HHS, other federal agencies, and external partners. Development of appropriate guidance often relied on CDC communication with many external partners several times a week, with the goal of achieving consensus on what the best practice would be given the best science currently available. For example, CDC worked with representatives from a number of organizations including but not limited to Council of State and Territorial Epidemiologists (CSTE), National Association of County and City Health Officials (NAACHO), American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), American College of Obstetricians and Gynecologists (ACOG), Association of State and Territorial Health Officials (ASTHO), American College of Physicians (ACP), Infectious Diseases Society of America (ISDA), American Academy of Pediatrics (AAP), Food and Drug Administration (FDA) and World Health Organization (WHO), during the development of guidance related to everything from surveillance systems to the appropriate use of antiviral drugs during the pandemic. On the topic of vaccination, these discussions helped inform decision-making by the Advisory Committee on Immunization Practices (ACIP). Apart from ongoing collaboration between CDC and its external partners, the communications response for 2009 H1N1 flu also was characterized by ongoing, close coordination between CDC’s communicators and its scientists to ensure that messages stayed scientifically accurate. Also, CDC communicators took time to regularly analyze feedback from a variety of external sources, including polls and surveys, in order to ensure that CDC's messages were clear. CDC provided a steady stream of information to audiences across the spectrum: from the public to pharmacists to laboratorians to international partners and countries around the globe. Information provided by CDC reached a myriad of audiences through a variety of channels including but not limited to: a 24-hour information hotline, press briefings for the media, dissemination through health alert networks, daily postings (including video and audio podcasts) to the CDC 2009 H1N1 web site, regular updates on Facebook and Twitter, and further outreach by partners and partner organizations to their own audiences, just to name a few channels. For example, in November 2009, CDC kicked off a national travelers’ health public awareness campaign and urged travelers to plan ahead and stay informed about what to do if they got sick while they were away from home. The campaign used a variety of media, including informational posters distributed at over 300 ports of entry in the United States, national radio and print advertising, and social media and online outreach, which culminated in over 80 million exposures. CDC also coordinated with HHS and the Flu.gov web site and posted communication toolkits for the 2009-2010 influenza season for businesses, employers, childcare groups and institutions of higher education. The CDC 2009 H1N1 influenza and seasonal influenza vaccination campaign was made up of multiple outreach efforts including placement of articles geared to numerous audiences like parents and young adults, in high-profile media outlets. Article placements led to nearly 403 million overall impressions. Other national outreach efforts made via social media tools, radio ads, two television public service announcements (PSAs), online media banners, and city bus ads. Numerous print materials in multiple languages were made for partners to distribute and were downloaded tens of thousands of times. Special audiences identified for additional print materials included Native Americans, African Americans, Hispanics, pregnant women, young adults, first responders, and health care workers. In addition to materials provided for the 2009 H1N1 and seasonal influenza vaccination campaign, CDC provided other key materials in multiple languages. For example, the entire English-language 2009 H1N1 web site was mirrored in Spanish. In addition, key tools and resources were created in Chinese, Vietnamese, Korean, French, German, Arabic, Russian, Amharic, Farsi, Somali, Karen, Burmese, Cambodian, and Kirundi. In all, between April 2009 when 2009 H1N1 flu first emerged and April 2010, CDC held 60 related media events – 39 press briefings and 22 telebriefings – for a total of more than 35,000 participants. CDC also hosted its first ever two-day workshop for the news media on the subjects of both 2009 H1N1 influenza and seasonal influenza in late August. Originally conceived to include 12 members of the news media, the attendance grew to over 40 journalists from national, regional and local news outlets representing radio, television, newspapers, magazines, and online news media. Speakers at the event included the Secretary of Health and Human Services, the CDC Director, influenza experts, vaccine safety experts, and laboratory experts. The CDC hotline (1-800-CDC-INFO) responded to more than 211,000 related inquiries from the general public and health care providers, and the CDC 2009 H1N1 web site had more than 219,595,000 page views. Also, the number of CDC Facebook fans rose to more than 55,000 fans and the CDC emergency profile on Twitter was tracked by more than 1,200,000 followers. Update: Influenza Activity --- United States, 2009--10 Season (BARDA) HHS 2009 H1N1 Vaccine Development Activities (FDA) Influenza (Flu) Antiviral Drugs and Related Information HHS 2009 H1N1 Vaccine Development Activities H1N1 Influenza Vaccine Development Process The Science behind Developing the H1N1 Vaccine Pan American Health Organization (PAHO): Pandemic (H1N1) 2009 World Health Organization (WHO): Pandemic 2009 H1N1 FDA 2009 H1N1 (Swine) Flu Page Medical Devices and Flu Emergencies H1N1: Meeting the Challenge (American Public Health Association) Public Health, APHA Respond to H1N1 Virus (Association of Public Health Laboratories) Novel H1N1 Flu (The Association of State and Territorial Health Officials) Responding to a virulent pandemic (The Public Health Informatics Institute (PHII)) National Association of State and City Health Officials, Programs and Activities, H1N1 To receive weekly email updates about this site, enter your email address: Page last reviewed June 24, 2010, 4:30 PM ET Page last updated August 3, 2010, 4:00 PM ET

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Industry No, there’s not a shortage of veterinarians By Tom Quaife June 03, 2011 | 2:43 pm EDT It’s generally been assumed there are not enough veterinarians to serve rural America. But that assumption may no longer be valid. “The veterinary schools and recruitment efforts have generated a supply of new and recent graduates that have both interest levels and skill sets that would serve them well in a food-animal practice, as well as a mixed-animal practice in rural America,” Gatz Riddell, executive vice president of the American Association of Bovine Practitioners, pointed out on the AgriTalk radio show this week. Rather than a shortage of veterinarians in rural areas, Riddell calls it a “distribution problem.” There are parts of the country that are underserved, where people with cattle do not have ready access to veterinarians, Riddell acknowledged. At the same time, “there may not be enough infrastructure, there may not be enough potential clientele to generate the type of business that a veterinarian would need to exist in that area,” he said. This situation is made even more acute by the large amount of debt that many students accumulate in veterinary school. To get veterinarians in the underserved areas, a better business or practice model may be needed, he adds. "We've got to make sure, at the end of the day, that there’s a robust practice model that will allow them to make a living in a part of the country where they want to work,” Riddell says. He mentioned some possibilities: Regional practice centers where the work load is shared among several veterinarians instead of having just one practitioner putting in long hours, with frequent emergency calls. Registered veterinary technicians working under the guidance of veterinarians. More mentoring opportunities. To hear the entire interview on AgriTalk, click here. Tom Quaife

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The evaluation of the data quality in Canada suggests that there are some problems concerning deaths and population counts over the age of 80 years, confirming at least in part the conclusions of the study made by Kannisto [20]. However, results in section 4.1 show that Canadian data are quite good up to the age of 100 (generation heaping and age misstatement are at levels similar to those found in comparable countries) and that the main problems concern the centenarians (overstatement of age at death and errors in census age declarations). International comparisons on the basis of two mortality indicators for the age 80 to 100 lead to the same conclusion: Canadian mortality is lower than most European countries. The best match is still with the United States. So, we can conclude that, although there are some problems with the data, there is some strong evidence of a lower mortality at older ages in Canada. In fact, the main comparisons shown in section 4.2 concern the 80-99 age interval where Canadian data are quite good. Can we also conclude that a North American mortality profile exists, as suggested by some authors [2] [17] [29]? This profile is characterised by relatively high mortality rates below age 65 and relatively low mortality rates above age 80, when compared to other low-mortality countries. According to our results, Canadian mortality corresponds to the latter part of this definition; however, mortality below age 65 in Canada is much lower than in the United States and more comparable to many European countries. Although Canada and the United States share the same low mortality level for the oldest-old, their mortality profiles are probably different. Our results show that Canada and the United States also share the same types of error in their data for the oldest-old. This is not a totally surprising result, because in the two countries it is very difficult to ascertain the date of birth due to the absence of birth registers (before 1921 in Canada). However, recent findings from a record linkage study by Hill et al. [16] show that the American data concerning the age at death of older persons are quite reliable, giving more support to the lower level of U.S. mortality rates above age 80 (at least among native whites). The same kind of matching study would be useful for Canada. In the meantime, a first step in improving estimation of mortality at advanced ages would be for all Canadian provinces to ameliorate the data on deaths; as there was no civil registration before 1921 in Canada, the task is not easy. However, some reconciliation can be done with administrative files (health records, for example). Another avenue would be to estimate mortality using only data from the Province of Quebec, where death registration is very good and age at death can be verified against baptism register before 1926 [5] [11]. Quebec has the added advantage of a universal health insurance program (Medicare) with a file on all beneficiaries. This would enable us to compare data from vital statistics and from the census to this file. These procedures would lead to a better knowledge of the mortality profile at old ages. Mortality Statistics for the Oldest-Old: An Evaluation of Canadian Data Robert Bourbeau and André Lebel © 2000 Max-Planck-Gesellschaft ISSN 1435-9871 http://www.demographic-research.org/Volumes/Vol2/2

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HomeArchiveSubscriptionStoryEmc.orgApril 2013Changing LivesOne Breath at a TimeBy: Maggie DownsJoseph Weaver, Cardiac Rehabilitation Fitness Instructor, demonstrates equipment at the Eisenhower Renker Wellness Center.Don’t wait — exercise your right to great health at the Eisenhower Renker Wellness Center, which features dynamic cardiac and pulmonary wellness programs. Offering exercise, education and support services, the Center provides the perfect balance of everything patients need to jump-start their health and move toward a goal of total wellness. “We literally see people change their lives here,” says Julia Dugan, RN, RCP, Coordinator, Renker Wellness Center. “They come in not able to move 10 feet without getting breathless. Then, before long, they’re walking on a treadmill.” Stories of success include people like Joe Crone who had a quadruple bypass in May 2012, and his wife, Jeanne, who is a graduate of the pulmonary wellness program. The couple visits the center at least four times a week for fitness and fun. “The discipline of this can’t be taken lightly,” says Joe Crone. “This is life we’re talking about here.” Jeanne Crone said she has made many strides toward better health since attending the pulmonary wellness program. “I used to have other people do things for me. Now I do a lot more housework. I take the dog for a walk. I do things for myself,” she says. “I’ve realized if you don’t keep moving, you’re going to die.” The wellness programs are available for those who have recently experienced a heart attack, stable angina, open heart surgery or suffer from chronic lung disease. A maintenance program is also available for those who no longer need to be monitored while they exercise but want the safety of a workout with licensed, experienced health professionals available on the premises. “People feel safe here,” explains Charles Harrill, RN, Manager, Renker Wellness Center. “It’s very scary to have a major health incident. People want to know what to do, how to get a normal life back.” The cardiac and pulmonary wellness programs help patients return to productive, active lifestyles. According to Harrill, exercise programs at the Renker Wellness Center are often customized for the individual patient. No two routines are ever the same, because no two people have the same needs. New members also receive a health evaluation and a cardiovascular exercise routine. “It can be intimidating to come here, especially for people who aren’t used to working out,” Dugan says. “We do everything we can to make them comfortable.” The Center features state-of-the-art rehabilitation equipment, including treadmills, stair climbers, bicycles, free weights and more. Need distraction? Plasma TVs will keep you entertained. In addition to the gym equipment, the Renker Wellness Center also boasts the latest telemetry equipment. Nurses, respiratory therapists and fitness trainers are available to monitor blood pressure, heart rate and oxygen readings before and after working out. Other services include on-site emergency equipment; a variety of yoga, Pilates and Tai Chi, plus aerobic and stretching classes; and educational lectures about cardiac risk reduction, anticoagulant therapy, and pulmonary disease. Harrill emphasizes that patients should begin an exercise program as soon as possible after their discharge from the hospital — with a doctor’s approval, of course. “That’s when the habit really sticks — when you realize how much your health depends on it,” he says. The eight-week pulmonary wellness program consists of three visits per week, two hours each session. Education sessions include discussions about medication, infection control/lung irritants, stress management/panic control, travel, intimacy and lung disease among others. “Some people come to us on oxygen, unable to do their daily activities. Participating in the wellness program builds strength, endurance and confidence — some patients are even able to reduce their use of oxygen during daily activities,” says Dugan. “That is a huge success story. I couldn’t ask for a better job.” Harrill echoes the same sentiments. “It becomes a family here,” he says. “We want everyone to succeed.”About the Renker Wellness Center Have you been diagnosed with heart or lung disease?The health care professionals at Renker Wellness Center want patients to regain a normal lifestyle. Their goal is to provide the correct balance of exercise, education and support services to help patients enjoy their best days ever. The Renker Wellness Center is located on the main campus of Eisenhower Medical Center, 39000 Bob Hope Drive in Rancho Mirage. Hours: 5:30 a.m. to 7 p.m., Monday through Friday. Closed noon to 1 p.m. Call 760-773-2030 for more information.HealthNotes is a publication of Eisenhower Medical Center · © Copyright 2016 All Rights Reserved

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Robyn J. Barst Pediatric Research and Mentoring Fund Family, friends and the entire pulmonary hypertension community mourn the loss of a pre-eminent leader in the field of pediatric PH, Robyn J. Barst, M.D., on April 19, 2013. For two-and-a-half decades, Dr. Robyn Barst established herself as a leader in the field by providing state-of-the-art medical care for children and adults with PH, founding the New York-Presbyterian PH Center, conducting groundbreaking research in the field, mentoring numerous clinicians, and serving in PHA leadership through the Board of Trustees and Scientific Leadership Council. Dr. Barst was both a pioneer in the field and a hero to many for her treatment of the disease and her compassion towards her patients. Her legacy continues to shape the medical profession and touch lives. Celebrate the memory of Dr. Barst with your donation to PHA “Robyn would have wanted people not to mourn her but continue her fight against PH. That’s why supporting PHA’s research and education to end this terrible disease is so important." – Sam Barst, Robyn’s husband Dr. Barst’s family has requested contributions to PHA’s Dr. Robyn J. Barst Pediatric Research and Mentoring Fund for Pulmonary Hypertension at PHA. Memorial gifts to this fund will carry on Dr. Barst’s commitment to advancing the field of pediatric PH. It is a mission she not only lived throughout her lifetime — she invested in its future by donating the generous gift that founded this important fund. We invite you strengthen PHA’s ability to educate and train even more pediatric PH specialists in Dr. Barst’s memory and learn more about the work of Barst Fund Award Winners. Why research in pediatric pulmonary hypertension matters Three decades ago, pediatric cardiologist Dr. Robyn Barst and other pioneer researchers helped to move pulmonary hypertension toward its first treatment in 1996. Before the FDA approved that first drug, survivability was 2.8 years for 50% of patients. Research has led to now twelve treatments for pulmonary hypertension — only two of the 7,000 identified rare diseases have more treatments. Unfortunately, there is still no approved treatment for children with PH. During the past decade of extraordinary research and clinical activity, the number of physicians treating this disease has increased from about 100 to an estimated 12,000. Driven by research, this medical field is in rapid formation. In this video, hear what Dr. Barst and others in the field have to say about the importance of pediatric research. Why PHA? PHA is committed to placing the issue of pediatric PH squarely at the forefront of the PH research agenda. PHA has a proven track record in supporting research through four leveraged partnerships which, to date, have enabled the organization to commit more than $15 million to PH research. Moreover, through PHA's Scientific Leadership Council — a body of 28 world-renowned PH researchers and clinicians — PHA has the structure in place to establish and oversee an effective pediatric PH research program. The SLC's Research Committee will play a critical role in the development, management, and oversight the pediatric research program.

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. Pulmonary Hypertension Research News Elusive Origin of Pulmonary Hypertension Uncovered From Brigham and Women’s Hospital - A new study published in EMBO Molecular Medicine by researchers from Brigham and Women’s Hospital (BWH) sheds light on the disease’s surprising cause, with crucial implications for diagnosis, treatment, and prevention of PH in persons at risk. Read more. Selexipag (Uptravi) Long-term Outcome Data in PAH Presented From PipelineReview.com - Yesterday, key long-term outcome data from Actelion's pivotal selexipag (Uptravi®) Phase III GRIPHON study were shared during an oral presentation at the American College of Cardiology (ACC) Congress in San Diego, Calif. The presentation highlighted that the investigational drug selexipag significantly reduced the risk of a morbidity/mortality event by 40 percent versus placebo (p<0.0001) in patients with pulmonary arterial hypertension (PAH). Read article Tuesday, March 17, 2015 11:33:00 AM Quebec Breathes New Hope into Lives of Those Affected by Pulmonary Arterial Hypertension (CNW) - The Pulmonary Hypertension Association of Canada (PHA Canada) was pleased to learn that a new treatment option for pulmonary arterial hypertension (PAH) is now being publicly funded in the province of Quebec. On October 1, the Institut national d'excellence en santé et services sociaux (INESSS) recommended that the drug Opsumit (macitentan) be added to the list of drugs covered by the prescription drug insurance plan administered by the Régie de l'assurance maladie du Québec (RAMQ). Read the full press release Tuesday, October 21, 2014 8:49:00 AM PHA Accredits First Six PH Care Centers; Application Process Now Open We are excited to announce that we have accredited our first six Pulmonary Hypertension Care Centers (PHCC). This initiative aims at improving overall quality of care and ultimately improving outcomes of patients with pulmonary hypertension. Two types of centers will be accredited: Centers of Comprehensive Care (CCC) - the first six are listed below - and Regional Clinical Programs (RCP). For interested centers, the PHCC Application is now open and available for download. Many PH programs have already submitted their application, and you can track their progress on the Applicant Center page. Quality Care from Experts in the Field “The PHCC will give PH patients security in knowing they are receiving quality care from the experts in the field,” said Dr. Murali Chakinala, from the Washington University School of Medicine and PHCC Committee Chair. “Patients can feel confident that the PHCCs have been vetted by a rigorous process that includes a detailed application and a comprehensive site visit with ultimate adjudication by a Committee of more than 20 health professionals with vast experience in caring for PH patients.” PHA's Scientific Leadership Council and the PHCC Oversight Committee set high parameters for PHCC accreditation. PHCC accreditation signifies that a PH program has demonstrated a dedication to making proper diagnosis and capacity to appropriately and comprehensively manage PH patients through a set of criteria established by the PHA Scientific Leadership Council – 28 global leaders in the field of pulmonary hypertension. These criteria have also been developed with input from many PH stakeholders including physicians, allied health care professionals, patients and PHA leadership and are considered essential to delivering high-quality care for these complex patients. Patient Registry for Determining Effective Care Accredited PH Care Centers will also contribute to a PH patient registry that will track diagnostic and treatment patterns at a national level, ultimately demonstrating quality improvement for the care of PH patients. “The PH patient registry will provide important data on the care and outcomes of patients with pulmonary hypertension across the country,” said Dr. Steven Kawut of the Perelman School of Medicine at the University of Pennsylvania. “We can then begin to understand best practices in the treatment of PH and continue to improve the quality of life and survival of individuals with this disease.” Linking Centers through a national network will increase collaboration in the PH community, through clinical, quality improvement and investigative partnership. First Six Accredited Centers Inova Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, Fairfax, Va. Penn Pulmonary Hypertension / Pulmonary Vascular Disease Program, University of Pennsylvania Health System and Perelman School of Medicine, Philadelphia, Pa. Kentuckiana Pulmonary Associates, Louisville, Ky. UC Health Pulmonary Hypertension Program, University of Cincinnati, Cincinnati, Ohio. Cottage Pulmonary Hypertension Center, Cottage Health System, Santa Barbara, Calif. Stanford Pulmonary Hypertension Program, Stanford University, Stanford, Calif. For more information on PHCC visit www.PHAssociation.org/PHCareCenters or email PHCC@PHAssociation.org. Wednesday, October 01, 2014 1:44:00 PM Screen Scleroderma Patients Annually for Pulmonary Hypertension Scleroderma patients should be screened every year for pulmonary hypertension even if they are recently diagnosed and have no respiratory symptoms. Noninvasive tests can catch pulmonary problems early, and treatments are available to slow the progression of scleroderma. Read more and watch the video Participating in research & clinical trials helps gain information vital to progress toward a cure Learn more about participating in research ADVOCATE FOR RESEARCH FUNDINGPut your Members of Congress to work for you, their constituent. Ask them to support federal funding for PH research and education.Advocate for PH research funding

医学

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URMC / Medicine / Endocrinology, Diabetes and Metabolism Division of Endocrinology, Diabetes and Metabolism Chief: Stephen R Hammes, M.D., Ph.D. The Division of Endocrinology and Metabolism at the University of Rochester School of Medicine and Dentistry consists of a diverse cadre of physicians and scientists with interests in all aspects of Endocrinology and Diabetes. The Division has three main missions: Provide top level care for all forms of endocrine disorders Maintain internationally recognized basic and clinical endocrine research programs Offer excellent training for the next generation of academic endocrinologists. Clinical Program: The clinical program in the Division of Endocrinology provides care for all major endocrine disorders. In addition to diabetes, this includes disorders of bone, pituitary, thyroid, parathyroid, adrenal gland, and gonads. Our Diabetes Center sees over 4000 patients each year, and runs one of the largest insulin pump programs in the Northeast. In addition, the Division runs several subspecialty clinics, including an active multi-disciplinary pituitary clinic with the Department of Neurosurgery, a combined Endocrine Tumor Clinic with the General Endocrine surgeons, a Metabolic Bone Disease Clinic, and a Gestational Diabetes Clinic. Research Program: The Division boasts several research laboratories studying a wide-range of subjects in Endocrinology, including bone physiology, cancer biology, steroid production and signaling, reproduction, circadian rhythms, cardiac development, and diabetes. Fellowship Program: The Endocrinology and Metabolism Fellowship is a three year program that provides in-depth clinical and research training in Endocrinology. Our educational mission is to produce academic physician scientists of the highest caliber.

医学

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Overweight primates model for obesity providing tangible results for humans Like many these days, Shiva sits around too much, eating rich, fatty foods and sipping sugary drinks. He has the pot belly to prove it, one that nearly touches the floor — when he’s on all fours, that is. Shiva belongs to a colony of monkeys who have been fattened up to help scientists study the twin human epidemics of obesity and diabetes. The overweight monkeys also test new drugs aimed at treating those conditions. Tuesday, February 22, 2011 - 13:12 Gene therapy experiment, tested in dogs, aims to prevent blindness in a 6-year-old girl Within months of Alexe Webb's birth, her parents noticed eye problems. Alexe seemed unable to fix her vision on faces. Bright lights triggered prolonged bouts of staring. In dim light, she groped with her hands to find toys or snacks in plain view. Friday, February 18, 2011 - 11:52 Testing method developed with mice could replace colonoscopies in the future Nobody enjoys colonoscopies, including mice. University of Missouri researchers are excited about the potential of using genetic biomarkers to predict colon cancer caused by inflammation. A new method developed at the MU Research Animal Diagnostic Laboratory (RADIL) could eventually lead to a method that might eliminate colonoscopies altogether. Long-term hair regrowth in stressed mutant mice could translate to solutions for humans It has been long known that stress plays a part not just in the graying of hair but in hair loss as well. Over the years, numerous hair-restoration remedies have emerged, ranging from hucksters' "miracle solvents" to legitimate medications such as minoxidil. But even the best of these have shown limited effectiveness. Mouse research yields possibility of reducing growth of bladder, breast cancer cells Researchers at the Johns Hopkins University School of Medicine have discovered that nitroxoline, an antibiotic commonly used around the world to treat urinary tract infections, can slow or stop the growth of human breast and bladder cancer cells by blocking the formation of new blood vessels. The results, appearing in the Dec. 15 issue of the Journal of the National Cancer Institute, suggest that nitroxoline shows promise as a potential therapeutic agent. New animal research study implicates natural toxin as triggering Parkinson's disease. In new research from Saint Louis University, investigators have found evidence that a toxin produced by the brain is responsible for the series of cellular events that lead to Parkinson's disease. The study, published in PLoS One, found that the brain toxin DOPAL plays a key role in killing the dopamine neurons which trigger the illness. Diets low in Omega-3 linked to depressive behavior in mice Although most people in developed countries get plenty of calories daily, their diets are often lacking in key nutrients that their bodies have evolved to expect. Omega-3 polyunsaturated fatty acids, such as those found in fish and walnuts, are one category of crucial ingredients that the body cannot make on its own. Wednesday, February 2, 2011 - 13:16 Researchers use biological cartilage for knee replacement in dogs A professor of veterinary medicine at the University of Missouri and his team have successfully performed a knee replacement procedure in dogs using biological cartilage. The cartilage was developed from the patient's own cells, which were grown in the lab and formed for insertion into the knee. Biologists grow beating heart cells from mice cells Biologists have grown beating heart cells directly from connective tissues in mice, skipping a previously required middle step -- the creation of stem cells. CAPTIONJem A. Efe Monday, January 31, 2011 - 15:39 Team develops "smart bomb" to neutralize HIV in animal model. After several years in the lab, researchers at City of Hope are reporting positive results in animal trials of a new treatment designed to both hunt down HIV-infected cells and stop the virus from spreading, according to a study published last week in the journal, "Science Translational Medicine." Monday, January 24, 2011 - 12:39 Blood-vessel cells combat aggressive cancer tumors successfully in mouse model MIT scientists have discovered that cells lining the blood vessels secrete molecules that suppress tumor growth and keep cancer cells from invading other tissues, a finding that could lead to a new way to treat cancer. Roundworm unlocks pancreatic cancer pathway Wed, Jan 19, 2011 — In a study published in the Cell Press journal Developmental Cell, a team of researchers led by Channing Der, PhD, Distinguished Professor of Pharmacology at UNC-Chapel Hill, took a step back to a simpler organism – a common roundworm – and made a discovery about how the Ras oncogene chooses a signaling pathway and how the consequences of that choice play out in cellular development – a key issue in cancer, which is characterized by uncontrolled cell growth. Thursday, January 20, 2011 - 14:59 New molecule discovery in mice can make brain cells resistant to programmed cell death or apoptosis This molecule, a tiny strand of nucleotides called microRNA-29 or miR-29, has already been shown to be in short supply in certain neurodegenerative illnesses such as Alzheimer’s disease and Huntington’s disease. Primate study reveals the fetal brain is vulnerable to moderate decreases in maternal nutrition The researchers found decreased formation of cell-to-cell connections, cell division and amounts of growth factors in the fetuses of mothers fed a reduced diet during the first half of pregnancy. Animal research improves understanding of tumor development and provide a new cancer biomarker. Massachusetts General Hospital (MGH) Cancer Center researchers have discovered a previously unknown feature of common tumor cells – massive overexpression of certain DNA sequences that do not code for proteins. These DNA sequences – called satellite repeats – have been studied for their role in chromosomal structure but previously were not suspected of having a role in cancer. The report will appear in the journal Science and is receiving early online release. Friday, January 14, 2011 - 12:10 Animal study finds nerve stimulation may thwart tinnitus Research in rats suggests that "rebooting" the brain can help stop tinnitus, a condition characterized by persistent ringing or other noises in the ears. New therapeutics target for multiple sclerosis identified in laboratory mice study. Using a mouse model, researchers have discovered that a molecular switch called EMMPRIN plays an important role in MS. Breakthrough in lung cancer research; drug successfully tested in mice Australian and international researchers have announced a potential breakthrough in lung cancer research – linking it to a genetic mutation for which blocking drugs already exist. Researchers successfully regenerate complete shoulder joint surfaces in rabbit model using the patient's own cells A team of University of Missouri and Columbia University researchers have found a way to create these biological joints in animals, and they believe biological joint replacements for humans aren't far away. Thursday, January 6, 2011 - 10:45 Animal research reveals unexpected biological pathway in glaucoma In a study published today in the Proceedings of the National Academy of Sciences (Early Edition ahead of print), a team of researchers from the Kennedy Krieger Institute and four collaborating institutions, identified a new and unexpected biological pathway that appears to contribute to the development of glaucoma and its resulting vision loss. Tuesday, January 4, 2011 - 11:18

医学

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Dentist gives back to tornado victims On June 4, Oklahoma was ravaged by one of the widest tornadoes ever recorded in the United States. The tornado carved out a damage path up to 2.6 miles wide and 16.2 miles long, a band at times that was wider and longer than Manhattan. The ferocity of the twisted torn apart communities and families lost almost everything, including loved ones.After hearing news of the devastation the staff at Water’s Edge Family & Cosmetic Dentistry, headed by Dr. Nicole Dahlkemper, got together and decided to donate 10 percent of all crowns, teeth whitening, veneers and Botox injections proceeds to the tornado victims. “We are more than just a private dental practice, we are a community-based practice that knows the importance of giving back to our community, no matter whether that community is here in the Lowcountry or over 1,000 miles away in Oklahoma,” states practice administrator, Mark Janowiak.Despite the aid already provided by national and federal relief programs, victims in Oklahoma are still trying to rebuild their lives and communities and require additional funding to do so. “Just because a tragedy is no longer in the news does not mean that people no longer need assistance.The government and other relief programs run dry and people are left to fend for themselves. When you lose everything, it takes months if not years to completely rebuild and move forward,” states Dr. Dahlkemper about donating to the tornado relief fund.The local Red Cross deployed 13 volunteers to Oklahoma to join more than 2,000 Red Cross workers from across the nation. Red Cross volunteers are still in Oklahoma providing health services, emotional support and assistance for long-term recovery.“The Oklahoma tornado relief effort and other disaster response operations are made possible because of the passion of businesses like Waters Edge Family & Cosmetic Dentistry that give to the American Red Cross,” said Louise Welch Williams, regional chief executive officer, American Red Cross, Palmetto SC Region. “We are grateful that Waters Edge Family & Cosmetic Dentistry chose to support the Red Cross, so that we can continue to help these families and communities with their long-term recovery.”Every day, trained Red Cross caseworkers are meeting one-on-one with people in Oklahoma who have unmet emergency needs or who need extra help creating recovery plans. More than 6,300 people are being provided with individualized support for their families.To date, the Red Cross has served nearly 460,000 meals and snacks, distributed almost 400,000 relief items and provided over 6,300 overnight stays in shelters. The Red Cross has also provided more than 24,000 health service referrals.With the fundraiser, which started on June 5, Water’s Edge Family & Cosmetic Surgery has raised more than $1,500. To learn more about how you can help raise money for Red Cross Relief programs, contact Lexie Leyman at 843-764-2323 x 359 or Lexie.Leyman@redcross.org. Latest Videos

医学

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Quest expands Mass. presence with additional lab space Madison-based Quest Diagnostics is expanding into the laboratories of academic health care facilities in Massachusetts, increasing the company's footprint outside New Jersey. Quest announced Wednesday it completed the acquisition of the UMass Memorial Medical Center clinical outreach laboratory, in Worcester, Mass., and announced the acquisition of the medical center’s anatomic pathology outreach lab. Quest also signed a lease for 200,000 square feet in Marlborough, Mass., for a new state-of-the-art clinical lab, which eventually will house the UMass lab assets as well as several other diagnostic services.Wendy Bost, director of media relations for Quest, said the acquisition is part of a national trend the company is seeing of hospitals wanting to focus on clinical care, and using acquisitions or joint ventures to provide quality and cost-effective diagnostic services.“We have a long standing commitment to the Massachusetts and New England region,” Bost said. “In this case, we were fortunate to come across a provider such as UMass that is forward-thinking about changes going on in the health care space, and making sure they’re providing financially viable services.”Bost said the company’s home state is “clearly an important region for us,” but would not elaborate on any potential similar transactions in New Jersey.“At this stage, we are exploring opportunities in different parts of the country, because we believe that there are hospital systems around the U.S. who are recognizing that, by focusing on their core business, focusing on patient care, they have an opportunity to drive cost synergies,” Bost said.Bost said Quest had done a number of acquisitions or joint ventures in the 1990s with hospitals, but in recent years, providers began building and operating their own labs. The UMass deal is the second in 12 months for Quest, which Bost said indicates another swing of the pendulum.“Through the transaction, we expect we will be able to benefit from the academic expertise of UMass Memorial, but we’re also in a position, thanks to Quest’s scale and our own diagnostic expertise, to provide services to that market that we expect will be more cost effective than hospital outreach labs could offer themselves,” Bost said.Academic faculty and other laboratory professionals from UMass Memorial and the University of Massachusetts Medical School will collaborate with Quest on pathology and other clinical services, according to the announcement. You May Have Missed...

医学

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It should be working well by the end of November. That's the Obama administration's rough timetable for completing a long list of fixes to HealthCare.gov, the new, trouble-plagued website for uninsured Americans to get coverage. It should be working well by the end of November. That's the Obama administration's rough timetable for completing a long list of fixes to HealthCare.gov, the new, trouble-plagued website for uninsured Americans to get coverage.Summarizing a week's worth of intensive diagnostics, the administration acknowledged Friday the site has dozens of complex problems and tapped a private company to oversee fixes.Jeffrey Zients, a management consultant brought in by the White House to assess the extent of problems, told reporters his review found dozens of issues across the entire system. The site is made up of layers of components that are meant to interact in real time with consumers, government agencies and insurance company computers.It will take a lot of work, but "HealthCare.gov is fixable," Zients declared.The vast majority of the issues will be resolved by the end of November, he asserted, and there will be many fewer screen freezes. He stopped short of saying problems will completely vanish.The troubles have been nightmarish for the White House, which had promoted enrollment to be as simple as making a purchase on Amazon.com. This week, President Barack Obama declared himself frustrated by the setbacks while still trumpeting the benefits of the health care law and encouraging consumers to apply by phone if the website proved a hindrance.In his weekly radio and internet address Saturday, Obama vowed that "in the coming weeks, we are going to get it working as smoothly as it's supposed to." In the meantime, he encouraged the public to call 1-800-318-2596 or visit LocalHelp.HealthCare.gov."We're only a few weeks into a six-month open enrollment period, and everyone who wants insurance through the marketplace will get it," he said.As part of its effort to repair the system, the administration said it is promoting one of the website contractors, a subsidiary of the nation's largest health insurance company, to take on the role of "general contractor" shepherding the fixes.Quality Software Services Inc. — owned by a unit of UnitedHealth Group— was responsible for two components of the government's online insurance system. One is the data hub, a linchpin that works relatively well, and the other is an accounts registration feature that initially froze and caused many problems.HealthCare.gov was supposed to be the online portal for uninsured Americans to get coverage under Obama's health care law. Envisioned as the equivalent of Amazon.com for health insurance, it became a huge bottleneck immediately upon launch Oct. 1. The flop turned into an embarrassment for Obama and will likely end up as a case study of how government technology programs can go awry.The briefing from Zients came a day after executives of QSSI and the other major contractor, CGI Federal, told Congress that the government didn't fully test the system and ordered up last-minute changes that contributed to logjams. Next week, Health and Human Services Secretary Kathleen Sebelius is scheduled to testify.Visiting a community health center on Friday in Austin, Texas, Sebelius said that "in an ideal world there would have been a lot more testing" but added that her department had little flexibility to postpone the launch against the backdrop of Washington's unforgiving politics. House Republicans trying to defund the nation's health insurance program precipitated a government shutdown.In the Republican address, Rep. Fred Upton of Michigan, the chairman of the House Energy and Commerce Committee, asked whether the problems evident now foreshadowed future troubles with the health care law.The marketplaces are the gateway to obtaining health insurance under the new health care law, which requires most Americans to have coverage by Jan. 1. Middle-class people who don't have insurance on the job can purchase a private plan with new tax credits to make the premiums more affordable. Low-income people will be steered to an expanded version of Medicaid in states that agree to extend the safety net program.The federal government is running the insurance markets or taking the lead in 36 states. The rest were set up by states themselves.Consumers have until Dec. 15 to sign up for coverage to take effect Jan. 1. Under the law, pre-existing medical conditions will no longer be a barrier. But the markets also need lots of young, healthy customers to keep premiums affordable. Open enrollment season extends until Mar. 31.

医学

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After decades of qualms about lung cancer screening, the American Cancer Society says there now is enough evidence to recommend it, but only for current and former heavy smokers ages 55 to 74 and after a frank talk about risks and benefits.The new guidelines, announced Friday, are a cautious but exciting step against the world's most deadly cancer, doctors who wrote the advice say.It is based on a big study in 2011 that found annual, low-dose CT scans — a type of X-ray — could cut the chances of dying of lung cancer by 20 percent and from any cause by nearly 7 percent.The study only included older people who smoked a pack of cigarettes a day for 30 years or the equivalent, such as two packs a day for 15 years. Whether screening would help others isn't known, so scans were not advised for them."We're trying to make sure we restrict harm that might come from screening," such as unneeded biopsies and follow-up procedures when scans falsely suggest cancer, said Dr. Richard Wender, family medicine chief at Thomas Jefferson University in Philadelphia. Lung cancer is fairly rare before age 55, so "the benefits of screening are going to be less if you start at a younger age."Wender, a former Cancer Society president, led the guidelines panel. Three of its 20 members have ties to companies that make cancer treatment or imaging products. The scans cost $100 to as much as $400 and are not covered by Medicare or private insurers."We believe insurance companies should cover this test for the right people — not for everybody," Wender said.More than 160,000 people die of lung cancer in the United States alone each year, and the vast majority are diagnosed after the disease has spread.Cancer screening has provoked great argument in recent years, especially over when and how often women should get mammograms and whether men should have PSA blood tests to look for prostate cancer.Some of the most influential guidelines come from a government-appointed panel — the U.S. Preventive Services Task Force — but it hasn't considered lung cancer screening since 2004, when it said there wasn't enough evidence to recommend for or against it. An update is in the works now.The Cancer Society used to recommend screening with chest X-rays but withdrew that advice in 1980 after studies showed they weren't saving lives. Since then, the CT scans have come into wider use, and several medical groups backed limited screening with them.Many private companies also market CT scans directly to the public, including for some who are at lower risk for lung cancer than the people in major studies have been.WellStar Health System, a network of hospitals and private doctors in suburban Atlanta, has screened nearly 900 people since 2008. Less than 3 percent were referred for lung biopsies because of suspicious findings, and of those, 70 percent turned out to have lung cancer, said screening coordinator Vickie Beckler.The system generally follows the advice of the National Comprehensive Cancer Network, a group of top cancer centers, but eligibility for scans is "a very fluid area" that's being refined, she said. Patients younger than 50 need a doctor's referral for a scan, but if they want one and have major risk factors, "it should be their prerogative to have access to screening as long as they understand the risks and benefits involved and come to that decision with their physician," she said.Kathy DeJoseph, 62, of suburban Atlanta, is glad she was screened as part of a study at WellStar. Several years of scans found nothing but last year, one detected cancer."I'd have been dead had I not had that scan," she said. "I was very, very lucky."She also finally quit smoking after 40 years to qualify for lung cancer surgery.Counseling smokers on how to quit is part of the Cancer Society's guidance. Having a scare from a scan "is a great motivator for people to quit smoking — fear that they might have had lung cancer, that they dodged a bullet, really causes people to change and take a look at their behavior," Wender said.People also should be told that a normal scan doesn't mean no change is needed."The absolute worse thing that would happen" is people thinking "now I'm safe and I can continue smoking," he said.

医学

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H1N1 > Posts H1N1 in the News: Some Countries Now Donating Vaccine to WHO February 1, 2010According the World Health Organization (WHO), H1N1 has reached more than 200 countries or territories, yet many of the poorest nations have not received H1N1 vaccine. WHO Director-General Dr. Margaret Chan cautions that, even though the disease has peaked in many parts of the world, the flu season is not yet over and influenza knows no boundaries. “To protect people in one country is to protect us all,” said Chan. In September of last year, before vaccine was available to many Americans, President Obama announced that the United States would donate 10 percent—or 25 million doses—of the country’s H1N1 vaccine supply to WHO. Dr. Thomas Frieden, Director of the Centers for Disease Control and Prevention (CDC), later said in a November press briefing that it would be difficult to say with certainty when and how much vaccine the U.S. would provide to other countries. U.S. H1N1 vaccine supplies have yet to be released to WHO. As the H1N1 pandemic wanes and vaccine uptake diminishes, some critics of WHO’s response to the pandemic have cried foul, saying the facts were exaggerated to boost pharmaceutical sales. Several European countries are now trying to rid themselves of excess supplies of vaccine. Some are canceling orders or renegotiating contracts with pharmaceutical countries. France is canceling 50 million of the 94 million doses ordered. Others are starting to give away vaccine. The Netherlands and Switzerland have both donated half of their supply. On the other side of the Atlantic, Canada loaned Mexico five million doses of H1N1 vaccine, a stopgap measure to meet public demand while Mexico waits for manufacturers to fulfill orders. Last week it was reported that Canada has agreed to donate five million doses to WHO. Mongolia was the first developing country to receive donated H1N1 vaccine doses from WHO—with 100,000 doses delivered in January—followed by Azerbaijan and Afghanistan. Azerbaijan received 170,000 doses, and Afghanistan received 500,000 doses sent by the WHO and 100,000 doses sent by Turkey. WHO plans to ship over eight million H1N1 vaccine doses to Cambodia, Cuba, Democratic People’s Republic of Korea, El Salvador, Fiji, Honduras, Kenya, Kiribati, Nauru, Nicaragua, Papua New Guinea, Philippines, Solomon Islands, Sri Lanka, Togo, and Tonga. Along with six drug companies, the U.S. is one of 14 industrialized countries that have pledged nearly 190 million doses for use in developing nations. More information on WHO's full response to H1N1 can be found here. Photo copyright: World Health Organization. Comments about this post The query did not return any results. Comment: © Copyright , NACCHO | Privacy Statement

医学

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Mark Mataosky, MD He is known in the local medical community as Dr. Mark Mataosky, but those who serve under his command in the U.S. Army Reserves call him “Colonel.” At the start of his 22 years in the military, he was deployed to the Middle East during Desert Shield/Desert Storm, and he would return to the region during the Iraq War. Currently, he balances his commitment to the Army Reserves with his responsibilities as director of cardiac rehabilitation for Trident and Summerville medical centers and the patients he sees through Cardiology Consultants of Charleston. Dr. Mataosky's work with Trident Health often takes him to the cardiac catheterization lab, where he searches for blockages in a patient's arteries. But it's more common for him to rule out heart problems in those who come to see him at his office. Medical School: Georgetown University Residency: Eisenhower Army Medical Center Cardiology fellowship: Medical College of Georgia To schedule an appointment with Dr. Mataosky, please call 843-875-4441. Friends2Follow

医学

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Opinion: The New Jersey Health Benefit Exchange, What’s Next? Joel C. Cantor | May 23, 2012 The governor's veto may be a key step toward meeting NJ's responsibilities under the Affordable Care Act. Last week Governor Christie vetoed the New Jersey Health Benefit Exchange Act (A2171/S1319), arguing that it is premature to move ahead with authorizing the exchange until the Supreme Court rules on the constitutionality of the federal health reform law. Even if the Affordable Care Act is upheld in its entirety, this veto is unlikely to interfere with New Jersey’s ability to effectively meet its obligations under the health reform law. To date, only 18 states and the District of Columbia have authorized their exchanges, most by enacting new legislation and a few through executive orders. About a dozen more states have action on exchanges pending. An important milestone in building exchanges is the deadline for states to apply for federal funding, so-called level 2 establishment grants to build their exchanges. States that miss that deadline risk having the federal government step in to create their exchanges, a move that seemingly nobody wants. Signaling their desire for states to take the lead on exchanges, the U.S. Department of Health and Human Services has already pushed back the level 2 grant deadline from June to November this year. (Technically, states have until January 2013 to have their exchanges certified by the federal government, but without level 2 funding states have little hope of achieving certification.) Judging by where New Jersey stands among peer states and the time available to apply for federal funding, New Jersey is still in a favorable position to react quickly once the U.S. Supreme Court renders its opinion in late June. In fact, one might argue, that the governor’s veto was an important step toward the goal of successfully meeting New Jersey’s responsibilities under the Affordable Care Act. Governor Christie’s veto message is clear and detailed; a must-read for health policy wonks. While highlighting three specific concerns about the exchange bill, Gov. Christie’s veto message closes with his commitment to implement the law should the Supreme Court uphold its constitutionality. For its part, legislative leadership has signaled a willingness to negotiate the shape of this law. Sometimes the political process actually works, and this appears to be one of those instances. The first issue raised by the governor is whether New Jersey should create a Basic Health Program (BHP), a coverage option for people whose incomes are too high for Medicaid but still below 200 percent of the federal poverty level; about $46,000 for a family of four. Incomes of individuals and families near this threshold tend to fluctuate as they take second jobs or lose seasonal employment, for instance. One aim of the BHP is to allow continuity of relationships between patients and providers by eliminating the need for patients to jump between Medicaid and commercial managed care networks. If the BHP offered Medicaid health plans, it also has the potential to save money because Medicaid plans pay hospitals and doctors less than commercial plans. While attractive in principle, the BHP could also have downsides. For example, low reimbursement rates limit providers willing to serve Medicaid patients. By adding as many as 75,000 new individuals to these networks, the BHP could further stress this provider capacity. State-commissioned analysis by my colleagues at Rutgers Center for State Health Policy describes the potential benefits and risks of a BHP for New Jersey. One issue singled out in the governor’s veto message is whether the complex federal funding formula for the BHP will cover its costs? The Center is working with Oliver Wyman Actuarial Consulting to address this question with support from the Robert Wood Johnson Foundation. We will have findings later this summer. The governor also questioned the composition of the exchange board of directors as envisioned by the legislature, specifically whether it should include health insurance stakeholders or pay salaries to attract outside experts. He also signaled his preference for an exchange board that does not have authority to exclude plans based on its judgment about value for consumers, often called the “active purchaser" model. Colleagues at the Seton Hall University School of Law's Center for Health & Pharmaceutical Law & Policy have conducted extensive analysis of exchange governance issues and are completing additional work on the pros and cons of alternative exchange purchasing strategies. These analyses will help policymakers work through these tough issues. With the Supreme Court expected to rule next month, the governor and New Jersey legislators are well positioned to formulate the state’s response to the Affordable Care Act, whatever form it takes. Joel C. Cantor is the director of the Center for State Health Policy and professor of public policy at Rutgers University. He has authored numerous studies of health insurance regulatory policy, healthcare delivery system performance, and access to care for low-income and minority populations. He serves frequently as an advisor on health policy matters to New Jersey state government. The views expressed in this essay are solely those of the author and are not endorsed by funders of the Center for State Health Policy. Read more in Healthcare Subscribe to NJ Spotlight Newsletters Weekly Editor's Picks In the Shadow of Liberty NJ Spotlight On Cities: Coming October 2016

医学

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Ubiquinone Ubiquinone, also known as coenzyme Q10, is an antioxidant compound found in the cells of all higher animals. More specifically, it makes its home inside the mitochondria of cells where it's involved in generating ATP, the energy currency that drives all cells. Because it's important for energy production, it's present in greatest amounts in organs that have high energy requirements like the heart, kidney and liver. ATP not only provides the energy needed for the function of organs like the heart, it powers all muscle movements.Ubiquinone is vital for cellular energy production, but it's also a potent antioxidant that protects cells against the damaging effects of free radicals. Free radicals are unpaired electrons generated by cells when they're exposed to oxygen. These unpaired electrons "grab onto" structures inside cells and damage them. This is believed to play a role in aging and may contribute to certain diseases such as cancer. Ubiquinone helps to keep free radicals from doing their damage by donating electrons to them, rendering them harmless. It also has the ability to regenerate other antioxidants such as vitamin E and vitamin C.Since ubiquinone is a such a powerful antioxidant, some research suggests taking it as a supplement may treat or help to prevent certain diseases or even slow down the aging process. Levels of coenzyme Q10 decrease with age and are lower in people who have certain health problems like cancer or heart disease. Some medications like statins used for lowering cholesterol decrease ubiquinone levels. That's why doctors often recommend coenzyme Q10 or ubiquinone supplements to people taking these drugs. In addition, preliminary evidence suggests that ubiquinone is beneficial for treating migraine headaches, Parkinson's disease and heart failure. It also lowers blood pressure and blood sugar levels, making it useful for those with hypertension and diabetes. There's ongoing research looking at its potential to prevent or treat cancer. Many health food stores sell ubiquinone as an oral supplement. Food sources of ubiquinone include fish, game meats and whole grains, although diet isn't a significant source of coenzyme Q10. That's why supplements are a popular way to get this antioxidant compound.As an antioxidant, topical ubiquinone also offers skin anti-aging benefits. When skin is exposed to sunlight, it generates free radicals that damage collagen and elastin, two proteins that give skin its support and ability to "bounce back." This is one of the ways sun exposure causes skin to age prematurely. Ubiquinone has the advantage of being able to penetrate the epidermis of the skin. This allows it to reach the dermis where it blocks the production of an enzyme called collagenase that breaks down collagen.Because ubiquinone protects skin against damage due to sun exposure and prevents the breakdown of collagen, some cosmetic manufacturers and makers of skin care products are adding it to their products. Some products that contain this powerful antioxidant are facial moisturizers, eye creams, sunscreens and other anti-aging skin care products. When using products that contain ubiquinone, it's best to choose products that are packed in opaque bottles since some antioxidants break down when they're exposed to light. When used and stored properly, topical antioxidants like ubiquinone may provide extra protection against the aging effects of free radicals, although it doesn't replace the need for a sunscreen. Fortunately, some sunscreens include ubiquinone or coenzyme Q10 as an ingredient.Is it safe? Coenzyme Q10 appears to be safe as an oral supplement, although some people experience a drop in blood pressure or blood sugar levels while taking it. It can also cause minor digestive upset, insomnia and headache, although this isn't common. People who take blood thinners shouldn't take it orally without consulting their doctor first. Ubiquinone appears to be safe in quantities found in skin care products and cosmetics. The Environmental Working Group Skin Deep Cosmetics Database classifies it as a low hazard cosmetic ingredient. Unlike some topical antioxidants like vitamin C, ubiquinone doesn't frequently cause skin irritation or redness.All in all, ubiquinone is a potent antioxidant that helps to protect cells against damage. It has benefits both as an oral supplement and as an ingredient in cosmetics and skin care products formulated for more mature skin. It also has an excellent safety profile.

医学

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Remembering The First IVF Mom Photo: Thinkstock / The Bump Lesley Brown, the first woman to successfully undergo IVF treatment, died at age 64 on June 6th. Lesley gave birth to the first IVF baby, her daughter Louise, in July 1978. She had another daughter, Natalie, via IVF a few years later. Louise spoke to The Telegraph about her mother saying, “Mum was a very quiet and private person who ended up in the world spotlight because she wanted a family so much. We are all missing her terribly.” Louise’s birth helped pave the way for more successful IVF treatments and procedures for other people who've wanted families just as badly. And for that, we remember her fondly. Has IVF touched your life? If so, tell us how.

医学

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L&M lays off 22 employees, cites $3.2M budget gap By Judy Benson, Day Staff Writer New London — Lawrence & Memorial Hospital on Thursday announced layoffs of 22 employees, an action it said it needed to take to close a $3.2 million budget gap.The layoffs, effective immediately, will eliminate the jobs of 14 full-time and eight part-time employees in a variety of departments "from the director level on down," hospital spokesman Mike O'Farrell said.Half the laid-off employees are members of one of the three hospital unions, and half are non-union. All of the affected employees were given severance packages, he added. The 22 layoffs account for less than 1 percent of the hospital's workforce.Eric Bailey, spokesman for AFT Connecticut, said that of the 11 union members, two or three were members of the nurses' local and the rest were in the service and maintenance workers' local.The budget gap is the result of a decline in inpatient volumes in the fiscal year that ended Sept. 30, cuts in Medicare and private insurance reimbursement income, the continuing need to invest in technology for an electronic medical records system, rising employee benefit costs, and other factors, O'Farrell said.The Board of Directors approved a budget for the new fiscal year that began Oct. 1 that was based on a revenue-expense ratio $3.2 million short of the level it wanted to achieve, along with a plan to close the gap. Over the past six weeks, the hospital has worked to close the gap through cost savings on supplies, overtime and the elimination of vacant positions, but did not achieve enough savings, he said.The board mandates that the hospital achieve at least a 3 percent margin of revenues over expenses. Total hospital revenues are about $320 million annually.O'Farrell said the hospital ended the last fiscal year in the black, but the layoffs combined with other cost-cutting measures were needed put it back on track to reach the 3 percent margin in the new fiscal year."We had to do this to make sure we continue to be strong," he said.He emphasized that no hospital services have been eliminated as a result of the layoffs.The recent presidential election, which set the Affordable Care Act on a path toward full implementation, had no bearing on the decision to lay off employees, he added.The layoffs come as L&M is involved in several major projects, including the $34.5 million Dana-Farber cancer center under construction in Waterford, a seven-year, $32 million investment in an electronic medical records system, the pending acquisition of The Westerly Hospital for $69 million in cash and other financial commitments, and the construction of a 14,000-square-foot medical office building in Old Lyme.O'Farrell said the hospital needs to simultaneously cut costs and invest in expansion to continue to grow its market."It has to do with how the health care landscape is constantly changing and how we're finding ways to adapt," he said. "We have to find a way to increase revenues through investments and at the same time make the overall infrastructure stronger."The layoffs, he said, were a painful but necessary step."This is the last thing that anyone wants to do," O'Farrell said. "We had to reach a number and we tried a variety of ways to get there, and the longer we waited, the more positions would have been affected."With about 2,500 full-time employees, L&M is one of the region's largest employers.In the fiscal year that ended Sept. 30, L&M cared for 14,942 inpatients, about 400 less than the previous year. At the same time, it saw increases in emergency department visits as well as in outpatient visits for same-day surgery, lab work and imaging, but the income from those sources did not offset the loss from inpatients and the increases in expenses, O'Farrell said.Bailey said that under the union contracts, employees have "bumping rights," meaning that if they receive a layoff notice, they can move into the job of a less senior employee, and that person would instead be laid off."We'll just handle this contractually and make sure people get all the benefits they're entitled to," he said. "Obviously it's tough, especially with the holidays right around the corner."The union will provide assistance to help those affected find new jobs and "make sure people end up back on their feet," he said.j.benson@theday.com CEO says L&M strategy is to contract and expand

医学

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HIV/AIDS What is HIV/AIDS? Women are at risk of HIV Preventing HIV infection Get tested for HIV Living with HIV/AIDS Opportunistic infections and other conditions Treatments for HIV/AIDS Deciding when to start treatment for HIV HIV/AIDS drugs and side effects Managing your treatment of HIV/AIDS Research and clinical trials in HIV/AIDS AIDS worldwide Government in action on HIV/AIDS Share your story HIV/AIDS in Spanish (en español) Subscribe to HIV/AIDS email updates. Home > HIV/AIDS > Treatments for HIV/AIDS HIV/AIDS This information in Spanish (en español) Treatments for HIV/AIDS HIV medicines are giving women longer, healthier futures and new strength. While there's no cure for HIV, the treatments today allow women to live longer, fuller lives. The U.S. Food and Drug Administration (FDA) has approved many drugs for treating HIV. Other drugs are used to treat complications of HIV/AIDS. The FDA has programs to speed up the review of important medicines for HIV/AIDS and other serious diseases.Making sense of all your treatment options can be hard. By getting the facts, you can decide the best way to manage your illness and get the most from these treatments. You will have a lot of questions about HIV treatment, from when to start it to how to keep track of medicines. The following pages provide more information:Deciding when to start treatment for HIVHIV/AIDS drugs and side effectsManaging your treatment of HIV/AIDSComplementary and alternative therapies for HIV/AIDS

医学

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SearchCHFSKentucky.gov Jump to Main ContentAbout CHFS | Contact Us | Forms and Documents | Información en Español Home > Newsroom > Press Release License, Permits and Certifications Health and Family Services Cabinet January is National Birth Defects Prevention Month Press Release Date: Friday, January 10, 2014 Revision Date: Wednesday, February 12, 2014 Contact Information: Gwenda Bond or Beth Fisher,(502) 564-6786, ext. 3100 and 3101 More than 120,000 babies are born with a birth defect each year in the United States – 3,000 of which are born in Kentucky, according to the state Department for Public Health (DPH). To help raise awareness of this issue and prevent future birth defects, the Kentucky Birth Surveillance Registry (KBSR) Program, which is housed in DPH, is partnering with the National Birth Defects Prevention Network this month to dispense educational information and promote public health resources. Gov. Steve Beshear officially proclaimed this monthlong observance in the Commonwealth to further emphasize the importance of taking steps to reduce and prevent birth defects. “Most people are unaware of how common, costly and critical birth defects are in the United States, or that there are simple steps that can be taken to reduce them,” said Monica Clouse, coordinator for KBSR. “Throughout the month of January, DPH will be focusing on raising awareness of this serious health issue among health care professionals, educators, social service professionals, and the general public to emphasize the high prevalence of birth defects and how to prevent them.” The risk for many types of birth defects can be reduced through healthy lifestyle choices and medical care before and during pregnancy. “The health of both parents prior to pregnancy can affect the risk of having a child with a birth defect,” said DPH Genetic Counselor, Joyce Robl. “Food intake, lifestyle choices, factors in the environment, health conditions and medications taken before and during pregnancy all can play a role in reducing or increasing the risk of birth defects.” Many different kinds of birth defects exist, including congenital heart defects; cleft lip or palate; defects of the brain and spine; defects of the bones, muscles and internal organs; and a variety of genetic syndromes such as Down syndrome. Some have only a minor and brief effect on a baby’s health, while others have life-threatening or life-long effects, which can often be lessened by early detection and treatment. Birth defects are the most common cause of death in infants and the second most common cause of death in children ages one to four years. Public awareness, expert medical care, accurate and early diagnosis, and social support systems are all essential for optimal prevention and treatment of these debilitating and often deadly conditions. Studies have demonstrated several important steps women can take to help prevent birth defects. Women who are pregnant or may become pregnant are advised to: • Consume 400 micrograms of folic acid daily.• Manage chronic maternal illnesses such as diabetes, seizure disorders or phenylketonuria (PKU).• Maintain a healthy weight.• Talk to a health care provider about taking any medications, both prescription and over-the-counter.• Avoid alcohol, smoking and illicit drugs.• See a health care provider regularly. • Avoid toxic substances at work or at home.• Ensure protection against domestic violence.• Know their family history and seek reproductive genetic counseling, if appropriate. “Small steps like visiting a health care provider before pregnancy and taking a multivitamin every day can go a long way,” said Robl. The National Birth Defects Prevention Network is working with health care professionals and public health agencies around the country to encourage prevention and awareness of birth defects among the more than 60 million women of childbearing age in the United States. In addition to its efforts in prevention, the network strives to improve nationwide surveillance of birth defects and to advance research on possible causes. It also offers support to families who are dealing with the realities of a child born with one of these conditions. Further information about the network can be found at www.NBDPN.org. To learn more about Kentucky’s outreach efforts, contact Clouse at (502) 564-4830, ext. 4394 or monica.clouse@ky.gov. The 2014 National Birth Defects Prevention Network Birth Defects Prevention information packet and archives of previous years’ packets are available online at: http://www.nbdpn.org/bdpm2014.php. All materials can be printed, electronically conveyed, or added to websites for distribution as needed. -30- The Cabinet for Health and Family Services is home to most of the state's human services and health care programs, including Medicaid, the Department for Community Based Services and the Department for Public Health. CHFS is one of the largest agencies in state government, with nearly 8,000 full and part-time employees throughout the Commonwealth focused on improving the lives and health of Kentuckians. Contact Us | Site Map | CHFS Webmaster | Información en Español

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Can a Urine Test Detect Deadly Prostate Cancer? Eben Harrell Wednesday, Feb. 11, 2009 Lester V. Bergman / Corbis Halting Hormone Therapy Reduces Breast Cancer Risk Quickly A new study suggests that a simple urine test may one day tell men whether they have prostate cancer that can be ignored or must be aggressively treated. Currently a man must undergo a series of diagnostic tests, including a surgical biopsy, to confirm that he has prostate cancer. But no test is able to determine reliably whether the cancer is slow-growing and probably nonfatal or aggressive and in need of immediate treatment. (Read "Halting Hormone Therapy Reduces Breast-Cancer Risk Quickly.") In the Feb. 11 edition of the journal Nature, however, a new study links specific molecules produced by the body to the aggressive form of the disease, suggesting that detecting these molecules could one day to lead to a reliable diagnosis of prostate cancer and a prognosis for patients. Using new scanning-and-detection technology, scientists looked at more than 1,000 metabolites — naturally occurring products of cell metabolism — and found that about 10 were often present in high levels in samples of blood, tissue and urine taken from patients with aggressive prostate cancer. "This is proof of principle that we can identify metabolites ... that might be correlated with aggressive prostate cancer vs. slower-growing prostate cancer," Arul Chinnaiyan of the University of Michigan Medical School, who led the study, said in a prepared statement. Cancer of the prostate is the most common type among men in the developed world. In the U.S., where 186,000 people receive the diagnosis each year, only skin cancer is more common. But despite its prevalence, the lack of a fail-safe test is a frustration to physicians. Currently, older men at risk of prostate cancer undergo a PSA test, which detects a protein called prostate-specific antigen in the blood. Men who have elevated PSA levels, which may indicate cancer, undergo invasive biopsies but often end up not having the disease at all. Even when the biopsy finds cancer, physicians are usually unable to accurately tell how quickly the cancer will spread. "One of the main issues with prostate cancer is trying to distinguish aggressive prostate cancer that goes on to metastasize from the slow-growing version of the disease, and what we end up doing as physicians is overtreating our patients because we can't distinguish between them," Chinnaiyan said. Given the risks and side effects of biopsies — which range from infection to impotence — an accurate diagnostic tool for physicians as straightforward as a urine test "would be, well, wonderful," says Cory Abate-Shen, a professor at Columbia University's College of Physicians and Surgeons who authored a commentary accompanying the paper for Nature. "But that's something that will require large clinical trials to develop." The Nature study focused on one particular metabolite, sarcosine, that was often found at elevated levels in samples taken from patients with advanced prostate cancer but was present in lower levels in samples of healthy tissue. According to the study, scanning for sarcosine proved a more accurate mode of cancer detection than scanning for the PSA protein. "We don't even know that sarcosine is the most promising metabolite," says Michael Shen, also a professor at Columbia University's College of Physicians and Surgeons, who co-authored the Nature commentary with Abate-Shen, his wife. "It's the one they focused on. There are other metabolites identified in their study that could easily be as interesting [as] or more interesting [than] sarcosine. So it would be very promising to look at the predictability of these individual metabolites, but also their combination." Warning that their work needed far more investigation, the researchers also raised the possibility that sarcosine could be a "therapeutic target" that might one day offer an effective treatment of the disease. In laboratory tests, they found that adding sarcosine to prostate cells caused benign cells to become cancerous and invasive. The researchers hope that drugs that stop sarcosine from working could effectively contain prostate cancer and maybe even have implications for other cancer treatments. In an interview with the newspaper the Guardian, Christopher Beecher, a co-author of the study, said, "This is the molecule that the cancer cells use when they want to spread. If it turns out to be involved in metastasis in other cancers, then this discovery will be huge." See pictures of what makes you eat more food. See new ideas about renewable energy. Home

医学

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New technology aids eye care patients By Mark Sherry Mark Sherry photos Dr. Gary Burkhardt’s eye care team includes (from left) Janet Zemlicka, Cheryl Hersey and Julie Pelch. At left, Pelch, a certified paraoptemetric, uses the new iVue machine on a patient. Dr. Gary Burkhardt and his staff at Burkhardt Eyecare in Chilton have further advanced the technology available to their patients. Dr. Burkhardt is the first eye care provider in the area to offer patients state-of-the-art spectral domain optical coherence tomography (SD-OCT) and the iWellnessExamTM. This instrument produces high definition cross sectional images of patients’ retinas, the sensitive area of the back of the eye. Often compared to an MRI or CT scan, SD-OCT images provide stunning details of retinal structures that are not visible with other examination techniques or tests. Dr. Burkhardt said this is important because it enables him to detect very early signs of vision threatening diseases, such as glaucoma, macular degeneration, diabetic retinopathy, and others. When diagnosed early, these conditions are easier to treat, slowing progression and often avoiding vision loss. “I am extremely pleased to offer this new technology to my patients,” Dr. Burkhardt said from his longtime office at 19 W. Main St. “Many people believe they should only go to the eye doctor when they experience problems with their vision. In reality, many eye problems can develop without warning and progress with no symptoms. Finding out early “Early on, you might not notice any change in your vision, but irreversible damage could be taking place,” he added. “This is why regular eye exams including a thorough evaluation of the retina are so important. We’re trying to pick up signs of disease before permanent damage can occur.” Early detection of retinal abnormalities and disease may lead to earlier and safer treatments and in many cases prevent or slow the progression of vision loss, Dr. Burkhardt added. “There’s nothing else quite like it as far as having this instrument,” he said of the iVue. The test is quite simple and pain free as well. “It’s simply a line of light going across their vision.” Images can be viewed immediately on the laptop computer attached and sitting next to the iVue. Burkhardt Eyecare has had the equipment since last fall, and Dr. Burkhardt said it has detected things in patients who were seeing 20/20 when they came in to the office. “It catches glaucoma at an earlier stage,” he said of just one of iVue’s many advantages. The iVue should not be confused with Optomap, another piece of equipment offered at Burkhardt Eyecare. The iWellnessExam and Optomap Retinal Exam are both noninvasive and can be performed quickly and easily as an initial first step in a routine comprehensive eye exam. These exams are often recommended annually regardless of symptoms, documenting and thereby allowing eye doctors to observe any subtle changes occurring over time. Huge step up in technology SD-OCT has twice the resolution and is 65 times faster than previous OCT technology. The faster speed provides extremely high resolution (down to five microns) for more accurate diagnosis of hidden eye conditions. This technological leap forward has been compared to the advantage that jet propulsion achieved over propeller-powered aviation or the difference between an old-style black and white analog TV and today’s high-definition color flat screens. Better equipment such as iVue comes in very handy at a time when the popu-offering all the full-service and friendly one-on-one eye care assistance it has for 20 years. That includes having a wide selection of the latest styles of eyeglass frames, the ability to assist first-time or longtime users of contact lenses, the treatment of “red eyes,” glaucoma, dry eyes and the removal of foreign bodies in the eye. “We strive to be a caring, local, family, neighborhood office,” Dr. Burkhardt said. In keeping with that helpful atmosphere, Burkhardt Eyecare currently has a Lions reader on display in its office. People who have difficulty reading due to significantly reduced or loss of vision are invited to come in and check out the unit. If they like it and think it might help them, Burkhardt Eyecare will work with lation is experiencing a few more challenges with its eyesight. Dr. Burkhardt said he is seeing more macular degeneration in patients, but most likely because people are living longer. Age-Related Macular Degeneration (AMD) is the leading cause of blindness in adults 55 and older and affects more than 15 million people in the U. S. AMD is caused by deterioration of the central portion of the retina, also known as the macula which is responsible for central vision. Early symptoms of AMD may include visual distortion, lines that appear wavy, blurring of central vision, or difficulty in reading, driving or facial recognition. Researchers have demonstrated that low macular pigment is associated with a higher risk of developing AMD. Burkhardt Eyecare employs an instrument called QuantifEye to measure macular pigment density through a simple, noninvasive exam. If low macular pigment is detected, it may be increased with dietary changes and supplements, helping to lower ones risk for macular degeneration. Some more at risk than others Risk factors for AMD include smoking, age, light colored skin and eyes, unprotected exposure to the sun, gender (females are more at risk), obesity and poor diet. Dr. Burkhardt said cataracts are also being seen at an earlier age. The good news is cataracts can be easily treated once they are detected but, again, that requires people to come in for annual exams. “Technology keeps changing,” Dr. Burkhardt added, “and I truly feel I owe it to my patients to continue investing in these technologies to improve the care that I am able to provide.” Around all this new, high-tech equipment, Burkhardt Eyecare still insists on the local Lions Club to see if one of the magnifying units can be placed in that person’s home. Burkhardt Eyecare is a member of VisionSource, a nationwide network of independent and caring eye care professionals, promoting quality eye care, unique products and personalized service. Their office is accepting new patients and most area insurances, and offer Care-Credit, a program by which people can set up monthly payments for their eye care costs if necessary. To make an appointment at Burkhardt Eyecare or to find out more, call 849-4291; check out www.burkhardteyecare.com.;or stop in during normal business hours.

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Acupuncture boosts effects of painkillers, natural or prescription High-tech images of the brains of chronic pain sufferers have found that the ancient practice of acupuncture fights pain by making key brain cells more sensitive to the pain-dampening effects of opioid chemicals. The study, published online in the August issue of the journal NeuroImage, comes less than a year after the publication of a controversial study that concluded acupuncture was no more effective than sham treatment at reducing pain. Researchers at the University of Michigan's Chronic Pain and Fatigue Research Center used a positron emission tomography (PET) scanner to view the brains of 20 women diagnosed with fibromyalgia who reported suffering nerve and muscle pain at least 50% of the time. The PET scans were conducted during each woman's first acupuncture session and, a month later, her eighth. In the regions of the brain that process and dampen pain signals -- the amygdala, caudate, cingula, thalamus and insula -- the PET scans showed an increase in the receptivity -- and possibly the number -- of brain cells to which opioid substances bind. Study author Richard E. Harris said that suggests that acupuncture appears to make the body more responsive to opioid painkillers. But the mainstay of traditional Chinese medicine also appears to enhance the body's ability to regulate pain naturally, Harris said. Many of the analgesic chemicals the body produces, including endorphins (the source of what endurance athletes call "the runner's high") and enkephalins (which act to tamp down the sensation of pain), also bind to the opioid receptors. So if acupuncture treatments enhance those chemicals' ability to find a receptor to bind to, these natural painkillers work better as well. Harris, a molecular and cell biologist at the University of Michigan and a licensed acupuncturist, said the group's findings are consistent with research that has found patients treated with acupuncture before surgery often need less post-operative medication to manage their pain. The acupuncture in these cases may have the effect of sensitizing the brain's opioid receptors to medication, making it work better. The study may even support the controversial earlier finding that sham acupuncture works as well as real acupuncture to reduce pain, but that the two work in to reduce pain in different ways. In that experiment, patients seemed to gain considerable pain relief merely by a procedure that inserted needles into the body randomly, as oppose to following the paths of energy meridians that guide needle placement in acupuncture. The random sinking of needles through the skin may prompt the body to increase its production of pain-dampening endorphins and enkephalins, Harris surmised. True acupuncture may work differently: Its painkilling effect may come not from boosting the supply of circulating natural analgesics, but by improving the ability of those chemicals to dock at a brain cell and exert their painkilling effects. While many patients may turn to acupuncture as an alternative to conventional medication, Harris said his group's study suggests that the two means of pain relief can complement each other. "I don't see them as mutually exclusive, and in some cases, they may work synergistically," Harris said. -- Melissa Healy

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Autism vaccine ruling sparks a lot of comment Today's decision by a federal court that the preservative thimerosal does not cause autism has sparked a lot of comment in the autism community, most of it negative. Many saw it as a government conspiracy to protect the vaccine industry, a claim that has also been made about the swine flu vaccination program. Some examples: The Coalition for Vaccine Safety argued that the special masters "appear to have based their decisions on the government policy to protect the vaccine program rather than to fulfill their role to do justice by vaccine-injured children.... The special masters appear to be following a misguided government policy that if they acknowledge a mercury-autism link, parents will stop vaccinating their children." Said Laura Bono, the parent of a "vaccine-injured child" whose case was dismissed: "The government has its thumb on the scales of justice.... The law only gives the illusion that parents will have their day in court. The process is dysfunctional and many families will not see justice done." The ruling may make parents even more distrustful of the vaccine program because the Department of Health and Human Services was both a defendant in the cases and the main source of crucial information about vaccine safety, said Lyn Redwood of SafeMinds. "There's an inherent conflict of interest." But Alison Singer, president of the Autism Science Foundation, disagrees. "The science here is very clear. There is no evidence that vaccines cause autism.... The studies are very clear, and the vast majority of families have come to the same conclusion. There is just a small, vocal minority of parents who just don't want to believe what the data show." Added Roy Richard Grinker, author of "Unstrange Minds: Remapping the World of Autism" and the father of an autistic child: "This decision reaffirms my faith in the experts' ability to understand reality. As a parent, I am tired of all the discussions about autism being controlled by a discourse on vaccines.... The time and money being spent on something of no significance is disheartening to me as a parent." The reaction to the decision was complicated by a red herring thrown into the mix Friday when it was revealed that a researcher at a Danish university who had been involved in the studies that debunked the autism-vaccines link was suspected of defrauding the government of nearly $2 million in grant money. Dr. Paul Thorsen was the subject of a probe by Aarhus University, which said it had detected a significant shortfall in funds from a grant from the Centers for Disease Control and Prevention for the studies. Advocates of a vaccine-autism link immediately seized on the announcement as an indicator that the whole research program was corrupt -- just as global warming denialists have seized on the e-mails released in the so-called Climategate to argue that global warming research is corrupt. In both cases, of course, the charges are nonsense. Thorsen may be a crook, but there were lots of other scientists involved in the research, and their integrity is not being contested. "We have no reason to suspect that there are any issues related to the integrity of the science," said Tom Skinner, a spokesman for the Centers for Disease Control and Prevention, which funded the studies. Finally, we'd like to share with you an e-mail from reader Erin Roberts of Camarillo: "More than 15 years ago, a family friend had a son diagnosed with autism. They had suspected vaccines being the cause. Because of this, I opted to not vaccinate my children until they were older. Now I have two sons, Xavier, 13, and Raven, 10, both diagnosed with autism and neither of them vaccinated until after they received their diagnosis.... I have known for years that vaccines do not cause autism." -- Thomas H. Maugh II -- Andrew Zajac -- Trine Tsouderos

医学

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News tagged with pandemic flu influenza Sorry, no news articles match your request. Your search criteria may be too narrow. An influenza pandemic is an epidemic of an influenza virus that spreads on a worldwide scale and infects a large proportion of the human population. In contrast to the regular seasonal epidemics of influenza, these pandemics occur irregularly, with the 1918 Spanish flu the most serious pandemic in recent history. Pandemics can cause high levels of mortality, with the Spanish influenza estimated as being responsible for the deaths of over 50 million people. There have been about three influenza pandemics in each century for the last 300 years. The most recent ones were the Asian Flu in 1957 and the Hong Kong Flu in 1968.Influenza pandemics occur when a new strain of the influenza virus is transmitted to humans from another animal species. Species that are thought to be important in the emergence of new human strains are pigs, chickens and ducks. These novel strains are unaffected by any immunity people may have to older strains of human influenza and can therefore spread extremely rapidly and infect very large numbers of people. Influenza A viruses can occasionally be transmitted from wild birds to other species causing outbreaks in domestic poultry and may give rise to human influenza pandemics.The World Health Organization (WHO) warns[when?] that there is a substantial risk of an influenza pandemic within the next few years[when?]. One of the strongest candidates is a highly pathogenic variation of the H5N1 subtype of Influenza A virus. As of 2006, prepandemic influenza vaccines are being developed against the most likely suspects which include H5N1, H7N1, and H9N2. Certain scholars and senior policy advisors argue that pandemic influenza represents a substantive threat to the international economy, to each nation's national security, and a challenge to international governance.On 11 June 2009, a new strain of H1N1 influenza was declared to be a global pandemic (Stage 6) by the World Health Organization after evidence of spreading in the southern hemisphere.

医学

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Equine surgery and lameness center breaks ground Wallis Ground has been broken for a much-needed entity that was identified by the study conducted on whether or not Aiken would be able to support an international horse park. The Surgery and Lameness Center at Performance Equine Vets will fill a greatly needed void, and veterinarians Dr. Sabrina Jacobs and Dr. Ty Wallis, will be the partners in the practice. Plans call for the facility to open in April. There will be an open house, and the public is invited to attend. “It’s something that’s been greatly needed in Aiken,” said Wallis. “Obviously, there hasn’t been a boarded surgeon in Aiken with a full-service referral type of facility. It’s been a dream of both Sabrina’s and mine, so that meshed really well for us, and I find it very rewarding to finally be able to offer something that’s needed.” The goal is for the facility to be a complete, full-service surgical and sports medicine practice, Wallis said. The Surgery and Lameness Center at Performance Equine Vets is designed with the public’s needs in mind, he said. “I feel very fortunate to have landed in such a growing community, with great owners, and such high-level horses, and people that take care of them,” said Wallis. “I feel like that meshes very well with my desire to grow a referral practice and offer specialty kind of services.” Wallis’ interest are in lameness and equine orthopedic surgery, but the center will be able to offer a number of surgical procedures. The center will be accessible for clients and will include a surgical suite, so they’ll be able to watch the surgical procedures being performed on their horse. The facility will also have a covered lameness evaluation area that will have two different surfaces and will feature a covered, pull-through unloading area to keep the horses and clients out of unfavorable weather. Jacobs and Wallis were classmates at Texas A&M, and both went through the school’s veterinary program. After graduation, both veterinarians kept up with each other’s career paths, and as fate would have it, they would end up in the Southeast – Jacobs in Aiken and Wallis in Knoxville, Tenn. Ultimately, the two doctors would like to see all areas of the practice expand, Wallis said. “For the time being, it will be just the two of us,” said Wallis. “But, we’re looking to bring on a third partner very soon. As the surgical case load grows, maybe we’ll need another sports medicine specialist to take care of the lamenesses in the field before they move into the hospital.” Enlarge Jacobs Jacobs

医学

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Janesville walk offers support to people with multiple sclerosis Jodi Swanberg of Janesville has made big changes in her life since being diagnosed with MS two years ago. One thing that hasn't changed is her will to fight and keep running her housekeeping business. IF YOU GOWhat: Multiple Sclerosis walkWhen: Sunday, May 4. Check-in is at 9 a.m with the walk starting at 10 a.m.Where: Palmer Park, 2501 Palmer Drive, Janesville.Details: People can register at the event. One- and 3-mile walks are offered on wooded trails. People with multiple sclerosis will get special recognition.The event will have a "Star Wars" theme and Kathy Schendt will offer warm-up stretches. Proceeds benefit Wisconsin Chapter of the National MS Society. For information or to donate, visit walkMSwisconsin.org or call 1-800-242-3358. JANESVILLE—Jodi Swanberg suspected the numbness around her torso and her stumbling were due to an illness familiar to her family. So when her neurologist diagnosed her with multiple sclerosis in 2011, Jodi was not surprised. Twenty years earlier, her sister also was diagnosed with the disease. On Sunday, May 4, Jodi will be among an estimated 700 people in a fund-raising walk at Janesville's Palmer Park. She is part of Team Beck, which includes more than 20 family members and friends. At least 65 teams will participate. The goal of the walk is to raise $75,000 for national research and local services to the more than 11,000 people in Wisconsin with multiple sclerosis. “The walk also provides support to people with MS,” Jodi said. “It is a way to hear their stories, what they are going through and what they are doing about it.” Because of the illness, Jodi has severe fatigue, decreased vision and numbness from her chest to her waist. “It has changed my life,” she said. “Before I was diagnosed, I did not even wear glasses. Now, my eyesight has diminished greatly. One of my feet keeps dropping down instead of moving. And I have a hard time remembering things.” Depending on the day, Jodi can walk. But her husband, her brothers and her daughter will take turns pushing her in a wheelchair during the fundraiser. The 49-year-old owns her own housekeeping company and used to work 50-plus-hour weeks. �“I have had to delegate responsibilities that I used to have,” Jodi said. “I still handle the business end of things, but I don't physically go out and clean anymore.” She explains that MS affects every person differently. “Some people have no symptoms at all,” she said. “Others have trouble walking, body fatigue, urinary issues or a combination of those things. Cognitive issues, like losing your train of thought, are big for me and a lot of people.” Multiple sclerosis is a disease in which the body's immune system mistakenly attacks the myelin, or protective coating around nerve fibers in the central nervous system. The central nervous system is made up of the brain, spinal cord and optic nerves. When any part of the myelin or nerve fiber is damaged or destroyed, nerve impulses traveling to and from the brain and spinal cord are distorted or interrupted, producing a wide range of symptoms. For unknown reasons, Wisconsin has a higher prevalence of multiple sclerosis than many areas of the country, according to the Wisconsin Chapter of the National Multiple Sclerosis Society. “We are looking at everything from viruses to the amount of sunlight that we are exposed to in the Northern Hemisphere as possible environmental factors,” said Colleen Kalt, president and chief executive officer of the state chapter. “The research is still occurring.” When Kalt started with the organization 32 years ago, no treatments existed for multiple sclerosis. “Now, we have 10 treatments that forestall disability in many people with MS,” she said. “Not all people react well to treatment medications, but we are working on it.” She encourages people with MS and their families to tell their stories. “In the old days, people would hide their diagnosis because of fear of discrimination,” Kalt said. “Now, because of better treatment and more encouragement from friends, people are breaking out of their shells and saying, 'I have this disease, but it is not controlling my life.'” Still, more work remains to dispel misunderstanding about the disease. “We have to continue to create awareness,” Kalt said. “We need to continue to keep up the funding on the federal level for all diseases that affect our loved ones.” She praises all the people in today's walk. “They have a direct connection to creating a world that is free of MS,” Kalt said. “It is a powerful thing, when a person stands up and says I am going to make a difference.” Anna Marie Lux is a columnist for The Gazette. Her columns run Sundays, Tuesdays and Thursdays. Call her with ideas or comments at 608-755-8264, or email amarielux@gazettextra.com. Stevens Point man pleads guilty to robbing credit unions, including one in Janesville Mark C. Venske, Edgerton/Janesville, WI

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Joint Commission Names Trident Health to Nation’s Top Hospital List For the third year in a row, the Joint Commission, the leading accreditor of health care organizations in America, has recognized Trident Health as a Top Hospital in Quality. Trident, Summerville and Moncks Corner Medical Centers attained some of the highest performance scores in the nation in treating heart attacks, heart failure, surgical care and pneumonia. Trident is the only Charleston area hospital and is one of only 182 (5%) hospitals that achieved the distinction three years in a row. ����������� Trident Health is one of the 1,099 hospitals in the U.S. earning the distinction of Top Performer on Key Quality Measures for attaining and sustaining excellence in accountability measure performance. The ratings are based on an aggregation of accountability measure data reported to The Joint Commission during the 2012 calendar year. The list of Top Performers increased by 77 percent from its debut last year, and represents 33 percent of accredited hospitals reporting data. Last year, The Joint Commission recognized Trident for its achievement on the following measure sets: heart attacks, heart failure and pneumonia. “We are proud to be in the top 5% of hospitals in the nation, that says a lot about our commitment to patient care,” said Todd Gallati, Trident Health CEO. Trident Health and each of the hospitals that were named as a Top Performer on Key Quality Measures must: 1) achieve cumulative performance of 95 percent or above across all reported accountability measures; 2) achieve performance of 95 percent or above on each and every reported accountability measure where there are at least 30 denominator cases; and 3) have at least one core measure set that has a composite rate of 95 percent or above, and (within that measure set) all applicable individual accountability measures have a performance rate of 95 percent or above. A 95 percent score means a hospital provided an evidence-based practice 95 times out of 100 opportunities to provide the practice. Each accountability measure represents an evidence-based practice – for example, giving aspirin at arrival for heart attack patients, giving antibiotics one hour before surgery, and providing a home management plan of care for children with asthma. Trident Health is an HCA hospital system comprised of two acute care hospitals – Trident Medical Center and Summerville Medical Center – as well as Moncks Corner Medical Center. The Joint Commission recently named Trident Health to their list of the nation’s top hospitals for quality and safety. In 2012, Trident Health provided almost $40 million in charity and uncompensated care and contributed $27 million in taxes. Accredited by The Joint Commission, Trident Health is committed to providing quality health services along with wellness information and opportunities to the communities it serves. For more information about Trident Health, please visit our website at www.tridenthealthsystem.com or call 843.797.7000. Friends2Follow

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American Medical Response back in good graces of key Manchester officials | New Hampshire Contact us American Medical Response back in good graces of key Manchester officials MANCHESTER — A key aldermanic committee has backed renewing the contract for American Medical Response, the emergency ambulance company that, until several months ago, was beset by complaints over large bills and aggressive collection practices...The Committee on Administration on Monday voted to go along with the recommendation of Fire Chief James Burkush, who argued that AMR had made great strides in addressing the prior issues. “My primary concern is the safety of our citizens and performance,” Burkush told the committee. “With confidence, I recommend they get the next contract.”..Specifically, Burkush noted that AMR has set up a local billing office and had reached a provider agreement with the city’s largest insurer, Anthem, following pressure from Mayor Ted Gatsas.AMR was chosen over American Ambulance Services of New England, the other company vying for the five-year contract. American, a division of the Scandinavian company Falck, has been expanding into New England in recent years. The company won its first emergency contract in New Hampshire in April, when the Somersworth City Council voted 7-1 to select American over AMR...At the core of the billing disputes with AMR were charges that could exceed $2,000 for a trip to the hospital. The final bill would often end up being lowered, but not before customers complained of a complicated and frustrating process dealing with AMR’s billing office in Ohio...Burkush said lower customer rates were part of the new contract. Burkush said AMR agreed to lower its rates after American, in its original proposal, proposed lower rates. Burkush said that American’s main disadvantage was that it didn’t have experience contracting with a city the size of Manchester...“We know some of the people involved (at American), but we were unable to contact a fire chief that had a similar system to us (for a reference),” he said. Criticism, praiseThe proposals were reviewed by a special ad-hoc committee that included the city’s finance, legal and health directors, and Aldermen Dan O’Neil and Jim Roy, a former firefighter...Roy strongly criticized the chief’s recommendation, noting that all the department heads felt that American was the stronger candidate. He also said he believed AMR’s application should have been invalidated because it did not properly disclose legal actions against the company.“That’s probably the most glaring thing,” Roy said. “One of the parts of the evaluation process is legal performance. If you got a zero on that, the way I read it, you’re out of the process.”AMR, which is the largest private ambulance company in the country, has faced legal action over its billing practices in several states. In 2011, it settled with the U.S. Office of the Inspector General, paying a $2.7 million fine and signing a “Corporate Integrity Agreement,” related to practices in the company’s New York City office...O’Neil, however, said he now supported AMR. O’Neil had been among the most outspoken critics of the company, alluding to the difficulties his own wife faced in settling a bill. At a meeting in March, he stated, “AMR lost the city’s trust.”..On Monday, O’Neil said that speaking with AMR’s new CEO made him feel comfortable the company had changed course. If problems arise, he said, “I can call him on his cell phone.”O’Neil also pointed to a letter from the International Association of Fire Fighters, in Washington, D.C., that accused American of attempting to “manipulate” the bid process by suggesting that the union supported American...The letter alludes to a communication from David Lang, the president of the Professional Fire Fighters of New Hampshire, that it describes as “a one-way correspondence that implies IAFF support to a company where none exists.”..American Chief Operating Officer Brendan McNiff said the letter in question was submitted to counter a false rumor that the company’s parent company had a plan to offer private firefighting services. McNiff also has a history with AMR; he was one of the executives who left amid a shake-up late last year...Since the staff reorganization, top executives from AMR have flown into the city to meet with the mayor and other officials in an attempt to address the issues. Gatsas has expressed support for AMR in recent months...“I think they’ve been handling the job without issues the past five months,” he said on Monday. As for the position of his department heads on the contract, Gatsas said, “I’m going to sit down and talk with them about why they’re leaning in that direction.”..The full Board of Mayor and Aldermen is expected to vote on the contract at its July 2 meeting. tsiefer@unionleader.com..

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The idea for a page on funerals grew out of a discussion in the Ped Onc listserve of "Life Insurance for Cancer Kids." Parents felt slapped in the face because their life insurance companies refused coverage for their cancer kids. We discovered that life insurance companies can indeed legally refuse to cover our kids. Some parents asked, "Who cares?", thinking that by the time the kids need life insurance, they will be able to afford it for themselves. Well, the taboo, somewhat morbid subject is out of the bag: "because funerals cost a lot of money." The money from a life insurance policy would help cover the funeral costs. "Your kid needs medical insurance. YOU need life insurance for your kid. That doesn't make the need any less real, but what I'm getting at is that policy will never do anything for your daughter herself. Or, put another way, life insurance isn't for the insured." (Mark) "We're just making sure we save even a little money in the event that it's needed. If we don't need it then she can use it for college." (Connie) "I have since gotten policies that would pay for the girls, but Eric is denied until off therapy for 5 yrs, I think. A real bummer, especially since I thought we would need it for burial costs. To complicate matters, Eric does have a small investment of about $6000. Paul and I were divided about the use of the money. I wanted to use it to enjoy the summer and he wanted to save it for funeral expenses. Well, my dad said not to worry about funeral expenses, my mom said "Play" and our church may help if the time comes. So, we're using some of the money to go on vacation next week and I plan to live it up. But, we still have half left untouched." (Winnie) "I hope they never "need" life insurance. But you see, I have no savings. It isn't that my savings is low. It is non-existent. My checking account lives from paycheck to paycheck. I have no assets (no house, the bank owns the truck, no jewelry, nothing). If, G-d forbid, I should have to say goodbye to one of my children, without insurance I would have NO way of paying for a funeral. I couldn't even afford the flowers. And my kids would deserve the best funeral possible, not the bargain basement variety. That extra life insurance for my children only costs me about a buck twenty each month, but what it saves me in worry is worth it. The last thing I want to be doing if one of my children dies is counting pennies. Six years ago when I signed up for the life insurance, I would have agreed that children never need it. I couldn't even tell you why I signed up for it. But now, that false reality has been shattered and the cold harsh truth has entered my life. Children do die." (Roxie) "In our case, obviously, buying life insurance would have been prudent. But I didn't ever think it was a necessity. We don't have it on the other two kids. That's a gamble, but so's life. Medical insurance, that's a necessity. But we have no crystal balls. We just plan the best we can and leave the rest to God." (Lynne) "Cancer really messed things up for our family financially. When Matthew relapsed in 1995, we had to refinance our house, and it's been a constant struggle ever since. We didn't have life insurance for our children. When you live from paycheck to paycheck, as we have for the past few years, trying to come up with almost $10,000 to give your child the burial that they deserve isn't easy." (Honna) "I remember 10 years ago when DH and I bought life insurance policies (privately, in addition to our employer-provided benefit), the policy states it would pay $1000 in the event of the death of a child. At that time, Brian was 3 years old, and I remember thinking how morbid that was, and it would be a drop in the bucket if we ever did need it. Anyway, I wonder if that is unusual or not for ins. to include a rider for children of the insured. We paid for the funeral of my nephew, killed in an auto accident 8 years ago. That one was around $5K, using a national military cemetery. What I'm trying to say is that we are NOT rich, but somehow you find a way, and the funeral home will work with you (at least ours does) and finance it over time." (Lisa) "Through much research and having to do this for others, I've discovered that there is usually memorial park in the community that will do funerals for children at greatly reduced prices. The one we've referred families to on numerous occasions will handle everything at no cost if the child is under 3 and at a 50% savings if the child is between 3 to 18." (kerri) "Kelly's uncle is a funeral director in the Seattle area, and he said that he does funerals for families (of anyone, not just kids) who can not pay for them. He gives them a nice funeral. Sometimes, people come forward to help with the expenses, other times he does it of his own goodness. He did mention that other funeral homes in the area will NOT do them for free and "refer" all of the customers who can't pay to him. (Nice huh?) He still refuses to turn them away. If only the whole world were as kind..." (Lori) "Something to check out is some sort of a memorial society that provides low-cost funeral arrangements. Here in Georgia there is something called the Memorial Society of Georgia (Atlanta area). I have not known anyone who dealt directly with them, but they're part of United Way in Atlanta, and they were recommended by a local consumer advocate who has a talk (radio) show. Apparently, there is a one-time fee for "membership." The one catch that I can think of at the moment (without having done any research on the subject) is that we are a very mobile society in the USA. You may pay this one-time fee for membership and then move away. The fee, however, is relatively inexpensive at $35 (US). Perhaps there are such associations or societies in your area." (Kirk and Ruth Andry) "I guess we felt funny asking for a hand or discount from the funeral home, we didn't plan ahead at all, so we felt we were between a rock and hard place. Asking our parents for the loan was the only way for us. But I wonder how people did it (do it) (Will do it) if that's not an option." (Lynne) "I would like to add that we are, 11 months after Matthew's death, still trying to dig out from under the huge financial burden that cancer has placed on us. Our funeral cost around $6,000 but I can at least say that it was done the way I wanted it. I bought Matthew the best casket available, an ivory steel model with ivory satin lining. Completely water proof. As morbid as this thread might be, most caskets designed for children are rather ugly. I remember the first time I walked into the display room to pick his casket, completely freaking out at the funeral director for bringing me in to see such ugly, tiny, "boxes", as I called them. He was extremely understanding and quickly got me the catalog so we could have one special ordered for my angel. I also made sure that I ordered as many flowers as I wanted, in the species that I knew Matthew would love. Lots of purple. It took us a long time, but a few months ago we made the final payment on his funeral. The funeral home was very compassionate with us, and eager to do whatever they could to help. We live in a small town where everyone knew Matthew. People did what they could to ease the financial burden. Our minister and organist refused to accept their payment for the service, the church would not take any money for his spot in the cemetery, the men that dug the hole would not take payment, the printer that designed our memorial tribute cards with Matthew's picture made an extra hundred or so for free. It was expensive, but my angel was worth every penny". (Honna) Note: the Kids Wish Network provides funeral assistance. Funeral Costs | Preparing Your Child for Death | Planning the Memorial or Funeral Service | Grief Resources (links and books) | Poems and Thoughts | more Poems and Thoughts | Handling the Holidays Ped-Onc Resource Center Home

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Chemist Direct discusses new treatments for migraines available at NHS including transcranial magnetic stimulation Chemist Direct discovers a simple hand held instrument exists that delivers magnetic pulses to those suffering from migraines as helpful as other treatments for some people. New treatments for migraines available on the NHS Migraine headaches affect over six million people in Britain with nearly 190,000 attacks per day and causing 20 million employees to skip work every year. London (PRWEB UK) When pain is felt in the brain, along the scalp, or in the neck and it lasts for an hour or more it is defined as a headache. Most headaches are undefined and can be caused by such things as too much sun, dehydration or as a side effect of treatment for other ailments. A headache is generally treated with a regular pain reliever and goes away after a few hours. There are however specific kinds of headaches that portray recurring characteristics such as bilateral pain, a throbbing or pulsating pain accompanied by nausea, and at times light sensitivities or auras. These headaches are known as tension, cluster, or migraine headaches. The cause of migraines is still undiscovered, but many of the triggers have been identified and can include chemical reactions to food or beverages, fluctuating hormones and environmental triggers that cause the arteries and veins to violently contract and dilate. Migraine headaches affect over six million people in Britain with nearly 190,000 attacks per day and causing 20 million employees to skip work every year and 5 million school aged children to remain at home on a school day. Without a cure or even reliable medication, the excruciating pain from migraine headaches can last from 4 up to 72 hours. http://bit.ly/1lue7Hn Common treatments given to those suffering from chronic migraines, besides extra strength pain pills, are triptans found in Imigran or Migraleve, nerve blockers, acupuncture or acupressure and occasionally Botox shots. A new treatment that has been cleared by the NHS is TMS, a non-intrusive magnetic therapy that does not interfere with any of the above medication or treatments. TMS stands for transcranial magnetic stimulation and is administrated through a device that is held on the scalp allowing a magnetic pulse to enter through the skin and penetrate the brain. Though the exact effect on the cells and blood vessels is yet unknown, this TMS therapy has proven to be effective in reducing pain. Several clinical trials conducted by the National Institute for Health and Care Excellence (NICE) have found this the treatment effective in minimising and preventing the onset of a migraine, without causing any serious side effects. During the clinical trials, over 164 patients were treated with the device, where 39% were pain free after two hours and 30% were pain free even after 24 hours. Even if this is just a temporary solution, this device reduces headache frequency significantly, although the long-term effects will only be known later on. http://bit.ly/1ivhE6q NICE recommends the use of transcranial magnetic stimulation (TMS) for chronic migraine patients as part of a combination therapy for those who do not respond to other treatments. The number of pulses can be changed – from a single pulse (sTMS) to repeated pulses (rTMS). The strength, frequency and length of time it is given can also be varied for each individual. NHS patients can also now benefit from TMS if they are under the care of headache specialists that keep detailed records of each patient’s experience to broaden the knowledge base on its effectiveness. http://bit.ly/1nFmC3C Samantha Smith Chemist Direct+44 1215414952 Ext: 205

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Department of Psychiatry and Behavioral Health Department of Psychiatry and Behavioral Health Overview Our Team Divisions and Clinical Centers Residencies Fellowships Internships Research and Clinical Trials Stress Trauma and Resilience (STAR) Harding Hospital Centennial Celebration Dept Psych The Ohio State Neurological Institute OSU Harding Hospital 1670 Upham Drive, Suite 130 Our goal is academic preeminence and excellent, comprehensive behavioral health care. We in the Department of Psychiatry and Behavioral Health believe there is no health without mental health. New research — some conducted at our own Institute for Behavioral Medicine — shows that human health cannot be separated into physical and mental. It is a unity of the two and must be treated as such. At Ohio State’s Neurological Institute, we bring together neurologists, neurosurgeons, psychiatrists and physical medical and rehabilitation specialists. Patients come to us for treatments and services they cannot find elsewhere. The OSU Department of Psychiatry and Behavioral Health boasts one of the largest, most diverse faculty in the region. Medical students have an unparalleled opportunity to learn the most advanced approaches to mental health from a world-renowned leaders. Comprehensive, individualized psychiatric education supported by a leading-edge research center stimulate professional growth and integrity. Learn more Further education in the field of psychiatry and behavioral health can be attained through our Forensic Psychiatry Fellowship or our Psychosomatic Medicine Fellowship. We also offer fellowship opportunities in pain medicine, psychosocial oncology, sleep medicine and community psychiatry. Learn more Psychology Internship Program Practicum and fellowship training has long been a part of our mission, but the inclusion of a formal psychology internship underscores the role that health behaviors play in the onset, maintenance and recovery from disease. Grand Rounds are held the first three Wednesdays of each month from 1:00 - 2:00 PM. They are located at the Davis Heart and Lung Research Institute Auditorium (DHLRI 170), 473 W. 12th Avenue, Columbus, OH 43210. Recorded versions of Grand Rounds are also available for viewing. Learn more Divisions and Clinical Centers Center for Psychiatry and Behavioral Health Our comprehensive center of treatment services across the continuum of care for all mental and behavioral health conditions, as well as in our research and educational endeavors. Division of Child and Adolescent Psychiatry With roots in both psychiatry and pediatrics, this branch of medicine is dedicated to problems and disorders of emotion, thinking and behavior in young people. Division of Psychology This division of the Department of Psychiatry and Behavioral Health is home to clinicians, researchers and clinician-researchers who are active in comprehensive assessment, inpatient consultation and outpatient psychotherapy. Division of Public and Community Psychiatry We provide education, evaluation, research and care to those who receive care from public and community clinics. Division of Molecular Neuropsychopharmacology This group studies the neurobiology of addiction, particularly nicotine addiction, and related psychiatric disorders, based on the idea that addiction is a biological disorder characterized by changes in specific regions of the brain. Neuropsychology Clinic Our clinic provides comprehensive evaluations on an outpatient basis for adults for adults with concerns about their thinking abilities Stress, Trauma And Resilience (STAR) The STAR Program promotes education, treatment and research in psychological trauma resulting from abuse or violence, disaster, a medical condition or sudden and profound loss. Women's Behavioral Health Ohio State's Women's Behavioral Health program provides care to women experiencing stress or stress-related illness during life events that are unique to women. Institute for Behavioral Medicine Research Childhood Mood Disorders Lab Psychiatry and Behavioral Health Clinical Trials Our History The Department of Psychiatry and Behavioral Health of The Ohio State University traces its inception to the 1847 appointment of Samuel M. Smith, MD (1816-1874), as “Professor of Medical Jurisprudence and Insanity” at the Willoughby Medical College of Columbus (a precursor of Ohio State’s College of Medicine). On Feb. 19, 1847, the trustees of the Willoughby Medical College met in and unanimously appointed Dr. Smith, a prominent Columbus physician, as chair. With this appointment, the first academic department of psychiatry (or its equivalent) in this country was established. Although Dr. Smith's appointment as professor of Psychiatry was for slightly less than one year, records demonstrate that he delivered his lectures on insanity for at least a six-year period, and most likely longer. Annual catalog announcements for Starling Medical College continued to list Dr. Smith’s lectures from 1847 through 1853. After this date there is a gap in available bulletins until 1868 when William L. Peck, MD, was appointed professor of Insanity and Nervous Diseases. Dr. Smith’s continuing interest in Psychiatry was demonstrated by his involvement with the Columbus Asylum for the Insane as a trustee from 1856 until his death in 1874, and by an appointment in 1870 to a special committee of the Ohio State Medical Association to examine the plea of insanity in cases of homicide. Dr. Smith died in Columbus on Nov. 30, 1874, two days after his 58th birthday from what was likely cerebral tuberculosis. In 1994, Ohio State built a $15-million neuropsychiatric facility, Ohio State Harding Hospital, to house a century and a half of knowledge about innovative patient treatment, as well as state-of-the-art clinical inpatient, outpatient, partial (for patients who commute to a treatment center) and research facilities. A bronze statue in Dr. Smith’s memory stands outside Ohio State Harding Hospital. Images of his deceased sons, Charles and Samuel, are designed as medallions and decorate the sides of the base. Above the marble base is a full-size figure of Dr. Smith with his hands folded behind his back, wearing a Prince Albert coat. It has a drinking fountain base and bears the inscription: “Memorial Fountain, to Dr. Samuel Mitchel Smith and His Sons, 1880.”

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Welcome Ontario has a long history of injured worker activism. In recent years, injured workers and their representatives have become more involved in research. They have been joined by a number of researchers and community partners who support their struggles. This group has formed a partnership called the Research Action Alliance on the Consequences of Work Injury. The mandate of the Alliance is to undertake research on the workers' compensation system and its role in the economic, social and health consequences of work injury. The Alliance builds on the expertise of all involved to produce insights into the compensation system that will influence policy development, education, and further investigation. Ultimately, the Alliance hopes to make the system work better for all injured workers. Goals of the initiative The main goals of the initiative are: To document the effects of work injury and illness and the role played by legislation, policies, programs and practices. To encourage evidence-informed policy-making in workers' compensation boards. To equip injured workers and their representatives with the skills to continue their involvement in research and the dissemination of evidence. To increase sensitivity to, and knowledge of injured workers' experiences. To increase awareness of the need to involve non-academic communities in research. Home | Partners & Funding | About Research Projects Events & Activities | Community Capacity Building | Academic Capacity Building Contact Us | E-Newsletter What's New! 2011 RAACWI Symposium STIGMARead about the successful RAACWI-WSIB initiative to address stigma against injured workers. Read our latest e-newsletter:Summer 2011 Read about the 2009 RAACWI Symposium Calendar of Events ---

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Home > Features > First Commencement for Public Health & Bioethics Masters Programs Masterful Commencement Living Her Dream: Hui Yang's Journey from China to Einstein Hayeem Rudy: Aiming for Humanity in Healthcare Triple Threat: Former Basketball Star and Singing Sensation Studies to Become a Scientist Einstein Alum Develops a Thriving Urgent-Care Network Einstein's IDDRC and the Children's Hospital at Montefiore: Teaming Up to Tackle Rare Childhood Diseases Features Archive > First Commencement for Public Health & Bioethics Masters Programs On Tuesday, June 5, 2012, Einstein’s Center for Public Health Sciences and the Einstein-Cardozo master’s program in bioethics came together on the Jack and Pearl Resnick Campus to mark the first graduation ceremony for each program. Held in Lubin Dining Hall, the ceremony marked the awarding of master’s degrees to five individuals: Nareen Abboud, Ph.D., Viraj Patel, M.D. and Elizabeth Poole-Di Salvo, M.D. each received a master of public health degree, while Einstein medical students Yonah Bardos and Michelle Goldsammler received a master of science in bioethics. In welcoming those in attendance, Dr. Paul Marantz, director of the Center for Public Health Sciences, noted that the occasion represented "the first-ever conferring of the degrees." He also expressed gratitude to Drs. Cheryl Merzel, director of Public Health Educational Programs and Tia Powell, director of the Montefiore-Einstein Center for Bioethics, for creation and institution of the two new programs in public health and in bioethics. The Center for Public Health Sciences introduced the M.P.H. in 2010, along with an option to pursue a certificate in public health. Each program focuses on community-based, applied research and offers a unique approach for training health professionals to become public health change agents in their field. Students study behavioral and social sciences applied to chronic disease prevention as well as, health disparities, global health, and community engagement. Dr. Tia Powell with M.B.E. graduate Yonah Bardos (Michelle Goldsammler not pictured)The M.S. in Bioethics was first offered in 2011, expanding on the bioethics certificate course that has been training professionals in bioethics since 1995. Today’s M.B.E. program represents a collaboration of Einstein and Montefiore with Yeshiva University’s Cardozo Law that builds on the tested foundation of the certificate program. The program teaches students how to solve complex bioethics issues through practical methods, and seeks to improve patient care, practice, scholarship and teaching with humane treatment and research at its core. As the commencement ceremony continued, Dr. Allen M. Spiegel, the Marilyn and Stanley M. Katz Dean of Einstein, congratulated the graduates. Keynote speaker Dr. Steven M. Safyer, president and CEO of Einstein’s University Hospital and academic medical center, Montefiore Medical Center, followed by mentioning his own experiences as a community organizer, where he discovered the importance of health in community. "Medicine seized my curiosity and captured my intellect, and it now gives me a position from which to advocate social justice." Dr. Safyer also spoke about his work with prisoners on Rikers Island, where AIDS presented new challenges. "We began to see tuberculosis and HIV, twin epidemics resisting treatment. I knew if I found common ground, we’d have the opportunity to make changes." Drs. Cheryl Merzel and Paul Marantz flank M.P.H. graduates (Drs. Elizabeth Poole-Di Salvo, Viraj Patel and Nareen Abboud)He continued, "Today’s twin epidemics are obesity and diabetes. Seventy percent of our borough is overweight or obese, and we’re seeing children being affected." He lauded Montefiore’s efforts to fight diabetes and promote activity in local schools. He also touched upon the current debate around healthcare reform, before closing with this advice for graduates: "Be curious, open, and ready to accept different opportunities." Before presenting the bioethics graduates, Dr. Powell discussed how bioethics is not an afterthought, but is woven into the fabric of our institution, exemplified by the unique collaboration with Cardozo Law. She reflected on the diversity of the student body, most of whom are mid-career professionals from fields as divergent as religion, social work, medicine and law. "Most people who are on hospital bioethics committees have little or no formal training and our aim is to provide better training in bioethics," she said. "We see our classes as a gateway drug. We know they will love our courses and want to take more. We are the pushers of bioethics. " Rounding out the ceremony, Dr. Merzel – who holds a doctorate and a master’s degree in public health – introduced graduates of the public health program. She observed, "Graduating our first students is an amazing milestone to reach. We’re trying to build a unique program to prepare health professionals for public health research and action." She added, "Our students commit themselves to advocacy and action that can improve health of people around the world." Posted on: Monday, July 23, 2012

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ANATOMY | DRUGS | JOB DESCRIPTIONS | COUNTRIES OF THE WORLD | AIRPORT CODES | RELIGIONS | FEEDBACK Human Body > IX. Neurology > The Trochlear Nerve 5d. The Trochlear Nerve FIG. 776– Nerves of the orbit. Seen from above. (N. Trochlearis; Fourth Nerve)The trochlear nerve (Fig. 776), the smallest of the cranial nerves, supplies the Obliquus superior oculi. It arises from a nucleus situated in the floor of the cerebral aqueduct, opposite the upper part of the inferior colliculus. From its origin it runs downward through the tegmentum, and then turns backward into the upper part of the anterior medullary velum. Here it decussates with its fellow of the opposite side and emerges from the surface of the velum at the side of the frenulum veli, immediately behind the inferior colliculus. The nerve is directed across the superior cerebellar peduncle, and then winds forward around the cerebral peduncle, immediately above the pons, pierces the dura mater in the free border of the tentorium cerebelli, just behind, and lateral to, the posterior clinoid process, and passes forward in the lateral wall of the cavernous sinus, between the oculomotor nerve and the ophthalmic division of the trigeminal. It crosses the oculomotor nerve, and enters the orbit through the superior orbital fissure. It now becomes the highest of all the nerves, and lies medial to the frontal nerve. In the orbit it passes medialward, above the origin of the Levator palpebræ superioris, and finally enters the orbital surface of the Obliquus superior. In the lateral wall of the cavernous sinus the trochlear nerve forms communications with the ophthalmic division of the trigeminal and with the cavernous plexus of the sympathetic. In the superior orbital fissure it occasionally gives off a branch to the lacrimal nerve. It gives off a recurrent branch which passes backward between the layers of the tentorium cerebelli and divides into two or three filaments which may be traced as far as the wall of the transverse sinus. I. Embryology II. Osteology III. Syndesmology IV. Myology V. Angiology VI. The Arteries VII. The Veins VIII. The Lymphatic System IX. Neurology X. The Organs of the Senses and the Common Integument XI. Splanchnology XII. Surface Anatomy and Surface Markings BIBLIOGRAPHIC RECORD http://www.theodora.com/anatomy/the_trochlear_nerve.html Copyright © 1995-2016 Photius Coutsoukis (All Rights Reserved).

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Public health officials have already investigated one outbreak at an assisted-living facility. DAYTONA BEACH — A new strain of stomach virus spreading across the country that causes nasty episodes of vomiting and diarrhea has arrived in Volusia County. Public health officials have already investigated one outbreak at an assisted-living facility, said Dr. Bonnie Sorensen, director of the Volusia County Health Department. Nineteen of the assisted-living facility's 28 residents, along with six staff members, came down with the new strain of norovirus — commonly referred to as stomach flu — around Thanksgiving. "It's in our community," Sorensen said. "It's very prominent this time of year." Investigators suspect the virus possibly contributed to the deaths of two of the facility's elderly residents. Because of patient privacy concerns, the Health Department would not name the assisted-living facility. The Volusia and Flagler County health departments are telling doctors, hospitals, schools, nursing homes and day cares to watch for the virus and report three or more possible cases. Flagler County has not had any confirmed cases of the new strain, but it is being monitored, said Patrick Johnson, administrator of the Flagler County Health Department. "Something new to us like this could potentially be a serious problem," he said. "There's ways to prevent this. It's one of those things we are getting ahead of which is good." The Centers for Disease Control and Prevention traced the origin of the new strain called GII.4 Sydney to Australia. The strain emerged in March and is now accounting for 58 percent of U.S. stomach virus outbreaks, according to the CDC. Over the past decade, new strains have emerged every two or three years, said Dr. Aron Hall, a CDC epidemiologist. Scientists are waiting to see if the new virus causes more outbreaks and more severe illness, he said. "Anytime a new strain emerges there is a potential for more outbreaks, more illness and possibly even more severe illness," Hall said. "The new strain means the population doesn't have immunity so there are a lot more people who are susceptible." Norovirus — sometimes associated with outbreaks of vomiting and diarrhea on cruise ships — is highly contagious and typically lasts one to three days. It can take as few as 18 norovirus particles to get sick, compared with hundreds or thousands for other viruses, Hall said. Although it's sometimes called the stomach flu, norovirus is not related to influenza, which is a respiratory illness that causes fever, aches and coughing. Norovirus spreads primarily through direct contact with infected people, but it also can be transmitted through contaminated food, water and surfaces. The virus sickens 21 million in the United States, hospitalizes 70,000 and kills about 800 annually. Young children and the elderly are at the highest risk for severe illness. Norovirus season typically lasts from November to April and peaks in January. The virus can have an economic effect on the community, leading to high absentee rates at schools and workplaces, Johnson said. A February 2010 outbreak of norovirus in Flagler County sickened hundreds and caused one-third of students at Rymfire Elementary School in Palm Coast to stay home from school. Tips for preventing the spread of norovirus No vaccine exists to prevent a norovirus infection, but research is being done in that area. However, you can take steps to lessen the chances of getting it or spreading it to others. — Wash your hands, especially before eating, preparing and handling food and after using the toilet and changing diapers. — Wash fruits and vegetables and cook seafood thoroughly. — When you are sick, do not prepare food or care for others who are sick. — Clean and disinfect contaminated surfaces. Use a chlorine bleach solution with a concentration of 1,000 to 5,000 ppm (5 to 25 tablespoons of household bleach per gallon of water) or other disinfectants registered as effective against norovirus by the Environmental Protection Agency. — Wash contaminated laundry thoroughly. SOURCE: Centers for Disease Control and Prevention

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DOHHome Topics A - Z Consumer Reports /Data VitalRecords Senior Benefits Diseases &Conditions Senior Services & Health Systems Contact OurPrograms Home > 2013 > New Jersey Municipalities Continue to Adopt Smoke-free Air Ordinances to Protect Public Health PO Box 360 Trenton, NJ 08625-0360For Release:April 12, 2013 Mary E. O'Dowd, M.P.H.CommissionerFor Further Information Contact:Office of Communications(609) 984-7160 New Jersey Municipalities Continue to Adopt Smoke-free Air Ordinances to Protect Public Health Nearly 6.1 million New Jersey Residents Now Protected Princeton, Palisades Park, North Bergen, Secaucus, Garfield, Perth Amboy, Kearny and Hopatcong are the latest New Jersey municipalities to adopt outdoor smoke-free air ordinances covering outdoor public recreation areas, the Christie Administration announced today. Currently, 163 municipalities in all 21 counties have smoke-free air ordinances in effect. In addition, nine counties also have adopted ordinances-some cover county parks, others apply to all county property and two apply to county zoos-Turtle Back Zoo in West Orange and the Cape May County Zoo. A list of the municipalities and counties is available at www.njgasp.org/Smokefree%20parks%20list.pdf. The municipal and county ordinances cover more than 6.1 million New Jersey residents. There are health and environmental benefits of smoke-free parks and recreation areas. The ordinances protect the community and non-smokers from exposure and send a clear public health message to children about the harmful effects of tobacco smoke. "Through the combined efforts of these local governments, concerned citizens and public-private partnerships, New Jersey is implementing model public policies that are changing social norms and community behaviors regarding exposure to secondhand tobacco smoke," said Health Commissioner Mary E. O'Dowd. "These ordinances protect the health of all New Jerseyans, especially infants, children and the elderly who are particularly susceptible to the harmful effects of secondhand smoke." There is no safe level of exposure to secondhand tobacco smoke, according to the U.S. Surgeon General. Even brief exposure can trigger health problems for people with asthma and cardiovascular illnesses. Children exposed to secondhand smoke are at increased risk for severe asthma attacks, bronchitis, painful ear infections, pneumonia and sudden infant death syndrome. The New Jersey Department of Health's Office of Cancer Control and Prevention (OCCP) and the Office of Tobacco Control (OTC) are working with New Jersey municipalities to educate communities and offer assistance to help implement smoke-free outdoor air ordinances. The U.S. Centers for Disease Control and Prevention (CDC) labeled this collaboration a "success story" in coordinating grantees and advocates to educate stakeholders and policy makers about the dangers of secondhand smoke and need to reduce exposure in outdoor public recreational spaces. A "Smoke-Free Policy Toolkit" and local advocacy groups called Integrated Municipal Advisory Councils provide guidance to local officials in increasing the number of smoke-free outdoor air ordinances. The Department provides more than $850,000 in grants to seven organizations which support this initiative: the American Cancer Society, Atlantic Prevention Resources, the Center for Prevention and Counseling, the Global Advisors on Smoke-free Policy (GASP), the Southern NJ Perinatal Cooperative, University of Medicine and Dentistry of New Jersey and the Vineland Health Department. Nonsmokers exposed to secondhand smoke inhale many of the same chemicals that smokers inhale. Tobacco smoke contains more than 7,000 chemicals, of which at least 250 are toxic and 70 cause cancer, including formaldehyde, benzene and vinyl chloride. Secondhand smoke has been designated as a known human cancer-causing agent by the U.S. Environmental Protection Agency, National Toxicology Program and the International Agency for Research on Cancer. In addition to the health benefits of clearing the air, outdoor smoke-free air ordinances also lower the risk of children and animals ingesting discarded and toxic cigarette butts, reduce litter and prevent accidental fires. The DOH offers free "100% smoke-free" signs to municipalities and counties with smoke-free policies covering their parks and recreational areas. The free sign program helps to educate the community and promotes self-enforcement of the policy. The Department has a free telephone counseling service called NJ Quitline to help people who want to quit smoking. For more information please visit njquitline.org. Contact Us | Privacy Notice |Legal Statement |Accessibility Statement | Department:NJDOH Home | Topic A to Z | Programs/Services Copyright © State of New Jersey, P. O. Box 360 Trenton, NJ 08625-0360

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Obama: Health website is being fixed Published October 22. 2013 12:01AM By SCOTT WILSON The Washington Post Washington - President Barack Obama gave a consumer-friendly defense of the health care law Monday and assured the country that the problems many have faced while trying to enroll in new insurance plans would be fixed quickly.At the same time, Obama admonished Republican critics of the federal insurance exchange and its implementation, saying that "it is time to stop rooting for its failure."The president's address reflected the rising anxiety within the administration over the widening problems with the exchange's enrollment process, namely through a federal website that has shut out many consumers looking to buy insurance plans before the benefits take effect on Jan. 1.A Washington Post-ABC News poll released Monday shows that a majority of Americans - 56 percent - believe flaws with the website reflect larger problems with the health care law, an alarming trend for the administration. But more Americans also support the law despite the enrollment issues, with 46 percent saying they support the law now, compared with 42 percent who said so last month.In his remarks, Obama was clear about his disappointment with the site's launch. "There's no sugarcoating it: The website is too slow; people have been getting stuck during the application process," he said. "And I think it is fair to say that no one is more frustrated by that than I am."There's no excuse for the problems," he added, "and they are being fixed." He said the government is "doing everything we can possibly do" to repair the site, including 24-hour work from "some of the best IT talent in the country."Speaking in the White House's Rose Garden, surrounded by a handful of guests who he said have benefited from the law, Obama served as chief salesman for the three-year-old Affordable Care Act. He emphasized the benefits that have taken effect and played down the faulty website. In outlining the health care changes under the new law, Obama said twice that "those do not depend on a website."As he insisted that problems would soon be fixed, Obama also highlighted alternative ways to apply for the health plans. Consumers can buy insurance through the exchanges "the old-fashioned way, offline," he said, including through call centers or in person.But the political and practical mood of the president's address reflected problems with the website that go beyond the technical issues that have been outlined by administration officials and that Obama emphasized Monday.The growing concerns over the flawed site - and the slow progress in addressing the problems since its rollout three weeks ago - have become a focus of Republican criticism in the aftermath of the government shutdown. Early on in that political standoff, Republicans demanded defunding or delaying the health care law, known informally as Obamacare, in return for keeping the government open.Addressing the opposition party Monday, Obama said, "I realize Republicans have made blocking the Affordable Care Act their signature policy idea. And I think, with the problems with the website so far, they are likely to go after it even harder."But, "we did not wage this long and contentious battle just around a website," he said. "We waged this battle to make sure that millions of Americans in the wealthiest nation on Earth finally have the same chance to get the same security of affordable quality health care as anybody else."White House officials said Monday that the administration is not considering delaying the law's individual mandate, which requires that most individuals have health insurance by March 31 or pay a fine, because of the online enrollment complications.In the budget fight, Republicans sought a year delay in the requirement but eventually gave up. Jennifer Palmieri, the White House communications director, told MSNBC Monday that delaying the individual mandate is "a hypothetical we don't expect to encounter."Congressional Republicans have called for the firing of Health and Human Services Secretary Kathleen Sebelius over the enrollment problems. Several have demanded that Sebelius testify before Congress this week on the law's implementation, including House Speaker John Boehner, R-Ohio.The agency's spokeswoman said Monday that Sebelius would not testify at a Thursday hearing because she would be out of town.In a statement issued Monday after Obama's address, Boehner said that "Americans didn't get any answers from the president today, but the House's oversight of this failure is just beginning."Sebelius, Boehner said, "must change her mind and appear at this week's hearing in the House. With more than one trillion taxpayer dollars being spent on a completely defective program, Congress is going to get to the bottom of this debacle."The Department of Health and Human Services announced Sunday that 19 million people had visited HealthCare.gov since the beginning of the month, although the administration has yet to release figures on how many have signed up for health insurance through the exchange.On another level, the problems confronting Obama's signature piece of domestic legislation undermine the broader argument he has made throughout his presidency, that government is capable of working effectively to improve lives. He has been receiving daily briefings on the implementation process, which will be a key part of his domestic legacy."No one is madder about the website than I am, which means it's going to get fixed," Obama said to applause.He reiterated that the Affordable Care Act should not be perceived solely as a website, although easily enrolling the uninsured is a central element of the law. He noted other new benefits from the law: that people younger than 26 can remain on their parents' health care plan; that mammograms and birth control are free through employer plans; and that premiums are declining in some places for those already insured."You may not have noticed them, but you've got them," Obama said. "They are not going anywhere. And they don't rely on a website." Need honest exchange

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Back|ACEProfessional Resources Certified NewsAugust 2011 IssueThe Six Doctors Every Fitness Pro Should Know August 2011 The Six Doctors Every Fitness Pro Should Know By MEGAN SENGER Your new client says her physiatrist wants her to work out less. Your spinning class regular asks whether he should see an orthopedic or osteopathic physician for his knee pain. A gym member wants to know if a chiropractor or a sports-medicine doctor is better for back injuries. And your regular trainees are all abuzz about the new bariatrics office opening down the street. You know fitness, but do you understand the medical specialties these individuals are referring to? Being well versed in the roles of these different types of doctors—chiropractors, osteopathic physicians, physiatrists, orthopedists, sports-medicine physicians and bariatricians—will help you make effective client referrals and expand your professional networking opportunities. Keep these six doctors in mind as you assist your clients in overcoming injuries and achieving their best. Two of these terms—chiropractor and osteopathic physician—refer to types of doctors, albeit with differing educations. Doctor of Chiropractic (D.C.) Chiropractors treat musculoskeletal conditions related to the nerves, muscles, ligaments and joints of the spine and extremities. They attend four to five years of rigorous post-graduate chiropractic education (distinct from medical school). How they help: Chiropractors use their hands or instruments to adjust (i.e., manipulate) joints, particularly the spine. They may also counsel patients on positive eating and exercise habits, explains Scott Bautch, D.C., a Wausau, Wisc.-based spokesperson for the American Chiropractic Association. Examples of conditions a chiropractor may see range from tendonitis and headaches to dysfunctions of the ankle, says Bautch. Of special interest: Bautch notes that while a D.C. typically has a limited education in the pharmacological treatment of diseases, an M.D. may have less of a background in nutrition-specific approaches. “The two professions can complement each other well because of their differences in education,” he says. Six Doctors At-a-Glance Professional Highlights Chiropractor (D.C.) Type of doctor Spine and joint adjustments, overall wellness approach Osteopathic Physician (D.O.) Type of doctor Qualified as all-around physician, trained in manual musculoskeletal therapies Physiatrist (M.D. or D.O.) Non-surgically treats musculoskeletal system, expert diagnostician Orthopedist (M.D. or D.O.) Qualified to surgically treat and repair the musculoskeletal system Sports Medicine (M.D. or D.O.) Medical subspecialty or area of focus May be a surgical or non-surgical specialist, treats sport and exercise-related injuries Bariatrician (M.D. or D.O.) Weight management, typically a non-surgical specialist Doctor of Osteopathic Medicine (D.O.) “D.O.s and M.D.s [i.e., medical doctors] are the only two groups of physicians in the United States fully licensed to prescribe medication and practice in all medical specialty areas, including surgery,” says Nicholas Parise, D.O., M.S., Director of Osteopathic Medical Education at Swedish Covenant Hospital in Chicago, Ill. Like M.D.s, D.O.s are fully qualified, comprehensive physicians who attend four years of medical school followed by additional residency training. However, explains Parise, in addition to their general medical training, D.O.s also learn osteopathic manipulative treatment (OMT): manual therapy techniques that include stretching, gentle pressure and resistance placed on muscles and joints. How they help: Like an M.D., a D.O. may be a general or specialist practitioner, and may choose to concentrate in a nonmusculoskeletal-focused specialty, such as radiology or cardiology, Parise notes. The philosophy of osteopathic medicine advocates a “whole person” approach to care. Parise explains that “D.O.s believe that structural abnormalities [e.g., of the musculoskeletal system] can compromise a person’s overall health.” Of special interest: The term “osteopath” means different things in different parts of the world. For example, in the United Kingdom or Australia an osteopath has a non-physician healthcare role (much like a physical therapist). However, in the U.S., the term “osteopath” refers to a medically qualified doctor. Thus, American D.O.s prefer the term “osteopathic physician” over “osteopath” to clarify their distinct medical training. SPECIALTIES AND SUBSPECIALTIESSpecialist M.D.s or D.O.s that you may encounter include physiatrists, orthopedists, sports-medicine doctors and bariatric physicians. Physiatry Physiatry—also termed physical medicine and rehabilitation—focuses on the non-surgical treatment of conditions related to nerves, muscles, bones or the brain. Recognized subspecialties include sports medicine, spinal cord injury medicine and pain medicine. How they help: “Physiatrists are an ideal first-line resource in dealing with musculoskeletal problems,” says Bruce Becker, M.D., M.S., the Spokane, Wash.-based editor of The Physiatrist, the official newsletter of the American Academy of Physical Medicine and Rehabilitation. Physiatrists are expert diagnosticians who may use rehabilitative treatments, medications and a team approach, explains Becker. “Physiatrists are used to leading a team of specialists such as physical therapists, personal trainers, occupational therapists and others.” They may deal with anything from traumatic brain injury to lower-back pain to preventative care for elite athletes. Of special interest: “Perhaps the most basic difference [between physiatry and other specialties] is the focus on the patient as a whole person, rather than a patient with a specific joint problem,” says Becker. “Physiatrists focus on trying to trace problems back to their root cause(s) in addition to treating immediate symptom(s).” OrthopedicsOrthopedists are trained to both surgically and non-surgically treat musculoskeletal problems; the terms “orthopedist” and “orthopedic surgeon” are interchangeable. How they help: “Orthopedic surgeons see patients with a myriad of musculoskeletal problems—the majority of which are treatable with non-operative intervention (for example, with physical therapy, home exercises, etc.),” says William Levine, M.D., a professor of orthopedic surgery at Columbia University Medical Center in New York City and spokesperson for the American Academy of Orthopedic Surgeons. Surgical orthopedic treatments include arthroscopy, joint replacement and soft tissue repair (as in the case of torn tendons or ligaments). Of special interest: “For many overuse injuries the personal trainer can typically use his or her judgment regarding referral,” says Levine. “In general, if an injury persists beyond seven days despite rest, ice, activity modification and the like, then it is advisable to refer [the client] to a physician.” Sports MedicineSports-medicine physicians treat sport- and exercise-related injuries for all athlete types and levels, from the professional athlete to the weekend warrior to the construction worker who hurts his shoulder lifting weights, says David Geier, M.D., director of the Medical University of South Carolina’s sports-medicine program in Charleston, S.C. Sports medicine is a recognized subspecialty (i.e., area of additional focus within an existing specialty) of several different fields, including emergency medicine, family medicine, physiatry and orthopedics. Depending on the physician’s background, he or she may concentrate on either surgical or non-surgical treatments. Specialization and Board Certification In the United States, a doctor is required to be licensed by the state in which he or she practices. However, board certification is voluntary and not legally required; it indicates an M.D. or D.O. has met additional formal requirements in a specific area of professional expertise. After becoming board certified in a specialty such as orthopedics or physiatry, a physician may choose to train in a recognized subspecialty such as sports medicine. Such accreditations are awarded through several organizations, including the American Board of Medical Specialties (ABMS) and the American Osteopathic Association (AOA). Board certification in bariatrics is available through the American Board of Bariatric Medicine, an organization that is working toward broader ABMS recognition. “As a relatively new field in medicine, we are working as a specialty to develop increasingly formal advanced-training opportunities,” notes Horn. The prevalence of chiropractic specialties is also on the rise. Offered as specialist “diplomates,” these include chiropractic nutrition, chiropractic orthopedics and chiropractic sports medicine. How they help: Sports-medicine doctors may work at clinics, or with sports teams covering professional or amateur games, Geier explains. Thus, a sports-medicine doctor's day may range from treating on-the-field injuries during a match, to liaising with physical therapists about the rehabilitation of a patient’s long-term knee issue. Of special interest: Not all sports-medicine physicians are board certified (nor are they required to be; see “Specialization and Board Certification” for a more detailed discussion). For example, Geier notes that a general orthopedist who also treats athletes may refer to him- or herself as a sports-medicine physician using experience or simple marketing to do so. Thus the term "sports medicine" may refer to a board-certified subspecialty or to an area of focus and interest within a physician’s existing practice. BariatricsBariatrics focuses on obesity and its related co-morbidities such as diabetes, arthritis and coronary artery disease. “While weight-loss surgery is referred to as bariatric surgery, bariatricians are typically non-surgeons who utilize many different tools to help manage an individual’s weight, metabolic changes and health,” notes Deborah Horn, D.O., M.S., M.P.H., of Houston, Texas. Horn sits on the board of directors of the American Society of Bariatric Physicians and is an ACE-certified Group Fitness Instructor. How they help: Bariatricians can help guide personal trainers in developing nutrition and exercise programs for overweight clients while monitoring health markers related to weight loss, such as blood glucose or lipids, Horn explains. They may also treat medical barriers to weight loss such as musculoskeletal issues or hyperthyroidism. Of special interest: “I encourage personal trainers to call the bariatricians in their area and ask to meet briefly and determine if it is a good [professional and referral] match,” says Horn. She adds that there are no weight or body mass index limitations related to seeing an obesity medicine specialist. Megan Senger is a writer, speaker and fitness sales consultant based in Southern California. Active in the exercise industry since 1995, she holds a bachelor’s degree in kinesiology and English. When not writing on health and lifestyle trends, techniques and business opportunities for leading trade magazines, she can be found in ardha uttanasana becoming reacquainted with her toes. She can be reached at www.megansenger.com. ACE-sponsored Research: Best Triceps Exercises Is Sugar to Blame for America’s Obesity Epidemic? Do Diet Sodas Make People Gain Weight? The Truth Behind the Greek Yogurt Craze The Six Doctors Every Fitness Pro Should Know Workout Watchdog: Tools for the Trainer—Step360TM Pro and BeamfitTM All-new ACE Group Fitness Instructor Manual - Now Available Just in time for summer! The new full-color, 3rd edition best-selling textbook, the ACE Group Fitness Instructor Manual, features the most up-to-date scientific information and latest guidelines along with the accompanying ACE’s Essentials of Exercise Science for Fitness Professionals textbook and instructional DVD, featuring award-winning presenter Lawrence Biscontini. Read More » Teach Yoga or Small-group Training? If you offer yoga classes or small-group training, there's a new opportunity to expand your client base. The AARP Fitness & Wellness Program is now offering all ACE-certified Fitness Professionals the great opportunity to bring the gift of a healthy mind and body to the growing number of older adults. Read More » Secrets to Avoiding Injuries: What Every Avid Runner Should Know If you’re an avid runner or work with clients who are, don't miss ACE’s live webinar, “Injury-prevention Strategies for Runners,” hosted by ACE Academy Director Todd Galati. Discover essential information on staying injury-free, plus learn how to assess clients and create proper exercise progressions and drills to improve running technique and form. Read More » What is ACE Saying in the Media? Serving as America’s Authority on Fitness®, ACE and its extended spokesperson network are regularly featured or quoted in print, online and broadcast media, reaching more than 450 million people each year. Read More »

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Home » Publications » DrugFacts » Stimulant ADHD Medications: Methylphenidate and Amphetamines DrugFacts: Stimulant ADHD Medications: Methylphenidate and Amphetamines Email Facebook Revised January 2014 Stimulant medications including amphetamines (e.g., Adderall) and methylphenidate (e.g., Ritalin and Concerta) are often prescribed to treat children, adolescents, or adults diagnosed with attention-deficit hyperactivity disorder (ADHD). People with ADHD persistently have more difficulty paying attention or are more hyperactive or impulsive than other people the same age. This pattern of behavior usually becomes evident when a child is in preschool or the first grades of elementary school; the average age of onset of ADHD symptoms is 7 years. Many people’s ADHD symptoms improve during adolescence or as they grow older, but the disorder can persist into adulthood. ADHD diagnoses are increasing. According to the U.S. Centers for Disease Control and Prevention, as of 2011, 11 percent of people ages 4–17 have been diagnosed with ADHD. How Are Prescription Stimulants Used? Prescription stimulants have a calming and “focusing” effect on individuals with ADHD. They are prescribed to patients for daily use, and come in the form of tablets or capsules of varying dosages. Treatment of ADHD with stimulants, often in conjunction with psychotherapy, helps to improve ADHD symptoms along with the patient’s self-esteem, thinking ability, and social and family interactions. Do Prescription Stimulants Make You Smarter? A growing number of teenagers and young adults are abusing prescription stimulants to boost their study performance in an effort to improve their grades in school, and there is a widespread belief that these drugs can improve a person’s ability to learn (“cognitive enhancement”). Prescription stimulants do promote wakefulness, but studies have found that they do not enhance learning or thinking ability when taken by people who do not actually have ADHD. Also, research has shown that students who abuse prescription stimulants actually have lower GPAs in high school and college than those who don’t. Prescription stimulants are sometimes abused however—that is, taken in higher quantities or in a different manner than prescribed, or taken by those without a prescription. Because they suppress appetite, increase wakefulness, and increase focus and attention, they are frequently abused for purposes of weight loss or performance enhancement (e.g., to help study or boost grades in school; see box). Because they may produce euphoria, these drugs are also frequently abused for recreational purposes (i.e., to get high). Euphoria from stimulants is generally produced when pills are crushed and then snorted or mixed with water and injected. How Do Prescription Stimulants Affect the Brain? All stimulants work by increasing dopamine levels in the brain—dopamine is a neurotransmitter associated with pleasure, movement, and attention. The therapeutic effect of stimulants is achieved by slow and steady increases of dopamine, which are similar to the way dopamine is naturally produced in the brain. The doses prescribed by physicians start low and increase gradually until a therapeutic effect is reached. When taken in doses and via routes other than those prescribed, prescription stimulants can increase brain dopamine in a rapid and highly amplified manner (similar to other drugs of abuse such as methamphetamine), thereby disrupting normal communication between brain cells and producing euphoria and, as a result, increasing the risk of addiction. What Are the Other Health Effects of Prescription Stimulants? Stimulants can increase blood pressure, heart rate, and body temperature and decrease sleep and appetite. When they are abused, they can lead to malnutrition and its consequences. Repeated abuse of stimulants can lead to feelings of hostility and paranoia. At high doses, they can lead to serious cardiovascular complications, including stroke. Addiction to stimulants is also a very real consideration for anyone taking them without medical supervision. Addiction most likely occurs because stimulants, when taken in doses and routes other than those prescribed by a doctor, can induce a rapid rise in dopamine in the brain. Furthermore, if stimulants are abused chronically, withdrawal symptoms—including fatigue, depression, and disturbed sleep patterns—can result when a person stops taking them. Additional complications from abusing stimulants can arise when pills are crushed and injected: Insoluble fillers in the tablets can block small blood vessels. Do Prescription Stimulants Affect a Patient’s Risk of Substance Abuse? Concerns have been raised that stimulants prescribed to treat a child’s or adolescent’s ADHD could affect an individual’s vulnerability to developing later drug problems—either by increasing the risk or by providing a degree of protection. The studies conducted so far have found no differences in later substance use for children with ADHD who received treatment and those that did not. This suggests treatment with ADHD medication appears not to affect (either negatively or positively) an individual’s risk for developing a substance use disorder. For additional information on prescription stimulants, see www.drugabuse.gov/publications/research-reports/prescription-drugs This publication is available for your use and may be reproduced in its entirety without permission from NIDA. Citation of the source is appreciated, using the following language: Source: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services. This page was last updated January 2014 More DrugFacts Health Effects of Specific Drugs Anabolic Steroids Cigarettes and Other Tobacco Products Cocaine Cough and Cold Medicine Abuse Electronic Cigarettes (e-Cigarettes) Fentanyl Hallucinogens Heroin Inhalants Is Marijuana Medicine? Marijuana MDMA (Ecstasy/Molly) Methamphetamine Prescription and Over-the-Counter Medications Stimulant ADHD Medications: Methylphenidate and Amphetamines Synthetic Cannabinoids Synthetic Cathinones ("Bath Salts") Effects of Drug Abuse Comorbidity: Addiction and Other Mental Disorders Drugged Driving HIV/AIDS and Drug Abuse: Intertwined Epidemics Understanding Drug Use and Addiction Survey Data Drug-Related Hospital Emergency Room Visits High School and Youth Trends Nationwide Trends Treatment Statistics Prevention and Treatment Lessons from Prevention Research Substance Abuse in the Military Treatment Approaches for Drug Addiction Get this Publication EspañolPDF (503KB) Cite this article National Institute on Drug Abuse. Stimulant ADHD Medications: Methylphenidate and Amphetamines Retrieved from https://www.drugabuse.gov/publications/drugfacts/stimulant-adhd-medications-methylphenidate-amphetamines press ctrl+c to copy Life Skills Training Shields Teens From Prescription Opioid Misuse Device Detects Marijuana in Breath Hours After Smoking Although Relatively Few, “Doctor Shoppers” Skew Opioid Prescribing Nora's Blog New Regulations on Flavored Tobacco Products and e-Cigarettes Will Protect Public Health NARCAN Nasal Spray: Life-Saving Science at NIDA HHS Announces Actions to Attack the Opioid Abuse Crisis Research Report Examines the non-medical use of prescription drugs-opioids, central nervous system depressants, and stimulants-describing adverse health effects of their use and the prevention and treatment of addiction. Safe Disposal of Medicines Disposal of Unused Medicines: What You Should Know (FDA)

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Andrew D. Zelenetz, MD, PhD Medical Director, Quality Informatics Conditions Treated: New Patient Appointments 646-497-9137 I am a medical oncologist with special expertise in lymphoma, and former Chief of Memorial Sloan Kettering’s Lymphoma Service. I am a member of a close-knit team that provides compassionate, multidisciplinary care to patients with lymphoma. Read more I have helped develop a number of the agents now approved to treat lymphoma — including 131I-tosituomab/tositumomab, bortezomib, and pralatrexate — and through clinical studies I am evaluating the benefits of novel combinations of agents. In another area of research I am working to improve the prognostic value of patients’ pathology specimens using computer-aided image analysis. I have published more than 100 papers on lymphoma research in journals such as Blood, Journal of Clinical Oncology, and Clinical Cancer Research. I am involved in several national organizations that provide information about lymphoma treatment and fund laboratory and clinical research. I am chairperson of the Non-Hodgkin Lymphoma Guidelines panel of the National Comprehensive Cancer Network and vice chairperson of the Lymphoma Core Committee of the Cancer and Leukemia Group B. I am also a member of the scientific advisory board of the Lymphoma Research Foundation. Clinical Expertise: Hodgkin and non-Hodgkin Lymphomas: Lymphocytic Lymphomas, Diffuse Large B Cell Lymphoma, Mantle Cell Lymphoma; Chronic Lymphocytic Leukemia; Immunotherapy for Lymphoma Awards and Honors: New York Magazine Top Doctors (2002-2016) Education: MD, Harvard Medical School Residencies: Stanford University Medical Center Fellowships: Stanford University Medical Center Board Certifications: Internal Medicine; Medical Oncology See My Colleagues Lymphoma Service West Harrison Medical Oncology Service Visit PubMed for a full listing of Andrew D. Zelenetz’s journal articlesPubmed is an online index of biomedical articles maintained by the U.S. National Library of Medicine and the National Institutes of Health. As home to one of the world’s top cancer research centers, Memorial Sloan Kettering is typically involved in more than 900 clinical trials at a given time. Currently, clinical trials focused on the conditions I treat are enrolling new patients. If you’re interested in joining a clinical trial, click to learn about the trial’s purpose, eligibility criteria, and how to get more information. Most major health insurers offer plans that include MSK as one of their in-network providers. If MSK is in-network, it means all our doctors are too. Medicaid and New York State Medicare also provide benefits for care at MSK. New Drug Combination Improves Outcomes in Patients with Chronic Lymphocytic Leukemia Role of FDG PET, CT, and Bone Marrow Biopsy (2011 ASH Conference) Monoclonal Antibody Drugs for Cancer Treatment

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HomeIntroductionMeet Local LegendsNews and EventsAbout UsContact Us MEET LOCAL LEGEND: Patricia A. Thomas, M.D. Patricia A. Thomas, M.D. “I was the middle child of five and then lost a brother and a sister. I felt helpless but came to see that medicine could give me the information and power to battle illness.” NOMINATING CONGRESSIONAL REPRESENTATIVE Dennis Moore “RENOWNED PATHOLOGIST, RESEARCHER AND LEADER IN DIVERSITY” A one-line "personal mission statement" accompanying her professional resume neatly characterizes Patricia Thomas' caring attitude and lifelong ambition: "I will inspire and empower others, and myself, to make a real difference in the world we share." Thomas has been guided by this commitment since her earliest days in her home town of Leavenworth, where she and her four siblings grew up, a brother and sister died, and a serendipitous encounter in high school with a college recruiter set her on the path to becoming the first member of her family to graduate from college. An honors student in high school, she was spotted by a representative from Harvard University who was interested in attracting gifted black students to the university. Thomas seized the opportunity, eventually graduating from Harvard with a degree in biochemistry and, later, from the University of Kansas with a master's degree in biology and biochemistry. Despite these accomplishments, Thomas felt her real calling was as a physician. Inspired in part by the loss of her siblings years earlier, she began to study medicine, eventually earning her M.D. from New York University Medical Center. Today she is a nationally known expert on pathology and cytopathology, with special interest and training in fine needle aspiration and breast pathology. Her current research focuses on early detection of benign breast lesions that might predict a woman's risk of developing breast cancer, as well as any racial or ethnic variations in breast cancer survival. Nominated as a Local Legend of Medicine by Rep. Dennis Moore (D-KS-3), she is Chair of the Department of Pathology and Laboratory Medicine at the University of Kansas and an Associate Dean heading the university's Office of Cultural Enhancement and Diversity (OCED), which addresses issues relating to the art, science, learning and "humanness" of medicine. As well, she strives to foster diversity in the School of Medicine. Thomas also directs both the Center for the Study of Race and Ethnicity in Medicine and the Minority Resource Center at the university. As a respected teacher and campus leader, she co-directs an initiative to increase the number of underrepresented students in health professions. Thanks to her efforts, the School of Medicine received a $5.5 million endowment grant from the National Institutes of Health National Center for Minority Health and Health Disparities for merit-based scholarships for minority students in the Greater Kansas City area. A prolific researcher, Thomas has published more than 110 articles and abstracts and made numerous presentations. Recipient of the University of Kansas Student Voice Award for Excellence in Teaching (2002-2003), she has many other awards and citations to her credit. "Medicine is the perfect combination of the things I like to do: study science, make a difference and make decisions that help people," she says. "The most important thing to me though, is my family. That I can have a family and be a doctor is what inspires me." MILESTONES 1997Appointed Professor, Department of Pathology and Laboratory Medicine, University of Kansas School of Medicine, Kansas City 1998Appointed Executive Co-Director, Greater Kansas City Health Professions Pipeway Initiative (GKC HPPI) 1998Appointed Director, Center for the Study of Race and Ethnicity in Medicine (now known as the Program on Diversity and Disparities in Health), and Appointed Co-Director, Center of Excellence for Minority Medical Faculty Development and Cultural Competency Education, University of Kansas School of Medicine 1999Appointed Associate Dean, Office of Cultural Enhancement and Diversity, University of Kansas School of Medicine 2001-2002Selected for Hedwig Van Ameringen Executive Leadership in Academic Medicine Program for Women, Bryn Mawr, PA 2003Appointed Chair, Department of Pathology and Laboratory Medicine, University of Kansas School of Medicine 2005Selected as Fellow, Harvard School of Public Health, Clinical Chief of Service Training Program, Boston BORN New York University School of Medicine, New York, NY Sub SpecialtyCytopathology Copyright, Privacy Policy, Accessibility

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Main News Filters Children's (Pediatrics) Digestive Disorders (Gastroenterology) Ear Nose Throat (Otolaryngology) Hospice / Palliative Care Immunology & Allergy Mental Health (Psychiatry) Physical Therapy / Rehabilitation Trauma & Burn Weight Loss / Bariatric Surgery Patient / Visitor / Caregiver U.S. News & World Report once again recognizes Yale New Haven Hospital Yale New Haven Hospital (YNHH) continues to rank among the top U.S. hospitals, according to U.S. News & World Report’s annual “America’s Best Hospitals” listing. Of the nearly 5,000 hospitals surveyed, YNHH ranks nationally in 11 of 16 specialties. 07/19/16 Magnet Recognition Program site visit Yale New Haven Hospital was designated as a Magnet organization in 2011 by the ANCC Magnet Recognition Program®. This prestigious designation recognizes excellence in nursing services. In August 2016, Yale New Haven Hospital is applying for re-designation. 07/12/16 Yale New Haven Health System named a 2016 “Most Wired” winner Yale New Haven Health System (YNHHS) has been selected as one of the most wired in the nation by Hospitals and Health Networks, a trade magazine published by the American Hospital Association. This recognition is based on technology advancements made by organizations to enhance patient safety, clinical quality and customer service in healthcare centers. 07/06/16 Stay cool and enjoy the summer safely With the warmest spate of weather descending upon Connecticut and the eastern portion of the United States over the next three days, doctors at Yale New Haven Hospital (YNHH) say that staying cool and beating the heat can become a serious challenge. The combination of warm temperatures expected to reach the low to mid-90s plus high humidity levels will make for a heat index approaching triple digits. 06/30/16 CMS Oncology Care Model selects Smilow Cancer Hospital The Centers for Medicare & Medicaid Services (CMS) today announced that it has selected Smilow Cancer Hospital at Yale New Haven/Yale Cancer Center as one of nearly 200 physician group practices and 17 health insurance companies to participate in a care delivery model that supports and encourages higher quality, more coordinated cancer care. Yale New Haven Hospital receives international designation as a baby-friendly designated birth facility Yale New Haven Hospital (YNHH) and Baby-Friendly USA have announced that YNHH has received the prestigious international recognition as a Baby-Friendly designated birth facility. Yale New Haven Hospital first in Connecticut to perform new procedure to open blocked carotid arteries YNHH was the first hospital in Connecticut to perform a new, less-invasive procedure to help clear plaque-ridden carotid arteries Six Yale New Haven Children's Hospital specialties ranked among top in the country by U.S. News & World Report Diabetes and endocrinology ranked 7th in the nation Norma Pfriem Healing Garden is ‘heart and soul’ of Trumbull’s new Park Avenue Medical Center Speaker after speaker recalled the generosity and compassion of philanthropist Norma Pfriem during the May 2 dedication ceremony for the healing garden named in her honor at Yale New Haven Health’s Park Avenue Medical Center. 05/04/16 Yale New Haven Health announces opening of Park Avenue Medical Center in Trumbull Yale New Haven Health cut the ribbon May 3 on a new outpatient medical center in Trumbull. Showing 1-10 Results

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Available Procedures Preparing For Bariatric Surgery Life After Bariatric Surgery Your Diet After Weight Loss Surgery Bariatric Surgery Information Request Yale New Haven Hospital offers comprehensive care for the morbidly obese patient through all stages of weight loss — from pre-operative treatment to post-surgical strategies for maintaining health. Led by a dedicated team of experts in medicine, nursing, nutrition, psychology and surgery, our Bariatric Surgery Program is recognized for its safety, efficiency, sensitivity and expertise. About Weight Loss Surgery About one-third of adults in the U.S. are considered obese, according to the most recently available statistics from the Centers for Disease Control and Prevention (CDC). When overweight reaches the stage where it affects your health and causes or worsens certain health issues, it is considered "morbid" or disease-causing obesity. A ratio of weight to height called Body Mass Index BMI is generally used to classify the degree of overweight. An individual is considered to have morbid obesity at a BMI of 40 or at 35 if health problems such as diabetes, high blood pressure, or obstructive sleep apnea are also present. Obesity isn't simply a result of overeating. There are many contributing factors such as genetics, hereditary, environmental, metabolic, and eating disorders. Certain medical conditions, like hypothyroidism, may result in obesity. Research has shown that in many cases an underlying cause of morbid obesity is genetic. Studies have demonstrated that once the problem is established, dieting and exercise programs have a limited long-term effect. Weight-loss surgery has been shown to be an effective treatment of morbid obesity. Although the complete mechanisms causing this are not yet fully understood, both the procedure and the required lifestyle changes can result in significant weight loss and health improvement. That's why it's important to understand that medical interventions, including weight-loss surgery, should not be considered medical cures. Rather they are attempts to reduce the effects of excessive weight and alleviate the serious physical, emotional and social consequences of the disease. Our physicians conduct free seminars throughout the year to give potential patients and their families’ information on the latest advances in weight-loss surgery, as well as the services provided at Yale New Haven Hospital. Yale New Haven Hospital offers three different, minimally invasive (i.e. laparoscopic) bariatric operations. Learn more about the innovative weight-loss procedures performed at YNNH Why Choose YNHH Patients at Yale New Haven Hospital benefit from a dedicated bariatric surgery team led by world-class surgeons and medical caregivers specializing in all facets of weight-loss surgery. All follow standardized protocols to provide consistent, compassionate care and support for the weight loss patient. Accredited as a “Comprehensive Center with Adolescent Qualifications” under MBSAQIP The bariatric surgery program at Yale New Haven Hospital (YNHH) has been accredited as a Comprehensive Center with Adolescent Qualifications under the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) administered jointly by the American College of Surgeons and the American Society of Metabolic and Bariatric Surgery. This designation means that YNHH has met the essential criteria that ensure it is fully capable of supporting a bariatric surgery care program and that its institutional performance meets the requirements outlined by the MBSAQIP Accreditation Program. Designation as a “Comprehensive Center with Adolescent Qualifications” provides confirmation that a bariatric surgery center has demonstrated its commitment to providing the highest quality care for its bariatric surgery patients of all ages. Our bariatric surgery team is recognized for its expertise and innovation. Each surgeon is fellowship-trained in minimally invasive, bariatric surgery. In fact, our surgeons teach laparoscopic techniques to other physicians around the country. They are also well known for their research, uncovering new approaches to weight loss surgery that may benefit patients in the future. Andrew J. Duffy, MD. FACS Geoffrey S. Nadzam, MD. FACS Kurt E. Roberts, MD. FACS Matthew Hubbard, MD Saber Ghiassi, MD Yale New Haven bariatric surgery physicians are recognized for their expertise and innovation. In fact, they have taught laparoscopic techniques to other surgeons around the country. In addition to being recognized for their surgical skill, YNHH bariatric surgeons are also well known for their research, uncovering new approaches to weight loss surgery that may benefit patients in the future. Is Bariatric Surgery right for you? Most weight loss programs are based on diet, exercise and behavior change. For the morbidly obese individual, these methods alone most often are not enough to cause substantial weight loss and health improvement, or to help maintain weight loss that does occur. New research has shown that the body often resists weight loss efforts for underlying hormonal and metabolic reasons, with a “set point” that often keeps the individual at an overweight level despite efforts to lose weight. Weight-loss surgery has been shown in studies to interrupt these metabolic patterns and result in reduced hunger, improved “satiety” or satisfaction with meals, and ultimately to reduce fat stores and weight. Other studies have found additional benefits for Type 2 diabetic patients, who may have reduced need for medication, and less complications from this debilitating disease. These results have caused the American Diabetes Association, the American Heart Association, the International Diabetes Foundation, and the American Association of Clinical Endocrinologists to endorse weight-loss surgery as a treatment for Type 2 diabetics with morbid obesity. Morbid obesity is a complex chronic disease. Weight-loss surgery should be viewed first and foremost as a method for alleviating this debilitating disease. Having surgery is a serious decision. The information provided is intended to help you become more informed, and to learn how to the start the process. Learn more about Eligibility Requirements for Bariatric Surgery Contact UsBariatric Center Find A DoctorFind A Location

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- Allergic Living - http://allergicliving.com - Food Allergies: When Treats and Food Take Over the Classroom Posted By Janice Paskey On 2010/07/02 @ 12:18 pm In School and Allergies, Asthma | No Comments [1]From the Allergic Living archives; this popular article was first published in the Canadian edition of the magazine in 2007. THE PIZZA day. The monthly birthday cake. Treats from the teacher for a job well done. Those holiday celebrations. The dad with the MBA using spreadsheet skills to organize the preschool snack schedule. The amount of food the average child comes in contact with at the modern school is several times what his 30- or 40-something parent encountered as a pupil. Today’s staples include the pizza-at-school fundraisers, rich and fatty cafeteria food, and school vending machines brimming with oversized beverages and chocolate bars. Add to the mix the modern child’s obsession with computers, the hours of instant and text messaging time, and results are a shocker: kids across Canada and the United States are more overweight now than at any other time in history. Between 1978 and 2004, government statistics show that the proportion of overweight Canadian kids aged 6 to 11 doubled to 26 per cent, while the rate of teenagers who were too heavy also doubled – to a whopping 29 per cent. The rate of obese teens tripled to 9 per cent. Due to weight issues, the federal government stated that, for the first time, this generation of children might not live as long as their parents. In the United States, over the past three decades there has been a doubling of obesity rates for preschoolers and teens, and a tripling for the 6-to-11-year-old group. “Kids are drinking more sugary drinks, and you have exercise being designed out of their lives,” says Dr. Brian McCrindle, a cardiologist at The Hospital for Sick Children in Toronto, professor of pediatrics and author of Get a Healthy Weight for Your Child. “Because of safety concerns, they don’t play outside, and you see a proliferation of sedentary pursuits, video and computer.” As children have grown ever heavier, the concurrent trend, of course, is the skyrocketing of food allergy. A study from Mount Sinai’s School of Medicine in New York, published in 2004, confirmed what allergists knew anecdotally; the incidence of food allergy in the U.S. had doubled, and those statistics are mirrored in Canada. Six to 8 per cent of Canadian school children now have food allergies, which can cause dangerous, even life-threatening reactions. Provinces and states are considering and, in a few cases, passing anaphylaxis-readiness laws in the schools. But as those bring restrictions on what is appropriate for the lunchbox, simultaneously, the weight issue has grabbed the attention of educators and the media. The result: the pendulum is beginning to swing toward better nutrition in some schools. This means a new focus on fruits and vegetables, which happens to dovetail neatly with concerns about allergens in the class, since those foods are not the top allergenic sources, and they won’t lead to accidental exposures. New Approach: No Food as Rewards or for Celebrations The Institute of Medicine, a scientific advisory group based in Washington, produced a report in April, 2007 calling for a dramatic new approach to food in the classroom: no food as rewards; no food for celebrations. Then it ranked foods into tiers. Tier 1 is acceptable: fruits, vegetables, real juice, low-fat dairy, and nothing with trans fat. These are the only snack foods to be allowed for elementary school children and fundraising efforts, while higher-fat and sugary Tier 2 food could be available for after-school activity for teens. No snack, though, should be more than 200 calories. The Institute of Medicine report also took aim at food sold to raise funds for schools, recommending it be curtailed. At the same time, a new bill that would amend the Child Nutrition Act to eliminate junk food from U.S. schools is gaining support in Congress. Bill Jeffrey, national coordinator of the Canadian wing of the Center for Science in the Public Interest, wrote a response to the Institute of Medicine’s report, calling for Canada’s federal government to take serious leadership on school nutrition. “We don’t have a good snapshot of food in the schools nationally,” he says. “There needs to be a national approach to improving it.” Indeed, there is a provincial patchwork approach to both food allergy and nutrition in the schools. “Things are changing with regard to improved nutrition,” says Dr. Peter Nieman, a Calgary pediatrician. “But they are changing too slowly.” One province showing leadership after a wake-up call is Nova Scotia. A 2003 study found more than 40 per cent of kids in Grade 5 to be overweight or obese, with poor kids more likely to be overweight, so the province decided that change had to come. Banning Sport Drinks, Deep Fryers and Super-Sized Portions In 2006, it began phasing in (over three years) its Food and Nutrition Policy for Nova Scotia Public Schools. The policy states boldly that food must be for nourishment rather than revenue generation. It bans sports drinks and deep fryers from cafeterias, eliminates super-sized portions, and ranks foods (and when they’re allowed to be eaten) according to nutritional content. Peter McLaughlin, spokesperson for the Department of Education, says schools expressed the greatest concerns with strict guidelines in the area of fundraising (no more cookie dough). To clarify, a comprehensive guide was created. “We were helped by the warnings that this would be the first generation not to outlive their parents,” he says. At the same time, Nova Scotia is updating its anaphylaxis guidelines and undertaking more emergency training. In Ontario, the food-in-the-class debates have been focused on compliance with Sabrina’s Law, the groundbreaking anaphylaxis legislation. But nutrition is also building as an issue. In late 2004, the Ministry of Education released guidelines for school boards that targeted the sale of chips and chocolate bars in elementary school vending machines. School boards were advised to restrict snacks to those that are nutritious, including fruit cups and some types of granola bars, crackers and cookies. Lower-fat milk, water and 100 per cent fruit juice were recommended as beverages, and the guidelines are part of a broader health framework. Meantime, British Columbia has similarly begun moving toward healthier eating habits. It is working with the school boards with the goal of eliminating junk food in the vending machines and cafeterias, and has introduced a program called Healthy Schools. But beyond provincial or statewide policies, changing the dynamic of food in the class also comes down to a single school’s own initiative. In the case of one Mississauga, Ontario school, the approach to reducing allergens in the junior kindergarten is steeped in nutritional advantage. St. Basil Elementary School implemented a fruits and veggies-only snack regime for its junior kindergarten pupils two years ago. This came about following discussions with a parent whose child had had an anaphylactic reaction. To make the classroom safe for that pupil, his teacher suggested this nutritious (if more limiting) solution. Clifford Read, the school’s principal, agreed. “This was as controversial as anything I’ve done in this school,” he recalls. “Parents were saying ‘what about cheese and crackers?’ They felt we were judging them. Next: New snack plans cause controversy from previous page “We really had to stick to our guns around fruits and vegetables,” he says. “We explained to them that we were looking for healthier snacks.” St. Basil has gone even further with allergy protocols. In all grades, birthday parties now don’t include food but games. No food is allowed in the playgrounds, as it adds risk for food allergic children and attracts bees (another anaphylaxis risk). The fruits and vegetables message has spread to École Saint-Clément in the Town of Mount Royal, located on the island of Montreal. Dr. Valérie Marchand has two daughters enrolled there, both of whom have multiple food allergies. The school is trying to improve nutrition and protect those with food allergies. Every Tuesday and Thursday, students must bring fruit and vegetable snacks only. “It’s not as easy as buying a quick snack at the store, but it’s healthier, and better for children with allergies,” says Marchand, a pediatric gastroenterologist at Montreal’s Ste-Justine Hospital, who often sees infants with failure to thrive, sometimes due to food allergies. But while anaphylaxis awareness in the schools has grown considerably, the pace of change on its nutrition counterpart is slower. And there’s a good reason: schools today have embraced foods, many of them unhealthy, for fundraising and as classroom rewards. Changing that dependence is a big undertaking. Consider the experience of Kari Gregory. She spent 10 years as an Alberta junior high and high school teacher and found food a common incentive in the classroom. “I don’t like the whole rewards thing; students need to do their best work because it teaches them to be accountable,” says Gregory, who left teaching to care for four young daughters. (She now works as a personal trainer.) When she taught, she’d bring in a big bag of fruit. “Often kids would ask me for a fruit. One might be hungry or another forgot his lunch.” She knows teachers, even excellent ones, who still give out surgary treats. “I think teachers are lost about what to give as rewards. It’s cheaper to buy a tub of $3 jelly beans, than other more nutritious snacks.” Fundraisers are Still Using Sugary Treats Then there are the fundraisers at her daughters’ school: pizza days, taco days, and subway sandwich days, all to raise funds for the parents’ advisory council. More fundraising is a fact of life in many public schools. In Calgary, Roman Catholic Bishop Fred Henry banned the high-earning casinos, so the Catholic schools in that city have turned now to food as one of several fundraising tools. This is still common. Kate Caldwell is a teacher in Cobourg, Ontario. She has qualms about certain fundraising practices, but takes a different view on food in the class: “I see school celebrations as a teaching moment.” She works in the same school as her daughter, who is food allergic and asthmatic. In a supervised setting with the practice of washing hands well-established, Caldwell says that food allergic children and their friends can learn how to manage food allergies. Caldwell and her husband, also a teacher, share the concerns about junk food, though. “A local school is currently raising money for new playground equipment and the parent group has sold chocolates, milkshakes and suckers throughout the school year. I joked with my husband that by the time the money is raised, the children will all be overweight and really need the equipment.” Caldwell believes there are higher expectations now than when she was a child for school trips, and playgrounds are more expensive to build because of enhanced safety standards. Fundraising is ingrained as a means of providing for sports teams, music programs, field trips or sometimes even basic school costs, such as library books. Gregg Bereznick is a superintendent of education for the Waterloo Region District School Board in Ontario and has watched this evolve over 25 years in the school system. “There is a growing interest in fundraising to enhance those extras in the elementary schools,” he says, and that often involves food products. But at the same time, schools are dealing with food allergies, diabetes and other health issues. Principals Face Complex Situations with Food “For principals, the food landscape has never been more complex,” says Bereznick. He describes a duality – while there may be more food in the schools, there is also more focus on health. “I think the birthday cake in the classroom is a dying trend. I’m not saying it doesn’t happen, but the current group of parents is more interested in nutrition than ever before.” In looking to the future, Anne Muñoz-Furlong, the founder and former CEO of the Food Allergy & Anaphylaxis Network, sees a natural evolution between the recognition of kids’ nutritional needs and awareness of food allergies in school. “From an educator’s perspective, having everyone avoid sweet snacks and desserts, which often contain allergens such as milk, eggs or peanuts, will make it easier to keep the children with food allergies safe. However, this goes beyond food allergies; the children with other diseases, such as diabetes, will benefit as well.” As the food allergic are all too aware, telling other parents what they can and can’t pack in their children’s lunches can be fraught with controversy. But the beauty of the nutritional approach is that it is for the benefit of everyone’s children, with food allergic kids also reaping the benefits of lessened exposures. As Muñoz-Furlong notes, “fruits and vegetables are a better food choice for everyone.” Change in that direction may be slow and uneven, but given the alarming statistics on children’s weight and allergies, in North America more provinces and states may soon feel the pressure to get in step with Nova Scotia’s lead. And one day, in the not-so distant future, perhaps a child will ask: “Mom, did you really used to eat cake – at school?” Originally published in the Fall 2007 [2] issue of Allergic Living magazine. To subscribe or order a back issue, click here. [3] Article printed from Allergic Living: http://allergicliving.com URL to article: http://allergicliving.com/2010/07/02/food-allergy-food-in-the-class-pt-1/ URLs in this post:[1] Image: http://allergicliving.com/wp-content/uploads/2010/07/Food-in-the-Class.jpg[2] Fall 2007: http://www.allergicliving.com/issues.asp?issue_id=13[3] here.: http://allergicliving.com/subscribe.asp Click here to print. Copyright © 2010 Allergic Living. All rights reserved.

医学

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Lab Report: Health, Science and Medicine Alice Park Monday, Jan. 31, 2011 OBESITY Menu Labeling Can't Change Eating Behavior With more Americans eating out and growing increasingly obese, several city and state governments are trying to help people eat healthier by forcing fast-food restaurants to divulge nutritional information on their menus. The idea is simple: putting calorie and fat counts on display should prompt consumers to opt for healthier, lighter fare. But it turns out that eating habits die hard, according to a new study involving the Taco Time fast-food chain in Washington State. Researchers found that adding calorie counts to restaurant menus had no impact on diners' choices. Similar studies in New York City have recently reported conflicting results; some surveys showed that menu labeling led to fewer calories purchased, but others found no difference in meal selection. Researchers are not discouraged by the results, however, noting that providing nutritional and calorie information on menus may still benefit consumers indirectly. As more local authorities mandate such changes, food vendors are pre-emptively modifying their menus to both lighten existing options and add healthier foods. TEEN BEHAVIOR How Video Games May Contribute to Mental Illness Obsessively playing video games isn't the healthiest way for a teen to spend an afternoon, but new research suggests that parents of "addicted" gamers may now have a more long-term concern: mental illness. A two-year study of over 3,000 elementary and middle-school students in Singapore sheds light on the associations between personality, gaming and future mental disorders. Researchers found that students with impulsive personalities and less empathy or social skills were more likely to become pathological gamers to start, logging an average of 31 hours each week on their consoles, compared with 19 hours a week for other students. Addicted gamers also tended to be more aggressive and antisocial. But more disturbingly, these pathological gamers were at higher risk of developing conditions such as depression, anxiety and social phobia two years later. The study's results highlight the long-lasting influence of excessive video-game playing, say the authors, and counter the popular belief among physicians that some teens play as a way to cope with existing mental issues. The latest results demonstrate that the relationship between gaming and mental health may be more complicated, with mental disorders being both contributors to and consequences of video-game dependence. FROM THE LABS Finding New Ways To Fight Bedbugs As bedbugs continue to stage their cringemaking comeback across the U.S., researchers have completed the first comprehensive study of the pest's genes. The analysis revealed chunks of DNA coding for pesticide resistance and may lead to new ways of controlling the critters without using the same toxic options, like DDT, employed in the past. Fetal Stem-Cell Transplants

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Frazer Lab Department of Pediatrics, Genome Information Sciences Kelly A. Frazer, Ph.D. kafrazer@ucsd.edu Dr. Frazer is a professor and the founding chief of the Division of Genome Information Sciences in the Department of Pediatrics, Director of UC San Diego’s Institute for Genomic Medicine and a leader at the university’s Clinical and Translational Research Institute. Prior to joining UCSD in 2009, Dr. Frazer was Professor of Translational Genomics at the Scripps Research Institute and, previously, Vice President of Genomic Biology at Perlegen Sciences. Dr. Frazer has spent the past 25 years studying various aspects of functional and structural human genomics, and her contributions include pioneering cross-species DNA sequence comparisons between humans and mice, generating the content now publicly available in the “HapMap Phase II,” and developing novel methods for identifying and functionally annotating variants underlying GWAS signals. Dr. Frazer’s current research studies are supported by the National Institutes of Health, the K.G. Jebsen Medical Foundation, the California Institute for Regenerative Medicine as well as industry and cross-institutional collaborations. Back to Top Page 'Breadcrumb' Navigation: Kelly Frazer PhD Kelly Frazer, PhD Lab Wiki Explore other UCSD Health Sciences Sites UC San Diego Health System UCSD School of Medicine UC San Diego Health Sciences UC San Diego Genome Information Sciences • 9500 Gilman Drive• La Jolla, CA 92093 • 858-822-0837 Official Web Site of the University of California, San Diego. Regents of the University of California. All rights reserved.

医学

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(http://womensenews.org/2009/09/industry-feds-entice-black-mothers-bottle-feed_2/) Black Maternal Health Industry, Feds Entice Black Mothers to Bottle Feed By: Molly M. Ginty | September 22, 2009 More on Black Maternal Health Subscribe to Black Maternal Health (WOMENSENEWS)--Four African American women gather for a baby shower. Two rave about an infant formula's new packaging. And one cuddles a sleeping newborn. These images fill the Web site for Similac, the most popular infant formula in the United States. Enfamil and other leading brands also publish ads featuring African Americans. "Since 1999, infant formula advertising increased from 7,000 print and television ads to 10,000 per year," says Mishawn Purnell-O'Neal, founder of the Chicago-based Breastfeeding America and author of "Breastfeeding Facts Over Fiction: Health Implications on the African-American Community," published in 2001. "With this aggressive marketing, it stands to reason that breastfeeding rates across all races, and particularly rates among African American women, do not meet government health objectives." Along with a growing number of black women's advocates, Purnell-O'Neal is sounding an alarm about two major ways that formula companies (which derive $4 billion of their $8 billion worldwide sales from the U.S. market) target African Americans: through government food subsidy programs and formula giveaways at public hospitals. "These particular forms of marketing have a high impact on the black community," she says. "And they help account for the fact that black women have low rates of breastfeeding." In April 2008, a report from the Atlanta-based Centers for Disease Control and Prevention indicated black women are less likely to breastfeed than white or Latina women. Only 65 percent of African American mothers had ever tried breastfeeding. And only 20 percent were following government recommendations and exclusively nursing when their infants were six months old, compared to the 40 percent of white women who did so. "The same health problems that are common in the African American community--asthma, obesity, diabetes and childhood infections--are problems that could be reduced through more breastfeeding," says Miriam Labbok, a professor of maternal and child health at the University of North Carolina at Chapel Hill. Lower Nursing Rates for Black Women Both the International Formula Council, a manufacturers' coalition based in Atlanta, and Bristol-Myers Squibb, the nation's top-selling infant formula maker, based in Princeton, N.J., deny making a special effort to market to black customers or track sales within this ethnic group. Researchers say one reason black women breastfeed less is that many rely on formula dispensed by WIC, the shorthand name for the federal government's Special Supplemental Nutrition Program for Women, Infants and Children, which was founded in 1972 and provides vouchers for free food to low-income mothers. The majority of WIC participants are white. But African Americans--just 12 percent of the U.S. population, according to the U.S. Census Bureau--account for a disproportionate 20 percent of WIC families, a total of 420,000 people, according to the program's parent agency, the U.S. Department of Agriculture. WIC's African American clients are less likely than its white clients to receive breastfeeding advice from WIC counselors and are more likely to receive tips on bottle feeding, found a 2003 study from the New York-based Commonwealth Fund. More than half the infant formula sold in the United States is distributed through WIC, and this greatly inflates formula's overall demand, according to a 2007 University of Hawaii study. WIC distributes nearly 700 million cans of formula annually, according to Department of Agriculture records, at a cost of $578 million. "Individual handouts don't last a full month," says Labbok. "A woman who uses formula continuously will need to go out and buy some on her own to supplement her monthly WIC subsidy." WIC Changes Approach In recent years, in response to studies about the health benefits of breastfeeding, WIC has started to actively encourage its recipients to breastfeed. In 2009, the program plans to spend $51 million to promote breastfeeding. It will continue giving formula vouchers to recipients who want formula. But it will also offer pamphlets and counseling sessions on breastfeeding to recipients and their partners, and will offer special incentives (such as a greater variety and quantity of food vouchers) to recipients who do choose to breastfeed. The program may need to do more to change some of the negative press and findings. Enrolling in WIC makes a woman half as likely to breastfeed as a non-WIC woman in the same income bracket, according to a 2005 study by the Centers for Disease Control. In 2006, a report by the U.S. Government Accountability Office found that most states allow formula makers to use the WIC acronym and logo in their ads in violation of the program's rules. "In inner-city communities where most residents are black, these ads for formula assistance and formula giveaways are everywhere," says Kathi Barber, founder of the Baltimore-based Black Mothers' Breastfeeding Association and author of "The Black Woman's Guide to Breastfeeding." Hospital Handouts Health advocates say that like WIC giveaways, the practice of offering new mothers free "hospital discharge bags"--also started in the 1970s--boosts black women's formula use. "Research shows commercial discharge bags from formula companies disproportionately impact women of color," says Melissa Bartick, chair of Massachusetts Breastfeeding Coalition, in Weston, Mass. "And women who get these bags are more likely to start using formula instead of exclusively breastfeeding." Mothers who receive discharge bags become habitual formula consumers more often than mothers who don't, according to a 1992 study in the Journal of Human Lactation. Through a national campaign called "Ban the Bags," more than 200 U.S. hospitals and birthing centers have stopped distributing formula discharge bags. Seventy hospitals in the United States have won "baby friendly" designation from the Geneva-based World Health Organization for refusing any form of formula companies' freebies and for promoting breastfeeding. Despite efforts like these, 93 percent of U.S. hospitals still hand out discharge bags, according to a study conducted by Boston University School of Medicine researchers and presented in October at an American Public Health Association meeting. Health advocates say that whether formula giveaways come from food subsidy programs or maternity wards, they have the same effect: enticing African American mothers--and mothers of all races--to rely on formula. "When government agencies, doctors and nurses hand out infant formula, mothers naturally assume that authorities are endorsing this product as the healthiest choice," says Deborah McCarter-Spaulding, an assistant professor of nursing at Saint Anslem College in Manchester, N.H. McCarter-Spaulding's studies indicate black women of distant African descent have less confidence in their ability to breastfeed than black women who come from the Caribbean or directly from Africa. After three decades of receiving formula handouts, black women whose families are long-established in the United States are thus more likely to bottle feed than black women who are recent immigrants, she found. This series is supported by the W.K. Kellogg Foundation. About Molly M. GintyMolly M. Ginty is a freelance writer based in New York City. More by Molly Health & ScienceBlack Maternal HealthMaternal Mortality LikeTweet EmailPrint Black Infant Mortality Points to Moms’ Crying Need By: Kimberly Seals Allers | September 22, 2009 During Infant Mortality Awareness Month, Kimberly Seals Allers would like to spur a public conversation about racial health disparities and reducing the pressures on black motherhood. Lawmakers Join Push to Close Maternal Health Gaps Advocates say a focus on maternal health is a critical component of any meaningful health care reform. Addressing deep racial disparities in maternal death rates remains an urgent priority in national reforms that promote women's wellbeing. Related SeriesBlack Maternal Health: A Legacy and a Future Comments are closed.

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

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International Essential Tremor Foundation to Facilitate Educational Seminar in Suffern, N.Y. Understanding Essential Tremor: The Diagnosis Process and Treatment Options Hannah Anthony - Fort Worth, TX teen affected by essential tremor At these seminars people will gain a better understanding of their condition and what options for treatment are available. Lenexa, KS (PRWEB) The International Essential Tremor Foundation (IETF) will host a free seminar in Suffern, N.Y. on the life-altering neurological condition called essential tremor (ET). The seminar will take place on Saturday, October 12, 2013 at the Crowne Plaza Hotel located at 3 Executive Blvd. in Suffern, N.Y. The program will run from 9:30 to 11:30 a.m., with a question and answer session with the physicians directly following the presentation. More information, including driving directions and event registration, is available by phone (toll free) at 888.387.3667 or on the web at http://www.essentialtremor.org/seminars. Essential tremor patients, family members, caregivers, and health care providers are invited to attend this special, free, educational seminar. Local physicians Blair Ford, MD - Movement Disorders Neurologist with Columbia University, Division of Movement Disorders, and Sameer A. Sheth, MD, PhD - Neurosurgeon with Columbia University will discuss the diagnosis process for essential tremor, commonly prescribed medications, surgical options, current scientific research, support groups and more. Attendees will be provided with an essential tremor information packet to take home and share with friends, family and their own health care providers. Refreshments will be served and parking is free. “The IETF is dedicated to offering hope to those affected by essential tremor,” explains Catherine Rice, IETF executive director. “The Foundation actively works to generate greater awareness of the condition, fund critical scientific research in order to fully understand the causes of ET and offer support to those affected by this life-altering condition. At these seminars people will gain a better understanding of their condition and what options for treatment are available. Hopefully they will also realize, as they look around the room, that they are not alone in this condition; that there are millions all over the world affected, just like them.” ET, which affects nearly 10 million people in the U.S., is the most common neurological movement disorder, but is frequently misdiagnosed as Parkinson’s disease. The condition is often characterized by rhythmic, involuntary and uncontrollable shaking of the hands and arms during movement, making daily tasks such as eating, drinking and writing difficult if not impossible. Sometimes ET can also affect the head, voice, legs and trunk. At this time there is no cure for essential tremor. About The International Essential Tremor Foundation: Headquartered in Lenexa, KS, and founded in 1988, the International Essential Tremor Foundation is the leading organization in the world dedicated to those affected by essential tremor. The mission of the IETF is to fund research that will find the cause of essential tremor and lead to better treatments and a cure, increase awareness about ET, and provide educational materials, tools and support to healthcare providers, the public, and those directly affected by ET. The IETF has distributed more than $685,000 in research grants, to fund 27 promising studies, in the search for the cause of ET. The Foundation has hosted numerous community awareness events across the U.S. to provide those affected with the basic knowledge necessary to become their own advocate when seeking treatment. And, the IETF also provides assistance to a vast network of support groups around the world. To learn more about essential tremor and the IETF mission, visit the IETF website at http://www.essentialtremor.org. For comment/interview, contact: Catherine Rice, Executive Director info(at)essentialtremor(dot)org Catherine Rice Int'l Essential Tremor Foundation +1 (888) 387-3667

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Leon Tauer received 40 units of blood after farm accident. You don't need a special reason to give blood–you just need your own reason.For Leon Tauer, he says his reason is to give back."Accidents are something that people don't think will happen to them," said Leon of a farming accident nearly 30 years ago that required him to receive 40 units of blood over the course of a 21-day hospital stay.It happened on May 13, 1984.Leon was outside filling the planter with fertilizer to do a couple more passes before him and his wife, Lorraine, headed into town for the Cadillac supper."Back in those days we could buy a raffle ticket for $100 a piece and a chance to win a car," Leon explained.He was alone on the farm yard filling up the planter to finish out the day.Thankfully, his son, Loren, was in a nearby field and happened to come on the yard and see his Dad laying on the ground."He stopped when he saw me laying in the yard and asked me what happened," Loren recalled. "I remember telling him my head hurt."What Leon believes happened is that while he was filling up the planter the tractor moved and ran him over. His family rushed him to the hospital where Dr. Murthy put in seven stitches under his eye. Loren said that is the last thing he remembers for the next 21 days."The rest of the story is just what I've been told," Leon added.It was decided at the Sleepy Eye Medical Center that Leon's condition was serious enough that he would need to be transferred. After some collaboration with the family, it was decided that Leon would be flown by helicopter to St. Mary's Hospital in Rochester.It was discovered after the transfer that Leon had suffered seven broken ribs, a punctured lung and his liver had been cut in three places, which Leon added, was the reason he needed so much blood.On the helicopter ride to the hospital, Leon said he was told he received 8 units of blood, his heart stopped beating and he stopped breathing somewhere over Owatonna.Once arriving at St. Mary's, and after determining the extent of Leon's injuries, he was taken to surgery where his liver was packed with gauze. He remained unconscious for 10 days. Three days after the first surgery, Leon said he was told that his kidneys began to fail and at that time two gallons of blood had been pumped from his stomach from the liver lacerations. Throughout his 21-day stay at St. Mary's Hospital in Rochester, Leon said he received a total of 40 units of blood."You think something like this will never happen to you, but it does happen," Leon said. "That's why giving blood is so important."After 15 days, Leon was moved from the intensive care unit where, according to Leon, it was just a matter of laying in bed and healing.Today, Leon still farms with his son, Loren, and looks forward to turning 81 on Jan. 11. He says without the help of his wife, Lorraine, who has been with him every step of the way, the dedicated Red Cross Bloodmobile coordinators and the gift of blood, Leon wouldn't be where he is today."I'm very thankful to be here and the people who donate blood are amazing," Leon added. "Give blood. I'm proof that it can save a life."On Jan. 14 the American Red Cross will hold a bloodmobile at the Eagles Orchid Inn, 500 Burnside, from 1 to 7 p.m."Donating blood is one of the simplest things you can do to help save a patient's life," said Geoff Kaufmann, CEO of the Red Cross North Central Blood Services Region. "For the hour it takes to give blood, there could be a whole community of people thankful for another birthday you have given to their loved one."According to the American Red Cross, every two seconds someone in the U.S. needs blood. In 2006, the American Red Cross collected 16 million donations in the U.S. with 9.5 million people donating.Donating blood is a safe process and takes four simple steps: registration, medical history and a mini-physical, donation and refreshments. During the mini-physical, the donor's temperature, blood pressure, pulse and hemoglobin are checked to ensure it is safe for the donor to give blood. The actual blood donation typically takes 10-12 minutes, while the entire process from the time the donor arrives until they leave takes just over an hour. All donated blood is tested for HIV, hepatitis B and C, syphilis and other infectious diseases before it is released to hospitals.There are four types of transfusable products that can be derived from blood: red cells, platelets, plasma and cryoprecipitate. Typically, two or three of these are produced from a pint of donated whole blood. Each donation can save up to three lives.Type O-negative blood is needed in emergencies before the patient's blood type is known and for newborns who need blood.The American Red Cross blood program started in 1940 and supplies approximately 40 percent of the nation's blood supply and for patients in nearly 3,000 hospitals across the U.S.

医学

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Health Story News for Healthier Living New Strategy Helps Young Lymphoma Patients Avoid Radiation TreatmentWEDNESDAY, April 10 (HealthDay News) -- A new treatment approach may mean that young people with a form of lymphoma can go without radiation therapy, sparing them side effects or raised cancer risks down the road. In a trial conducted by the U.S. National Cancer Institute, nearly all patients with a form of cancer known as primary mediastinal B-cell lymphoma who received chemotherapy, but did not undergo chest radiation, achieved a full remission. Standard treatment for this cancer typically includes radiation to the chest, the study authors pointed out, but this has been linked to significant harmful effects in the future, particularly for women. "These results are exciting and demonstrate that, using this approach, almost all patients appear to be cured and very few patients require radiation," study co-author Dr. Kieron Dunleavy, of the U.S. National Cancer Institute, said in an agency news release. One expert not connected to the study agreed. "This study is a significant achievement in improving the care of a group of lymphoma patients that urgently need it: young patients with an aggressive and -- if left untreated -- rapidly lethal disease," said Dr. Joshua Brody, assistant professor of medicine at the Icahn School of Medicine at Mount Sinai in New York City. The study "yielded very exciting success rates with almost all patients going into complete remission even without the use of radiation therapy, which is frequently used for this disease," Brody added. All of the patients in the study maintained remission "for a long time," he noted, and "most of the patients are certainly cured of their disease." The study is published in the April 11 issue of the New England Journal of Medicine. Primary mediastinal B-cell lymphoma usually affects people in their teens to early 30s. Although many people with the disease who are treated with both chemotherapy and radiation do achieve a cure, roughly 20 percent do not, according to an NCI news release. The research team noted that radiation to the chest area could also boost a patient's risk for other types of cancer down the road, including breast cancer, as well as cause damage to the heart. Complicating matters, as young people age, their risk for heart disease and new forms of cancer also rises. The NIH trial involved 51 patients with untreated primary mediastinal B-cell lymphoma who were followed over the course of 14 years. The largest tumor diameter of any patient in the study was 11 centimeters. Each patient received a regimen of drugs known as dose-adjusted EPOCH-R. The regimen included the following drugs: etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone and rituximab. The dosages of these drugs were adjusted to make them as effective as possible. In the study, only two patients who received this dose-adjusted chemotherapy treatment did not go on to achieve complete remission. These two patients, the researchers noted, also received radiation and have not had their tumors come back. Meanwhile, none of the patients who did achieve a complete remission experienced disease recurrence. The researchers added there were no signs of heart damage or other long-term negative health effects among the patients. "The high success of this regimen in greatly reducing the need for radiation and improving the cure rate in this disease may relate to specialized dosing and continuous infusion delivery of the EPOCH-R agents," explained lead researcher Dr. Wyndham Wilson, head of the NCI's Lymphoma Therapeutics Section. Wilson and his colleagues also collaborated with researchers at Stanford University who used the regimen to treat their own group of 16 slightly older patients with primary mediastinal B-cell lymphoma. The Stanford study found all 16 patients who received the dose-adjusted chemotherapy regimen achieved full remission and none of them required radiation. Other experts were optimistic about the research. "What is encouraging is the fact that so many patients did well without radiotherapy, which will reduce the risk these patients have of developing late complications, including secondary solid tumors, acute leukemia and cardiac disease," said Dr. Jonathan Kolitz, associate chief of hematological oncology at the North Shore-LIJ Cancer Institute in Lake Success, N.Y. He stressed, however, that more research needs to be done to confirm that the new approach "is truly superior to the more conventional administration" used today. Dr. Alan Astrow is director of hematology/medical oncology at Maimonides Cancer Center in New York City. He called the findings "highly impressive results." "It appears that radiation therapy is not required for patients with primary mediastinal B-cell lymphoma who achieve a complete response after treatment with the reported chemotherapy regimen," he said. For his part, Brody said the new results are exactly what most physicians long to see. "Oncologists go into this business to try to save lives but, truthfully, the opportunity to save the lives of young, healthy people, and give them back a whole lifetime of quality time . . . is particularly gratifying," Brody said. The Leukemia & Lymphoma Society provides more information on lymphoma. -- Mary Elizabeth DallasHealth News Copyright © 2013 HealthDay. All rights reserved.

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HomeHutch NewsNews Releases NCI taps three Fred Hutchinson Cancer Research Center scientists for its ‘Provocative Questions Project’ SEATTLE – Oct. 25, 2012 – Three investigators at Fred Hutchinson Cancer Research Center have won awards totaling nearly $3.6 million from the National Cancer Institute to participate in its “Provocative Questions Project” – an opportunity to address “potentially game-changing scientific questions” that could influence future directions of NCI-sponsored research. Denise Galloway, Ph.D., and Patrick Paddison, Ph.D., of the Hutchinson Center’s Human Biology Division and Robert Eisenman, Ph.D., of the Basic Sciences Division are among 57 U.S. investigators to receive the NCI’s first set of Provocative Questions awards. In 2010, NCI director Harold Varmus led a series of workshops to define new directions for U.S. cancer research with the goal of ultimately funding more challenging and more creative research projects. The group came up with 24 questions to guide such research and put out a call for applications; this year’s awards go to projects that will attempt to answer 20 of those questions. Below are the three questions Fred Hutch researchers are addressing. “Given the recent discovery of the link between a polyomavirus and Merkel cell cancer, what other cancers are caused by novel infectious agents and what are the mechanisms of tumor induction?” In collaboration with others at the Hutchinson Center and at Washington University in St. Louis, Galloway will look for new links between infection and cancer. Nearly 20 percent of the world’s cancers are caused by infections, and these cancers are even more prevalent in immunosuppressed people, such as HIV-infected individuals and organ-transplant recipients, because dampened immune systems are less able to defend against the cancer-causing viruses. Well-known examples of infection-associated cancers include cervical cancer, which is caused by human papillomaviruses (HPV), and liver cancer, which is caused by hepatitis B virus (HBV). Galloway’s group was instrumental in drawing a definitive link between HPV, cervical and other anogenital cancers. Her group will screen human DNA and RNA from tumor samples for the genetic signatures left by viruses and bacteria. The samples will come from HIV-positive patients at the Uganda Cancer Institute with lung cancer, non-HPV-associated genital cancers, or certain types of lymphomas. Uganda has one of the world’s highest rates of infection-associated cancers, in part because of the high levels of HIV infection in that country. The cancer types Galloway’s group are studying occur at much higher rates in HIV positive and other immunosuppressed people, so she suspects that some or all of these cancers may have infectious roots that are yet to be uncovered. “If we find even one virus that’s associated with one type of cancer, it will make a huge difference,” Galloway said. “Why do certain mutational events promote cancer phenotypes in some tissues and not in others?” Despite certain similarities among all cancer cells, cancers in different tissues tend to behave very differently. For example, spontaneous mutations in certain genes can frequently lead to cancers in one tissue type but not another. The growing tumor’s local environment is clearly very important to its specific development, but researchers currently understand very little about these tissue-specific effects. This means that we lack targeted therapies for most cancer types. Paddison and colleagues are studying gliobastoma multiforme, the most aggressive and common form of brain cancer in adults. They have developed a technique to isolate the tumor-forming stem cells from patients’ tumors and grow them in the lab, meaning they have patient-specific experimental models of tumor cells. Unlike traditional cancer cells used for lab experiments, the cells Paddison studies retain their patient- and tissue-specific genetic and epigenetic characteristics. In collaboration with Seattle biotechnology company Sage Bionetworks, Paddison’s group is using a gene knockdown technology called RNA interference to disable genes one at a time in these brain tumor cells to determine which genes are necessary for the tumor’s survival. This project will help the researchers understand which cellular processes are important for brain tumor development and survival, and it ultimately could lead to targeted therapies for glioblastomas. “Are there new technologies to inhibit traditionally “undruggable” target molecules, such as transcription factors, that are required for the oncogenic phenotype?” Transcription factors, proteins that activate or de-activate genes, play important roles in cancer development but have traditionally proved to be difficult drug targets. Eisenman studies the transcription factor known as Myc, which is involved in activating many different genes in many different cell types. His group has characterized how Myc goes haywire in cancerous cells, and has found many other proteins that interact with Myc to regulate its function. In healthy cells, Myc’s gene-activating activity is balanced by another protein, Mxd, which represses many of the genes that Myc turns on. “When Myc is deregulated in cancers, this balance is lost,” Eisenman said, and many genes that would normally remain silent are aberrantly activated. Inhibiting Myc’s abundant activity in cancer cells could vastly improve cancer treatments, but finding drugs to bind and disrupt Myc has been difficult due to its large binding surfaces. Eisenman’s group plans to use a type of experimental evolution to find a protein piece that can disrupt Myc but not Mxd. They’ll do this by rapidly changing the peptide’s sequence in the lab and selecting for those that best bind to Myc. The researchers will then test whether these potential anti-Myc drugs can kill off cancer cells in the lab. At Fred Hutchinson Cancer Research Center interdisciplinary teams of world-renowned scientists – including three Nobel laureates – seek new and innovative ways to prevent, diagnose and treat cancer, HIV/AIDS and other life-threatening diseases. The Hutchinson Center’s pioneering work in bone marrow transplantation led to the development of immunotherapy, which harnesses the power of the immune system to treat cancer with minimal side effects. An independent, nonprofit research institute based in Seattle, the Hutchinson Center houses the nation’s first and largest cancer prevention research program, as well as the clinical coordinating center of the Women’s Health Initiative and the international headquarters of the HIV Vaccine Trials Network. Private contributions are essential for enabling Hutchinson Center scientists to explore novel research opportunities that lead to important medical breakthroughs. For more information visit www.fhcrc.org or follow the Hutchinson Center on Facebook, Twitter or YouTube. Kristen Woodward kwoodwar@fhcrc.org

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South Pole Stroke Victim Arrives in New Zealand By Kevin Dolak More from Kevin KATTI GRAY Star PlayABC NewsWATCH Possible Stroke Victim Rescued from South Pole Email Renee-Nicole Douceur, who suffered an apparent stroke at the South Pole in the dead of winter, landed at a New Zealand airport today after an emergency evacuation. Douceur, 58, boarded a U.S. Air Force cargo plane that took off from McMurdo in Antarctic today and landed at the Christchurch airport at about 5 a.m. ET. Douceur and a medical attendant were taken from her Amundsen-Scott research station. After landing, she was taken to a hospital in New Zealand. "I was worried about ... whether it could do some more serious damage ... or a stroke or who knows what else. ... They kept the plane at very low altitudes so the aircrew knew what to do if there was something that had happened to me," Douceur said after arriving in New Zealand. Researcher Douceur said the first response she received from officials with the company that operates the site, Raytheon, seemed sympathetic to her plight, despite the highly dangerous flight conditions at this time of year. "The Denver people had told me, 'We'll get you out as soon as possible, within a couple weeks.' Then, all of a sudden ... it's like, 'Oh no, she's just going to go out on a regular scheduled flight,'" she said. She was evacuated seven weeks after suffering what might have been a stroke at the research site. Raytheon operates the site for the National Science Foundation and Douceur said she was stunned when the company told her no special flight would be scheduled for her evacuation because of dangerous flight conditions. "As far as going for medical services, it's just more of a mere convenience than a medical necessity ... and I'm saying a person who had a stroke and needs an MRI and every other testing ... is that just a convenience? I don't think so," she said. Douceur will receive a CAT Scan and MRI Tuesday morning, and then will move on to Johns Hopkins medical center. Rescuing Douceur from her South Pole station was a controversial effort. Because it is still winter at the pole, with temperatures as low as 58 degrees below zero at last report. In October, less than a month after the equinox, there is constant twilight. Winds can kick snow hundreds of feet into the air, making it dangerous for a plane to land on the ice. "'Hastily. Quickly. Needs to get out of here.' That has been the theme from all the doctors here," Douceur told "Good Morning America" via telephone Saturday. A cargo plane designated for her rescue headed from Chile toward the South Pole Friday, but blizzard winds and blinding snow prevented the aircraft from landing safely. Sub-zero temperatures and storm conditions for months have prevented planes from landing at the National Science Foundation's South Pole research station where Douceur works. "As I sit here waiting, who knows what is going on inside me. I don't know what is inside me," Douceur of Seabrook, N.H., said, adding that she had impaired speech and vision. "I am very concerned about my health and the possible consequences of staying here." Dr. Paul Nyquist of Johns Hopkins University in Baltimore said it was hard to diagnose Douceur from a distance, and without the right equipment. "If she had a disease that was potentially treatable at this point -- and was stuck in Antarctica undiagnosed and waiting -- that would be a bad thing for her," Nyquist said. An airlift to New Zealand, which houses the nearest full-service hospitals, might exacerbate her illness, given the uncertain effects of airplane cabin pressure and oxygen levels, he said. Doctors have said that a tumor might be causing her vision and speech problems. The last risky medical evacuation from the South Pole was that of Jerri Nielsen Fitzgerald, a physician who had diagnosed and treated her own breast cancer until she could be flown out in 1999. " Stroke Victim Rescued from S. Pole " Clinton Foundation Official Requests State Lunch Access, Emails Show " Clinton Receives 1st Classified Briefing as Democratic Nominee " Southwest Flight Forced to Make Emergency Landing " Student With Down Syndrome Who Went Viral to Start College " Officer Calms Girl Who Is Afraid of Police " This One-of-a-Kind House Is Inside an Airplane Hangar " 'Baby Simulator' Programs May Make Teen Girls More Likely to Become Pregnant " Prince William and Kate Open up About Parenting " This Sleeping Beauty Plays Dress Up With Her Mom While She Naps " Video Shows Teen Who Was Shot by Police in 2013 Appearing to Surrender The Embrace of Life: A Story of 2 Sisters in Italy's Quake " Everything You Need to Know About Burning Man " See This, Skip That: Visit the Smallest National Parks

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Health Policy Commission to review Partners HealthCare plan to acquire South Shore Hospital By Robert Weisman The state’s new Health Policy Commission is moving forward with a cost and market impact review of Partners HealthCare System’s plan to acquire South Shore Hospital in Weymouth, the first test of its ability to influence the ongoing hospital consolidation trend in Massachusetts. A statement issued by the commission staff Wednesday afternoon said executives at South Shore and Boston-based Partners, which owns Massachusetts General and Brigham and Women’s hospitals, were notified that the commission will examine how the proposed merger of the two highly paid health care providers is likely to affect costs and the state’s health care market. The commission was created by last year’s state health cost containment law as a watchdog to monitor changes in the health care business. It was formed at a time when providers have been banding together to better coordinate care while insurers have been shifting toward fixed payments for overall patient care rather than reimbursements for individual doctors’ visits, tests, and procedures. It was widely expected that the commission staff would review the Partners-South Shore alliance, the largest merger now underway. Commission executive director David Seltz is scheduled to report to the 11-member panel on June 19 regarding the staff’s initial findings. The commission will then determine whether to move forward with a more intensive review. The proposed acquisition already has been approved by the state Department of Public Health, which last month granted a license to transfer ownership of the 378-bed Weymouth hospital to Partners. The commission is also set to decide by June 6 whether to review two other hospital merger deals: Mass General’s proposed takeover of Cooley Dickinson Hospital in Northampton, and the Beth Israel Deaconess Medical Centers plan to acquire Jordan Hospital in Plymouth. Robert Weisman can be reached at weisman@globe.com. Follow him on Twitter @GlobeRobW. Most Popular

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When medical marijuana goes bad: What should misuse of a state program mean for Massachusetts? Few opponents of a ballot question that would legalize the use and distribution of marijuana for medical use stake their argument on whether the drug benefits people who are suffering from pain, nausea, or other effects of long-term medical problems. Many are focused on how medical marijuana programs can go awry. I wrote in today’s G section about concern among substance abuse doctors and researchers that medical marijuana will lead to increased use of the drug among teens and adolescents whose developing brains are particularly vulnerable to its effects. Recent studies have found that the drug can have long-term effects on cognition and mental health, particularly for those who begin using it when they are young and continue over time. Others point to drug trafficking issues. The Oregonian published a series of stories this weekend outlining how marijuana ostensibly grown for medical use has been shipped to dealers across the country. Oregon voters passed a ballot measure in 1998 legalizing production and use of marijuana by patients with certain medical conditions and a doctor recommendation. Advertisement - Continue Reading Below Reporter Noelle Crombie detailed a story of a woman licensed to grow medical marijuana who was caught attempting to ship 74 pounds of marijuana in a cargo container bound for Boston. Crombie writes: Authorities found 350 pounds of medical marijuana in packages moving through the U.S. mail facility in Portland from October 2011 through May of this year. They also discovered a half-million dollars in cash—proceeds from the sale of medical marijuana—in packages mailed to Oregon addresses. The incentive to move Oregon medical marijuana out of state boils down to simple economics. It goes for $1,000 to $3,000 a pound in Oregon, law enforcement officials say. Once it reaches the Midwest and East Coast, Oregon pot can net up to $5,200 a pound. In separate stories, Crombie outlined how some growers participate in “card stacking,” becoming caregiver to multiple patients in order to increase the amount of pot they are able to grow legally. And she wrote about how convicted felons, including some with a drug history, are eligible to become cardholders. Some say health concerns and even the changing black market support the case for widespread legalization of marijuana for medical use, because such laws provide a path to better regulation. Dr. Eric Ruby, a pediatrician in private practice in Taunton, e-mailed me this morning after reading about the drug’s effects on teens. Ruby, who also has advocated for the ballot question that would allow doctors to prescribe life-ending drugs to people who are terminally ill, said his patients’ families want access to medical marijuana. He wrote: We know tobacco causes lung disease, worsens heart ailments, and is the leading cause of death from disease in the United States. We regulate it, we tax it and we allow for individual choice and its consequences. We know that liquor causes cirrhosis. We regulate it, we tax it, and we allow for individual choice and its consequences. We are involved in the legalization of gambling in Massachusetts even today. The Commonwealth benefits from it financially knowing full well what public health consequences may result. I won’t even talk about guns. In so far as medical marijuana is concerned, if revenue is an issue, here is a solution. If crime is an issue, here is a solution. If clinical trials are an issue, have the FDA reclassify THC. There are already more significantly more expensive, toxic and addictive pharmaceuticals approved. If quality control is an issue, this is the way to protect our population. What’s your take on medical marijuana, readers? Is its prohibition in Massachusetts an inadequate substitute for better regulation or necessary to protect public health? Chelsea Conaboy can be reached at cconaboy@boston.com. Follow her on Twitter @cconaboy. Most Popular

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Listeria Outbreak Claims Maryland Woman’s Life Filed Under: Cantaloupe, Colorado, Death, Illness, immune system, Listeria, tainted fruit BALTIMORE (WJZ)– A deadly listeria outbreak claims the life of a Maryland woman. Kai Jackson reports how the bacteria is spreading across the country through fruit. Consumers across the nation are on edge, and now the fear has spread to Maryland. The bacteria has gotten into cantaloupes in more than a dozen states. The Centers for Disease Control says eight people have died from eating listeria tainted cantaloupe–four in New Mexico, two in Colorado, one in Oklahoma and most recently a person in Maryland. Leigh Chapman is the infection prevention coordinator at St. Joseph Medical Center. “Listeria is a bacteria that is found in water and soil,” Chapman said. “When consumers purchase a cantaloupe and bring it home, they are not washing the outside of the fruit and using the knife to cut and that is how people have gotten sick.” The tainted cantaloupe has been traced to a farm in Holly, Colo. The fruit was shipped July 29 through Sept. 10. In addition to the deaths, 55 people in 14 states have become sick from the cantaloupe. The labels are Colorado grown, Frontera Produce, Jensen Farms, and Sweet Rocky Fords. Experts say most healthy adults can consume listeria without getting sick, but it can kill the elderly and people with compromised immune systems. Angel says: September 24, 2011 at 11:14 am Thank GOD we got the media to help us report these types of mishave in our World. We all know nothing is perfect and there will be cautions and problems as we live our lives…Thanks to the Media we can caught these mishave…GOD Bless the families who have lost their loved one…

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Slow Obamacare payers may cut total enrollee figures, but jury still out April 2, 2014, 5:24 PM ET By Russ BrittOne of the central questions making the rounds in the wake of Obamacare’s open enrollment period is how many of those who signed up are actually paying their premiums, and how that will play into the final tally. Reports are circulating that roughly 15% to 20% of those who fully enrolled in insurance plans under the Affordable Care Act had yet to pony up their premiums, perhaps letting a little air out of the Obama administration’s proclamation that the program was able to sign up 7.1 million-plus participants by the end of the open enrollment period on March 31. That would bring the fully paid number down to less than 6 million. It seems that doesn’t tell the whole story, though. The Blue Cross Blue Shield Association is reporting that it has received payments from 80% to 85% of those who signed up, but that was as of Feb. 1. It’s unclear how many have sent in their check since that time and how many will send in their money, a spokesman said. The group of insurers won’t drop any of those who have yet to pay, he added. Further, Obamacare is proving to be a different kind of beast in the mechanics of how it works. Before Obamacare, individual policy purchasers had to pay up front, but those who buy policies through the exchanges aren’t able to pay up front. So it’s hard to read what the 80% to 85% figure on those who have paid up actually means. Don’t forget that states operating their own exchanges had yet to report their numbers, and a fair number of those who couldn’t fill out their applications in time could drive the enrollment number up as well. No tallies are available yet, but Blue Cross/Blue Shield plans are likely going to end up with the largest share of all plans sold through the exchanges. The association of 37 plans has 100 million members, or one-third of all those on health plans in the nation. Further, 35 of those 37 plans are participating in Obamacare. There are only three states in which Blue Cross/Blue Shield is not participating: South Dakota, Iowa and Mississippi. Follow Russ Britt on Twitter @russbrittmktw. Follow Health Exchange on Twitter @MWHealthBlog. Myriad shares soar after company gets a Medicare raise MannKind shares nearly double on FDA panel’s decision Obamacare Round 2: Getting ready for next sign-up period Blue Cross Blue Shield Association, enrollment, health care, Obamacare « Previous Myriad shares soar after Medicare reimbursements get a 37% boost Next » Party drugs to cure depression? British scientists say it’s possible Share:

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Blistering exposé prompts Johns Hopkins to suspend black-lung screenings By John Upton on Nov 4, 2013 Share The coal industry has a decades-old friendship with Johns Hopkins University, but now that cozy relationship is being torn apart by the scrutiny of investigative journalists. When employees filed for black-lung-related benefits, coal companies paid the Baltimore-based university handsome sums to screen the claimants for the disease. After reviewing chest X-rays, the university’s scientists almost always concluded that the scans did not show black lung — a conclusion which often overwhelmed any other medical opinion in the case. (Black lung disease, or coal workers’ pneumoconiosis, kills an estimated 1,500 former coal miners every year. It is a painful and preventable ailment contracted by inhaling coal dust.) The racket was exposed by the ABC, working in partnership with the Center for Public Integrity: For 40 years, these doctors have been perhaps the most sought-after and prolific readers of chest films on behalf of coal companies seeking to defeat miners’ claims. Their fees flow directly to the university, which supports their work, an investigation by the Center for Public Integrity and ABC News has found. According to the university, none of the money goes directly to the doctors. Their reports — seemingly ubiquitous and almost unwaveringly negative for black lung — have appeared in the cases of thousands of miners, and the doctors’ credentials, combined with the prestigious Johns Hopkins imprimatur, carry great weight. Their opinions often negate or outweigh whatever positive interpretations a miner can produce. For the credibility that comes with these readings, which the doctors perform as part of their official duties at Johns Hopkins, coal companies are willing to pay a premium. For an X-ray reading, the university charges up to 10 times the rate miners typically pay their physicians. … In the more than 1,500 cases decided since 2000 in which [senior university scientist Paul] Wheeler read at least one X-ray, he never once found the severe form of the disease, complicated coal workers’ pneumoconiosis. Other doctors looking at the same X-rays found this advanced stage of the disease in 390 of these cases. After the results of the investigation were broadcast late last week, the university announced on its website that it was suspending the screening program: Following the news report we are initiating a review of the pneumoconiosis B-reader service. Until the review is completed, we are suspending the program. United Mine Workers called on the federal government to take action following the revelations. “Whatever penalties or punitive actions that can be taken with respect to Dr. Wheeler should be,” union spokesman Phil Smith said. “But whatever they are, they will pale in comparison to the pain and suffering he has caused thousands of afflicted miners. There is no penalty which will make up for that.” Johns Hopkins suspends black lung program after Center-ABC investigation, Center for Public Integrity. Statement from Johns Hopkins Medicine Regarding ABC News Report About Our B-Reads for Pneumoconiosis (Black Lung), Johns Hopkins University. Johns Hopkins medical unit rarely finds black lung, helping coal industry defeat miners' claims, Center for Public Integrity. Share

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LifestyleHealth The interpreter of maladies The interpreter of maladies Through an array of antiquities and contemporary materials, an exhibition explores the history and modern practice of medicine in India. Written by Pooja Pillai Updated: Jan 17, 2016, 15:05 About Author Pooja PillaiPooja Pillai is a Principal correspondent working with The Indian Express. read more... Into InfinityAfter All This TimePoll Position lifestyle Tagore’s works not translated perfectly: Gulzar Designers giving Indian weaves a new context: Payal Khandwala | Updated: January 17, 2016 3:05 pm An ear cleaner at work by unknown Delhi artist, 1825; The Ayurvedic Man, an 18th century drawing, possibly of Nepalese origin “One can learn as much about civilisation from a tongue scraper, as from the Taj Mahal,” says Ratan Vaswani. The London-based curator makes this quip at the end of a long conversation about his latest project, the exhibition ‘Tabiyat: Medicine and Healing in India’. A visit to the show, which is on at the Premchand Roychand Gallery inside Mumbai’s Chhatrapati Shivaji Maharaj Vastu Sangrahalaya (CSMVS), illustrates Vaswani’s point — the large array of objects, which ranges from miniatures and manuscripts, public health posters and clothing, utensils and personal care items like combs, hair dryers and tongue scrapers, tells us how, despite our growing contemporary preference for “Western” medicine, the over two millenia-long history of Indian medicine continues to impact the choices we make, even today. “The tongue scraper is a good example of this. Most Indians still look on it as an essential part of their oral hygiene routine and yet, the earliest mention of this instrument is found in the Charaka Samhita, which is over 2,000 years old,” says Vaswani. ‘Tabiyat’ is the centrepiece of Medicine Corner, an initiative by the Wellcome Collection, a UK-based cultural venue which is a part of the Wellcome Trust, a global health charity. The Wellcome Trust was founded by Henry Wellcome, a pharmacist and medical entrepreneur, whose passion for medicine led him to amass an impressive collection on the subject, from all parts of world, spanning many centuries. Many of the objects from this collection are now at the CSMVS as part of ‘Tabiyat’, alongside exhibits from the museum’s own vast collection, private collections from across India and specially commissioned pieces. The exhibition is divided into four sections — Home, Shrine, Street and Clinic — but Vaswani’s curatorial approach is more ambitious than merely separating traditional Indian medical practices according to the spaces they occupy. While he states that there is no official manifesto for the exhibition and that the idea is to lay out the facts of history as they are, one can discern a few distinct ideas that have determined the way Vaswani has arranged the exhibits. The corridor that leads to the gallery, for example, is lined with pots of medicinal herbs like holy basil and aloe vera, following them is a set of recent photographs from Meghalaya of the Garo people, mostly Christians, working with medicinal herbs, just like their ancestors once did. Thus, Vaswani’s intention of showing the continuity of Indian medical traditions is immediately laid out for the visitor. This historical continuity is further highlighted inside the gallery, where ancient objects sit next to modern pieces. For example, a lota which was ordered via mail by Vaswani for this exhibition, sits next to an 18th or 19th century vajri, or foot scrubber, from the CSMVS permanent collection. Then there’s the gouache painting of an ear cleaner at work which was commissioned by Colonel James Skinner in 1825. Placed right below are the instruments that one of the curatorial and research associates, Lina Vincent, purchased from a ear cleaner in Mumbai. A touch of humour comes from tiny toy soldiers striking various yoga poses. Inspired by the hyper-masculine toy, GI Joe, there is something rather ridiculous about these ‘Yoga Joes’ doing the virabhadrasana or bakasana in full military gear, but to Vaswani they are also good objects with which one can comment on the journey of yoga across space and time. “I got them for a couple of dollars,” he says, “and I found them funny because in the West, there is a perception that yoga is a ‘female’ exercise. In Indian tradition, of course, yoga is meant to be a holistic system that addresses physiological, psychological and spiritual problems, but in the West, its importance has been reduced to the physical benefits that it offers. And the interesting thing is that this idea of yoga has now circled all the way back to India.” The show also confronts one with common assumptions about medicine. Vaswani says, “While Ayurveda is definitely an Indian tradition, it is not necessarily a Hindu one, as is popularly believed.” He uses Buddha with Five Ascetics, a 1948 Li Gotami copy of a Tibetan fresco, to highlight this idea, propounded by Kenneth Zysk in his book Asceticism and Healing in Ancient India. “Ayurveda is highly compatible with Buddhism. They’re both about seeking the middle path and avoiding extremes in order to find solutions to problems — physiological, for the former, and psychological for the latter.” Not that he’s trying to make a political statement, Vaswani says quickly. “We’re not trying to say anything about the efficacy of one system over another. But if there is one overriding feature to the exhibition, then it is plurality. Throughout Indian history, traditions have met and blended together, there have been syntheses between different schools of thought and this has produced a rich tradition of health and healing,” he says. For example, in the Shrine section, are wax and metal votive offerings, made in the shape of different body parts. Devotees offer these at certain shrines like Mumbai’s Mount Mary Basilica to pray for health and healing. “The metal votive offerings on display were picked up from outside St Mary’s Catholic Basilica in Bangalore and the Meenakshi Amman temple in Madurai. There is no way to tell which is from a Hindu shrine and which is from a Catholic shrine, because they’re so alike. This is a clear example of certain beliefs cutting across faiths,” says Vaswani. The synthesis of ideas is best demonstrated by a series of anatomical illustrations, beginning with a drawing from an 18th century copy of a 14th century Persian medical text called Tasrih-i-Mansuri. The circular head and squatting pose of the figure is typical of the Persian style, and one finds it imitated in an Indian anatomical painting from the 18th century. The Indian illustration reconciles the “Islamic” depiction with Hindu metaphysical ideas by superimposing the chakras on the figure, along with text in old Gujarati. One can also see evidence of a Trans-Himalayan commerce of ideas in the highlight of the exhibition, an 18th century anatomical illustration of possibly Nepalese origin called The Ayurvedic Man. This is the only known historical illustration of the human anatomy as understood by Ayurveda. A closer look at the style, particularly at the out-turned feet of the figure, shows that it is at least partly inspired by the Tibetan style of rendering anatomical drawings, as it appears in a pair of illustrations placed right next to The Ayurvedic Man. Similar to the dialogue between various exhibits in “Tabiyat”, is the dialogue between this exhibition and other events organised in Delhi and Kolkata. The series of 19th century paintings commissioned by Colonel Skinner, which depict street medical practitioners is linked with ‘Trick or Treat’, a project by Delhi-based mixed media and performance duo, BLOT!, that looks at India’s vast parallel health system of informal practices like street dentistry. In Kolkata, Latika Gupta has curated a show called ‘Jeevanchakra’, which explores the life cycle of the human body and its link to medical practices. It features photographs, videos, paintings and multimedia installations by contemporary artists like Gauri Gill, Nilima Sheikh and Mithu Sen. In fact, one of Gill’s photographs of the moment the umbilical cord is cut right after birth, is displayed at ‘Tabiyat’, establishing a direct link between the two exhibitions. When talking about the genesis of the exhibition, Vaswani often narrates his encounter with a handcart puller who told him that chewing paan is what gets him through the day. “It’s interesting he said that, because that seems to be true for a lot of Indians. And the surprising thing is that even though chewing paan is a very Indian tradition, the areca nut (betel nut) is not native to India. How then did it come to be so widely-used in India? I find that these are the aspects of civilisation, our everyday habits, which are worth enquiring into,” says Vaswani. After all, if the Taj Mahal tell us about how Indians once viewed death, the tongue cleaner shows us how we once lived.Eye 2016 The Mumbai exhibition is on till March 28. ‘Jeevanchakra’ is on till February 15. The Delhi event is on January 22. Island City high on entertainment scale: Vinay Pathak07:53 pm, Aug 28, 2016Pope Francis mulls Italy quake visit as survivors dig in07:53 pm, Aug 28, 2016Tagore’s works not translated perfectly: Gulzar07:51 pm, Aug 28, 2016Sukhbir Badal writes to Rajnath Singh seeking probe into AAP funding07:51 pm, Aug 28, 2016Designers giving Indian weaves a new context: Payal Khandwala07:49 pm, Aug 28, 2016 Pooja PillaiPooja Pillai is a Principal correspondent working with The Indian Exp... read more Into InfinityAfter All This TimePoll Position Pooja PillaiPooja Pillai is a Principal correspondent working with The Indian Exp... read more Into InfinityAfter All This TimePoll Position The Express Group

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The Infectious Disease Ontology Ontologies Development Strategy The IDO ontologies are designed as a set of interoperable ontologies that will together provide coverage of the infectious disease domain. At the core of the set is a general Infectious Disease Ontology (IDO-Core) of entities relevant to both biomedical and clinical aspects of most infectious diseases. Sub-domain specific extensions of IDO-Core complete the set providing ontology coverage of entities relevant to specific pathogens or diseases. The sub-domain specific IDO extensions currently under development are: IDO - HIV IDO - Brucellosis IDO - Dengue fever IDO - infective endocarditis IDO - influenza IDO - malaria and other vector-borne diseases IDO - Staphylococcus aureus IDO - tuberculosis IDO - Vaccines More information about each of these ontologies can be found on the IDO Extensions page. Development of the IDO set of ontologies is a community-wide effort focused on the development of a set of interoperable ontologies that together provide coverage of the infectious disease domain. The IDO set of ontologies includes a general Infectious Disease Ontology (IDO-Core) along with sub-domain-specific ontologies developed as extensions of the neutral core. This modular approach affords many benefits. Each sub-domain-specific ontology can be developed and maintained by researchers expert in that particular disease ensuring biological accuracy. The resulting division of labor allows rapid progress towards the needed set of ontologies. Coordination of the development effort through the use of IDO-Core ensures interoperability between the sub-domain-specific ontologies. The IDO ontologies are being developed in accordance with the principles of the Open Biomedical Ontologies (OBO) Foundry and with extensive use of its member ontologies. This approach ensures that IDO and its sub-domain-specific extensions have sufficient underlying formalism to support computational analyses and automated reasoning and that they are interoperable with other relevant biomedical and clinical ontologies, including those outside the domain of infectious diseases. Ontology documents, software, and issue tracking occurs at our Google code site. In recent years, the benefits of ontology for the management, integration, and processing of data and information have been realized, resulting in a surge of interest in ontology within the biomedical research community and the NIH. As yet, however, there is little ontology coverage of the infectious disease domain resulting in both an urgent need for ontology development in this field and the opportunity for a coordinated, community-wide effort rooted in ontology development best practices. To achieve this, we have formed an Infectious Disease Ontology Consortium that has as its mission the creation and maintenance of the described set of ontologies. We invite interested researchers to visit the Consortium page and to join. The IDO developers gratefully acknowledge the support of the Burroughs Wellcome Fund and the National Institute of Allergy and Infectious Diseases. Retrieved from "http://infectiousdiseaseontology.org/page/Main_Page" IDO Home IDO Consortium IDO Extensions Download IDO Browse IDO Email discussion list OBO Foundry Neurocommons Upload file Special pages This page Log in / create accountlog in with OpenID About IDO This page has been accessed 23,834 times. It was last modified at 16:35 on 28 July 2016

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In his own words: living with multiple myeloma Mike was married with 3 children and a partner at a leading management consulting firm when he was diagnosed with multiple myeloma in 1990 at age 37. He has spent the past thirteen years fighting a personal battle with myeloma, raising a family, pursuing a challenging career, and working as a volunteer and advocate with the International Myeloma Foundation, the National Cancer Institute, the Eastern Cooperative Oncology Group, and the FDA. Traveling to Hong Kong on business, I got off the plane after the long flight and found I was limping badly. When I got back to the US, I went to a sports medicine doctor who diagnosed it as sciatica and put me in physical therapy, which made me feel better. Six months later, I felt a crack while dancing, which turned out to be a plasma cell tumor breaking through the back of my pelvis. It was mind numbing. The initial shock was the need for major orthopedic surgery, involving removal of diseased bone and replacement with a donor graft, to be followed by radiation therapy. Once past that, there was the reality of myeloma, characterized as incurable with a median survival of 3 years. At first, I was overcome with grief and horror, as much for the upcoming surgical ordeal as the gloomy prognosis. Once through the surgery, though, I shifted my focus towards getting my life back, going so far as commuting daily between New York and Toronto to allow me to get my daily radiation treatments while working on a critical client assignment. How do you manage multiple myeloma? My approach to dealing with the disease has been vigilance and conservatism. I am very diligent about diagnostic tests (blood, urine, bone scans, etc.) to make sure that it doesn't sneak up on me again and cause major bone damage. And, I’ve been very conservative about treatments, avoiding the “hit it early, hit it hard” approach in favor of a minimalist strategy to knock the disease down when it rears its ugly head. That has meant using radiation repeatedly over the years in lieu of systemic therapy. It has meant selective use of low-dose systemic therapy (some chemo, some steroids, some thalidomide.) I harvested stem cells seven years ago but have not had a transplant. I’m in this for the long-term and trying to keep my options open, playing for time, because there is so much promising research—and I don’t have time to be sick! Did you have to make any lifestyle or dietary changes in response to multiple myeloma? I went through a phase where I was taking all sorts of vitamins, exotic mushrooms, and even shark cartilage. That ended when the next lesion appeared. I have endeavored to take better care of myself and live a bit more for the moment. I did get some benefit from stress reduction and meditation classes. But working to help other myeloma patients has been the most rewarding experience. The support I received from the International Myeloma Foundation led me to make a serious commitment to volunteerism and advocacy to help others battling the disease. I lead two in-person support groups and an Internet listserv for myeloma patients and caregivers. Using the knowledge I’ve gained to help others deal with the disease helps me focus on the positive. Does multiple myeloma have any impact on your family? My wife and I decided early on that as long as I was able to function normally and not in immediate danger, we would not tell the children until they were older (the youngest was 7 when I was diagnosed.) We told them almost ten years later, which was quite a relief--hiding it was getting harder and harder. And, they’ve dealt with it well. We try to live our lives as if there was no myeloma. And, the “kids” (the youngest is now 19) seem to take their cues from us. What advice would you give to anyone living with multiple myeloma? There is no known cure for myeloma, but the disease is highly treatable, and there are more treatment options today then ever before, with many more in the pipeline. It’s possible to live many years with myeloma and to have wonderful quality of life. With the progress that has been made and the new treatments being researched, the day may soon come where myeloma can be managed as a chronic disease like diabetes. There is much reason to be hopeful and there’s no reason to put your life on hold.

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

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Return to Butler County Community Page » Mercy Health’s Dr. Yousuf Ahmad Wins the 2013 Tomorrow’s Leader Award from the Catholic Health Association Contributed By: Nanette Bentley | Mercy Health Mercy Health, which provides quality care with compassion in your neighborhood through its network of care, announces that Dr. Yousuf Ahmad, Chief Transformation Officer for Mercy Health, has won the prestigious 2013 Tomorrow’s Leader Award from the Catholic Health Association (CHA). The Tomorrow’s Leaders program honors young leaders who will guide the Catholic health ministry in the future. Dr. Ahmad won the award based on the role he’s played in preparing Mercy Health for healthcare transformation. His achievements include the deployment of electronic health records throughout Mercy Health and the establishment of Mercy Health Physicians, which Modern Healthcare magazine named the nation’s hottest healthcare organization based on growth. Under his leadership, Mercy Health’s physician practices have achieved the most stringent accreditation as patient-centered medical homes and Mercy Health Select secured its status as the region’s only Accountable Care Organization. “Being named a Tomorrow’s Leader winner is an honor not just for me but for Mercy Health as whole, which is forward thinking, diverse and collaborative,” said Ahmad. “I would be remiss if I didn’t share the award with the many people who have supported me and worked side-by-side with me to help our organization achieve all that it has.” The CHA notes that the Catholic health ministry of tomorrow depends on strong leadership and passionate commitment to the healing mission. To encourage the promising young leaders of today to continue their careers in the ministry, the CHA’s annual Tomorrow's Leaders program honors an impressive cadre of dedicated, high-performing individuals who already have demonstrated commitment to advancing the mission of Catholic healthcare. Dr. Ahmad will receive his award on Monday, June 3, at the 2013 Catholic Health Assembly, taking place in Anaheim, Calif. Prior to the ceremony, Dr. Ahmad will participate in an exclusive leadership formation retreat, which will bring him face to face with senior leaders from across the ministry who are currently leading and shaping Catholic healthcare. It will be an opportunity for all present to explore and discuss the future of Catholic healthcare. Mercy Health makes quality healthcare easy to help you be well in mind, body and spirit. Mercy Health is a premier healthcare provider that has been serving Greater Cincinnati for more than 160 years. Mercy Health provides an integrated network of leading physicians, compassionate caregivers, comprehensive services and exceptional care at more than 100 locations across the region. The Mercy Health network of care includes six award-winning hospitals, eight senior living communities, primary care and specialty physician practices, outpatient centers, social service agencies, fitness centers and a variety of outreach programs. Mercy Health Hospitals are the only Greater Cincinnati hospitals to earn national top 100 rating placing them among the best hospitals in the nation. To learn more visit, www.e-mercy.com and engage in the conversation via Mercy Health’s social media channels (@mercy_health on Twitter and Mercy Health on Facebook.) » Butler County Local News Headlines » Butler County Share Headlines » Butler County Share Photo Gallery

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Dry January: Giving Up Booze For A Month Does Have Benefits ShareTwitter Facebook Google+ Email Give your liver a break every now and then. Originally published on January 24, 2014 12:37 pm As New Year's resolutions go, cutting back on food and drink are right at the top of the list. And while those resolved to change their eating habits may cut the carbohydrates or say a sweet goodbye to sugar, for regular drinkers, the tradition may involve what's known as a dry January: giving up booze for a month. But could such a short-term breakup with alcohol really impart any measurable health benefits? Recently, the staff at the British magazine New Scientist decided to find out, using themselves as guinea pigs. The findings of their small but intriguing study suggest the answer is a resounding yes. Fourteen healthy New Scientist employees filled out lifestyle questionnaires, underwent ultrasounds and gave blood samples. Then, 10 of them gave up alcohol for five weeks, while four of them continued drinking normally. "Normal" drinking for the New Scientist group ranged from 10 units of alcohol per week — the equivalent of about eight 12-ounce bottles of regular-strength beer — to 80 units, or 64 beers, per week. Those numbers may seem high, but in Britain, where drinking is a national pastime, the group's supervising doctor told them none were problem drinkers. (Incidentally, Britain's National Health Service recommends no more than 14 to 21 alcohol units per week.) The results of these changes were significant enough to make you put down your pint and take notice. Dr. Rajiv Jalan, a liver specialist at the Institute for Liver and Digestive Health at University College London, analyzed the findings. They revealed that liver fat, a precursor to liver damage, for all of those in the study who gave up drinking fell by at least 15 percent, and almost 20 percent for some. Abstainers also saw their blood glucose levels — a key factor in determining diabetes risk — fall by an average of 16 percent. It's the first study to show such an immediate drop from going dry, says Dr. James Ferguson, a liver specialist at Queen Elizabeth Hospital Birmingham in England, who was not involved in the experiment. Overall, Ferguson says, the evidence is convincing but not all that surprising. "If you take time off from alcohol, it's going to be beneficial for your liver from the reduction of fat," he tells The Salt. "People always forget the amount of calories in alcohol, so if you take a month off, and you usually consume 20 units, you're going to lose weight and fat. It's a massive reduction in calories. " The main causes of excessive fat in the liver are obesity and excessive alcohol consumption. Alcohol changes the way the liver processes fat, resulting in more fat cells that can cause inflammation, leading to liver disease. But Ferguson warns that a dry January could trigger the same sort of negative boomerang effect as do restrictive diets: First you abstain, then you binge to make up for it. He questions whether a dry January leads to a wetter-than-normal February. Beyond that, there's the question of whether and how much these improvements last in the long run. Ferguson takes a sobering view. "I don't think taking one month a year off alcohol makes any difference," he says. "It's more important to cut back generally." In fact, The British Liver Trust doesn't endorse a dry January, saying the tradition is "medically futile" and encourages alcohol abuse the rest of the year. Instead, the Trust suggests staying off the sauce two or three days every week, allowing the liver to recover regularly.Copyright 2014 NPR. To see more, visit http://www.npr.org/. View the discussion thread. © 2016 New Hampshire Public Radio

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Tribute to Dr. Kornhauser Welcome To The Official Website of The National Institute Of Electromedical Information The National Institute of Electromedical Information (NIEI), founded in 1984 under the laws of the State of New York as a free standing, non-profit, charitable organization under section 501©3 of the Internal Revenue Code, provides an educational forum and communication network to further the development, advancement, promotion and use of Electromedical devices and therapies in all areas of healthcare. In recent years, the focus of NIEI has broadened to include attention to healthcare applications of consumer electronic devices, pharmaceutical and nutraceutical innovations and technological advances across the healthcare and medical landscape Founded by the late Dr. Stanley Kornhauser (November 8, 1934 - March 9, 2012), the Institute has proudly served the needs of the biomedical community throughout the world, by functioning as an ardent advocote for the field of electromedicine, physical medicine, rehabilition and pain management. Through the tireless efforts and outreach of NIEI, the organization has built bridges and developed critical networks to optimize education, training, and research within the medical community. By parterning with academic institutions, consumer groups and commercial industries, NIEI strives to create a better world by promoting and disseminating the importace and value of electomedical technology and pharmaceutical advances in the ever-important promotion of health and wellness, and the prevention and treatment of disease. DONATE Donate to NIEI © 2014 niei.org. All rights reserved.

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Heart disease in men can be fought head-on By Nanci Hellmich, USA TODAY Heart disease is the No. 1 killer of men (and women) in the USA, so it's no wonder that cardiologist Gordon Tomaselli dispenses direct, no-nonsense advice: "Get up and move more, don't smoke, make sure you control your blood pressure and cholesterol, and don't ignore symptoms of heart disease, particularly if you have a family history."By Martha Irvine, APGet heart-healthier by the day: Strive for 30 minutes of moderate physical activity.EnlargeCloseBy Martha Irvine, APGet heart-healthier by the day: Strive for 30 minutes of moderate physical activity.Sponsored LinksIt may sound difficult, but the results could be lifesaving, says Tomaselli, president of the American Heart Association (AHA) and director of the division of cardiology at the Johns Hopkins University School of Medicine in Baltimore.Heart disease or cardiovascular disease are umbrella terms used to describe disease processes of the heart.Although the rate of death from cardiovascular disease declined by 31% from 1998 to 2008, the disease is still the leading cause of death in the USA. One in every three deaths are from heart disease and stroke, according to the heart association and the Centers for Disease Control and Prevention.Men often develop and die from heart disease at a younger age than women, says Russell Luepker, Mayo professor of public health at the University of Minnesota and a spokesman for the American Heart Association. "While more women die of heart disease, they die at a later age from it than men."Why men are vulnerableMen suffer from the disease at a younger age because they "tend to have higher blood pressure, higher cholesterol, and they are more likely to be smokers than women," says Luepker, program director of the Minnesota Heart Survey, a population-based study that tracks trends in heart disease. And men are less likely to be treated for high blood pressure than women, he says. "Men are not seekers of care. We did a study a couple of years ago, and we autopsied people who were under 60 who died a premature, sudden death — 95% of them were men. Practically all of them had heart disease. They all had physicians and medical insurance but rarely went to the doctor."They may have gone to the doctor because they cut their finger with a hedge trimmer, but they weren't going in and being evaluated for heart disease." Ways to live a heart-healthier lifeGet active. Get at least 30 minutes of moderate physical activity each day like brisk walking, five times a week.“Make a commitment that you are going to be more active today than you were yesterday ,” says cardiologist Gordon Tomaselli, president of the heart association.Eat better. Avoid excess salt which leads to hypertension, and saturated fats which leads to high cholesterol, Tomaselli says. Also, limit sugar intake. Instead eat fruits, vegetables, whole grains, fish, poultry, low-fat or non-fat dairy and other healthy fare.Manage your blood pressure. Normal blood pressure is less than 120/80. If it’s within healthy ranges, you reduce the strain on your heart, arteries, and kidneys, the heart association says.Control cholesterol. “Your total cholesterol and LDL (bad) cholesterol should be low, and your HDL (good) cholesterol should be as high as possible,” Tomaselli says. If your total cholesterol is 200 or higher, you need to take action. High cholesterol can cause blocked arteries, and like a multi-car pile-up, one problem often creates another.Don’t smoke. “Tobacco at any level of intake is bad for your health and should be avoided,” Tomaselli says.Lose weight. Being obese — roughly 30 or more pounds over a healthy weight — increases the risk of heart disease.Source: American Heart Association (mylifecheck.heart.org)One big problem for men is a lot of them don't manage their blood pressure as well as women do, he says. "It's better than it was 10 years ago, but women still do better."High blood pressure is the most significant risk factor for heart disease, Tomaselli says. It means the blood running through your arteries flows with too much force and puts pressure on your arteries, stretching them past their healthy limit and causing microscopic tears, the heart association says. Unfortunately, the scar tissue that forms to repair those tears traps plaque and white blood cells, which can lead to blockages, blood clots and hardened, weakened arteries, the heart association says.One in three adults have high blood pressure, but many people don't even know they have it, the heart group says. The risk can be reduced by following a healthful diet, including cutting back on salt; exercising; keeping a healthy weight; managing stress; limiting alcohol; and avoiding smoking, Tomaselli says. But some people who do those things may still need medication, he says.If one prescription medication for hypertension doesn't work, you usually can find another that is going to cause you few or no side effects, Luepker says.Maintain your plumbingHeart disease is largely preventable, says Gina Lundberg, a cardiologist in Atlanta.She tells her patients that there are multiple things that can go wrong with your heart, just like the things that go wrong with your house. Your heart, like your house, has plumbing, electricity, doors and walls.The plumbing in your heart is the coronary arteries that can get blocked up, Lundberg says. The heart has an electrical system that can result in irregular heartbeat or arrhythmia. The doors of the heart are the heart valves and the valves can leak or not open properly and need to be replaced. The walls of the heart can be weak or enlarged which can lead to congestive heart failure, she says.Adds Tomaselli: "If you have known risk factors for heart disease — diabetes, high blood pressure, high cholesterol, you need to get them under control. It's better to be safe than sorry."

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Ohio Jails: Mental Health Treatment Of Last Resort Share Share Download As the state scales back its psychiatric institutions, jails often become de facto mental hospitals. Earlier this year, when Summit County’s sheriff said ‘no more,’ he sparked a national debate about how people with mental illnesses are treated in the criminal justice system. Amanda Rabinowitz of Ohio Public Radio station WKSU goes inside Summit County’s jail to explore the issue. Thursday, July 26, 2012 at 4:18 pm A door inside the Summit County Jail is marked “1-D.” That’s the pod with 24 cells devoted to inmates who have mental illnesses – things like schizophrenia, bipolar and dissociative disorders. Inside, a common area smells like urine. Metal tables and TVs are bolted to the floor. One inmate is in a cell wearing a special green gown that’s thick, quilted and sleeveless to prevent the man from being able to tear the material and hang himself. Another common area with a skylight is around the corner. There, about a dozen inmates in striped uniforms sit together in the sun, many rocking back and forth. Together, they represent a small fraction of the jail population with psychiatric problems. Summit County jail Chief Gary James says as many 140 inmates are on psychotropic drugs on any given day. JAMES: “Obviously, [they’re] probably pretty good and medicated, they look like they’re doing pretty good,” he said. “And, this is a good day. Normally, there’s somebody in here that is kicking the doors and yelling and screaming and hollering and the deputies have to deal with that.” This may be a good day, but Summit County Sheriff Drew Alexander says there have been too many bad ones. So bad, that back in 2006, an inmate, Mark McCullough, died after struggling violently with deputies in the jail’s mental health unit. The officers were charged criminally; one was acquitted of murder and the charges against four others were dismissed. In February of this year, Alexander became the first sheriff in the country to say he would no longer book violent mentally ill offenders unless they get mental-health treatment first. The policy came at the recommendation of the National Institute of Corrections, which Alexander brought in to review the situation. Alexander says his facility cannot be a dumping ground for people who cycle through hospitals, jails and the streets. ALEXANDER: “These people turned to the streets, they have nowhere to go, and as a result they end up in our jails. We could go downtown Akron, and I could walk around and show you 10 beds of people who are sleeping outside all winter, and they probably are in and out this jail, too, sometimes they just come in to get warm.” Within the last two years, the jail began videotaping each incident in which deputies had to enter a cell to control a violent inmate. Chief James sifts through hundreds of video files on his computer. He finds one in which an inmate diagnosed with schizophrenia arrives off his medication and in the midst of a psychotic break. James fast-forwards the tape to 17 minutes: The team, of five deputies is getting ready to enter the cell as the inmate is screaming profanities and kicking. They are prepared with stun shields and helmets. He fast forwards to 22 minutes. “They’re putting his ankles in restraints, and they’re going to lay him down and put his wrists in padded restraints,” James said. Many deputies receive what’s called CIT, Crisis Intervention Training, on how to safely “take down” a violent inmate. Akron has become a national leader in the training, certifying more than 4,000 deputies nationwide. Still, the training is voluntary. Paul Wright has been a deputy in the Summit County jail’s mental health pod for about a year. He’s not CIT certified, but says he knows how to handle the regulars. WRIGHT: “You’ve got four deputies controlling almost 100 inmates. So when you’ve got people who do have violent tendencies due to their mental illness, we always have to be on guard for that. My undergraduate degree is in special education so I’ve been exposed to a lot of different populations so that’s why it helps me interact with them pretty well.” Complicating the problem, Summit County Sheriff Drew Alexander says the county Alcohol, Drug and Mental Health board had cut back the hours of psychiatric care provided to the jail. The board restored the cuts, but Alexander says it’s still not enough. ALEXANDER: “They weren’t getting the attention and the evaluation they needed and they were having psychotic episodes in their cells because we couldn’t get them back on their meds. We didn’t have the right or the knowledge to get them back on their meds. And Mark McCullough was a good example of this.” The Summit County board’s director, Jerry Craig, says two-thirds of his budget goes to mental health treatment and $1 million a year on treatment services in the jail. He says the board’s trying to provide the best it can. CRAIG: “Certainly I understand his frustration [with that],” he said. “But I would maintain that working with so many different systems is very complex and it takes a lot of work over time. And I think that one of the things we can be proud of is that we have made progress over the several years that we have been working together.” For at least one group of people - the inmates themselves - the concerns about jail access go beyond money and policy. They go to survival. Sharon Bushner of Akron is diagnosed with bipolar disorder and depression. Ten years ago she was homeless and a drug addict and spent three weeks in the Summit County Jail on a domestic violence charge. There, she learned about the county’s mental health court. It linked her with resources and treatment. Today, she’s sober, takes her medication regularly and is employed. BUSHNER: “What if [it was me? And] they turned me away like that or feel that they didn’t need me at their jail facility because of they mental status or whatever like that. What would I would have did? What agency would have came to talk to me? That’s what that mental pod there is for. That’s what we have agencies there for. To try to get them in the same program like I went through.” The Summit County Jail has turned away fewer than 10 people since the sheriff announced his policy six months ago. Alexander says most of the mentally ill inmates are regulars and his deputies have developed a good rapport with them. Main Topic Tags List

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With This Year's Flu, Young Adults Are Not So Invincible By Maanvi Singh Feb 13, 2014 ShareTwitter Facebook Google+ Email A flu shot would have helped protect young adults, but most didn't get it. Originally published on February 13, 2014 11:40 am We usually think of the flu as an illness that afflicts the elderly. But this season the virus seems to be hitting younger people hard. This winter at Duke University Medical Center in Durham, N.C., the median age of people hospitalized with influenza was 28.5 years. Many of the worst cases of flu occurred in young, otherwise healthy people. "There's nothing that's been personally more dreadful to me as a young guy with a kid at home than to walk into our ICU and see pregnant women or young, otherwise healthy people struggling not to die on a ventilator," says Dr. Cameron Wolfe, an assistant professor of infectious disease at Duke. Wolfe and his colleagues found that out of the 55 flu cases the hospital has seen so far, 87 percent were infected with H1N1, the same strain responsible for the global pandemic in 2009. They reported their findings in a small preliminary study in the American Journal of Respiratory and Critical Care Medicine. The takeaway message, Wolfe tells Shots, is that even the young and healthy should get flu shots. "Very young teenagers and college-age kids tend to think they're immortal," Wolf says. "And I think there's a general misunderstanding of the role of vaccines." Many people don't realize that the vaccine can take up to two weeks to kick in, Wolfe says, and then when they get sick they assume that the vaccine isn't effective. Others avoid it because in some people, side effects of the vaccine resemble flu symptoms. The flu vaccine in particular is misunderstood, Wolfe says, "because at the end of the day it's not a perfect vaccine." Even those who have gotten the shot can fall ill, especially if they contract a strain that's not covered by the annual vaccine. But the vaccine protects against several strains, and it encourages our bodies to create antibodies that can also protect against viruses that aren't the flu, according to the National Institutes of Health. The Duke researchers found that while a third of those who ended up in the general ward of the hospital with flu symptoms were vaccinated, only 2 of the 22 who ended up in the intensive care unit had had the shot. "What that hints at is maybe the vaccine has a protective effect," Wolfe says. "Even if you're going to be one of the people who do get the flu, if you get a vaccine it's going to be less severe." Of course, this study was just a first look at flu trends in one hospital. We are only halfway through flu season, and the Centers for Disease Control and Prevention won't be putting together a picture of the national trends until this summer. But Dr. Michael Jhung, an infectious diseases officer at the CDC, says a lot of what the Duke researchers found sounds similar to national trends he's been observing. He says the predominance of the H1N1 strain might be responsible for the uptick in young adults suffering from the flu. Since a similar strain was circulating in the 1940s, Jhung tells Shots, many older people have developed immunity to H1N1. "Last year, which was a year when we saw H3N2 predominate, was particularly bad for the elderly," he says. But there's another possible reason, he says: "Young and middle-aged adults are among the lowest vaccinated age groups in the U.S." Last year, only 26 percent of 18- to 49-year-olds got flu shots. The CDC estimates that this flu season will be a bit better, with around 31 percent getting the vaccine. "Often [young people] can't imagine that the flu could cause a severe illness in them," Jhung says. But he says he's not sure what will push people in this age group to actually get vaccinated. Younger adults are also not good at getting other recommended shots. A 2007 CDC survey found that only 57 percent of 18- to 49-year-olds had gotten the tetanus booster shot in the past 10 years. That's pretty low considering that one quick shot every 10 years could prevent people from getting this serious infection, which is caused by bacteria in the environment that get into the body through cuts or puncture wounds and is fatal 10 percent of the time. "I suspect that numbers and surveillance data and national estimates aren't going to be very compelling for most people," Jhung says. "It may unfortunately take a personal encounter with influenza to convince people."Copyright 2014 NPR. To see more, visit http://www.npr.org/. View the discussion thread. © 2016 WFAE

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NEW ORLEANS, Jan. 12 /PRNewswire/ -- At a ribbon cutting ceremony at 10:00am on Monday, January 12, 2009, DHH Secretary Alan Levine and New Orleans City Councilwoman Stacy Head will join Ochsner Baptist Medical Center and the community to celebrate the opening of its full-service Emergency Room and a 43 all-private room hospital wing at 2700 Napoleon Avenue in Uptown New Orleans. This additional $12 million investment includes expanding the Ochsner Baptist ICU from three to 12 beds and is in addition to the more than $20 million to re-open 22 medical/surgical beds, two endoscopy suites and the Imaging Center in 2006 and 2007. Following guided tours, the ER will officially open for patient care at 11:00am. Emergency services have not been available at the Ochsner Baptist campus since Hurricane Katrina in 2005. "With local ERs still plagued with frequent overcrowding and diversion problems, Ochsner Baptist's services will fill a significant need and provide residents with a new, full-service ER closer to home," explains Robert Wolterman, Chief Executive Officer at Baptist. The 6,000-square-foot ER includes two trauma rooms, nine exam rooms, one triage room, an electronic medical records system, and computerized patient tracking for fast door-to-doctor care and quicker treatment. "Another advantage to the Ochsner Baptist ER is our on-campus, comprehensive Imaging Center. In an emergency situation, an X-ray, ultrasound, CT or MRI are crucial to proper care and diagnoses," explains Dr. Joe Guarisco, Ochsner Systems Chief of Emergency Services. Opened in November 2007, Ochsner Imaging includes a 64-slice CT machine, MRI, Ultrasound, Radiography, Fluoroscopy, Digital Mammography, Nuclear Medicine and Echo Cardiology testing. "We expect to average approximately 40 to 45 visits per day in the first few months of operation," says Dr. Guarisco. Labor and delivery and complex neurological emergencies will be stabilized, and then transferred to Ochsner's main campus just four miles away. Residents of Uptown, Downtown, New Orleans East, Gentilly, Chalmette, Mid City and Lakeview/Lakefront neighborhoods are expected to utilize the Ochsner Baptist ER. "The return of emergency services to the Broadmoor community is a huge step in our recovery process and will provide quality emergency care that's easily accessible to our families," says LaToya Cantrell, President of the Broadmoor Improvement Association. Wolterman goes on to add, "The support of the medical staff and the community has been tremendous. And, patients will feel right at home with the ER in the same location as before and will see many of the same physicians at Baptist as they did pre-Katrina." Ochsner Baptist has consistently ranked in the top 95th percentile in patient satisfaction in Press Ganey scores. Ochsner purchased the Baptist campus in October 2006 from Tenet Healthcare. "In such a short time, we've gone from a small surgical institution to a full-service facility capable of handling critical cases," says Wolterman. The Clara Wing's $8 million expansion brings the campus to 43 medical/surgical beds. Wolterman promises, "As patient needs continue to increase and patient demand grows, we'll continue to grow." Current campus services now include an expanded 12-bed ICU, six operating rooms, two cardiac catheterization suites and endoscopy suites, an Outpatient Imaging Center, a Laser Vision Center, and over 300 community physicians. "A massive undertaking, the $12 million renovation of the Ochsner Baptist Clara Building is an investment in our city's healthcare and its economy, as all construction was through local contractors," explains Warner Thomas, Ochsner Health System President and Chief Operating Officer. The architectural firm Rozas/Ward Architects handled architectural design and remodeling and Construction South was the general contractor. "It was important to us that we used a local firm to manage this project and provide work to over 250 local workers," says Thomas. Additional improvements to the Ochsner Baptist campus include a family chapel, physician's dining area, new cafeteria, and improved boiler and chiller infrastructures. As the campus grows, so will its staffing. "We anticipate hiring over 100 new employees to staff the additional beds and the ER," says Thomas. "This will funnel an additional $5M into the local economy through employee salaries; support that's much needed during our nation's financial crisis." To date, Ochsner has invested over $30 million to revitalize the Baptist campus. "This facility has deep roots in the New Orleans community and we're committed to making it a thriving resource for the city's future," says Wolterman. The facility is still in negotiations to develop a Senior Living Center anticipated for opening in 2013. "In 2006, Ochsner promised the region that 'Baptist was back!' and we're making good on that promise and our plan," says Dr. Patrick Quinlan, M.D. Chief Executive Officer of Ochsner Health System. "The Baptist facility holds over 70 years of outstanding care for thousands of New Orleanians, and we want our community to know we're here to stay and committed to rebuilding our region's healthcare system." As a community partner, Ochsner has "adopted" Samuel J. Green Charter Elementary investing staff time at the school to educate students on healthy living and has reached out to local neighborhood associations to hold monthly meetings at the Baptist Campus. Ochsner Baptist Healing Arts An innovative campus, Ochsner Baptist has also embraced the Healing Arts philosophy which seeks to improve patients' lives through visual arts. The Ochsner Baptist ER, Clara Wing and ICU feature artwork by renowned Covington, LA, artist, Emery Clark. Clark explains, "We sought to transform the experience of healthcare; to facilitate healing by alleviating stress and creating a peaceful and nurturing environment for both patients and staff." Studies have shown that exposure to themes in art, such as nature, landscapes and calm waters are proven to reduce anxiety, lower blood pressure, and diminish the need for pain medication; JAMA, "The Art of Healing," M.J. Freidrich, May 19, 1999. "Ochsner Medical Center and Ochsner Medical Center for Children began incorporating Healing Arts in 2004 and have since gained tremendous support from patients and staff," says Dr. Quinlan. Ochsner Health System (www.ochsner.org) is a non-profit, academic, multi-specialty, healthcare delivery system dedicated to patient care, research and education. The system includes seven hospitals and over 35 health centers located throughout Southeast Louisiana. Ochsner employs more than 750 physicians in 90 medical specialties and subspecialties and over 300 clinical research trials annually. Ochsner has been listed as one of the "Best Places to Work" by New Orleans CityBusiness since 2005 and received the Consumer Choice for Healthcare in New Orleans for 13 consecutive years. Ochsner was ranked as "Best" Hospital by U.S. News and World Report in 2007. Ochsner has 11,000 employees system-wide. '/>"/>SOURCE Ochsner Medical CenterCopyright©2009 PR Newswire.All rights reserved0GOODRelated medicine news :1. Ochsner Health System, Surgical Information Systems Partner to Rebuild New Orleans Healthcare Infrastructure2. Video: Ochsner Medical Center Drives Mobile P.E. Class to New Orleans Schools in Fight Against Child Obesity3. Ochsner Health System Partners with DocuSys for Presurgical Care, AIMS and Medication Management Technology4. BAPTIST HEALTH Uses Real-Time Clinical Surveillance from Thomson Reuters to Lower Costs and Improve Quality in the Pharmacy5. Sentillion and Baptist Health System to Speak at Upcoming Gartner Identity & Access Management Summit6. Baptist Health System Deploys Sentillions Vergence Solution to Provide Secure Identity and Access Management to 3,000 Clinicians7. Leading Neurologist Opens Missouri Baptist Medical Centers First MS Center8. Alabamas Baptist Health System and Aegis Health Group Partner to Address Local Employers Health-Management Concerns9. BlueCross Recognizes Baptist Womens Hospital10. Metrologic and Wake Forest University Baptist Medical Center Sponsored Healthcare Educational Forum11. Valley Baptist Health System Leveraging TITAN Technology Partners Hosting and Managed Services

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Health Care Technology Company Overview of Surescripts, LLC Ben Stuart Chief Marketing Officer and Senior Vice President, Surescripts, LLCAgeTotal Calculated CompensationThis person is connected to 1 Board Members in 1 different organizations across 2 different industries.See Board Relationships---- Mr. Ben Stuart serves as the Chief Marketing Officer and Senior Vice President at Surescripts, LLC (formerly SureScripts-RxHub, LLC). Mr. Stuart plays a critical role as a key member of the senior leadership team with responsibility for all aspects of marketing. He provides leadership, guidance and implementation for marketing including the SureScripts-RxHub's brand strategy and marketing programs. He works with groups across the SureScripts-RxHub to establish Surescripts ... as a leader in Health IT with customers, employees, and external stakeholders. Mr. Stuart has over 20 years of experience growing brands within regulated industries and managing complex marketing programs in both B-to-B and B-to-C businesses. He joined Surescripts from American Express where he was Vice President of US Advertising and Global Agency Relations. Prior to joining American Express, he was Senior Vice President of Brand and Digital Marketing for the Charles Schwab Corporation where he managed the Brand Strategy, Advertising and Media functions. During his tenure at Schwab, he created and led the company-wide "Talk to Chuck" marketing effort that drove significant franchise growth while dramatically increasing brand strength. While at Schwab, Mr. Stuart managed a wide range of marketing areas including marketing for Charles Schwab Bank and served on the board of the Charles Schwab Foundation. Prior to Schwab, he held various positions at leading global advertising agencies. In the U.S., Mr. Stuart managed the Procter & Gamble Vick's franchise at DMB&B New York. While at Ammirati Puris Lintas New York and Chicago he worked on the MasterCard and Compaq Computer brands. Internationally, he spent five years managing key accounts across Central Europe including Russia, Poland, Hungary and the Czech and Slovak Republics. He started his advertising career as an Account Manager with BBDO in Prague helping launch the Pepsi brands in former Czechoslovakia. He has been a Director of The Advertising Council, Inc., since July 2, 2012. For the past six years, he served on the board of the Ad Council and serves as an advisor to WealthGUARD. Mr. Stuart holds a B.S. in Journalism from the University of Kansas.Read Full Background Corporate Headquarters 2800 Crystal DriveArlington, Virginia 22202United StatesPhone: 703-921-2121Fax: 703-921-2191 2012-PresentDirectorThe Advertising Council, Inc. BS University of Kansas University of KansasThe Advertising Council, Inc. To contact Surescripts, LLC, please visit . Company data is provided by Capital IQ. Please use this form to report any data issues.

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Whooping cough making a comeback in Md., U.S. TDAP shot Karl Merton Ferron, Baltimore Sun Medical assistant Bronte Brown administers a TDAP (combined Tetanus, Diphtheria and Pertussis) shot to Joshua Hubbard, 11 of Carney. Medical assistant Bronte Brown administers a TDAP (combined Tetanus, Diphtheria and Pertussis) shot to Joshua Hubbard, 11 of Carney. (Karl Merton Ferron, Baltimore Sun) Meredith Cohn, The Baltimore Sun Public health officials are warning adults and adolescents to get booster shots in the wake of an unusually large number of cases of whooping cough this year around the nation and in Maryland.More than 20,000 cases of the respiratory disease were reported in the first seven months of the year in the United States, almost 21/2 times the number in all of last year, according to the U.S. Centers for Disease Control and Prevention. The agency says there are likely many more cases that are not reported. In Maryland, the CDC has preliminarily logged 125 cases this year, and state data show about a quarter of the cases are in infants too young to be vaccinated.Washington State, with more than 3,000 cases, was the first to declare an epidemic in April, but CDC officials said so many states are logging large outbreaks that this could be the worst year for whooping cough since 1959. Officials say outbreaks of the disease, officially called pertussis, are cyclical, though they can't say for sure what is causing this year's unusually high number of cases. They say it's possible the disease is being better diagnosed, and that the effectiveness of the vaccine, routinely given only to children, not adolescents and adults, is waning."The vaccine isn't perfect, but it's good," said Dr. Lucy Wilson, chief of the Center for Surveillance, Infection Prevention and Outbreak Response at the Maryland Department of Health and Mental Hygiene. "That's why we're advocating for boosters."State and federal officials say anyone older than 6 months can get the booster, called Tdap, a combination vaccine with diphtheria and tetanus. Because cases are most dangerous to infants, officials strongly advise parents and other caretakers and pregnant women, as well as health workers, to get another vaccination.More than half of children with whooping cough are hospitalized, Wilson said. One in five gets pneumonia and one percent die.Small children generally get a series of five vaccinations, but officials say boosters should be given to 11- and 12-year-olds, the age when immunity appears to begin waning. Boosters aren't required for school in Maryland now, but will be in 2014, Wilson said.Lisa Hubbard, a Carney mother of two, decided to have her children vaccinated regardless of the law. Joshua Hubbard, 11, got his shot Wednesday. She's also made sure her pregnant sister and sister-in-law know about the outbreak and protect themselves."To keep children safe you have to pro-actively get these shots and take that small risk of side effects, versus taking the bigger risk of a child contracting a highly contagious even deadly disease," she said. "It's our job to make decisions that are in the best interests of our children and all children."The doctor who recommended the boosters to Hubbard was Dr. Scott Krugman, chairman of the department of pediatrics at MedStar Franklin Square Medical Center and the president of the Maryland Chapter of the American Academy of Pediatrics.He said to protect children and the community at large, enough people need to be vaccinated: "Pediatricians are encouraging all teenagers to come in for their annual physicals to make sure they have received their Tdap booster shot, not only to protect themselves, but to protect vulnerable infants through herd immunity."A problem doctors can have is that only adolescents tend to make the whooping noise associated with whooping cough, so the illness sometimes is mistaken for the common cold. Early symptoms are runny noses, congestion, sneezing and a mild cough and fever. The heavy coughing usually begins after a couple of weeks. CDC officials recommend antibiotics for treatment of the sufferer and for prevention in those who have come in contact with it.Vaccine experts at the CDC and elsewhere still stand behind the vaccine, though some evidence suggests that a newer version is less likely to provoke immunity and could be linked to more cases.The formulation was changed in 1997 to reduce side effects such as pain at the vaccination site, listlessness, prolonged crying and some other rare and serious complications in babies, said Dr. Andrea A. Berry, a pediatric infectious disease specialist at the University of Maryland School of Medicine's Center for Vaccine Development.The older vaccine was made using the whole pertussis bacteria, which is grown and later inactivated. The newer one contains only individual antigens of the bacteria that still produce an immune response but with fewer side effects.A recent study from Australia published in the Journal of the American Medical Association found children given the newer, "acellular" vaccine had higher rates of disease. But Berry said it doesn't explain the severity of this outbreak, and she's not advocating a return to the older vaccine."The vaccine is not perfect, but I would not recommend returning to the whole-cell vaccine," she said. "The acellular vaccine does provide protection and has a much better safety profile. The key is using it more broadly."Already, she said that the vaccine has saved many from the disease. In the early part of the last century, before there was a vaccine, there were routinely 270,000 or more cases a year in the United States and 10,000 deaths. There are fewer deaths in modern times — only 10 so far this year and none in Maryland.Others also are pushing boosters to continue to cut down on the illness and related deaths, including insurers. CareFirst BlueCross BlueShield, for example, makes sure doctors know that boosters are recommended for adolescents and adults, said Dr. Daniel Winn, the insurer's senior medical director. He said vaccination rates are good for young children but not for older kids and adults."Rates of vaccination for older people, those over 50, are abysmal," he said. "That means the herd immunity is much less because not enough people are vaccinated." Winn recommended that people ask their doctors about vaccinations in general because sometimes when other medical issues are more pressing such preventive steps can be forgotten.He said swine flu and West Nile virus also are becoming problems in other states and people should be taking precautions. All recent cases of swine flu nationally appear to have come from contact with pigs, and at the upcoming Maryland state fair, Winn said, children should wash their hands frequently and avoid touching their faces.Maryland recently recorded its first West Nile Virus case, and officials are recommending people avoid areas of high mosquito activity and outdoor activities at dawn and dusk when mosquitoes are most active. They also say wear long-sleeved pants and shirts and hat and use insect repellent."There are simple things you can do to protect yourself," Winn said.Meredith.cohn@baltsun.com •20,469 cases reported in the United States through July 2012, up from 8,846 in 2011•125 cases were reported in Maryland through July 2012, up from 56 cases in 2011Source: CDC Second case of West Nile diagnosed in Maryland Picture of Health blog Health Professionals on the Move archive

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Dynamic ChiropracticJuly 13, 1998, Volume 16, Issue 15 Printer Friendly VersionE-mail to a Friend Search ChiroWeb! Chiropractic Mailing Lists Interview with Stanford Researcher John Astin, PhD Editor's note: John Astin, PhD, is with the Stanford University Center for Research in Disease Prevention. The genesis of this interview was Dr. Astin's paper, "Why Patients Use Alternative Medicine: Results of a National Study," published in the May 20, 1998 Journal of the American Medical Association. with various forms of alternative medicine. For example, the Eisenberg study in 1993 reported that 34% of adults in the United States have used at least one "unconventional" form of health care during the previous year. The reasons behind the use of alternative procedures are not clearly understood. Through written survey, Dr. Astin examined possible predictors of alternative health care including health status, attitudes toward conventional medicine and demographics. The top four treatment categories were chiropractic (15.7%); lifestyle diet (8%); exercise/movement (7.2%); and relaxation (6.9%). Chiropractic was listed as being the first or second most frequently used form of care for severe headaches (1st), sprain/strains (1st), arthritis (2nd) and chronic pain (2nd). The interview that follows provides insight into Dr. Astin's observations regarding alternative health care. Dr. Cleveland: Dr. Astin, as a graduate from University of California at Irvine, with a PhD in health psychology, how do you describe the discipline of health psychology? Dr. Astin: It is the study of the role of psychological factors in health and illness. It includes such things as lifestyle behaviors, coping with stress, the effects of mood states on immune function, as well as how people respond to illness. It is the academic discipline that examines the interface, if you will, between mind and body, and is purportedly the fastest growing discipline within psychology. Dr. Cleveland: How did you become interested in the topic of alternative medicine? Dr. Astin: My personal interests have centered for many years around the relationship of mind and body. I had also experimented myself with a number of alternative therapies and found that my academic interests in health psychology dovetailed nicely with the study of alternative medicine. My review of the literature indicated that the factors underlying people's decision to use alternative therapies had not been extensively researched. This project then became my PhD thesis. � your PhD thesis? Dr. Astin: As you may know, a call for papers regarding the area of alternative medicine has been issued for all the AMA journals (including JAMA and Archives of Internal Medicine). This is in response to a survey of AMA members indicating that alternative medicine was among their top areas of interest. Dr. Cleveland: What accounts for the medical profession's interest in alternative therapies? Dr. Astin: There is probably some basic intellectual interest. As indicated in my study, it was the most highly educated who were more likely to use alternative therapies. There is also the awareness now that large numbers of patients are using these therapies and a corresponding professional need or responsibility for physicians to understand what it is their patients are doing. A more cynical interpretation is that the interest stems from some feelings of threat. With 40% of patients using alternative care, it probably gets into a kind of turf war for some physicians who subsequently view the phenomenon as a negative development. Some physicians, maybe due to such feelings of threat, unfortunately take a rather unscientific approach to alternative medicine, one that presumes or assumes they could never have any real validity or efficacy. Dr. Cleveland: How do you define alternative medicine? Dr. Astin: I essentially follow Eisenberg and colleagues' definition as those practices "neither taught widely in U.S. medical schools nor generally practiced in U.S. hospitals." It is interesting that you ask that question as I believe these definitional issues are very relevant to your own profession. I often use chiropractic as an example of the difficulty and ambivalence around what therapies should be considered "alternative." I actually debated whether to exclude chiropractic as an alternative (particularly for treating certain conditions) since the survey revealed that 50% of patients with back problems reported using chiropractic to treat that condition. This finding certainly suggests that chiropractic care has become less and less alternative and more what people consider standard care for back pain. This is a difficult issue. There are many ways to determine which therapies are or are not "alternative." For example, some want to make the cut based on which therapies are evidenced-based versus which are not, but that becomes complicated because as we know, a considerable amount of conventional medical practice is not evidenced-based. Dr. Cleveland: In your estimate, what proportion of conventional medicine would not be evidenced-based?� If you consider the randomized controlled trial (RCT), there is an enormous amount of conventional medicine that cannot be ethically or practically tested by RCTs. You cannot ethically perform sham surgeries to know if there is a true treatment effect. This is a very complicated issue, because on the one hand a lot of alternative medicine is being held to the RCT gold standard, which doesn't hold for a lot of how medicine is actually practiced. Any good health care must be tailored to the individual patient. But RCTs are not typically tailored to the individual but rather attempt to test an intervention that is systematically applied in the same way across a group of individuals. Evidence is critical, of course, but the debate becomes what qualifies as good enough evidence. It is too limiting to say that the RCT is the only irrefutable evidence. Dr. Cleveland: If not RCTs, then outcome studies? Dr. Astin: That is certainly a good option. Sometimes you have to look at outcomes-based research that is occurring in a natural setting rather than the more contrived or controlled setting. One of the problems with the RCT is that essentially you attempt to control extraneous variables, but these are often the very same variables that are operating in the real lives of patients. Therefore, one can question how externally valid the tightly controlled RCT or experiment really is. Dr. Cleveland: You indicated that in one survey of patients with back pain, slightly over 50% utilized chiropractic services. Given that degree of utilization, would chiropractic then not be considered alternative? Dr. Astin: I think one could make that argument. At least with this study that found over 50% of patients with back problems had used chiropractic, it would be difficult to call that treatment "unconventional." It is, however, alternative from the standpoint of not being a truly integrated or accepted part of the dominant, political medical system in this country. Based on how it is viewed from both the public's and conventional medicine's perspective, it is probably the least alternative of those therapies that show up on lists of alternative medicine. Dr. Cleveland: In what way might your findings in your study be used to affect future health care policy? Dr. Astin: I don't know that the findings would directly affect policy. I would say, however, that part of policy is understanding the attitudes and beliefs of the constituents affected by that policy. One of the strongest findings from the study is an apparent shift of attitudes and beliefs regarding the nature of health and illness. This is reflected in the literature being read by the society. Books on mind-body relationships and holistic health top the best seller lists. � philosophical orientation toward health and life and use of alternative medicine. Having an appreciation for or understanding about certain beliefs and attitudes held by the public and what they think about health is important. The attraction to alternative therapies, as the study suggests, stems in part from the feeling that these therapies share an appreciation for the role of non-physical factors in health and illness. I don't see a direct policy outcome from this particular study, but probably more from studies examining the efficacy of these therapies. As the efficacy (or lack thereof) is demonstrated scientifically, then policy needs to change to reflect that. Dr. Cleveland: In the conclusion of your study, you indicate that alternative medicine users are more educated, that the majority are not dissatisfied with conventional medicine, and that they are choosing this approach, "... largely because they find these health care alternatives to be more congruent with their own values, beliefs, and philosophical orientations toward health and life." How do you describe that philosophical orientation? Dr. Astin: It centers around two areas. First, there is a strong association between what I refer to as a holistic orientation (a belief in the importance of body, mind and spirit in health) and use of alternative medicine. This is not surprising given the more holistic philosophies underlying many of the alternative therapies. Second, significantly greater use of alternative medicine was observed in a segment or subculture of the population characterized by the following values: a commitment to environmentalism, feminism, interest in personal growth psychology and esoteric spiritual pursuits, and an openness to things foreign and exotic. Among these individuals, a group sociologist Paul Ray refers to in his research as the "cultural creatives," 55% used alternative health care. Dr. Cleveland: The 1993 Eisenberg study has made us aware of the extent of the use of alternative therapies in the United States. What impact has this had for the conventional health care system? Dr. Astin: In many ways it was a kind of wake-up call, one that documented just how big a phenomenon use of alternative medicine really is in our culture. It also served to fuel much of the subsequent scientific interest in these therapies, which has been extremely useful. Dr. Cleveland: Given the new awareness and public interest in alternative health care, do you have any comment or advice to the chiropractic profession with respect to defining itself as part of the changing health delivery system? Dr. Astin: In the same way that I argue that it is important for conventional practitioners to understand what alternative procedures their patients are using and why, the DCs also need to� patients. And this includes what types of alternative approaches they are utilizing and for what reasons. That's an important piece of information that any practitioner should have. Dr. Cleveland: Thank you, Dr. Astin, for being part of this interview. Editor's note: Individuals may obtain reprints of the JAMA publication at the following address: John A. Astin, PhD Stanford Center for Research in Disease Prevention 730 Welch Road Palo Alto, CA 94304-1583 Post your thoughts in our discussion forum To report inappropriate ads, webmastermpamedia.com Dynamic Chiropractic Media Guide Dynamicchiropractic.com

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Connecticut Magazine / October 2008 / Understanding Autism Understanding Autism by Patricia Grandjean (page 4 of 4)According to Suzanne Wright, Autism Speaks’ stated goal is to find “the cause and cure for autism,” which brings us back to the question, “What are we really dealing with?” The preponderance of research evidence, says Ami Klin, is that “there is a very strong genetic contribution to it. We know there’s a very high concordance rate in twins. We also know that in many families, autism has been present for generations.” At the same time, for others an afflicted child is the first in his family, and thus may represent a genetic anomaly. “The vast majority of genetic info we have explains autism only in one individual or one family. So we don’t have a genetic test that can predict it.”Others take such information as a sign that environmental factors, either inside the womb or postdelivery, may also play a role. One such is Trumbull’s Kim Stagliano, the mother of three daughters with autism and managing editor of the Web blog Age of Autism (ageofautism.com), who believes that her girls’ disabilities may not be neurological, but biomedical. She claims to have seen great improvement in all three after putting them on a gluten-free, casein (dairy)-free diet. “We’ve seen this avalanche of childen with all kinds of disabilities: asthma, food allergies, diabetes—our kids are chronically sick,” she points out. Could the “bad stuff” that’s part of our daily lives—pollution, chemical food additives, global warming, you name it—be contributors to autism?Then there’s the never-ending vaccination debate. In addition to the well-chronicled controversy over thimerosal, a mercury-based preservative that some still suspect is linked to autism, there’s the fact that kids are getting more routine vaccinations than ever—10 immunizations by the age of 6, via 30 shots, and in some cases infants may get up to five shots per doctor visit. Some vaccines are bundled, such as the MMR (measles, mumps and rubella) and the DIP/TET (diptheria, tetanus and whooping cough). Are we overloading tiny immune systems in the quest to eradicate acute illnesses? Katie Wright-Hildebrand thinks so. Her son Christian had terrible reactions to his vaccines. “At 2 months old, he had seven. I brought him home and he was screaming, like someone was stabbing him. My husband and I walked him up and down the street till midnight, trying to calm him down.” Successive vaccinations left the little boy with chronic diarrhea, up to 10 incidents a day. Recently, the 7-year-old was diagnosed with Crohn’s disease.Klin points out that research has yet to find that any environmental factor plays a significant role in autism. This brings us to the whole question of “epidemic.” In the 1960s, autism was considered a rare condition, perhaps four in 10,000. How does one explain the jump to one in 150 in the last several years? Klin credits better diagnostic procedures, broadened DSM categories, and improved reporting by more aware clinicians. It’s not, he says, that the CDC is reporting a rampant growth, or incidence of new cases—just that the medical field is doing a much better job of accounting for the prevalence of the disability (the cases that already exist). Thus, he believes, to call autism “epidemic”—as if it were an ever-spreading virus—is misleading.Whatever autism is, however it’s caused, others feel these debates are irrelevant. “They’re not going to get the NIH to spend the money it should be spending, they’re not going to get insurance companies to pay for therapies, and they’re certainly not going to get our families what they need to get through the day,” says Sara Reed. “They’re not helpful. Our focus should be help now, hope for the future.” This article appeared in the October 2008 issue of Connecticut Magazine Understanding Autism

医学

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Category: Dermatology | Endocrinology | Family Medicine | Oncology | Reproductive Medicine | News Back to Health News Could Hair Loss at 20 Signal Higher Prostate Cancer Risk? Last Updated: February 15, 2011. Researchers say these men may turn out to be candidates for screening, but more study needed. Researchers say these men may turn out to be candidates for screening, but more study needed TUESDAY, Feb. 15 (HealthDay News) -- Men with prostate cancer may be twice as likely to have started showing signs of male pattern baldness at the age of 20 than those without prostate cancer, a new French study suggests. Men who start losing their hair in their 30s or 40s do not appear to face a similar boost in prostate cancer risk. And those whose hair loss starts in their 20s do not face a higher risk of developing the cancer at an early age or of developing more aggressive tumors, the research team noted. Whether or not men who experience youthful hair loss may benefit from prostate cancer screening is yet to be determined, the study authors added. "At present, there is no hard evidence to show any benefit from screening the general population for prostate cancer," study author Dr. Philippe Giraud, from the European Georges Pompidou Hospital in Paris, said in a news release from the European Society for Medical Oncology. "We need a way of identifying those men who are at high risk of developing the disease." Noting that androgens associated with hair loss are also associated with prostate cancer, he and the other researchers called for more studies to see whether interventions might be appropriate for men with very early balding. Physicians need to know "who could be targeted for screening and also considered for chemo-prevention using anti-androgenic drugs such as finasteride," Giraud said. "Balding at the age of 20 may be one of these easily identifiable risk factors, and more work needs to be done now to confirm this," he added. Giraud, who is also a professor of radiation oncology at the Paris Descartes University, reports his team's findings in the Feb. 15 online edition of the journal Annals of Oncology. The authors noted that male pattern baldness (androgenic alopecia) is very common, affecting about half of all men at some point in their lives. Its onset has previously been linked to the conversion of testosterone to androgenic hormones, and androgens have also been previously implicated in the onset and growth of prostate cancer. The drug finasteride -- used to treat baldness -- blocks the conversion of testosterone to an androgen thought to cause hair loss, and the drug has also been demonstrated to lower the incidence of prostate cancer. To explore the possible connection between balding patterns and prostate cancer, the research team spent more than two years analyzing disease progression and hair loss patterns in 388 men with prostate cancer. The men were diagnosed between the ages of 46 and 84. Starting in 2004, the investigators asked them to indicate whether or not they had experienced any previous balding, when their hair loss began, and specifically what type of hair loss had occurred at 20, 30 and 40. Another 281 healthy men were enlisted in the study for comparison. The research team found that 37 of the prostate cancer patients (and 14 of the healthy men) had experienced some form of hair loss at the age of 20, ranging from a receding hairline to a bald patch at the top of the head, or a combination of both. Any form of hair loss at age 20 was linked to a doubling of prostate cancer risk, the study authors reported, with no specific pattern of hair loss being more predictive of risk than any other. The research team cautioned, however, that it is premature to conclude that baldness and prostate cancer are, in fact, linked. For his part, Dr. Nelson Neal Stone, a clinical professor of urology and radiation oncology at Mount Sinai School of Medicine in New York City, agreed that while "the study is food for thought," it is in no way conclusive. "First of all, the number of patients involved is very low, which makes interpretation and application to the general population very risky," he said. "But we do know that there are genetic factors that make prostate cancer more prevalent," Stone said. "For example, men who have a first-degree relative -- an uncle, father or brother -- who have a diagnosis of prostate cancer are 2.5 to three times more likely to develop prostate cancer themselves than men who don't have such a history. And genetics also plays a role in men who develop early hair loss." "So, you have two genetically related factors that there may be an association from, and each may be linked to early high male hormone levels. So it may be a hormonally related situation," Stone acknowledged. "But it's very hard to prove." For more on prostate cancer risk, visit the American Cancer Society. SOURCES: European Society for Medical Oncology, news release, Feb. 15, 2011; Nelson Neal Stone, M.D., clinical professor, urology and radiation oncology, Mount Sinai School of Medicine, New York City Previous: Motorcycle Helmets Help Protect Against Spine Injury: Study Next: PSA Test Cut-off Could Signal Low-Risk Prostate Cancer

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Print Close Beyond the Obamacare debate -- why does health care cost so much? By John Robbins ObamaCare has been upheld. But whether you are horrified, elated, or indifferent, one fact remains. The cost of health care just keeps on rising. In fact, medical care now represents nearly 20% of total US GDP. Health care spending is so far out of control that not only individuals and families, but the entire economy is buckling under the strain. General Motors spends so much money for its employees’ health care that Warren Buffet has called the corporation “a health and benefits company with an auto company attached.” Each year, General Motors, like Ford and other U.S. automakers, pays more than $1,500 in health care costs for every car they make. Japan’s Honda pays only $150. The chairman and CEO of Starbucks, Howard Schultz, says that his company spends more money on insurance for its employees than it spends on coffee. It hasn’t always been like this. We now spend more than $2.5 trillion annually on medical care. But as recently as 1950, Americans spent only about $8.4 billion ($70 billion in today’s dollars). The increase has been mind-boggling. After adjusting for inflation, we now spend as much on health care every ten days as we did in the entire year of 1950. But Aren’t We Healthier Than Ever? Perhaps skyrocketing spending could be justified if the result was greatly improved health for the nation’s citizens. But the truth is that our health has actually been declining in recent decades. According to a 2005 Johns Hopkins University analysis, “On most health indicators, the US relative performance declined since 1960; on none did it improve.” Despite spending far more per capita on health care than any other nation, the U.S. now ranks a dismally low 37th among nations in infant mortality rates, and 38th in life expectancy. In 2010, the World Health Organization assessed the overall health outcomes of nations. It placed 36 other countries ahead of the United States. We are fast becoming the fattest and sickest industrialized country in world history. What Should We Do? This would be tragic in any case, but it is especially so because we know exactly how to bring down the costs of health care while dramatically improving our health. Studies have shown that 50 to 70 percent of the nation’s health care costs are preventable, and the single most effective step most people can take to improve their health is to eat a healthier diet. If we were to stop overeating, to stop eating unhealthy foods, and to instead eat more foods with higher nutrient densities and cancer protective properties, we would have a more affordable, sustainable and effective health care system. We’d be less dependent on insurance companies and doctors, and more dependent on our own health-giving choices. The typical American diet is producing devastating rates of cancer, heart disease, diabetes and obesity. It’s making us sick, and it’s bankrupting our families, our companies, and our government. If you were to design a diet to promote heart disease, cancer and diabetes, you’d be hard pressed to do better than what many of us in the US eat today. Benjamin Franklin spoke of becoming “healthy, wealthy and wise.” We are doing the exact opposite. Ocean Robbins is founder of YES!, and serves as CEO and co-host of the 32,000 member Food Revolution Network. John Robbins is author of "No Happy Cows: Dispatches from the Front Lines of the Food Revolution," and co-host of "The Food Revolution Network." Find out more about his work at johnrobbins.info. http://www.foxnews.com/opinion/2012/06/28/beyond-obamacare-debate-why-does-health-care-cost-so-much.html This material may not be published, broadcast, rewritten, or redistributed. © FOX News Network, LLC. All rights reserved. All market data delayed 20 minutes.

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Joseph J. McArdle University of Medicine and Dentistry of New Jersey, USA Joseph J. McArdle New Jersey Medical School, Newark, USA Joseph J. McArdle was born in Wilmington, Delaware in 1945. He earned a BA in Biology and Chemistry from the University of Delaware (1967) and a PhD in Cellular Neuropharmacology from the State University of New York at Buffalo (1972) with Edson X. Albuquerque. While a lieutenant in the US Army reserve from 1967 to 1975, he joined the faculty of the NJ Medical School where he is currently Professor of Pharmacology and Physiology. The focus of his research is the neuromuscular junction (NMJ). Specifically, NMJ development and recovery from peripheral nerve damage. This research utilizes toxins, drugs, as well as genetically altered mice to explore the molecular processes involved in NMJ plasticity and trophic regulation of muscle. He has studied the NMJ with Alberto Mallart and Peter Gage at the CNRS, Gif-sur-Yvette, France (1979) and the John Curtin School of Medical Research, Canberra, Australia (1987), respectively. After learning neuronal tissue culture in the laboratory of Phillip Nelson (Developmental Neurobiology, NICHHD, Bethesda, USA, 1987), he studied the action of drugs of abuse on voltage and ligand gated ion channels using patch clamp techniques. His laboratory applied these techniques to the study of myocardial calcium channels in a rat model of hypertension. He has served as an ad hoc and full time reviewer of research applications to the National Science Foundation and the National Institutes of Health. Biography Updated on 8 January 2009 Biography Updated on 11 January 2009

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THIRD METRIC How Obamacare Tries To Make Us Healthier, One Community At A Time Jeffrey Young Health Care Reporter, The Huffington Post AP Photo/Gregory Bull President Barack Obama's health care reform law will spend more than $1 trillion over the next decade to extend health coverage to millions of people -- and about $20 billion actually trying to make us healthier. The money supporting these initiatives is tucked inside the Affordable Care Act in the form of the Prevention and Public Health Fund, a pot of money to finance efforts in hundreds of communities to curtail obesity, promote exercise and better nutrition, and reduce tobacco use. Improving the health of Americans and reducing preventable deaths wouldn't just benefit those individuals. Better health could prove key to reversing decades of skyrocketing health care spending. And the prevention fund is Obamacare's primary means of making inroads on these problems, one community at a time. “If we removed the barriers to healthy living, we would bend the cost curve in health care spending. In order to do that, we had to target communities," Sen. Tom Harkin (D-Iowa), who created the fund, said in a written statement. Up to 40 percent of deaths each year from the five leading causes in America -- heart disease, cancer, chronic lower respiratory diseases, stroke and unintentional injuries -- are preventable, the Centers for Disease Control and Prevention reported in May. And medical treatments for the half of the population with chronic health conditions such as cardiovascular disease, diabetes and tobacco-related illnesses account for 84 percent of health care spending, according to a 2010 report from the Robert Wood Johnson Foundation in Princeton, New Jersey. The Affordable Care Act called for the prevention fund to receive $18.8 billion from 2010 to 2022, then $2 billion annually in future years. But that supply of money has diminished since Obama enacted the law in 2010. Congress has taken more than $6 billion out of the fund since 2012. Also, the main source of dollars for local initiatives, the Community Transformation Grants program, is ending Sept. 30, two years early, because Congress reallocated the funding to other Centers for Disease Control and Prevention programs. In addition, the Department of Health and Human Services diverted $453.8 million of the money to help finance the implementation of Obamacare's health insurance exchanges. Perhaps the highest-profile use of the prevention fund is the CDC's $162 million anti-tobacco advertising campaign called "Tips From Former Smokers." The medical journal The Lancet credited these ads with prompting 1.6 million people to attempt to quit smoking and 100,000 people actually to do so in 2012. The spots feature graphic accounts from individuals with serious tobacco-related ailments, such as a cancer patient from North Carolina who had her larynx removed. Most of the projects financed by the prevention fund are smaller in scale and cost and based in individual communities, however. These aim to address the underlying cultural and behavioral factors that lead to poor nutrition, inactivity, obesity and tobacco use, and they have the potential to make measurable improvements in health, said Georges Benjamin, executive director of the American Public Health Association in Washington. "We think that there's evidence that communities have begun talking about those problems, identifying the root causes, trying to use these monies to leverage other funding and other things that they're already doing to begin to make a difference," Benjamin said. In San Diego County, California, the local government and the Chula Vista Elementary School District used federal grants to make an immediate impact on students' weight, said Nick Macchione, the director of the county Health and Human Services Agency. School administrators approached county officials in 2010, concerned that unhealthy weight was holding back their students, Macchione said. In partnership with the county's Live Well San Diego initiative, they conducted voluntary body mass index screenings of 25,000 kids in 44 schools. The findings confirmed the leaders' fears: Almost 40 percent of the children were either overweight or obese. "This was shockingly alarming," Macchione said. Using some of the $8.2 million the county received from the prevention fund, the health agency and the school started making changes, Macchione said. The cafeteria started offering healthier food and local farmers visited to talk about agriculture and provide fresh produce. Math teachers incorporated physical activity into counting lessons. And students and parents received information about nutrition and exercise. Two years later, Chula Vista schools already could boast gains: a 3.2 percent reduction in the share of students who were obese or overweight. The county has since started spreading this program to 300 schools serving 650,000 children, Macchione said. Programs in Indiana also focused on children brought home the challenges faced by those working to address health in their communities, said Andrea Hays, the project director overseeing the $3 million in Community Transformation Grants managed by the Healthy Communities Partnership of Southwest Indiana in Evansville. As in San Diego County, they worked with local schools to incorporate healthier food and physical activity in students' daily routines. Under one pilot program, Healthy Communities Partnership of Southwest Indiana joined with a local hospital to deliver fresh fruits and vegetables to a school, where Hays saw firsthand how deeply rooted the problem was. "We had kids that had never tried a banana before," Hays said. "It's culture shock for these kids." In Iowa, the Department of Public Health tapped into $8.2 million in prevention funding to link patients to more medical providers. As part of the Iowa Community Referral Project, a partnership with local health boards and the Urbandale-based Iowa Primary Care Association, dentists received training to take blood pressure measurements and ask patients about tobacco use. Four of the dental clinics participating in this program provided blood pressure tests to more than 4,000 people and discovered that 6 percent had hypertension, more than 70 percent of whom visited a medical doctor for further care, said Kala Shipley, the executive officer for health promotion at the Des Moines-based department. Results like these won't reverse years of rising obesity rates and worsening health, but they're a good place to start, Macchione said. "Culture change takes time," he said. "If we just look back 30 years ago on smoking, can you imagine in our first year and we started our campaign and we showed probably little-to-no impact, if we would've given up?" 7 Surprising Health Benefits Of Exercise Lower your blood pressure "There seem to be acute benefits from cardiovascular training that occur for 24-48 hours after each moderate exercise session," says Randi S. Lite, Associate Professor of Practice and Director of the Exercise Science Program at Simmons College. "These include a reduction in resting blood pressure, particularly for those who have high blood pressure." How does this happen? As we age, our blood vessels become stiffer, which raises blood pressure, says Rani Whitfield, M.D., a family physician and American Heart Association spokesperson. "The hormones released during exercise make blood vessels more compliant, similar to what happens with blood pressure medications," says Dr. Whitfield. "You won't feel a difference, but your doctor will—and [he'll] start to smile." Health Fr éducation Health Care Diet And Nutrition Obamacare

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Glucose Control More register Diabetes Conference for Northwest Ohio November 14, 2015, Toledo, OH 7:30 am - 1:30 pm You're My Type: Educating and Empowering People Living with Diabetes. REGISTER TODAY for this FREE conference and exhibits. Learn about the latest care and treatment for Type 1 & Type 2 Diabetes; Network with families, experts, and medical suppliers; and Actively participate in hands-on breakout sessions catered to your specific situation. Chef Rory Schepisi "Southern Yankee" Celebrity Chef and Restauranteur Rory Schepisi, known affectionately as the "Southern Yankee," is a chef, restaurateur, television host, competitor, promoter, cowgirl, and Novo Nordisk Diabetes Educator. In addition to appearances on her weekly cooking segment on the NBC affiliate in Amarillo, Texas, Rory owns and runs her restaurant, Boot Hill Saloon & Grill. Traveling around the United States as a celebrity chef, host and guest speaker, Rory shares her knowledge of food, different cultures and cuisine with her fans and food enthusiasts. Rory recently appeared as a featured chef on The Today Show, hosted the popular Cadillac Culinary Challenge and spoke with esteemed chefs on a culinary industry panel in New York City. Rory's best known as a beloved competitor on The Next Food Network Star, where she placed second on the reality show, but first in the hearts of fans across the country. Since the competition, Rory has appeared as the guest chef on TLC's show Homemade Simple and the Rachael Ray Show, holds the title of the Texas Restaurant Association's "Best Chef of the West" in 2008 and 2009, and her famous ribs landed the cover of Bon Appétit magazine. Rory's career in television started when the New Jersey native landed a spot on the reality television program Popularity Contest on Country Music Television. The show was set in a small farming town in West Texas, where Rory planted roots after discovering her love for Vega and one of the local cowboys. The "Southern Yankee" was born, as Rory underwent her transformation from "city girl" to "cow girl," learning how to brand cattle, milk cows, break horses and rope steer along the way. Andy Suhy A type 1 diabetes diagnosis at age 15, didn't stop avid hockey player, Andy Suhy. After taking control of his diabetes, Andy played Division 1 college hockey and was drafted by the Detroit Red Wings, with whom he won two championships. Andy founded Type1Rules, has written two diabetes management books, and his now a motivational speaker. Marc Milkie In March 2002, Marc was diagnosed with Wegener's Granulomatosis, a disease with no known cause or cure. After surviving the onslaught of the disease in which his lungs, liver and kidney's failed, and a seven-week coma, it became apparent that he would require both legs to be amputated below the knee. Marc credits his family and friends, his belief in a higher power, and a positive attitude for much of what he has accomplished since 2002. Partnership With 101 Summit Street Event Contact Presented by ProMedica (419) 291-2716 | www.nwohio.jdrf.org Sign up for the most important T1D news and events

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Cancer Pain Syndromes Fibrocystic Disease Mastalgia Memory issues after cancer may not be due to chemo Gene therapy proves effective for hemophilia B Former Penn State coach Paterno breaks pelvis, hospitalized Many elderly screened for cancer despite doubts No extra birth defect risk after cancer treatment NEW YORK (Reuters Health) - Women treated for breast cancer with radiation with or without chemotherapy had more thinking and memory problems a few years after their treatment ended than women who'd never had cancer, in a new study.Research has suggested some women experience mental haziness, dubbed "chemo brain," during and soon after chemotherapy treatment. And one recent study found evidence of changes in the activity of certain brain regions in women who'd undergone chemotherapy (see Reuters Health story of November 15, 2011). But some researchers have questioned whether those problems are due to the specific drug treatments, or possibly to the cancer itself. In the new report, breast cancer survivors showed certain small mental deficits, regardless of whether or not they'd had chemotherapy. "It's a very, very subtle thing. We're not talking about patients becoming delirious, demented, amnesic," said Barbara Collins, a neuropsychologist who has studied chemotherapy-related cognitive changes at Ottawa Hospital in Ontario, Canada, but wasn't involved in the new study."We're talking about a group of people that are saying, 'I'm pretty much still able to function, but I find it harder...it doesn't come as easily, and I can't do as many things at the same time.'"The current study involved 129 breast cancer survivors in their fifties, on average. About half of them had been treated with radiation and chemotherapy, while the other women only had radiation. Six months after finishing treatment, and another three years later, women took a range of thinking and memory tests. Their scores were compared against the performance of 184 women who'd never had cancer, but were a similar age and from the same areas. On three out of five types of memory tests, women who'd had either course of treatment performed similarly to the non-cancer group. But on two, their scores were noticeably lower.At both six months and a few years after treatment, cancer survivors scored worse on tests of "executive functioning," which included naming words beginning with a particular letter. And on tests of processing speed, which included marking specific numbers on lists of random numbers and letters -- a measure of speed and concentration -- women who'd received radiation only or chemo and radiation had lower scores than women with no cancer history at the later time point. Those scores differed by about one to three points on a scale where 50 is considered average. CAUSES STILL UNCLEAROne limitation of using tests to measure cognition is that it's not clear how exactly they apply to functioning in everyday life, Paul Jacobsen, from the Moffitt Cancer Center in Tampa, Florida, and his colleagues wrote Monday in the journal Cancer. The researchers also didn't have information on women's thinking and memory skills before they were diagnosed with cancer or treated.Cancer survivors who'd had radiation without chemotherapy scored similarly to those who were treated with radiation and chemo on all measures of mental ability. That challenges the notion that chemotherapy is the driving force behind mental changes in breast cancer survivors, researchers said."People talk about 'chemo brain,' and there's sort of a general view that if people have cognitive problems after the cancer treatment, it must be due to the fact that they had chemotherapy," Jacobsen told Reuters Health."We provided the most definitive evidence to date to suspect it's not just chemotherapy that is contributing to cognitive problems after breast cancer."What exactly might be the cause, or causes, is still up for debate. "There is very likely something to do with having cancer that already affects your cognitive function," Collins said. "What is it? Could it be stress? Could it be anxiety? Could it be depression? That's a possibility." It could also be that the immune system's response to cancer affects the brain, she added.Collins said that most of the data still points to some mental effect of chemotherapy in certain patients -- but that small differences between treatment groups might have been missed in this analysis.Still, she said, "We can't be too quick to conclude, even if we find some subtle things, that they're all due to the chemotherapy. We have to step very carefully here in terms of understanding what the real factors are."Collins told Reuters Health that women should know foggy thinking and memory after cancer treatment tends to improve over time. "Nobody's suggesting they don't get their chemotherapy, not at all," she said.Many women won't notice any mental fuzziness after treatment at all, Jacobsen added, but he said those that do should talk to their doctors to rule out other causes and to consider strategies to compensate for those problems. SOURCE: http://bit.ly/gzhzel Cancer, online December 12, 2011. Rate This Article

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Setting Protocol Helps Quell Fever in Cancer Patients by Nancy Walsh Staff Writer, MedPage Today LAS VEGAS -- Instituting an algorithm for the antibiotic treatment of febrile neutropenia in patients with cancer led to better adherence to current guidelines from the Infectious Diseases Society of America (IDSA), a researcher reported here. For instance, the initial antibiotic selection was considered appropriate in 96% of patients after the algorithm was implemented, compared with 76% beforehand, according to Kristina Frinzi, who is a pharmacy resident at the University of Alabama Birmingham. "Fever is a common occurrence during the neutropenia associated with chemotherapy, and treatment is generally empiric because often nothing grows out in cultures," Frinzi said in a poster session at the midyear clinical symposium of the American Society of Health-System Pharmacists. "But these patients can die within hours if not treated, because they have no white blood cells," she told MedPage Today. Up to half of all patients with solid tumors and more than 80% of those with hematologic malignancies develop febrile neutropenia during chemotherapy, and in the majority of cases when patients present at the emergency department, no clear source for the fever can be identified, she explained. In 2011, the IDSA published its guidelines for the management of this event, but at that time her institution had no formal guidelines in place. To help standardize the management of this clinical scenario, she and her colleagues from the University of Alabama department of pharmacy developed an algorithm based on the IDSA recommendations, including recommendations for choice of first antibiotic, subsequent modification of antibiotic choice, and duration of use. In this study, they assessed the adherence to their algorithm for 50 patients, half of whom were admitted prior to the institution of the algorithm and half who were treated subsequently. Median age of the patients was 55 years, and slightly more than half were men. A total of 88% had hematologic malignancies, and the remainder had solid tumors. Among the changes seen following development of the antibiotic algorithm were: Initial monotherapy, 84% versus 56% First antibiotic given within 2 hours of presentation at the emergency department, 67% versus 53% Appropriate antimicrobial escalation, 76% versus 44% Appropriate antimicrobial de-escalation, 52% versus 35% Appropriate duration of antibiotic therapy 86% versus 68% In addition, the use of vancomycin decreased from 96% to 84%, "which should decrease the potential for drug-resistant Enterococcus and Staphylococcus species in our hematology/oncology ward," Frinzi observed. However, room for improvement still exists, she noted. One example is that the IDSA recommends that if cultures for gram-positive organisms are not positive within 48 hours, vancomycin should be discontinued and treatment with a beta-lactam agent such as cefepime continued. That has not always been done at her center, probably because of clinicians' concerns about withdrawing the treatment, she said. Another area that still needs improvement is in the initiation of a first antibiotic within 2 hours of presentation, because of the importance of rapid treatment of these patients, she said. The authors reported no financial disclosures. Reviewed by Dori F. Zaleznik, MD Associate Clinical Professor of Medicine, Harvard Medical School, Boston Primary Source American Society of Health-System Pharmacists Source Reference: Flores B, et al "Development of an antibiotic algorithm for febrile neutropenia" ASHP 2012; Abstract 170.

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